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.
A multiproxy oxygen and carbon isotope (δ13C and δ18O), growth rate, and trace element stalagmite paleoenvironmental record is presented for the Early Holocene from Ethiopia. The annually laminated stalagmite grew from 10.6 to 10.4 ka and from 9.7 to 9.0 ka with a short hiatus at ~9.25 ka. Statistically significant and coherent spectral frequencies in δ13C and δ18O are observed at 15–25 and 19–23 years, respectively. The observed ~1‰ amplitude variability in stalagmite δ18O is likely forced by nonequilibrium deposition, due to kinetic effects during the progressive degassing of CO2 from the water film during stalagmite formation. These frequencies are similar to the periodicity reported for other Holocene stalagmite records from Ethiopia, suggesting that multidecadal variability in stalagmite δ18O is typical. Several processes can lead to this multidecadal variability and operate in different directions. A hydroclimate forcing is likely the primary control on the extent of the partial evaporation of soil and shallow epikarst water and associated isotopic fractionation. The resulting oxygen isotope composition of percolation water is subsequently modulated by karst hydrology. Further isotopic fractionation is possible in-cave during nonequilibrium stalagmite deposition. Combined with possible recharge biases in drip-water δ18O, these processes can generate multidecadal δ18O variability.
The effect of vitamin D (VD) on the risk of preeclampsia (PE) is uncertain. Few of previous studies focused on the relationship between dietary VD intake and PE risk. Therefore, we conducted this 1:1 matched case–control study to explore the association of dietary VD intake and serum VD concentrations with PE risk in Chinese pregnant women. A total of 440 pairs of participants were recruited during March 2016 to June 2019. Dietary information was obtained using a seventy-eight-item semi-quantitative FFQ. Serum concentrations of 25(OH)D2 and 25(OH)D3 were measured by liquid chromatography–tandem MS. Multivariate conditional logistic regression was used to estimate OR and 95 % CI. Restricted cubic splines (RCS) were plotted to evaluate the dose–response relationship of dietary VD intake and serum VD concentrations with PE risk. Compared with the lowest quartile, the OR of the highest quartile were 0·45 (95 % CI 0·29, 0·71, Ptrend = 0·001) for VD dietary intake and 0·26 (95 % CI 0·11, 0·60, Ptrend = 0·003) for serum levels after adjusting for confounders. In addition, the RCS analysis suggested a reverse J-shaped relationship between dietary VD intake and PE risk (P-nonlinearity = 0·02). A similar association was also found between serum concentrations of total 25(OH)D and PE risk (P-nonlinearity = 0·02). In conclusion, this study provides evidence that higher dietary intake and serum levels of VD are associated with the lower risk of PE in Chinese pregnant women.
Webinars have recently replaced in-person medical conferences, including paediatric cardiology conferences, given the COVID-19 pandemic.
Methods:
With increasing environmental concerns, we analysed the differences between the environmental footprint of a paediatric cardiology webinar with a hypothetical conference. Travel data was collected, with assumptions made on the amount of computer use, internet use and accordingly the overall use of electricity for both forms of conference. Life Cycle Assessment methodology was used (OpenLCA and Ecovinvent v 3.7).
Results:
We showed that the theoretical environmental impact of a virtual conference is significantly less (4 tons CO2 equivalent) than the traditional international face-to-face conference (192 tons CO2 equivalent). The life cycle assessment methodology showed that resource use for a face-to-face conference lasting 2.5 days for 1374 attendees is equivalent to 400 times what an average person would use in one year, the climate change and photochemical ozone formation approximately 250 times and the eutrophication terrestrial equivalent to 225 times. However, using carbon equivalent emissions to measure environmental harm from flying is an under estimate of the potential damage, when one considers the additional production of airplane contrails. Notwithstanding this, there is a 98% reduction in climate change impact when meetings are held virtually.
Conclusions:
While the virtual conference may never completely replace the traditional in-person paediatric cardiology conference, due to networking benefits, the significant theoretical benefits to the environment highlighted in this study, warrants consideration for the virtual conference taking a more common place in sustainable academia.
The co-occurrence of the 2020 Atlantic hurricane season and the ongoing coronavirus disease 2019 (COVID-19) pandemic creates complex dilemmas for protecting populations from these intersecting threats. Climate change is likely contributing to stronger, wetter, slower-moving, and more dangerous hurricanes. Climate-driven hazards underscore the imperative for timely warning, evacuation, and sheltering of storm-threatened populations – proven life-saving protective measures that gather evacuees together inside durable, enclosed spaces when a hurricane approaches. Meanwhile, the rapid acquisition of scientific knowledge regarding how COVID-19 spreads has guided mass anti-contagion strategies, including lockdowns, sheltering at home, physical distancing, donning personal protective equipment, conscientious handwashing, and hygiene practices. These life-saving strategies, credited with preventing millions of COVID-19 cases, separate and move people apart. Enforcement coupled with fear of contracting COVID-19 have motivated high levels of adherence to these stringent regulations. How will populations react when warned to shelter from an oncoming Atlantic hurricane while COVID-19 is actively circulating in the community? Emergency managers, health care providers, and public health preparedness professionals must create viable solutions to confront these potential scenarios: elevated rates of hurricane-related injury and mortality among persons who refuse to evacuate due to fear of COVID-19, and the resurgence of COVID-19 cases among hurricane evacuees who shelter together.
Nutraceuticals have generated interest as a way to mitigate the cognitive decline in older adults. The aim of this systematic review was to determine the evidence for these claims from the scientific literature in randomised, double-blinded, controlled trials (duration: ≥1 year; participants: n≥100; age(mean): ≥65 years). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched four electronic databases (PubMed, Scopus, CINAHL and Web of Science) and identified twenty-five studies published between the 15·June·2006 and 14·June·2016. Interventions included B-vitamins, n-3 fatty acids, antioxidant vitamins and herbs. Of the B-vitamin studies, four found benefits to cognition with supplementation. The first of these B-vitamin studies, in individuals with mild cognitive impairment (n 266; duration=2 years), included benefit to executive function (P=0·015) and improvements in the Mini-Mental State Examination (MMSE) among participants with baseline homocysteine above 11·3 µmol/l (P<0·001). In the same sample, the second study found cognitive benefits of B-vitamins dependent on the higher baseline plasma n-3 fatty acid status. The third B-vitamin study (n 900; duration=2 years) reported improved performance in immediate (P=0·046) and delayed recall (P=0·013), whereas the fourth study (n 856; duration=2 years) reported slower rate of cognitive decline in the MMSE (P=0·05). One study investigating DHA treatment (n 402; duration=1·5 years) revealed the slower rate of cognitive change in apoE e4 non-carriers (P=0·03). As only five included studies revealed notable benefits, presently based on the specific compounds explored here, there is not compelling evidence to support the use nutraceuticals to improve cognition in the elderly. Future long-term trials of nutraceuticals should investigate interactions with lifestyle, blood biomarkers and genetic risk factors.
A controversy at the 2016 IUCN World Conservation Congress on the topic of closing domestic ivory markets (the 007, or so-called James Bond, motion) has given rise to a debate on IUCN's value proposition. A cross-section of authors who are engaged in IUCN but not employed by the organization, and with diverse perspectives and opinions, here argue for the importance of safeguarding and strengthening the unique technical and convening roles of IUCN, providing examples of what has and has not worked. Recommendations for protecting and enhancing IUCN's contribution to global conservation debates and policy formulation are given.
Rates of 0, 1.7, and 3.4 kg/ha of 3-amino-2,5-dichlorobenzoic acid (chloramben) were incorporated to 0, 3.8, and 7.6-cm depths in 0.7 by 0.7-m microplots under low, moderate, and high rainfall conditions. Soybean [Glycine max (L.) Merr., var. Amsoy] injury increased with increasing depth of incorporation of 3.4 kg/ha chloramben. Chloramben incorporation under low rainfall conditions significantly improved control of giant foxtail (Setaria faberii Herrm.), smooth pigweed (Amaranthus hybridus L.), and velvetleaf (Abutilon theophrasti Medic.) compared to surface treatments. Jimsonweed (Datura stramonium L.) was not controlled well by chloramben regardless of rate or incorporation depth. In larger field plots over a 3-year period, 3.4 kg/ha chloramben incorporated with a disc produced slight but insignificant soybean injury. Giant foxtail, smooth pigweed, common ragweed (Ambrosia artemisiifolia L.), and velvetleaf control with incorporated chloramben was equal to or better than the control obtained with surface-applied chloramben. Regardless of method of application, control of common cocklebur (Xanthium pensylvanicum Wallr.), jimsonweed, and annual morningglory (Ipomoea spp.) was poor.
Efficacy, movement, and degradation of dithiopyr and pendimethalin were monitored after application to perennial ryegrass turf in 1990 and 1991. Dithiopyr at 0.6 kg ai ha−1 reduced large crabgrass infestation by ≥ 90% up to 87 DAT in both years, while pendimethalin at 1.7 kg ai ha−1 provided similar control up to 59 DAT in 1 of 2 yr. Turf thinning due to disease and insect damage in 1990 allowed more herbicide to reach the thatch, mat, and underlying soil in 1991. In both years, more pendimethalin but less dithiopyr was found in thatch 7 DAT than 1 DAT, suggesting greater pendimethalin retention in verdure and thatch. Precipitation was greater after herbicide application in the second year, and concentration in the mat layer reached a maximum by 7 DAT compared to 14 DAT in 1990. Maximum concentrations of dithiopyr and pendimethalin in soil at 0 to 5 cm deep were 20 and 56 μg kg−1, respectively, measured 7 DAT in 1991. Herbicide concentration 5 to 10 cm deep was ≤ 5 μg kg−1 at all sampling dates in 1990. In 1991, dithiopyr and pendimethalin concentrations 5 to 10 cm deep did not exceed 4 and 20 μg kg−1, respectively, measured within 1 DAT. Neither herbicide was detected 10 to 20 cm deep, nor in samples collected 30 cm outside of the experimental plots in either year. At 126 DAT (final sampling date), little herbicide was detected in verdure, but residues were found in most thatch and all mat samples. The estimated time for a 50% reduction in detectable residues (DT50) of dithiopyr and pendimethalin from the sampling zone was 35 and 23 days, respectively.
Persistent complex bereavement disorder (PCBD) is a protracted form of grief included in DSM Section 3 indicating a need for more research. Two other criteria sets [prolonged grief disorder (PGD) and complicated grief (CG) disorder] are also currently in use by researchers. This study evaluates rates of diagnosis of each proposed criteria set in a clinical sample of bereaved individuals participating in clinical research.
Method
Two groups in which persistent grief was judged to be present or absent completed an assessment instrument that included items needed to diagnose PCBD as well as PGD and CG. One group included grief treatment-seeking participants in our multicenter National Institute of Mental Health (NIMH)-sponsored study who scored ⩾30 on the Inventory of Complicated Grief (ICG) and the other comprised bereaved adults enrolled in clinical research studies who scored <20 on the ICG. Rates of diagnosis were determined for proposed PCBD, PGD and CG criteria.
Results
PCBD criteria diagnosed 70 [95% confidence interval (CI) 64.2–75.8] % of the grief treatment-seeking group, PGD criteria identified 59.6 (95% CI 53.4–65.8) % of these individuals and CG criteria identified 99.6 (95% CI 98.8–100.0) %. None of the three proposed criteria identified any cases in the bereaved comparison group.
Conclusions
Both proposed DSM-5 criteria for PCBD and criteria for PGD appear to be too restrictive as they failed to identify substantial numbers of treatment-seeking individuals with clinically significant levels of grief-related distress and impairment. Use of CG criteria or a similar algorithm appears to be warranted.
We aimed to investigate the prevalence and associated factors of HSV-2 discordance and concordance in HIV-1-discordant couples. This study used the baseline data from a cohort study of HIV-1-discordant couples in Dehong prefecture of Yunnan province, China. Of 954 participating couples, 42·4% were affected by HSV-2, of which 20·4% were HSV-2-concordant positive, 7·6% were HSV-2-discordant where the male was HSV-2 positive, and 14·4% were HSV-2 discordant where the female was HSV-2 positive. Compared to HSV-2-negative concordance, HSV-2 discordance with an HSV-2-positive male spouse was significantly associated with characteristics of the male spouse, including Han ethnicity and being in a second marriage. HSV-2 discordance with an HSV-2-positive female spouse was significantly associated with characteristics of the female spouse, including Han ethnicity, having engaged in commercial sex, having a sexual relationship of <3 years and being HIV-1 infected. Compared to HSV-2 discordance, HSV-2-positive concordance was significantly associated with an education level of middle school or higher for both spouses, a sexual relationship of ⩾3 years, more frequent sex and having an HIV-1-infected male spouse. The findings highlight the need for HSV-2 prevention and treatment efforts to reduce HSV-2 transmission in this population, and emphasize the importance of implementing prevention interventions early in couples' relationships.
This paper outlines potential research applications of the unquantified (paper or digital) electroencephalography (EEG) in psychiatry. Three main areas are highlighted: first, the need for thorough familiarity with the unquantified EEG is emphasized, including the ability to confidently recognize all normal and abnormal activities that could influence further analysis of the record as well as artifacts that can contaminate the tracings; second, the fact that definitive studies relating EEG abnormalities to psychiatric symptomatology and clinical response are lacking; and third, the potential for EEG to be utilized as a tool to decrease the risk of invasive research studies is discussed.
We investigated the seasonality of tuberculosis (TB) in Wuhan, China, to evaluate the increased risk of disease transmission during each season and to develop an effective TB control strategy. We applied spectral analysis to the weekly prevalence data of sputum smear positive (SSP) and sputum smear negative (SSN) pulmonary TB reported from 2006 to 2010. Cases of both SSP and SSN feature 1·0- and 0·5-year periodic modes. The least squares method was used to fit curves to the two periodic modes for SSP and SSN data. The curves demonstrated dominant peaks in spring similar to cases reported previously for other locations. Notably for SSP, dominant peaks were also observed in summer. The spring peaks of SSP and SSN were explained in terms of poorly ventilated and humid rooms and vitamin D deficiency. For the summer peaks of SSP, summer influenza epidemics in Wuhan may contribute to the increase in TB prevalence.
To determine relative rates of blood culture contamination for 3 skin antisepsis interventions—10% povidone iodine aqueous solution (PI), 2% iodine tincture (IT), and 2% chlorhexidine gluconate in 70% isopropyl alcohol (CHG)—when used by dedicated phlebotomy teams to obtain peripheral blood cultures.
Design.
Randomized crossover trial with hospital floor as the unit of randomization.
Setting.
Teaching hospital with 885 beds.
Patients.
All adult patients undergoing peripheral blood culture collection on 3 medical-surgical floors from May 2009 through September 2009.
Intervention.
Each antisepsis intervention was used for 5 months on each study floor, with random crossover after a 1-month washout period. Phlebotomy teams collected all peripheral blood cultures. Each positive blood culture was adjudicated by physicians blinded to the intervention and scored as a true positive or contaminated blood culture. The primary outcome was the rate of blood culture contamination for each antisepsis agent.
Results.
In total, 12,904 peripheral blood culture sets were evaluated, of which 735 (5.7%) were positive. There were 98 contaminated cultures, representing 13.3% of all positive cultures. The overall blood culture contamination rate for the study population was 0.76%. Intent-to-treat rates of contaminated blood cultures were not significantly different among the 3 antiseptics (P = .18), yielding 0.58% with PI (95% confidence interval [CI], 0.38%-0.86%), 0.76% with IT (95% CI, 0.52%-1.07%), and 0.93% with CHG (95% CI, 0.67%-1.27%).
Conclusion.
Choice of antiseptic agent does not impact contamination rates when blood cultures are obtained by a phlebotomy team and should, therefore, be based on costs or preference.
This study is a randomized, prospective, investigation of the relationships between clinical trial design, patient expectancy and the outcome of treatment with antidepressant medication.
Method
Adult out-patients with major depressive disorder (MDD) were randomized to either placebo-controlled (PC, 50% probability of receiving active medication) or comparator (COMP, 100% probability of receiving active medication) administration of antidepressant medication. Independent-samples t tests and analysis of covariance (ANCOVA) were used to determine whether the probability of receiving active medication influenced patient expectancy and to compare medication response in the PC v. COMP conditions. We also tested the correlations between baseline expectancy score and final improvement in depressive symptoms across study groups.
Results
Subjects randomized to the COMP condition reported greater expectancy of improvement compared to subjects in the PC condition (t = 2.60, df = 27, p = 0.015). There were no statistically significant differences in the analyses comparing antidepressant outcomes between subjects receiving medication in the COMP condition and those receiving medication in the PC condition. Higher baseline expectancy of improvement was correlated with lower final depression severity scores (r = 0.53, p = 0.021) and greater improvement in depressive symptoms over the course of the study (r = 0.44, p = 0.058).
Conclusions
The methods described represent a promising way of subjecting patient expectancy to scientific study. Expectancy of improvement is affected by the probability of receiving active antidepressant medication and seems to influence antidepressant response.
An overview of data from five research groups participating in a 3-year pilot test on the efficacy of foliar applications of Beauveria bassiana (Balsamo) Vuillemin for control of Colorado potato beetle, Leptinotarsa decemlineata (Say), populations in the northern United States is presented. Four treatments were used at each site: high and low B. bassiana dosages (5 × 1013 colony forming units (CFU) per hectare (ha) and 5 × 1012 CFU/ha), the recommended insecticide for each region, and an untreated check. The primary response variable was potato yield. For analyses considering test sites as replicates, during all 3 years the highest yields were produced in plots treated with insecticides. Within test sites, yields from plots receiving B. bassiana applications were greater than control plot yields in 8 of 24 trials but in only two of these instances, B. bassiana plot yields also did not differ from insecticide plot yields. Evaluating 1983 data from all states together, no differences were found between either high or low B. bassiana treatments and controls. The 1983 study design allowed no plot replication within states. In 1985, an altered plot design providing within-site replication demonstrated increased yield with increased dosage of B. bassiana when initial egg density was used as a covariate.
Potato yields greater than control plot yields were noted with a minimum of 5.39 and 6.62 × 1011 CFU/ha B. bassiana. The lowest B. bassiana concentration producing yields not significantly different from insecticide plot yields was 6.62 × 1012 CFU/ha (Rhode Island, 1984). Defoliation ratings did not differ between B. bassiana treatments and controls in 1984 and 1985, although variability was found between yields.