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Background: TeleStroke can improve access to stroke care in rural areas. We aim to evaluate the safety and effectiveness of intravenous thrombolysis in our TeleStroke system. Methods: The Manitoba TeleStroke program was rolled out across 7 sites between November 2014 and January 2019. We retrospectively analyzed prospectively collected consecutive acute stroke patients’ data in this duration. The primary outcome was safety and effectiveness measured in terms of 90-day modified Rankin score (mRs). The number of acute ischemic stroke (AIS) patients receiving thrombolysis and endovascular thrombectomy [EVT] and process metrics were also analyzed. R/RStudio version-4.3.2 was used (p<0.05). Results: Of the 1,748 TeleStroke patients (age 71 years [IQR 58-81], female 810[46.3%]), 696 were identified as AIS. Of these, 265(38.1%) received thrombolysis and 48(6.9%) EVT. Ninety-day mortality was 53(20.0%) among those receiving thrombolysis and 117(44.2%) had a favorable outcome (mRs ≤2). Of those who received intravenous thrombolysis, 9 patients (4.2%) were found to have symptomatic intracranial hemorrhage. The median last-seen-normal (LSN)-to-door was121 minutes and the median door-to-needle, 55 minutes. Conclusions: Intravenous thrombolysis was found to be effective with acceptable safety. TeleStroke improved overall access to stroke care and played an important role in identifying AIS patients eligible for thrombolysis and EVT.
Background: Anterior (ACS) and posterior circulation (PCS) stroke patients have different clinical presentations and prognoses, though both benefit from endovascular thrombectomy (EVT). We sought to determine whether ACS and PCS patients treated with EVT differed with regards to treatment metrics and functional outcomes. Methods: We retrospectively analysed theCanadian OPTIMISE registry which included data from 20 comprehensive stroke centers across Canada between January 1, 2018, and December 31, 2022. We performed a descriptive analysis of patients divided in two groups (ACS= carotid artery and its branches, PCS= vertebrobasilar system). Results: Of the 6391 patients included (5929 ACS and 462 PCS), PSC patients were younger (67 vs. 71.3, p<0.001), more often male (61.9% vs. 48.6%, p<0.001), had longer (in minutes) onset-to-door (362 vs. 256, p<0.001), door-to-needle (172 vs. 144, p=0.0016), and onset-to-puncture (459 vs. 329, p<0.001) times. They were less often thrombolyzed (39.8% vs. 50.4%, p<0.001), and more frequently underwent general anesthesia (47.6% vs. 10.6%, p<0.001). Successful reperfusion and functional independence at 90 days were similar between the two groups. Conclusions: Patients with PCS had worst treatment metrics than ACS. Strategies to improve PCS management times are critical to decrease these disparities, including faster pre-hospital recognition and in-hospital workflows.
Previous studies (various designs) present contradicting insights on the potential causal effects of diet/physical activity on depression/anxiety (and vice versa). To clarify this, we employed a triangulation framework including three methods with unique strengths/limitations/potential biases to examine possible bidirectional causal effects of diet/physical activity on depression/anxiety.
Methods
Study 1: 3-wave longitudinal study (n = 9,276 Dutch University students). Using random intercept cross-lagged panel models to study temporal associations. Study 2: cross-sectional study (n = 341 monozygotic and n = 415 dizygotic Australian adult twin pairs). Using a co-twin control design to separate genetic/environmental confounding. Study 3: Mendelian randomization utilizing data (European ancestry) from genome-wide association studies (n varied between 17,310 and 447,401). Using genetic variants as instrumental variables to study causal inference.
Results
Study 1 did not provide support for bidirectional causal effects between diet/physical activity and symptoms of depression/anxiety. Study 2 did provide support for causal effects between fruit/vegetable intake and symptoms of depression/anxiety, mixed support for causal effects between physical activity and symptoms of depression/anxiety, and no support for causal effects between sweet/savoury snack intake and symptoms of depression/anxiety. Study 3 provides support for a causal effect from increased fruit intake to the increased likelihood of anxiety. No support was found for other pathways. Adjusting the analyses including diet for physical activity (and vice versa) did not change the conclusions in any study.
Conclusions
Triangulating the evidence across the studies did not provide compelling support for causal effects of diet/physical activity on depression/anxiety or vice versa.
This study investigated the psychometric properties of the Highly Sensitive Child-Rating System (HSC-RS), the existence of sensitivity groups, and the characterization of sensitivity at behavioral, genetic, and physiological levels in 541 preschoolers (M(SD)age = 3.56(0.27); 45%male; 87%Caucasian). Temperament, genetic, cortisol, and electroencephalography asymmetry data were collected in subsamples (n = 94-476). Results showed a reliable observational measure of sensitivity. Confirmatory factor and latent class analysis supported a one-factor solution and three sensitivity groups, that are a low (23.3%), medium (54.2%), and a high (22.5%) sensitivity group. Hierarchical regression analyses showed moderate associations between HSC-RS and observed temperament traits (i.e., behavioral level). In addition, a small negative association between HSC-RS and a genome-wide association study polygenic risk score (GWAS PGS) for Attention Deficit Hyperactivity Disorder was found. No relations with candidate genes, other GWAS PGS phenotypes, and physiological measures were found. Implications of our findings and possible explanations for a lack of these associations are discussed.
Herbicides have been placed in global Herbicide Resistance Action Committee (HRAC) herbicide groups based on their sites of action (e.g., acetolactate synthase–inhibiting herbicides are grouped in HRAC Group 2). A major driving force for this classification system is that growers have been encouraged to rotate or mix herbicides from different HRAC groups to delay the evolution of herbicide-resistant weeds, because in theory, all active ingredients within a herbicide group physiologically affect weeds similarly. Although herbicide resistance in weeds has been studied for decades, recent research on the biochemical and molecular basis for resistance has demonstrated that patterns of cross-resistance are usually quite complicated and much more complex than merely stating, for example, a certain weed population is Group 2-resistant. The objective of this review article is to highlight and describe the intricacies associated with the magnitude of herbicide resistance and cross-resistance patterns that have resulted from myriad target-site and non–target site resistance mechanisms in weeds, as well as environmental and application timing influences. Our hope is this review will provide opportunities for students, growers, agronomists, ag retailers, regulatory personnel, and research scientists to better understand and realize that herbicide resistance in weeds is far more complicated than previously considered when based solely on HRAC groups. Furthermore, a comprehensive understanding of cross-resistance patterns among weed species and populations may assist in managing herbicide-resistant biotypes in the short term by providing growers with previously unconsidered effective control options. This knowledge may also inform agrochemical company efforts aimed at developing new resistance-breaking chemistries and herbicide mixtures. However, in the long term, nonchemical management strategies, including cultural, mechanical, and biological weed management tactics, must also be implemented to prevent or delay increasingly problematic issues with weed resistance to current and future herbicides.
In order to recognize the best nutrient supply options for profitable and sustainable production systems, observations were recorded from 2001 to 2020 (20 years) in a long-term fertilizer experiment initiated in 1995–96 with soybean–wheat cropping systems (SWCSs) under irrigated conditions. The experiment comprised of seven treatments including control, organic, inorganic and their combinations. A combined use of 10 Mg farmyard manure (FYM)/ha (M) along with 120 kg N/ha provided statistically (P < 0.05) similar yield and economic benefits to the M + NPK and also provided a positive yield trend (30.0 and 16.2 kg/ha/year) and net return (14.7 and 5.81 US$/ha/year) over the year in both wheat and soybean, respectively. The combined use of organic and chemical fertilizers, provided 32–41% higher production efficiency than their individual use. In contrast, long-term chemical fertilization provided a negative yield trend in both the crops with the highest reduction in sole N-fertilized plots ranged from −39 to −42 kg/ha/year. Water-use efficiency ranged from 3.20 to 12.3 kg/ha/mm in soybean–wheat rotation and increased almost 1.74–3.15 times in wheat and 1.30–1.80 times in soybean due to fertilizer application. A similar trend was observed for water-expense efficiency and remain closely associated with fertilization practice. Long-term chemical fertilizers declined the yield potential of the studied crops while their conjoint application with FYM in the winter season considered as an input efficient approach to sustain the overall productivity and profitability of SWCSs.
V5579 Sgr was a fast nova discovered in 2008 April 18.784 UT. We present the optical spectroscopic observations of the nova observed from the Castanet Tolosan, SMARTS, and CTIO observatories spanning over 2008 April 23 to 2015 May 11. The spectra are dominated by hydrogen Balmer, Fe II, and O I lines with P-Cygni profiles in the early phase, typical of an Fe II class nova. The spectra show He I and He II lines along with forbidden lines from N, Ar, S, and O in the nebular phase. The nova showed a pronounced dust formation episode that began about 20 days after the outburst. The dust temperature and mass were estimated using the WISE data from spectral energy distribution (SED) fits. The PAH-like features are also seen in the nova ejecta in the mid-infrared Gemini spectra taken 522 d after the discovery. Analysis of the light curve indicates values of $t_2$ and $t_3$ about 9 and 13 days, respectively, placing the nova in the category of fast nova. The best-fit cloudy model of the early decline phase JHK spectra obtained on 2008 May 3 and the nebular optical spectrum obtained on 2011 June 2 shows a hot white dwarf source with $T_{BB}$$\sim$ 2.6 $\times$ 10$^5$ K having a luminosity of 9.8 $\times$ 10$^{36}$ ergs s$^{-1}$. Our abundance analysis shows that the ejecta is significantly enhanced relative to solar, O/H = 32.2, C/H = 15.5, and N/H = 40.0 in the early decline phase and O/H = 5.8, He/H = 1.5, and N/H = 22.0 in the nebular phase.
Dementia is one of the greatest health challenges worldwide. According to the World Health Organisation (WHO) factsheet, currently more than 55 million people worldwide have dementia, with over 60% living in low- and middle-income countries. Every year, there are nearly 10 million new cases of dementia. WHO Global Status Report 2021 estimated growth of 139 million people with dementia by 2050. The estimated total global cost of dementia is likely to surpass US$ 2.8 trillion by 2030. As one grows older, the risk of developing dementia, particularly Alzheimer’s Disease, progressively increases. The Lancet Commission Reports 2017 and 2020 on dementia prevention, intervention, and care identified 12 modifiable risk factors, including physical inactivity, obesity, midlife hypertension, and diabetes. Addressing these lifestyle factors may significantly reduce the risk of dementia and its progression. While no curative or disease-modifying treatment is available for dementia at his stage, addressing modifiable risk factors may have a preventive role in reducing the risk of dementia.
Objectives
The objective of the literature review is to explore current evidence on Physical Activity (PA) in reducing the risk of developing dementia and its progression. The focus is also to see the association of different forms and intensities of PA and their intensities, including aerobic, strength-based, and leisure, with the risk and progression of dementia.
Methods
Narrative review
Results
Results from the reviewed studies showed that PA was found to be associated with a reduced risk of dementia, particularly Alzheimer’s Disease. Studies comparing different intensities of PA indicate though all levels of PA decrease the risk of dementia, there is a linear relationship between the higher intensity PA and the increased beneficial effect in terms of reduced risk of dementia. Leisure-time PA also has a protective role against dementia in longitudinal studies. There is more consistent evidence in favour of aerobic PA; however, it has a ceiling effect. The combination of aerobic and strength-based experience provides optimum beneficial effects. The elderly population who started physical activity in their 80s experienced the beneficial effects of PA in reducing the risk of dementia. There is mixed evidence of the protective effect of PA on the population who have already developed cognitive impairment or have genetic vulnerabilities. The author will also include the results of any relevant study published by 31 March 2024.
Conclusions
The details of the literature results and conclusions will be discussed at the conference.
Disclosure of Interest
I. Singh Consultant of: The author declare that the review was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., R. Chandra: None Declared
Attendance at university can result in social support network disruption. This can have a negative impact on the mental health of young people. Demand for mental health support continues to increase in universities, making identification of factors associated with poorer outcomes a priority. Although social functioning has a bi-directional relationship with mental health, its association with effectiveness of psychological treatments has yet to be explored.
Objectives
To explore whether students showing different trajectories of change in social function over the course of treatment differed in eventual treatment outcome.
Methods
Growth mixture models were estimated on a sample of 5221 students treated in routine mental health services. Different trajectories of change in self-rated impairment in social leisure activities and close relationships (Work and Social Adjustment Scale (WSAS) items 3 and 5) during the course of treatment were identified. Associations between trajectory classes and treatment outcomes were explored through multinomial regression.
Results
Five trajectory classes were identified for social leisure activity impairment (Figure 1), and three classes were identified for close relationship impairment (Figure 2). For both measures the majority of students remained mildly impaired (Class 1). Other trajectories included severe impairment with limited improvement (Class 2), severe impairment with delayed improvement (Class 3), and, in social leisure activities only, rapid improvement (Class 4), and deterioration (Class 5). There was an association between trajectories of improvement in social functioning over time and positive treatment outcomes. Trajectories of worsening or stable severe impairment were associated with negative treatment outcomes.
Image:
Image 2:
Conclusions
Changes in social functioning impairment are associated with psychological treatment outcomes in students, suggesting that these changes may be associated with treatment effectiveness or recovery experiences. Future research should look to establish whether a causal link exists to understand if additional benefit for students can be gained through integrating social support within psychological treatment.
In recent times, Health Professionals (HPs) people may feel a sense of discomfort and nervousness when disconnected from their smartphones, causing the emergence of the new phenomenon of “No Mobile Phone Phobia,” or Nomophobia.
Objectives
We aim to study lifestyle-related factors that influence HPs’ Nomophobia.
Methods
From April- June 2023, a global cross-sectional study was conducted using the modified Nomophobia questionnaire (NMP-Q). The original 20 NMP-Q questions (Qs) were reduced to 14 to avoid repetitive Qs with similar meanings. The Qs were categorized into 4 sections, A- Not Being Able to Access Information; B- Losing Connectedness; C- Not Being Able to Communicate; and D- Giving Up Convenience. A new section, “E- Daily Habits”, and “F- Smartphone Type”, and “Hours Spent Daily” were added. Before the launch, it was internally and externally validated by trained psychiatrists as well as experienced researchers. We utilized social media, WhatsApp, text and emails to share it with HPs of different specialties worldwide. The survey was anonymous and IRB-exempt.
Results
Total 105 countries’ HPs participation led to 12,253 responses. Total 47.3% of HPs agreed/strongly agreed (A/SA) that they prefer to use their smartphone before bedtime. Over half (57.8%) of HPs A/SA checked their notifications immediately after waking up in the morning. Only 19.4 % of HPs A/SA that woke up in the middle of the night to check notifications. Total 40.5% of HPs A/SA, 22% were neutral, and 37.3% of HPs disagreed /strongly disagreed (D/SD) with using smartphones while eating their meals. A total of 52.7% of HPs preferred smartphone usage over exercising as a break, while 454.9% of HPs A/SA that they chose smartphones over exploring other hobbies for relaxation. A total of 44.2% of respondents A/SA with smartphone usage in the restroom, 39.8% D/SD. 37.4% of participants D/SD with getting distracted by notifications and resisted the urge to answer any calls or texts while performing a focused task, whereas 39.6% A/SA and 23% were neutral. A total of 80% of respondents met the modified criteria for moderate-severe nomophobia.
Conclusions
In a large-scale survey-based study on Nomophobia, additional Qs in NMP-Q may help recognize that nomophobia can be a result of daily lifestyle decisions rather than an isolated issue.
Hot brewed coffee is the most popular hot beverage in the world, and its health properties have been published in the literature(1). Conversely, over the past decade, cold-brewed coffee has gained popularity, but its eventual nutritional properties are unclear. Both hot and cold brewed coffee produces over 6 million tons of spent coffee grounds (SCG) yearly disposed in landfills(1). Interestingly, studies have shown that SCG can improve several metabolic parameters via changes in the gut microbiome in obese and diabetic rats(2), and reduce energy consumption in overweight humans(3). However, studies investigating the nutritional properties of SCG are lacking in the literature. Hence, in this study, we aimed to identify, quantify and compare two main bioactive compounds in hot- and cold-brewed coffee as a beverage, as well as in the SCG. Samples from hot and cold coffee beverages and SCG were obtained from a local coffee shop (n = 3 per group). The coffee beans were composed of Coffea arabica from Papa New Guinea, Brazil, Ethiopia, and Colombia (in order from highest to lowest proportion). All samples were analysed by high-performance liquid chromatography and mass spectrometry (HPLC-MS). The analyses focused on two main bioactive compounds; trigonelline and chlorogenic acid (CGA). Statistical analyses were performed using an unpaired t-test with Welch’s correction and two-way ANOVA with Tukey’s post-hoc test (p<0.05). When compared to hot-brewed coffee beverages, cold-brewed coffee beverages have shown lower (p<0.05) levels of trigonelline (17.26 mg/g + 1.305 vs. 8.46 mg/g + 0.74, respectively) and CGA (9.82 mg/g + 0.93 vs. 5.31 mg/g + 0.48, respectively). In SCG obtained from hot-brewed coffee, a higher concentration of CGA was found (0.12 mg/g + 0.006), when compared to SCG obtained from cold-brewed coffee (0.10 mg/g + 0.03). However, trigonelline in cold-brewed SCG was found in higher (p<0.05) concentration, when compared to hot-brewed SCG (0.11 mg/g + 0.03 vs. 0.09 mg/g + 0.017, respectively). Moreover, hot-brewed coffee beverages showed higher (p<0.05) concentrations of trigonelline and CGA, when compared to hot-brewed SCG. Similarly, cold-brewed coffee beverages showed higher (p<0.05) concentrations of both bioactive compounds, when compared to cold-brewed SCG. Our results indicated that hot brewed coffee beverage contains high concentrations of bioactive compounds (CGA and trigonelline), which possibly explain its health properties. Although SCG obtained from hot and cold-brewed coffee showed lower concentrations of both bioactive compounds than coffee beverages, our results shed light on the possible health benefits of SCG consumption. In a world seeking more sustainable solutions, further studies investigating the potential use of SCG as a functional food are required.
Single crystal X-ray diffraction and electron-optical analysis were used to investigate the weathering of a chromium-bearing muscovite (fuchsite). The muscovite had mostly altered to kaolinite with minor amounts of halloysite occurring between kaolinite plates. Evidence for both epitactic and topotactic growth of kaolinite from muscovite was obtained and no intermediate poorly-crystalline phases were detected. About half of the Cr in fuchsite was incorporated into kaolinite, whereas most of the Ti, Fe and Mg was lost.
Dates from recently excavated Gangetic site of Sakas in Bihar, India, place it at ca.1800–1100 BC. The ceramic and lithic chronologies have been interpreted as Early Farming, Transitional and Chalcolithic/Developed Farming in date. However, depending on where in the Ganges Plains is studied, the time frame of Early, Developed and Advanced Farming periods varies widely, from 7th millennium to 2nd millennium BC and beyond, making the chronological framing of absolute dates within a regional scheme highly complex. In this paper we report the new radiocarbon results from Sakas and note how while these are critical for cementing the absolute dating of the site, until such time as a more stable periodization linked not only to relative and absolute dates but also human lifeways within the different zones of the Ganges plains is created, there remains difficulties in understanding how Sakas and other sites of similar date fit into the changing social, cultural and economic systems in this region.
The incorporation of transition metals into hematite may limit the aqueous concentration and bioavailabity of several important nutrients and toxic heavy metals. Before predicting how hematite controls metal-cation solubility, we must understand the mechanisms by which metal cations are incorporated into hematite. Thus, we have studied the mechanism for Ni2+ and Mn3+ uptake into hematite using extended X-ray absorption fine structures (EXAFS) spectroscopy. EXAFS measurements show that the coordination environment of Ni2+ in hematite corresponds to that resulting from Ni2+ replacing Fe3+. No evidence for NiO or Ni(OH)2 was found. The infrared spectrum of Ni-substituted hematite shows an OH-stretch band at 3168 cm−1 and Fe-OH bending modes at 892 and 796 cm−1. These vibrational bands are similar to those found in goethite. The results suggest that the substitution of Ni2+ for Fe3+ is coupled with the protonation of one of the hematite oxygen atoms to maintain charge balance.
The solubility of Mn3+ in hematite is much less extensive than that of Ni2+ because of the strong Jahn-Teller distortion of Mn3+ in six-fold coordination. Structural evidence of Mn3+ substituting for Fe3+ in hematite was found for a composition of 3.3 mole % Mn2O3. However a sample with nominally 6.6 mole % Mn2O3 was found to consist of two phases: hematite and ramsdellite (MnO2). The results indicate that for cations, such as Mn3+ showing a strong Jahn-Teller effect, there is limited substitution in hematite.
A well-characterized kaolinite has been hydrated in order to test the hypothesis that platey kaolinite will roll upon hydration. Kaolinite hydrates are prepared by repeated intercalation of kaolinite with potassium acetate and subsequent washing with water. On hydration, kaolinite plates roll along the major crystallographic directions to form tubes identical to proper tubular halloysite. Most tubes are elongated along the b crystallographic axis, while some are elongated along the a axis. Overall, the tubes exhibit a range of crystallinity. Well-ordered examples show a 2-layer structure, while poorly ordered tubes show little or no 3-dimensional order. Cross-sectional views of the formed tubes show both smoothly curved layers and planar faces. These characteristics of the experimentally formed tubes are shared by natural halloysites. Therefore, it is proposed that planar kaolinite can transform to tubular halloysite.
Parallel-oriented and exceptionally long (> 10 μm) tubes of halloysite occur in the pallid zone of a deeply-weathered lateritic profile on granite in southwest Australia.
Transmission electron microscopy and selected-area electron diffraction of ultrathin sections showed that kaolinite plates within pseudomorphs of mica crystals had fractured at irregular intervals along the a crystallographic axis to produce laths elongated along the b axis. The laths near the edges of the pseudomorphs were less constrained by the pseudomorph and had rolled to produce halloysite tubes. The tubes varied in diameter and degree of roundness. Some tubes were polyhedral rather than cylindrical in cross section. The length and number of planar faces in a tube and the angle between faces varied, exhibiting no consistent pattern.
Tubes in dispersed clay samples showed two types of twinning. In the first type, tubes and associated laths were joined together side by side. In the second type, single tubes bifurcated into two individual tubes. It is proposed that the first type of twinning occurred by folding of adjacent laths that remained joined together while the second type occurred due to exfoliation of a thick lath followed by folding of the exfoliated lath fragments into tubes.
Analytical electron microscopy showed that the chemical compositions of halloysite tubes, laths, and kaolinite plates were similar with the average cation exchange capacity of single tubes being small (4.5 meq/100 g) but higher than values for laths (2.8 meq/100 g) and plates (1.9 meq/100 g).
Silcretes developed within the in situ regolith in the Barr Smith Range, Western Australia, were investigated using optical and electron-beam techniques. One of the cementing agents in these silcretes showed gel-like optical properties and had a variable aluminosilicate chemical composition at the scale of electron microprobe analysis so that it might be considered as allophane-like material. High resolution transmission electron microscopy demonstrated that the material consists of a fine-grained and poorly ordered kaolinite embedded in a matrix of amorphous silica.
Weathering of spodumene in a lateritized pegmatite in Western Australia was studied by investigating in situ samples by electron-beam techniques. The spodumene had mostly altered to smectite. However, some non-crystalline material adjacent to smectite and intermixed with smectite was also observed. No crystallographic orientation between spodumene and smectite was observed by high resolution techniques. The spodumene dissolved to produce etch pits similar to those observed on hornblende grains. The etch pits were almost completely filled with smectite. Most of the Li in the spodumene was lost during its weathering to smectite.