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Operationalizing multi-site Community Engagement (CE) Studios to inform a research program is valuable for researchers. We describe the process and outcomes of hosting three CE Studios with Community Experts aged 65 years or older with chronic conditions and care partners of older adults. Experts gave feedback about processes for testing the feasibility, efficacy, effectiveness, and implementation of audio recording clinic visits and sharing recordings with patients who have multimorbidity and their care partners.
Methods:
The CE Cores of the Clinical and Translational Science Awards Programs at three academic health science centers created a joint CE Studio guide. Studios were conducted iteratively by site. Following receipt of the final reports, responses were compared to find themes, similarities, and differences on four topics in addition to overall commentary: Recruitment and Retention, Study Protocol, Study Reminders and Frequency, and Recording Technology.
Results:
Eighteen older adults and care partners in three states provided valuable feedback to inform multi-site trials. Feedback influenced multiple aspects of trials in process or subsequently funded. Experts provided critique on the wording of study invitations, information sheets, and reminders to engage in study procedures. Experts were concerned for participants being disappointed by randomization to a control arm and advised how investigators should prepare to address that.
Conclusions:
Multi-site CE Studios should be consecutive, so each team can learn from the previous teams. Using the CES Toolkit ensures that final reports were easily comparable and utilized to develop a research program that now includes three federally funded clinical trials.
The 2016–17 European outbreak of H5N8 HPAIV (Clade 2.3.4.4b) affected a wider range of avian species than the previous H5N8 outbreak (2014–15), including an incursion of H5N8 HPAIV into gamebirds in England. Natural infection of captive-reared pheasants (Phasianus colchicus) led to variable disease presentation; clinical signs included ruffled feathers, reluctance to move, bright green faeces, and/or sudden mortality. Several birds exhibited neurological signs (nystagmus, torticollis, ataxia). Birds exhibiting even mild clinical signs maintained substantial levels of virus replication and shedding, with preferential shedding via the oropharyngeal route. Gross pathology was consistent with HPAIV, in gallinaceous species but diphtheroid plaques in oropharyngeal mucosa associated with necrotising stomatitis were novel but consistent findings. However, minimal or modest microscopic pathological lesions were detected despite the systemic dissemination of the virus. Serology results indicated differences in the timeframe of exposure for each case (n = 3). This supported epidemiological conclusions confirming that the movement of birds between sites and other standard husbandry practices with limited hygiene involved in pheasant rearing (including several fomite pathways) contributed to virus spread between premises.
The crop-weed interference relationship is a critical component of bioeconomic weed management models. Multi-year field experiments were conducted at five locations to determine the stability of corn-velvetleaf interference relationships across years and locations. Two coefficients (I and A) of a hyperbolic equation were estimated for each data set using nonlinear regression procedures. The I and A coefficients represent percent corn yield loss as velvetleaf density approaches zero, and maximum percent corn yield loss, respectively. The coefficient I was stable across years at two locations, but varied across years at one location. The coefficient A did not vary across years within locations. Both coefficients, however, varied among locations. Results do not support the use of common coefficient estimates for all locations within a region.
Variation in interference relationships have been shown for a number of crop-weed associations and may have an important effect on the implementation of decision support systems for weed management. Multiyear field experiments were conducted at eight locations to determine the stability of corn-foxtail interference relationships across years and locations. Two coefficients (I and A) of a rectangular hyperbola equation were estimated for each data set using nonlinear regression procedures. The I and A coefficients represent percent corn yield loss as foxtail density approaches zero and maximum percent corn yield loss, respectively. The coefficient I was stable across years at two locations and varied across years at four locations. Maximum yield loss (A) varied between years at one location. Both coefficients varied among locations. Although 3 to 4 foxtail plants m−-1 row was a conservative estimate of the single-year economic threshold (Tc) of foxtail density, variation in I and A resulted in a large variation in Tc. Therefore, the utility of using common coefficient estimates to predict future crop yield loss from foxtail interference between years or among locations within a region is limited.
A multifaceted approach to evaluating expert systems is overviewed. This approach has three facets: a technical facet, for “looking inside the black box”; an empirical facet, for assessing the system’s impact on performance; and a subjective facet, for obtaining users’ judgments about the system. Such an approach is required to test the system against the different types of criteria of interest to sponsors and users and is consistent with evolving lifecycle paradigms. Moreover, such an approach leads to the application of different evaluation methods to answer different types of evaluation questions. Different evaluation methods for each facet are overviewed.
Fructose consumption in the USA has increased over the past three decades. During this time, obesity, insulin resistance and the metabolic syndrome have also increased in prevalence. While diets high in fructose have been shown to promote insulin resistance and increase TAG concentrations in animals, there are insufficient data available regarding the long-term metabolic effects of fructose consumption in humans. The objective of the present study was to investigate the metabolic effects of 10-week consumption of fructose-sweetened beverages in human subjects under energy-balanced conditions in a controlled research setting. Following a 4-week weight-maintaining complex carbohydrate diet, seven overweight or obese (BMI 26·8–33·3 kg/m2) postmenopausal women were fed an isoenergetic intervention diet, which included a fructose-sweetened beverage with each meal, for 10 weeks. The intervention diet provided 15 % of energy from protein, 30 % from fat and 55 % from carbohydrate (30 % complex carbohydrate, 25 % fructose). Fasting and postprandial glucose, insulin, TAG and apoB concentrations were measured. Fructose consumption increased fasting glucose concentrations and decreased meal-associated glucose and insulin responses (P = 0·0002, P = 0·007 and P = 0·013, respectively). Moreover, after 10 weeks of fructose consumption, 14 h postprandial TAG profiles were significantly increased, with the area under the curve at 10 weeks being 141 % higher than at baseline (P = 0·04). Fructose also increased fasting apoB concentrations by 19 % (P = 0·043 v. baseline). In summary, consumption of fructose-sweetened beverages increased postprandial TAG and fasting apoB concentrations, and the present results suggest that long-term consumption of diets high in fructose could lead to an increased risk of CVD.