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Schizophrenia is a chronic condition that requires long-term management. Quality of life is an important outcome measure for individuals diagnosed with schizophrenia; it can be tracked over time allowing evaluation of whether interventions lead to sustainable improvements. Nutrition and dietary interventions are an underutilized treatment for tackling the metabolic consequences of mental illness, which is now recognized as having increased importance in the management of schizophrenia. This study examines the impact of nutrition and dietary interventions on quality of life outcomes for those with schizophrenia.
Methods:
A systematic review of the literature was conducted, assessing the impact of nutritional interventions on quality of life outcomes in individuals with a diagnosis of schizophrenia.
Results:
A total of 982 articles were screened, of which nine articles met the inclusion criteria. Quality of life measures varied across studies, which made comparison across studies challenging. Previous studies had relatively small sample sizes and did not have long follow-up durations. Some of the studies found that dietary interventions such as counselling, weight management programs, food diaries and nutritional education improved quality of life, whereas others did not detect any effect.
Conclusions:
The review provides preliminary evidence that nutrition and dietary interventions may benefit quality of life among individuals with schizophrenia. There were however substantial limitations in studies highlighting the need for further research. The paper also highlights the need to standardize assessment tools for future quality-of-life research.
Opportunistic use of limited resources is often attributed to invasive species, and as a mature vine, old man’s beard (Clematis vitalba L.) is known to have devastating negative impacts on the trees it colonizes. No previous experimental studies have been published on how easily C. vitalba seedlings can colonize ground covered by other established vegetation. This species has had an increasing presence in forestry blocks and riparian zones in New Zealand, both of which usually maintain some grass cover. To determine the importance of vegetative ground cover for preventing ingress of new C. vitalba plants, this study looked at seedling emergence through the soil and establishment of C. vitalba within four different levels of grassy cover at three sites: (1) ground kept bare after vegetation removal; (2) ground bare at C. vitalba seed sowing, but thereafter allowed to recover; (3) vegetative cover trimmed to 4 cm high at C. vitalba sowing, and then allowed to recover; and (4) unmanaged vegetation. At the highest level of vegetation density (unmanaged vegetation), no C. vitalba seedlings were ever detected throughout a 1-yr monitoring period. At lower ground cover densities, poor seedling emergence was observed, with a maximum of 36% of seeds sown in bare plots producing a seedling. Also, seedlings did not survive past 1 yr, except in bare plots or in plots where vegetation grew sparsely. However, seedlings that did survive began producing multiple stems within 6 mo of emergence. These results indicate that obstacles to seedling emergence and poor development at the young seedling stage when vegetative cover is dense severely limit C. vitalba’s chances to invade new sites via seed. Yet some successful seedling recruitment does occur due to the magnitude of the propagule pressure on the landscape and the difficulty of maintaining high-density ground cover across large areas throughout the year.
Cancer health research relies on large-scale cohorts to derive generalizable results for different populations. While traditional epidemiological cohorts often use costly random sampling or self-motivated, preselected groups, a shift toward health system-based cohorts has emerged. However, such cohorts depend on participants remaining within a single system. Recent consumer engagement models using smartphone-based communication, driving projects, and social media have begun to upend these paradigms.
Methods:
We initiated the Healthy Oregon Project (HOP) to support basic and clinical cancer research. HOP study employs a novel, cost-effective remote recruitment approach to effectively establish a large-scale cohort for population-based studies. The recruitment leverages the unique email account, the HOP website, and social media platforms to direct smartphone users to the study app, which facilitates saliva sample collection and survey administration. Monthly newsletters further facilitate engagement and outreach to broader communities.
Results:
By the end of 2022, the HOP has enrolled approximately 35,000 participants aged 18–100 years (median = 44.2 years), comprising more than 1% of the Oregon adult population. Among those who have app access, ∼87% provided consent to genetic screening. The HOP monthly email newsletters have an average open rate of 38%. Efforts continue to be made to improve survey response rates.
Conclusion:
This study underscores the efficacy of remote recruitment approaches in establishing large-scale cohorts for population-based cancer studies. The implementation of the study facilitates the collection of extensive survey and biological data into a repository that can be broadly shared and supports collaborative clinical and translational research.
Background: We aimed to develop an efficient and reliable artificial intelligence solution to automate prediction of neurosurgical intervention using acute traumatic brain injury computed tomography (CT) scans. Methods: TBI patients were identified from 2005 - 2022 at a Level 1 Canadian trauma center. Model training, validation, and testing was performed using head CT scans with patient-level labels corresponding to whether the patient received neurosurgical intervention. The finalized model was then deployed in a simulated prospective fashion on all TBI patients presenting to our center over an 18-month epoch. Results: 2,806 TBI scans were utilized for development of the Automated Surgical Intervention Support Tool (ASIST-TBI). 612 additional consecutive scans were used for simulated prospective model deployment. Prediction of neurosurgical intervention exhibited an area under receiver operating curve (AUC) of 0.92, accuracy of 0.87, sensitivity of 0.87, and specificity of 0.88 on the test dataset. On simulated prospective data, the results were: AUC 0.89, sensitivity 0.85, specificity 0.84 and accuracy of 0.84. Conclusions: We demonstrate the development and validation of ASIST-TBI, a machine learning model that accurately predicts whether TBI patients will need neurosurgical intervention. This model has potential application to optimize decision support and province-wide efficiency of inter-facility TBI triage to tertiary care centers.
Old man’s beard is a woody liana that has become an invasive weed in many areas of its introduction, through its vigorous spread and negative impacts on the tree hosts it climbs. Control techniques that improve precision and reduce non-target damage are increasingly preferred for weed control yet have not been compared in published research for use against old man’s beard. Field experiments in New Zealand were conducted to: (i) assess targeted herbicide techniques for control of this weed’s climbing stems when growing among trees and (ii) assess foliar herbicides for control of creeping stems in ruderal sites. For climbing stems, triclopyr in oil was applied around the circumference of woody stems near their base, which was compared with cutting the stems and applying concentrated glyphosate gel (45% ai) to each cut end. Herbicides were applied in autumn directly to individual stem bases of the weed, thereby protecting tree hosts and other non-target vegetation. The basal application of triclopyr to intact stems was highly effective (>95% mortality) with no damage to nearby trees noted. The glyphosate gel applications to cut stems were less effective (56% mortality by 2 yr after treatment). For creeping stems in grass-dominated ruderal sites, selective foliar herbicide sprays had not been previously juxtaposed to compare control of old man’s beard. Three selective sprays that do not damage existing grass cover were applied in autumn at their recommended rates: (i) metsulfuron; (ii) triclopyr; and (iii) a mixture of triclopyr, picloram, and aminopyralid. All herbicide treatments provided effective control, although metsulfuron had a negative effect on grass vigor, which might allow new establishment of old man’s beard seedlings by competitive release. These results provide effective options that reduce non-target damage for control of both climbing and creeping old man’s beard stems.
Approximately 70% of patients with bipolar disorder (BPD) are initially misdiagnosed, resulting in significantly delayed diagnosis of 7–10 years on average. Misdiagnosis and diagnostic delay adversely affect health outcomes and lead to the use of inappropriate treatments. As depressive episodes and symptoms are the predominant symptom presentation in BPD, misdiagnosis as major depressive disorder (MDD) is common. Self-rated screening instruments for BPD exist but their length and reliance on past manic symptoms are barriers to implementation, especially in primary care settings where many of these patients initially present. We developed a brief, pragmatic bipolar I disorder (BPD-I) screening tool that not only screens for manic symptoms but also includes risk factors for BPD-I (eg, age of depression onset) to help clinicians reduce the misdiagnosis of BPD-I as MDD.
Methods
Existing questionnaires and risk factors were identified through a targeted literature search; a multidisciplinary panel of experts participated in 2 modified Delphi panels to select concepts thought to differentiate BPD-I from MDD. Individuals with self-reported BPD-I or MDD participated in cognitive debriefing interviews (N=12) to test and refine item wording. A multisite, cross-sectional, observational study was conducted to evaluate the screening tool’s predictive validity. Participants with clinical interview-confirmed diagnoses of BPD-I or MDD completed a draft 10-item screening tool and additional questionnaires/questions. Different combinations of item sets with various item permutations (eg, number of depressive episodes, age of onset) were simultaneously tested. The final combination of items and thresholds was selected based on multiple considerations including clinical validity, optimization of sensitivity and specificity, and pragmatism.
Results
A total of 160 clinical interviews were conducted; 139 patients had clinical interview-confirmed BPD-I (n=67) or MDD (n=72). The screening tool was reduced from 10 to 6 items based on item-level analysis. When 4 items or more were endorsed (yes) in this analysis sample, the sensitivity of this tool for identifying patients with BPD-I was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. These properties represent an improvement over the Mood Disorder Questionnaire, while using >50% fewer items.
Conclusion
This new 6-item BPD-I screening tool serves to differentiate BPD-I from MDD in patients with depressive symptoms. Use of this tool can provide real-world guidance to primary care practitioners on whether more comprehensive assessment for BPD-I is warranted. Use of a brief and valid tool provides an opportunity to reduce misdiagnosis, improve treatment selection, and enhance health outcomes in busy clinical practices.
We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding of Earth's sensitivity to carbon dioxide, finds that permafrost thaw could release more carbon emissions than expected and that the uptake of carbon in tropical ecosystems is weakening. Adverse impacts on human society include increasing water shortages and impacts on mental health. Options for solutions emerge from rethinking economic models, rights-based litigation, strengthened governance systems and a new social contract. The disruption caused by COVID-19 could be seized as an opportunity for positive change, directing economic stimulus towards sustainable investments.
Technical summary
A synthesis is made of ten fields within climate science where there have been significant advances since mid-2019, through an expert elicitation process with broad disciplinary scope. Findings include: (1) a better understanding of equilibrium climate sensitivity; (2) abrupt thaw as an accelerator of carbon release from permafrost; (3) changes to global and regional land carbon sinks; (4) impacts of climate change on water crises, including equity perspectives; (5) adverse effects on mental health from climate change; (6) immediate effects on climate of the COVID-19 pandemic and requirements for recovery packages to deliver on the Paris Agreement; (7) suggested long-term changes to governance and a social contract to address climate change, learning from the current pandemic, (8) updated positive cost–benefit ratio and new perspectives on the potential for green growth in the short- and long-term perspective; (9) urban electrification as a strategy to move towards low-carbon energy systems and (10) rights-based litigation as an increasingly important method to address climate change, with recent clarifications on the legal standing and representation of future generations.
Social media summary
Stronger permafrost thaw, COVID-19 effects and growing mental health impacts among highlights of latest climate science.
There are no data relating to gambling advertisements shown during live sporting events in Ireland. The aim of the present study was to analyze gambling advertisements shown during live sporting events broadcast in Ireland and to assess these advertisements for responsible gambling (RG) practices.
Methods:
Sixty-five live televised sporting events comprising Association Football (soccer), Rugby Union, and Gaelic Athletic Association (GAA) matches broadcast in Ireland were analyzed. Pre-match (up to 30 minutes before kick-off), half-time, and post-match (up to 30 minutes after the match has ended) advertisement breaks were analyzed for gambling advertisements, including in-game fixed (static advertising) and dynamic (electronic advertisements changing at regular intervals) pitch-side advertising. Gambling advertisements were studied for evidence of RG practices.
Results:
A total of 3602 television advertisements, 618 dynamic advertisements, and 394 static advertisements were analyzed. Gambling advertisements were shown in 75.4% (n = 49) games and were the seventh most commonly televised advertisement shown overall. Gambling advertising was more common in football (fourth most common advertisement) compared to rugby (12th most common) and GAA (13th most common). Static and dynamic gambling advertising were common during football matches (second and first most common advertisements, respectively). The majority of advertisements contained RG messaging, an age limit, and an RG organization. No advertisements showing responsible gambling tools were observed.
Conclusions:
Gambling advertisements are commonly shown during live televised sporting broadcasts in Ireland, especially during live football matches and typically before the adult television watershed. Gambling legislation is required to minimize harm to vulnerable groups including children.
Cephalopods are important prey in the diet of top predators, such as marine mammals and seabirds. However, detailed information on their trophic relationships in the Patagonian marine ecosystem is scarce, including those cephalopod species with commercial interest. The aims of this study were to evaluate the composition of the cephalopod component in the diet of Otaria byronia and determine the habitat use and trophic levels of their main cephalopod prey by measuring the stable isotopic signature of cephalopod beaks. Between May 2005 and February 2009, fresh faecal samples were collected from two sea lions rookeries in San Matias Gulf. Cephalopods occurred in 39.4% of the 1112 samples collected during the whole period of study. The dominant prey species was Octopus tehuelchus, which occurred in 45.8% of scats containing cephalopod remains, and represented 58.7% in terms of numerical abundance and 52.0% in mass of cephalopods consumed. The second species most consumed was the myopsid Doryteuthis gahi. The significant higher δ15N values of O. tehuelchus beaks in comparison with those of D. gahi showed that these two species have different trophic levels while occupying similar habitat (δ13C values) in neritic waters of the Patagonian shelf.
In the Swedish KBS-3 repository concept, there is potential for gas to be generated from corrosion of ferrous materials under anoxic conditions, combined with the radioactive decay of the waste and radiolysis of water. A full understanding of the probable behaviour of this gas phase within the engineered barrier system (EBS) is therefore required for performance assessment. We demonstrate key features from gas transport experiments on pre-compacted Mx80 bentonite, under laboratory and field conditions, and discuss their implications in terms of a conceptual model for gas migration behaviour. On both scales, major gas entry is seen to occur close to the sum of the porewater and swelling pressures of the bentonite. In addition, gas pressure at breakthrough is profoundly sensitive to the number and location of available sinks for gas escape. Observations of breakthrough can be explained by the creation of dilatational pathways, resulting in localized changes in the monitored porewater pressures and total stresses. These pathways are highly unstable, evolving spatially and temporally, and must consequently influence the gas permeability as their distribution/geometry develops.
Such observations are poorly embodied by conventional concepts of two-phase flow, which do not fully represent the key processes involved. Although dilatancy based models provide a better description of these processes, the paucity of data limits further development and validation of these models at present.
The concept of effective stress is one of the basic tenets of rock mechanics where the stress acting on a rock can be viewed as the total stress minus the pore water pressure. In many materials, including clay-rich rocks, this relationship has been seen to be imperfect and a coefficient (χ) is added to account for the mechanical properties of the clay matrix. Recent experimental results during the flow testing (both gas and water) of several rocks (Callovo-Oxfordian claystone, Opalinus Clay, Boom Clay) and geomaterials (bentonite, kaolinite) has given evidence for stable high pressure differentials. The design of the experiments allows multiple measurements of pore pressure, which commonly shows a complex distribution for several different experimental geometries. The observed stable high pressure differentials and heterogeneous pore pressure distribution makes the describing of stress states in terms of effective stress complex. Highly localized pore pressures can be sustained by argillaceous materials and concepts of evenly distributed pore pressures throughout the sample (i.e. conventional effective stress) do not fit many clay-rich rocks if the complexities observed on the micro-scale are not incorporated, especially when considering the case of gas flow.
Corrosion, water radiolysis and microbial degradation will result in the generation of gas within repositories designed for the geological disposal of high-level radioactive waste. It is therefore crucial in the design of such facilities that the relevant mechanisms allowing gas migration through repository materials, both engineered barriers and clay-based candidate host rocks, are correctly identified. In Belgium, the Boom Clay represents a candidate host material for which the advective gas breakthrough characteristics and transport properties have been extensively tested and are well defined by numerous studies. The Boom Clay displays a significant capacity for self-sealing and both laboratory and field tests indicate that advective gas transport occurs not by visco-capillary flow, but instead through the formation of pressure-induced dilatant pathways. In this study, we present results from a gas injection test designed to demonstrate the presence of these features by injecting nanoparticulate tracers with helium gas into a sample of Boom Clay. The results provide conclusive evidence for the formation of transient, dilatant gas pathways within a candidate clay-based host rock. This technique provides a novel diagnostic tool for the identification of processes governing multi-phase flow, supporting robust long-term assessments of repository performance.
One of the most challenging aspects of understanding the flow of gas and water during testing in clay-rich low-permeability materials is the difficulty in visualizing localized flow. Whilst understanding has been increased using X-ray Computed-tomography (CT) scanning, synchrotron X-ray imaging and Nuclear Magnetic Resonance (NMR) imaging, real-time testing is problematic under realistic in situ conditions confining pressures, which require steel pressure vessels. These methods tend not to have the nano-metre scale resolution necessary for clay mineral visualization, and are generally not compatible with the long duration necessary to investigate flow in such materials. Therefore other methods are necessary to visualize flow paths during post-mortem analysis of test samples. Several methodologies have been established at the British Geological Survey (BGS), in order to visualize flow paths both directly and indirectly. These include: (1) the injection of fluorescein-stained water or deuterium oxide; (2) the introduction of nanoparticles that are transported by carrier gas; (3) the use of radiologically tagged gas; and (4) the development of apparatus for the direct visualization of clay. These methodologies have greatly increased our understanding of the transport of water and gas through intact and fractured clay-rich materials. The body of evidence for gas transport through the formation of dilatant pathways is now considerable. This study presents observations using a new apparatus to directly visualize the flow of gas in a kaolinite paste. The results presented provide an insight into the flow of gas in clay-rich rocks. The flow of gas through dilatant pathways has been shown in a number of argillaceous materials (Angeli et al., 2009; Autio et al., 2006; Cuss et al., 2014; Harrington et al., 2012). These pathways are pressure induced and an increase in gas pressure leads to the dilation of pathways. Once the gas breakthrough occurs, pressure decreases and pathways begin to close. This new approach is providing a unique insight into the complex processes involved during the onset, development and closure of these dilatant gas pathways.
The development of 157 tanoak [Lithocarpus densiflorus (Hook. and Am.) Rehd.] and 130 Pacific madrone (Arbutus menziesii Pursh) sprout-clumps 1 to 6 yr after cutting or burning was studied on a range of sites in southwest Oregon. The width and area of sprout-clumps originating from trees ≥ 2-cm stem diameter at 1.4-m height of both species was related to the size of the parent stem and time since cutting (tanoak, r2 = 0.77 and 0.75; Pacific madrone, r2 = 0.84 and 0.83). The sprouting capacity of tanoak develops slowly, and 5 to 6 yr after cutting, sprout-clumps produced by small tanoak 40 to 50 yr old averaged only 37 cm in diameter. Prediction equations, along with stem-diameter distributions of these species in forest stands, can be used to estimate hardwood foliar cover up to 6 yr after cutting.
The Darwin region in northern Australia has experienced rapid population growth in recent years, and with it, an increased incidence of melioidosis. Previous studies in Darwin have associated the environmental presence of Burkholderia pseudomallei, the causative agent of melioidosis, with anthropogenic land usage and proximity to animals. In our study, we estimated the occurrence of B. pseudomallei and Burkholderia spp. relatives in faecal matter of wildlife, livestock and domestic animals in the Darwin region. A total of 357 faecal samples were collected and bacteria isolated through culture and direct DNA extraction after enrichment in selective media. Identification of B. pseudomallei, B. ubonensis, and other Burkholderia spp. was carried out using TTS1, Bu550, and recA BUR3–BUR4 quantitative PCR assays, respectively. B. pseudomallei was detected in seven faecal samples from wallabies and a chicken. B. cepacia complex spp. and Pandoraea spp. were cultured from wallaby faecal samples, and B. cenocepacia and B. cepacia were also isolated from livestock animals. Various bacteria isolated in this study represent opportunistic human pathogens, raising the possibility that faecal shedding contributes to the expanding geographical distribution of not just B. pseudomallei but other Burkholderiaceae that can cause human disease.
Economic analyses of typical farms are often useful in applied agricultural research, because agricultural policymakers and analysts have a particular need for information on policy impacts and indicators of well-being at the farm level.