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This paper investigates the association between potential serum biomarkers and diabetes status in older Australians by employing traditional and machine learning methods. Data from Sydney Memory and Ageing Study (MAS) were interrogated cross-sectionally in 801 participants aged 70–90 years (n = 801). Twenty-eight serum biomarkers and 6 other factors were investigated as potential indicators that may distinguish diabetes status. Diabetes status was categorised as No-Diabetes, Pre-diabetes, and Type 2 diabetes (T2D). Diabetes is defined as follows when using fasting plasma glucose: no diabetes/ normal: < 5.6 mmol/L; prediabetes: 5.6–6.9 mmol/L; and diabetes: ≥ 7 mmol/L(1). Variable selection was executed using two distinct regression methods (i) multinomial logistic regression with backward selection and (ii) machine learning using elasticNet regression. Multiple imputation was used to address missing data. Age and sex were included as a priori covariates in the multinomial regression model. Using a multinomial logistic regression, Malondialdehyde (MDA), Macrophage inhibiting cytokine 1 (MIC1), and vitamin E were associated with diabetes status. MDA was strongly associated with diabetes with relative risk ratio (RRR) of 4.78 (95% CI = 3.39, 6.75; p < 0.001) when comparing to no diabetes, surpassing usual markers insulin, triglycerides, and waist-to-hip (WHR). Diabetes was associated with lower vitamin E levels, compared to no diabetes, with an RRR of 0.54 (95% CI:0.38, 0.75; p < 0.001). Comparing diabetes to prediabetes, RRR for lower vitamin E levels was 0.71 (95% CI: 0.51, 0.98; p = 0.035). MIC1 distinguished between diabetes and prediabetes status (RRR: 1.84; 95% CI:1.41, 2.41; p < 0.001). Consistent with the traditional methods, machine learning also identified MDA as being associated with T2D, with an odds ratio (OR) of 1.9, followed hierarchically by insulin (OR = 1.23), WHR (OR = 1.22) and triglyceride (OR = 1.13). Higher serum Vitamin E were associated with a lower risk of being in diabetes category (OR = 0.84). MIC1, urate, IL1b, HDL, and carotene were identified by the machine learning model, but showed minimal association. These results suggest that the oxidative stress and inflammation markers distinguish the state of having T2D.
Recent experiments aiming to measure phenomena predicted by strong-field quantum electrodynamics (SFQED) have done so by colliding relativistic electron beams and high-power lasers. In such experiments, measurements of collision parameters are not always feasible. However, precise knowledge of these parameters is required to accurately test SFQED.
Here, we present a novel Bayesian inference procedure that infers collision parameters that could not be measured on-shot. This procedure is applicable to all-optical non-linear Compton scattering experiments investigating radiation reaction. The framework allows multiple diagnostics to be combined self-consistently and facilitates the inclusion of known information pertaining to the collision parameters. Using this Bayesian analysis, the relative validity of the classical, quantum-continuous and quantum-stochastic models of radiation reaction was compared for several test cases, which demonstrates the accuracy and model selection capability of the framework and highlight its robustness if the experimental values of fixed parameters differ from their values in the models.
Objectives/Goals: The aim of the study is to identify resistance factors for substance use (i.e., factors that explicitly help to avoid or reduce drug use). Identification of resistance factors could inform strategies that seek to reduce the prevalence of substance use and related disorders. Methods/Study Population: Adult twins aged 30–70 years were recruited from the Mid-Atlantic Twin Registry. A mixed-method approach, group concept mapping, was used to identify factors influencing participants to resist using substances. Approximately 155 participants produced 97 statements reflecting substance use resistance factors. Hierarchical cluster analysis and multidimensional scaling assessed how participants sorted and rated statements for their lifetime and current importance. Factor analysis was used to reduce data dimensionality. Reliability analyses were conducted to identify a subset of statements anticipated to consistently represent each cluster. Results were shared with participants to assess accuracy with their experiences. Results/Anticipated Results: Participants sorted 97 statements into 9 thematic clusters: (1) Controlling Personal, Negative Consequences; (2) Concern About Health and Well-being; (3) Lack of Desire; (4) Outside Influences; (5) Social Norms and My Reputation; (6) Career and Legal Impacts, (7) Avoiding Harm to Family and Relationships; (8) Preserving Family Relationships; and (9) Family and Friends Impact on Me. Participants consistently identified health concerns as an important substance use resistance factor. The statements will be further reduced to represent a smaller subset for future use as a scale to measure exposure to resistance factors. Discussion/Significance of Impact: Health concerns related to substance use were identified as an important resistance factor. This has been supported by research on smoking cessation and implemented in smoking prevention campaigns. Therefore, prioritizing health-related outcomes in prevention may be important to reduce substance use prevalence.
Ion homeostasis is a crucial process in plants that is closely linked to the efficiency of nutrient uptake, stress tolerance and overall plant growth and development. Nevertheless, our understanding of the fundamental processes of ion homeostasis is still incomplete and highly fragmented. Especially at the mechanistic level, we are still in the process of dissecting physiological systems to analyse the different parts in isolation. However, modelling approaches have shown that it is not individual transporters but rather transporter networks (homeostats) that control membrane transport and associated homeostatic processes in plant cells. To facilitate access to such theoretical approaches, the modelling of the potassium homeostat is explained here in detail to serve as a blueprint for other homeostats. The unbiased approach provided strong arguments for the abundant existence of electroneutral H+/K+ antiporters in plants.
Almost half of countries globally are implementing national strategies to lower population salt intake towards the World Health Organization’s target of a 30% reduction by 2025(1). However, most are yet to lower population salt intake(1). We conducted process evaluations of national salt reduction strategies in Malaysia and Mongolia to understand the extent to which they were implemented and achieving their intended outcomes, using the findings to generate insights on how to strengthen strategies and accelerate population salt reduction. Mixed methods process evaluations were conducted at the mid-point of implementation of the strategies in Malaysia (2018-19) and Mongolia (2020-21)(2). Guided by theoretical frameworks, information on the implementation, mechanism and contextual barriers and enablers of the strategies were collected through desk-based reviews of documents related to salt reduction, interviews with key stakeholders (n = 12 Malaysia, n = 10 Mongolia), and focus group discussions with health professionals in Malaysia (n = 43) and health provider surveys in Mongolia (n = 12). Both countries generated high-quality evidence about salt intake and salt levels in foods, and culturally-specific education resources in 3 and 5 years respectively. However, in Malaysia there was moderate dose delivered and low reach in terms of education and reformulation activities. Within 5 years, Mongolia implemented education among schools, health professionals and food producers on salt reduction with high reach but with moderate dose and reach among the general population. There were challenges in both countries with respect to implementing legislative interventions and both could improve the scaling up of their reformulation and education activities to have population-wide reach and impact. In the first half of Malaysia’s and Mongolia’s strategies, both countries generated necessary evidence and education materials, mobilised health professionals to deliver salt reduction education and achieved small-scale salt reformulation in foods. However, both faced challenges in implementing regulatory policies and the scaling up of their reformulation and education activities to have population-wide reach and impact could be strengthened. Similar process evaluations of existing salt reduction strategies are needed to strengthen intervention delivery and inform areas for adaptation, to aid achievement of the WHO’s global target of a 30% reduction in population salt intake by 2025.
A machine learning model was created to predict the electron spectrum generated by a GeV-class laser wakefield accelerator. The model was constructed from variational convolutional neural networks, which mapped the results of secondary laser and plasma diagnostics to the generated electron spectrum. An ensemble of trained networks was used to predict the electron spectrum and to provide an estimation of the uncertainty of that prediction. It is anticipated that this approach will be useful for inferring the electron spectrum prior to undergoing any process that can alter or destroy the beam. In addition, the model provides insight into the scaling of electron beam properties due to stochastic fluctuations in the laser energy and plasma electron density.
The demand of palliative care is increasing due to the aging population and treatment hesitancy or intentional avoidance compromises symptom management.
Objectives
To identify patient beliefs associated with medication hesitancy by using the theory of planned behavior (TPB) namely, attitudes, subjective norms, behavioral intention, and perceived behavioral control associated with medication hesitancy or intentional noncompliance by avoidance.
Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was followed to conduct a systematic literature search involving the CINAHL, Embase, MEDLINE, and PsycINFO databases from inception until March 2022. Hand-searched articles from reference lists and gray literature were included. Thematic analysis was conducted on qualitative data and triangulated with quantitative data.
Results
About 554 articles were retrieved from the literature search and 17 articles were included based on the eligibility criteria. Three subthemes that were identified under TPB constructs were attitude: negative attitude toward medications, passive attitude toward illness and inaccurate information about disease or medication; one subtheme was identified under subjective norms: perceived negative opinions from others; and one subtheme was identified under perceived behavioral control: perception of manageable symptoms. Quantitative data provided triangulation of qualitative findings related to fear of addiction and side effects, feelings of hopelessness, unclear direction and information, social stigma, endurable symptoms, and illness as determinants for medication avoidance.
Significance of results
This systematic review highlighted some patient beliefs related to medication hesitancy or avoidance. Clinicians should take patient beliefs and concerns into consideration when creating treatment regimens for people receiving palliative care to optimize medication adherence and the quality of care.
When applied in the health sector, AI-based applications raise not only ethical but legal and safety concerns, where algorithms trained on data from majority populations can generate less accurate or reliable results for minorities and other disadvantaged groups.
The special mental states such as hallucination and confusion in schizophrenia have been creating obstacles in research in spirituality in this population. Although primary treatment should focus on symptom management, psychosocial and spiritual care should not be neglected. This study aimed to understand spirituality from the perspectives of both the patients and the healthcare professionals and its role in different stages of disease and rehabilitation.
Method:
Schizophrenic patients (n=22) and healthcare professionals including psychiatric doctors, nurses, and social workers (n=19) were recruited from an out-patient clinic of a hospital and a mental health rehabilitation complex. Semi-structured interviews on the meaning and experiences of spirituality, and its role in rehabilitation were conducted, with follow-up interviews when further clarification was needed. Interviews were transcribed into verbatim and analyzed with the assistance of computer software based on Ground theory. Trustworthiness was assured through member checking and peer scrutiny.
Results:
Both patients and professionals regarded spirituality as an inherent part of the patients’ well-being. Spirituality could be a practice, a way of thinking, sense of peace and fulfillment, and connectedness towards oneself, others, and a higher power. Spiritual experiences were helpful in the rehabilitation phase. However, some patients considered spirituality as apparitional experiences, thus hindered their recovery.
Conclusion:
This study demonstrated that the spirituality played a part in patients’ lives and rehabilitation. Findings suggest the importance of spiritual care in this population and provide insights and roadmap for developing spiritual assessments and holistic care in psychiatric context.
The aim of the present study is to estimate the prevalence of impulse control disorders (ICDs) and obsessive compulsive disorder (OCD) in a population of elderly patients with Parkinson's Disease living in the community.
Methods
This is a monocentric cross sectional study in which a total of 250 subjects with Parkinson's Disease aged 65 or more will be selected during a period of one year, from all the outpatients referring to the Geriatric Day Hospital of Policlinico A. Gemelli in Rome. An age matched reference group will be selected from all the subjects without Parkinson's Disease attending the Elderly Fitness Center in the same hospital. During a preliminary phase, a linguistic validation of the Italian version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) will be conducted. Afterwards, every enrolled patient will be evaluated through a clinical interview in order to obtain socio-demographic and clinical data and to assess mood status and quality of life. ICDs and OCD will be assessed respectively, using the Italian versions of self reported scales QUIP and OCI-R.
Results
Enrollment should end in July 2015. Preliminary results from ad interim analyses will be presented.
Conclusion
Data on the prevalence of ICDs and OCD in elderly population, particularly in subjects with Parkinson's Disease, are still lacking in medical literature. Nevertheless, they can be clinically relevant and may have implications on the specific approach to this subgroup of patients.
Abnormal effort-based decision-making represents a potential mechanism underlying motivational deficits (amotivation) in psychotic disorders. Previous research identified effort allocation impairment in chronic schizophrenia and focused mostly on physical effort modality. No study has investigated cognitive effort allocation in first-episode psychosis (FEP).
Method
Cognitive effort allocation was examined in 40 FEP patients and 44 demographically-matched healthy controls, using Cognitive Effort-Discounting (COGED) paradigm which quantified participants’ willingness to expend cognitive effort in terms of explicit, continuous discounting of monetary rewards based on parametrically-varied cognitive demands (levels N of N-back task). Relationship between reward-discounting and amotivation was investigated. Group differences in reward-magnitude and effort-cost sensitivity, and differential associations of these sensitivity indices with amotivation were explored.
Results
Patients displayed significantly greater reward-discounting than controls. In particular, such discounting was most pronounced in patients with high levels of amotivation even when N-back performance and reward base amount were taken into consideration. Moreover, patients exhibited reduced reward-benefit sensitivity and effort-cost sensitivity relative to controls, and that decreased sensitivity to reward-benefit but not effort-cost was correlated with diminished motivation. Reward-discounting and sensitivity indices were generally unrelated to other symptom dimensions, antipsychotic dose and cognitive deficits.
Conclusion
This study provides the first evidence of cognitive effort-based decision-making impairment in FEP, and indicates that decreased effort expenditure is associated with amotivation. Our findings further suggest that abnormal effort allocation and amotivation might primarily be related to blunted reward valuation. Prospective research is required to clarify the utility of effort-based measures in predicting amotivation and functional outcome in FEP.
Marine mollusk shells have been extensively used to provide radiocarbon (14C)-based chronologies in paleoenvironmental and archaeological studies, however uncertainties in age measurements are introduced because secondary factors such as vital effects and diet may influence 14C incorporation into these shells. Deep burrowing and deposit feeding mollusks, in particular, may incorporate “old” carbon resulting in apparently older ages than their contemporary environment. In this study, we present paired 14C and stable isotope (δ13C and δ18O) measurements for nine species of known-age bivalves having different feeding strategies and collected in six localities around the NE Atlantic. We exclude potential “old” carbon contamination in these known-age mollusk shells, acquire a better understanding of local ecology and provide an improved context for the environmental interpretation of 14C ages. Our results indicate that, in the NE Atlantic, marine mollusk-derived 14C ages provide a reliable basis for environmental and archaeological investigation, independently of vital effects and differences in microhabitats, feeding strategies and sample location—all of which are apparent from stable isotopes.
OBJECTIVES/SPECIFIC AIMS: The aim of this study is to determine whether quantitative measures of knee structures including effusion, bone marrow lesions, cartilage, and meniscal damage can improve upon an existing model of demographic and clinical characteristics to classify accelerated knee osteoarthritis (AKOA). METHODS/STUDY POPULATION: We conducted a case-control study using data from baseline and four annual follow-up visits from the osteoarthritis initiative. Participants had no radiographic knee osteoarthritis (KOA) at baseline. AKOA is defined as progressing from no KOA to advance-stage KOA in at least 1 knee within 48 months. AKOA knees were matched 1:1 based on sex to (1) participants who did not develop KOA within 48 months and (2) participants who developed KOA but not AKOA. Analyses were person based. Classification and regression tree analysis was used to determine the important variables and percent of variance explained. RESULTS/ANTICIPATED RESULTS: A previous classification and regression tree analysis found that age, BMI, serum glucose, and femorotibial angle explained 31% of the variability between those who did and did not develop AKOA. Including structural measurements as candidate variables yielded a model that included effusion, BMI, serum glucose, cruciate ligament degeneration and coronal slope and explained 39% of the variability. DISCUSSION/SIGNIFICANCE OF IMPACT: Knee structural measurements improve classification of participants who developed AKOA Versus those who did not. Further research is needed to better classify patients at risk for AKOA.
Three natural amphibole samples collected from the former vermiculite mine near Libby, Montana. USA, have been analysed by Rietveld X-ray powder diffraction (XRPD) refinement and Fourier transform infrared spectroscopy (FTIR) in the OH-stretching region. The same materials have been analysed previously by electron microprobe analysis (EMPA), Mössbauer spectroscopy and structure refinement (SREF) single crystal X-ray diffraction (SC-XRD), which revealed that these amphiboles have a crystal chemical formula very close to an intermediate composition between winchite and richterite, i.e. AA0.5BNaCaCMg4.5M3+T0.5Si8O22(OH)2 (A = Na and/or K; M3+ = Fe3+ and/or Al). The Rietveld analysis showed the powder samples used for the experiments here to be composed only of amphibole. This in turn allowed us to use FTIR OH-stretching data to derive cation ordering on these powder samples. The three FTIR spectra are quite similar and up to four components can be fitted to the patterns. The two lower-frequency components (labelled A and B) can be attributed to a local O(3)-H dipole surrounded by M(1)M(3)Mg3 and M(1)M(3)Mg2Fe2+; (respectively), an empty A site and rSi8 environments; on the contrary, the higher-frequency C and D bands indicate the presence of an occupied A site. The FTIR OH-stretching data alone allow us to calculate the site occupancy of the A, M(1)–M(3) and T sites with confidence, as compared with previously published data. By contrast M(4)- and M(2)-site occupancies are more difficult to evaluate. This study takes advantage of the large database of well characterized synthetic amphiboles, built over the last two decades. The comparison of vibrational spectroscopy data with micro-chemical and crystallographic data reported in this study demonstrate that the FTIR OH-stretching method alone is a valuable and rapid method to derive or at least sensibly constrain site occupancy for natural amphiboles. A much more detailed cation site occupancy can be obtained by combining micro-chemical and FTIR OH-stretching data.
Ovine reproduction efficiency in herds at high altitude (ha) is lower than that at low altitude (la). In ewes, ha effects are due to hypoxia and oxidative stress. Our aim was to establish the effect of antioxidant vitamin supplementation on semen traits and antioxidant status of rams exposed to short or long time ha. A total of 32 rams native to la (~500 m) were used, 16 were kept at la and the other 16 were brought to ha (~3600 m), where they were placed in the same flock as the ha native rams (n=16). Half of the animals in each group were supplemented daily with vitamins C 600 mg and E 450 IU per os, during the entire experimental period, starting the 4th day after animal’s arrival at ha (day 0). At days 0, 30 and 60 of treatment, blood and semen samples were collected for evaluation of antioxidant status and semen standard characteristics. Data were compared within each experimental time by analysis of variance using a general linear model. Elevated concentrations of oxidative stress biomarkers were present in blood from animals maintained at ha. Ejaculates from ha exposed rams showed decreased sperm concentration, progressive motility and viability, in addition to decreased antioxidant status in seminal fluid. A total of 30 days of oral supplementation with vitamins C and E prevented some ha negative effects on semen characteristics, mainly in recently ha exposed rams. It is concluded that exposure of rams to ha negatively affects semen quality, where oxidative stress plays a predominant role. These effects are mainly prevented by oral supplementation of vitamins C and E, which constitutes a simple and cheap alternative to improve semen quality of rams when they are moved to ha.
In our attempt to investigate the basic active galactic nucleus (AGN) paradigm requiring a centrally located supermassive black hole (SMBH), a close to Keplerian accretion disk and a jet perpendicular to its plane, we have searched for radio continuum in galaxies with H2O megamasers in their disks. We observed 18 such galaxies with the Very Large Baseline Array in C band (5 GHz, ~2 mas resolution) and we detected 5 galaxies at 8 σ or higher levels. For those sources for which the maser data is available, the positions of masers and those of the 5 GHz radio continuum sources coincide within the uncertainties, and the radio continuum is perpendicular to the maser disk’s orientation within the position angle uncertainties.
Childhood trauma has been significantly associated with first-episode psychosis, affective dysfunction and substance use.
Aims
To test whether people with first-episode psychosis who had experienced childhood trauma, when compared with those who had not, showed a higher rate of affective psychosis and an increased lifetime rate of substance use.
Method
The sample comprised 345 participants with first-episode psychosis (58% male, mean age 29.8 years, s.d.=9.7).
Results
Severe sexual abuse was significantly associated with a diagnosis of affective psychosis (χ2=4.9, P=0.04) and with higher rates of lifetime use of cannabis (68% v. 41%; P = 0.02) and heroin (20% v. 5%; P=0.02). Severe physical abuse was associated with increased lifetime use of heroin (15% v. 5%; P = 0.03) and cocaine (32% v. 17%; P = 0.05).
Conclusions
Patients with first-episode psychosis exposed to childhood trauma appear to constitute a distinctive subgroup in terms of diagnosis and lifetime substance use.
Starting from polydisperse diatomaceous earth (DE), we proposed an efficient separation method for obtaining different morphologies of biosilica from diatoms. DE is a very low-cost source of silica containing all the differently nanostructured elements. By a glucose gradient/dialysis, three types of biosilica morphologies were achieved: rods, valves, and clusters. We fully characterized the diatom fractions and we used them to produce fluorescent biosilica platforms (“tabs”). These supports exhibited good resistance in water, ethanol, and soft scraping. A preliminary biologic application by testing Saos-2 proliferation was also performed to check osteoblasts-like cells biologic attitude for this scaffolds with tunable nanostructure.
Archaeological tunneling is a standard excavation strategy in Mesoamerica. The ancient Maya built new structures atop older ones that were no longer deemed usable, whether for logistical or ideological reasons. This means that as archaeologists excavate horizontal tunnels into ancient Maya structures, they are essentially moving back in time. As earlier constructions are encountered, these tunnels may deviate in many directions in order to document architectural remains. The resultant excavations often become intricate labyrinths, extending dozens of meters. Traditional forms of archaeological documentation, such as photographs, plan views, and profile drawings, are limited in their ability to convey the complexity of tunnel excavations. Terrestrial Lidar (light detection and ranging) instruments are able to generate precise 3D models of tunnel excavations. This article presents the results of a model created with a Faro™ Focus 3D 120 Scanner of tunneling excavations at the site of El Zotz, Guatemala. The lidar data document the excavations inside a large mortuary pyramid, including intricately decorated architecture from an Early Classic (A.D. 300–600) platform buried within the present form of the structure. Increased collaboration between archaeologists and scholars with technical expertise maximizes the effectiveness of 3D models, as does presenting digital results in tandem with traditional forms of documentation.