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.
To successfully show that fusion is an attractive energy source, the ARC$^{\scriptstyle \mathrm{TM}}$ fusion power plant will need to operate with a robust, integrated power and particle exhaust solution. To maximise ARC’s fusion power output while avoiding excessive erosion of the plasma-facing components, we will need to radiatively dissipate most of the power crossing the last-closed flux surface, injecting radiating impurities such as argon or neon to access divertor detachment. Divertor detachment will need to be integrated with a high-performance core plasma, and with efficient impurity pumping to prevent the accumulation of helium ash in the core. To access and control detachment in high-performance plasmas, we have designed ARC with up–down-symmetric divertors, with secondary X-points in long, tightly baffled outer legs. Using a core-edge modelling workflow, we predict that with this divertor design, ARC will access detachment with modest argon seeding in the divertor (${c_{Ar,div}}\sim {0.9\,\%}$), which should have minimal impact on the core (${\Delta Z_{\textit{eff},\textit{core}}}\lt {0.5}$) for reasonable argon enrichment (${c_{Ar,div}/c_{Ar,\textit{core}}}={6}$). Due to the high predicted divertor neutral pressure (${p_{\textit{div}}}\sim {20\,\mathrm{Pa}}$), we predict that ARC will sufficiently pump helium to limit ash accumulation in the core (${c_{\textit{He},\textit{core}}}\lt {2\,\%}$) for a helium enrichment of ${c_{\textit{He},\textit{div}}/c_{\textit{He},\textit{core}}}={0.4}$. ARC’s divertor design is expected to increase the stability of a detachment front in the outer divertor leg, helping to prevent divertor reattachment during smaller heat-flux transients such as scrape-off-layer filaments associated with the quasi-continuous exhaust regime. However, this buffering will not be sufficient to prevent divertor reattachment during large type-I edge-localised modes (ELMs), and as such these will need to be avoided on ARC. Experiments on SPARC will be used to select an integrated scenario which avoids or mitigates type-I-ELMs while maintaining access to detachment, good core fusion performance and sufficient impurity exhaust. SPARC experiments will also be used to finalise ARC’s divertor design, by studying the impact of magnetic and first-wall geometry on detachment stability, impurity enrichment and neutral baffling under conditions similar to those expected for ARC. In conclusion, our analysis finds that ARC will have a viable power and particle exhaust solution which is compatible with high-power operations, and this solution will be validated in experiments on SPARC.
Racial disparities in colorectal cancer (CRC) can be addressed through increased adherence to screening guidelines. In real-life encounters, patients may be more willing to follow screening recommendations delivered by a race concordant clinician. The growth of telehealth to deliver care provides an opportunity to explore whether these effects translate to a virtual setting. The primary purpose of this pilot study is to explore the relationships between virtual clinician (VC) characteristics and CRC screening intentions after engagement with a telehealth intervention leveraging technology to deliver tailored CRC prevention messaging.
Methods:
Using a posttest-only design with three factors (VC race-matching, VC gender, intervention type), participants (N = 2267) were randomised to one of eight intervention treatments. Participants self-reported perceptions and behavioral intentions.
Results:
The benefits of matching participants with a racially similar VC trended positive but did not reach statistical significance. Specifically, race-matching positively influenced screening intentions for Black participants but not for Whites (b = 0.29, p = 0.10). Importantly, perceptions of credibility, attractiveness, and message relevance significantly influenced screening intentions and the relationship with race-matching.
Conclusions:
To reduce racial CRC screening disparities, investments are needed to identify patient-focused interventions to address structural barriers to screening. This study suggests that telehealth interventions that match Black patients with a Black VC can enhance perceptions of credibility and message relevance, which may then improve screening intentions. Future research is needed to examine how to increase VC credibility and attractiveness, as well as message relevance without race-matching.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
Aims
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Method
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Results
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
Conclusions
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
The Southern dietary pattern, derived within the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, is characterised by high consumption of added fats, fried food, organ meats, processed meats and sugar-sweetened beverages and is associated with increased risk of several chronic diseases. The aim of the present study was to identify characteristics of individuals with high adherence to this dietary pattern. We analysed data from REGARDS, a national cohort of 30 239 black and white adults ≥45 years of age living in the USA. Dietary data were collected using the Block 98 FFQ. Multivariable linear regression was used to calculate standardised beta coefficients across all covariates for the entire sample and stratified by race and region. We included 16 781 participants with complete dietary data. Among these, 34·6 % were black, 45·6 % male, 55·2 % resided in stroke belt region and the average age was 65 years. Black race was the factor with the largest magnitude of association with the Southern dietary pattern (Δ = 0·76 sd, P < 0·0001). Large differences in Southern dietary pattern adherence were observed between black participants and white participants in the stroke belt and non-belt (stroke belt Δ = 0·75 sd, non-belt Δ = 0·77 sd). There was a high consumption of the Southern dietary pattern in the US black population, regardless of other factors, underlying our previous findings showing the substantial contribution of this dietary pattern to racial disparities in incident hypertension and stroke.
Maternal mental health during pregnancy and postpartum predicts later emotional and behavioural problems in children. Even though most perinatal mental health problems begin before pregnancy, the consequences of preconception maternal mental health for children's early emotional development have not been prospectively studied.
Methods
We used data from two prospective Australian intergenerational cohorts, with 756 women assessed repeatedly for mental health problems before pregnancy between age 13 and 29 years, and during pregnancy and at 1 year postpartum for 1231 subsequent pregnancies. Offspring infant emotional reactivity, an early indicator of differential sensitivity denoting increased risk of emotional problems under adversity, was assessed at 1 year postpartum.
Results
Thirty-seven percent of infants born to mothers with persistent preconception mental health problems were categorised as high in emotional reactivity, compared to 23% born to mothers without preconception history (adjusted OR 2.1, 95% CI 1.4–3.1). Ante- and postnatal maternal depressive symptoms were similarly associated with infant emotional reactivity, but these perinatal associations reduced somewhat after adjustment for prior exposure. Causal mediation analysis further showed that 88% of the preconception risk was a direct effect, not mediated by perinatal exposure.
Conclusions
Maternal preconception mental health problems predict infant emotional reactivity, independently of maternal perinatal mental health; while associations between perinatal depressive symptoms and infant reactivity are partially explained by prior exposure. Findings suggest that processes shaping early vulnerability for later mental disorders arise well before conception. There is an emerging case for expanding developmental theories and trialling preventive interventions in the years before pregnancy.
Self-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother–infant bonding problems.
Methods
The Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3–9. VIHCS enrolment began in 2006 (when participants were aged 28–29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother–infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum.
Results
Five hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20–29) reported higher levels of perinatal depressive symptoms and mother–infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42–7.39; mother–infant bonding problems adjusted β = 7.51, 95% CI 3.09–11.92]. There was no evidence that self-harm in adolescence (ages 15–17) was associated with either perinatal outcome.
Conclusions
Self-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother–infant bonding problems.
Hypocotyl callus cultures were established from six tomato (Lycopersicon esculentum L.) cultivars that exhibited differential tolerance to preemergence and postemergence metribuzin [4-amino-6-tert-butyl-3-(methylthio)-as-triazin-5(4H)-one] at 0.5 kg ai/ha in the greenhouse. Metribuzin in a low sucrose growth medium inhibited callus growth, but calli were not highly sensitive to the herbicide Differences between cultivars in the response of calli to 50 ppm metribuzin were observed. The degree of tolerance of tomato cultivars to postemergence metribuzin at 0.5 kg/ha was similar to the degree of tolerance of their hypocotyl calli to 50 ppm metribuzin in the growth medium.
Gaia's Radial Velocity Spectrometer (RVS) has been operating in routine phase for over one year since initial commissioning. RVS continues to work well but the higher than expected levels of straylight reduce the limiting magnitude. The end-of-mission radial-velocity (RV) performance requirement for G2V stars was 15 km s−1 at V = 16.5 mag. Instead, 15 km s−1 precision is achieved at 15 < V < 16 mag, consistent with simulations that predict a loss of 1.4 mag. Simulations also suggest that changes to Gaia's onboard software could recover ~0.14 mag of this loss. Consequently Gaia's onboard software was upgraded in April 2015. The status of this new commissioning period is presented, as well as the latest scientific performance of the on-ground processing of RVS spectra. We illustrate the implications of the RVS limiting magnitude on Gaia's view of the Milky Way's halo in 6D using the Gaia Universe Model Snapshot (GUMS).
There is currently little information on the genetic epidemiology of Alzheimer disease (AD) among North American Aboriginal populations. No cases of familialAD (FAD) in these populations have been published to date.
Methods:
Here, we describe a large North American Aboriginal kindred with early onset FAD (EOFAD) in which genetic testing was done.
Results and Conclusions:
A novel Presenilin 1 (PS1) gene mutation (L250F) has been identified. In contrast to the three previously reported families with PS1 codon 250 mutations, affected members of this kindred demonstrate neither myoclonus nor seizures. Furthermore, the identification of a PS1 mutation in a North American Aboriginal kindred presents several unique challenges with respect to knowledge transfer and continuity of care in a geographically remote and culturally distinct community.
In this paper we calculate and compare diagnosis and net premium rates for critical illness insurance using different models for the claim delay distribution (CDD). The choice of CDD affects the diagnosis rates and hence the net premium rates in two ways: through the estimation of missing dates of diagnosis and through the adjustment of the exposure to allow for claims diagnosed but not settled in the observation period. We consider two CDDs: a three-parameter Burr distribution and a lognormal distribution. Our conclusion, based on a single, but extensive, data set, is that net premium rates are not significantly affected by the choice of CDD.
In 2006, the National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN) Vascular Cognitive Impairment Harmonization Standards recommended a 5-Minute Protocol as a brief screening instrument for vascular cognitive impairment (VCI). We report demographically adjusted norms for the 5-Minute Protocol and its relation to other measures of cognitive function and cerebrovascular risk factors. We performed a cross-sectional analysis of 7199 stroke-free adults in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study on the NINDS-CSN 5-Minute Protocol score. Total scores on the 5-Minute Protocol were inversely correlated with age and positively correlated with years of education, and performance on the Six-Item Screener, Word List Learning, and Animal Fluency (all p-values <.001). Higher cerebrovascular risk on the Framingham Stroke Risk Profile (FSRP) was associated with lower total 5-Minute Protocol scores (p <.001). The 5-Minute Protocol also differentiated between participants with and without confirmed stroke and with and without stroke symptom histories (p <.001). The NINDS-CSN 5-Minute Protocol is a brief, easily administered screening measure that is sensitive to cerebrovascular risk and offers a valid method of screening for cognitive impairment in populations at risk for VCI. (JINS, 2014, 20, 1–12)
Nano- and micron-sized metal particles have important applications in catalysis and in the medical and electronic industries. For applications requiring high conductivity, such as thick film conductive pastes or isotropic conductive adhesives, AgCu particles combine high conductivity with advantages of lower costs. Here, we report the generation of AgCu particles by spray pyrolysis, a process that has the advantages of simple experimental setup, large-scale production ability, and controllable particle size. Solutions of copper nitrate and silver nitrate dissolved in deionized water with either 40 vol% ethanol (ET) or 40 vol% ethylene glycol (EG) were used as the precursor. Phase separation was observed during the generation of AgCu particles, and the particles were mainly Ag-rich and Cu-rich solid solutions. The short reactor residence time experiments indicated that both the cosolvent properties and operating conditions affect the particle formation process and change the structure of particles.
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
Design
Longitudinal study.
Setting
Information about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
Subjects
Infants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
Results
Daily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
Conclusions
Most of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
A cosolvent spray pyrolysis process was used for the generation of micrometer-sized pure copper particles. Ethylene glycol (EG) and ethanol (ET) were selected as cosolvents, and their effects on particle morphology and composition were systematically investigated. Experimental results showed that oxide-free copper particles could be generated at temperatures greater than 400 °C with either cosolvent. Hollow particles with cracks were generated with ET at temperatures from 400 to 1000 °C, whereas EG promoted the formation of porous particles at temperatures up to 600 °C and hollow shell particles with smooth surfaces at 875 and 1000 °C. Results from short residence time experiments indicated that, during the generation process, lamellar and fragment-like copper hydroxy nitrate [Cu2(OH)3NO3] precipitated when EG and ET were used respectively. Cu2(OH)3NO3 then decomposed to cupric oxide (CuO) and cuprous oxide (Cu2O). Finally the oxides were reduced to copper (Cu) in the reducing atmosphere created by EG and ET.
The first matings of males resulted in the transfer of large spermatophores, while subsequent matings resulted in smaller and eventually no spermatophore. The transfer of a spermatophore was not required to produce a normal number of fertile eggs. Some young males inseminated two females within 24 hours and regardless of whether or not a spermatophore was formed the number of resulting progeny was normal. Thus males were found to be capable of inseminating more females than the yield of spermatophores obtained by dissecting females indicated.
Virgin females increased in attractiveness with age at least until their fifth day.