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.
A ceftriaxone safety alert prompted a review of rapid response and cardiac arrest events in relation to the timing of intravenous cephalosporin administrations across a large health system. Despite high utilization, we found a low rate of significant ceftriaxone-related adverse events with a similar incidence as other intravenous cephalosporins.
Parasite species interactions, host biology traits, and external environmental factors can drive co-occurrence patterns between parasite species. We investigated co-occurrence patterns between three ectoparasite species (mite (Neotrombicula harperi), and fleas (Orchopeas caedens and Ceratophyllus vison)) of North American red squirrels (Tamiasciurus hudsonicus). We evaluated (1) whether ectoparasites of red squirrels exhibit non-random co-occurrence patterns, and (2) the contribution of host and external environmental factors to parasite co-occurrence. Bayesian ordination and regression analysis (boral) revealed random associations between parasite species pairs when accounting for host and external environmental factors. However, the mite N. harperi exhibited a negative association with the flea O. caedens and positive association with the flea C. vison linked to temporal patterns of occurrence. Our data suggests that parasites of the investigated population of red squirrels tend to form associations based on temporal trends in infestation rather than species interactions. Further experimentation should investigate the role of additional factors on parasite co-occurrence patterns, such as temperature, precipitation, and humidity.
We recently reported on the radio-frequency attenuation length of cold polar ice at Summit Station, Greenland, based on bi-static radar measurements of radio-frequency bedrock echo strengths taken during the summer of 2021. Those data also allow studies of (a) the relative contributions of coherent (such as discrete internal conducting layers with sub-centimeter transverse scale) vs incoherent (e.g. bulk volumetric) scattering, (b) the magnitude of internal layer reflection coefficients, (c) limits on signal propagation velocity asymmetries (‘birefringence’) and (d) limits on signal dispersion in-ice over a bandwidth of ~100 MHz. We find that (1) attenuation lengths approach 1 km in our band, (2) after averaging 10 000 echo triggers, reflected signals observable over the thermal floor (to depths of ~1500 m) are consistent with being entirely coherent, (3) internal layer reflectivities are ≈–60$\to$–70 dB, (4) birefringent effects for vertically propagating signals are smaller by an order of magnitude relative to South Pole and (5) within our experimental limits, glacial ice is non-dispersive over the frequency band relevant for neutrino detection experiments.
The annual bluegrass weevil (ABW) is a pest of fine turfgrass, but recent research has found that withholding insecticides for ABW control can reduce annual bluegrass cover. The objective of this research was to evaluate threshold-based insecticide and paclobutrazol programs for annual bluegrass control. The effect of three insecticide programs (preventive, threshold, and no insecticide) and four rates of paclobutrazol (0, 70, 105, or 210 g ha−1 applied monthly) were evaluated. Replicate experiments were conducted from April to November in both 2018 and 2019 on a mixed creeping bentgrass and annual bluegrass fairway in North Brunswick, NJ. By the conclusion of both experiments, all paclobutrazol programs exhibited reduced annual bluegrass cover compared with the nontreated plots. In threshold and no-insecticide programs, reduction in annual bluegrass cover was enhanced by paclobutrazol applied at 105 g ha−1 in both years, and at 70 g ha−1 in the 2019 experiment. Paclobutrazol at 210 g ha−1 resulted in annual bluegrass cover of <20% regardless of insecticide program. In 2019, threshold-based ABW control without paclobutrazol provided similar annual bluegrass control as monthly applications of paclobutrazol at 70 and 105 g ha−1 with the preventive insecticide program. A reduction in turfgrass quality from threshold-based insecticide programs persisted for a shorter duration than the no-insecticide program, regardless of paclobutrazol treatment. Threshold-based ABW insecticide programs that allow ABW feeding damage to occur can result in reduced annual bluegrass cover. These reductions were further enhanced by paclobutrazol applications. The combination of threshold-level insecticide with moderate rates of paclobutrazol (70 to 105 g ha−1) provided reductions in annual bluegrass cover that were similar to the highest rate of paclobutrazol (210 g ha−1) without ABW damage. Turfgrass managers who integrate the threshold-level insecticide approach and monthly paclobutrazol applications may achieve greater annual bluegrass control than either strategy alone if temporary reductions in turf quality can be tolerated.
Background: Poorly-defined cases (PDCs) of focal epilepsy are cases with no/subtle MRI abnormalities or have abnormalities extending beyond the lesion visible on MRI. Here, we evaluated the utility of Arterial Spin Labeling (ASL) MRI perfusion in PDCs of pediatric focal epilepsy. Methods: ASL MRI was obtained in 25 consecutive children presenting with poorly-defined focal epilepsy (20 MRI- positive, 5 MRI-negative). Qualitative visual inspection and quantitative analysis with asymmetry and Z-score maps were used to detect perfusion abnormalities. ASL results were compared to the hypothesized epileptogenic zone (EZ) derived from other clinical/imaging data and the resection zone in patients with Engel I/II outcome and >18 month follow-up. Results: Qualitative analysis revealed perfusion abnormalities in 17/25 total cases (68%), 17/20 MRI-positive cases (85%) and none of the MRI-negative cases. Quantitative analysis confirmed all cases with abnormalities on qualitative analysis, but found 1 additional true-positive and 4 false-positives. Concordance with the surgically-proven EZ was found in 10/11 cases qualitatively (sensitivity=91%, specificity=50%), and 11/11 cases quantitatively (sensitivity=100%, specificity=23%). Conclusions: ASL perfusion may support the hypothesized EZ, but has limited localization benefit in MRI-negative cases. Nevertheless, owing to its non-invasiveness and ease of acquisition, ASL could be a useful addition to the pre-surgical MRI evaluation of pediatric focal epilepsy.
Environmental sociology studies societal–environmental relations and interactions. With emphasis given to the inseparability of humanity and nature, this chapter adopts an interdisciplinary approach to environmental sociology in order to link environmental philosophy with nature-based tourism. Environmental philosophy studies philosophical issues pertaining to the human–nature relationship, yet few studies address environmental philosophy in relation to tourism. Here we argue that the application of environmental philosophy to nature-based tourism offers potential insights that are important to the interests of environmental sociologists. Using a theoretical framework of environmental philosophy, we carefully explore how the development of mainland ecosanctuaries in New Zealand is linked with theories of environmental ethics, aesthetics and metaphysics. Under the umbrella of environmental sociology, our analysis identifies challenges and opportunities related to how nature-based tourism operators communicate their environmental understandings and conservation practices to tourists shaped by distinct social norms and value systems. It is argued that the ecocentrism-based environmental philosophy and ecological restoration of mainland ecosanctuaries in New Zealand pose a great challenge to the experiences and interests of international tourists from a wide range of diverse social and environmental ‘home’ contexts.
The transgenic Liberty Link® (LL) soybean is tolerant to glufosinate, conferred by the enzyme phosphinothricin acetyltransferase (PAT), which is encoded by the pat gene from Streptomyces viridochromogenes. Because symptoms of injury can be observed in soybean [Glycine max (L.) Merr.] plants in some situations, this study evaluated the effects of rates of glufosinate on agronomic performance; quality of LL soybean seeds; and the ammonia, glufosinate, and N-acetyl-l-glufosinate concentration (NAG) in soybeans with and without the pat gene after application of increasing glufosinate rates. Field and greenhouse experiments were conducted; the first evaluated the selectivity of glufosinate in LL soybeans, and the second evaluated the metabolic changes in soybeans with (LL) and without (RR2) the pat gene, after application of glufosinate. For fieldwork, application of glufosinate at rates up to four times the maximum recommended caused initial injury symptoms (up to 38.5%) in LL soybean plants. However, no negative effect was found on seed quality and agronomic performance of LL plants, including yield. This shows the selectivity of glufosinate promoted by pat gene insertion for application in POST (V4), in LL soybean. For the greenhouse experiment, it was concluded that the LL soybean plants presented high glufosinate metabolism, lower ammonia concentration, and no reduction in dry matter, in comparison with RR2 soybean, after application of high rates of glufosinate.
Antarctica's ice shelves modulate the grounded ice flow, and weakening of ice shelves due to climate forcing will decrease their ‘buttressing’ effect, causing a response in the grounded ice. While the processes governing ice-shelf weakening are complex, uncertainties in the response of the grounded ice sheet are also difficult to assess. The Antarctic BUttressing Model Intercomparison Project (ABUMIP) compares ice-sheet model responses to decrease in buttressing by investigating the ‘end-member’ scenario of total and sustained loss of ice shelves. Although unrealistic, this scenario enables gauging the sensitivity of an ensemble of 15 ice-sheet models to a total loss of buttressing, hence exhibiting the full potential of marine ice-sheet instability. All models predict that this scenario leads to multi-metre (1–12 m) sea-level rise over 500 years from present day. West Antarctic ice sheet collapse alone leads to a 1.91–5.08 m sea-level rise due to the marine ice-sheet instability. Mass loss rates are a strong function of the sliding/friction law, with plastic laws cause a further destabilization of the Aurora and Wilkes Subglacial Basins, East Antarctica. Improvements to marine ice-sheet models have greatly reduced variability between modelled ice-sheet responses to extreme ice-shelf loss, e.g. compared to the SeaRISE assessments.
To explore tolerability, safety and treatment response of flexible doses of paliperidone ER in adult non-acute patients with schizophrenia previously unsuccessfully treated with oral antipsychotics.
Methods
International prospective 6-month open-label study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity Scale (CGI-S), patient satisfaction, adverse events (AEs), extrapyramidal symptoms (Extrapyramidal Symptom Rating Scale; ESRS) and weight change.
Results
1812 patients were included (59.9% male, mean age 40.1±12.6 years, 75.8% paranoid schizophrenia); most were enrolled because of lack of efficacy (n=1026) or lack of tolerability (n=490) with prior antipsychotic treatment. The median mode dose of paliperidone ER was 6 mg/day. 70.7% of patients completed the 6-month study. Most frequent reasons for early discontinuation were patient choice (8.8%), lack of efficacy or adverse event (5.1% each) independent of the reason for switching. Mean total PANSS decreased significantly from 79.4±20.4 at baseline to 66.1±21.5 at endpoint (mean change -13.3±19.7; 95% confidence interval -14.2;-12.3, p< 0.0001). The percentage of patients rated mildly ill or less in CGI-S increased from 27.0% to 52.2% at endpoint, and the rate of patients with mild functional impairment increased from 15.8% to 34.9%. AEs reported in greater-than-or-equal-to 5% of patients were insomnia (9.2%) and anxiety (7.2%). Extrapyramidal symptoms in ESRS decreased significantly from 3.5±5.8 to 2.1±4.6 (p< 0.0001). Mean weight gain from baseline to endpoint was 0.3±4.8kg.
Conclusion
These data support results from recent randomized controlled studies that paliperidone ER is safe, well tolerated and effective in patients previously unsuccessfully treated with other oral antipsychotics.
Background: Focal cortical dysplasias (FCDs) are congenital structural abnormalities of the brain, and represent the most common cause of medication-resistant focal epilepsy in children and adults. Recent studies have shown that somatic mutations (i.e. mutations arising in the embryo) in mTOR pathway genes underlie some FCD cases. Specific therapies targeting the mTOR pathway are available. However, testing for somatic mTOR pathway mutations in FCD tissue is not performed on a clinical basis, and the contribution of such mutations to the pathogenesis of FCD remains unknown. Aim: To investigate the feasibility of screening for somatic mutations in resected FCD tissue and determine the proportion and spatial distribution of FCDs which are due to low-level somatic mTOR pathway mutations. Methods: We performed ultra-deep sequencing of 13 mTOR pathway genes using a custom HaloPlexHS target enrichment kit (Agilent Technologies) in 16 resected histologically-confirmed FCD specimens. Results: We identified causal variants in 62.5% (10/16) of patients at an alternate allele frequency of 0.75–33.7%. The spatial mutation frequency correlated with the FCD lesion’s size and severity. Conclusions: Screening FCD tissue using a custom panel results in a high yield, and should be considered clinically given the important potential implications regarding surgical resection, medical management and genetic counselling.
Activity of brown and beige adipocytes could contribute to breed differences in fat deposition. Therefore, we compared the abundance of markers for adipocyte types in steers from three cattle breeds differing in fat deposition (Japanese Black, Holstein, Charolais). Markers for white (leptin (LEP)), beige (transmembrane protein 26 (TMEM26), uncoupling protein 1 (UCP1)), and brown adipocytes (Zic family member 1 (ZIC1), UCP1) were analysed by quantitative reverse transcription PCR in subcutaneous fat (SCF), intramuscular fat (IMF), intermuscular fat (IRMF), perirenal fat (PF) and visceral fat (VF). LEP messenger RNA (mRNA) was less abundant in VF compared with other depots (P<0.05). TMEM26 was weakly but evenly expressed in all depots in all animals, whereas UCP1 mRNA showed higher individual variation in some depots. ZIC1 was not detectable in VF and PF but abundant in SCF, IMF and even more abundant in IRMF (P<0.05). No significant breed differences were detected. Using antibodies against UCP1, TMEM26 and ZIC1, we demonstrated that fat depots of 26-month-old cattle still comprise different adipocyte types. However, our results did not support the hypothesis that higher energy expenditure associated with higher abundance or activity of beige or brown adipocytes contributed to differences in fat deposition.
Among several potential animal models that can be used for adipogenic studies, Wagyu cattle is the one that presents unique molecular mechanisms underlying the deposit of substantial amounts of intramuscular fat. As such, this review is focused on current knowledge of such mechanisms related to adipose tissue deposition using Wagyu cattle as model. So abundant is the lipid accumulation in the skeletal muscles of these animals that in many cases, the muscle cross-sectional area appears more white (adipose tissue) than red (muscle fibers). This enhanced marbling accumulation is morphologically similar to that seen in numerous skeletal muscle dysfunctions, disease states and myopathies; this might indicate cross-similar mechanisms between such dysfunctions and fat deposition in Wagyu breed. Animal models can be used not only for a better understanding of fat deposition in livestock, but also as models to an increased comprehension on molecular mechanisms behind human conditions. This revision underlies some of the complex molecular processes of fat deposition in animals.
We assessed for vancomycin-resistant Staphylococcus aureus (VRSA) precursor organisms in southeastern Michigan, an area known to have VRSA. The prevalence was 2.5% (pSK41-positive methicillin-resistant S. aureus, 2009–2011) and 1.5% (Inc18-positive vancomycin-resistant Enterococcus, 2006–2013); Inc18 prevalence significantly decreased after 2009 (3.7% to 0.82%). Risk factors for pSK41 included intravenous vancomycin exposure.
Infect Control Hosp Epidemiol 2014;35(12):1531–1534
Obtaining valid, reliable measures of food environments that serve Latino communities is important for understanding barriers to healthy eating in this at-risk population.
Design
The primary aim of the study was to examine agreement between retail food outlet data from two commercial databases, Nielsen TDLinx (TDLinx) for food stores and Dun & Bradstreet (D&B) for food stores and restaurants, relative to field observations of food stores and restaurants in thirty-one census tracts in Durham County, NC, USA. We also examined differences by proportion of Hispanic population (</≥23·4 % Hispanic population) in the census tract and for outlets classified in the field as ‘Latino’ on the basis of signage and use of Spanish language.
Setting
One hundred and seventy-four food stores and 337 restaurants in Durham County, NC, USA.
Results
We found that overall sensitivity of food store listings in TDLinx was higher (64 %) than listings in D&B (55 %). Twenty-five food stores were characterized by auditors as Latino food stores, with 20 % identified in TDLinx, 52 % in D&B and 56 % in both sources. Overall sensitivity of restaurants (68 %) was higher than sensitivity of Latino restaurants (38 %) listed in D&B. Sensitivity did not differ substantially by Hispanic composition of neighbourhoods.
Conclusions
Our findings suggest that while TDLinx and D&B commercial data sources perform well for total food stores, they perform less well in identifying small and independent food outlets, including many Latino food stores and restaurants.
Of the 13 US vancomycin-resistant Staphylococcus aureus (VRSA) cases, 8 were identified in southeastern Michigan, primarily in patients with chronic lower-extremity wounds. VRSA infections develop when the vanA gene from vancomycin-resistant enterococcus (VRE) transfers to S. aureus. Incl8-like plasmids in VRE and pSK41-like plasmids in S. aureus appear to be important precursors to this transfer.
Objective.
Identify the prevalence of VRSA precursor organisms.
Design.
Prospective cohort with embedded case-control study.
Participants.
Southeastern Michigan adults with chronic lower-extremity wounds.
Methods.
Adults presenting to 3 southeastern Michigan medical centers during the period February 15 through March 4, 2011, with chronic lower-extremity wounds had wound, nares, and perirectal swab specimens cultured for S. aureus and VRE, which were tested for pSK41-like and Incl8-like plasmids by polymerase chain reaction. We interviewed participants and reviewed clinical records. Risk factors for pSK41-positive S. aureus were assessed among all study participants (cohort analysis) and among only S. aureus-colonized participants (case-control analysis).
Results.
Of 179 participants with wound cultures, 26% were colonized with methicillin-susceptible S. aureus, 27% were colonized with methicillin-resistant S. aureus, and 4% were colonized with VRE, although only 17% consented to perirectal culture. Six participants (3%) had pSK41-positive S. aureus, and none had Incl8-positive VRE. Having chronic wounds for over 2 years was associated with pSK41-positive S. aureus colonization in both analyses.
Conclusions.
Colonization with VRSA precursor organisms was rare. Having long-standing chronic wounds was a risk factor for pSK41-positive S. aureus colonization. Additional investigation into the prevalence of VRSA precursors among a larger cohort of patients is warranted.
Hospital readmissions are a current target of initiatives to reduce healthcare costs. This study quantified the association between having a clinical culture positive for 1 of 3 prevalent hospital-associated organisms and time to hospital readmission.
Design.
Retrospective cohort study.
Patients and Setting.
Adults admitted to an academic, tertiary care referral center from January 1, 2001, through December 31, 2008.
Methods.
The primary exposure of interest was a clinical culture positive for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), or Clostridium difficile obtained more than 48 hours after hospital admission during the index hospital stay. The primary outcome of interest was time to readmission to the index facility. Multivariable Cox proportional hazards models were used to model the adjusted association between positive clinical culture result and time to readmission and to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results.
Among 136,513 index admissions, the prevalence of hospital-associated positive clinical culture result for 1 of the 3 organisms of interest was 3%, and 35% of patients were readmitted to the index facility within 1 year after discharge. Patients with a positive clinical culture obtained more than 48 hours after hospital admission had an increased hazard of readmission (HR, 1.40; 95% CI, 1.33–1.46) after adjusting for age, sex, index admission length of stay, intensive care unit stay, Charlson comorbidity index, and year of hospital admission.
Conclusions.
Patients with healthcare-associated infections may be at increased risk of hospital readmission. These findings may be used to impact health outcomes after discharge from the hospital and to encourage better infection prevention efforts.
We evaluated the effect of a high-protein diet (HP) on pregnancy, lactational and rearing success in mice. At the time of mating, females were randomly assigned to isoenergetic diets with HP (40% w/w) or control protein levels (C; 20%). After parturition, half of the dams were fed the other diet throughout lactation resulting in four dietary groups: CC (C diet during gestation and lactation), CHP (C diet during gestation and HP diet during lactation), HPC (HP diet during gestation and C diet during lactation) and HPHP (HP diet during gestation and lactation). Maternal and offspring body mass was monitored. Measurements of maternal mammary gland (MG), kidney and abdominal fat pad masses, MG histology and MG mRNA abundance, as well as milk composition were taken at selected time points. HP diet decreased abdominal fat and increased kidney mass of lactating dams. Litter mass at birth was lower in HP than in C dams (14.8 v. 16.8 g). Dams fed an HP diet during lactation showed 5% less food intake (10.4 v. 10.9 g/day) and lower body and MG mass. On day 14 of lactation, the proportion of MG parenchyma was lower in dams fed an HP diet during gestation as compared to dams fed a C diet (64.8% v. 75.8%). Abundance of MG α-lactalbumin, β-casein, whey acidic protein, xanthine oxidoreductase mRNA at mid-lactation was decreased in all groups receiving an HP diet either during gestation and/or lactation. Milk lactose content was lower in dams fed an HP diet during lactation compared to dams fed a C diet (1.6% v. 2.0%). On days 14, 18 and 21 of lactation total litter mass was lower in litters of dams fed an HP diet during lactation, and the pups’ relative kidney mass was greater than in litters suckled by dams receiving a C diet. These findings indicate that excess protein intake in reproducing mice has adverse effects on offspring early in their postnatal growth as a consequence of impaired lactational function.