To send 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 sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.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 sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent 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.
Feed represents a substantial proportion of production costs in the dairy industry and is a useful target for improving overall system efficiency and sustainability. The objective of this study was to develop methodology to estimate the economic value for a feed efficiency trait and the associated methane production relevant to Canada. The approach quantifies the level of economic savings achieved by selecting animals that convert consumed feed into product while minimizing the feed energy used for inefficient metabolism, maintenance and digestion. We define a selection criterion trait called Feed Performance (FP) as a 1 kg increase in more efficiently used feed in a first parity lactating cow. The impact of a change in this trait on the total lifetime value of more efficiently used feed via correlated selection responses in other life stages is then quantified. The resulting improved conversion of feed was also applied to determine the resulting reduction in output of emissions (and their relative value based on a national emissions value) under an assumption of constant methane yield, where methane yield is defined as kg methane/kg dry matter intake (DMI). Overall, increasing the FP estimated breeding value by one unit (i.e. 1 kg of more efficiently converted DMI during the cow’s first lactation) translates to a total lifetime saving of 3.23 kg in DMI and 0.055 kg in methane with the economic values of CAD $0.82 and CAD $0.07, respectively. Therefore, the estimated total economic value for FP is CAD $0.89/unit. The proposed model is robust and could also be applied to determine the economic value for feed efficiency traits within a selection index in other production systems and countries.
Buddhist and Hindu discourse often juxtapose statements about the inexpressibility of ultimate reality with descriptions drawing on metaphor and paradox. This raises the question of how particular types of metaphor fulfill the role of expressing what is believed to be inexpressible. The current study employs a cognitive linguistic framework to examine how modern Buddhist and Hindu religious teachers use metaphor to talk about enlightenment. Adopting a usage-based approach focusing on how figurative language is recontexualized by the same speaker within a stretch of discourse, the study identifies a recurrent pattern within the discourse on enlightenment that consists of four elements. The first is source domain reversal, which we define as a speaker making use of a particular source domain to refer to a target, and then later, in the same discourse segment, using a source domain with a seemingly opposite meaning to refer to the same target. The other three involve a movement from force to object-based schemas, from the perceived revelation of more conventional to deeper truths, and from description of a process to description of a state. We conclude by briefly discussing our findings within the context of research on apophatic discourse in other religions.
We evaluated the impact of an electronic health record based 72-hour antimicrobial time-out (ATO) on antimicrobial utilization. We observed that 6 hours after the ATO, 21% of empiric antimicrobials were discontinued or de-escalated. There was a significant reduction in the duration of antimicrobial therapy but no impact on overall antimicrobial usage metrics.
Following publication, errors were discovered in the y-axis labels of the electron and hole concentration plots in the following figure panels: figure 4c, figure 4d, figure 5c, figure 5d, figure 6c, figure 6d, figure 8c and figure 8d. The error does not affect the description, analysis or conclusions. The correct representation of the figure panels are shown here.
Introduction: Although use of point of care ultrasound (PoCUS) protocols for patients with undifferentiated hypotension in the Emergency Department (ED) is widespread, our previously reported SHoC-ED study showed no clear survival or length of stay benefit for patients assessed with PoCUS. In this analysis, we examine if the use of PoCUS changed fluid administration and rates of other emergency interventions between patients with different shock types. The primary comparison was between cardiogenic and non-cardiogenic shock types. Methods: A post-hoc analysis was completed on the database from an RCT of 273 patients who presented to the ED with undifferentiated hypotension (SBP <100 or shock index > 1) and who had been randomized to receive standard care with or without PoCUS in 6 centres in Canada and South Africa. PoCUS-trained physicians performed scans after initial assessment. Shock categories and diagnoses recorded at 60 minutes after ED presentation, were used to allocate patients into subcategories of shock for analysis of treatment. We analyzed actual care delivered including initial IV fluid bolus volumes (mL), rates of inotrope use and major procedures. Standard statistical tests were employed. Sample size was powered at 0.80 (α:0.05) for a moderate difference. Results: Although there were expected differences in the mean fluid bolus volume between patients with non-cardiogenic and cardiogenic shock, there was no difference in fluid bolus volume between the control and PoCUS groups (non-cardiogenic control 1878 mL (95% CI 1550 – 2206 mL) vs. non-cardiogenic PoCUS 1687 mL (1458 – 1916 mL); and cardiogenic control 768 mL (194 – 1341 mL) vs. cardiogenic PoCUS 981 mL (341 – 1620 mL). Likewise there were no differences in rates of inotrope administration, or major procedures for any of the subcategories of shock between the control group and PoCUS group patients. The most common subcategory of shock was distributive. Conclusion: Despite differences in care delivered by subcategory of shock, we did not find any significant difference in actual care delivered between patients who were examined using PoCUS and those who were not. This may help to explain the previously reported lack of outcome difference between groups.
Introduction: Point of care ultrasound has been reported to improve diagnosis in non-traumatic hypotensive ED patients. We compared diagnostic performance of physicians with and without PoCUS in undifferentiated hypotensive patients as part of an international prospective randomized controlled study. The primary outcome was diagnostic performance of PoCUS for cardiogenic vs. non-cardiogenic shock. Methods: SHoC-ED recruited hypotensive patients (SBP < 100 mmHg or shock index > 1) in 6 centres in Canada and South Africa. We describe previously unreported secondary outcomes relating to diagnostic accuracy. Patients were randomized to standard clinical assessment (No PoCUS) or PoCUS groups. PoCUS-trained physicians performed scans after initial assessment. Demographics, clinical details and findings were collected prospectively. Initial and secondary diagnoses including shock category were recorded at 0 and 60 minutes. Final diagnosis was determined by independent blinded chart review. Standard statistical tests were employed. Sample size was powered at 0.80 (α:0.05) for a moderate difference. Results: 273 patients were enrolled with follow-up for primary outcome completed for 270. Baseline demographics and perceived category of shock were similar between groups. 11% of patients were determined to have cardiogenic shock. PoCUS had a sensitivity of 80.0% (95% CI 54.8 to 93.0%), specificity 95.5% (90.0 to 98.1%), LR+ve 17.9 (7.34 to 43.8), LR-ve 0.21 (0.08 to 0.58), Diagnostic OR 85.6 (18.2 to 403.6) and accuracy 93.7% (88.0 to 97.2%) for cardiogenic shock. Standard assessment without PoCUS had a sensitivity of 91.7% (64.6 to 98.5%), specificity 93.8% (87.8 to 97.0%), LR+ve 14.8 (7.1 to 30.9), LR- of 0.09 (0.01 to 0.58), Diagnostic OR 166.6 (18.7 to 1481) and accuracy of 93.6% (87.8 to 97.2%). There was no significant difference in sensitivity (-11.7% (-37.8 to 18.3%)) or specificity (1.73% (-4.67 to 8.29%)). Diagnostic performance was also similar between other shock subcategories. Conclusion: As reported in other studies, PoCUS based assessment performed well diagnostically in undifferentiated hypotensive patients, especially as a rule-in test. However performance was similar to standard (non-PoCUS) assessment, which was excellent in this study.
Englerophytum and Synsepalum are two closely related genera of trees and shrubs from the African tropics. Previous molecular studies have shown that these genera collectively form a clade within the subfamily Chrysophylloideae (Sapotaceae). However, little is known about the inter-relationships of the taxa within the Englerophytum–Synsepalum clade. In this study, nuclear ribosomal DNA and plastid trnH–psbA sequences were used to estimate the phylogeny within the clade. Results indicate that the clade consists of six major lineages, two composed solely of taxa from the genus Englerophytum and four composed of taxa from the genus Synsepalum. Each lineage can be distinguished by suites of vegetative and floral characters. Leaf venation patterns, calyx fusion, style length and staminodal structure were among the most useful characters for distinguishing clades. Some of the subclades within the Englerophytum–Synsepalum clade were also found to closely fit descriptions of former genera, most of which were described by Aubréville, that have since been placed in synonymy with Englerophytum and Synsepalum. The clade with the type species of Englerophytum also contains the type species of the genera Wildemaniodoxa and Zeyherella, which are confirmed as synonyms.
We have been using the technique of pulsed neutron powder diffraction to study several problems in the physics and chemistry of the actinide elements. In these elements one often encounters very complex structures resulting from polymorphic transformations presumably induced by the presence of 5f-electrons. For exampie, at least five distinct structures of plutonium metal are found between room temperature and its melting point of 640°C, and two of the structures are monoclinic! Single crystals are usually not available, and the high resolution which is intrinsic to the time-of-flight powder technique is a powerful tool in the solution of complex structural problems. The relatively low absorption coefficients for neutrons for at least some actinide isotopes is an advantage when surface oxidation is a problem (as in high-temperature experiments) and provides good particle statistics so that high-quality data are available for Rietveld refinement. The low absorption of neutrons by other materials such as vanadium and fused silica enables the use of these materials for the containment of samples in high- and low-temperature environments, and the fixed geometry of the time-of-flight technique simplifies the design of furnaces and cryostats.
Pulsed neutron powder diffraction studies at IPNS have expanded our understanding of the phases present in Integral Fast Reactor (IFR) metal fuel alloys at temperatures in the range of reactor operating conditions. We report results from the binary alloy (U-10wt.%Zr) and ternary alloys (U-8%Pu-10%Zr) and (U-19%Pu-10%Zr). Determining the role and the location of Zr and Pu in these alloys is considered of fundamental importance for maximizing engineering efficiency.
Rietveld profile analysis was utilized to study the phase diagrams. Data were collected at temperatures ranging from 25-650°C. Although the expected U/Pu/Zr phases (α-U, β-U, γ-U, δ-U/Zr/Pu, ζ-U/Pu) were observed in appropriate temperature ranges, there were some unexpected results. Relative amounts of all phases at each temperature were calculated from Rietveld scale factors and inferences were made as to the location of zirconium and plutonium, i.e. amounts in each phase, from site occupancies and absorption characteristics of the phases present. Finally, we were able to identify ZrO and ZrO1-x inclusion phases in the U-Zr alloy present in very small (0.5-1.0%) amounts.
We have determined the strain and particle size for several samples of palladium powder by time-of-flight nrutron powder diffraction on two different diffractometers and by x-ray powder diffraction. The results are compared and found to be in fair agreement. The time-of-flight method gives good enough precision to reveal deficiencies in the simple models used for strain and particle size line broadening.
Diagnosing delirium superimposed on dementia (DSD) remains challenging because of a lack of specific tools, though motor dysfunction in delirium has been relatively under-explored. This study aimed to use dysfunction in balance and mobility (with the Hierarchical Assessment of Balance And Mobility: HABAM) to identify DSD. This is a cross-sectional multicenter study, recruiting consecutive patients ≥70 years admitted to five acute or rehabilitation hospitals in Ireland, Italy, Portugal, and Switzerland. Delirium was diagnosed using DSM-5 criteria; dementia was determined by the Mini-Mental State Examination and the Questionnaire of Cognitive Decline in the Elderly. HABAM score was recorded at admission. Out of 114 patients (mean age ± SD = 82 ± 7; 54% female), dementia alone was present in 24.6% (n = 28), delirium alone in 18.4% (n = 21) and DSD in 27.2% (n = 31). Patients with DSD had a mean HABAM score 7 points greater than those with dementia alone (19.8 ± 8.7 vs 12.5 ± 9.5; p < 0.001); 70% of participants with DSD were correctly identified using the HABAM at a cut off of 22 (sensitivity 61%, specificity 79%, AUC = 0.76). Individuals with delirium have worse motor function than those without delirium, even in the context of comorbid dementia. Measuring motor function using the HABAM in older people at admission may help to diagnose DSD.
Ion flow in charged nanopores is strongly influenced by the ratio of the Debye length to the pore radius. We investigate the asymptotic behaviour of solutions to the Poisson–Nernst–Planck (PNP) system in narrow pore like geometries and study the influence of the pore geometry and surface charge on ion transport. The physical properties of real pores motivate the investigation of distinguished asymptotic limits, in which either the Debye length and pore radius are comparable or the pore length is very much greater than its radius This results in a quasi-one-dimensional (1D) PNP model, which can be further simplified, in the physically relevant limit of strong pore wall surface charge, to a fully 1D model. Favourable comparison is made to the two-dimensional (2D) PNP equations in typical pore geometries. It is also shown that, for physically realistic parameters, the standard 1D area averaged PNP model for ion flow through a pore is a very poor approximation to the (real) 2D solution to the PNP equations. This leads us to propose that the quasi-1D PNP model derived here, whose computational cost is significantly less than 2D solution of the PNP equations, should replace the use of the 1D area averaged PNP equations as a tool to investigate ion and current flows in ion pores.
Following a cluster of serious pseudomonas skin infections linked to a body piercing and tattooing premises, a look-back exercise was carried out to offer clients a screen for blood-borne viruses. Of those attending for screening 72% (581/809) had a piercing procedure in the premises of interest: 94 (16%) were under 16 years of age at the time of screening. The most common site of piercing was ear (34%), followed by nose (27%), nipple (21%) and navel (21%). A small number (<5) tested positive for hepatitis B and C, with no evidence this was linked to the premises. However, 36% (211/581) of clients reported a skin infection associated with their piercing. Using data from client forms, 36% provided a false age. Those aged under 16 years (OR 4.5, 95% CI 2.7–7.7) and those receiving a piercing at an intimate site (OR 2.1, 95% CI 1.3–3.6) were more likely to provide a false age. The findings from this exercise were used to support the drafting of the Public Health (Wales) Bill which proposed better regulation of piercing premises and the need to provide proof of being 18 years of age or over before having a piercing of an intimate site.
Increasing evidence suggests that the presence of mobile ions in perovskite solar cells (PSCs) can cause a current–voltage curve hysteresis. Steady state and transient current–voltage characteristics of a planar metal halide CH3NH3PbI3 PSC are analysed with a drift-diffusion model that accounts for both charge transport and ion vacancy motion. The high ion vacancy density within the perovskite layer gives rise to narrow Debye layers (typical width ~2 nm), adjacent to the interfaces with the transport layers, over which large drops in the electric potential occur and in which significant charge is stored. Large disparities between (I) the width of the Debye layers and that of the perovskite layer (~600 nm) and (II) the ion vacancy density and the charge carrier densities motivate an asymptotic approach to solving the model, while the stiffness of the equations renders standard solution methods unreliable. We derive a simplified surface polarisation model in which the slow ion dynamics are replaced by interfacial (non-linear) capacitances at the perovskite interfaces. Favourable comparison is made between the results of the asymptotic approach and numerical solutions for a realistic cell over a wide range of operating conditions of practical interest.
To investigate the association of policy, systems and environmental factors with improvement in household food security among low-income Indiana households with children after a Supplemental Nutrition Assistance Program-Education (SNAP-Ed) direct nutrition education intervention.
Household food security scores measured by the eighteen-item US Household Food Security Survey Module in a longitudinal randomized and controlled SNAP-Ed intervention study conducted from August 2013 to April 2015 were the response variable. Metrics to quantify environmental factors including classification of urban or rural county status; the number of SNAP-authorized stores, food pantries and recreational facilities; average fair market housing rental price; and natural amenity rank were collected from government websites and data sets covering the years 2012–2016 and used as covariates in mixed multiple linear regression modelling.
Thirty-seven Indiana counties, USA, 2012–2016.
SNAP-Ed eligible adults from households with children (n 328).
None of the environmental factors investigated were significantly associated with changes in household food security in this exploratory study.
SNAP-Ed improves food security regardless of urban or rural location or the environmental factors investigated. Expansion of SNAP-Ed in rural areas may support food access among the low-income population and reduce the prevalence of food insecurity in rural compared with urban areas. Further investigation into policy, systems and environmental factors of the Social Ecological Model are warranted to better understand their relationship with direct SNAP-Ed and their impact on diet-related behaviours and food security.
Previous studies have demonstrated that including fish oil (FO) in the diet of beef cattle resulted in increased long chain C20n -3 PUFA (20:5n -3 and 22:6n -3) in muscle resulting in a lower n -6:n -3 ratio (Scollan et al., 2001). However, it may result in negative effects on colour shelf life and organoleptic properties (Vatansever et al., 2000). Fish oil is also a good inhibitor of biohydrogenation in the rumen, resulting in increased production of 18:1trans (TVA), the precursor for conjugated linoleic acid (CLA cis -9, trans -11) in muscle. This study investigated the effects of incremental levels of fish oil in the diet on the fatty acid composition of the m. longissimus dorsi and meat quality.
Nutritional recommendations to improve the human diet are to increase the P:S ratio and to decrease the n-6:n-3 ratio of food (Department of Health 1994). However, increasing the degree of unsaturation of meat lipids may alter the flavour of the cooked meat and can increase its susceptibility to oxidative changes such as lipid rancidity and colour deterioration. We have studied these quality aspects in meat from three breeds of lambs fed different fats.
Seventy two entire ram lambs of three genotypes were used in a 3x4 factorial design: Suffolk x Lleyn, Frieslands x Lleyn and Soay lambs were fed diets, for an average of 80 days, containing one of four fats at 50g/kg supplemented with 200 IU/kg vitamin E: 1, control, 2, linseed, 3, fish oil and 4, fish oil plus linseed (50:50). Sensory assessment was performed on loin chops grilled to an internal temperature of 74°C which were rated using 100mm unstructured line scales. For colour and lipid oxidation measurements, 10mm thick leg steaks were aged for 10 days in vacuum at 1°C then repacked in modified atmosphere (O2:CO2,75:25) and displayed under light at 4°C for 6 days.