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(i) Describe the development of a multipurpose Cardio-Med survey tool (CMST) comprising a semi-quantitative FFQ designed to measure dietary intake in multicultural patients with or at high risk of CVD and (ii) report pilot evaluation of test–retest reliability and validity of the FFQ in measuring energy and nutrient intakes.
The CMST was developed to identify CVD risk factors and assess diet quality over 1 year using an FFQ. Design of the ninety-three-item FFQ involved developing food portion photographs, and a list of foods appropriate for the Australian multicultural population allowing the capture of adherence to a Mediterranean diet pattern. The FFQ was administered twice, 2 weeks apart to assess test–retest reliability, whilst validity was assessed by comparison of the FFQ with a 3-d food record (3DFR).
The Northern Hospital and St Vincent’s Hospital, Melbourne, Australia.
Thirty-eight participants aged 34–81 years with CVD or at high risk.
Test–retest reliability of the FFQ was good: intraclass correlation coefficient (ICC) ranged from 0·52 (Na) to 0·88 (alcohol) (mean 0·79), with energy and 70 % of measured nutrients being above 0·75. Validity was moderate: ICC ranged from 0·08 (Na) to 0·94 (alcohol) (mean 0·59), with energy and 85 % of measured nutrients being above 0·5. Bland–Altman plots demonstrated good levels of agreement between the FFQ and 3DFR for carbohydrates, protein, alcohol, vitamin D and Na.
The CMST FFQ demonstrated good test–retest reliability and moderate validity for measuring dietary energy and nutrients in a multicultural Australian cardiology population.
Dialysis patients may not have access to conventional renal replacement therapy (RRT) following disasters. We hypothesized that improvised renal replacement therapy (ImpRRT) would be comparable to continuous renal replacement therapy (CRRT) in a porcine acute kidney injury model.
Following bilateral nephrectomies and 2 hours of caudal aortic occlusion, 12 pigs were randomized to 4 hours of ImpRRT or CRRT. In the ImpRRT group, blood was circulated through a dialysis filter using a rapid infuser to collect the ultrafiltrate. Improvised replacement fluid, made with stock solutions, was infused pre-pump. In the CRRT group, commercial replacement fluid was used. During RRT, animals received isotonic crystalloids and norepinephrine.
There were no differences in serum creatinine, calcium, magnesium, or phosphorus concentrations. While there was a difference between groups in serum potassium concentration over time (P < 0.001), significance was lost in pairwise comparison at specific time points. Replacement fluids or ultrafiltrate flows did not differ between groups. There were no differences in lactate concentration, isotonic crystalloid requirement, or norepinephrine doses. No difference was found in electrolyte concentrations between the commercial and improvised replacement solutions.
The ImpRRT system achieved similar performance to CRRT and may represent a potential option for temporary RRT following disasters.
Marine-terminating glaciers, such as those along the coastline of Greenland, often release meltwater into the ocean in the form of subglacial discharge plumes. Though these plumes can dramatically alter the mass loss along the front of a glacier, the conditions surrounding their genesis remain poorly constrained. In particular, little is known about the geometry of subglacial outlets and the extent to which seawater may intrude into them. Here, the latter is addressed by exploring the dynamics of an arrested salt wedge – a steady-state, two-layer flow system where salty water partially intrudes a channel carrying fresh water. Building on existing theory, we formulate a model that predicts the length of a non-entraining salt wedge as a function of the Froude number, the slope of the channel and coefficients for interfacial and wall drag. In conjunction, a series of laboratory experiments were conducted to observe a salt wedge within a rectangular channel. For experiments conducted with laminar flow (Reynolds number
), good agreement with theoretical predictions are obtained when the drag coefficients are modelled as being inversely proportional to
. However, for fully turbulent flows on geophysical scales, these drag coefficients are expected to asymptote toward finite values. Adopting reasonable drag coefficient estimates for this flow regime, our theoretical model suggests that typical subglacial channels may permit seawater intrusions of the order of several kilometres. While crude, these results indicate that the ocean has a strong tendency to penetrate subglacial channels and potentially undercut the face of marine-terminating glaciers.
This chapter seeks to identify the distinctive characteristics of Greek, Punic and Roman urbanism in North Africa, and to explore similarities and differences between them. It presents an overview of urban morphology, infrastructure (streets, water supply), architectural characteristics (materials and aesthetics), and the common range of public buildings and types of domestic housing found in the various cultures; it also explores the extent to which we can reconstruct the use of public space and the character of urban life from inscriptions and the evidence of the statue habit in Roman towns. Questions of size and population, and economic roles, will also be considered. The main aim is to provide a succinct summary of fundamental information to enable comparison and contrast with other chapters in the collection which look at indigenous state formation and urbanism in the Maghrib and the Sahara.
We aimed to explore access by Black, Asian and minority ethnic (BAME) elders to the memory services in Leicester and Leicestershire, examining any trends over time. We then compared the odds of referral by ethnicity, using observed versus expected referrals for the city of Leicester. We gathered data on a comprehensive county-wide memory clinic used by people with suspected dementia and memory problems from the Trust electronic record system during the period 2011–2017. For Leicester city, we compared referral rates for 2011–2017 and compared observed and expected referral rates with demographics from the UK Census 2011.
In Leicester, there was a significant underrepresentation of referrals from the BAME population as compared with the White population in 2011, 2012 and 2013, when compared with population estimates of those aged ≥60 years from the 2011 UK Census Leicester city data. Data for the Black population were too small for comparisons. The odds of being referred to a memory clinic for the White group was double that of the Asian group in 2011 (odds ratio 2.15, 95% CI 1.52–3.02) and nearly 1.5 times in 2012 (odds ratio 1.40, 95% CI 1.01–1.93). This difference did not persist after 2014. However, this differential odds of referral changes when the age difference between the groups is accounted for. After adjusting for age, there were no differences between the two groups in their odds of referral to the memory clinic from 2011 to 2013, but from 2014 to 2017, members of the Asian group had higher odds of being referred.
The relationship between BAME and access to memory services is complex. The relative lower prevalence of Asian people among referrals to memory services in Leicester from 2011 to 2013 may partly be explained by the lower ages of the Asian population at referral. The higher prevalence of Asian people in 2014–2017 may be owing to use of denominators from the 2011 UK Census, which are likely to be disproportionately low for this group. Further studies are needed to explore any potential barriers to the access of services by BAME communities.
Iron-rich meteorites are significantly underrepresented in collection statistics from Antarctica. This has led to a hypothesis that there is a sparse layer of iron-rich meteorites hidden below the surface of the ice, thereby explaining the apparent shortfall. As standard Antarctic meteorite collecting techniques rely upon a visual surface search approach, the need has thus arisen to develop a system that can detect iron objects under a few tens of centimetres of ice, where the expected number density is of the order one per square kilometre. To help answer this hypothesis, a large-scale pulse induction metal detector array has been constructed for deployment in Antarctica. The metal detector array is 6 m wide, able to travel at 15 km h-1 and can scan 1 km2 in ~11 hours. This paper details the construction of the metal detector system with respect to design criteria, notably the ruggedization of the system for Antarctic deployment. Some preliminary results from UK and Antarctic testing are presented. We show that the system performs as specified and should reach the pre-agreed target of the detection of a 100 g iron meteorite at 300 mm when deployed in Antarctica.
Quaternary processes and environmental changes are often difficult to assess in remote subantarctic islands due to high surface erosion rates and overprinting of sedimentary products in locations that can be a challenge to access. We present a set of high-resolution, multichannel seismic lines and complementary multibeam bathymetry collected off the eastern (leeward) side of the subantarctic Auckland Islands, about 465 km south of New Zealand's South Island. These data constrain the erosive and depositional history of the island group, and they reveal an extensive system of sediment-filled valleys that extend offshore to depths that exceed glacial low-stand sea level. Although shallow, marine, U-shaped valleys and moraines are imaged, the rugged offshore geomorphology of the paleovalley floors and the stratigraphy of infill sediments suggests that the valley floors were shaped by submarine fluvial erosion, and subsequently filled by lacustrine, fjord, and fluvial sedimentary processes.
Iran's geography gives it an important place in the world. To the west lie Turkey, Iraq and Syria. South is Arabia and the Persian Gulf. To the southeast is the Indian subcontinent. To the north are Russia and the Caucasus. To the northeast lie the developing states of Central Asia. To the east, Afghanistan and China.
Schmidt-hammer exposure-age dating (SHD) of boulders on cryoplanation terrace treads and associated bedrock cliff faces revealed Holocene ages ranging from 0 ± 825 to 8890 ± 1185 yr. The cliffs were significantly younger than the inner treads, which tended to be younger than the outer treads. Radiocarbon dates from the regolith of 3854 to 4821 cal yr BP (2σ range) indicated maximum rates of cliff recession of ~0.1 mm/yr, which suggests the onset of terrace formation before the last glacial maximum. Age, angularity, and size of clasts, together with planation across bedrock structures and the seepage of groundwater from the cliff foot, all support a process-based conceptual model of cryoplanation terrace development in which frost weathering leads to parallel cliff recession and, hence, terrace extension. The availability of groundwater during autumn freezeback is viewed as critical for frost wedging and/or the growth of segregation ice during prolonged winter frost penetration. Permafrost promotes cryoplanation by providing an impermeable frost table beneath the active layer, focusing groundwater flow, and supplying water for sediment transport by solifluction across the tread. Snow beds are considered an effect rather than a cause of cryoplanation terraces, and cryoplanation is seen as distinct from nivation.
Kochia is one of the most problematic weeds in the United States. Field studies were conducted in five states (Wyoming, Colorado, Kansas, Nebraska, and South Dakota) over 2 yr (2010 and 2011) to evaluate kochia control with selected herbicides registered in five common crop scenarios: winter wheat, fallow, corn, soybean, and sugar beet to provide insight for diversifying kochia management in crop rotations. Kochia control varied by experimental site such that more variation in kochia control and biomass production was explained by experimental site than herbicide choice within a crop. Kochia control with herbicides currently labeled for use in sugar beet averaged 32% across locations. Kochia control was greatest and most consistent from corn herbicide programs (99%), followed by soybean (96%) and fallow (97%) herbicide programs. Kochia control from wheat herbicide programs was 93%. With respect to the availability of effective herbicide options, glyphosate-resistant kochia control was easiest in corn, soybean, and fallow, followed by wheat; and difficult to manage with herbicides in sugar beet.