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The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) cohort study of the Canadian Consortium on Neurodegeneration in Aging (CCNA) is a national initiative to catalyze research on dementia, set up to support the research agendas of CCNA teams. This cross-country longitudinal cohort of 2310 deeply phenotyped subjects with various forms of dementia and mild memory loss or concerns, along with cognitively intact elderly subjects, will test hypotheses generated by these teams.
The COMPASS-ND protocol, initial grant proposal for funding, fifth semi-annual CCNA Progress Report submitted to the Canadian Institutes of Health Research December 2017, and other documents supplemented by modifications made and lessons learned after implementation were used by the authors to create the description of the study provided here.
The CCNA COMPASS-ND cohort includes participants from across Canada with various cognitive conditions associated with or at risk of neurodegenerative diseases. They will undergo a wide range of experimental, clinical, imaging, and genetic investigation to specifically address the causes, diagnosis, treatment, and prevention of these conditions in the aging population. Data derived from clinical and cognitive assessments, biospecimens, brain imaging, genetics, and brain donations will be used to test hypotheses generated by CCNA research teams and other Canadian researchers. The study is the most comprehensive and ambitious Canadian study of dementia. Initial data posting occurred in 2018, with the full cohort to be accrued by 2020.
Availability of data from the COMPASS-ND study will provide a major stimulus for dementia research in Canada in the coming years.
Depictions of eye images and messages encouraging compliance with social norms have successfully motivated behavioral change in a variety of experimental and applied settings. We studied the effect of these 2 visual cues on hand hygiene adherence in a cohort of hospital-based healthcare providers participating in an electronic monitoring and feedback program.
Prospective, quasi-experimental study utilizing an interrupted time-series design. Intervention placards depicting an image of eyes, a social norms message, or a control placard were placed near soap and alcohol-based hand-rub dispensers on 2 hospital units. Placards were alternated every 10 days. Hand hygiene opportunities and adherence rates were assessed electronically via the CenTrak Hand Hygiene Compliance Solution.
A total of 166 nurses and certified nursing assistants (74 on a medical-surgical unit and 92 on a progressive care unit) were monitored electronically over the 4-month study period. In total, 184,172 electronic observations were collected (110,903 on a medical-surgical unit and 73,269 on a progressive care unit). The median daily number of electronic observations was 1,471 (interquartile range, 1,337–1,584). The preintervention baseline hand hygiene adherence rate was 70%. No statistically significant increase in hand hygiene adherence was observed as a result of either intervention.
Displaying eye images or a social norms message in the hospital environment did not result in measurable improvements in HH adherence in a cohort of healthcare providers participating in an electronic monitoring and feedback program.
Introduction: Although oral rehydration therapy is recommended for children with acute gastroenteritis (AGE) with none to some dehydration, intravenous (IV) rehydration is still commonly administered to these children in high-income countries. IV rehydration is associated with pain, anxiety, and emergency department (ED) revisits in children with AGE. A better understanding of the factors associated with IV rehydration is needed to inform knowledge translation strategies. Methods: This was a planned secondary analysis of the Pediatric Emergency Research Canada (PERC) and Pediatric Emergency Care Applied Research Network (PECARN) randomized, controlled trials of oral probiotics in children with AGE-associated diarrhea. Eligible children were aged 3-48 months and reported > 3 watery stools in a 24-hour period. The primary outcome was administration of IV rehydration at the index ED visit. We used mixed-effects logistic regression model to explore univariable and multivariable relationships between IV rehydration and a priori risk factors. Results: From the parent study sample of 1848 participants, 1846 had data available for analysis: mean (SD) age of 19.1 ± 11.4 months, 45.4% females. 70.2% (1292/1840) vomited within 24 hours of the index ED visit and 34.1% (629/1846) received ondansetron in the ED. 13.0% (240/1846) were administered IV rehydration at the index ED visit, and 3.6% (67/1842) were hospitalized. Multivariable predictors of IV rehydration were Clinical Dehydration Scale (CDS) score [compared to none: mild to moderate (OR: 8.1, CI: 5.5-11.8); severe (OR: 45.9, 95% CI: 20.1-104.7), P < 0.001], ondansetron in the ED (OR: 1.8, CI: 1.2-2.6, P = 0.003), previous healthcare visit for the same illness [compared to no prior visit: prior visit with no IV (OR: 1.9, 95% CI: 1.3-2.9); prior visit with IV (OR: 10.5, 95% CI: 3.2-34.8), P < 0.001], and country [compared to Canada: US (OR: 4.1, CI: 2.3-7.4, P < 0.001]. Significantly more participants returned to the ED with symptoms of AGE within 3 days if IV fluids were administered at the index visit [30/224 (13.4%) versus 88/1453 (6.1%), P < 0.001]. Conclusion: Higher CDS scores, antiemetic use, previous healthcare visits and country were independent predictors of IV rehydration which was also associated with increased ED revisits. Knowledge translation focused on optimizing the use of antiemetics (i.e. for those with dehydration) and reducing the geographic variation in IV rehydration use may improve the ED experience and reduce ED-revisits.
Method validation is vital for regulatory and nutrient analysis of foods, and imposes criteria for representative sampling and analysis along with more common requirements for precision and accuracy. When solid food samples are directly analyzed by x-ray fluorescence (XRF), they must be homogeneous on a mass scale at least similar to that penetrated by the interrogating and fluorescent x-ray beams. This mass varies with x-ray energy, and hence with the elements being determined, and few data are available documenting the scale on which homogeneity can be assured. This paper examines the effective sample masses that are represented in measuring 21 different elements in pelletized dry food samples, and also the homogeneity of mimerous foods and biological standard reference materials.
OBJECTIVES/SPECIFIC AIMS: The goals of this study were (1) to evaluate the effect of proarrhythmic drugs on calcium transient and (2) to use three-dimensional human engineered cardiac tissue (hECT) technology to evaluate cardiac contractile properties in response to pharmacological challenge with proarrhythmic drugs. METHODS/STUDY POPULATION: Calcium transient was measured in subject-specific iPSC-CMs by using the IonOptix system in Sotalol treated vs. untreated conditions. We fabricated human engineered cardiac tissues (hECT) in a custom designed bioreactor using low- and high-sentitive subject-specific iPSC-CMs. Contractile function of the hECT was evaluated at baseline and after Sotalol [300 µM] administration. The change in beat rate was recorded under spontaneous beating conditions; changes in other twitch parameters, including time to relaxation, were recorded under electrical stimulation. Time to relaxation served as an indicator of action potential duration (APD), which has a temporal correlation with the QT interval. RESULTS/ANTICIPATED RESULTS: The low-sensitive iPSC-CM showed a considerable drop in overall peak height of the calcium transient, in the presence of 100 µM Sotalol. The high-sensitive line, however, showed a more pronounced drop in peak height. Sotalol treatment also induced a more pronounced increase in the exponential decay time constant (tau) in the high-sensitive line compared to the low-sensitive line. The hECT fabricated with high sensitive hiPSC-CM showed a larger decrease in spontaneous beat rate in response to Sotalol (0.41 vs 0.23 fold decrease), with a higher increase in time to relaxation (1.8 vs 1.3 fold increase), compared to hECT from low sensitive hiPSC-CM. Moreover, while the low-sensitive hECT showed a positive correlation between time to relaxation and developed force, as expected after Sotalol stimulation; the high-sensitive hECT failed to show a positive inotropic response. DISCUSSION/SIGNIFICANCE OF IMPACT: Our findings suggest subject-specific iPSC-CMs and hECT, can be used to model functional abnormalities observed in diLQTS in response to Sotalol, and offer novel insights into human-based screening assays for toxic drug reactions. Success of this study may help identify key components underlying diLQT susceptibility to ultimately develop novel therapeutic agents.
Terrorism is a complex problem that is highly relevant in contemporary society, underscoring the need for greater understanding as well as cross-disciplinary and international research in this area. Controversies surround potential associations between mental illness and terrorism, many due to the limited and conflicting existing research, and mental health professionals’ duties to their patients versus society and the state. In this article, we review the literature, discuss clinical implications and the role of psychiatrists in anti-terrorism efforts. We also propose a simplified framework that may be incorporated into clinical practice to screen for potential terrorist tendencies.
•Understand the landscape and recent advances in the research of terrorism
•Appreciate the importance and role of mental health professionals in preventing patients from engaging in terrorist activities
•Understand how to assess risk of patients engaging in terrorist activities
A graph G is called complete if any two of its vertices are connected by an edge; a set of vertices of G are said to be independent if no two of them are connected by an edge. It follows from a well-known theorem of Ramsay (1) that for each pair of positive integers k, l there is an integer f(k, l), which we take to be minimal, such that every graph with f(k, l) vertices either contains a complete graph of k vertices or a set of l independent points.
We sought to explore factors associated with depressive symptom severity among older persons (≥60 years of age) and to compare the depressive symptoms commonly experienced by older elderly (≥75 years) with those commonly experienced by younger elderly (<75 years).
Secondary analysis was conducted on data from a nationally representative survey.
Four parishes in Jamaica.
A total of 2,943 older community dwellers participated.
The survey included the Zung Self-rating Depression Scale (ZSDS), the Mini Mental State Examination (MMSE), and items on age, sex, and educational level. Linear regression analysis was used to determine the association between ZSDS score and: age, sex, MMSE score, and educational level. Logistic regression analysis was used to determine, for each ZSDS item, whether particular responses were more associated with older or younger elderly.
Higher ZSDS scores were associated with increasing age (B = 0.13, p < 0.001), lower MMSE score (B = −0.42, p < 0.001), the female sex (B = 3.52, p < 0.001), and lower educational level (B = −1.27, p < 0.001). The ZSDS items that were endorsed significantly more (p < 0.05) by older elderly related to negative evaluations about their functionality and value. Hopelessness was also more prominent among the older elderly. The items that were endorsed significantly more (p < 0.05) by the younger elderly had less of a focus.
Among older persons, increasing age was associated with marginally higher levels of depressive symptoms. Female gender, cognitive deficits, preoccupations about value and functionality, and feelings of hopelessness may serve as useful screening parameters.
The present paper aimed to demonstrate how 24 h dietary recall data can be used to generate a nutrition-relevant food list for household consumption and expenditure surveys (HCES) using contribution analysis and stepwise regression.
The analysis used data from the 2011/12 Bangladesh Integrated Household Survey (BIHS), which is nationally representative of rural Bangladesh. A total of 325 primary sampling units (PSU=village) were surveyed through a two-stage stratified sampling approach. The household food consumption module used for the analysis consisted of a 24 h open dietary recall in which the female member in charge of preparing and serving food was asked about foods and quantities consumed by the whole household.
A total of 6500 households.
The original 24 h open dietary recall data in the BIHS were comprised of 288 individual foods that were grouped into ninety-four similar food groups. Contribution analysis and stepwise regression were based on nutrients of public health interest in Bangladesh (energy, protein, fat, Fe, Zn, vitamin A). These steps revealed that a list of fifty-nine food items captures approximately 90 % of the total intake and up to 90 % of the between-person variation for the key nutrients based on the diets of the population.
The study illustrates how 24 h open dietary recall data can be used to generate a country-specific nutrition-relevant food list that could be integrated into an HCES consumption module to enable more accurate and comprehensive household-level food and nutrient analyses.
The low yield of pearl millet largely due to the low adoption of improved varieties substantiates the application of client-oriented plant breeding for pearl millet. Hence to enhance adoption, new varieties must correspond to farmers’ preferences and respond to the constraints prevailing in the production environments, participatory rural appraisals were conducted in two agro-ecological zones (Sahel and North-Sudan) to determine farmers’ preferences in the choice of varieties and to identify constraints to pearl millet production. The study revealed that the major production constraints are hierarchically drought, Striga, head miner, bird and downy mildew. Compact panicle, large grain size and non-bristle panicle were the most preferred traits in pearl millet across agro-ecological zones. Very long panicle and early maturity crop cycle were more preferred in the Sahel zone whereas, in the North-Sudan zone medium panicle length and medium maturity cycle were more preferred by farmers. Traits largely rejected by farmers were small grain size, narrow, loose and bristled panicle. Very few investigations were done to understand the raison of the low adoption of improved technologies in pearl millet. This study identified the major criteria of new pearl millet variety adoption by farmers. It is expected that breeding program must integrate these criteria in new pearl millet variety profiling to enhance adoption.
Chondrules contain ferromagnetic minerals that may retain a record of the magnetic field environments in which they cooled. Paleomagnetic experiments on separated chondrules can potentially reveal the presence of remanent magnetization from the time of chondrule formation. The existence of such a magnetization places quantitative bounds on the frequency of interchondrule collisions, while the intensity of magnetization may be used to infer the strength of nebular magnetic fields and thereby constrain the mechanism of chondrule formation. Recent advances in laboratory instrumentation and techniques have permitted the isolation of nebular remanent magnetization in chondrules, providing the potential basis to probe the formation environments of chondrules from a range of chondrite classes.
Outbreaks of Old World cutaneous leishmaniasis (CL) have significantly increased due to the conflicts in the Middle East, with most of the cases occurring in resource-limited areas such as refugee settlements. The standard methods of diagnosis include microscopy and parasite culture, which have several limitations. To address the growing need for a CL diagnostic that can be field applicable, we have identified five candidate neoglycoproteins (NGPs): Galα (NGP3B), Galα(1,3)Galα (NGP17B), Galα(1,3)Galβ (NGP9B), Galα(1,6)[Galα(1,2)]Galβ (NGP11B), and Galα(1,3)Galβ(1,4)Glcβ (NGP1B) that are differentially recognized in sera from individuals with Leishmania major infection as compared with sera from heterologous controls. These candidates contain terminal, non-reducing α-galactopyranosyl (α-Gal) residues, which are known potent immunogens to humans. Logistic regression models found that NGP3B retained the best diagnostic potential (area under the curve from receiver-operating characteristic curve = 0.8). Our data add to the growing body of work demonstrating the exploitability of the human anti-α-Gal response in CL diagnosis.
Factors associated with relapse among children who are discharged after reaching a threshold denoted ‘recovered’ from moderate acute malnutrition (MAM) are not well understood. The aim of this study was to identify factors associated with sustained recovery, defined as maintaining a mid-upper-arm circumference≥12·5 cm for 1 year after release from treatment. On the basis of an observational study design, we analysed data from an in-depth household (HH) survey on a sub-sample of participants within a larger cluster randomised controlled trial (cRCT) that followed up children for 1 year after recovery from MAM. Out of 1497 children participating in the cRCT, a subset of 315 children participated in this sub-study. Accounting for other factors, HH with fitted lids on water storage containers (P=0·004) was a significant predictor of sustained recovery. In addition, sustained recovery was better among children whose caregivers were observed to have clean hands (P=0·053) and in HH using an improved sanitation facility (P=0·083). By contrast, socio-economic status and infant and young child feeding practices at the time of discharge and HH food security throughout the follow-up period were not significant. Given these results, we hypothesise that improved water, sanitation and hygiene conditions in tandem with management of MAM through supplemental feeding programmes have the possibility to decrease relapse following recovery from MAM. Furthermore, the absence of associations between relapse and nearly all HH-level factors indicates that the causal factors of relapse may be related mostly to the child’s individual, underlying health and nutrition status.
Lamb mortality is high in hill farming systems. This is not a new phenomenon. Orr and Fraser (1932) reported losses of lambs between birth and weaning of over 30% and indeed an annual ewe death rate of up to 24%.
Poor nutrition, of both macro- and micro-nutrients, is a prime cause of this problem exaggerated by difficult environmental conditions at the time of birth. Improved nutrition during late pregnancy was believed to be the most important (Wallace, 1948) and nutrition during mid pregnancy received scant attention. However, applied experiments with mid-pregnancy feeding of hill ewes (Milne, 1984; Waterhouse and McClelland, 1987) showed very significant effects of better nutrition during this period. The present paper summarizes the implementation of improved mid-pregnancy nutrition in a monitored systems study, associated with changes in management in late pregnancy made possible by assessment of foetal numbers from ultrasound pregnancy scanning.
Increased prolificacy is often believed to increase the incidence of both lamb and ewe mortality especially in harsher environments. Fecundin® (Coopers Pittman Moore) is a vaccine which leads to immunization against androstenedione and a resulting increase in prolificacy (Rhind, 1987). The use of this drug gives a method of manipulating prolificacy without confounding any effects with improved nutrition, the most usual means of modifying reproductive success.
A programme was commenced in 1985 in which half the ewes in a flock of Scottish Blackface ewes was vaccinated with Fecundin (F), the remainder left unvaccinated (N). In subsequent years ewes were maintained on the same treatment. The data presented here are an analysis of a single age group of ewes completing a full lifetime on each treatment. Eighty-five ewes were allocated at random to each treatment. These were vaccinated in autumn 1985, given a booster vaccination 4 weeks pre-ram joining in 1986, 1987 and 1988 and sold as ‘cast for age’ after lamb weaning in 1989. With the exception of injection with Fecundin, at all times management was independent of treatment.
We have continued to improve and update the OPAL opacity code. Addition of intermediate coupling has further increased the opacity over earlier LS coupling results. A ‘corresponding states’ method has been used to extend the tables in both X and Z. This has allowed the calculation and distribution of extensive opacity tables for several different sets of metal abundance.