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 email@example.com
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.
Identifying options for the sustainable intensification of cropping systems in southern Africa under prevailing high climate risk is needed. With this in mind, we tested an intercropping system that combined the staple crop maize with lablab, a local but underutilised legume. Grain and biomass productivity was determined for four variants (i) sole maize (sole-maize), (ii) sole lablab (sole-lablab), (iii) maize/lablab with both crops sown simultaneously (intercropped-SP) and (iv) maize/lablab with lablab sown 28 days after the maize crop (intercropped-DP). Soil water and weather data were monitored and evaluated. The trial was conducted for two seasons (2015/2016 and 2016/2017) at two sites in the Limpopo Province, South Africa: Univen (847 mm rainfall, 29.2 °C maximum and 18.9 °C minimum temperature average for the cropping season over the years 2008–2017) and Syferkuil (491 mm rainfall, with 27.0 °C maximum and 14.8 °C minimum temperature). Analysis revealed three key results: The treatment with intercropped-SP had significantly lower maize yields (2320 kg ha−1) compared with maize in intercropped-DP (2865 kg ha−1) or sole-maize (2623 kg ha−1). As expected, maize yields in the El Niño affected in season 2015/2016 were on average 1688 kg ha−1 lower than in 2016/2017. Maize yields were significantly lower (957 kg ha−1) at Univen, the warmer site with higher rainfall, than at Syferkuil. In 2015/2016, maximum temperature at Univen exceeded 40 °C around anthesis. Furthermore, soil water was close to the estimated permanent wilting point (PWP) for most of the cropping season, which indicates possible water limitations. In Syferkuil, the soil water was maintained well above PWP. Lablab yields were low, around 500 ha−1, but stable as they were not affected by treatment across season and site. Overall, the study demonstrated that intercropped-DP appears to use available soil water more efficiently than sole maize. Intercropped-DP could therefore be considered as an option for sustainable intensification under high climate risk and resource-limited conditions for smallholders in southern Africa.
Older people have a higher risk of drug-related problems (DRPs). However, little is known about the prevalence of DRPs in community-dwelling people who screened positive for dementia. Our study aimed to determine (1) the prevalence and types of DRPs and (2) the socio-demographic and clinical variables associated with DRPs in people screened positive for dementia in primary care.
The Dementia: life- and person-centered help in Mecklenburg-Western Pomerania (DelpHi-MV) study is a general practitioner (GP)-based cluster-randomized controlled intervention study to implement and evaluate an innovative concept of collaborative dementia care management in the primary care setting in Germany. Medication reviews of 446 study participants were conducted by pharmacists based on a comprehensive baseline assessment that included a computer-based home medication assessment. ClinicalTrials.gov Identifier: NCT01401582.
A total of 1,077 DRPs were documented. In 414 study participants (93%), at least one DRP was detected by a pharmacist. The most frequent DRPs were administration and compliance problems (60%), drug interactions (17%), and problems with inappropriate drug choice (15%). The number of DRPs was significantly associated with the total number of drugs taken and with a formal diagnosis of a mental or behavioral disorder.
Degree of cognitive impairment (MMSE defined) and formal diagnosis of dementia were not risk factors for an increased number of DRPs. However, the total number of drug taken and the presence of a diagnosis of mental and behavioral disorders were associated with an increased total number of DRPs.
Strategies for the involvement of primary care in the management of patients with presumed or diagnosed dementia are heterogeneous across Europe. We wanted to explore attitudes of primary care physicians (PCPs) when managing dementia: (i) the most popular cognitive tests, (ii) who had the right to initiate or continue cholinesterase inhibitor or memantine treatment, and (iii) the relationship between the permissiveness of these rules/guidelines and PCP's approach in the dementia investigations and assessment.
Key informant survey. Setting: Primary care practices across 25 European countries. Subjects: Four hundred forty-five PCPs responded to a self-administered questionnaire. Two-step cluster analysis was performed using characteristics of the informants and the responses to the survey. Main outcome measures: Two by two contingency tables with odds ratios and 95% confidence intervals were used to assess the association between categorical variables. A multinomial logistic regression model was used to assess the association of multiple variables (age class, gender, and perceived prescription rules) with the PCPs’ attitude of “trying to establish a diagnosis of dementia on their own.”
Discrepancies between rules/guidelines and attitudes to dementia management was found in many countries. There was a strong association between the authorization to prescribe dementia drugs and pursuing dementia diagnostic work-up (odds ratio, 3.45; 95% CI 2.28–5.23).
Differing regulations about who does what in dementia management seemed to affect PCP's engagement in dementia investigations and assessment. PCPs who were allowed to prescribe dementia drugs also claimed higher engagement in dementia work-up than PCPs who were not allowed to prescribe.
Introduction: Point of care ultrasound has become an established tool in the initial management of patients with undifferentiated hypotension. Current established protocols (RUSH, ACES, etc) were developed by expert user opinion, rather than objective, prospective data. We wished to use reported disease incidence to develop an informed approach to PoCUS in hypotension using a “4 F’s” approach: Fluid; Form; Function; Filling. Methods: We summarized the incidence of PoCUS findings from an international multicentre RCT, and using a modified Delphi approach incorporating this data we obtained the input of 24 international experts associated with five professional organizations led by the International Federation of Emergency Medicine. The modified Delphi tool was developed to reach an international consensus on how to integrate PoCUS for hypotensive emergency department patients. Results: Rates of abnormal PoCUS findings from 151 patients with undifferentiated hypotension included left ventricular dynamic changes (43%), IVC abnormalities (27%), pericardial effusion (16%), and pleural fluid (8%). Abdominal pathology was rare (fluid 5%, AAA 2%). After two rounds of the survey, using majority consensus, agreement was reached on a SHoC-hypotension protocol comprising: A. Core: 1. Cardiac views (Sub-xiphoid and parasternal windows for pericardial fluid, cardiac form and ventricular function); 2. Lung views for pleural fluid and B-lines for filling status; and 3. IVC views for filling status; B. Supplementary: Additional cardiac views; and C. Additional views (when indicated) including peritoneal fluid, aorta, pelvic for IUP, and proximal leg veins for DVT. Conclusion: An international consensus process based on prospectively collected disease incidence has led to a proposed SHoC-hypotension PoCUS protocol comprising a stepwise clinical-indication based approach of Core, Supplementary and Additional PoCUS views.
Introduction: Point of care ultrasound (PoCUS) provides invaluable information during resuscitation efforts in cardiac arrest by determining presence/absence of cardiac activity and identifying reversible causes such as pericardial tamponade. There is no agreed guideline on how to safely and effectively incorporate PoCUS into the advanced cardiac life support (ACLS) algorithm. We consider that a consensus-based priority checklist using a “4 F’s” approach (Fluid; Form; Function; Filling), would provide a better algorithm during ACLS. Methods: The ultrasound subcommittee of the Australasian College for Emergency Medicine (ACEM) drafted a checklist incorporating PoCUS into the ACLS algorithm. This was further developed using the input of 24 international experts associated with five professional organizations led by the International Federation of Emergency Medicine. A modified Delphi tool was developed to reach an international consensus on how to integrate ultrasound into cardiac arrest algorithms for emergency department patients. Results: Consensus was reached following 3 rounds. The agreed protocol focuses on the timing of PoCUS as well as the specific clinical questions. Core cardiac windows performed during the rhythm check pause in chest compressions are the sub-xiphoid and parasternal cardiac views. Either view should be used to detect pericardial fluid, as well as examining ventricular form (e.g. right heart strain) and function, (e.g. asystole versus organized cardiac activity). Supplementary views include lung views (for absent lung sliding in pneumothorax and for pleural fluid), and IVC views for filling. Additional ultrasound applications are for endotracheal tube confirmation, proximal leg veins for DVT, or for sources of blood loss (AAA, peritoneal/pelvic fluid). Conclusion: The authors hope that this process will lead to a consensus-based SHoC-cardiac arrest guideline on incorporating PoCUS into the ACLS algorithm.
Superconductivity and magnetism at intermediate (“mesoscopic”) length scales between atomic and bulk have a long history of interesting science. New science emerges due to the presence of multiple length scales, especially when these become comparable to relevant geometric sizes. New phenomena may appear due to topological interactions, geometric confinement, proximity between dissimilar materials, dimensional crossover, and collective effects induced by periodicity. In this review, we select a few, recent highlights that illustrate the type of novel science that can be accomplished in superconducting and magnetic structures. These materials can serve as model systems and provide new ideas, which can be extended to other systems such as ferroelectrics and multiferroics. We also highlight general open questions and new directions in which the field may move.
In this study, a video-based infrared camera (IRC) was investigated as a tool to monitor the body temperature of calves. Body surface temperatures were measured contactless using videos from an IRC fixed at a certain location in the calf feeder. The body surface temperatures were analysed retrospectively at three larger areas: the head area (in front of the forehead), the body area (behind forehead) and the area of the entire animal. The rectal temperature served as a reference temperature and was measured with a digital thermometer at the corresponding time point. A total of nine calves (Holstein-Friesians, 8 to 35 weeks old) were examined. The average maximum temperatures of the area of the entire animal (mean±SD: 37.66±0.90°C) and the head area (37.64±0.86°C) were always higher than that of the body area (36.75±1.06°C). The temperatures of the head area and of the entire animal were very similar. However, the maximum temperatures as measured using IRC increased with an increase in calf rectal temperature. The maximum temperatures of each video picture for the entire visible body area of the calves appeared to be sufficient to measure the superficial body temperature. The advantage of the video-based IRC over conventional IR single-picture cameras is that more than one picture per animal can be analysed in a short period of time. This technique provides more data for analysis. Thus, this system shows potential as an indicator for continuous temperature measurements in calves.
There is an urgent need to understand how climate change, including sea-level rise, is likely to threaten biodiversity and cause secondary effects, such as agro-ecosystem alteration and human displacement. The consequences of climate change, and the resulting sea-level rise within the Forests of East Australia biodiversity hotspot, were modelled and assessed for the 2070–2099 period. Climate change effects were predicted to affect c. 100000 km2, and a rise in sea level an area of 860 km2; this could potentially lead to the displacement of 20600 inhabitants. The two threats were projected to mainly affect natural and agricultural areas. The greatest conservation benefits would be obtained by either maintaining or increasing the conservation status of areas in the northern (Wet Tropics) or southern (Sydney Basin) extremities of the hotspot, as they constitute about half of the area predicted to be affected by climate change, and both areas harbour high species richness. Increasing the connectivity of protected areas for Wet Tropics and Sydney Basin species to enable them to move into new habitat areas is also important. This study provides a basis for future research on the effects on local biodiversity and agriculture.
Ecological restoration of trees is often constrained by limited knowledge of the biology, propagation and management requirements of individual species. Consequently, restoration initiatives rarely incorporate less well-known species or those that are difficult to source and grow. We describe challenges associated with the restoration of threatened trees in the Araucaria Forest of southern Brazil, and analyse the effectiveness of methods used to define target species, identify seed sources and generate information on the phenology of rare or threatened tree species. A review of secondary data identified 71 rare or threatened taxa as targets for seed collection. We then surveyed 68.7 km of trails in 26 forest remnants, identifying and mapping 1,027 seed-producing trees of 38 species. Surveys confirmed the scarcity of several tree species (including seven species with an abundance of <0.04 individuals per km), and nine species showed no signs of fruiting during 3 years of phenological monitoring. These findings, together with limited knowledge and application of optimal seed collection methods, are significant factors impeding the recovery of these species within their natural habitat. Wider application of the results of this case study could support restoration of the Araucaria Forest with seedlings from a wider diversity of species.
In Germany, active bat rabies surveillance was conducted between 1993 and 2012. A total of 4546 oropharyngeal swab samples from 18 bat species were screened for the presence of EBLV-1- , EBLV-2- and BBLV-specific RNA. Overall, 0·15% of oropharyngeal swab samples tested EBLV-1 positive, with the majority originating from Eptesicus serotinus. Interestingly, out of seven RT–PCR-positive oropharyngeal swabs subjected to virus isolation, viable virus was isolated from a single serotine bat (E. serotinus). Additionally, about 1226 blood samples were tested serologically, and varying virus neutralizing antibody titres were found in at least eight different bat species. The detection of viral RNA and seroconversion in repeatedly sampled serotine bats indicates long-term circulation of the virus in a particular bat colony. The limitations of random-based active bat rabies surveillance over passive bat rabies surveillance and its possible application of targeted approaches for future research activities on bat lyssavirus dynamics and maintenance are discussed.
Understanding the interaction of group V impurities with intrinsic defects in ZnO is important for developing p-type material. We have studied N-doped ZnO thin films and N-doped bulk ZnO crystals, with positron annihilation spectroscopy, in contrast to earlier studies that have concentrated on N-implanted ZnO crystals. We show that the introduction of N impurities into ZnO, irrespective of whether it is done during the growth of thin films or bulk crystals or through implantation and subsequent thermal treatments, leads to the formation of stable vacancy clusters and negative ion-type defects. Interestingly, the stability of these vacancy clusters is found almost exclusively for N introduction, whereas single Zn vacancy defects or easily removable vacancy clusters are more typically found for ZnO doped with other impurities.
We present numerical as well as experimental results of axisymmetric, axially propagating vortices appearing in counter-rotating Taylor–Couette flow below the centrifugal instability threshold of circular Couette flow without additional externally imposed forces. These propagating vortices are periodically generated by the shear flow near the Ekman cells that are induced by the non-rotating end walls. These axisymmetric vortices propagate into the bulk towards mid-height, where they get annihilated by rotating, non-propagating defects. These propagating structures appear via a supercritical Hopf bifurcation from axisymmetric, steady vortices, which have been discovered recently in centrifugally stable counter-rotating Taylor–Couette flow (Abshagen et al., Phys. Fluids, vol. 22, 2010, 021702). In the nonlinear regime of the Hopf bifurcation, contributions of non-axisymmetric modes also appear.
Leptin is thought to act as an important mediator in stress reactions. To date, no study has examined the association between psychological stress and leptin levels in children. This study aimed to assess the association between emotional symptoms and peer problems and serum leptin levels in children aged 10 years of the two population-based GINI-plus and LISA-plus birth cohorts.
Cross-sectional data from 2827 children aged 10 years were assessed with regard to leptin concentrations in serum and behavioral problems using the parent-reported Strengths and Difficulties Questionnaire (SDQ). Linear regression modeling was applied to determine the likelihood of elevated leptin levels in children with emotional symptoms and peer problems, controlling for socio-economic status (SES), body mass index (BMI), fasting serum leptin levels, pubertal development and sex hormones.
We found that increases in emotional symptoms (exp βadj = 1.03, s.e. = 0.02, p < 0.04) and peer problems (exp βadj = 1.05, s.e. = 0.01, p = 0.0001) were significantly associated with higher serum leptin levels controlled for BMI and sociodemographic factors. Similar results were found when the fasting serum leptin sample was examined (exp βadj = 1.08, s.e. = 0.04, p = 0.0294). Gender-stratified analyses showed a significant relationship between serum leptin and peer problems in girls (exp βadj = 1.05, s.e. = 0.02, p = 0.03), and a borderline significant association in boys (exp βadj = 1.04, s.e. = 0.02, p = 0.05).
Children with peer problems have higher stress and eat more, acquire a higher body fat mass and thus, through increased leptin resistance, exhibit higher leptin levels.
Rangea is the type genus of the Rangeomorpha, an extinct clade near the base of the evolutionary tree of large, complex organisms which prospered during the late Neoproterozoic. It represents an iconic Ediacaran taxon, but the relatively few specimens previously known significantly hindered an accurate reconstruction. Discovery of more than 100 specimens of Rangea in two gutter casts recovered from Farm Aar in southern Namibia significantly expands this data set, and the well preserved internal and external features on these specimens permit new interpretations of Rangea morphology and lifestyle. Internal structures of Rangea consist of a hexaradial axial bulb that passes into an axial stalk extending the length of the fossil. The axial bulb is typically filled with sediment, which becomes increasingly loosely packed and porous distally, with the end of the stalk typically preserved as an empty, cylindrical cone. This length of the axial structure forms the structural foundation for six vanes arranged radially around the axis, with each vane consisting of a bilaminar sheet composed of a repetitive pattern of elements exhibiting at least three orders of self-similar branching. Rangea was probably an epibenthic frond that rested upright on the sea bottom, and all known fossil specimens were transported prior to their final burial in storm deposits.
The Dawn spacecraft orbited Asteroid (4) Vesta for a year, and returned disk-resolved images and spectra covering visible and near-infrared wavelengths at scales as high as 20 m/pix. The visible geometric albedo of Vesta is ~ 0.36. The disk-integrated phase function of Vesta in the visible wavelengths derived from Dawn approach data, previous ground-based observations, and Rosetta OSIRIS observations is consistent with an IAU H-G phase law with H=3.2 mag and G=0.28. Hapke's modeling yields a disk-averaged single-scattering albedo of 0.50, an asymmetry factor of -0.25, and a roughness parameter of ~20 deg at 700 nm wavelength. Vesta's surface displays the largest albedo variations observed so far on asteroids, ranging from ~0.10 to ~0.76 in geometric albedo in the visible wavelengths. The phase function of Vesta displays obvious systematic variations with respect to wavelength, with steeper slopes within the 1- and 2-micron pyroxene bands, consistent with previous ground-based observations and laboratory measurement of HED meteorites showing deeper bands at higher phase angles. The relatively high albedo of Vesta suggests significant contribution of multiple scattering. The non-linear effect of multiple scattering and the possible systematic variations of phase function with albedo across the surface of Vesta may invalidate the traditional algorithm of applying photometric correction on airless planetary surfaces.