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A higher intake of foods rich in flavonoids such as quercetin can reduce the risk of cardiovascular disease. Enzymatically modified isoquercitrin (EMIQ®) has a bioavailability 17-fold higher than quercetin aglycone and has shown potential cardiovascular disease moderating effects in animal studies. The present study aimed to determine if acute ingestion of EMIQ® improves endothelial function, blood pressure, and cognitive function in human volunteers at risk of cardiovascular disease. Twenty-five participants (12 males, 13 females) with at least one cardiovascular disease risk factor completed this randomized, controlled, crossover study. In a random order, participants were given EMIQ® (2 mg aglycone equivalent)/kg body weight or placebo alongside a standard breakfast meal. Endothelial function, assessed by flow mediated dilatation (FMD) of the brachial artery was measured before and 1.5 hrs after intervention. Blood pressure (BP), arterial stiffness, cognitive function, BP during cognitive stress and measures of quercetin metabolites, oxidative stress and markers of nitric oxide (NO) production were assessed post-intervention. After adjustment for pre-treatment measurements and treatment order, EMIQ® treatment resulted in a significantly higher FMD response compared to the placebo [0.60%, 95% CI: 0.03, 1.17 (p=0.04)]. Plasma concentrations of quercetin metabolites were significantly higher (p<0.001) after EMIQ® treatment compared to the placebo. No changes in blood pressure, arterial stiffness, cognitive function, or biochemical parameters were observed. In this human intervention study, the acute administration of EMIQ® significantly increased circulating quercetin metabolites and improved endothelial function. Further clinical trials are required to assess whether health benefits are associated with long-term EMIQ® consumption.
The role of vegetable and fruit intake in reducing falls risk in elderly populations is uncertain. This study examined the associations of vegetable and fruit intake with falls-related hospitalisations in a prospective cohort study of elderly women (n 1429, ≥70 years), including effects on muscular function, which represented a potential causal pathway. Muscular function, measured using grip strength and timed-up-and-go (TUG), and vegetable and fruit intake, quantified using a validated FFQ, were assessed at baseline (1998). Incident falls-related hospitalisation over 14·5-year follow-up was captured by the Hospital Morbidity Data Collection, linked via the Western Australian Data Linkage System. Falls-related hospitalisation occurred in 568 (39·7 %) of women. In multivariable-adjusted models, falls-related hospitalisations were lower in participants consuming more vegetables (hazard ratio (HR) per 75 g serve: 0·90 (95 % CI 0·82, 0·99)), but not fruit intake (per 150 g serve: 1·03 (95 % CI 0·93, 1·14)). Only total cruciferous vegetable intake was inversely associated with falls-related hospitalisation (HR: per 20 g serve: 0·90 (95 % CI 0·83, 0·97)). Higher total vegetable intake was associated with lower odds for poor grip strength (OR: 0·87 (95 % CI 0·77, 0·97)) and slow TUG (OR: 0·88 (95 % CI 0·78, 0·99)). Including grip strength and TUG in the multivariable-adjusted model attenuated the association between total vegetable intake and falls-related hospitalisations. In conclusion, elderly women with higher total and cruciferous vegetable intake had lower injurious falls risk, which may be explained in a large part by better physical function. Falls reduction may be considered an additional benefit of higher vegetable intake in older women.
The newborn lamb lacks circulating antibodies and relies on an early and adequate intake of colostrum for passive protection against disease and for energy (Black, Francis and Nicholls, 1985; Mellor, 1990). However, lambs may receive less colostrum than they require because of sibling competition, maternal undernutrition or udder disease. Colostrum insufficiency accounts for about 25% of perinatal lamb deaths world wide (Khalaf, Doxey and Baxter, 1979).
Powdered colostrum substitutes may be used to supplement ‘at risk’ lambs but, because the products are manufactured outside the United Kingdom (UK), mainly from bovine sources, their relevance to UK sheep enterprises is uncertain. Further, their available energy content is low because the main constituent, protein, is not catabolized by newborn lambs (Mellor and Cockburn, 1986). The present work measured the ability of one substitute derived from bovine whey (based on ProLAM, Fisons Animal Health Ltd), with or without supplementary glucose; to prevent disease and promote growth to 3 months in lambs reared in typical UK farm conditions.
Arterial wall thickening, stimulated by low-grade systemic inflammation, underlies many cardiovascular events. As diet is a significant moderator of systemic inflammation, the dietary inflammatory index (DIITM) has recently been devised to assess the overall inflammatory potential of an individual’s diet. The primary objective of this study was to assess the association of the DII with common carotid artery–intima-media thickness (CCA–IMT) and carotid plaques. To substantiate the clinical importance of these findings we assessed the relationship of DII score with atherosclerotic vascular disease (ASVD)-related mortality, ischaemic cerebrovascular disease (CVA)-related mortality and ischaemic heart disease (IHD)-related mortality more. The study was conducted in Western Australian women aged over 70 years (n 1304). Dietary data derived from a validated FFQ (completed at baseline) were used to calculate a DII score for each individual. In multivariable-adjusted models, DII scores were associated with sub-clinical atherosclerosis: a 1 sd (2·13 units) higher DII score was associated with a 0·013-mm higher mean CCA–IMT (P=0·016) and a 0·016-mm higher maximum CCA–IMT (P=0·008), measured at 36 months. No relationship was seen between DII score and carotid plaque severity. There were 269 deaths during follow-up. High DII scores were positively associated with ASVD-related death (per sd, hazard ratio (HR): 1·36; 95 % CI 1·15, 1·60), CVA-related death (per sd, HR: 1·30; 95 % CI 1·00, 1·69) and IHD-related death (per sd, HR: 1·40; 95 % CI 1·13, 1·75). These results support the hypothesis that a pro-inflammatory diet increases systemic inflammation leading to development and progression of atherosclerosis and eventual ASVD-related death.
We present recent observation results of Sgr A* at millimeter obtained with VLBI arrays in Korea and Japan.
7 mm monitoring of Sgr A* is part of our AGN large project. The results at 7 epochs during 2013-2014, including high resolution maps, flux density and two-dimensional size measurements are presented. The source shows no significant variation in flux and structure related to the G2 encounter in 2014. According to recent MHD simulations by kawashima et al., flux and magnetic field energy can be expected to increase several years after the encounter; We will keep our monitoring in order to test this prediction.
Astrometric observations of Sgr A* were performed in 2015 at 7 and 3.5 millimeter simultaneously. Source-frequency phase referencing was applied and a combined ”core-shift” of Sgr A* and a nearby calibrator was measured. Future observations and analysis are necessary to determine the core-shift in each source.
Higher fruit intake is associated with lower risk of all-cause and disease-specific mortality. However, data on individual fruits are limited, and the generalisability of these findings to the elderly remains uncertain. The objective of this study was to examine the association of apple intake with all-cause and disease-specific mortality over 15 years in a cohort of women aged over 70 years. Secondary analyses explored relationships of other fruits with mortality outcomes. Usual fruit intake was assessed in 1456 women using a FFQ. Incidence of all-cause and disease-specific mortality over 15 years was determined through the Western Australian Hospital Morbidity Data system. Cox regression was used to determine the hazard ratios (HR) for mortality. During 15 years of follow-up, 607 (41·7 %) women died from any cause. In the multivariable-adjusted analysis, the HR for all-cause mortality was 0·89 (95 % CI 0·81, 0·97) per sd (53 g/d) increase in apple intake, HR 0·80 (95 % CI 0·65, 0·98) for consumption of 5–100 g/d and HR 0·65 (95 % CI 0·48, 0·89) for consumption of >100 g/d (an apple a day), compared with apple intake of <5 g/d (Pfor trend=0·03). Our analysis also found that higher apple intake was associated with lower risk for cancer mortality, and that higher total fruit and banana intakes were associated lower risk of CVD mortality (P<0·05). Our results support the view that regular apple consumption may contribute to lower risk of mortality.
High blood pressure (BP) variability, which may be an important determinant of hypertensive end-organ damage, is emerging as an important predictor of cardiovascular health. Dietary antioxidants can influence BP, but their effects on variability are yet to be investigated. The aim of the present study was to assess the effects of vitamin E, vitamin C and polyphenols on the rate of daytime and night-time ambulatory BP variation. To assess these effects, two randomised, double-blind, placebo-controlled trials were performed. In the first trial (vitamin E), fifty-eight individuals with type 2 diabetes were given 500 mg/d of RRR-α-tocopherol, 500 mg/d of mixed tocopherols or placebo for 6 weeks. In the second trial (vitamin C–polyphenols), sixty-nine treated hypertensive individuals were given 500 mg/d of vitamin C, 1000 mg/d of grape-seed polyphenols, both vitamin C and polyphenols, or neither (placebo) for 6 weeks. At baseline and at the end of the 6-week intervention, 24 h ambulatory BP and rate of measurement-to-measurement BP variation were assessed. Compared with placebo, treatment with α-tocopherol, mixed tocopherols, vitamin C and polyphenols did not significantly alter the rate of daytime or night-time systolic BP, diastolic BP or pulse pressure variation (P>0·05). Treatment with the vitamin C and polyphenol combination resulted in higher BP variation: the rate of night-time systolic BP variation (P= 0·022) and pulse pressure variation (P= 0·0036) were higher and the rate of daytime systolic BP variation was higher (P= 0·056). Vitamin E, vitamin C or grape-seed polyphenols did not significantly alter the rate of BP variation. However, the increase in the rate of BP variation suggests that the combination of high doses of vitamin C and polyphenols could be detrimental to treated hypertensive individuals.
In a constant effort to capture effectively more of the spectral range from the sun, multi-junction cells are being investigated. In this context, the marriage of thin film and dye-sensitized solar cells (DSC) PV technologies may be able to offer greater efficiency whilst maintaining the benefits of each individual technology. DSC devices offer advantages in the nature of both the metal oxide photo-electrode and dye absorption bands, which can be tuned to vary the optical performance of this part of a tandem device, while CdTe cells absorb the majority of light above their band-gap in only a few microns of thickness. The key challenge is to assess the optical losses with the goal of reaching a net gain in photocurrent and consequently increased conversion efficiency. This study reports on the influence of optical losses from various parts of the stacked tandem structure using UV-VIS spectrometry and EQE measurements. A net gain in photocurrent was achieved from a model developed for the DSC/CdTe mechanically stacked tandem structure.
There is growing awareness that small-scale fisheries may have large impacts on threatened marine fauna. Bycatch of small cetaceans by the Peruvian small-scale driftnet fleet results in the deaths of thousands of animals annually. We sought to assess the effectiveness of acoustic alarms (pingers) for reducing the incidental capture of dolphins and porpoises by this fleet. Forty-three experimental trips (156 fishing sets) and 47 control trips (195 fishing sets) out of Salaverry Port, northern Peru, were observed from April 2009 to August 2011. Twenty-two percent of control sets captured small cetaceans (67 individuals) and 16% of experimental sets had captures of small cetaceans (33 individuals). The bycatch rate of experimental sets was 0.50 individuals km−2h−1, whereas for control sets the rate was 0.80 individuals km−2h−1. This 37% reduction in bycatch rate suggests that pingers may be effective in reducing the bycatch of small cetaceans in this fishery. Catch rates of the fishery's target shark and ray species were unchanged. Given the vast size of this fishery and its current levels of bycatch of small cetaceans (> 10,000 individuals annually), even the modest declines in bycatch we observed could result in reductions in mortality of hundreds or thousands of small cetaceans per annum. Challenges, including increased costs, to large-scale utilization of pingers have yet to be overcome. The harpooning of dolphins for use as bait will also need to be addressed for further reductions in dolphin and porpoise bycatch and mortality to be achievable.
We present an update of the ‘key points’ from the Antarctic Climate Change and the Environment (ACCE) report that was published by the Scientific Committee on Antarctic Research (SCAR) in 2009. We summarise subsequent advances in knowledge concerning how the climates of the Antarctic and Southern Ocean have changed in the past, how they might change in the future, and examine the associated impacts on the marine and terrestrial biota. We also incorporate relevant material presented by SCAR to the Antarctic Treaty Consultative Meetings, and make use of emerging results that will form part of the Intergovernmental Panel on Climate Change (IPCC) Fifth Assessment Report.
Statistical models of epidemiology in wildlife populations usually consider diseased individuals as a single class, despite knowledge that infections progress through states of severity. Bovine tuberculosis (bTB) is a serious zoonotic disease threatening the UK livestock industry, but we have limited understanding of key epidemiological processes in its wildlife reservoirs. We estimated differential survival, force of infection and progression in disease states in a population of Eurasian badgers (Meles meles), naturally infected with bTB. Our state-dependent models overturn prevailing categorizations of badger disease states, and find novel evidence for early onset of disease-induced mortality in male but not female badgers. Males also have higher risk of infection and more rapid disease progression which, coupled with state-dependent increases in mortality, could promote sex biases in the risk of transmission to cattle. Our results reveal hidden complexities in wildlife disease epidemiology, with implications for the management of TB and other zoonotic diseases.
The main objectives of our study were to explore reasons for seasonal influenza vaccine acceptance and declination in employees of a large integrated healthcare system and to identify underlying constructs that influence acceptance versus declination. Secondary objectives were to determine whether vaccine acceptance varied by hospital location and to identify facility-level measures that explained variability.
A national health promotion survey of employees was conducted that included items on vaccination in the 2009-2010 influenza season. The survey was administered with two other institutional surveys in a stratified fashion: approximately 40% of participating employees were randomly assigned to complete the health promotion survey.
National single-payer healthcare system with 152 hospitals.
Employees of the healthcare system in 2010 who responded to the survey.
Factor analysis was used to identify underlying constructs that influenced vaccine acceptance versus declination. Mean factor scores were examined in relation to demographic characteristics and occupation. Multilevel logistic regression models were used to determine whether vaccine acceptance varied by location and to identify facility-level measures that explained variability.
Four factors were identified related to vaccine declination and were labeled as (1) “don't care,” (2) “don't want,” (3) “don't believe,” and (4) “don't know.” Significant differences in mean factor scores existed by demographic characteristics and occupation. Vaccine acceptance varied by location, and vaccination rates in the previous year were an important facility-level predictor.
Results should guide interventions that tailor messages on the basis of particular reasons for declination. Occupation-specific and culturally appropriate messaging should be considered. Continued efforts will be taken to better understand how workplace context influences vaccine acceptance.
Patients with schizophrenia have excess cardiovascular morbidity and mortality. Previous studies suggest that this may be partly due to inadequate somatic treatment and care, such as non-optimal use of lipid-lowering and antihypertensive pharmacotherapy, but longitudinal studies on such aetiological pathways are scarce.
We investigated the use of lipid-lowering and antihypertensive pharmacotherapy, and the risk of hospitalization for and death from coronary heart disease and stroke among patients with schizophrenia in a birth cohort of 12 939 subjects (Helsinki Birth Cohort Study). This cohort was followed for over 30 adult years by using national databases on cardio- and cerebrovascular hospitalizations and mortality and on reimbursement entitlements and use of drugs for treatment of hypertension, dyslipidaemia, coronary heart disease and diabetes.
Individuals with schizophrenia had a higher risk of hospitalization for coronary heart disease [hazard ratio (HR) 1.65, 95% confidence interval (CI) 1.03–2.57], and mortality from this disease was markedly higher (HR 2.92, 95% CI 1.70–5.00), particularly among women (p=0.001 for women, p=0.008 for men). Women with schizophrenia had also marginally increased stroke mortality (p=0.06). However, patients with schizophrenia used less lipid-lowering (odds ratio 0.47, 95% CI 0.27–0.80) and antihypertensive drug treatment (HR 0.37, 95% CI 0.22–0.61).
In this longitudinal study, coronary heart disease morbidity was increased and coronary heart disease mortality markedly increased in patients, especially in women with schizophrenia. These patients nevertheless received less antihypertensive and lipid-lowering treatment.
We have used an ultrahigh power, 100kW vortex cooled arc lamp to anneal As+ implant damage in <100> silicon wafers. When the wafer temperature was held above 1100°C for ∼1sec, TEM analysis indicated that the material was free of extended defects.The dopant diffused much more rapidly than would be expected from the usual models. However, preliminary results indicate that defect free material can be produced with dopant movement limited to ∼100Å.
A plastic, mechanically ventilated source isolator with filters in the air effluent was designed to enable infected patients to be nursed and treated in a general ward or to be transported without risk to staff or other contacts.
Two models of isolator were developed. Their potential value was tested by the challenge of heavy dispersal, inside the isolator, of bacteria (a) from patients with burns, during the change of dressings, (b) from contaminated bedding during simulated bed-making, and (c) from the dispersal of a suspension of Bacillus subtilis var. globigii.
Sampling of air by slit samplers outside the isolator and, in comparable control patients, from the air of the room in which dressings were changed, showed consistently lower counts of bacteria and of Staph. aureus during dressings when the isolator was used; on removal of the isolator canopy there was, in some experiments, a considerable increase in airborne bacteria, due to residual bacteria in the isolator or to the re-dispersal of bacteria which settled on the patient and his bedding during the dressing.
Simultaneous sampling with slit samplers inside and outside the isolator during and after bed-making or dispersal of B. subtilis var. globigii showed an almost complete protection of the air outside the isolator against contamination by bacteria released inside the isolator.
The effects of manipulation of sward maturity on ingestive behaviour and diet selection of grazing cattle were tested in two experiments using legumes which are equally preferred by cattle. Yearling heifers, in groups of three, grazed plots formed by alternate 2·4 m wide strips of a mixture of birdsfoot trefoil (Lotus corniculatus L.) and white clover (Trifolium repens L.) (BW) and strips of red clover (Trifolium pratense L.) (RC). The treatments comprised four combinations of each of the two swards at two contrasting levels of maturity/height replicated over four successive 3-day periods, in an order which balanced the effect of previous treatments. Observations of the distribution of grazing activity and biting rate were made over 3-hour periods each evening and in the morning of Day 2.
Rate of biting was generally greater on immature than mature swards, and on BW than on RC, with little evidence of interactions between these effects. The animals demonstrated partial preference throughout the two studies, the proportion of grazing time devoted to BW being 0·40±0·010 in Expt 1 and 0·47±0·017 in Expt 2. The distribution of grazing time between sward type and maturity combinations was influenced progressively by herbage mass and height contrasts as strips were grazed down. An overall analysis using the results from these studies and a companion experiment indicated differences between studies in partial preference for BW and RC which appeared to be related to variations in sward morphology.
Alternate 2·4 m wide strips of a mixture of birdsfoot trefoil (Lotus corniculatus L.) with white clover (Trifolium repens L.) (BW), and of red clover (Trifolium pratense L.) (RC) were offered in the proportions (by area) of 0·80[ratio ]0·20, 0·67[ratio ]0·33, 0·33[ratio ]0·67 and 0·20[ratio ]0·80 to yearling heifers in groups of three for periods of 3 days over four replicates in time, balanced for effects of previous treatments. Observations on the distribution of grazing activity and biting rate were made over 3 h periods each evening, and on the morning of Day 2. Biting rates were consistently higher on BW than RC (52·3 v. 46·3±0·59 bites/min, P<0·001). Initially the animals showed a strong tendency to concentrate grazing on the sward of smaller proportional area, but the selection coefficient (log θ) changed from positive to negative with time as herbage on minority strips was depleted. These results are discussed in the context of concepts of partial grazing preference.
Based on the physical, psychological, and developmental characteristics of childhood and adolescence, significant differences and similarities may be expected from the adult population. This summary focuses on the negative biological effects and sequelae of eating disorders in children and adolescents. These may encompass effects on growth and pubertal development, and medical complications of different organ systems, including morbidity and mortality. All organs are affected by the protein-calorie malnutrition associated with AN. Similarly, the malnutrition seen with BN results in medical sequelae. Table 9.1 lists the medical complications commonly associated with eating disorders in children and adolescents. In addition, investigations and measurement strategies to assess the medical impact of eating disorders are discussed.
Adolescence may be defined using many different parameters. Chronological age is used most widely in the literature. For the purpose of this chapter, the terms “adolescent” and “youth” will refer to the age group between 11 and 19 years of age. From the philosophical point of view, adolescence may be defined as a time of change that encompasses not only biological changes but also major psychological and social adjustments.
A vast literature related to medical complications in patients with eating disorders already exists for the adult population, serving as AN excellent source of reference for developing adolescents. Some of the previously highlighted differences between these two groups may be categorized based on the physiological hallmarks of adolescent development.