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Tuberculosis (TB) is the leading cause of death among infectious diseases worldwide. Among the estimated cases of drug-resistant TB, approximately 60% occur in the BRICS countries (Brazil, Russia, India, China and South Africa). Among Brazilian states, primary and acquired multidrug-resistant TB (MDR-TB) rates were the highest in Rio Grande do Sul (RS). This study aimed to perform molecular characterisation of MDR-TB in the State of RS, a high-burden Brazilian state. We performed molecular characterisation of MDR-TB cases in RS, defined by drug susceptibility testing, using 131 Mycobacterium tuberculosis (M.tb) DNA samples from the Central Laboratory. We carried out MIRU-VNTR 24loci, spoligotyping, sequencing of the katG, inhA and rpoB genes and RDRio sublineage identification. The most frequent families found were LAM (65.6%) and Haarlem (22.1%). RDRio deletion was observed in 42 (32%) of the M.tb isolates. Among MDR-TB cases, eight (6.1%) did not present mutations in the studied genes. In 116 (88.5%) M.tb isolates, we found mutations associated with rifampicin (RIF) resistance in rpoB gene, and in 112 isolates (85.5%), we observed mutations related to isoniazid resistance in katG and inhA genes. An insertion of 12 nucleotides (CCAGAACAACCC) at the 516 codon in the rpoB gene, possibly responsible for a decreased interaction of RIF and RNA polymerase, was found in 19/131 of the isolates, belonging mostly to LAM and Haarlem families. These results enable a better understanding of the dynamics of transmission and evolution of MDR-TB in the region.
The energy supplied by the high-forage diets used in organic farming may be insufficient to meet the requirements of dairy cattle. However, few studies have considered this problem. The present study aimed to analyze the composition of the diets and the nutritional status (focusing on the energy–protein balance of the diets) of dairy cattle reared on organic farms in northern Spain, which are similar to other organic farming systems in temperate regions. Exhaustive information about diets was obtained from organic (ORG) and representative conventional grazing (GRZ) and conventional no-grazing (CNG) farms. Samples of feed from the respective farms were analyzed to determine the composition. Overall, the diets used on the ORG farms were very different from those used on the CNG farms, although the difference was not as evident for GRZ. The CNG farms were characterized by a higher total dry matter intake with a high proportion of concentrate feed, maize silage and forage silage. By contrast, on ORG and GRZ farms, the forage, pasture and fibre intake were the most important variables. The ration used on ORG farms contained a significantly higher percentage of ADF and lower organic matter (OM) content than the rations used in both of the conventional farming systems, indicating that the diets in the former were less digestible. Although the protein concentration in the diets used on the grazing farms (ORG and GRZ) was higher than those used on CNG farms, the protein intake was similar. The results indicated an imbalance between energy and protein due to the low level of energy provided by the ORG diets, suggesting that more microbial protein could be synthesized from the available rumen-degraded dietary nitrogen if rumen-fermentable OM was not limiting. The imbalance between energy and protein led to a reduced amount of total digestible protein reaching the intestine and a lower milk yield per kilogram of CP intake on the ORG farms. In order to improve the protein use efficiency and consequently to reduce the loss of nitrogen to the environment, organic farming should aim to increase the energy content of cattle diets by improving forage quality and formulating rations with more balanced combinations of forage and grain.
The mental health and social functioning of millions of forcibly displaced individuals worldwide represents a key public health priority for host governments. This is the first longitudinal study with a representative sample to examine the impact of interpersonal trust and psychological symptoms on community engagement in refugees.
Participants were 1894 resettled refugees, assessed within 6 months of receiving a permanent visa in Australia, and again 2–3 years later. Variables measured included post-traumatic stress disorder symptoms, depression/anxiety symptoms, interpersonal trust and engagement with refugees’ own and other communities.
A multilevel path analysis was conducted, with the final model evidencing good fit (Comparative Fit Index = 0.97, Tucker–Lewis Index = 0.89, Root Mean Square Error of Approximation = 0.05, Standardized Root-Mean-Square-Residual = 0.05). Findings revealed that high levels of depression symptoms were associated with lower subsequent engagement with refugees’ own communities. In contrast, low levels of interpersonal trust were associated with lower engagement with the host community over the same timeframe.
Findings point to differential pathways to social engagement in the medium-term post-resettlement. Results indicate that depression symptoms are linked to reduced engagement with one's own community, while interpersonal trust is implicated in engagement with the broader community in the host country. These findings have potentially important implications for policy and clinical practice, suggesting that clinical and support services should target psychological symptoms and interpersonal processes when fostering positive adaptation in resettled refugees.
The aim of this study was to evaluate the effect of incubating semen for different periods (90, 270 or 450 min) with or without Trolox® (100 or 150 µM) on the quality of sperm from Saimiri collinsi. Sperm motility, vigour, and plasma membrane integrity (PMI) were evaluated in both fresh semen and semen incubated for different time periods, i.e. 90, 270 or 450 min of incubation. Supplementation of semen extender with Trolox® 100 µM improved sperm motility, vigour and PMI for up to 270 min of incubation.
The goal of this study was to analyse the spatial pattern of tuberculosis (TB) mortality using different approaches, namely: mortality rates (MR), spatial relative risks (RR) and Bayesian rates (Global and Local) and their association with human development index (HDI), Global and its three dimensions: education, longevity and income. An ecological study was developed in Curitiba, Brazil based on data from Mortality Information System (2008–2014). Spatial scan statistics were used to compute RR and identify high-risk clusters. Bivariate Local Indicator of Spatial Associations was used to assess associations. MR ranged between 0 and 25.24/100.000 with a mean (standard deviation) of 1.07 (2.66). Corresponding values for spatial RR were 0–27.46, 1.2 (2.99) and for Bayesian rates (Global and Local) were 0.49–1.66, 0.90 (0.19) and 0–6.59, 0.98 (0.80). High-risk clusters were identified for all variables, except for HDI-income and Global Bayesian rate. Significant negative spatial relations were found between MR and income; between RR and HDI global, longevity and income; and Bayesian rates with all variables. Some areas presented different patterns: low social development/low risk and high risk/high development. These results demonstrate that social development variables should be considered, in mortality due TB.
Projected changes to post-traumatic stress disorder (PTSD) diagnostic criteria in the upcoming International Classification of Diseases (ICD)-11 may affect the prevalence and severity of identified cases. This study examined differences in rates, severity, and overlap of diagnoses using ICD-10 and ICD-11 PTSD diagnostic criteria during consecutive assessments of recent survivors of traumatic events.
The study sample comprised 3863 survivors of traumatic events, evaluated in 11 longitudinal studies of PTSD. ICD-10 and ICD-11 diagnostic rules were applied to the Clinician-Administered PTSD Scale (CAPS) to derive ICD-10 and ICD-11 diagnoses at different time intervals between trauma occurrence and 15 months.
The ICD-11 criteria identified fewer cases than the ICD-10 across assessment intervals (range −47.09% to −57.14%). Over 97% of ICD-11 PTSD cases met concurrent ICD-10 PTSD criteria. PTSD symptom severity of individuals identified by the ICD-11 criteria (CAPS total scores) was 31.38–36.49% higher than those identified by ICD-10 criteria alone. The latter, however, had CAPS scores indicative of moderate PTSD. ICD-11 was associated with similar or higher rates of comorbid mood and anxiety disorders. Individuals identified by either ICD-10 or ICD-11 shortly after traumatic events had similar longitudinal course.
This study indicates that significantly fewer individuals would be diagnosed with PTSD using the proposed ICD-11 criteria. Though ICD-11 criteria identify more severe cases, those meeting ICD-10 but not ICD-11 criteria remain in the moderate range of PTSD symptoms. Use of ICD-11 criteria will have critical implications for case identification in clinical practice, national reporting, and research.
We show that on-off intermittency in solar and stellar cycles is a result of amplitude-phase synchronization in multiscale interactions in solar/stellar dynamos or magnetorotational instability which leads to the formation of kinematic and magnetic coherent structures, and the novel techniques of Lagrangian coherent structures can detect transport barriers and vortices such as magnetic flux tubes/ropes in solar and stellar turbulence with high accuracy.
The present study aimed to evaluate trace mineral status of organic dairy herds in northern Spain and the sources of minerals in different types of feed. Blood samples from organic and conventional dairy cattle and feed samples from the respective farms were analysed by inductively coupled plasma mass spectrometry to determine the concentrations of the essential trace elements (cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), iodine (I), manganese (Mn), molybdenum (Mo), nickel (Ni), selenium (Se) and zinc (Zn)) and toxic trace elements (arsenic (As), cadmium (Cd), mercury (Hg) and lead (Pb)). Overall, no differences between organic and conventional farms were detected in serum concentrations of essential and toxic trace elements (except for higher concentrations of Cd on the organic farms), although a high level of inter-farm variation was detected in the organic systems, indicating that organic production greatly depends on the specific local conditions. The dietary concentrations of the essential trace elements I, Cu, Se and Zn were significantly higher in the conventional than in the organic systems, which can be attributed to the high concentration of these minerals in the concentrate feed. No differences in the concentrations of trace minerals were found in the other types of feed. Multivariate chemometric analysis was conducted to determine the contribution of different feed sources to the trace element status of the cattle. Concentrate samples were mainly associated with Co, Cu, I, Se and Zn (i.e. with the elements supplemented in this type of feed). However, pasture and grass silage were associated with soil-derived elements (As, Cr, Fe and Pb) which cattle may thus ingest during grazing.
Research suggests that lesbian, gay and bisexual (LGB) adolescents have a higher risk of suicidal behaviours than their heterosexual peers, but little is known about specific risk factors.
To assess sexual orientation as a risk factor for suicidal behaviours, and to identify other risk factors among LGB adolescents and young adults.
A systematic search was made of six databases up to June 2015, including a grey literature search. Population-based longitudinal studies considering non-clinical populations aged 12–26 years and assessing being LGB as a risk factor for suicidal behaviour compared with being heterosexual, or evaluating risk factors for suicidal behaviour within LGB populations, were included. Random effect models were used in meta-analysis.
Sexual orientation was significantly associated with suicide attempts in adolescents and youths (OR=2.26, 95% CI 1.60–3.20). Gay or bisexual men were more likely to report suicide attempts compared with heterosexual men (OR=2.21, 95% CI 1.21–4.04). Based on two studies, a non-significant positive association was found between depression and suicide attempts in LGB groups.
Sexual orientation is associated with a higher risk of suicide attempt in young people. Further research is needed to assess completed suicide, and specific risk factors affecting the LGB population.
High-quality placebo-controlled evidence for food, nutrient or dietary advice interventions is vital for verifying the role of diet in optimising health or for the management of disease. This could be argued to be especially important where the benefits of dietary intervention are coupled with potential risks such as compromising nutrient intake, particularly in the case of exclusion diets. The objective of the present paper is to explore the challenges associated with clinical trials in dietary research, review the types of controls used and present the advantages and disadvantages of each, including issues regarding placebos and blinding. Placebo-controlled trials in nutrient interventions are relatively straightforward, as in general placebos can be easily produced. However, the challenges associated with conducting placebo-controlled food interventions and dietary advice interventions are protean, and this has led to a paucity of placebo-controlled food and dietary advice trials compared with drug trials. This review appraises the types of controls used in dietary intervention trials and provides recommendations and nine essential criteria for the design and development of sham diets for use in studies evaluating the effect of dietary advice, along with practical guidance regarding their evaluation. The rationale for these criteria predominantly relate to avoiding altering the outcome of interest in those delivered the sham intervention in these types of studies, while not compromising blinding.
New remote sensing technologies have provided unprecedented results in vineyard monitoring. The aim of this work was to evaluate different sources of images and processing methodologies to describe spatial variability of spectral-based and canopy-based vegetation indices within a vineyard, and their relationship with productive and qualitative vine parameters. Comparison between image-derived indices from Sentinel 2 NDVI, unfiltered and filtered UAV NDVI and with agronomic features have been performed. UAV images allow calculating new non-spectral indices based on canopy architecture that provide additional and useful information to the growers with regards to within-vineyard management zone delineation.
The order Chiroptera is considered the second largest group of mammals in the world, hosting important zoonotic virus and bacteria. Bartonella and hemotropic mycoplasmas are bacteria that parasite different mammals’ species, including humans, causing different clinical manifestations. The present work aimed investigating the occurrence and assessing the phylogenetic positioning of Bartonella spp. and Mycoplasma spp. in neotropical bats sampled from Brazil. Between December 2015 and April 2016, 325 blood and/or tissues samples were collected from 162 bats comprising 19 different species sampled in five states of Brazil. Out of 322 bat samples collected, while 17 (5·28%) were positive to quantitative PCR for Bartonella spp. based on nuoG gene, 45 samples (13·97%) were positive to cPCR assays for hemoplasmas based on 16S rRNA gene. While seven sequences were obtained for Bartonella (nuoG) (n = 3), gltA (n = 2), rpoB (n = 1), ftsZ (n = 1), five 16S rRNA sequences were obtained for hemoplasmas. In the phylogenetic analysis, the Bartonella sequences clustered with Bartonella genotypes detected in bats sampled in Latin America countries. All five hemoplasmas sequences clustered together as a monophyletic group by Maximum Likelihood and Bayesian Inference analyses. The present work showed the first evidence of circulation of Bartonella spp. and hemoplasmas among bats in Brazil.
Long-term care facilities have partly taken over the traditional asylum function of psychiatric hospitals and house an increasing group of patients with mental–physical multimorbidity (MPM). Little is known about the characteristics, behavior, and care dependency of these patients. This paper aims to describe these aspects.
Explorative, descriptive study among patients with MPM without dementia (n = 142), living in 17 geronto-psychiatric nursing home (NH) units across the Netherlands, stratified by those referred from mental healthcare services (MHS) and other healthcare services (OHS). Data collection consisted of chart review, semi-structured interviews, (brief) neuropsychological testing, and self-report questionnaires. Patients referred from MHS (n = 58) and from OHS (n = 84) were compared by descriptive statistics.
Despite exclusion of patients with dementia, the majority of participants had cognitive impairment. Prevalence and severity of frontal impairment were high, as well as the number of patients with clinically relevant neuropsychiatric symptoms. MHS patients were younger, had more chronic psychiatric disorders, and more often used antipsychotics. Neuropsychiatric symptoms, domains of care dependency, physical conditions and concomitant medication use differed not significantly between the subgroups.
Both groups of patients with MPM showed heterogeneity in various aspects but differed not significantly regarding the consequences of their multimorbidity. In a variety of characteristics, this group seems to be different from other NH patient groups, which requires extra knowledge and skills of the staff. To uncover which knowledge and skills are necessary, the next step should be to investigate the specific care needs of NH patients with MPM without dementia.
Air pollution in Mexico City, which has more than 22 million inhabitants, continues to be one of the main environmental issues. Aerosol samples (PM10) collected in Mexico City and the city of Cuernavaca (a clean reference site) have been characterized using different techniques. This multifaceted approach addresses the source apportionment of the carbonaceous matter in PM10, as well as the airborne elements and ions. Accelerator mass spectrometry (AMS) radiocarbon analysis of total carbon, X-ray fluorescence (XRF), and ion chromatography were performed on aerosols collected at three sites in Mexico City and one site in Cuernavaca, during 2 months of the cold-dry season (November–December) in 2012. New results obtained for Mexico City are compared with previous reports. Average levels of PM10 were higher in Mexico City sites (43.3–60.8 μg/m3) than in Cuernavaca (32.2 μg/m3). According to the material balance, PM10 collected in Mexico City had a lower contribution of crustal material (31.2–36.8%) than Cuernavaca (46.9%). Average contributions of particulate carbonaceous matter to PM10 were similar in both cities, but much higher contributions of mineral salts, trace elements, and ions were observed in Mexico City in comparison to Cuernavaca. Total organic carbon (OC) and elemental carbon (EC) contents were higher in aerosols from Mexico City than those from Cuernavaca. The temporal variation results showed that within all locations studied the OC concentration was high compared to the EC. Results from a theoretical calculation of fossil carbon (FC) and biogenic carbon (BC) concentrations showed that FC and BC levels depend on the site: at Mexico City sites, FC was equal or higher than BC. At Cuernavaca, BC was always higher than FC.
We conducted a survival analysis with competing risks to estimate the mortality rate and predictive factors for immunodeficiency-related death in people living with HIV/AIDS (PLWH) in northeast Brazil. A cohort with 2372 PLWH was enrolled between July 2007 and June 2010 and monitored until 31 December 2012 at two healthcare centres. The event of interest was immunodeficiency-related death, which was defined based on the Coding Causes of Death in HIV Protocol (CoDe). The predictor variables were: sociodemographic characteristics, illicit drugs, tobacco, alcohol, nutritional status, antiretroviral therapy, anaemia and CD4 cell count at baseline; and treatment or chemoprophylaxis for tuberculosis (TB) during follow-up. We used Fine & Gray's model for the survival analyses with competing risks, since we had regarded immunodeficiency-unrelated deaths as a competing event, and we estimated the adjusted sub-distribution hazard ratios (SHRs). In 10 012·6 person-years of observation there were 3·1 deaths/100 person-years (2·3 immunodeficiency-related and 0·8 immunodeficiency-unrelated). TB (SHR 4·01), anaemia (SHR 3·58), CD4 <200 cells/mm3 (SHR 3·33) and being unemployed (SHR 1·56) were risk factors for immunodeficiency-related death. This study discloses a 13% coverage by highly active antiretroviral therapy (HAART) in our state and adds that anaemia at baseline or the incidence of TB may increase the specific risk of dying from HIV-immunodeficiency, regardless of HAART and CD4.
The population growth of endangered whooping cranes (Grus americana) is not consistent with species recovery goals, and the impact of parasite infection on whooping crane populations is largely unknown. Disease ecology and epidemiology research of endangered species is often hindered by limited ability to conduct invasive sampling on the target taxa. Accordingly, we hypothesized that sandhill cranes (Grus canadensis) would be a useful surrogate species to investigate the health impacts of Haemosporida infection in whooping cranes. Our goal was to compare the prevalence and diversity of Haemosporida infection between whooping cranes and sandhill cranes. We detected an overall infection prevalence of 83·6% (n = 61) in whooping cranes and 59·6% (n = 47) and 63·6 (n = 22) in two sympatric sandhill crane populations captured in Texas. Prevalence was significantly lower in allopatric sandhill cranes captured in New Mexico (12·1%, n = 33). Haemoproteus antigonis was the most abundant haemoparasite in cranes, present in 57·4% of whooping cranes and 39·2% of sandhill cranes; Plasmodium and Leucocytozoon were present at significantly lower levels. The high prevalence of Haemosporida in whooping cranes and sympatric sandhill cranes, with shared parasite lineages between the two species, supports sandhill cranes as a surrogate species for understanding health threats to endangered whooping cranes.
Long-slit optical spectroscopy and VLA-B radio continuum (λ = 3.6 cm) observations toward the compact planetary nebulae Cn 3-1 and M 3-27 are presented. Optical spectra were taken at different position angles (PAs) with the 2.2 m telescope at Calar Alto (Spain), covering the range from 6549 to 6751 Å. The radio and optical data show that the ionized shell of Cn 3-1 is an ellipsoid (size ≃ 6″ × 5″, PA ≃ 72°) containing a bright ring-like equatorial zone (size ≃ 2″.6, expansion velocity ≃ 14 km s–1) and two bright point-symmetric arcs, extending from the equator towards the polar regions of the ellipsoid (Fig. 1). These arcs seem to be filamentary structures embedded in the ellipsoid. An ionized stellar wind has been detected through faint extended wings in the Hα (≃ 660 km s–1) and [N II] (≃ 460 km s–1) emission lines. M 3-27 is unresolved at 3.6 cm (size ≤ 0″6). The detected [N II] and [S II] emission lines arise in a compact (≤ 1″4) probably non-spherical region which is identified with the ionized shell of M 3-27. The Hα emission from M 3-27 is dominated by strong emission from an ionized stellar wind and exhibits a Type III P Cygni profile with very extended wings (≃ 3000 km s–1). The estimated kinematic age and ionized mass of Cn 3-1 (≃ 1300 yr, 4 × 10–2 M⊙) and M 3-27 (≤ 530 yr, ≃ 3 × 10–4 M⊙) indicate that both objects are young planetary nebulae. Extended halos (size ≃ 36″ in Cn 3-1, ≃ 24″ in M 3-27) have been spectroscopically detected in both objects. An analysis of the kinematic and emission properties shows that both halos are reflection nebulosities and suggests that the distribution of neutral material in them probably is largely isotropic. The results suggest that the halos correspond to isotropic mass ejections occurred in the last ≃ 2 × 104 yr of the AGB phase of the Cn 3-1 and M 3-27 progenitors.
We present VLA-A radio continuum at 3.6 cm and H92α observations, and optical long-slit spectra at high spectral and spatial resolution of the compact Planetary Nebulae (PNs) Hu 2-1, IC 4997, IC 5117 and NGC 6884. The radio continuum maps show the subarcsecond structure of the PNs in detail. From the optical spectra, the basic kinematical properties can be deduced. The H92α emission line, spatially and spectrally resolved in IC 5117 and Hu 2-1, allows us to observe the kinematics of the PNs in spatial scales of ∼ 0.3″. By combining the radio and optical data, it is possible to identify the components present in the nebulae, to deduce their spatio-kinematical structure, and to obtain estimates for the electron density and temperature, ionized masses and kinematical ages. All this information permits to impose constraints about the mass ejection processes involved in the formation of PNs and when they have occurred.