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.
To determine which established diet quality indices best predict weight-related outcomes in young women.
In this cross-sectional analysis, we collected dietary information using the Harvard Food Frequency Questionnaire (FFQ), and measured body fat percentage (BF%) by duel-energy X-ray absorptiometry. We used FFQ data to derive five diet quality indices: Recommended Food Score (RFS), Healthy Eating Index 2015 (HEI-2015), Alternate Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean Diet Score (aMED), Healthy Plant-Based Diet Index (HPDI).
University of Massachusetts at Amherst
n=260 healthy women aged 18-30
The AHEI-2010 and HPDI were associated with body mass index (BMI) and BF%, such that a 10-point increase in either diet score was associated with a 1.2 percentage-point lower BF% and a 0.5 kg/m2 lower BMI (P<0.05). Odds of excess body fat (i.e., BF%>32%) were 50% lower for those in the highest vs. lowest tertile of the AHEI-2010 (P=0.04). Neither the RFS nor HEI-2015 were associated with BMI or BF%; the aMED was associated with BMI but not BF%.
These results suggest that diet quality tends to be inversely associated with BMI and BF% in young women, but that this association is not observed for all diet quality indices. Diet indices may have limited utility in populations where the specific healthful foods and food groups emphasized by the index are not widely consumed. Future research should aim to replicate these findings in longitudinal studies that compare body composition changes over time across diet indices in young women.
Rapid vegetative growth and adverse application conditions are common factors leading to the failure of postemergence herbicides on Palmer amaranth. A sequential herbicide application, or respray, is often necessary to control weeds that have survived the initial herbicide application to protect crop yield and minimize weed seed production. The optimum timing after the initial application and the most effective herbicide for control of Palmer amaranth has not been characterized. The objectives of these experiments were to determine the optimum herbicide for treating Palmer amaranth regrowth, the optimum timing for each of those herbicides, and how the initial failed herbicide might affect efficacy of a second herbicide application. Bare ground field experiments were performed in 2017 and 2018 in which glufosinate or fomesafen herbicide failure was induced on Palmer amaranth plants that were 30 cm in height. Respray treatments of glufosinate, fomesafen, lactofen, 2,4-D, and dicamba were applied once at timings of 4 to 5 days, 7 days, or 11 days after the initial spray application. Nearly all herbicide treatment and timing combinations increased control by at least 13 percentage points compared to no respray herbicide treatment. Regardless of initial herbicide, glufosinate applied as a respray treatment was the most consistent and efficacious with up to 97% control. The specific herbicide used in the second application impacted final weed control more so than timing of the respray application. For instance, control by glufosinate respray treatments was 10 to 18 percentage points greater than control from lactofen respray treatments, whereas control decreased by 3 percentage points when respray applications of any herbicide were made 11 days after initial application of glufosinate compared to 4 to 5 and 7 days after initial application of glufosinate. In the event of failure to control Palmer amaranth with glufosinate or fomesafen, glufosinate should be applied in order to maximize control.
Radiotherapy is a mainstay of cancer therapy for a wide variety of anatomical areas. An unfortunate side effect of treatment can be radiation damage to the skin which can be a painful and debilitating problem. Previous experience from the experimental use of Flamigel® in two large-scale clinical studies on affected skin has proven sufficiently positive for the addition of a new product in the Flamigel® family (now commercially available in the UK as Flamigel RT®, Flen Health UK). The aim of this investigation is to evaluate the use of this new product to study how effective it is in the prevention and/or treatment of radiation-induced skin damage.
Materials and methods:
A survey was conducted among radiotherapy specialist teams in dedicated UK radiotherapy centres between 1 January 2017 and 31 October 2017. This report is of a preliminary evaluation conducted by UK-based specialists on 108 patients undergoing radiotherapy. The scoring system for skin reactions of the ‘Radiation Therapy Oncology Group’ was used.
Results show that the use of Flamigel® has the potential to soothe (p = 0·0001), reduce pain (p = 0·0001) and reduce pruritus (p = 0·004). The product met the expectations of the clinicians involved (p < 0·0001) of whom most were happy to continue use or to recommend its use to colleagues (p < 0·0001).
Flamigel® is an effective treatment in the management of radiation-induced skin reactions. Erythema was unchanged through the study period (p = 0·42). No adverse reactions were reported after the use of Flamigel from twice to six times a day.
During the last fifteen years there has been a paradigm shift in the continuum modelling of granular materials; most notably with the development of rheological models, such as the $\mu (I)$-rheology (where $\mu$ is the friction and I is the inertial number), but also with significant advances in theories for particle segregation. This paper details theoretical and numerical frameworks (based on OpenFOAM) which unify these currently disconnected endeavours. Coupling the segregation with the flow, and vice versa, is not only vital for a complete theory of granular materials, but is also beneficial for developing numerical methods to handle evolving free surfaces. This general approach is based on the partially regularized incompressible $\mu (I)$-rheology, which is coupled to the gravity-driven segregation theory of Gray & Ancey (J. Fluid Mech., vol. 678, 2011, pp. 353–588). These advection–diffusion–segregation equations describe the evolving concentrations of the constituents, which then couple back to the variable viscosity in the incompressible Navier–Stokes equations. A novel feature of this approach is that any number of differently sized phases may be included, which may have disparate frictional properties. Further inclusion of an excess air phase, which segregates away from the granular material, then allows the complex evolution of the free surface to be captured simultaneously. Three primary coupling mechanisms are identified: (i) advection of the particle concentrations by the bulk velocity, (ii) feedback of the particle-size and/or frictional properties on the bulk flow field and (iii) influence of the shear rate, pressure, gravity, particle size and particle-size ratio on the locally evolving segregation and diffusion rates. The numerical method is extensively tested in one-way coupled computations, before the fully coupled model is compared with the discrete element method simulations of Tripathi & Khakhar (Phys. Fluids, vol. 23, 2011, 113302) and used to compute the petal-like segregation pattern that spontaneously develops in a square rotating drum.
Amid public health concerns over climate change, “precision public health” (PPH) is emerging in next generation approaches to practice. These novel methods promise to augment public health operations by using ever larger and more robust health datasets combined with new tools for collecting and analyzing data. Precision strategies to protecting the public health could more effectively or efficiently address the systemic threats of climate change, but may also propagate or exacerbate health disparities for the populations most vulnerable in a changing climate. How PPH interventions collect and aggregate data, decide what to measure, and analyze data pose potential issues around privacy, neglecting social determinants of health, and introducing algorithmic bias into climate responses. Adopting a health justice framework, guided by broader social and climate justice tenets, can reveal principles and policy actions which may guide more responsible implementation of PPH in climate responses.
As herbicide-resistant weeds become more problematic, producers will consider the use of cover crops to suppress weeds. Weed suppression from cover crops may occur especially in the label-mandated buffer areas of dicamba-resistant soybean where dicamba use is not allowed. Three cover crops terminated at three timings with three herbicide strategies were evaluated for their effect on weed suppression in dicamba-resistant soybean. Delaying termination until soybean planting or after and using cereal rye or cereal rye + crimson clover increased cover-crop biomass by at least 40% compared to terminating early or using a crimson clover–only cover crop. Densities of problematic weed species were evaluated in early summer before a blanket POST application. Plots with cereal rye had 75% less horseweed compared to crimson clover at two of four site-years. Cereal rye or the mixed cover crop terminated at or after soybean planting reduced waterhemp densities by 87% compared to early termination timings of crimson clover and the earliest termination timing of the mix at one of two site-years. Cover crops were not as effective in reducing waterhemp densities as they were in reducing horseweed densities. This difference was due to a divergence in emergence patterns; waterhemp emergence generally peaks after termination of the cover crop, whereas horseweed emergence coincides with establishment and rapid vegetative growth of cereal rye. Cover crops alone were generally not as effective as was using a high-biomass cover crop combined with an herbicide strategy that contained dicamba and residual herbicides. However, within label-mandated buffer areas where dicamba cannot be used, a cover crop containing cereal rye with delayed termination until soybean planting combined with residual herbicides could be used to improve suppression of horseweed and waterhemp.
Psychotherapy research aims to investigate predictors and moderators of treatment outcome, but there are few consistent findings. This study aimed to investigate cytokines in patients undergoing treatment for anxiety disorders and whether the level of cytokines moderated the treatment outcome. Thirty-seven patients with comorbid and treatment-resistant anxiety disorders were investigated using multilevel modelling. Serum cytokine levels were measured three times: pretreatment, in the middle of treatment, and at the end of treatment. Anxiety and metacognitions were measured weekly throughout treatment by self-report. The levels of monocyte chemoattractant protein-1, tumour necrosis factor-alpha, and interleukin-1 receptor antagonist did not change during therapy or were not related to the level of anxiety. Metacognitive beliefs predicted anxiety, but the relationship between metacognitions and anxiety was not moderated by cytokines. Limitations of the study include that the patients were not fasting at blood sampling, and we did not assess body mass index, which may affect cytokine levels. The lack of significance for cytokines as a predictor or moderator may be due to a lack of power for testing moderation hypotheses, a problem associated with many psychotherapy studies. Cytokines did not predict the outcome in the treatment of comorbid anxiety disorders in our sample. Furthermore, cytokines did not moderate the relationship between metacognitions and anxiety.
A number of recent results have shown that within the shallow water, rigid-lid approximation, alongshore variations in the bathymetry, i.e. a submerged ridge, can lead to continental shelf waves (CSWs) that are localised geographically at the ridge and then decay both along and away from the coast. Removing the rigid-lid assumption, introduces the superinertial Poincaré waves and a Kelvin wave that is present at all frequencies. This implies that the spectrum of the associated wave operator, which is bounded for the rigid lid case, is continuous and unbounded for the free-surface case. In the rigid-lid case the localisation of modes are isolated eigenvalues lying above the continuous spectrum whereas any localised modes for the free-surface problem must necessarily be embedded in the continuous spectrum. The purpose of this work is to construct trapped CSWs analytically and numerically for a non-rectilinear shelf. A regular asymptotic method is employed by considering a slowly varying, non-rectilinear shelf with an approximate boundary condition at the shelf–ocean boundary. It is shown that even with the free-surface present, trapped CSWs do indeed exist for the submerged ridge topography. Comparison with highly accurate numerical results demonstrates the accuracy of the asymptotic method and also allows the consideration of shelves that abut an open ocean so avoiding the approximate boundary condition at the shelf–ocean boundary.
Elective surgical patients routinely bathe with chlorhexidine gluconate (CHG) at home days prior to their procedures. However, the impact of home CHG bathing on surgical site CHG concentration is unclear. We examined 3 different methods of applying CHG and hypothesized that different application methods would impact resulting CHG skin concentration.
The addition of dicamba as a weed control option in soybean [Glycine max (L.) Merr.] is a valuable tool. However, this technology must be utilized with other herbicide sites of action (SOAs) to reduce selection pressure on weed communities and ensure its prolonged usefulness. A long-term trial was conducted for 7 yr in Indiana to evaluate weed community densities and species richness with four levels of dicamba selection pressure in a corn (Zea mays L.)–soybean rotation. Monocot densities and richness increased over time in the dicamba-reliant treatment. Dicot densities in the dicamba-reliant treatment declined over time, but dicot richness increased. The soil weed seedbank was affected by the varying herbicide strategies. The dicamba-reliant strategy had greater than 43% higher total weed density than all other treatments, primarily due to having a monocot density that was at least 71% higher than the other treatments. The fully diversified strategy with eight SOAs and residual herbicides used every year had the lowest total weed species richness in the soil seedbank, which supported the in-field observations.
Foliar herbicide applications to waterhemp can result in inadequate control, leading to subsequent regrowth that often necessitates a second herbicide application to prevent crop interference and seed production. The most effective herbicides and application timings are unknown in situations where waterhemp has regrown from previous injury, such as failed applications of glufosinate or fomesafen. The objective of this research was to determine the optimum combination of herbicide and time from the first failed herbicide application to a sequential herbicide application for control of waterhemp regrowth. Reduced rates of either glufosinate or fomesafen were applied to 30-cm waterhemp plants to mimic failure of the initial herbicide application in separate bare-ground experiments. Respray treatments of glufosinate, fomesafen, lactofen, 2,4-D, or dicamba were applied 3, 7, or 11 d after the initial application. Glufosinate and fomesafen as respray treatments resulted in 90% to 100% control of waterhemp regardless of application timing following a failed glufosinate application. After a failed application of fomesafen, applying glufosinate or 2,4-D resulted in 87% to 99% control of waterhemp. Waterhemp control with fomesafen and lactofen was 13% to 21% greater, respectively, when those treatments followed glufosinate compared with fomesafen as the initial herbicides. On the basis of these results, glufosinate and fomesafen should be used for respray situations after inadequate control from glufosinate; and 2,4-D or glufosinate should be used for respray situations following inadequate control from fomesafen where crop tolerance and herbicide product labels allow. Although glufosinate followed by glufosinate was very effective for controlling waterhemp regrowth, caution should be exercised to avoid sequential application of herbicide with the same site of action.
Field experiments were conducted in 2017 and 2018 at two locations in Indiana to evaluate the influence of cover crop species, termination timing, and herbicide treatment on winter and summer annual weed suppression and corn yield. Cereal rye and canola cover crops were terminated early or late (2 wk before or after corn planting) with a glyphosate- or glufosinate-based herbicide program. Canola and cereal rye reduced total weed biomass collected at termination by up to 74% and 91%, in comparison to fallow, respectively. Canola reduced horseweed density by up to 56% at termination and 57% at POST application compared to fallow. Cereal rye reduced horseweed density by up to 59% at termination and 87% at POST application compared to fallow. Canola did not reduce giant ragweed density at termination in comparison to fallow. Cereal rye reduced giant ragweed density by up to 66% at termination and 62% at POST application. Termination timing had little to no effect on weed biomass and density reduction in comparison to the effect of cover crop species. Cereal rye reduced corn grain yield at both locations in comparison to fallow, especially for the late-termination timing. Corn grain yield reduction up to 49% (4,770 kg ha–1) was recorded for cereal rye terminated late in comparison to fallow terminated late. Canola did not reduce corn grain yield in comparison to fallow within termination timing; however, late-terminated canola reduced corn grain yield by up to 21% (2,980 kg ha–1) in comparison to early-terminated fallow. Cereal rye can suppress giant ragweed emergence, whereas canola is not as effective at suppressing large-seeded broadleaves such as giant ragweed. These results also indicate that early-terminated cover crops can often result in higher corn grain yields than late-terminated cover crops in an integrated weed management program.
To advance the quality of mental healthcare in Europe by developing guidance on implementing quality assurance.
We performed a systematic literature search on quality assurance in mental healthcare and the 522 retrieved documents were evaluated by two independent reviewers (B.J. and J.Z.). Based on these evaluations, evidence tables were generated. As it was found that these did not cover all areas of mental healthcare, supplementary hand searches were performed for selected additional areas. Based on these findings, fifteen graded recommendations were developed and consented by the authors. Review by the EPA Guidance Committee and EPA Board led to two additional recommendations (on immigrant mental healthcare and parity of mental and physical healthcare funding).
Although quality assurance (measures to keep a certain degree of quality), quality control and monitoring (applying quality indicators to the current degree of quality), and quality management (coordinated measures and activities with regard to quality) are conceptually distinct, in practice they are frequently used as if identical and hardly separable. There is a dearth of controlled trials addressing ways to optimize quality assurance in mental healthcare. Altogether, seventeen recommendations were developed addressing a range of aspects of quality assurance in mental healthcare, which appear usable across Europe. These were divided into recommendations about structures, processes and outcomes. Each recommendation was assigned to a hierarchical level of analysis (macro-, meso- and micro-level).
There was a lack of evidence retrievable by a systematic literature search about quality assurance of mental healthcare. Therefore, only after further topics and search had been added it was possible to develop recommendations with mostly medium evidence levels.
Evidence-based graded recommendations for quality assurance in mental healthcare were developed which should next be implemented and evaluated for feasibility and validity in some European countries. Due to the small evidence base identified corresponding to the practical obscurity of the concept and methods, a European research initiative is called for by the stakeholders represented in this Guidance to improve the educational, methodological and empirical basis for a future broad implementation of measures for quality assurance in European mental healthcare.
This study investigated the point prevalence of extrapyramidal movement disorders in patients with chronic schizophrenia and related disorders who are currently treated by Northland District Health Board (DHB) mental health services, New Zealand. The study also investigated evidence of variation in the point prevalence of these disorders based on the ethnicity of the patients (indigenous Māori patients and non-Māori).
151 patients, who had received antipsychotic medication for 3 months or more, were recruited as participants for the study using randomised computer software. Ethnicity was documented using self-identification. Akathisia was assessed using the Barnes Akathisia Rating Scale (BARS). The Abnormal Involuntary Movement Scale (AIMS) was used to assess tardive dyskinesia and extrapyramidal side effects (EPSE) were assessed by the Simpson-Angus Rating Scale (SAS).
9.3 % had akathisia using Barnes scale, 43% had Parkinsonian symptoms on SAS scale, and 18.5 % had tardive dyskinesia using AIMS scale. The analysis failed to show any statistically significant differences based on ethnicity (indigenous Māori and non-Māori). P = 0.284, 0.176, and 0.201 for Barnes, SAS and Aims respectively.
The findings suggest that the prevalence of neuroleptics-induced movement disorders in psychotic patients within Northland DHB (9%-43%), is similar to the documented international figures. These findings also indicate that there is no significant difference based on ethnicity between Māori and non-Māori in terms of movement disorders profile.