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International jurists pride themselves on keeping busy, and between permanent tribunal seats, ad hoc arbitral appointments, speaking engagements, writing, and teaching (among other activities), many do keep their calendars full.
Review findings on the role of dietary patterns in preventing depression are inconsistent, possibly due to variation in assessment of dietary exposure and depression. We studied the association between dietary patterns and depressive symptoms in six population-based cohorts and meta-analysed the findings using a standardised approach that defined dietary exposure, depression assessment and covariates.
Included were cross-sectional data from 23 026 participants in six cohorts: InCHIANTI (Italy), LASA, NESDA, HELIUS (the Netherlands), ALSWH (Australia) and Whitehall II (UK). Analysis of incidence was based on three cohorts with repeated measures of depressive symptoms at 5–6 years of follow-up in 10 721 participants: Whitehall II, InCHIANTI, ALSWH. Three a priori dietary patterns, Mediterranean diet score (MDS), Alternative Healthy Eating Index (AHEI-2010), and the Dietary Approaches to Stop Hypertension (DASH) diet were investigated in relation to depressive symptoms. Analyses at the cohort-level adjusted for a fixed set of confounders, meta-analysis used a random-effects model.
Cross-sectional and prospective analyses showed statistically significant inverse associations of the three dietary patterns with depressive symptoms (continuous and dichotomous). In cross-sectional analysis, the association of diet with depressive symptoms using a cut-off yielded an adjusted OR of 0.87 (95% confidence interval 0.84–0.91) for MDS, 0.93 (0.88–0.98) for AHEI-2010, and 0.94 (0.87–1.01) for DASH. Similar associations were observed prospectively: 0.88 (0.80–0.96) for MDS; 0.95 (0.84–1.06) for AHEI-2010; 0.90 (0.84–0.97) for DASH.
Population-scale observational evidence indicates that adults following a healthy dietary pattern have fewer depressive symptoms and lower risk of developing depressive symptoms.
We evaluated whether a diagnostic stewardship initiative consisting of ASP preauthorization paired with education could reduce false-positive hospital-onset (HO) Clostridioides difficile infection (CDI).
Single center, quasi-experimental study.
Tertiary academic medical center in Chicago, Illinois.
Adult inpatients were included in the intervention if they were admitted between October 1, 2016, and April 30, 2018, and were eligible for C. difficile preauthorization review. Patients admitted to the stem cell transplant (SCT) unit were not included in the intervention and were therefore considered a contemporaneous noninterventional control group.
The intervention consisted of requiring prescriber attestation that diarrhea has met CDI clinical criteria, ASP preauthorization, and verbal clinician feedback. Data were compared 33 months before and 19 months after implementation. Facility-wide HO-CDI incidence rates (IR) per 10,000 patient days (PD) and standardized infection ratios (SIR) were extracted from hospital infection prevention reports.
During the entire 52 month period, the mean facility-wide HO-CDI-IR was 7.8 per 10,000 PD and the SIR was 0.9 overall. The mean ± SD HO-CDI-IR (8.5 ± 2.0 vs 6.5 ± 2.3; P < .001) and SIR (0.97 ± 0.23 vs 0.78 ± 0.26; P = .015) decreased from baseline during the intervention. Segmented regression models identified significant decreases in HO-CDI-IR (Pstep = .06; Ptrend = .008) and SIR (Pstep = .1; Ptrend = .017) trends concurrent with decreases in oral vancomycin (Pstep < .001; Ptrend < .001). HO-CDI-IR within a noninterventional control unit did not change (Pstep = .125; Ptrend = .115).
A multidisciplinary, multifaceted intervention leveraging clinician education and feedback reduced the HO-CDI-IR and the SIR in select populations. Institutions may consider interventions like ours to reduce false-positive C. difficile NAAT tests.
As part of the “America First” agenda discussed in his inaugural address, President Donald J. Trump promised that “[e]very decision” on trade, among other areas, would be “made to benefit American workers and American families.” During its first months, the Trump Administration made a number of trade moves apparently in connection with this “America First” trade agenda, including initiating national security investigations into steel and aluminum imports under Section 232 of the Trade Expansion Act of 1962 and preparing an “omnibus” report on trade deficits. The Trump Administration also took steps to alter U.S. treaty relationships, by withdrawing from the Trans-Pacific Partnership Agreement, announcing the renegotiation of the North American Free Trade Agreement, and requesting a special session of a joint committee created under the United States-Korea Free Trade Agreement. In August 2017, President Trump continued this course—and indicated a willingness to take unilateral action against U.S. trading partners—by signing a presidential memorandum directing the United States Trade Representative to determine whether China's treatment of U.S. intellectual property warranted investigation under Section 301 et seq. of the Trade Act of 1974.
In 1964 (Solar Cycle 20; SC 20), Patrick McIntosh began creating hand-drawn synoptic maps of solar magnetic features, based on Hα images. These synoptic maps were unique in that they traced magnetic polarity inversion lines, and connected widely separated filaments, fibril patterns, and plage corridors to reveal the large-scale organization of the solar magnetic field. Coronal hole boundaries were later added to the maps, which were produced, more or less continuously, into 2009 (i.e., the start of SC 24). The result was a record of ~45 years (~570 Carrington rotations), or nearly four complete solar cycles of synoptic maps. We are currently scanning, digitizing and archiving these maps, with the final, searchable versions publicly available at NOAA's National Centers for Environmental Information. In this paper we present preliminary scientific studies using the archived maps from SC 23. We show the global evolution of closed magnetic structures (e.g., sunspots, plage, and filaments) in relation to open magnetic structures (e.g., coronal holes), and examine how both relate to the shifting patterns of large-scale positive and negative polarity regions.
The relationship between humans and domestic animals has changed in dramatic ways over the ages, and those transitions have had profound consequences for all parties involved. As societies evolve, the selective pressures that shape domestic populations also change. Some animals retain close relationships with humans, but many do not. Those who establish residency in the wild, free from direct human control, are technically neither domestic nor wild: they are feral. If we really want to understand humanity's complex relationship with domestic animals, then we cannot simply ignore the ones who went feral. This is especially true in the American South, where social and cultural norms have facilitated and sustained large populations of feral animals for hundreds of years. Feral Animals in the American South retells southern history from this new perspective of feral animals.