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A Doyle–Fuller–Newman (DFN) model for the charge and discharge of nano-structured lithium iron phosphate (LFP) cathodes is formulated on the basis that lithium transport within the nanoscale LFP electrode particles is much faster than cell discharge, and is therefore not rate limiting. We present some numerical solutions to the model and show that for relevant parameter values, and a variety of C-rates, it is possible for sharp discharge fronts to form and intrude into the electrode from its outer edge(s). These discharge fronts separate regions of fully utilised LFP electrode particles from those that are not. Motivated by this observation an asymptotic solution to the model is sought. The results of the asymptotic analysis of the DFN model lead to a reduced order model, which we term the reaction front model (or RFM). Favourable agreement is shown between solutions to the RFM and the full DFN model in appropriate parameter regimes. The RFM is significantly cheaper to solve than the DFN model, and therefore has the potential to be used in scenarios where computational costs are prohibitive, e.g. in optimisation and parameter estimation problems or in engineering control systems.
We sought to determine whether combined chemical, mechanical, and heat cleaning was superior to standard cleaning for the decontamination of 32 sink and shower drains harboring carbapenemase-producing organisms (CPOs). Of 16 intervention drains, 10 (63%) were decontaminated until day 7 versus 1 (5%) of 16 comparator drains (P = .002). Intensive cleaning may be useful if administered repeatedly in drain-associated CPO outbreaks.
Rescuing Human Rights: A Radically Moderate Approach (Rescuing) was published shortly before the outbreak in 2020 of the novel coronavirus and its myriad human rights and class issues regarding equality, discrimination, health, and labor rights of people of color. This was also prior to the concurrent public murder of George Floyd as an unarmed Black man by the Minneapolis police in late May 2020, and the resulting continuing Black Lives Matter massive national and international movement against the deaths of Floyd and others and the history of systemic American racism, including police shooting deaths, discrimination, and brutality against African Americans, particularly unarmed Black men. Such comprehensive street protests have not been seen in America since 1968. They represent, inter alia, the cover of disguises of national racism being publicly stripped away, and the national confrontation with irrefutable evidence of a wide spectrum of systemic rights violations and the deficits of American law and government to ensure African Americans’ basic rights. Further, Rescuing was published before it became fully apparent that the federal government's responses to Black Lives Matter, particularly the executive branch, would fan the racial conflicts of national mourning and demands for new justice narratives, rather than healing and unifying for American citizens as a whole, even as these protests were the most diverse in recent memory.
Although research has shown that exposure to potentially traumatic and morally injurious events is associated with psychological symptoms among veterans, knowledge regarding functioning impacts remains limited.
A population-based sample of post-9/11 veterans completed measures of intimate relationship, health, and work functioning at approximately 9, 15, 21, and 27 months after leaving service. Moral injury, posttraumatic stress, and depression were assessed at ~9 months post-separation. We used Latent Growth Mixture Models to identify discrete classes characterized by unique trajectories of change in functioning over time and to examine predictors of class membership.
Veterans were assigned to one of four functioning trajectories: high and stable, high and decreasing, moderate and increasing, and moderate and stable. Whereas posttraumatic stress, depression, and moral injury associated with perpetration and betrayal predicted worse outcomes at baseline across multiple functioning domains, moral injury associated with perpetration and depression most reliably predicted assignment to trajectories characterized by relatively poor or declining functioning.
Moral injury contributes to functional problems beyond what is explained by posttraumatic stress and depression, and moral injury due to perpetration and depression most reliably predicted assignment to trajectories characterized by functional impairment over time.
Media coverage of non-suicidal self-injury (NSSI) ranges from providing helpful education to displaying graphic images. We offer the first research-informed, consensus-based guidelines for the responsible reporting and depicting of NSSI in the media, while also advising on ideas for dissemination and collaboration between media professionals and healthcare experts.
Wild radish (Raphanus raphanistrum L.) is a weed found globally in agricultural systems. The facultative winter annual nature of this plant and high genetic variability makes modeling its growth and phenology difficult. In the present study, R. raphanistrum natural seedbanks exhibited a biphasic pattern of emergence, with emergence peaks occurring in both fall and spring. Traditional sigmoidal models were inadequate to fit this pattern, regardless of the predictive environmental variable, and a corresponding biphasic model (sigmoidal + Weibull) was used to describe emergence based on the best parameters. Each best-fit chronological, thermal, and hydrothermal model accounted for at least 85% of the variation of the validation data. Observations on phenology progression from four cohorts were used to create a common model that described all cohorts adequately. Different phenological stages were described using chronological, thermal, hydrothermal, daylength-dependent thermal time, and daylength-dependent hydrothermal time. Integrating daylength and temperature into the models was important for predicting reproductive stages of R. raphanistrum.
The disease burden of surgical site infection (SSI) following total knee (TKA) replacement is considerable and is expected to grow with increased demand for the procedure. Diagnosing and treating SSI utilizes both inpatient and outpatient services, and the timing of diagnosis can affect health service requirements. The purpose of this study was to estimate the health system costs of infection and to compare them across time-to-diagnosis categories.
Administrative data from 2005–2016 were used to identify cases diagnosed with SSI up to 1 year following primary TKA. Uninfected controls were selected matched on age, sex and comorbidities. Costs and utilization were measured over the 2-year period following surgery using hospital and out-of-hospital data. Costs and utilization were compared for those diagnosed within 30, 90, 180, and 365 days. A subsample of cases and controls without comorbidities were also compared.
We identified 238 SSI cases over the study period. On average, SSI cases cost 8 times more than noninfected controls over the 2-year follow-up period (CaD$41,938 [US$29,965] vs CaD$5,158 [US$3,685]) for a net difference of CaD$36,780 (US$26,279). The case-to-control ratio for costs was lowest for those diagnosed within 30 days compared to those diagnosed later. When only patients without comorbidities were included, costs were >7 times higher.
Our results suggest that considerable costs result from SSI following TKA and that those costs vary depending on the time of diagnosis. A 2-year follow-up period provided a more complete estimate of cost and utilization.
We examined demographic, clinical, and psychological characteristics of a large cohort (n = 368) of adults with dissociative seizures (DS) recruited to the CODES randomised controlled trial (RCT) and explored differences associated with age at onset of DS, gender, and DS semiology.
Prior to randomisation within the CODES RCT, we collected demographic and clinical data on 368 participants. We assessed psychiatric comorbidity using the Mini-International Neuropsychiatric Interview (M.I.N.I.) and a screening measure of personality disorder and measured anxiety, depression, psychological distress, somatic symptom burden, emotional expression, functional impact of DS, avoidance behaviour, and quality of life. We undertook comparisons based on reported age at DS onset (<40 v. ⩾40), gender (male v. female), and DS semiology (predominantly hyperkinetic v. hypokinetic).
Our cohort was predominantly female (72%) and characterised by high levels of socio-economic deprivation. Two-thirds had predominantly hyperkinetic DS. Of the total, 69% had ⩾1 comorbid M.I.N.I. diagnosis (median number = 2), with agoraphobia being the most common concurrent diagnosis. Clinical levels of distress were reported by 86% and characteristics associated with maladaptive personality traits by 60%. Moderate-to-severe functional impairment, high levels of somatic symptoms, and impaired quality of life were also reported. Women had a younger age at DS onset than men.
Our study highlights the burden of psychopathology and socio-economic deprivation in a large, heterogeneous cohort of patients with DS. The lack of clear differences based on gender, DS semiology and age at onset suggests these factors do not add substantially to the heterogeneity of the cohort.
This study examined the initial clinical presentation and monthly re-assessments of treatment outcome for a group of combat veterans and deployed peacekeepers with posttraumatic stress disorder (PTSD).
Participants were 102 Canadian combat and peacekeeping Veterans attending specialized PTSD treatment clinic (Operational Stress Injury Clinic).
Help seeking veterans with PTSD presented with significant comorbid major depressive disorder and results at 12 months demonstrated significant improvement in symptoms of PTSD, depression and anxiety. There was no significant predictor of PTSD symptoms decline. Initial depression significantly predicted anxiety symptom declines, and initial anxiety predicted depression symptom declines. There was also a demonstrable improvement in health-related quality of life as measured by the SF 36.
This project will work closely with existing service partners involved in street level services and focus on testing and evaluating three approaches for street level interventions for youth who are homeless and who have severe or moderate mentally illness. Youth will be asked to choose their preferred service approach:
Housing First related initiatives focused on interventions designed to move youth to appropriate and available housing and ongoing housing supports.
Treatment First initiatives to provide Mental Health/Addiction supports and treatment solutions, and; Simultaneous attention to both Housing and Treatment Together
Our primary objective is to understand the service delivery preferences of homeless youth and understand the outcomes of these choices. Our research questions include:
1. Which approaches to service are chosen by youth?
2. What are the differences and similarities between groups choosing each approach?
3. What are the critical ingredients needed to effectively implement services for homeless youth from the perspectives of youth, families and service providers?
Focus groups with staff and family members will occur to assist in understanding the nature of each of service approach, changes that evolve within services, & facilitators and barriers to service delivery. This work will be important in determining which approach is chosen by youth and why. Evaluating the outcomes with each choice will provide valuable information about outcomes for the service options chosen by youth. This assist in better identifying weaknesses in the services offered and inform further development of treatment options that youth will accept.
Gene × environment (G × E) interactions in eating pathology have been increasingly investigated, however studies have been limited by sample size due to the difficulty of obtaining genetic data.
To synthesize existing G × E research in the eating disorders (ED) field and provide a clear picture of the current state of knowledge with analyses of larger samples.
Complete data from seven studies investigating community (n = 1750, 64.5% female) and clinical (n = 426, 100% female) populations, identified via systematic review, were included. Data were combined to perform five analyses: 5-HTTLPR × Traumatic Life Events (0–17 events) to predict ED status (n = 909), 5-HTTLPR × Sexual and Physical Abuse (n = 1097) to predict bulimic symptoms, 5-HTLPR × Depression to predict bulimic symptoms (n = 1256), and 5-HTTLPR × Impulsivity to predict disordered eating (n = 1149).
The low function (s) allele of 5-HTTLPR interacted with number of traumatic life events (P < .01) and sexual and physical abuse (P < .05) to predict increased likelihood of an ED in females but not males (Fig. 1). No other G × E interactions were significant, possibly due to the medium to low compatibility between datasets (Fig. 1).
Early promising results suggest that increased knowledge of G × E interactions could be achieved if studies increased uniformity of measuring ED and environmental variables, allowing for continued collaboration to overcome the restrictions of obtaining genetic samples.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Given the common view that pre-exercise nutrition/breakfast is important for performance, the present study investigated whether breakfast influences resistance exercise performance via a physiological or psychological effect. Twenty-two resistance-trained, breakfast-consuming men completed three experimental trials, consuming water-only (WAT), or semi-solid breakfasts containing 0 g/kg (PLA) or 1·5 g/kg (CHO) maltodextrin. PLA and CHO meals contained xanthan gum and low-energy flavouring (approximately 122 kJ), and subjects were told both ‘contained energy’. At 2 h post-meal, subjects completed four sets of back squat and bench press to failure at 90 % ten repetition maximum. Blood samples were taken pre-meal, 45 min and 105 min post-meal to measure serum/plasma glucose, insulin, ghrelin, glucagon-like peptide-1 and peptide tyrosine-tyrosine concentrations. Subjective hunger/fullness was also measured. Total back squat repetitions were greater in CHO (44 (sd 10) repetitions) and PLA (43 (sd 10) repetitions) than WAT (38 (sd 10) repetitions; P < 0·001). Total bench press repetitions were similar between trials (WAT 37 (sd 7) repetitions; CHO 39 (sd 7) repetitions; PLA 38 (sd 7) repetitions; P = 0·130). Performance was similar between CHO and PLA trials. Hunger was suppressed and fullness increased similarly in PLA and CHO, relative to WAT (P < 0·001). During CHO, plasma glucose was elevated at 45 min (P < 0·05), whilst serum insulin was elevated (P < 0·05) and plasma ghrelin suppressed at 45 and 105 min (P < 0·05). These results suggest that breakfast/pre-exercise nutrition enhances resistance exercise performance via a psychological effect, although a potential mediating role of hunger cannot be discounted.
Flagellar dyneins are the molecular motors responsible for producing the propagating bending motions of cilia and flagella. They are located within a densely packed and highly organised super-macromolecular cytoskeletal structure known as the axoneme. Using the mesoscale simulation technique Fluctuating Finite Element Analysis (FFEA), which represents proteins as viscoelastic continuum objects subject to explicit thermal noise, we have quantified the constraints on the range of molecular conformations that can be explored by dynein-c within the crowded architecture of the axoneme. We subsequently assess the influence of crowding on the 3D exploration of microtubule-binding sites, and specifically on the axial step length. Our calculations combine experimental information on the shape, flexibility and environment of dynein-c from three distinct sources; negative stain electron microscopy, cryo-electron microscopy (cryo-EM) and cryo-electron tomography (cryo-ET). Our FFEA simulations show that the super-macromolecular organisation of multiple protein complexes into higher-order structures can have a significant influence on the effective flexibility of the individual molecular components, and may, therefore, play an important role in the physical mechanisms underlying their biological function.
This chapter focuses on the concept of time to evaluate the barriers and opportunities to environmentally responsible finance, and to assess existing governance reforms. With the sustainability discourse increasingly penetrating the financial economy, some investors and lenders profess to be more mindful of the value of long term and patient financial decisions, both for their own economic returns and environmental responsibility. However, the system of global finance capitalism, with its myopic and frenetic tempo, clashes with this aspiration. The movement for socially responsible investing, and the associated 'slow money' movement, are helping to inculcate more eco-friendly time-scales into the financial world. These movements are emerging agents of environmental governance, helping to overcome the lacunae and deficits in official regulation of the financial sector's environmental performance.
In recent years, unmanned aerial vehicle (UAV) technology has expanded to include UAV sprayers capable of applying pesticides. Very little research has been conducted to optimize application parameters and measure the potential of off-target movement from UAV-based pesticide applications. Field experiments were conducted in Raleigh, NC during spring 2018 to characterize the effect of different application speeds and nozzle types on target area coverage and uniformity of UAV applications. The highest coverage was achieved with an application speed of 1 m s−1 and ranged from 30% to 60%, whereas applications at 7 m s−1 yielded 13% to 22% coverage. Coverage consistently decreased as application speed increased across all nozzles, with extended-range flat-spray nozzles declining at a faster rate than air-induction nozzles, likely due to higher drift. Experiments measuring the drift potential of UAV-applied pesticides using extended-range flat spray, air-induction flat-spray, turbo air–induction flat-spray, and hollow-cone nozzles under 0, 2, 4, 7, and 9 m s−1 perpendicular wind conditions in the immediate 1.75 m above the target were conducted in the absence of natural wind. Off-target movement was observed under all perpendicular wind conditions with all nozzles tested but was nondetectable beyond 5 m away from the target. Coverage from all nozzles exhibited a concave-shaped curve in response to the increasing perpendicular wind speed due to turbulence. The maximum target coverage in drift studies was observed when the perpendicular wind was 0 and 8.94 m s−1, but higher turbulence at the two highest perpendicular wind speeds (6.71 and 8.94 m s−1) increased coverage variability, whereas the lowest variability was observed at 2.24 m s−1 wind speed. Results suggested that air-induction flat-spray and turbo air–induction flat-spray nozzles and an application speed of 3 m s−1 provided an adequate coverage of target areas while minimizing off-target movement risk.
Early in a foodborne disease outbreak investigation, illness incubation periods can help focus case interviews, case definitions, clinical and environmental evaluations and predict an aetiology. Data describing incubation periods are limited. We examined foodborne disease outbreaks from laboratory-confirmed, single aetiology, enteric bacterial and viral pathogens reported to United States foodborne disease outbreak surveillance from 1998–2013. We grouped pathogens by clinical presentation and analysed the reported median incubation period among all illnesses from the implicated pathogen for each outbreak as the outbreak incubation period. Outbreaks from preformed bacterial toxins (Staphylococcus aureus, Bacillus cereus and Clostridium perfringens) had the shortest outbreak incubation periods (4–10 h medians), distinct from that of Vibrio parahaemolyticus (17 h median). Norovirus, salmonella and shigella had longer but similar outbreak incubation periods (32–45 h medians); campylobacter and Shiga toxin-producing Escherichia coli had the longest among bacteria (62–87 h medians); hepatitis A had the longest overall (672 h median). Our results can help guide diagnostic and investigative strategies early in an outbreak investigation to suggest or rule out specific etiologies or, when the pathogen is known, the likely timeframe for exposure. They also point to possible differences in pathogenesis among pathogens causing broadly similar syndromes.
Sleep disturbances are prevalent in cancer patients, especially those with advanced disease. There are few published intervention studies that address sleep issues in advanced cancer patients during the course of treatment. This study assesses the impact of a multidisciplinary quality of life (QOL) intervention on subjective sleep difficulties in patients with advanced cancer.
This randomized trial investigated the comparative effects of a multidisciplinary QOL intervention (n = 54) vs. standard care (n = 63) on sleep quality in patients with advanced cancer receiving radiation therapy as a secondary endpoint. The intervention group attended six intervention sessions, while the standard care group received informational material only. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), administered at baseline and weeks 4 (post-intervention), 27, and 52.
The intervention group had a statistically significant improvement in the PSQI total score and two components of sleep quality and daytime dysfunction than the control group at week 4. At week 27, although both groups showed improvements in sleep measures from baseline, there were no statistically significant differences between groups in any of the PSQI total and component scores, or ESS. At week 52, the intervention group used less sleep medication than control patients compared to baseline (p = 0.04) and had a lower ESS score (7.6 vs. 9.3, p = 0.03).
Significance of results
A multidisciplinary intervention to improve QOL can also improve sleep quality of advanced cancer patients undergoing radiation therapy. Those patients who completed the intervention also reported the use of less sleep medication.