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We performed a retrospective analysis of the changes in accuracy of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes for colectomy and hysterectomy surgical site infection surveillance. After the transition from ICD-CM ninth edition to tenth edition codes, there was no significant change in the accuracy of these codes for SSI surveillance.
The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.
In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.
From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.
A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.
This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.
Dietary delivery of bacterially expressed double-stranded RNA (dsRNA) has a great potential for management of Leptinotarsa decemlineata. An important first step is to discover possible RNA-interference (RNAi)-target genes effective against larvae, especially the old larvae. In the present paper, five putative Broad-Complex (BrC) cDNAs (Z1-Z4, and Z6) were identified in L. decemlineata. The expression of the five LdBrC isoforms was suppressed by juvenile hormone signaling, whereas the transcription was upregulated by 20-hydroxyecdysone signaling at the fourth (final) instar larval stage. Feeding of bacterially expressed dsBrC (derived from a common fragment of the five LdBrC variants) in the third- and fourth-instar larvae successfully knocked down the target mRNAs. For the fourth-instar LdBrC RNAi hypomorphs, they had a higher larval mortality compared with the controls. Moreover, most dsBrC-fed beetles did not pupate normally. After removal of the apolysed larval cuticle, a miniature adult was found. The adult head, compound eyes, prothorax, mesothorax, metathorax were found on the dorsal view. Distinct adult cuticle pigmentation was seen on the prothorax. The mouthparts, forelegs, midlegs, and hindlegs could be observed on the ventral view of the miniature adults. For the third-instar LdBrC RNAi specimens, around 20% moribund beetles remained as prepupae and finally died. Therefore, LdBrC is among the most attractive candidate genes for RNAi to control the fourth-instar larvae in L. decemlineata.
Correcting a sign error results in no changes to the key conclusions of Hutchings and others (2011). However, there is an improved agreement with previous work. Mean total sea-ice deformation scales log linearly with distance and the scaling exponent was found to be dependent on time. We find a linear relationship between the temporal scale and spatial scaling exponent, for timescales of an hour to a day. Extrapolating to the timescales of deformation resolved by RADARSAT, we find total deformation and distance scale with an exponent of between −0.16 and −0.19.
Pressure ridges impact the mass, energy and momentum budgets of the sea-ice cover and present an obstacle to transportation through ice-infested waters. Quantifying ridge characteristics is important for understanding total sea-ice mass and for improving the representation of sea-ice dynamics in high-resolution models. Multi-sensor measurements collected during annual Operation IceBridge (OIB) airborne surveys of the Arctic provide new opportunities to assess the sea ice at the end of winter. We present a new methodology to derive ridge sail height from high-resolution OIB Digital Mapping System (DMS) visible imagery. We assess the efficacy of the methodology by mapping the full sail height distribution along 12 pressure ridges in the western and central Arctic. Comparisons against coincident Airborne Topographic Mapper (ATM) elevation anomalies are used to demonstrate the methodology and evaluate DMS-derived sail heights. Sail heights and elevation anomalies were correlated at 0.81 or above. On average mean and maximum sail height agreed with ATM elevation to within 0.11 and 0.49 m, respectively. Of the ridges mapped, mean sail height ranged from 0.99 to 2.16 m, while maximum sail height ranged from 2.1 to 4.8 m. DMS also delivered higher sampling along ridge crests than coincident ATM data.
Se and green tea have been shown in epidemiological, observational and preclinical studies to be inversely related to the risk of developing colorectal cancer (CRC). However, there are limited studies to evaluate their regulatory effects on genes/proteins that relate to CRC oncogenesis in human subjects, such as selenoproteins, WNT signalling pathway, inflammation and methylation. This study examined the effects of supplementation of Se using Brazil nuts and green tea extract (GTE) capsules, alone and in combination, on targeted biomarkers. In total, thirty-two volunteers (>50 years of age) with plasma Se≤1·36 µmol/l were randomised to one of three treatment groups: nine to Se (approximately 48 µg/d) as six Brazil nuts, eleven to four GTE capsules (800 mg (-)-epigallocatechin-3-gallate) and twelve to a combination of Brazil nuts and GTE. Blood and rectal biopsies were obtained before and after each intervention. Plasma Se levels, rectal selenoprotein P (SePP) and β-catenin mRNA increased significantly in subjects consuming Brazil nuts alone or in combination, whereas rectal DNA methyltransferase (DNMT1) and NF-κB mRNA were reduced significantly in subjects consuming GTE alone or in combination. None of the interventions significantly affected rectal acetylated histone H3 or Ki-67 expression at the protein level or plasma C-reactive protein. Effects of the combination of Brazil nuts and GTE did not differ from what would be expected from either agent alone. In conclusion, supplementation of Brazil nuts and/or GTE regulates targeted biomarkers related to CRC oncogenesis, specifically genes associated with selenoproteins (SePP), WNT signalling (β-catenin), inflammation (NF-κB) and methylation (DNMT1). Their combination does not appear to provide additional effects compared with either agent alone.
Germany has been an officially bovine tuberculosis (bTB)-free (OTF) country since 1996. Gradually rising numbers of bTB herd incidents due to Mycobacterium bovis and M. caprae in North-Western and Southern Germany during the last few years prompted the competent authorities to conduct a nationwide bTB survey in 2013/2014. This led to the detection of a dairy herd in which as many as 55 cattle reacted positively to consecutive intra vitam testing. Test-positive animals lacked visible lesions indicative of bTB at necropsy. Extensive mycobacterial culturing as well as molecular testing of samples from 11 tissues for members of the M. tuberculosis complex (MTC) yielded negative results throughout. However, caseous lymphadenitis of Ln. mandibularis accessorius was observed during meat inspection of a fattening pig from the same farm at regular slaughter at that time. Respective tissue samples tested MTC positive by polymerase chain reaction, and M. tuberculosis T1 family were identified by spoligotyping. Four human reactors within the farmer's family were also found to be immunoreactive. As exposure of livestock to M. tuberculosis is not generally considered, its impact may result in regulatory and practical difficulties when using protocols designed to detect classical bTB, particularly in OTF countries.
Despite substantial research, uncertainty remains about the clinical and etiological heterogeneity of major depression (MD). Can meaningful and valid subtypes be identified and would they be stable cross-culturally?
Symptoms at their lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years, with recurrent DSM-IV MD. Latent class analysis (LCA) was performed in Mplus.
Using the nine DSM-IV MD symptomatic A criteria, the 14 disaggregated DSM-IV criteria and all independently assessed depressive symptoms (n = 27), the best LCA model identified respectively three, four and six classes. A severe and non-suicidal class was seen in all solutions, as was a mild/moderate subtype. An atypical class emerged once bidirectional neurovegetative symptoms were included. The non-suicidal class demonstrated low levels of worthlessness/guilt and hopelessness. Patterns of co-morbidity, family history, personality, environmental precipitants, recurrence and body mass index (BMI) differed meaningfully across subtypes, with the atypical class standing out as particularly distinct.
MD is a clinically complex syndrome with several detectable subtypes with distinct clinical and demographic correlates. Three subtypes were most consistently identified in our analyses: severe, atypical and non-suicidal. Severe and atypical MD have been identified in multiple prior studies in samples of European ethnicity. Our non-suicidal subtype, with low levels of guilt and hopelessness, may represent a pathoplastic variant reflecting Chinese cultural influences.
To investigate water contributors in relation to dietary and serum micronutrient profiles.
A cross-sectional study. The main exposures were water contributors. Selected dietary and serum micronutrient levels were outcome measures.
The US population and its subgroups.
US adults (n 2691) aged ≥20 years from the National Health and Nutrition Examination Survey 2005–2006.
The daily mean total water intake was 3·1 (se 0·047) litres, with 68 % of adults consuming below the Adequate Intake level. Total water intake was higher in adults with higher BMI and physical activity, those taking dietary supplements and alcohol consumers (P < 0·05). Plain water intake was positively associated with food moisture and negatively with beverage moisture (P < 0·001). Beverage moisture was negatively associated with food moisture (P < 0·001). In multivariate regression analyses, plain water and food moisture intakes were positively associated with Fe, Ca, vitamins A, B, C, E and K and carotenoid intakes (P < 0·05). However, beverage moisture was unrelated to Ca, niacin and vitamin B6 intakes, and negatively associated with Fe, vitamin A, folate, vitamins C, E and K and carotenoid intakes (P < 0·05). Concentrations of serum vitamins A and C and carotenoids increased with plain water and food moisture intakes (P < 0·05) but decreased (P < 0·01) or were unrelated to beverage moisture intake.
Various contributors of total water intake differed in their associations with dietary and serum micronutrient profiles in US adults. The study provides evidence of plain water benefits on micronutrient adequacy over beverages.
The effects of melamine on gas production (GP) kinetics, methane (CH4) production and fermentation of diets differing in forage content (low-forage (LF) diet: 200 g/kg and high-forage (HF) diet: 800 g/kg) by rumen micro-organisms in vitro were studied using batch cultures. Rumen contents were collected from three Simmental×Luxi crossbred beef cattle. Melamine was added to the incubation bottles to achieve final concentration of 0 (control), 2, 6, 18, 54, 162 and 484 mg/kg of each diet. Cumulative GP was continuously measured in an automated gas recording instrument during 72 h of incubation, while fermentation gas end-products were collected to determine molar proportions of carbon dioxide (CO2), CH4 and hydrogen gas (H2) in manually operated batch cultures. Differences in GP kinetics and fermentation gases were observed in response to the nature of the diets incubated. Although melamine addition did not affect GP kinetics and fermentation gas pattern compared to the control, the increase of melamine addition stimulated the yield of CH4 by decreasing CO2, especially during the fermentation of the HF diet. The concentrations of ammonia nitrogen (N), amino acid N and microbial N in culture fluids were greater in the fermentation of LF- than HF diets, and these concentrations were increased by the increase of melamine addition after 72-h fermentation. The concentrations of total volatile fatty acids (VFA) were greater in HF than LF diets. The addition of melamine decreased total VFA concentrations and this response was greater in HF than LF diet fermentations. Melamine addition did not affect molar proportions of acetate, butyrate, propionate and valerate compared with the control; however, branched-chain VFA production, which was lower in the HF than the LF diet, was increased by the melamine addition, especially in the HF diet fermentation. The ratio of non-glucogenic to glucogenic acids was lower in the HF than the LF diet, but it was not affected by melamine addition. In brief, the greater reduction in the rate and extent of rumen fermentation found for the HF diet in comparison with the LF diet suggested that rumen fermentation rate and extent in vitro depended mainly on the nature of the incubated substrate, and that they could be further inhibited by the increase of melamine addition.
The symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome?
Symptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples.
The preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety.
MD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome.
To validate an FFQ to assess antioxidant intake in overweight postmenopausal women.
A seventy-four-item antioxidant 1-month FFQ was developed based on major antioxidant sources in the American diet. Forty overweight postmenopausal women participated in a 9-month observational study and completed four sets of FFQ and 7 d food record (7dFR) every 3 months. Twelve-hour fasting blood was collected for plasma antioxidant measurement at the first visit.
Forty overweight postmenopausal women.
Spearman correlation coefficients of 1-month antioxidant intake estimated from the first set of FFQ and 7dFR ranged from 0·34 to 0·87, except for γ-tocopherol. The proportion of participants categorized into the extremely opposite tertiles averaged 7 %. Significant correlations were observed for diet–plasma vitamin C, α-tocopherol and carotenoids (P < 0·05). No time effect was observed on the dietary antioxidant intakes estimated from four 7dFR and four FFQ. Dietary antioxidants estimated from averaged four 7dFR showed moderate to high correlation with those estimated from averaged four FFQ and from each FFQ collected every 3 months. Bland–Altman plots did not show any systematic bias. Averaged misclassifications were below 10 % between these two instruments.
These findings attested a reasonable validity and a good acceptance of this 1-month FFQ in assessing both short-term and long-term diverse antioxidant intakes in these overweight postmenopausal women. The use of this FFQ in associating antioxidant intake with disease risk needs further investigation.
Previous studies support Beck's cognitive model of vulnerability to depression. However, the relationship between his cognitive triad and other clinical features and risk factors among those with major depression (MD) has rarely been systematically studied.
The three key cognitive symptoms of worthlessness, hopelessness and helplessness were assessed during their lifetime worst episode in 1970 Han Chinese women with recurrent MD. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression.
Compared to patients who did not endorse the cognitive trio, those who did had a greater number of DSM-IV A criteria, more individual depressive symptoms, an earlier age at onset, a greater number of episodes, and were more likely to meet diagnostic criteria for melancholia, postnatal depression, dysthymia and anxiety disorders. Hopelessness was highly related to all the suicidal symptomatology, with ORs ranging from 5.92 to 6.51. Neuroticism, stressful life events (SLEs) and a protective parental rearing style were associated with these cognitive symptoms.
During the worst episode of MD in Han Chinese women, the endorsement of the cognitive trio was associated with a worse course of depression and an increased risk of suicide. Individuals with high levels of neuroticism, many SLEs and high parental protectiveness were at increased risk for these cognitive depressive symptoms. As in Western populations, symptoms of the cognitive trio appear to play a central role in the psychopathology of MD in Chinese women.
To validate a brief FFQ developed for capturing short-term antioxidant intake in a sample of US college students.
A seventy-four-item antioxidant FFQ was developed based on major antioxidant sources in the American diet. The FFQ was validated against 30 d food records (FR) and plasma antioxidant concentrations. The reliability of the FFQ was evaluated by two FFQ administered at a 1-month interval.
University of Connecticut, CT, USA.
Sixty healthy college students.
Estimates of dietary antioxidants from the FFQ were moderately to highly correlated with those estimated from the 30 d FR (r = 0·29–0·80; P < 0·05) except for γ-tocopherol and β-cryptoxanthin. Total antioxidant capacity from diet only or from diet and supplements estimated by the 30 d FR and FFQ were highly correlated (r = 0·67 and 0·71, respectively; P < 0·0001). The FFQ categorized 91 % of participants into the same or adjacent tertiles of antioxidant intake as the 30 d FR. Most dietary carotenoids estimated from the FFQ were correlated with plasma levels (P < 0·05). Correlation coefficients for test–retest reliability ranged from 0·39 to 0·86. More than 94 % of the participants were classified in the same or adjacent tertiles between the two administrations of the FFQ.
The brief FFQ demonstrated reasonable validity for capturing a comprehensive antioxidant intake profile. This FFQ is applicable in epidemiological or clinical studies to capture short-term antioxidant intake or to simply document the variations of antioxidant intake in intervention trials. Cross-validation studies are warranted in other target populations.
In 2008 January the 24th Chinese expedition team successfully deployed the Chinese Small Telescope ARray (CSTAR) to Dome A, the highest point on the Antarctic plateau. CSTAR consists of four 14.5cm optical telescopes, each with a different filter (g, r, i and open) and has a 4.5°×4.5° field of view (FOV). Based on the CSTAR data, initial statistics of astronomical observational site quality and light curves of variable objects were obtained. To reach higher photometric quality, we are continuing to work to overcome the effects of uneven cirrus cloud cirrus, optical “ghosts” and intra-pixel sensitivity. The snow surface stability is also tested for further astronomical observational instrument and for glaciology studies.
The present study evaluated the contribution of 100 % orange juice (OJ) consumption to the intakes of macronutrients and energy and its impact on body composition.
A cross-sectional study was conducted. The main exposure was OJ consumption based on two non-consecutive 24 h diet recalls. Macronutrient and energy intakes and body composition parameters were outcome measures. All statistical analyses were carried out using SAS and SUDAAN statistical software packages to allow for multistage sample designs.
The US population and its subgroups.
The US population aged ≥4 years (n 13 971) from the National Health and Nutrition Examination Survey 2003–2006, conducted by the National Center for Health Statistics.
In this US population, OJ consumers had lower BMI and healthier lifestyle behaviours (including lower alcohol consumption and smoking as well as higher exercise level) than non-consumers (P < 0·05). After adjusting for covariates, OJ consumers had higher daily intakes of carbohydrate, total sugar, total fat and energy than non-consumers (P < 0·01). However, these linear trends still remained even after OJ was removed from the food list of items consumed. Adult OJ consumers had lower BMI, waist circumference and percentage body fat than non-consumers (P < 0·01), as well as lower odds ratio for overweight and obesity (P < 0·01). These effects were not seen in children and adolescents, where there was no significant difference in BMI, waist circumference and percentage body fat in OJ consumers compared with non-consumers.
OJ consumption was associated with healthier body composition in adults; while there were no significant associations between OJ consumption and body composition in children and adolescents.
Regenerative engineering represents a new multidisciplinary paradigm to engineer complex tissues, organs, or organ systems through the integration of tissue engineering with advanced materials science, stem cell science and developmental biology. While possessing elements of tissue engineering, regenerative medicine, and morphogenesis, regenerative engineering is distinct from these individual disciplines since it specifically focuses on the integration and subsequent response of stem cells to biomaterials. One goal of regenerative engineering is the design of materials capable of inducing associated cells toward highly specialized functions. For example, the interaction of cells with calcium phosphate surfaces has proven to be an important signaling modality in promoting osteogenic differentiation. A biodegradable polymer-ceramic composite system has been developed from poly(lactide-co-glycolide) and in situ synthesized hydroxyapatite based on the three-dimensional sintered microsphere matrix platform. We have systematically optimized scaffold physico-chemical, mechanical, and structural properties for bone tissue regeneration applications by varying several parameters such as solution pH, polymer:ceramic ratio, sintering time and sintering temperature. The bioactivity of composite scaffolds is attributed to their ability to deliver calcium ions to surrounding medium and allow for reprecipitation of calcium phosphate on the scaffold surface. Furthermore, the composite scaffolds have demonstrated increased loading capacity of osteoinductive growth factor (BMP-2) and a more sustained release profile due to a greater number of adsorption sites provided by the ionic calcium and phosphate groups as well as a larger matrix surface area. In vitro cell studies were performed to investigate the efficacy of this composite system to induce osteogenic differentiation of human adipose-derived stem cells. Cells cultured on the ceramic containing scaffolds exhibited significantly higher expression of osteoblastic markers and greater extracellular matrix mineralization than non-ceramic containing scaffolds, indicating the potential for the ceramic phase to promote osteogenic differentiation. In addition, loaded BMP-2 retained its bioactivity as a mitogen and osteoinductive agent during the differentiation of adipose-derived stem cells into mature osteoblasts. In vivo evaluation using a critical-sized ulnar defect model in New Zealand white rabbits demonstrated the ability of composite scaffolds to support cellular infiltration throughout the scaffold pore structure and vascularization of new tissue, as well as facilitate formation of newly mineralized bone tissue. The work described herein provides strong evidence for the potential of polymer-ceramic composite scaffolds to function as osteoinductive bone graft substitutes, and paves the way for future development of advanced tissue-inducing materials.
The pin-on-disc wear behavior of nanostructured two-phase Fe30Ni20Mn20Al30 and eutectic lamellar-structured Fe30Ni20Mn35Al15 is compared emphasizing the influence of the microstructure and mechanical properties of alloys as well as the effect of test environment. Although the wear of both alloys was greater in oxygen-containing environments, eutectic Fe30Ni20Mn35Al15 is less sensitive to oxygen than nanostructured Fe30Ni20Mn20Al30. Abrasive wear dominated during the wear in all cases, while plastic deformation also occurred during the wear of eutectic Fe30Ni20Mn35Al15. A tribolayer of zirconia, which was embedded in the surface of the wear pin, was characterized using a scanning transmission electron microscope equipped with an energy dispersive spectrometer.