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Not all plant-based and animal foods exert the same health effects due to their various nutrient compositions. We aimed to assess the quality of plant-based vs. animal foods in relation to mortality in a prospective cohort study. Using data collected from a nationally representative sample of 36,825 adults in the National Health and Nutrition Examination Survey 1999-2014, we developed a de novo Comprehensive Diet Quality Index (cDQI) that assesses the quality of 17 foods based on the healthfulness, and separately scored the quality of 11 plant-based foods in a plant-based Diet Quality Index (pDQI) and 6 animal foods in an animal-based Diet Quality index (aDQI). Mortality from all causes, heart disease, and cancer were obtained from linkage to the National Death Index through December 31, 2015. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after multivariable adjustments. During a median follow-up of 8.3 years, 4,669 all-cause deaths occurred, including 798 deaths due to heart disease and 1,021 due to cancer. Compared to individuals in the lowest quartile, those in the highest quartile of cDQI had a lower risk of all-cause mortality (HR=0.75, 95% CI: 0.65, 0.86; P-trend<0.001), which largely reflected the inverse relationship between quality of plant-based foods (pDQI) and all-cause mortality (HR=0.66; 95% CI: 0.58, 0.74, P-trend<0.001). No independent association was found for the quality of animal-foods (aDQI) and mortality. Our results suggest that consuming healthy plant-based foods is associated with lower all-cause mortality among US adults.
Standardizing healthcare surface sampling requires the evaluation of sampling tools for organism adherence. Here, 7 sampling tools were evaluated to assess their elution efficiencies in the presence of 5 pathogens. Foam sponges (80.6%), microfiber wipes (80.5%), foam swabs (77.9%), and cellulose sponges (66.5%) yielded the highest median elution efficiencies.
In Canada, recreational use of cannabis was legalized in October 2018. This policy change along with recent publications evaluating the efficacy of cannabis for the medical treatment of epilepsy and media awareness about its use have increased the public interest about this agent. The Canadian League Against Epilepsy Medical Therapeutics Committee, along with a multidisciplinary group of experts and Canadian Epilepsy Alliance representatives, has developed a position statement about the use of medical cannabis for epilepsy. This article addresses the current Canadian legal framework, recent publications about its efficacy and safety profile, and our understanding of the clinical issues that should be considered when contemplating cannabis use for medical purposes.
In preparation for a multisite antibiotic stewardship intervention, we assessed knowledge and attitudes toward management of asymptomatic bacteriuria (ASB) plus teamwork and safety climate among providers, nurses, and clinical nurse assistants (CNAs).
Prospective surveys during January–June 2018.
All acute and long-term care units of 4 Veterans’ Affairs facilities.
The survey instrument included 2 previously tested subcomponents: the Kicking CAUTI survey (ASB knowledge and attitudes) and the Safety Attitudes Questionnaire (SAQ).
A total of 534 surveys were completed, with an overall response rate of 65%. Cognitive biases impacting management of ASB were identified. For example, providers presented with a case scenario of an asymptomatic patient with a positive urine culture were more likely to give antibiotics if the organism was resistant to antibiotics. Additionally, more than 80% of both nurses and CNAs indicated that foul smell is an appropriate indication for a urine culture. We found significant interprofessional differences in teamwork and safety climate (defined as attitudes about issues relevant to patient safety), with CNAs having highest scores and resident physicians having the lowest scores on self-reported perceptions of teamwork and safety climates (P < .001). Among providers, higher safety-climate scores were significantly associated with appropriate risk perceptions related to ASB, whereas social norms concerning ASB management were correlated with higher teamwork climate ratings.
Our survey revealed substantial misunderstanding regarding management of ASB among providers, nurses, and CNAs. Educating and empowering these professionals to discourage unnecessary urine culturing and inappropriate antibiotic use will be key components of antibiotic stewardship efforts.
The ALMA twenty-six arcmin2 survey of GOODS-S at one millimeter (ASAGAO) is a deep (1σ ∼ 61μJy/beam) and wide area (26 arcmin2) survey on a contiguous field at 1.2 mm. By combining with archival data, we obtained a deeper map in the same region (1σ ∼ 30μJy/beam−1, synthesized beam size 0.59″ × 0.53″), providing the largest sample of sources (25 sources at 5σ, 45 sources at 4.5σ) among ALMA blank-field surveys. The median redshift of the 4.5σ sources is 2.4. The number counts shows that 52% of the extragalactic background light at 1.2 mm is resolved into discrete sources. We create IR luminosity functions (LFs) at z = 1–3, and constrain the faintest luminosity of the LF at 2 < z < 3. The LFs are consistent with previous results based on other ALMA and SCUBA-2 observations, which suggests a positive luminosity evolution and negative density evolution.
Whereas genetic susceptibility increases the risk for major depressive disorder (MDD), non-genetic protective factors may mitigate this risk. In a large-scale prospective study of US Army soldiers, we examined whether trait resilience and/or unit cohesion could protect against the onset of MDD following combat deployment, even in soldiers at high polygenic risk.
Data were analyzed from 3079 soldiers of European ancestry assessed before and after their deployment to Afghanistan. Incident MDD was defined as no MDD episode at pre-deployment, followed by a MDD episode following deployment. Polygenic risk scores were constructed from a large-scale genome-wide association study of major depression. We first examined the main effects of the MDD PRS and each protective factor on incident MDD. We then tested the effects of each protective factor on incident MDD across strata of polygenic risk.
Polygenic risk showed a dose–response relationship to depression, such that soldiers at high polygenic risk had greatest odds for incident MDD. Both unit cohesion and trait resilience were prospectively associated with reduced risk for incident MDD. Notably, the protective effect of unit cohesion persisted even in soldiers at highest polygenic risk.
Polygenic risk was associated with new-onset MDD in deployed soldiers. However, unit cohesion – an index of perceived support and morale – was protective against incident MDD even among those at highest genetic risk, and may represent a potent target for promoting resilience in vulnerable soldiers. Findings illustrate the value of combining genomic and environmental data in a prospective design to identify robust protective factors for mental health.
Radio-echo sounding (RES) can be used to understand ice-sheet processes, englacial flow structures and bed properties, making it one of the most popular tools in glaciological exploration. However, RES data are often subject to ‘strip noise’, caused by internal instrument noise and interference, and/or external environmental interference, which can hamper measurement and interpretation. For example, strip noise can result in reduced power from the bed, affecting the quality of ice thickness measurements and the characterization of subglacial conditions. Here, we present a method for removing strip noise based on combined wavelet and two-dimensional (2-D) Fourier filtering. First, we implement discrete wavelet decomposition on RES data to obtain multi-scale wavelet components. Then, 2-D discrete Fourier transform (DFT) spectral analysis is performed on components containing the noise. In the Fourier domain, the 2-D DFT spectrum of strip noise keeps its linear features and can be removed with a ‘targeted masking’ operation. Finally, inverse wavelet transforms are performed on all wavelet components, including strip-removed components, to restore the data with enhanced fidelity. Model tests and field-data processing demonstrate the method removes strip noise well and, incidentally, can remove the strong first reflector from the ice surface, thus improving the general quality of radar data.
Childhood maltreatment is one of the strongest predictors of adulthood depression and alterations to circulating levels of inflammatory markers is one putative mechanism mediating risk or resilience.
To determine the effects of childhood maltreatment on circulating levels of 41 inflammatory markers in healthy individuals and those with a major depressive disorder (MDD) diagnosis.
We investigated the association of childhood maltreatment with levels of 41 inflammatory markers in two groups, 164 patients with MDD and 301 controls, using multiplex electrochemiluminescence methods applied to blood serum.
Childhood maltreatment was not associated with altered inflammatory markers in either group after multiple testing correction. Body mass index (BMI) exerted strong effects on interleukin-6 and C-reactive protein levels in those with MDD.
Childhood maltreatment did not exert effects on inflammatory marker levels in either the participants with MDD or the control group in our study. Our results instead highlight the more pertinent influence of BMI.
Declaration of interest
D.A.C. and H.W. work for Eli Lilly Inc. R.N. has received speaker fees from Sunovion, Jansen and Lundbeck. G.B. has received consultancy fees and funding from Eli Lilly. R.H.M.-W. has received consultancy fees or has a financial relationship with AstraZeneca, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Ferrer, Janssen-Cilag, Lundbeck, MyTomorrows, Otsuka, Pfizer, Pulse, Roche, Servier, SPIMACO and Sunovian. I.M.A. has received consultancy fees or has a financial relationship with Alkermes, Lundbeck, Lundbeck/Otsuka, and Servier. S.W. has sat on an advisory board for Sunovion, Allergan and has received speaker fees from Astra Zeneca. A.H.Y. has received honoraria for speaking from Astra Zeneca, Lundbeck, Eli Lilly, Sunovion; honoraria for consulting from Allergan, Livanova and Lundbeck, Sunovion, Janssen; and research grant support from Janssen. A.J.C. has received honoraria for speaking from Astra Zeneca, honoraria for consulting with Allergan, Livanova and Lundbeck and research grant support from Lundbeck.
The Triarchic Psychopathy Measure (TriPM) provides Disinhibition, Boldness, and Meanness scales for assessing the three trait domains of the triarchic model. Here we examined the genetic and environmental etiology of these three domains, including evaluation of potential sex differences.
A total of 1016 men and women ages 19–20 years were drawn from the University of Southern California Risk Factors for Antisocial Behavior twin study.
Scores for the three TriPM scales were correlated to differing degrees, with the strongest phenotypic correlation between Disinhibition and Meanness. No sex differences were found in the genetic and environmental influences underlying these three domains, suggesting that the same genes and life experiences contribute to these traits in young men and women. For TriPM Disinhibition and Boldness, genetic factors explained about half or less of the variance, with the rest of the variance being explained by non-shared environmental factors. For TriPM Meanness, on the other hand, genetic, shared environmental, and non-shared environmental factors accounted for the variance. The phenotypic correlation between Disinhibition and Meanness was explained in part by common genes (26%), with the remainder attributable about equally to common shared (39%), and non-shared environmental influences (35%).
These findings contribute to our understanding of psychopathic personality traits by demonstrating the importance of heritable factors for disinhibition and boldness facets of psychopathy, and the importance of shared environmental influences for the meanness facet.
To determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [MDROs]) on high-touch healthcare environmental surfaces after routine or terminal cleaning.
Prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2).
MDRO contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states.
Samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms).
Using a standard sponge-wipe sampling protocol, 2 composite samples were collected from each room; a third sample was collected from each Clostridium difficile room. Composite 1 included the TV remote, telephone, call button, and bed rails. Composite 2 included the room door handle, IV pole, and overbed table. Composite 3 included toileting surfaces. Total bacteria and MDROs (ie, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci [VRE], Acinetobacter baumannii, Klebsiella pneumoniae, and C. difficile) were quantified, confirmed, and tested for drug resistance.
The mean microbial bioburden and range from routine cleaned room composites were higher (2,700 colony-forming units [CFU]/100 cm2; ≤1–130,000 CFU/100 cm2) than from terminal cleaned room composites (353 CFU/100 cm2; ≤1–4,300 CFU/100 cm2). MDROs were recovered from 34% of routine cleaned room composites (range ≤1–13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (≤1–524 CFU/100 cm2). MDROs were recovered from 40% of rooms; VRE was the most common (19%).
This multicenter bioburden summary provides a first step to determining microbial bioburden on healthcare surfaces, which may help provide a basis for developing standards to evaluate cleaning and disinfection as well as a framework for studies using an evidentiary hierarchy for environmental infection control.
Transition metal dichalcogenides such as WS2 show exciting promise in electronic and optoelectronic applications. Significant variations in the transport, Raman, and photoluminescence (PL) can be found in the literature, yet it is rarely addressed why this is. In this report, Raman and PL of monolayered WS2 produced via different methods are studied and distinct features that indicate the degree of crystallinity of the material are observed. While the intensity of the LA(M) Raman mode is found to be a useful indicator to assess the crystallinity, PL is drastically more sensitive to the quality of the material than Raman spectroscopy. We also show that even exfoliated crystals, which are usually regarded as the most pristine material, can contain large amounts of defects that would not be apparent without Raman and PL measurements. These findings can be applied to the understanding of other two-dimensional heterostructured systems.
The genetic and environmental etiology of individual differences was examined in initial level and change in psychopathic personality from ages 9 to 18 years. A piecewise growth curve model, in which the first change score (G1) influenced all ages (9–10, 11–13, 14–15, and 16–18 years) and the second change score (G2) only influenced ages 14–15 and 16–18 years, fit the data better did than the standard single slope model, suggesting a turning point from childhood to adolescence. The results indicated that variations in levels and both change scores were mainly due to genetic (A) and nonshared environmental (E) influences (i.e., AE structure for G0, G1, and G2). No sex differences were found except on the mean values of level and change scores. Based on caregiver ratings, about 81% of variance in G0, 89% of variance in G1, and 94% of variance in G2 were explained by genetic factors, whereas for youth self-reports, these three proportions were 94%, 71%, and 66%, respectively. The larger contribution of genetic variance and covariance in caregiver ratings than in youth self-reports may suggest that caregivers considered the changes in their children to be more similar as compared to how the children viewed themselves.
The genetic architecture of the association between psychopathic traits and reduced skin conductance responses (SCRs) is poorly understood. By using 752 twins aged 9–10 years, this study investigated the heritability of two SCR measures (anticipatory SCRs to impending aversive stimuli and unconditioned SCRs to the aversive stimuli themselves) in a countdown task. The study also investigated the genetic and environmental sources of the covariance between these SCR measures and two psychopathic personality traits: impulsive/disinhibited (reflecting impulsive–antisocial tendencies) and manipulative/deceitful (reflecting the affective–interpersonal features). For anticipatory SCRs, 27%, 14%, and 59% of the variation was due to genetic, shared environmental, and nonshared environmental effects, respectively, while the percentages for unconditioned SCRs were 44%, 2%, and 54%. The manipulative/deceitful (not impulsive/disinhibited) traits were negatively associated with both anticipatory SCRs (r = –.14, p < .05) and unconditioned SCRs (r = –.17, p < .05) in males only, with the former association significantly accounted for by genetic influences (rg = –.72). Reduced anticipatory SCRs represent a candidate endophenotype for the affective–interpersonal facets of psychopathic traits in males.
Although prospective memory (PM) is compromised in mild cognitive impairment (MCI), it is unclear which specific cognitive processes underlie these PM difficulties. We investigated older adults’ performance on a computerized event-based focal versus nonfocal PM task that made varying demands on the amount of attentional control required to support intention retrieval. Participants were nondemented individuals (mean age=81.8 years; female=66.1%) enrolled in a community-based longitudinal study, including those with amnestic MCI (aMCI), nonamnestic MCI (naMCI), subjective cognitive decline (SCD), and healthy controls (HC). Participants included in the primary analysis (n=189) completed the PM task and recalled and/or recognized both focal and nonfocal PM cues presented in the task. Participants and their informants also completed a questionnaire assessing everyday PM failures. Relative to HC, those with aMCI and naMCI were significantly impaired in focal PM accuracy (p<.05). In a follow-up analysis that included 13 additional participants who successfully recalled and/or recognized at least one of the two PM cues, the naMCI group showed deficits in nonfocal PM accuracy (p<.05). There was a significant negative correlation between informant reports of PM difficulties and nonfocal PM accuracy (p<.01). PM failures in aMCI may be primarily related to impairment of spontaneous retrieval processes associated with the medial temporal lobe system, while PM failures in naMCI potentially indicate additional deficits in executive control functions and prefrontal systems. The observed focal versus nonfocal PM performance profiles in aMCI and naMCI may constitute specific behavioral markers of PM decline that result from compromise of separate neurocognitive systems. (JINS, 2014, 20, 1–13)
The bully/victim relationship was studied in a sample of elementary school children (N = 1,289 in first, third, and fifth grades). Three questions were tested. Does bullying involve a power differential between bully and victim? Are bully/victim dyads participants in a relationship, whether mutual liking or disliking? Does the gender composition of the bully/victim dyad moderate power differential and relational context patterns? Hierarchical linear modeling was used to analyze predictors of the reputational strength of bully/victim ties. The findings revealed that the bully/victim dyads most frequently nominated by peers were characterized by asymmetries in social status, where bullies were increasingly more popular than their victims, and by asymmetries in aggression, where bullies were increasingly less aggressive than their victims. Bullies and victims were likely to select one another as among the children that they least like. Most effects with respect to aggression, popularity, and relationships were moderated by the gender composition of the bully/victim dyad. Implications for a developmental psychopathology perspective on peer bullying and victimization are highlighted.