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The 2009 American Recovery and Reinvestment Act (ARRA) increased monthly Supplemental Nutrition Assistance Program (SNAP) benefits and expanded SNAP eligibility, yet limited evidence exists on the potential impact of ARRA on dietary intake among at-risk individuals. We aimed to examine pre-/post-ARRA differences in food insecurity (FI) and dietary intake by SNAP participation status.
Boston, MA, USA.
Data were from the longitudinal Boston Puerto Rican Health Study (2007–2015). The US Department of Agriculture ten-item adult module assessed FI. A validated FFQ assessed dietary intake. Diet quality was assessed using the Alternate Healthy Eating Index-2010 (AHEI-2010). Self-reported pre-/post-ARRA household SNAP participation responses were categorized as: sustained (n 249), new (n 95) or discontinued (n 58). We estimated differences in odds of FI and in mean nutrient intakes and AHEI-2010 scores post-ARRA.
Compared with pre-ARRA, OR (95 % CI) of FI post-ARRA were lower for all participants (0·69 (0·51, 0·94)), and within sustained (0·63 (0·43, 0·92)) but not within new (0·94 (0·49, 1·80)) or discontinued (0·63 (0·25, 1·56)) participants. Post-ARRA, total carbohydrate intake was higher, and alcohol intake was lower, for sustained and new participants, and dietary fibre was higher for sustained participants, compared with discontinued participants. Scores for AHEI-2010 and its components did not differ post-ARRA, except for lower alcohol intake for sustained v. discontinued participants.
Post-ARRA, FI decreased for sustained participants and some nutrient intakes were healthier for sustained and new participants. Continuing and expanding SNAP benefits and eligibility likely protects against FI and may improve dietary intake.
A theoretically based relationship for the Darcy–Weisbach friction factor
for rough-bed open-channel flows is derived and discussed. The derivation procedure is based on the double averaging (in time and space) of the Navier–Stokes equation followed by repeated integration across the flow. The obtained relationship explicitly shows that the friction factor can be split into at least five additive components, due to: (i) viscous stress; (ii) turbulent stress; (iii) dispersive stress (which in turn can be subdivided into two parts, due to bed roughness and secondary currents); (iv) flow unsteadiness and non-uniformity; and (v) spatial heterogeneity of fluid stresses in a bed-parallel plane. These constitutive components account for the roughness geometry effect and highlight the significance of the turbulent and dispersive stresses in the near-bed region where their values are largest. To explore the potential of the proposed relationship, an extensive data set has been assembled by employing specially designed large-eddy simulations and laboratory experiments for a wide range of Reynolds numbers. Flows over self-affine rough boundaries, which are representative of natural and man-made surfaces, are considered. The data analysis focuses on the effects of roughness geometry (i.e. spectral slope in the bed elevation spectra), relative submergence of roughness elements and flow and roughness Reynolds numbers, all of which are found to be substantial. It is revealed that at sufficiently high Reynolds numbers the roughness-induced and secondary-currents-induced dispersive stresses may play significant roles in generating bed friction, complementing the dominant turbulent stress contribution.
Introduction: Insufficient analgesia affects around 50% of emergency department patients. The use of a protocol helps to reduce the risk of oligoanalgesia in this context. Our objective was to describe the feasibility and efficacy of a multimodal analgesia protocol (combining paracetamol, oxycodone, and inhaled low-dose methoxyflurane) initiated by triage nurse. Methods: We performed a prospective, observational study in the emergency department at Grenoble Alpes University Hospital (Grenoble, France) between October 2017 and April 2018. Non severe adult trauma patients with a numerical pain rating scale (NRS) score ≥4 and receiving MEOF were included. The primary efficacy criterion was the proportion of patients with an NRS score ≤3 at 15min post-administration. Pain intensity was measured for 60 min as well as during radiography. Data on adverse events and satisfaction were also recorded. Data are presented as median [interquartile (IQR)] and were compared using non parametric tests. Results: A total of 200 adult patients were included (age: 32 [IQR: 23–49] years; 126 men (63%)). Patients presented at triage with a pain score of 7 [IQR: 6-8]. Sixty-six patients (33%) reported an NRS score ≤3 at 15 min post-administration. The time required to achieve a decrease of at least 2 points in the NRS score was 10 [IQR 5–20] min. The pain intensity was 4 [IQR: 2–5] before radiography and 4 [IQR: 2–6] during radiography. Adverse events were frequent (n = 128, 64%), mainly dizziness. No serious adverse events were reported and 89% of minor adverse events resolved at one hour. Both patients and health care providers reported good levels of satisfaction. Conclusion: The administration of a nurse-driven multimodal analgesia protocol combining paracetamol, oxycodone, and low-dose methoxyflurane was feasible on triage. It rapidly produced long-lasting analgesia in adult trauma patients.
Cognitive behavioral therapy (CBT) is an effective treatment for many patients suffering from major depressive disorder (MDD), but predictors of treatment outcome are lacking, and little is known about its neural mechanisms. We recently identified longitudinal changes in neural correlates of conscious emotion regulation that scaled with clinical responses to CBT for MDD, using a negative autobiographical memory-based task.
We now examine the neural correlates of emotional reactivity and emotion regulation during viewing of emotionally salient images as predictors of treatment outcome with CBT for MDD, and the relationship between longitudinal change in functional magnetic resonance imaging (fMRI) responses and clinical outcomes. Thirty-two participants with current MDD underwent baseline MRI scanning followed by 14 sessions of CBT. The fMRI task measured emotional reactivity and emotion regulation on separate trials using standardized images from the International Affective Pictures System. Twenty-one participants completed post-treatment scanning. Last observation carried forward was used to estimate clinical outcome for non-completers.
Pre-treatment emotional reactivity Blood Oxygen Level-Dependent (BOLD) signal within hippocampus including CA1 predicted worse treatment outcome. In contrast, better treatment outcome was associated with increased down-regulation of BOLD activity during emotion regulation from time 1 to time 2 in precuneus, occipital cortex, and middle frontal gyrus.
CBT may modulate the neural circuitry of emotion regulation. The neural correlates of emotional reactivity may be more strongly predictive of CBT outcome. The finding that treatment outcome was predicted by BOLD signal in CA1 may suggest overgeneralized memory as a negative prognostic factor in CBT outcome.
Jumping to conclusions (JTC), which is the proneness to require less information before forming beliefs or making a decision, has been related to formation and maintenance of delusions. Using data from the National Institute of Health Research Biomedical Research Centre Genetics and Psychosis (GAP) case–control study of first-episode psychosis (FEP), we set out to test whether the presence of JTC would predict poor clinical outcome at 4 years.
One-hundred and twenty-three FEP patients were assessed with the Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF) and the probabilistic reasoning ‘Beads’ Task at the time of recruitment. The sample was split into two groups based on the presence of JTC bias. Follow-up data over an average of 4 years were obtained concerning clinical course and outcomes (remission, intervention of police, use of involuntary treatment – the Mental Health Act (MHA) – and inpatient days).
FEP who presented JTC at baseline were more likely during the follow-up period to be detained under the MHA [adjusted OR 15.62, 95% confidence interval (CI) 2.92–83.54, p = 0.001], require intervention by the police (adjusted OR 14.95, 95% CI 2.68–83.34, p = 0.002) and have longer admissions (adjusted IRR = 5.03, 95% CI 1.91–13.24, p = 0.001). These associations were not accounted for by socio-demographic variables, IQ and symptom dimensions.
JTC in FEP is associated with poorer outcome as indicated and defined by more compulsion police intervention and longer periods of admission. Our findings raise the question of whether the implementation of specific interventions to reduce JTC, such as Metacognition Training, may be a useful addition in early psychosis intervention programmes.
Understanding the peculiar properties of Ultra Diffuse Galaxies (UDGs) via spectroscopic analysis is a challenging task that is now becoming feasible. The advent of 10m-class telescopes and high sensitivity instruments is enabling the gathering of high quality spectra even for the faintest systems. In addition, advances in the modelling of stellar populations, stellar libraries, and full-spectral fitting codes are allowing the recovery of the stellar content shaping those spectra with unprecedented reliability. In this contribution we report on the extensive tests we have carried out using the inversion code STECKMAP. The similarities between the Star Formation Histories (SFH) recovered from STECKMAP (applied to high-quality spectra) and deep Colour-Magnitude diagrams fitting (resolved stars) in two Local Group dwarf galaxies (LMC and LeoA) are remarkable, demonstrating the impressive performance of STECKMAP. We exploit the capabilities of STECKMAP and perform one of the most complete and reliable characterisations of the stellar component of UDGs to date using deep spectroscopic data. We measure radial and rotation velocities, SFHs and mean population parameters, such as ages and metallicities, for a sample of five UDG candidates in the Coma cluster. From the radial velocities, we confirm the Coma membership of these galaxies. We find that their rotation properties, if detected at all, are compatible with dwarf-like galaxies. The SFHs of the UDG are dominated by old (∼ 7 Gyr), metal-poor ([M/H] ∼ -1.1) and alpha-enhanced ([Mg/Fe]∼ 0.4) populations followed by a smooth or episodic decline which halted ∼ 2 Gyr ago, possibly a sign of cluster-induced quenching. We find no obvious correlation between individual SFH shapes and any UDG morphological properties. The recovered stellar properties for UDGs are similar to those found for DDO 44, a local UDG analogue resolved into stars. We conclude that the UDGs in our sample are extended dwarfs whose properties are likely the outcome of both internal processes, such as bursty SFHs and/or high-spin haloes, as well as environmental effects within the Coma cluster.
We study experimentally the dynamics and statistics of capillary waves forced by random steep gravity waves mechanically generated in the laboratory. Capillary waves are produced here by gravity waves from nonlinear wave interactions. Using a spatio-temporal measurement of the free surface, we characterize statistically the random regimes of capillary waves in the spatial and temporal Fourier spaces. For a significant wave steepness (0.2–0.3), power-law spectra are observed both in space and time, defining a turbulent regime of capillary waves transferring energy from the large scale to the small scale. Analysis of temporal fluctuations of the spatial spectrum demonstrates that the capillary power-law spectra result from the temporal averaging over intermittent and strong nonlinear events transferring energy to the small scale in a fast time scale, when capillary wave trains are generated in a way similar to the parasitic capillary wave generation mechanism. The frequency and wavenumber power-law exponents of the wave spectra are found to be in agreement with those of the weakly nonlinear wave turbulence theory. However, the energy flux is not constant through the scales and the wave spectrum scaling with this flux is not in good agreement with wave turbulence theory. These results suggest that theoretical developments beyond the classic wave turbulence theory are necessary to describe the dynamics and statistics of capillary waves in a natural environment. In particular, in the presence of broad-scale viscous dissipation and strong nonlinearity, the role of non-local and non-resonant interactions should be reconsidered.
It is known that tungsten oxide may be reacted with selenium sources to form WSe2 but literature reports include processing steps that involve high temperatures, reducing atmospheres, and/or oxidative pre-treatments of tungsten oxide. In this work, we report a non-vacuum process for the fabrication of compositionally high quality WSe2 thin films via the selenization of tungsten oxide under milder conditions. Tungsten source materials were various hydrated WO3 and WO2.9 compounds that were prepared using chemical solution techniques. Resulting films were selenized using a two-stage heating profile (250 °C for 15 minutes and 550 °C for 30 minutes) under a static argon atmosphere. Effects of the starting tungsten oxide phase on WSe2 formation after single and double selenization cycles were investigated using Raman spectroscopy and X-ray diffraction (XRD). After two selenization cycles, hydrated WO3 was converted to (002)-oriented WSe2 that exhibits well-resolved peaks for E12g and A1g phonon modes. Only a single selenization cycle was required to convert amorphous WO2.9 to WSe2. All selenizations in this work were achieved in non-reducing atmospheres and at lower temperatures and shorter times than any non-laser-assisted processes reported for WO3-to-WSe2 conversions.
Several studies show that attention-deficit/hyperactivity disorder (ADHD) may persist into adulthood, increasing the risk of antisocial behaviour, drug abuse, psychiatric comorbidities, aggressive behaviour, social impairment and suicide risk.
Analyze correlations among ADHD, substances abuse, alcoholism and suicide risk.
The aim of our study is to better understand the clinical features of ADHD during adulthood.
We analyzed the presence of ADHD symptoms, suicide risk and levels of hopelessness, alcoholism and substance abuse in a sample of 50 (40% males) in/outpatients of S. Andrea Hospital in Rome, between February and May 2016. We administered the following scales: Adult-Self Report Scale (ASRS), Columbia Suicide Severity Rating Scale (C-SSRS), Beck Hopelessness Scale (BHS), Michigan Alcoholism Screening Test (MAST), Drug Abuse Screening Test (DAST).
In our sample of 50 adult patients, 20% had ADHD symptoms (10 subjects). We found that those with ADHD showed more frequently death desires (85.7%; χ2 = 1.31; P = 0.25) and higher levels of hopelessness (66.7%; χ2 = 0.83; P = =0.36) if compared to subjects without ADHD symptoms (respectively 63% and 45.8%). In the overall group of ADHD patients, 10% showed severe alcoholism, 20% (χ2 = 1.39; P = 0.49) had a borderline behavior, whereas 40% presented a substance abuse (χ2 = 1.75; P = 0.18).
ADHD may represent a psychiatric disorder with an increased suicide risk. It would be important to screen for suicidality and comorbid symptoms routinely in ADHD in order to improve the treatment of the patients.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Suicidal behaviour and drug and alcohol dependence represent two different aspects of self-destructive behavior.
We evaluated the relationship between suicidal behavior and substance and alcohol addiction. It was investigated the role of childhood trauma in these self-destructive behaviors and in the development of the two mental constructions of hopelessness and mentalization.
We also assessed how a high level of hopelessness could affect suicidal ideation and how low or absent capacity of mentalization could influence the development of substance and/or alcohol addiction.
This naturalistic, observational study included 50 patients (mean age = 46.54; S.D = 14.57) recruited from the department of psychiatry (n = 18) and the centre for suicide prevention (n = 32) of Sant’Andrea Hospital (Rome). Different questionnaires were administered to each patient from February to May 2016.
There was not a statistically significant relationship between suicidal behavior and addict behavior. Childhood trauma resulted a risk factor for alcohol abuse with a relationship that tended to significance (P = 0.07). Physical and sexual abuses were significantly associated with addiction (respectively P = 0.014; P = 0.033). It was showed a statistically significant interaction between high level of hopelessness and suicidal ideation (P = 0.037). The absence of mentalization was related to the absence of alcohol abuse (P = 0.061). Finally, trauma experienced during childhood was associated with high level of hopelessness (P = 0.005).
Suicidal behavior is influenced indirectly by a childhood traumatic experience that conditioning the level of hopelessness. Childhood trauma affected directly the development of drug abuse and alcoholism. The capacity of mentalization was not related with childhood trauma.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We experimentally study resonant interactions of oblique surface gravity waves in a large basin. Our results strongly extend previous experimental results performed mainly for perpendicular or collinear wave trains. We generate two oblique waves crossing at an acute angle, while we control their frequency ratio, steepnesses and directions. These mother waves mutually interact and give birth to a resonant wave whose properties (growth rate, resonant response curve and phase locking) are fully characterized. All our experimental results are found in good quantitative agreement with four-wave interaction theory with no fitting parameter. Off-resonance experiments are also reported and the relevant theoretical analysis is conducted and validated.
In 2007, a partnership was initiated between a small-volume paediatric cardiac surgery unit located in Las Palmas de Gran Canaria, Spain, and a large-volume cardiac surgery unit located in Milan, Italy. The main goal of this partnership was to provide surgical treatment to children with CHD in the Canary Islands.
An operative algorithm for performing surgery in elective, urgent, and emergency cases was adopted by the this joint programme. Demographic and in-hospital variables were collected from the medical records of all the patients who had undergone surgical intervention for CHD from January, 2009 to March, 2013. Data were introduced into the congenital database of the European Congenital Heart Surgeons Association Congenital Database and the database was interrogated.
In total, 65 surgical mission trips were performed during the period of this study. The European Congenital Heart Surgeons Association Congenital Database documented 214 total patients with a mean age at operation of 36.45 months, 316 procedures in total with 198 cardiopulmonary bypass cases, 46 non-cardiopulmonary bypass cases, 26 cardiovascular cases without cardiopulmonary bypass, 22 miscellaneous other types of cases, 16 interventional cardiology cases, six thoracic cases, one non-cardiac, non-thoracic procedure on a cardiac patient with cardiac anaesthesia, and one extracorporeal membrane oxygenation case. The 30-day mortality was 6.07% (13 patients).
A joint programme between a small-volume centre and a large-volume centre may represent a valid and reproducible model for safe paediatric cardiac surgery in the context of a peripheral region.
The objective of this research was to describe proportional differences across time and region in management practices among southern cotton farmers who experienced glyphosate-resistant (GR) weeds on their farms earlier than those who experienced them later and among farmers who were closest to one of four historical outbreak epicenters: Lauderdale County, TN; Macon County, GA; Edgecombe County, NC; and Terry County, TX. A mail survey was conducted with cotton farmers in 2012 from 13 southern, cotton-producing states. Survey responses on practices used by farmers were classified into three broad categories of labor, mechanical/tillage/chemical (MTC), and cultural. Proportions of respondents using practices from each category were identified by time and region; across which, proportional-difference tests were conducted. Results indicated respondents encountering GR weeds earlier were more likely than farmers who experienced them later to use the three broad-category practices (labor, 98 vs. 92%; MTC, 95 vs. 89%; and cultural, 86 vs. 76%) and specific practices, including hooded sprayers (76 vs. 58%), in-season herbicide change (83 vs. 60%), and field-border management (60 vs. 35%). Also, respondents closest to Lauderdale County were more likely than farmers closest to Edgecombe County to use broad-labor practices (99 vs. 91%) and specific practices, including hand hoeing (96 vs. 84%), hand spraying (49 vs. 31%), spot spraying (76 vs. 59%), wick applicator (13 vs. 11%), and field-border management (58 vs. 39%). Education programs on weed management can be developed and tailored according to the time and regional differences to provide effective information and communication channels to farmers.
Lenticular galaxies (S0s) represent the majority of early-type galaxies in the local Universe, but their formation channels are still poorly understood. While galaxy mergers are obvious pathways to suppress star formation and increase bulge sizes, the marked parallelism between spiral and lenticular galaxies (e.g. photometric bulge–disc coupling) seemed to rule out a potential merger origin. Here, we summarise our recent work in which we have shown, through N-body numerical simulations, that disc-dominated lenticulars can emerge from major mergers of spiral galaxies, in good agreement with observational photometric scaling relations. Moreover, we show that mergers simultaneously increase the light concentration and reduce the angular momentum relative to their spiral progenitors. This explains the mismatch in angular momentum and concentration between spirals and lenticulars recently revealed by CALIFA observations, which is hard to reconcile with simple fading mechanisms (e.g. ram-pressure stripping).
Gravity wave turbulence is investigated experimentally in a large wave basin in which irregular waves are generated unidirectionally. The roles of the basin boundary conditions (absorbing or reflecting) and of the forcing properties are investigated. To that purpose, an absorbing sloping beach opposite the wavemaker can be replaced by a reflecting vertical wall. We observe that the wave field properties depend strongly on these boundary conditions. A quasi-one-dimensional field of nonlinear waves propagates towards the beach, where they are damped whereas a more multidirectional wave field is observed with the wall. In both cases, the wave spectrum scales as a frequency power law with an exponent that increases continuously with the forcing amplitude up to a value close to
. The physical mechanisms involved most likely differ with the boundary condition used, but cannot be easily discriminated with only temporal measurements. We also studied freely decaying gravity wave turbulence in the closed basin. No self-similar decay of the spectrum is observed, whereas its Fourier modes decay first as a time power law due to nonlinear mechanisms, and then exponentially due to linear viscous damping. We estimate the linear, nonlinear and dissipative time scales to test the time scale separation that highlights the important role of a large-scale Fourier mode. By estimation of the mean energy flux from the initial decay of wave energy, the Kolmogorov–Zakharov constant of the weak turbulence theory is evaluated and found to be compatible with a recently obtained theoretical value.
We study the stellar content of three galactic bulges with the high resolution gratings (R=7000) of the WiFeS integral field unit in order to better understand their formation and evolution. In all cases we find that at least 50% of the stellar mass already existed 12 Gyrs ago, more than currently predicted by simulations. A younger component (age between ∼1 to ∼8 Gyrs) is also prominent and its present day distribution seems to be much more affected by morphological structures, especially bars, than the older one. This in-depth analysis supports the notion of increasing complexity in bulges which cannot be achieved by mergers alone, but requires a non-negligible contribution from secular evolution.
There is little research on factors associated with alcohol consumption among Puerto Ricans living in the USA; thus the aim of the present study was to examine alcohol intake patterns, and factors associated with drinking categories, in a cohort of Puerto Rican adults in Massachusetts.
Cross-sectional study. Descriptive and polytomous logistic regression analyses were used to identify factors associated with drinking patterns, stratified by gender.
Greater Boston area, MA, USA.
Puerto Rican adults (n 1292), aged 45–75 years.
Eight per cent of men and 39 % of women were lifetime abstainers; 40 % of men and 25 % of women were former drinkers; 31 % of men and 27 % of women were moderate drinkers; and 21 % of men and 8 % of women were heavy drinkers. Thirty-five per cent of participants reported drinking alcohol while taking medications with alcohol contraindications. After multivariable adjustment, young men were less likely than older men to be moderate drinkers. Among women, higher BMI, age, lower income and lower psychological acculturation were associated with abstention; age and lower perceived emotional support were associated with increased likelihood of former drinking; and women without v. with diabetes were more likely to be heavy drinkers.
High prevalence of chronic disease, heavy drinking and alcohol use while taking medications with alcohol contraindications suggest an urgent need for better screening and interventions tailored to this rapidly growing Hispanic national subgroup. As heavy drinking appears to increase with acculturation for women, public health initiatives are needed to support appropriate alcohol use.
A way of estimating Stress Intensity Factors is proposed by extending available solutions (solid and crack configurations) to stress fields not considered in available formulations. The accuracy of the proposed estimation is considered with respect to fatigue life assessment and crack shape tracing. It is aimed as very fast initial estimation, in comparison with the use of Finite Elements, in those cases were a high stress gradient is observed: stress concentrations (holes, notches, grooves) or due to surface residual stresses produced by machining techniques or induced –on purpose- to improve fatigue life (for example, by shot-peening), where no SIF solutions are available.