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Precise measurements of the calcium (Ca) isotopes have provided constraints on Ca cycling at global and local scales, and quantified rates of carbonate diagenesis in marine sedimentary systems. Key to applying Ca isotopes as a geochemical tracer of Ca cycling, carbonate (bio)mineralization, and diagenesis is an understanding of the impact of multiple factors potentially impacting Ca isotopes in the rock record. These factors include variations in stable isotopic fractionation factors, the influence of local-scale Ca cycling on Ca isotopic gradients in carbonate settings, carbonate dissolution and reprecipitation, and the relationship between the Ca isotopic composition of seawater and mineral phases that record the secular evolution of seawater chemistry.
Despite advances in endovascular interventions, including the introduction of drug-eluting stents (DES), high target lesion revascularization (TLR) rates still burden the treatment of symptomatic lower-limb peripheral arterial disease (PAD). EluviaTM, a novel, sustained-release, paclitaxel-eluting DES, was shown to further reduce TLRs when compared with the paclitaxel-coated Zilver® PTX® stent, in the IMPERIAL randomized controlled trial. This evaluation estimated the cost-effectiveness of Eluvia when compared with Zilver PTX in Australia, based on 12-month clinical outcomes from the IMPERIAL trial.
A state-transition, decision-analytic model with a 12-month time horizon was developed from an Australian public healthcare system perspective. Cost parameters were obtained from the Australian National Hospital Cost Data Collection Cost Report (2016–17). All costs were captured in Australian dollars (AUD), where AUD 1 = USD 0.69 (June 2020). Complete sets of clinical parameters (primary patency loss, TLR, amputation, and death) and cost parameters from their respective distributions were bootstrapped in samples of 1,000 patients, for each intervention arm of the model. One-way and probabilistic sensitivity analyses were performed.
At 12 months, modeled TLR rates were 4.5 percent for Eluvia and 8.9 percent for Zilver PTX, and mean total direct costs were AUD 6,537 [USD 4,511] and AUD 6,908 [USD 4,767], respectively (Eluvia average per patient savings; overall cohort=AUD 371 [USD 256]; diabetic cohort=AUD 625 [USD 431]). In probabilistic sensitivity analyses, Eluvia was cost-effective relative to Zilver PTX in 92.0 percent of all simulations at a threshold of $10,000 per TLR avoided. Eluvia was more effective and less costly (dominant) than Zilver PTX in 76.0 percent of simulations.
In the first year after the intervention, Eluvia was more effective and less costly than Zilver PTX, making Eluvia the dominant treatment strategy for treatment of symptomatic lower-limb PAD, from an Australian public healthcare system perspective. These findings should be considered when formulating policy and practice guidelines in the context of priority setting and making evidence-based resource allocation decisions for treatment of PAD in Australia.
The Rapid ASKAP Continuum Survey (RACS) is the first large-area survey to be conducted with the full 36-antenna Australian Square Kilometre Array Pathfinder (ASKAP) telescope. RACS will provide a shallow model of the ASKAP sky that will aid the calibration of future deep ASKAP surveys. RACS will cover the whole sky visible from the ASKAP site in Western Australia and will cover the full ASKAP band of 700–1800 MHz. The RACS images are generally deeper than the existing NRAO VLA Sky Survey and Sydney University Molonglo Sky Survey radio surveys and have better spatial resolution. All RACS survey products will be public, including radio images (with
15 arcsec resolution) and catalogues of about three million source components with spectral index and polarisation information. In this paper, we present a description of the RACS survey and the first data release of 903 images covering the sky south of declination
made over a 288-MHz band centred at 887.5 MHz.
This chapter provides a brief overview of gaming disorder (GD) and its treatment. There are now over twenty different screens for assessing problematic gaming although relatively few have used nationally representative samples. The prevalence rates in these nationally representative studies have ranged from 1.2 percent to 8.5 percent depending upon country and screening instrument used. There have been a number of studies describing treatment of GD, although many of these tend not to distinguish between Internet Use Disorder and GD. In terms of treatment for GD, both psychological and pharmacological approaches have been adopted. More specifically, psychological treatment using a cognitive-behavioral framework (CBT) appears to be the most widely used. Furthermore, pharmacological treatment using opioid receptor antagonists, antidepressants, antipsychotics, opioid receptor antagonists, and psychostimulants has been reported in the literature. It is concluded that standardized and comprehensive methods of diagnosis are at present lacking, and that further research into GD is needed from clinical, epidemiological, cross-cultural, and neurobiological perspectives of GD.
There are no data relating to gambling advertisements shown during live sporting events in Ireland. The aim of the present study was to analyze gambling advertisements shown during live sporting events broadcast in Ireland and to assess these advertisements for responsible gambling (RG) practices.
Sixty-five live televised sporting events comprising Association Football (soccer), Rugby Union, and Gaelic Athletic Association (GAA) matches broadcast in Ireland were analyzed. Pre-match (up to 30 minutes before kick-off), half-time, and post-match (up to 30 minutes after the match has ended) advertisement breaks were analyzed for gambling advertisements, including in-game fixed (static advertising) and dynamic (electronic advertisements changing at regular intervals) pitch-side advertising. Gambling advertisements were studied for evidence of RG practices.
A total of 3602 television advertisements, 618 dynamic advertisements, and 394 static advertisements were analyzed. Gambling advertisements were shown in 75.4% (n = 49) games and were the seventh most commonly televised advertisement shown overall. Gambling advertising was more common in football (fourth most common advertisement) compared to rugby (12th most common) and GAA (13th most common). Static and dynamic gambling advertising were common during football matches (second and first most common advertisements, respectively). The majority of advertisements contained RG messaging, an age limit, and an RG organization. No advertisements showing responsible gambling tools were observed.
Gambling advertisements are commonly shown during live televised sporting broadcasts in Ireland, especially during live football matches and typically before the adult television watershed. Gambling legislation is required to minimize harm to vulnerable groups including children.
Reconstructing the provenance of siliciclastic marine sediment is important for understanding sediment pathways and constraining palaeoclimate and erosion records. However, physical fractionation of different size fractions can occur during sediment transport, potentially biasing records derived from bulk sediment. In this study, records of radiogenic Sr and Nd isotopic composition and K/Al ratio of the separated clay fraction, as well as bulk grain size, are presented, measured from deep-sea sediments recovered from International Ocean Discovery Program (IODP) Sites U1456 and U1457 in the Arabian Sea. These new records are compared with published bulk sediment records to investigate the influence of sediment transport on these proxies and to constrain provenance evolution and its relationship to climate variability since middle Miocene time. Correlations between grain size and the bulk sediment isotopic composition confirm that transport processes are influencing the bulk sediment record. This relationship, although present, is not as strong in the clay-fraction isotopic records. Heterogeneity of bulk sediment likely drives differences between bulk and clay records, thought to be largely controlled by sediment transport processes. The isotopic records reveal variations in provenance that correlate with climatic change at 8–7 Ma, as well as an increase in overall provenance variability beginning at c. 3.5 Ma, likely linked to monsoon strength and glacial–interglacial cycles. The clay-fraction records highlight the potential value of measuring proxy records from multiple size fractions to help constrain provenance records as well as investigate sediment transport and/or weathering and erosion processes recorded in deep-sea sediment archives.
A number of studies suggests that for a small minority of users, excessive engagement with the Internet can lead to Internet addiction. Internet addiction has been linked to specific personality traits. Research indicates that Internet addicts score high on introversion, and low on agreeableness and emotional stability. In terms of populations at risk for developing Internet addiction, university students have been identified. They have free and unlimited access, flexible schedules, and university settings can foster social intimidation and alienation. Sixty percent of students jeopardizes their academic and professional performance because of their Internet habits and in order to cope, they engage in Internet activities excessively. Internet addiction in students is claimed to be as high as 15% in Taiwan, however, no such data exists for English students. In order to fill this gap in knowledge, a web-based study on the prevalence of Internet addiction and its associations with personality traits in UK university students (N = 2257) was conducted. Results indicate that 3.2% of the sample can be classified as potentially addicted to the Internet. A combination of online shopping and neuroticism decreased the risk for Internet addiction, whereas online gaming together with openness to experience increased it. Moreover, frequent usage of online shopping and social online activities, high neuroticism and low agreeableness significantly increased the chances of being addicted to the Internet. Findings and their implications are discussed.
The American Psychiatric Association introduced in Internet Gaming Disorder (IGD) in the appendix as a tentative disorder in the last edition of the Diagnostic and Statistical Manual of Mental Disorders. However, currently no systematic review exists about excessive gaming viewed from a clinical perspective.
Objectives and aims
To review clinical studies on gaming addiction in order to ascertain characteristics of both clinical and research studies to provide retrospective evidence in relation with the proposed IGD classification (including criteria, measures and therapies).
A systematic literature review of studies published from 1980 to 2015 has been conducted using three major psychology databases: Academic Search Complete, PsycInfo, and PsycArticles. A total of 5033 results from peer-reviewed journals were obtained, where 32 were identified as empirical clinical papers focused on gaming addiction.
The clinical research studies on gaming identified were published between 1998 and 2015, most of which included patient samples. Categorizations identified in the research papers included: (i) patients’ characteristics (e.g., socio-demographics), (ii) criteria and measures used (e.g., scales to diagnose), (iii) types of gaming problems (e.g., game genre), (iv) and treatments (e.g., type of therapy).
Findings will be discussed against the background of the controversial IGD diagnostic criteria proposed in the DSM-5 in order to assess the extent to which previously published clinical knowledge matched the current proposal for including gaming addiction as behavioral addiction in the next diagnostic manual.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
To characterize the prevalence of and seasonal and regional variation in inpatient antibiotic use among hospitalized US children in 2017–2018.
We conducted a cross-sectional examination of hospitalized children. The assessments were conducted on a single day in spring (May 3, 2017), summer (August 2, 2017), fall (October 25, 2017), and winter (January 31, 2018). The main outcome of interest was receipt of an antibiotic on the study day.
The study included 51 freestanding US children’s hospitals that participate in the Pediatric Health Information System (PHIS).
This study included all patients <18 years old who were admitted to a participating PHIS hospital, excluding patients who were admitted solely for research purposes.
Of 52,769 total hospitalized children, 19,174 (36.3%) received antibiotics on the study day and 6,575 of these (12.5%) received broad-spectrum antibiotics. The overall prevalence of antibiotic use varied across hospitals from 22.3% to 51.9%. Antibiotic use prevalence was 29.2% among medical patients and 47.7% among surgical patients. Although there was no significant seasonal variation in antibiotic use prevalence, regional prevalence varied, ranging from 32.7% in the Midwest to 40.2% in the West (P < .001). Among units, pediatric intensive care unit patients had the highest prevalence of both overall and broad-spectrum antibiotic use at 58.3% and 26.6%, respectively (P < .001).
On any given day in a national network of children’s hospitals, more than one-third of hospitalized children received an antibiotic, and 1 in 8 received a broad-spectrum antibiotic. Variation across hospitals, setting and regions identifies potential opportunities for enhanced antibiotic stewardship activities.
A new fossil site in a previously unexplored part of western Madagascar (the Beanka Protected Area) has yielded remains of many recently extinct vertebrates, including giant lemurs (Babakotia radofilai, Palaeopropithecus kelyus, Pachylemur sp., and Archaeolemur edwardsi), carnivores (Cryptoprocta spelea), the aardvark-like Plesiorycteropus sp., and giant ground cuckoos (Coua). Many of these represent considerable range extensions. Extant species that were extirpated from the region (e.g., Prolemur simus) are also present. Calibrated radiocarbon ages for 10 bones from extinct primates span the last three millennia. The largely undisturbed taphonomy of bone deposits supports the interpretation that many specimens fell in from a rock ledge above the entrance. Some primates and other mammals may have been prey items of avian predators, but human predation is also evident. Strontium isotope ratios (87Sr/86Sr) suggest that fossils were local to the area. Pottery sherds and bones of extinct and extant vertebrates with cut and chop marks indicate human activity in previous centuries. Scarcity of charcoal and human artifacts suggests only occasional visitation to the site by humans. The fossil assemblage from this site is unusual in that, while it contains many sloth lemurs, it lacks ratites, hippopotami, and crocodiles typical of nearly all other Holocene subfossil sites on Madagascar.
The decontamination of hazardous chemical agents from porous media is an important and critical part of the clean-up operation following a chemical weapon attack. Decontamination is often achieved through the application of a cleanser, which reacts on contact with an agent to neutralise it. While it is relatively straightforward to write down a model that describes the interplay of the agent and cleanser on the scale of the pores in the porous medium, it is computationally expensive to solve such a model over realistic spill sizes.
In this paper, we consider the homogenisation of a pore-scale model for the interplay between agent and cleanser, with the aim of generating simplified models that can be solved more easily on the spill scale but accurately capture the microscale structure and chemical activity. We consider two situations: one in which the agent completely fills local porespaces and one in which it does not. In the case when the agent does not completely fill the porespace, we use established homogenisation techniques to systematically derive a reaction–diffusion model for the macroscale concentration of cleanser. However, in the case where the agent completely fills the porespace, the homogenisation procedure is more in-depth and involves a two-timescale approach coupled with a spatial boundary layer. The resulting homogenised model closely resembles the microscale model with the effect of the porous material being incorporated into the parameters. The two models cater for two different spill scenarios and provide the foundation for further study of reactive decontamination.
We determined how pasture and grazing management practices affected the number of days hay was fed to cattle by season. Data were collected from a survey of Tennessee cattle producers. Days of cattle on hay varied across seasons because of variations in forage production and weather. The number of days hay was fed to cattle varied with pasture-animal management practices such as rotating pastures, forage mixtures, and weed management strategies. Having mixtures of cool- and warm-season grasses reduced the number of days on hay in the winter, spring, and summer months indicating benefits from diversified forages.
We develop a general model to describe a network of interconnected thin viscous sheets, or viscidas, which evolve under the action of surface tension. A junction between two viscidas is analysed by considering a single viscida containing a smoothed corner, where the centreline angle changes rapidly, and then considering the limit as the smoothing tends to zero. The analysis is generalized to derive a simple model for the behaviour at a junction between an arbitrary number of viscidas, which is then coupled to the governing equation for each viscida. We thus obtain a general theory, consisting of
partial differential equations and
algebraic conservation laws, for a system of
viscidas connected at
junctions. This approach provides a framework to understand the fabrication of microstructured optical fibres containing closely spaced holes separated by interconnected thin viscous struts. We show sample solutions for simple networks with
or 3. We also demonstrate that there is no uniquely defined junction model to describe interconnections between viscidas of different thicknesses.
Little information is available on the prevalence of Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 eating disorders in adolescence, and eating disorders remain unique in the DSM for not systematically including a criterion for clinical significance. This study aimed to provide the first prevalence report of the full suite of DSM-5 eating disorders in adolescence, and to examine the impact of applying a criterion for clinical significance.
In total, 5191 (participation rate: 70%) Australian adolescents completed a survey measuring 1-month prevalence of eating disorder symptoms for all criterial, ‘other specified’ and unspecified eating disorders, as well as health-related quality of life and psychological distress.
The point prevalence of any eating disorder was 22.2% (12.8% in boys, 32.9% in girls), and ‘other specified’ disorders (11.2%) were more common than full criterial disorders (6.2%). Probable bulimia nervosa and binge eating disorder, but not anorexia nervosa (AN), were more likely to be experienced by older adolescents. Most disorders were associated with an increased odds for being at a higher weight. The prevalence of eating disorders was reduced by 40% (to 13.6%) when a criterion for clinical significance was applied.
Eating disorders, particularly ‘other specified’ syndromes, are common in adolescence, and are experienced across age, weight, socioeconomic and migrant status. The merit of adding a criterion for clinical significance to the eating disorders, similar to other DSM-5 disorders, warrants consideration. At the least, screening tools should measure distress and impairment associated with eating disorder symptoms in order to capture adolescents in greatest need for intervention.
We derive a mathematical model for the drawing of a two-dimensional thin sheet of viscous fluid in the direction of gravity. If the gravitational field is sufficiently strong, then a portion of the sheet experiences a compressive stress and is thus unstable to transverse buckling. We analyse the dependence of the instability and the subsequent evolution on the process parameters, and the mutual coupling between the weakly nonlinear buckling and the stress profile in the sheet. Over long time scales, the sheet centreline ultimately adopts a universal profile, with the bulk of the sheet under tension and a single large bulge caused by a small compressive region near the bottom, and we derive a canonical inner problem that describes this behaviour. The large-time analysis involves a logarithmic asymptotic expansion, and we devise a hybrid asymptotic–numerical scheme that effectively sums the logarithmic series.
International Ocean Discovery Program Expedition 355 drilled Sites U1456 and U1457 in Laxmi Basin (eastern Arabian Sea) to document the impact of the South Asian monsoon on weathering and erosion of the Himalaya. We revised the chronostratigraphic framework for these sites using a combination of biostratigraphy, magnetostratigraphy and strontium isotope stratigraphy. The sedimentary section at the two sites is similar and we divided it into six units bounded by unconformities or emplaced as a mass-transport deposit (MTD). Unit 1 underlies the MTD, and is of early–middle Miocene age at Site U1456 and early Paleocene age at Site U1457. An unconformity (U1) created by emplacement of the MTD (unit 2) during the late Miocene Epoch (at c. 9.83–9.69 Ma) separates units 1 and 2 and is identified by a marked change in lithology. Unit 3 consists of hemipelagic sediment with thin interbeds of graded sandstone of late Miocene age, separated from unit 4 by a second unconformity (U2) of 0.5–0.9 Myr duration. Unit 4 consists of upper Miocene interbedded mudstone and sandstone and hemipelagic chalk deposited between c. 8 and 6 Ma. A c. 1.4–1.6 Myr hiatus (U3) encompasses the Miocene–Pliocene boundary and separates unit 4 from unit 5. Unit 5 includes upper Pliocene – lower Pleistocene siliciclastic sediment that is separated from unit 6 by a c. 0.45 Myr hiatus (U4) in the lower Pleistocene sediments. Unit 6 includes a thick package of rapidly deposited Pleistocene sand and mud overlain by predominantly hemipelagic sediment deposited since c. 1.2 Ma.
Age- and sex-based BMI cut-offs are used to define overweight and obesity, but the relationship between BMI and body composition has not been very well studied in children or compared between children of different ethnic groups. Body size and composition in childhood are also influenced by size at birth. Our aim was to compare body size and composition at 2 years in children with different ethnicity and size at birth. We prospectively followed a multi-ethnic cohort of 300 children born with risk factors for neonatal hypoglycaemia (infants of diabetics, large or small at birth or late preterm) to 2 years corrected age. Complete data on weight, height and head circumference and body composition using bioelectrical impedance 24±1 months corrected age were available in 209 children. At birth, compared with European children, Chinese, Indian and other ethnicity children were lighter, and Indian children had smaller head circumferences, but birth lengths were similar in all ethnic groups. At 2 years, Pacific children were heavier and had higher BMI z scores, and Indian children had smaller head circumferences and lower BMI z scores than those from other ethnic groups. However, fat mass and fat-free mass indices were similar in all groups. At median BMI, fat mass:fat-free mass ratio was 23 % lower in Pacific than in Indian children (0·22 v. 0·27, P=0·03). BMI is not a good indicator of adiposity in this multi-ethnic cohort of 2-year-old New Zealand children.
A 1108.6 m long core was recovered at Site U1457 located on the Indus Fan in the Laxmi Basin of the eastern Arabian Sea during IODP Expedition 355. Shipboard examinations defined five lithologic units (I to V) of the lower Paleocene to Holocene sedimentary sequence. In this study, δ13C values of sedimentary organic matter (SOM) confirm the differentiation of the lithologic units and further divide units III and IV into two subunits (1 and 2). Based on the underlying assumption that the SOM is decided primarily by a mixture of marine and terrestrial origins, δ13CSOM values at Site U1457 provide information on the terrestrial catchment conditions since late Miocene time. Low δ13CSOM values from late Miocene to late Pleistocene times are similar (c. −22.0 ‰) for the most part, reflecting a consistent contribution of terrestrial organic matter from the catchment areas characterized by dominant C3 land plants. Significantly lower δ13CSOM values (c. −24.0 ‰) in Unit III-2 (∼8 to ∼7 Ma) might be due to a greater input of C3 terrestrial organic matter. The increase in δ13CSOM values at ∼7 Ma and the appearance of high δ13CSOM values (c. −18.0 ‰) within Unit III-1 (∼7 to ∼2 Ma) indicate that C4 biomass overwhelmed the terrestrial catchment environment as a result of enhanced terrestrial aridity in the Himalayan foreland. The three-end-member simple mixing model, estimating the relative contributions of SOM from terrestrial C3 and C4 plants and marine phytoplankton, supports our interpretation of the distribution of C3 and C4 land plants in the terrestrial catchment environment.