To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Dementia is a leading cause of morbidity and mortality without pharmacologic prevention or cure. Mounting evidence suggests that adherence to a Mediterranean dietary pattern may slow cognitive decline, and is important to characterise in at-risk cohorts. Thus, we determined the reliability and validity of the Mediterranean Diet and Culinary Index (MediCul), a new tool, among community-dwelling individuals with mild cognitive impairment (MCI). A total of sixty-eight participants (66 % female) aged 75·9 (sd 6·6) years, from the Study of Mental and Resistance Training study MCI cohort, completed the fifty-item MediCul at two time points, followed by a 3-d food record (FR). MediCul test–retest reliability was assessed using intra-class correlation coefficients (ICC), Bland–Altman plots and κ agreement within seventeen dietary element categories. Validity was assessed against the FR using the Bland–Altman method and nutrient trends across MediCul score tertiles. The mean MediCul score was 54·6/100·0, with few participants reaching thresholds for key Mediterranean foods. MediCul had very good test–retest reliability (ICC=0·93, 95 % CI 0·884, 0·954, P<0·0001) with fair-to-almost-perfect agreement for classifying elements within the same category. Validity was moderate with no systematic bias between methods of measurement, according to the regression coefficient (y=−2·30+0·17x) (95 % CI −0·027, 0·358; P=0·091). MediCul over-estimated the mean FR score by 6 %, with limits of agreement being under- and over-estimated by 11 and 23 %, respectively. Nutrient trends were significantly associated with increased MediCul scoring, consistent with a Mediterranean pattern. MediCul provides reliable and moderately valid information about Mediterranean diet adherence among older individuals with MCI, with potential application in future studies assessing relationships between diet and cognitive function.
Amorphous TiO2 and SnO2 electron transport layers (ETLs) were deposited by low-temperature atomic layer deposition (ALD). Surface morphology and x-ray photoelectron spectroscopy (XPS) indicate uniform and pinhole free coverage of these ALD hole blocking layers. Both mesoporous and planar perovskite solar cells were fabricated based on these thin films with aperture areas of 1.04 cm2 for TiO2 and 0.09 cm2 and 0.70 cm2 for SnO2. The resulting cell performance of 18.3 % power conversion efficiency (PCE) using planar SnO2 on 0.09 cm2 and 15.3 % PCE using mesoporous TiO2 on 1.04 cm2 active areas are discussed in conjunction with the significance of growth parameters and ETL composition.
Escherichia coli O157 are zoonotic bacteria for which cattle are an important reservoir. Prevalence estimates for E. coli O157 in British cattle for human consumption are over 10 years old. A new baseline is needed to inform current human health risk. The British E. coli O157 in Cattle Study (BECS) ran between September 2014 and November 2015 on 270 farms across Scotland and England & Wales. This is the first study to be conducted contemporaneously across Great Britain, thus enabling comparison between Scotland and England & Wales. Herd-level prevalence estimates for E. coli O157 did not differ significantly for Scotland (0·236, 95% CI 0·166–0·325) and England & Wales (0·213, 95% CI 0·156–0·283) (P = 0·65). The majority of isolates were verocytotoxin positive. A higher proportion of samples from Scotland were in the super-shedder category, though there was no difference between the surveys in the likelihood of a positive farm having at least one super-shedder sample. E. coli O157 continues to be common in British beef cattle, reaffirming public health policy that contact with cattle and their environments is a potential infection source.
An unworked quartz vein-hosted gold deposit occurs in the Clew bay area of County Mayo, western Ireland. The veins are late-Caledonian in age and transect greenschist-facies poly-deformed Silurian quartzites. The veins contain disseminated arsenopyrite that may be a primary mineral source for elevated levels of arsenic (As) found in groundwater samples recovered from wells related spatially to the gold deposit. Levels from 5 to 188 μg/L (significantly above the 7.5 μg/L threshold for safe drinking water) have been detected. A series of element distribution maps using a scanning electron microscope (Hitachi model S-4700) linked to an energy-dispersive spectrometer (INCA® Oxford Instruments) and mineral distribution maps generated by QEMSCAN® (Quantitative Evaluation of Minerals by Scanning electron microscopy) were used to map the distribution of the primary arsenopyrite and related secondary As-bearing phases. Laser Raman microspectroscopy was used to identify the secondary As-bearing phases. 'Island weathering' of primary arsenopyrite together with hydrated pseudomorphs of arseniosiderite, pharmacosiderite and scorodite after arsenopyrite are recorded. Circulating groundwater hydrates the primary arsenopyrite, providing the release mechanism that forms the secondary As-bearing phases that occur as microfracture infills together with muscovite and biotite. The textural relationships between the primary and secondary As minerals indicate their potential as mineral sources of As that could enter transport pathways leading to its release into groundwater.
Background: Approximately, one-third of TIA clinics use the ABCD2 score to triage referrals. However, the usefulness of the score is limited because of its low specificity for non-cerebrovascular/mimic conditions. Timely access of referred patients to specialized TIA clinics may reduce recurrent stroke. Methods: The SpecTRA project implemented a novel electronic triage system in the TIA clinic that services Vancouver Island (BC), which replaced the existing ABCD2 triage model. A clinical classifier generating an ACVS probability score was calculated on the basis of the clinic referral form information. Next, a time-varying ABCD2-based risk score derived from Johnston et al. (2007) was calculated, which is then weighted by the ACVS probability score to produce a finalized triage score. Time-to-care was compared pre- (2013/14) and post- (2014/15) implementation. Results: One year results show a statistically significant improvement in that time-to-care for ACVS patients (ABCD2 4/5) was one day earlier with the new triage system (median= 4days since symptom onset; N=250) compared to the previous year (median=5days; N=255) (Mann-Whitney U=38130, p< 0.001). No difference in unit arrival times (median= 5days) for non-cerebrovascular patients was observed (Mann-Whitney U=5563, p= 0.15). Conclusions: The performance of our ACVS triage system highlights quality improvement potential in time-to-care for outpatient TIA clinics.
Mental health research funding priorities in high-income countries must balance longer-term investment in identifying neurobiological mechanisms of disease with shorter-term funding of novel prevention and treatment strategies to alleviate the current burden of mental illness. Prioritising one area of science over others risks reduced returns on the entire scientific portfolio.
Bipolar disorder is a highly heritable polygenic disorder. Recent
enrichment analyses suggest that there may be true risk variants for
bipolar disorder in the expression quantitative trait loci (eQTL) in the
We sought to assess the impact of eQTL variants on bipolar disorder risk
by combining data from both bipolar disorder genome-wide association
studies (GWAS) and brain eQTL.
To detect single nucleotide polymorphisms (SNPs) that influence
expression levels of genes associated with bipolar disorder, we jointly
analysed data from a bipolar disorder GWAS (7481 cases and 9250 controls)
and a genome-wide brain (cortical) eQTL (193 healthy controls) using a
Bayesian statistical method, with independent follow-up replications. The
identified risk SNP was then further tested for association with
hippocampal volume (n = 5775) and cognitive performance
(n = 342) among healthy individuals.
Integrative analysis revealed a significant association between a brain
eQTL rs6088662 on chromosome 20q11.22 and bipolar disorder (log Bayes
factor = 5.48; bipolar disorder P =
5.85×10–5). Follow-up studies across multiple independent
samples confirmed the association of the risk SNP (rs6088662) with gene
expression and bipolar disorder susceptibility (P =
3.54×10–8). Further exploratory analysis revealed that
rs6088662 is also associated with hippocampal volume and cognitive
performance in healthy individuals.
Our findings suggest that 20q11.22 is likely a risk region for bipolar
disorder; they also highlight the informative value of integrating
functional annotation of genetic variants for gene expression in
advancing our understanding of the biological basis underlying complex
disorders, such as bipolar disorder.
Malaria remains a life-threatening parasitic infection endemic throughout much of the world. It is estimated that in 2010 there were 216 million infections and 655 000 deaths due to malaria, with the majority of deaths among African children. In nonendemic countries, it is one of the most common causes of fever in returned travelers and recent immigrants, and several thousand people with malaria arrive in nonendemic countries yearly.
Malaria is a mosquito-borne protozoal infection caused by one of four human Plasmodium species (Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae), or with the monkey parasite, Plasmodium knowlesi, which has been increasingly described in parts of Southeast Asia. Malaria endemic countries are shown in Figure 200.1. Given the risk of rapid progression to severe disease in nonimmune individuals, a high index of suspicion is critical when evaluating patients with febrile illness following travel to malarious areas, especially those endemic for P. falciparum. Proper treatment of malaria requires knowledge of the infecting species and where it was acquired, since drug resistance patterns vary geographically. Widespread chloroquine-resistant P. falciparum (CRPF) malaria and emergence of resistance to other drugs have complicated treatment and prophylaxis.
Fever in a patient who has recently traveled to an area endemic for malaria should be considered a medical emergency. The minimum incubation period is generally considered to be 7 days after inoculation, and of greatest concern is the patient who has traveled to a P. falciparum endemic area within 2 months of presentation, since an incubation period of 2 to 4 weeks is typical for falciparum malaria.
Whether for business, tourism, study, or aid work, more individuals are traveling to more parts of the world. The World Tourism Organization estimates that in 2011, there were 990 million international tourist arrivals worldwide. Health problems associated with travel are common, especially in developing countries where as many as 22% to 64% of travelers self-report a travel-associated health problem and 8% seek healthcare while traveling or after return. Healthcare providers can play a critical role in minimizing the risk of illness and injury during travel.
While administration of travel-related vaccinations and malaria prophylaxis remain cornerstones of the pre-travel consultation, providing advice on managing chronic medical conditions, food and water hygiene, physical safety, and disease vector avoidance is also important. Noninfectious causes of morbidity and mortality such as injury and exacerbation of chronic illness are typically the most common health issues travelers encounter. Important considerations include:
Pre-existing medical conditions, current medications, and allergies
Itinerary, including details of travel within countries, duration of stay, and sequence of countries visited
Purpose of travel, accommodations, and activities
Previous vaccination history and recommended vaccines for the itinerary
Need for prophylactic and self-treatment medications, including those for malaria prevention, treatment of travelers’ diarrhea, and altitude sickness.
Referral to a travel health specialist should be considered, particularly for medically complex travelers, for those traveling to developing nations, and when travel-specific vaccines are indicated. Since vaccines typically take 10 to 14 days to elicit full immune responses, and some require a primary series to become effective, travelers should ideally be evaluated in a travel clinic at least 4 to 6 weeks prior to departure. However, when this is not possible travelers should still be seen, even when travel is imminent.
Thin diamond foils are needed in many particle accelerator experiments regarding nuclear and atomic physics, as well as in some interdisciplinary research. Particularly, nanodiamond texture is attractive for this purpose as it possesses a unique combination of diamond properties such as high thermal conductivity, mechanical strength and high radiation hardness; therefore, it is a potential material for energetic ion beam stripper foils. At the ORNL Spallation Neutron Source (SNS), the installed set of foils must be able to survive a nominal five-month operation period, without the need for unscheduled costly shutdowns and repairs. Thus, a single nanodiamond foil about the size of a postage stamp is critical to the entire operation of SNS and similar sources in U.S. laboratories and around the world. We are investigating nanocrystalline, polycrystalline and their admixture films fabricated using a hot filament chemical vapor deposition (HFCVD) system for H- stripping to support the SNS at Oak Ridge National Laboratory. Here we discuss optimization of process variables such as substrate temperature, process gas ratio of H2/Ar/CH4, substrate to filament distance, filament temperature, carburization conditions, and filament geometry to achieve high purity diamond foils on patterned silicon substrates with manageable intrinsic and thermal stresses so that they can be released as free standing foils without curling. An in situ laser reflectance interferometry tool (LRI) is used for monitoring the growth characteristics of the diamond thin film materials. The optimization process has yielded free standing foils with no pinholes. The sp3/sp2 bonds are controlled to optimize electrical resistivity to reduce the possibility of surface charging of the foils. The integrated LRI and HFCVD process provides real time information on the growth of films and can quickly illustrate growth features and control over film thickness. The results are discussed in the light of development of nanodiamond foils that will be able to withstand a few MW proton beam and hopefully will be able to be used after possible future upgrades to the SNS to greater than a 3MW beam.
We carried out an extensive photometric and spectroscopic investigation of the SPB binary, HD 25558 (see Fig. 1 for the time and geographic distribution of the observations). The ~2000 spectra obtained at 13 observatories during 5 observing seasons, the ground-based multi-colour light curves and the photometric data from the MOST satellite revealed that this object is a double-lined spectroscopic binary with a very long orbital period of about 9 years. We determined the physical parameters of the components, and have found that both lie within the SPB instability strip. Accordingly, both components show line-profile variations consistent with stellar pulsations. Altogether, 11 independent frequencies and one harmonic frequency were identified in the data. The observational data do not allow the inference of a reliable orbital solution, thus, disentangling cannot be performed on the spectra. Since the lines of the two components are never completely separated, the analysis is very complicated. Nevertheless, pixel-by-pixel variability analysis of the cross-correlated line profiles was successful, and we were able to attribute all the frequencies to the primary or secondary component. Spectroscopic and photometric mode-identification was also performed for several of these frequencies of both binary components. The spectroscopic mode-identification results suggest that the inclination and rotation of the two components are rather different. While the primary is a slow rotator with ~6 d rotation period, seen at ~60° inclination, the secondary rotates fast with ~1.2 d rotation period, and is seen at ~20° inclination. Our spectropolarimetric measurements revealed that the secondary component has a magnetic field with at least a few hundred Gauss strength, while no magnetic field was detected in the primary.
The detailed analysis and results of this study will be published elsewhere.
Methiozolin is a new isoxazoline herbicide being investigated for selective POST annual bluegrass control in creeping bentgrass putting greens. Glasshouse and field research was conducted from 2010 to 2012 in Tennessee and Texas to evaluate annual bluegrass control efficacy with methiozolin. Application placement experiments in the glasshouse illustrated that root absorption was required for POST annual bluegrass control with methiozolin at 1,000 g ai ha−1. Soil-plus-foliar and soil-only applications of methiozolin reduced annual bluegrass biomass greater than treatments applied foliar-only. Field experiments evaluated annual bluegrass control efficacy with two application rates (500 and 1,000 g ha−1) and six application regimes (October, November, December, October followed by [fb] November, November fb December, and October fb November fb December) on sand- and soil-based putting greens. Annual bluegrass control with methiozolin at 1,000 g ha−1 on sand-based greens ranged from 70 to 72% compared to 87 to 89% on soil-based greens. Treatment at 500 g ha−1 controlled annual bluegrass 57 to 64% on sand-based greens compared to 72 to 80% on soil-based greens. Most sequential methiozolin application regimes controlled annual bluegrass more than single applications. On sand-based greens, sequential application programs controlled annual bluegrass 70 to 79% compared to 85 to 92% on soil-based greens. Responses indicate that methiozolin is a root-absorbed herbicide with efficacy for selective control of annual bluegrass in both sand- and soil-based creeping bentgrass putting greens.
Ground ivy and khakiweed are troublesome broadleaf weeds of warm-season turfgrass. Field studies were conducted in Tennessee (TN) and Texas (TX) from 2008 to 2010 to evaluate the efficacy of sulfentrazone plus metsulfuron and carfentrazone plus metsulfuron tank mixtures compared with metsulfuron alone for control of ground ivy and khakiweed. In TN, sulfentrazone plus metsulfuron and carfentrazone plus metsulfuron provided accelerated control of ground ivy compared with metsulfuron alone. Over a 2-yr period, ground ivy control with metsulfuron at 10, 21, and 42 g ai ha−1 ranged from 0 to 5% 7 d after treatment (DAT) and 12 to 60% 14 DAT. Ground ivy control with mixtures of sulfentrazone plus metsulfuron ranged from 40 to 72% 7 DAT and 87 to 100% 14 DAT. Similarly, carfentrazone plus metsulfuron controlled ground ivy 5 to 32% 7 DAT and 23 to 93% 14 DAT. In TX, carfentrazone plus metsulfuron and sulfentrazone plus metsulfuron controlled khakiweed greater than metsulfuron alone 7 and 14 DAT as well. Few differences in ground ivy and khakiweed control were detected 56 DAT because metsulfuron applied alone at 21 g ai ha−1 controlled both weeds > 77%, similar to each mixture. These data indicate that when applied in mixtures, sulfentrazone and carfentrazone accelerate ground ivy and khakiweed control with metsulfuron but do not affect long-term efficacy.