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.
The effect of minor orthopaedic day surgery (MiODS) on patient’s mood.
A prospective population-based cohort study of 148 consecutive patients with age above 18 and less than 65, an American Society of Anaesthesiology (ASA) score of 1, and the requirement of general anaesthesia (GA) were included. The Medical Outcomes Study – Short Form 36 (SF-36), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used pre- and post-operatively.
The mean physical component score of SF-36 before surgery was 45.3 (SD = ±10.1) and 8 weeks following surgery was 44.9 (SD = ±11.04) [n = 148, p = 0.51, 95% CI = (−1.03 to 1.52)]. For the measurement of the changes in mood using BDI, BAI and SF-36, latent construct modelling was employed to increase validity. The covariance between mood pre- and post-operatively (cov = 69.44) corresponded to a correlation coefficient, r = 0.88 indicating that patients suffering a greater number of mood symptoms before surgery continue to have a greater number of symptoms following surgery. When the latent mood constructs were permitted to have different means the model fitted well with χ2 (df = 1) = 0.86 for which p = 0.77, thus the null hypothesis that MiODS has no effect on patient mood was rejected.
MiODS affects patient mood which deteriorates at 8 weeks post-operatively regardless of the pre-operative patient mood state. More importantly patients suffering a greater number of mood symptoms before MiODS continue to have a greater number of symptoms following surgery.
Minors Mental Disorders (MDM) is a term created to describe symptoms such as insomnia, fatigue, irritability, forgetfulness, difficulty concentrating, and somatic complaints.
This study aimed to estimate the prevalence of MDM in São Francisco do Conde (SFC), Bahia.
We conducted a cross-sectional study by randomly selecting 456 individuals aged over 18 years, registered at the Family Health Program of CFS. The data were collected through home visits in the period from October to December 2010. The subjects answered a questionnaire containing the “Self-Report Questionnaire” (SRQ-20), the demographics and lifestyles. The SRQ-20 is composed of 20 questions, four about physical symptoms and sixteen on psycho emotional symptoms. The answers are “yes” or “no” and attributed, respectively, values of “1” and “0”. The cutoff suggested for identifying DPM was seven or more positive responses. The project was approved by a Research Ethics Committee registered the CONEP.
The results showed a prevalence of 37.7% of MDM. Among males the prevalence was 17.6% and in females was 47.5%, this result was statistically significant.
The results showed a high prevalence of psychological distress in this population, especially among females. The results stimulate the continuity of the actions of health surveillance carried out in the city.
To describe an investigation into 5 clinical cases of carbapenem-resistant Acinetobacter baumannii (CRAB).
Epidemiological investigation supplemented by whole-genome sequencing (WGS) of clinical and environmental isolates.
A tertiary-care academic health center in Boston, Massachusetts.
Patients or participants:
Individuals identified with CRAB clinical infections.
A detailed review of patient demographic and clinical data was conducted. Clinical isolates underwent phenotypic antimicrobial susceptibility testing and WGS. Infection control practices were evaluated, and CRAB isolates obtained through environmental sampling were assessed by WGS. Genomic relatedness was measured by single-nucleotide polymorphism (SNP) analysis.
Four clinical cases spanning 4 months were linked to a single index case; isolates differed by 1–7 SNPs and belonged to a single cluster. The index patient and 3 case patients were admitted to the same room prior to their development of CRAB infection, and 2 case patients were admitted to the same room within 48 hours of admission. A fourth case patient was admitted to a different unit. Environmental sampling identified highly contaminated areas, and WGS of 5 environmental isolates revealed that they were highly related to the clinical cluster.
We report a cluster of highly resistant Acinetobacter baumannii that occurred in a burn ICU over 5 months and then spread to a separate ICU. Two case patients developed infections classified as community acquired under standard epidemiological definitions, but WGS revealed clonality, highlighting the risk of burn patients for early-onset nosocomial infections. An extensive investigation identified the role of environmental reservoirs.
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 the present study, we aimed to compare anthropometric indicators as predictors of mortality in a community-based setting.
We conducted a population-based longitudinal study nested in a cluster-randomized trial. We assessed weight, height and mid-upper arm circumference (MUAC) on children 12 months after the trial began and used the trial’s annual census and monitoring visits to assess mortality over 2 years.
Children aged 6–60 months during the study.
Of 1023 children included in the study at baseline, height-for-age Z-score, weight-for-age Z-score, weight-for-height Z-score and MUAC classified 777 (76·0 %), 630 (61·6 %), 131 (12·9 %) and eighty (7·8 %) children as moderately to severely malnourished, respectively. Over the 2-year study period, fifty-eight children (5·7 %) died. MUAC had the greatest AUC (0·68, 95 % CI 0·61, 0·75) and had the strongest association with mortality in this sample (hazard ratio = 2·21, 95 % CI 1·26, 3·89, P = 0·006).
MUAC appears to be a better predictor of mortality than other anthropometric indicators in this community-based, high-malnutrition setting in Niger.
Older adults, especially those above age 80, are the fastest growing segment of the population in the United States and at risk for age-related cognitive decline and dementia. There is growing evidence that cognitive activity and training may allow adults to maintain or improve cognitive functioning, but little is known about the potential benefit in the oldest old. In this randomized trial, the effectiveness of a computerized cognitive training program (CCT program) was compared to an active control games program to improve cognition in cognitively normal individuals aged 80 and older.
Sixty-nine older adults were randomized to a 24-session CCT program (n = 39) or an active control program (n = 30). Participants completed a pre- and post- training neuropsychological assessment. The primary outcome measure was a global cognitive composite, and the secondary outcomes were the scores on specific cognitive domains (of memory, executive function/attention, and language).
Using linear mixed models, there were no significant differences between the CCT and the active control program on the primary (p = 0.662) or any of the secondary outcomes (language functioning, p = .628; attention/executive functioning, p = .428; memory, p = .749).
This study suggests that short-term CCT had no specific benefit for cognitive functioning in non-demented individuals aged 80 and older.
Combined archaeological, ecological, and geologic research on Chuginadak and Carlisle Islands in the Islands of Four Mountains (IFM) probed questions about the sustainability of human settlements over the past 4000 years in the face of geologic, ecological, and social hazards. We use a human ecodynamics approach to frame the investigation and present original archaeological evidence from this poorly known region of the remote Aleutian Islands. Several village sites occupied during the last four millennia are clustered in locations that were not damaged by earthquake-induced tsunamis; however, new geologic evidence indicates that at least one volcanic eruption forced humans to abandon one or more prehistoric village sites. Combined archaeological, ecological, and geologic analyses demonstrate resilient Unangax̂ occupations of the IFM through long-term climate change as well as earthquakes, tsunamis, and volcanic eruptions with occasional community vulnerability to volcanic eruptions.
In the absence of partisan ownership of an issue, what factors shape public preferences for federal, state and local policy action? The Zika virus provides a unique context in which to examine this question, as it is a new threat to public health in the United States and lacks clear partisan ownership. We examine (1) which Zika policies do citizens support, (2) at which level(s) of government and (3) what factors explain citizen assignment of policy responsibility to different levels of government? Using nationally representative survey data, we find that the three most popular policy responses to Zika are travel warnings, research funding and public education, with the federal government being the preferred policy actor. In the absence of clear partisan issue ownership, we find that Republicans are significantly more likely to prefer state policy action, while partisanship has no impact on public preferences for federal or local policy action.
Consuming whey protein before a meal may reduce postprandial glucose excursions, however, optimising timing of supplementation is important to improve its clinical utility. A total of thirteen centrally obese, insulin-resistant males (waist circumference: 121 (sem 3) cm; homeostasis model assessment for insulin resistance (HOMA-IR): 6·4 (sem 1·2)) completed four experimental conditions in a single-blind, crossover design. Participants consumed mixed-macronutrient breakfast and lunch meals on all occasions, with 20 g whey protein consumed 15 min before (PRE), alongside (DUR) or 15 min post-breakfast (POST) or omitted (CON). Capillary glucose and plasma concentrations of insulin, TAG and NEFA, in addition to subjective appetite ratings, were collected for 180 min after each meal. PRE and DUR reduced post-breakfast glucose peak by 17·0 (sem 1·9) % (P<0·001) and 9·2 (sem 2·9) % (P=0·046), respectively, compared with CON. Post-breakfast glucose AUC was lower following PRE compared with POST and CON (PRE: 982 (sem 30) v. POST: 1031 (sem 36) and CON: 1065 (sem 37) mmol/l×180 min; P≤0·042) but similar to DUR (1013 (sem 32) mmol/l×180 min; P=0·77). Insulin was lower during PRE, when compared with POST and DUR (both P≤0·042) but similar to CON. There were no between-condition differences in measures of postprandial lipaemia or appetite, and no effect of condition post-lunch. Consumption of whey protein as a preload or alongside a mixed-macronutrient breakfast reduces postprandial glucose excursions in centrally obese, insulin-resistant males. Whey consumed as a preload has superior glycaemic-lowering effects. Supplementation at breakfast does not alter glycaemic responses to subsequent meals.
Psychopathic traits predispose individuals toward antisocial behavior. Such antagonistic acts often result in “unsuccessful” outcomes such as incarceration. What mechanisms allow some people with relatively high levels of psychopathic traits to live “successful”, unincarcerated lives, in spite of their antisocial tendencies? Using neuroimaging, we investigated the possibility that “successful” psychopathic individuals exhibited greater development of neural structures that promote “successful” self-regulation, focusing on the ventrolateral prefrontal cortex (VLPFC). Across two structural magnetic resonance imaging studies of “successful” participants (Study 1: N = 80 individuals in long-term romantic relationships; Study 2: N = 64 undergraduates), we observed that gray matter density in the left and right VLPFC was positively associated with psychopathic traits. These preliminary results support a compensatory model of psychopathy, in which “successful” psychopathic individuals develop inhibitory mechanisms to compensate for their antisocial tendencies. Traditional models of psychopathy that emphasize deficits may be aided by such compensatory models that identify surfeits in neural and psychological processes.
This chapter reviews the state of our knowledge about Saturn’s polar atmosphere that has been revealed through Earth- and space-based observation as well as theoretical and numerical modeling. In particular, the Cassini mission to Saturn, which has been in orbit around the ringed planet since 2004, has revolutionized our understanding of the planet. The current review updates a previous review by Del Genio et al. (2009), written after Cassini’s primary mission phase that ended in 2008, by focusing on the north polar region of Saturn and comparing it to the southern high latitudes. Two prominent features in the northern high latitudes are the northern hexagon and the north polar vortex; we extensively review observational and theoretical investigations to date of both features. We also review the seasonal evolution of the polar regions using the observational data accumulated during the Cassini mission since 2004 (shortly after the northern winter solstice in 2002), through the equinox in 2009, and approaching the next solstice in 2017. We conclude the current review by listing unanswered questions and describing the observations of the polar regions planned for the Grand Finale phase of the Cassini mission between 2016 and 2017.
To examine the association between household food insecurity and dietary diversity in the past 24h (dietary diversity score (DDS, range: 0–9); minimum dietary diversity (MDD, consumption of three or more food groups); consumption of nine separate food groups) among pregnant and lactating women in rural Malawi.
Two rural districts in Central Malawi.
Pregnant (n 589) and lactating (n 641) women.
Of surveyed pregnant and lactating women, 66·7 and 68·6 %, respectively, experienced moderate or severe food insecurity and only 32·4 and 28·1 %, respectively, met MDD. Compared with food-secure pregnant women, those who reported severe food insecurity had a 0·36 lower DDS (P<0·05) and more than threefold higher risk (OR; 95 % CI) of not consuming meat/fish (3·19; CI 1·68, 6·03). The risk of not consuming eggs (3·77; 1·04, 13·7) was higher among moderately food-insecure pregnant women. Compared with food-secure lactating women, those who reported mild, moderate and severe food insecurity showed a 0·36, 0·44 and 0·62 lower DDS, respectively (all P<0·05). The risk of not achieving MDD was higher among moderately (1·95; 1·06, 3·59) and severely (2·82; 1·53, 5·22) food-insecure lactating women. The risk of not consuming meat/fish and eggs increased in a dose–response manner among lactating women experiencing mild (1·75; 1·01, 3·03 and 2·81; 1·09, 7·25), moderate (2·66; 1·47, 4·82 and 3·75; 1·40, 10·0) and severe (5·33; 2·63, 10·8 and 3·47; 1·19, 10·1) food insecurity.
Addressing food insecurity during and after pregnancy needs to be considered when designing nutrition programmes aiming to increase dietary diversity in rural Malawi.
The conservation benefits of maintaining social groupings during and after animal translocations are unclear. Although some studies report improved post-release survival, others found no discernible influence on reintroduction success. Understanding the effects of social groupings is difficult because release methods can influence the animals’ ability to maintain social groups. We explored this relationship by first studying whether release protocols influenced post-release cohesion in the communal burrowing bettong Bettongia lesueur, and then investigating whether maintenance of social cohesion conferred any post-release advantage. We released bettongs into a small (8 ha) and large (2,600 ha) area and compared the proportion that maintained social groupings in the different settings. The proportion of bettongs sharing with previous warren co-occupants was higher than expected by chance in both areas, however, a significantly higher proportion of bettongs maintained social groupings in the small (75%) compared to the large release area (13%). This suggests bettongs prefer to maintain social groupings but are unable to locate members of their group in large release areas. Bettongs that did maintain social groupings showed no difference in reproductive or health outcomes compared to those that formed new social groupings, suggesting no benefit to reintroduction success. We conclude that release protocols can influence post-release cohesion, but that greater cohesion does not necessarily confer advantages to group-living animals. To test the importance of social cohesion, further research on reintroductions should compare post-release parameters for animals released using protocols that do and do not facilitate maintenance of social groupings.
Weed species develop resistance to herbicides through the repeated use of the same herbicide mechanism of action (MOA). Farmers often resort to different MOAs once a weed population has become resistant to the MOA that resulted in a resistant weed population. Delaying herbicide resistance is of great importance to growers due to the limited number of commercially available MOAs. Resistance may occur through monogenic or polygenic traits, and various academic and industrial modeling tools have been developed to help infer cause–effect from multiple interacting factors that may not be intuitive. This work explores various best management practices in delaying weed resistance, and we give details for monogenic and quantitative polygenic resistance models and investigate combinations of management strategies that lead to maximizing the product life span for a herbicide. Management practices under parametric uncertainty are provided to showcase how various practices can be used to extend lifetime product performance before resistance is manifest. Penalty functions associated with choosing a unique management strategy, based upon grower constraints, are the subject of a companion manuscript.
Bacterial cultures exposed to iron-doped apatite nanoparticles (IDANPs) prior to the introduction of antagonistic viruses experience up to 2.3 times the bacterial destruction observed in control cultures. Maximum antibacterial activity of these bacteria-specific viruses, or phage, occurs after bacterial cultures have been exposed to IDANPs for 1 hr prior to phage introduction, demonstrating that IDANP-assisted phage therapy would not be straight forward, but would instead require controlled time release of IDANPs and phage. These findings motivated the design of an electrospun nanofiber mesh treatment delivery system that allows burst release of IDANPs, followed by slow, consistent release of phage for treatment of topical bacterial infections. IDANPs resemble hydroxyapatite, a biocompatible mineral analogous to the inorganic constituent of mammalian bone, which has been approved by the Food and Drug Administration for many biomedical purposes. The composite nanofiber mesh was designed for IDANP-assisted phage therapy treatment of topical wounds and consists of a superficial, rapid release layer of polyethylene oxide (PEO) fibers doped with IDANPs, followed by inner, coaxial polycaprolactone / polyethylene glycol (PCL/PEG) blended polymer fiber layer for slower phage delivery. Our investigations have established that IDANP-doped PEO fibers are effective vehicles for dissemination of IDANPs for bacterial exposure and resultant increased bacterial death by phage. In this work, slower delivery of the phage behind IDANPs was accomplished using coaxial, electrospun fibers composed of PCL/PEG polymer blend.
Russian-olive is a nitrogen-fixing tree invading riparian corridors in western North America. The premise of revegetation after weed removal is that revegetation is required to return native species to a removal site and that revegetation improves site resistance to invasion or reinvasion via competitive exclusion. Therefore, we expected that revegetation would reduce invasive species cover and increase native species cover compared with non-revegetated controls. Native understory species diversity increased with time since removal. We recorded 18.2 native species in 2012, and 28.2 native species in 2016. Out of 22 planted species, 2 did not establish. Diversity in revegetated plots did not differ from unplanted controls, likely because species spread quickly across plot boundaries. Native perennial grass, seeded species, and annual bromes increased over time, while nonnative forbs and native forbs decreased over time. Only invasive perennial grass cover responded to the revegetation treatment with cover much higher in controls compared with revegetated plots (25.7% vs. 7.7%); this was likely a response to a preplanting herbicide treatment. All categories of species diversity except invasive species diversity increased over time. Only 4% of Russian-olive stumps resprouted in the first year of removal, less than 1% resprouted 2 yr after removal. There was no Russian-olive emergence from seed in the removal year, and seed emergence varied exponentially among following years. Seeded native species did not have trouble establishing once adequate spring moisture occurred in the second growing season after Russian-olive removal, indicating that removal did not present substantial obstacles to successful revegetation. Follow-up control of Russian-olive is critical after initial treatment.
We obtained radiocarbon (14C) dates with accelerator mass spectrometry (AMS) of vascular plant samples and a charcoal sample collected from peat deposits near the prehistoric village site informally designated CR-03 on Carlisle Island in the Islands of Four Mountains group, Alaska, to determine the eruption age of the CR-02 tephra. A fine vitric ash erupted from Okmok caldera, Umnak Island (ca. 2 ka BP) was also discovered in the bog. The ages of the CR-02 tephra and Okmok II ash are estimated to be 1050 and 2000 cal BP, respectively. Because both tephras are distinctive and widespread, these are important chronostratigraphic markers for archaeological sites in this island group. The 14C dates obtained from this bog are 800 years younger than the dates of the charcoal fragments from cultural layers in the Unit 3 of prehistoric village site CR-02 (AMK-0003).