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.
Studies suggest that alcohol consumption and alcohol use disorders have distinct genetic backgrounds.
We examined whether polygenic risk scores (PRS) for consumption and problem subscales of the Alcohol Use Disorders Identification Test (AUDIT-C, AUDIT-P) in the UK Biobank (UKB; N = 121 630) correlate with alcohol outcomes in four independent samples: an ascertained cohort, the Collaborative Study on the Genetics of Alcoholism (COGA; N = 6850), and population-based cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC; N = 5911), Generation Scotland (GS; N = 17 461), and an independent subset of UKB (N = 245 947). Regression models and survival analyses tested whether the PRS were associated with the alcohol-related outcomes.
In COGA, AUDIT-P PRS was associated with alcohol dependence, AUD symptom count, maximum drinks (R2 = 0.47–0.68%, p = 2.0 × 10−8–1.0 × 10−10), and increased likelihood of onset of alcohol dependence (hazard ratio = 1.15, p = 4.7 × 10−8); AUDIT-C PRS was not an independent predictor of any phenotype. In ALSPAC, the AUDIT-C PRS was associated with alcohol dependence (R2 = 0.96%, p = 4.8 × 10−6). In GS, AUDIT-C PRS was a better predictor of weekly alcohol use (R2 = 0.27%, p = 5.5 × 10−11), while AUDIT-P PRS was more associated with problem drinking (R2 = 0.40%, p = 9.0 × 10−7). Lastly, AUDIT-P PRS was associated with ICD-based alcohol-related disorders in the UKB subset (R2 = 0.18%, p < 2.0 × 10−16).
AUDIT-P PRS was associated with a range of alcohol-related phenotypes across population-based and ascertained cohorts, while AUDIT-C PRS showed less utility in the ascertained cohort. We show that AUDIT-P is genetically correlated with both use and misuse and demonstrate the influence of ascertainment schemes on PRS analyses.
To detect modest associations of dietary intake with disease risk, observational studies need to be large and control for moderate measurement errors. The reproducibility of dietary intakes of macronutrients, food groups and dietary patterns (vegetarian and Mediterranean) was assessed in adults in the UK Biobank study on up to five occasions using a web-based 24-h dietary assessment (n 211 050), and using short FFQ recorded at baseline (n 502 655) and after 4 years (n 20 346). When the means of two 24-h assessments were used, the intra-class correlation coefficients (ICC) for macronutrients varied from 0·63 for alcohol to 0·36 for polyunsaturated fat. The ICC for food groups also varied from 0·68 for fruit to 0·18 for fish. The ICC for the FFQ varied from 0·66 for meat and fruit to 0·48 for bread and cereals. The reproducibility was higher for vegetarian status (κ > 0·80) than for the Mediterranean dietary pattern (ICC = 0·45). Overall, the reproducibility of pairs of 24-h dietary assessments and single FFQ used in the UK Biobank were comparable with results of previous prospective studies using conventional methods. Analyses of diet–disease relationships need to correct for both measurement error and within-person variability in dietary intake in order to reliably assess any such associations with disease in the UK Biobank.
We present an indentation-scope that interfaces with confocal microscopy, enabling direct observation of the three-dimensional (3D) microstructural response of coatings on substrates. Using this method, we compared microns-thick polymer coatings on glass with and without silica nanoparticle filler. Bulk force data confirmed the >30% modulus difference, while microstructural data further revealed slip at the glass-coating interface. Filled coatings slipped more and about two times faster, as reflected in 3D displacement and von Mises strain fields. Overall, these data indicate that silica-doping of coatings can dramatically alter adhesion. Moreover, this method compliments existing theoretical and modeling approaches for studying indentation in layered systems.
The rate at which the poaching of rhinoceroses has escalated since 2010 poses a threat to the long-term persistence of extant rhinoceros populations. The policy response has primarily called for increased investment in military-style enforcement strategies largely based upon simple economic models of rational crime. However, effective solutions will probably require a context-specific, stakeholder-driven mix of top-down and bottom-up mechanisms grounded in theory that represents human behaviour more realistically. Using a problem-oriented approach we illustrate in theory and practice how community-based strategies that explicitly incorporate local values and institutions are a foundation for combating rhinoceros poaching effectively in specific contexts. A case study from Namibia demonstrates how coupling a locally devised rhinoceros monitoring regime with joint-venture tourism partnerships as a legitimate land use can reconcile individual values represented within a diverse stakeholder group and manifests as both formal and informal community enforcement. We suggest a social learning approach as a means by which international, national and regional governance can recognize and promote solutions that may help empower local communities to implement rhinoceros management strategies that align individual values with the long-term health of rhinoceros populations.
Red Bull Stratos was a commercial program that brought a test parachutist, protected by a full-pressure suit, in a stratospheric balloon with pressurized capsule to over 127,582 ft (38,969 m), from which he free fell and subsequently parachuted to the ground. Given that the major risks to the parachutist included ebullism, negative Gz (toe-to-head) acceleration exposure from an uncontrolled flat spin, and trauma, a comprehensive plan was developed to recover the parachutist under nominal conditions and to respond to any medical contingencies that might have arisen. In this report, the project medical team describes the experience of providing emergency medical support and crew recovery for the manned balloon flights of the program.
The phases of flight, associated risks, and available resources were systematically evaluated.
Six distinct phases of flight from an Emergency Medical Services (EMS) standpoint were identified. A Medical Support Plan was developed to address the risks associated with each phase, encompassing personnel, equipment, procedures, and communications.
Despite geographical, communications, and resource limitations, the medical team was able to implement the Medical Support Plan, enabling multiple successful manned balloon flights to 71,615 ft (21,828 m), 97,221 ft (29,610 m), and 127,582 ft (38,969 m). The experience allowed refinement of the EMS and crew recovery procedures for each successive flight and could be applied to other high altitude or commercial space ventures.
BlueRS, NortonSC, LawJ, PattariniJM, AntonsenEL, GarbinoA, ClarkJB, TurneyMW. Emergency Medical Support for a Manned Stratospheric Balloon Test Program. Prehosp Disaster Med. 2014;29(5):1-6.
We replicated a 1994 study that surveyed the state of supportive care services due to changes in the field and the increased need for such services. We provide an updated assessment, comparing the changes that have occurred and describing the current status of supportive care services in comprehensive cancer settings.
We used Coluzzi and colleague's 60-question survey from their 1995 Journal of Clinical Oncology article to frame the 98-question survey employed in the current study. Medical and palliative care directors for the 2011 National Cancer Institute (NCI) comprehensive cancer centers were surveyed regarding their supportive care services and their subjective review of the overall effectiveness of the services provided.
We achieved a 76% response rate (n = 31). The data revealed increases in the number of cancer beds in the hospitals, the degree of integration of supportive care services, the availability of complementary services, and the number of pain and palliative care services offered. There was also an overall shift toward centers becoming more patient centered, as 65% reported now having a patient and family advisory council. Our findings revealed a growing trend to offer distress screening for both outpatients and inpatients. Medical and palliative care directors' evaluations of the supportive care services they offered also significantly improved. However, the results revealed an ongoing gap in services for end-of-life care and timely referrals for hospice services.
Significance of results:
Overall, both the quantity and quality of supportive care services in the surveyed NCI-designated cancer centers has improved.
Archaeological marine shell artifacts moving over long distances may reveal the remnants of social networks, social currency, and the nuances of exchange. For the southwestern United States and northern Mexico, potential sources of marine shell are predominantly the Gulf of California and Pacific Ocean. There exists some taxonomic overlap between molluscan communities of these regions and the Gulf of California, necessitating non-biogeographic methods to distinguish their origins. Combined oxygen and carbon stable isotope ratio measurements demonstrate that modern shells from these water bodies have distinct isotopic ranges. Molluscan isotopie composition within the Gulf of California varies, which allows for the identification of distinct source regions. Archaeological marine shell from Pueblo III and IV sites in the Mogollon Rim region of east-central Arizona are sourced, demonstrating that archaeological shell was obtained from a northeastern subregion of the Gulf of California. This is the closest source for the Puebloan communities, but it is not consistent with previous hypotheses concerning the origin of marine shell in the Colorado Plateau and Mogollon Highlands, which suggested an exchange route via Paquimé originating south of Isla Tiburón. We discuss the implications of these results in the context of previous research and draw conclusions about the meaning of shell use in the region.
The complex relationship between masculinity and religion, as experienced in both the secular and ecclesiastical worlds, forms the focus for this volume, whose range encompasses the rabbis of the Babylonian and Palestinian Talmud, and moves via Carolingian and Norman France, Siena, Antioch, and high and late medieval England to the eve of the Reformation. Chapters investigate the creation and reconstitution of different expressions of masculine identity, from the clerical enthusiasts for marriage to the lay practitioners of chastity, from crusading bishops to holy kings. They also consider the extent to which lay and clerical understandings of masculinity existed in an unstable dialectical relationship, at times sharing similar features, at others pointedly different, co-opting and rejecting features of the other; the articles show this interplay to be more far more complicated than a simple linear narrative of either increasing divergence, or of clerical colonization of lay masculinity. They also challenge conventional historiographies of the adoption of clerical celibacy, of the decline of monasticism and the gendered nature of piety. Patricia Cullum is Head of History at the University of Huddersfield; Katherine J. Lewis is Senior Lecturer in History at the University of Huddersfield. Contributors: James G. Clark, P.H. Cullum, Kirsten A. Fenton, Joanna Huntington, Katherine J. Lewis, Matthew Mesley, Catherine Sanok, Michael L. Satlow, Rachel Stone, Jennifer D. Thibodeaux, Marita von Weissenberg