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.
In New York City, a multi-disciplinary Mass Casualty Consultation team is proposed to support prioritization of patients for coordinated inter-facility transfer after a large-scale mass casualty event. This study examines factors that influence consultation team prioritization decisions.
As part of a multi-hospital functional exercise, 2 teams prioritized the same set of 69 patient profiles. Prioritization decisions were compared between teams. Agreement between teams was assessed based on patient profile demographics and injury severity. An investigator interviewed team leaders to determine reasons for discordant transfer decisions.
The 2 teams differed significantly in the total number of transfers recommended (49 vs 36; P = 0.003). However, there was substantial agreement when recommending transfer to burn centers, with 85.5% agreement and inter-rater reliability of 0.67 (confidence interval: 0.49–0.85). There was better agreement for patients with a higher acuity of injuries. Based on interviews, the most common reason for discordance was insider knowledge of the local community hospital and its capabilities.
A multi-disciplinary Mass Casualty Consultation team was able to rapidly prioritize patients for coordinated secondary transfer using limited clinical information. Training for consultation teams should emphasize guidelines for transfer based on existing services at sending and receiving hospitals, as knowledge of local community hospital capabilities influence physician decision-making.
Sources and implications of black carbon (BC) and mineral dust (MD) on two glaciers on the central Tibetan Plateau were estimated based on in situ measurements and modeling. The results indicated that BC and MD accounted for ~11 ± 1% and 4 ± 0% of the albedo reduction relative to clean snow, while the radiative forcing varied between 11 and 196 and 1–89 W m−2, respectively. Assessment of BC and MD contributions to the glacier melt can reach up 88 to 434 and 35 to 187 mm w.e., respectively, contributing ~9–23 and 4–10% of the total glacier melt. A footprint analysis indicated that BC and MD deposited on the glaciers originated mainly from the Middle East, Central Asia, North China and South Asia during the study period. Moreover, a potentially large fraction of BC may have originated from local and regional fossil fuel combustion. This study suggests that BC and MD will enhance glacier melt and provides a scientific basis for regional mitigation efforts.
We report a novel strategy to render stainless steel (SS) a more versatile material that is suitable to be used as the substrate for preparing electrodes for efficient hydrogen evolution by interface engineering. Our strategy involves the growth of carbon nanotubes (CNTs) by atmospheric pressure chemical vapor deposition (APCVD) as the interface material on the surface of SS. We optimized the procedure to prepare CNTs/SS and demonstrate a higher activity of the CNTs/SS prepared at 700 °C for the hydrogen evolution reaction (HER) when compared to samples prepared at other temperatures. This can be attributed to the higher number of defects and the higher content of pyrrolic N obtained at this temperature. Our strategy offers a new approach to employ SS as a substrate for the preparation of highly efficient electrodes and has the potential to be widely used in electrochemistry.
Mineral particles in bone are interlaced with collagen fibrils, hindering the investigation of bioapatite crystallites (BAp). This study utilized a special whale rostrum (the most highly mineralized bone ever recorded) to measure the crystallites of bone BAp via long-term dissolution in water. The BAp in the rostrum has a low solubility (6.7 ppm Ca and 3.8 ppm P after 150 days dissolution) as well as in normal bones, which leads to its Ksp value of ~10−53. Atomic force microscopy results show tightly compacted mineral crystallites and confirm the low amount of collagen in the rostrum. Additionally, the mineral crystallites demonstrate irregular plate-like shapes with variable sizes. The small crystallites (~11 × 24 nm) are easily detached from BAp prisms, compared with the large crystallites (~50 nm). Moreover, various orientations of crystallites are observed on the edge of the prisms, which suggest a random direction of mineral growth. Furthermore, these plate-like crystallites prefer to be stacked layer by layer under weak regulation from collagen. The morphology of rostrum after dissolution provides new insights into the actual morphology of BAp crystallites.
Oxidative stress is implicated in the aetiology of schizophrenia, and the antioxidant defence system (AODS) may be protective in this illness. We examined the major antioxidant glutathione (GSH) in prefrontal brain and its correlates with clinical and demographic variables in schizophrenia.
GSH levels were measured in the dorsolateral prefrontal region of 28 patients with chronic schizophrenia using a magnetic resonance spectroscopy sequence specifically adapted for GSH. We examined correlations of GSH levels with age, age at onset of illness, duration of illness, and clinical symptoms.
We found a negative correlation between GSH levels and age at onset (r = −0.46, p = 0.015), and a trend-level positive relationship between GSH and duration of illness (r = 0.34, p = 0.076).
Our findings are consistent with a possible compensatory upregulation of the AODS with longer duration of illness and suggest that the AODS may play a role in schizophrenia.
Apolipoprotein E (APOE) E4 is the main genetic risk factor for Alzheimer’s disease (AD). Due to the consistent association, there is interest as to whether E4 influences the risk of other neurodegenerative diseases. Further, there is a constant search for other genetic biomarkers contributing to these phenotypes, such as microtubule-associated protein tau (MAPT) haplotypes. Here, participants from the Ontario Neurodegenerative Disease Research Initiative were genotyped to investigate whether the APOE E4 allele or MAPT H1 haplotype are associated with five neurodegenerative diseases: (1) AD and mild cognitive impairment (MCI), (2) amyotrophic lateral sclerosis, (3) frontotemporal dementia (FTD), (4) Parkinson’s disease, and (5) vascular cognitive impairment.
Genotypes were defined for their respective APOE allele and MAPT haplotype calls for each participant, and logistic regression analyses were performed to identify the associations with the presentations of neurodegenerative diseases.
Our work confirmed the association of the E4 allele with a dose-dependent increased presentation of AD, and an association between the E4 allele alone and MCI; however, the other four diseases were not associated with E4. Further, the APOE E2 allele was associated with decreased presentation of both AD and MCI. No associations were identified between MAPT haplotype and the neurodegenerative disease cohorts; but following subtyping of the FTD cohort, the H1 haplotype was significantly associated with progressive supranuclear palsy.
This is the first study to concurrently analyze the association of APOE isoforms and MAPT haplotypes with five neurodegenerative diseases using consistent enrollment criteria and broad phenotypic analysis.
Re-planning mid-treatment, with the adjustment of target volumes, has been performed as part of the normal workflow at our institution. We sought to quantify the benefit of this approach and identify factors to optimise plan adaptive strategies.
Materials and methods:
Patients with locally advanced oropharyngeal cancer treated to 70 Gy with concurrent chemoradiation (CCRT) on TomoTherapy® who underwent re-planning during the treatment were eligible. Survival and prognostic factors were evaluated with Kaplan–Meier and Cox proportional hazards, two-side p-value <0·05 significant.
Forty-two patients were identified with Stage III (n = 5), IVA (n = 34) and IVB (n = 3) [AJCC 7th] disease. Median re-planning dose was 40 Gy (14–60 Gy). Median change in mean total parotid dose was reduction of 1 Gy (range –7·5 Gy to +13·9 Gy). The volume of PTV70 and PTV60 receiving 99% of the prescribed (V99) dose was increased by 2·2% (–3·3 to +16·6%) and 1·9% (–11·5 to +12·6%) by re-planning. As a continuous variable, increasing per cent nodal regression was associated with the improved disease control in a multivariate model including stage, pack years smoking and human papilloma viral (HPV) status (HR: 0·85, 0·71–0·99, p = 0·05).
Adaptive planning generates a superior plan for the majority of patients, but there is modest overall parotid gland sparing.
To determine whether oral vancomycin prophylaxis accompanying systemic antibiotics reduces the risk of relapse in patients with history of Clostridioides difficile infection (CDI).
Retrospective cohort study.
Adult inpatients with a history of CDI who received systemic antibiotics in either of 2 hospitals between January 2009 and June 2015.
We compared relapse rates in patients who started oral vancomycin concurrently with systemic antibiotics (exposed group) versus those who did not. We assessed for CDI relapse by toxin or nucleic acid testing at 90 days. We used inverse probability weighting and machine learning to adjust for confounders, to estimate propensity for treatment, and to calculate odds ratios for CDI relapse. We performed secondary analyses limited to toxin-positive relapses, patients with 1 versus >1 prior CDI episodes, and patients who received oral vancomycin on each antibiotic day.
CDI relapse occurred within 90 days in 19 of 193 exposed patients (9.8%) versus 53 of 567 unexposed patients (9.4%; unadjusted odds ratio [OR], 1.06; 95% confidence interval [CI], 0.60–1.81; adjusted OR, 0.63; 95% CI, 0.35–1.14). CDI relapses at 90 days were less frequent in exposed patients with only 1 prior episode of CDI (OR, 0.42; 95% CI, 0.19–0.93) but not in those with >1 prior episode (OR, 1.19; 95% CI, 0.42–3.33). Our findings were consistent with a lack of benefit of oral vancomycin when restricting results to toxin-positive relapses and to patients who received vancomycin each antibiotic day.
Prophylactic oral vancomycin was not consistently associated with reduced risk of CDI relapse among hospitalized patients receiving systemic antibiotics. However, patients with only 1 prior CDI episode may benefit.
Late-life depression has become an important public health problem. Available evidence suggests that late-life depression is associated with all-cause and cardiovascular mortality among older adults living in the community, although the associations have not been comprehensively reviewed and quantified.
To estimate the pooled association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults.
We conducted a systematic review and meta-analysis of prospective cohort studies that examine the associations of late-life depression with all-cause and cardiovascular mortality in community settings.
A total of 61 prospective cohort studies from 53 cohorts with 198 589 participants were included in the systematic review and meta-analysis. A total of 49 cohorts reported all-cause mortality and 15 cohorts reported cardiovascular mortality. Late-life depression was associated with increased risk of all-cause (risk ratio 1.34; 95% CI 1.27, 1.42) and cardiovascular mortality (risk ratio 1.31; 95% CI 1.20, 1.43). There was heterogeneity in results across studies and the magnitude of associations differed by age, gender, study location, follow-up duration and methods used to assess depression. The associations existed in different subgroups by age, gender, regions of studies, follow-up periods and assessment methods of late-life depression.
Late-life depression is associated with higher risk of both all-cause and cardiovascular mortality among community-dwelling elderly people. Future studies need to test the effectiveness of preventing depression among older adults as a way of reducing mortality in this population. Optimal treatment of late-life depression and its impact on mortality require further investigation.
Contrast sensitivity functions reveal information about a subject’s overall visual ability and have been investigated in several species of nonhuman primates (NHPs) with experimentally induced amblyopia and glaucoma. However, there are no published studies comparing contrast sensitivity functions across these species of normal NHPs. The purpose of this investigation was to compare contrast sensitivity across these primates to determine whether they are similar. Ten normal humans and eight normal NHPs (Macaca fascicularis) took part in this project. Previously published data from Macaca mulatta and Macaca nemestrina were also compared. Threshold was operationally defined as two misses in a row for a descending method of limits. A similar paradigm was used for the humans except that the descending method of limits was combined with a spatial, two-alternative forced choice (2-AFC) technique. The contrast sensitivity functions were fit with a double exponential function. The averaged peak contrast sensitivity, peak spatial frequency, acuity, and area under the curve for the humans were 268.9, 3.40 cpd, 27.3 cpd, and 2345.4 and for the Macaca fascicularis were 99.2, 3.93 cpd, 26.1 cpd, and 980.9. A two-sample t-test indicated that the peak contrast sensitivities (P = 0.001) and areas under the curve (P = 0.010) were significantly different. The peak spatial frequencies (P = 0.150) and the extrapolated visual acuities (P = 0.763) were not different. The contrast sensitivities for the Macaca fascicularis, Macaca mulatta, and Macaca nemestrina were qualitatively and quantitatively similar. The contrast sensitivity functions for the NHPs had lower peak contrast sensitivities and areas under the curve than the humans. Even though different methods have been used to measure contrast sensitivity in different species of NHP, the functions are similar. The contrast sensitivity differences and similarities between humans and NHPs need to be considered when using NHPs to study human disease.
In this paper we present empirical tests of an extended version of the capital asset pricing model (CAPM) that replaces the single-period horizon with a probability distribution over different horizons. Adopting a simple parameterization of the probability distribution of the length of the horizon, we estimate the parameters of the distribution as well as the parameters of the CAPM. We find that the extended model is not rejected for several different samples of common stocks, and for these samples it outperforms not only the standard CAPM but also the Fama–French (1993) 3-factor model. The probability distribution over horizon dates varies over time with the New York Stock Exchange (NYSE) turnover rate. We also find that returns satisfy the Euler equation of a representative financial institution that holds the market portfolio and has horizon probabilities estimated from 13F filings.
Climatic change that affects biological productivity is often argued to be a primary force influencing human activities during the glacial period. To test this assumption, we combine in-site pollen, paleoclimatic, and archaeological data from the Dadiwan site and nearby areas on the western Loess Plateau (WLP) that date to Marine Oxygen Isotope Stage (MIS) 3. Our comparison of multiple datasets suggests that regional human activities increased when the vegetation around the Dadiwan area shifted from forest steppe in the early MIS 3 (59–46.7 ka) to steppe in the middle to late MIS 3 (46.7–29.5 ka). Our results indicate that regional human activities increased again during the late MIS 3 when the amount of precipitation was higher, as indicated by the lower Artemisia proportion. We suggest that increased precipitation on the WLP enhanced the above-ground biomass production and may be responsible for an increase in human activity and population in this region.
While most papers on high-entropy alloys (HEAs) focus on the microstructure and mechanical properties for structural materials applications, there has been growing interest in developing high-entropy functional materials. The objective of this paper is to provide a brief, timely review on select functional properties of HEAs, including soft magnetic, magnetocaloric, physical, thermoelectric, superconducting, and hydrogen storage. Comparisons of functional properties between HEAs and conventional low- and medium-entropy materials are provided, and examples are illustrated using computational modeling and tuning the composition of existing functional materials through substitutional or interstitial mixing. Extending the concept of high configurational entropy to a wide range of materials such as intermetallics, ceramics, and semiconductors through the isostructural design approach is discussed. Perspectives are offered in designing future high-performance functional materials utilizing the high-entropy concepts and high-throughput predictive computational modeling.
Triticum monococcum ssp. monococcum has useful traits for bread wheat improvement. The synthesis of Triticum turgidum–T. monococcum amphiploids is an essential step for transferring genes from T. monococcum into bread wheat. In this study, 264 wide hybridization combinations were done by crossing 60 T. turgidum lines belonging to five subspecies with 83 T. monococcum accessions. Without embryo rescue and hormone treatment, from the 10,810 florets pollinated, 1983 seeds were obtained, with a mean crossability of 18.34% (range 0–89.29%). Many hybrid seeds (90.73%, 923/1017) could germinate and produce plants. A total of 56 new amphiploids (AABBAmAm) were produced by colchicine treatment of T. turgidum × T. monococcum F1 hybrids. The chromosome constitution of amphiploids was characterized by fluorescence in situ hybridization using oligonucleotides probes with different chromosome and sub-chromosome specificities. Sodium dodecyl sulphate polyacrylamide gel electrophoresis analysis indicated that the Glu-A1m-b, Glu-A1m-c, Glu-A1m-d and Glu-A1m-h proteins of T. monococcum were expressed in some amphiploids. Despite resistance reduction in several cases, 45 out of 56 amphiploids exhibited resistance to the current predominant Chinese stripe rust races at both the seedling and adult plant stage. These novel amphiploids provide new germplasm for the potential improvement of bread wheat quality and stripe rust resistance.
Two phases of diabase-sill-forming magmatism are recorded within the Badu anticline where magmas were emplaced into upper Palaeozoic carbonates and clastic rocks of the Youjiang fold-and-thrust belt in the SW South China Block, China. Zircons from these diabase units yield weighted mean U–Pb ages of 249.2±2.0 Ma and 187.1±3.3 Ma, and magmatic oxygen fugacity values from ‒20 to ‒6 (average of ‒12, equating to FMQ +5) and ‒20 to ‒10 (average of ‒15, equating to FMQ +2), respectively. These data indicate that the sills were emplaced during Early Triassic and Early Jurassic times. The discovery of c. 250 Ma mafic magmatism in this area was probably related to post-flood-basalt extension associated with the Emeishan mantle plume or rollback of the subducting Palaeo-Tethys slab. The c. 190 Ma diabase sills indicate that the southwestern South China Block records Early Jurassic mafic magmatism and lithospheric extension that was likely associated with a transition from post-collisional to within-plate tectonic regimes. The emplacement of diabase intrusions at depth may have driven hydrothermal systems, enabling the mobilization of elements from sedimentary rocks and causing the formation of a giant epigenetic metallogenic domain. The results indicate that high-oxygen-fugacity materials within basement rocks caused crustal contamination of the magmas, contributing to the wide range of oxygen fugacity conditions recorded by the Au-bearing Badu diabase. In addition, data from inherited xenocrystic zircons within the Badu diabase and detrital zircons from basement rocks suggest that the Neoproterozoic Jiangshao suture extends to the south of the Badu anticline.
OBJECTIVES/SPECIFIC AIMS: The aim of this study was to assess the ultra-dose Na18F dPET protocol feasibility for skeleton imaging in a canine model with reduced radiation dose and preserved quantitative characteristics. We hypothesized that administering an ultra-low Na18F dose would provide suitable image quality while reducing subject’s exposure to radiation. METHODS/STUDY POPULATION: In total, 13 adult male beagles [weight (kg) mean±SD; 14.3±2.2] were scanned. The dogs were administered 3 different Na18F doses: 3 (standard dose/SD), 1 (low dose/LD), and 0.05 (ultra-low dose/ULD) mCi. Imaging started ≃45 minutes post injection for ≃ 33 minute total acquisition time. Covering the whole body, 11 bed positions, acquiring 120 (3 mCi) and 180 (1, 0.05 mCi) seconds per bed position. All imaging was performed on a digital photon counting system (Philips Vereos, pre-commercial release). PET list mode data were reconstructed using Time-of-flight with 4, 2, and 1 mm3 voxel volumes. Point spread function, and Gaussian filtering were applied. Two experienced blinded readers evaluated image sets overall quality, tissue characterization, and quality of background in the whole body skeleton. Three-dimensional (3D) regions of interest (ROI) were traced over the distal femur, first lumbar vertebra, and a portion of the liver, recording standard uptake values (SUVmax and SUVmean). RESULTS/ANTICIPATED RESULTS: All the scans and reconstructions were successfully completed in all subjects. Decreasing Na18F dose from the standard dose (3 mCi) to the ultra-low dose/ULDO (0.05 mCi), demonstrated acceptable image quality and quantification. Ultra-low dose Na18F SUVmean values for the 3D ROIs reported (mean±SD) 2.6±0.7, 2.5±1.1, 9±1.6, and 0.6±0.3 from the right and left distal femur, first lumbar vertebra, and a portion of the liver, respectively. When compared the SD with the LD and ULD, dPET demonstrated acceptable image quality and definition for qualitative overall assessment. This was also found for the overall quantitative ROI assessment of the healthy canine skeletons. DISCUSSION/SIGNIFICANCE OF IMPACT: Ultra-low dose Na18F at a level of 50 μCi for a 14 kg canine appears to be diagnostically feasible and a robust option to reduce (60-fold) radiotracer doses in a translational animal model using a dPET system. Furthermore, it allows us to move preclinical nuclear medicine imaging forward with substantial reduced exposure levels while preserving image quality. Both visual and quantitative results indicate that the standard-dose bone Na18F dPET can be decreased with a satisfactory diagnostic image quality. Ultra-low Na18F dose is indeed important for younger populations, control patients, and nononcological diseases/conditions. Favorable pharmacokinetics of Na18F (such as high bone uptake, minimal binding to serum proteins, rapid single-pass extraction, and fast clearance from the soft tissues) in addition to the technological capabilities of dPET/CT demonstrated feasibility enabling dose reduction strategies. Ultra-low dose has diagnostic reproducibility and lower radiation burden compared with higher fixed dose techniques in current available guidelines [Society of Nuclear Medicine and Molecular Imaging; SNMMI (5–10 mCi)]. Na18F dPET/CT provides higher sensitivity and diagnostic accuracy, which enables high-quality images with lower tracer activity in this translational animal model. Future research will apply the same methodology to other anatomical targets as well as to the use of different tracers. Preclinical nuclear medicine imaging using ultra-low tracer doses, demonstrated the potential to obtain reasonable quality images and diminishing radiation surveillance in accordance with as low as reasonably achievable tracer levels.
Using the recently developed techniques of electron tomography, we have explored the first stages of disfiguring formation of zinc soaps in modern oil paintings. The formation of complexes of zinc ions with fatty acids in paint layers is a major threat to the stability and appearance of many late 19th and early 20th century oil paintings. Moreover, the occurrence of zinc soaps in oil paintings leading to defects is disturbingly common, but the chemical reactions and migration mechanisms leading to large zinc soap aggregates or zones remain poorly understood. State-of-the-art scanning (SEM) and transmission (TEM) electron microscopy techniques, primarily developed for biological specimens, have enabled us to visualize the earliest stages of crystalline zinc soap growth in a reconstructed zinc white (ZnO) oil paint sample. In situ sectioning techniques and sequential imaging within the SEM allowed three-dimensional tomographic reconstruction of sample morphology. Improvements in the detection and discrimination of backscattered electrons enabled us to identify local precipitation processes with small atomic number contrast. The SEM images were correlated to low-dose and high-sensitivity TEM images, with high-resolution tomography providing unprecedented insight into the structure of nucleating zinc soaps at the molecular level. The correlative approach applied here to study phase separation, and crystallization processes specific to a problem in art conservation creates possibilities for visualization of phase formation in a wide range of soft materials.
A critical question in invasion biology involves the relative importance of propagule rain and community invasibility. For plant invasions, invasibility is often related to disturbance, but few studies of forest invaders have simultaneously investigated both canopy and ground-level disturbance. We investigated the relative importance of seed rain, canopy disturbance, and soil disturbance in a mature forest in Maryland on the recruitment of four invasive species: wine raspberry (Rubus phoenicolasius Maxim.), Japanese barberry (Berberis thunbergii DC), multiflora rose (Rosa multiflora Thunb.), and Japanese stiltgrass [Microstegium vimineum (Trin.) A. Camus]. Using complete censuses of a 9-ha plot at two points in time (2011–12 and 2014), we mapped new recruits, and related their locations to canopy and soil disturbance, as well as to a seed rain index based on locations of reproducing plants and seed-dispersal kernels.
We found that propagule rain, as measured by the seed rain index, was a significant predictor of recruitment for B. thunbergii, R. phoenicolasius, and M. vimineum. For R. multiflora, seed sources were not located, precluding assessment of propagule rain, but recruitment was linked to canopy disturbance, as was recruitment of M. vimineum. However, because reproduction of R. phoenicolasius and, in some years, of B. thunbergii is higher in treefall gaps, these gaps experience higher propagule rain, with the result that recruitment is indirectly associated with these gaps. Ground-layer disturbance was an important predictor of recruitment only for B. thunbergii. Our findings reveal that the importance of propagule rain is the most consistent driver of recruitment, but canopy or ground-layer disturbance promotes recruitment of some invasive plant species.