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 firstname.lastname@example.org
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.
Recent years have seen an exponential increase in the variety of healthcare data captured across numerous sources. However, mechanisms to leverage these data sources to support scientific investigation have remained limited. In 2013 the Pediatric Heart Network (PHN), funded by the National Heart, Lung, and Blood Institute, developed the Integrated CARdiac Data and Outcomes (iCARD) Collaborative with the goals of leveraging available data sources to aid in efficiently planning and conducting PHN studies; supporting integration of PHN data with other sources to foster novel research otherwise not possible; and mentoring young investigators in these areas. This review describes lessons learned through the development of iCARD, initial efforts and scientific output, challenges, and future directions. This information can aid in the use and optimisation of data integration methodologies across other research networks and organisations.
Hydraulic processes within and beneath glacial bodies exert a far-reaching control on ice flow through their influence on basal sliding. Within the subglacial system, rapid changes in these processes may excite resonances whose interpretation requires an understanding of the underlying wave mechanics. Here, we explore these mechanics using observations from a kHz-sampled pressure sensor installed in a borehole directly above the hard granite bedrock of a temperate mountain glacier in Switzerland. We apply a previously established theory of wave propagation along thin, water-filled structures such as water-filled voids, basal water layers, or hydraulic fractures. Within such structures, short-wavelength waves experience restoring forces due to compressibility and are composed of sound waves. Long-wavelength resonances, in contrast, experience restoring forces due to elasticity and are composed of anomalously dispersed crack waves or Krauklis waves. Our borehole observations confirm the occurrence of both sound and crack waves within the basal water layer. Using both the resonance frequencies and attenuation of recorded crack waves we estimate thickness, aperture and length of the resonating basal water layer patch into which we drilled. We demonstrate that high-frequency observations of subglacial hydraulic processes provide new insights into this evolving dynamic system.
In recent years, the use of cover crops has increased in U.S. crop production systems. An important aspect of successful cover crop establishment is the preceding crop and herbicide program, because some herbicides have the potential to persist in the soil for several months. Few studies have been conducted to evaluate the sensitivity of cover crops to common residual herbicides used in soybean production. The same field experiment was conducted in 2016 in Arkansas, Illinois, Indiana, Missouri, Tennessee, and Wisconsin, and repeated in Arkansas, Illinois, Indiana, Mississippi, and Missouri in 2017 to evaluate the potential of residual soybean herbicides to carryover and reduce cover crop establishment. Herbicides applied during the soybean growing season included acetochlor; acetochlor plus fomesafen; chlorimuron plus thifensulfuron; fomesafen; fomesafen plus S-metolachlor followed by acetochlor; imazethapyr; pyroxasulfone; S-metolachlor; S-metolachlor plus fomesafen; sulfentrazone plus S-metolachlor; sulfentrazone plus S-metolachlor followed by fomesafen plus S-metolachlor; and sulfentrazone plus S-metolachlor followed by fomesafen plus S-metolachlor followed by acetochlor. Across all herbicide treatments, the sensitivity of cover crops to herbicide residues in the fall, from greatest to least, was forage radish = turnip > annual ryegrass = winter oat = triticale > cereal rye = Austrian winter pea = hairy vetch = wheat > crimson clover. Fomesafen (applied 21 and 42 days after planting [(DAP]); chlorimuron plus thifensulfuron and pyroxasulfone applied 42 DAP; sulfentrazone plus S-metolachlor followed by fomesafen plus S-metolachlor; and sulfentrazone plus S-metolachlor followed by fomesafen plus S-metolachlor followed by acetochlor caused the highest visual ground cover reduction to cover crop species at the fall rating. Study results indicate cover crops are most at risk when following herbicide applications in soybean containing certain active ingredients such as fomesafen, but overall there is a fairly low risk of cover crop injury from residual soybean herbicides applied in the previous soybean crop.
A nineteen element mercuric iodide (HgI2) detector array has been developed in order to investigate the potential of using this technology for in-vivo x-ray and gamma-ray imaging. A prototype cross-grid detector array was constructed with hexagonal pixels of 1.9 mm diameter (active area = 3.28 mm2) and 0.2 mm thick septa. The overall detector active area is roughly 65 mm2. A detector thickness of 1.2 mm was used to achieve about 100% efficiency at 60 keV and 67% efficiency at 140 keV The detector fabrication, geometry and structure were optimized for charge collection and to minimize crosstalk between elements. A section of a standard high resolution cast-lead gamma-camera collimator was incorporated into the detector to provide collimation matching the discrete pixel geometry. Measurements of spectral and spatial performance of the array were made using 241-Am and 99m-Tc sources. These measurements were compared with similar measurements made using an optimized single HgI2 x-ray detector with active area of about 3 mm2 and thickness of 500 μm.
Bipolar disorder (BD) is associated with attentional and processing abnormalities. Such abnormalities are also seen in healthy subjects with sleep disruption. We hypothesised cognitive abnormalities in BD patients would be worse in those with objectively verified sleep abnormalities.
Forty-six BD patients and 42 controls had comprehensive sleep/circadian rhythm assessment over 21 days alongside mood questionnaires. Cognitive function was assessed with a range of tasks including Psychomotor Vigilance Test (PVT), Attention Network Task (ANT) and Digit Symbol Substitution Test (DSST). BD participants with normal and abnormal sleep were compared with age- and sex-matched controls.
BD patients had longer response times and made more lapses (responses >500 ms) than controls on the PVT (both p < 0.001). However, patients with normal sleep patterns did not differ from controls while those with sleep abnormalities did (p < 0.001). An identical pattern of effects were seen with the ANT response times, with the abnormality in bipolar abnormal sleepers related to the executive attentional network. Similarly, patients made fewer correct responses on the DSST compared with the controls (p < 0.001). Bipolar normal sleepers did not differ while those with abnormal sleep did (p < 0.001). All these differences were seen in bipolar abnormal sleepers who were euthymic (p < 0.01) and across the main abnormal sleep phenotypes.
We confirm impairment in attention and processing speed in BD. Rather than sleep abnormalities exacerbating such dysfunction, the impairments were confined to bipolar abnormal sleepers, consistent with sleep disturbance being the main driver of cognitive dysfunction.
Optimising short- and long-term outcomes for children and patients with CHD depends on continued scientific discovery and translation to clinical improvements in a coordinated effort by multiple stakeholders. Several challenges remain for clinicians, researchers, administrators, patients, and families seeking continuous scientific and clinical advancements in the field. We describe a new integrated research and improvement network – Cardiac Networks United – that seeks to build upon the experience and success achieved to-date to create a new infrastructure for research and quality improvement that will serve the needs of the paediatric and congenital heart community in the future. Existing gaps in data integration and barriers to improvement are described, along with the mission and vision, organisational structure, and early objectives of Cardiac Networks United. Finally, representatives of key stakeholder groups – heart centre executives, research leaders, learning health system experts, and parent advocates – offer their perspectives on the need for this new collaborative effort.
Background: Two ‘sibling’ disorders have been proposed for the fourthcoming 11th version of the International Classification of Diseases (ICD-11): post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD). Examining psychological factors that may be associated with CPTSD, such as self-compassion, is an important first step in its treatment that can inform consideration of which problems are most salient and what interventions are most relevant. Aims: We set out to investigate the association between self-compassion and the two factors of CPTSD: the PTSD factor (re-experiencing, avoidance, sense of threat) and the Disturbances in Self-Organization (DSO) factor (affect dysregulation, negative self-concept and disturbances in relationships). We hypothesized that self-compassion subscales would be negatively associated with both PTSD and DSO symptom clusters. Method: A predominantly female, clinical sample (n = 106) completed self-report scales to measure traumatic life events, ICD-11 CPTSD and self-compassion. Results: Significant negative associations were found between the CPTSD DSO clusters of symptoms and self-compassion subscales, but not for the PTSD ones. Specifically it was also found that self-judgement and common humanity significantly predicted hypoactive affect dysregulation whereas self-judgement and isolation significantly predicted negative self-concept. Conclusions: Our results indicate that self-compassion may be a useful treatment target for ICD-11 CPTSD, particularly for symptoms of negative self-concept and affect dysregulation. Future research is required to investigate the efficacy and acceptability of interventions that have implicit foundations on compassion.
To determine whether probiotic prophylaxes reduce the odds of Clostridium difficile infection (CDI) in adults and children.
Individual participant data (IPD) meta-analysis of randomized controlled trials (RCTs), adjusting for risk factors.
We searched 6 databases and 11 grey literature sources from inception to April 2016. We identified 32 RCTs (n=8,713); among them, 18 RCTs provided IPD (n=6,851 participants) comparing probiotic prophylaxis to placebo or no treatment (standard care). One reviewer prepared the IPD, and 2 reviewers extracted data, rated study quality, and graded evidence quality.
Probiotics reduced CDI odds in the unadjusted model (n=6,645; odds ratio [OR] 0.37; 95% confidence interval [CI], 0.25–0.55) and the adjusted model (n=5,074; OR, 0.35; 95% CI, 0.23–0.55). Using 2 or more antibiotics increased the odds of CDI (OR, 2.20; 95% CI, 1.11–4.37), whereas age, sex, hospitalization status, and high-risk antibiotic exposure did not. Adjusted subgroup analyses suggested that, compared to no probiotics, multispecies probiotics were more beneficial than single-species probiotics, as was using probiotics in clinical settings where the CDI risk is ≥5%. Of 18 studies, 14 reported adverse events. In 11 of these 14 studies, the adverse events were retained in the adjusted model. Odds for serious adverse events were similar for both groups in the unadjusted analyses (n=4,990; OR, 1.06; 95% CI, 0.89–1.26) and adjusted analyses (n=4,718; OR, 1.06; 95% CI, 0.89–1.28). Missing outcome data for CDI ranged from 0% to 25.8%. Our analyses were robust to a sensitivity analysis for missingness.
Moderate quality (ie, certainty) evidence suggests that probiotic prophylaxis may be a useful and safe CDI prevention strategy, particularly among participants taking 2 or more antibiotics and in hospital settings where the risk of CDI is ≥5%.
Identifying genetic relationships between complex traits in emerging adulthood can provide useful etiological insights into risk for psychopathology. College-age individuals are under-represented in genomic analyses thus far, and the majority of work has focused on the clinical disorder or cognitive abilities rather than normal-range behavioral outcomes.
This study examined a sample of emerging adults 18–22 years of age (N = 5947) to construct an atlas of polygenic risk for 33 traits predicting relevant phenotypic outcomes. Twenty-eight hypotheses were tested based on the previous literature on samples of European ancestry, and the availability of rich assessment data allowed for polygenic predictions across 55 psychological and medical phenotypes.
Polygenic risk for schizophrenia (SZ) in emerging adults predicted anxiety, depression, nicotine use, trauma, and family history of psychological disorders. Polygenic risk for neuroticism predicted anxiety, depression, phobia, panic, neuroticism, and was correlated with polygenic risk for cardiovascular disease.
These results demonstrate the extensive impact of genetic risk for SZ, neuroticism, and major depression on a range of health outcomes in early adulthood. Minimal cross-ancestry replication of these phenomic patterns of polygenic influence underscores the need for more genome-wide association studies of non-European populations.