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Dysphagia is a common symptom with associated complications ranging from mild discomfort to life-threatening pulmonary compromise. Videofluoroscopic swallow is the ‘gold standard’ evaluation for oropharyngeal dysphagia, but little is known about how patients’ performance changes over time.
This was a retrospective cohort study evaluating dysphagia patients’ clinical course by serial videofluoroscopic swallow study. Univariate analysis followed by multivariate analysis were used to identify correlations between pneumonia outcomes, diet allocation, aetiology and comorbidities.
This study identified 104 patients (53 per cent male) stratified into risk groups by penetration-aspiration scale scores. Mean penetration-aspiration scale worsened over time (p < 0.05), but development of pneumonia was not associated with worsened penetration-aspiration scale score over time (p = 0.57) or severity of dysphagia (p = 0.88).
Our dataset identified a large cohort of patients with oropharyngeal dysphagia and demonstrated mean penetration-aspiration scale tendency to worsen. Identifying prognostic factors associated with worsening radiological findings and applying this to patients at risk of clinical swallowing difficulty is needed.
Most epidemiological studies show a decrease of internalizing disorders at older ages, but it is unclear how the prevalence exactly changes with age, and whether there are different patterns for internalizing symptoms and traits, and for men and women. This study investigates the impact of age and sex on the point prevalence across different mood and anxiety disorders, internalizing symptoms, and neuroticism.
We used cross-sectional data on 146 315 subjects, aged 18–80 years, from the Lifelines Cohort Study, a Dutch general population sample. Between 2012 and 2016, five current internalizing disorders – major depression, dysthymia, generalized anxiety disorder, social phobia, and panic disorder – were assessed according to DSM-IV criteria. Depressive symptoms, anxiety symptoms, neuroticism, and negative affect (NA) were also measured. Generalized additive models were used to identify nonlinear patterns across age, and to investigate sex differences.
The point prevalence of internalizing disorders generally increased between the ages of 18 and 30 years, stabilized between 30 and 50, and decreased after age 50. The patterns of internalizing symptoms and traits were different. NA and neuroticism gradually decreased after age 18. Women reported more internalizing disorders than men, but the relative difference remained stable across age (relative risk ~1.7).
The point prevalence of internalizing disorders was typically highest between age 30 and 50, but there were differences between the disorders, which could indicate differences in etiology. The relative gap between the sexes remained similar across age, suggesting that changes in sex hormones around the menopause do not significantly influence women's risk of internalizing disorders.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
The 1717 Christmas flood is one of the most catastrophic storm surges the Frisian coast (Netherlands and Germany) has ever experienced. With more than 13,700 casualties it is the last severe storm surge with a death toll of this order. At the same time, little is known about the hydrodynamic conditions and the morphological effects associated with this storm surge.
In this study, 41 potential dyke failures in the Province of Groningen (Netherlands) associated with the 1717 Christmas flood were systematically reconstructed and mapped by using historical maps and literature and by analysing the recent topography in search of typical pothole structures and sediment fans. The dimensions of the sediment fans as derived from the topography show a good accordance with the dimensions documented by vibracore profiles, direct push tests and electrical resistivity tomography data taken at three fieldwork sites. Moreover, the fan dimensions closely agree with the dimensions as simulated using a process-based morphodynamic numerical model for one of the three sites, the village of Wierhuizen. Consequently, the recent topography is still indicative for the locations and dimensions of dyke failures and sediment fans associated with the 1717 Christmas flood. Considering the large number of detected dyke failures (41) and the large dimensions of the potholes and particularly of the sediment fans up to a few hundred metres wide and up to 0.7 m thick, this study proves significant morphological effects of the 1717 Christmas flood on the mainland of the Province of Groningen.
Based on the numerical simulation approach and the comparison with field data and field observations, a maximum seaward water level of 5 m NAP for the dyke failure at Wierhuizen during the Christmas flood can be derived. A similar maximum water level is indicated for the two other fieldwork sites Vierhuizen and Kohol, which is in good agreement with the maximum storm surge level of 4.62 m NAP historically documented for the city of Emden located almost 50 km to the east of Wierhuizen.
The results of the current study demonstrate that the reconstruction of historical dyke failures based on (i) historical sources, (ii) recent lidar/high-resolution topographical data, (iii) multi-proxy sedimentary field data and (iv) hydro- and morphodynamic numerical simulations is a highly promising approach to derive hydrodynamic conditions and the morphological onshore response of the 1717 Christmas flood in the Province of Groningen. This knowledge is essential to improve our understanding of extreme storm surge dynamics, their influence on the coastal landscape and the associated hazards for the coastal population.
In a cross-sectional study, we assessed family functioning prior to outpatient visits and routine heart catheterisations in the families of paediatric heart transplant recipients. Caregivers rated higher short-term family functioning prior to outpatient visits, but not prior to catheterisations. This finding may indicate that family functioning benefits from the support provided during outpatient visits.
To investigate (i) changes in stakeholder commitment and (ii) perceptions of the purpose, challenges and benefits of healthy food and beverage provision in community sports settings during the stepwise implementation of a healthy beverage policy.
Convergent, parallel, mixed-methods design complemented (i) repeat semi-structured interviews with council stakeholders (n 17 interviews, n 6 interviewees), with (ii) repeat quantitative stakeholder surveys measuring Commitment to Organisational Change; (iii) weekly sales data examining health behaviour and revenue effects (15 months pre-intervention; 14 months post-intervention); (iv) customer exit surveys (n 458); and (v) periodic photographic audits of beverage availability. Interviews were analysed inductively. Stakeholder surveys, sales data, customer surveys and audits were analysed descriptively.
Four local government-owned sports and recreation centres in Melbourne, Australia, completed a 3-month trial to increase the availability of healthy beverages and decrease the availability of unhealthy beverages in food outlets.
Interviews were conducted with council managers and those involved in implementation (September 2016–October 2017). Customers were surveyed (September–October 2017).
Interviews and surveys indicated that stakeholders’ commitment to policies varied such that, over time, optimism that changing beverage availability could increase the healthiness of customers’ purchases became more widespread among interviewees. Stakeholder focus generally progressed from anticipatory concern to solutions-focused discussions. Sales, audit and customer survey data supported interview findings.
We found a general increase in optimism regarding policy outcomes over time during the implementation of a healthy beverage policy. Stepwise trials should be further explored as an engagement tool within community retail settings.
The default mode network (DMN) dysfunction has emerged as a consistent biological correlate of multiple psychiatric disorders. Specifically, there is evidence of alterations in DMN cohesiveness in schizophrenia, mood and anxiety disorders. The aim of this study was to synthesize at a fine spatial resolution the intra-network functional connectivity of the DMN in adults diagnosed with schizophrenia, mood and anxiety disorders, capitalizing on powerful meta-analytic tools provided by activation likelihood estimation.
Results from 70 whole-brain resting-state functional magnetic resonance imaging articles published during the last 15 years were included comprising observations from 2,789 patients and 3,002 healthy controls.
Specific regional changes in DMN cohesiveness located in the anteromedial and posteromedial cortex emerged as shared and trans-diagnostic brain phenotypes. Disease-specific dysconnectivity was also identified. Unmedicated patients showed more DMN functional alterations, highlighting the importance of interventions targeting the functional integration of the DMN.
This study highlights functional alteration in the major hubs of the DMN, suggesting common abnormalities in self-referential mental activity across psychiatric disorders.
The African Network of Women in Astronomy and STEM for GIRLS in Ethiopia initiatives have been established with aim to strengthen the participation of girls and women in astronomy and science in Africa and Ethiopia. We will not be able to achieve the UN Sustainable Development Goals without full participation of women and girls in all aspects of our society and without giving in future the same opportunity to all children to access education independently on their socio-economical status. In this paper both initiatives are briefly introduced.
Stictococcus vayssierei is a major pest of root and tuber crops in central Africa. However, data on its ecology are lacking. Here we provide an updated estimate of its distribution with the aim of facilitating the sustainable control of its populations. Surveys conducted in nine countries encompassing 13 ecological regions around the Congo basin showed that African root and tuber scale was present in Cameroon, Central African Republic, Congo, Democratic Republic of Congo, Equatorial Guinea, Gabon and Uganda. It was not found on the sites surveyed in Chad and Nigeria. The pest occurred in the forest and the forest-savannah mosaic as well as in the savannah where it was never recorded before. However, prevalence was higher in the forest (43.1%) where cassava was the most infested crop, compared to the savannah (9.2%) where aroids (cocoyam and taro) were the most infested crops. In the forest habitat, the pest was prevalent in all but two ecological regions: the Congolian swamp forests and the Southern Congolian forest-savanna mosaic. In the savannah habitat, it was restricted to the moist savannah highlands and absent from dry savannahs. The scale was not observed below 277 m asl. Where present, the scale was frequently (87.1% of the sites) attended by the ant Anoplolepis tenella. High densities (>1000 scales per plant) were recorded along the Cameroon–Gabon border. Good regulatory measures within and between countries are required to control the exchange of plant materials and limit its spread. The study provides information for niche modeling and risk mapping.
The almost universally-occurring aggregated distributions of helminth burdens in host populations have major significance for parasite population ecology and evolutionary biology, but the mechanisms generating heterogeneity remain poorly understood. For the direct life cycle monogenean Discocotyle sagittata infecting rainbow trout, Oncorhynchus mykiss, variables potentially influencing aggregation can be analysed individually. This study was based at a fish farm where every host individual becomes infected by D. sagittata during each annual transmission period. Worm burdens were examined in one trout population maintained in isolation for 9 years, exposed to self-contained transmission. After this year-on-year recruitment, prevalence was 100% with intensities 10–2628, mean 576, worms per host. Parasite distribution, amongst hosts with the same age and environmental experience, was highly aggregated with variance to mean ratio 834 and negative binomial parameter, k, 0.64. The most heavily infected 20% of fish carried around 80% of the total adult parasite population. Aggregation develops within the first weeks post-infection; hosts typically carried intensities of successive age-specific cohorts that were consistent for that individual, such that heavily-infected individuals carried high numbers of all parasite age classes. Results suggest that host factors alone, operating post-infection, are sufficient to generate strongly overdispersed parasite distributions, rather than heterogeneity in exposure and initial invasion.
The spectrum of gluten-related disorders includes coeliac disease (CD), wheat allergy (WA) and the suggested entity of non-coeliac gluten sensitivity (NCGS). An increasing number of the world’s population are avoiding gluten due to the assumption of health benefits and self-diagnosed gastrointestinal and/or extra-intestinal symptoms. Unlike CD and WA, NCGS is a relatively new entity with an unknown prevalence and mechanisms, complicated by recent literature suggesting that gluten is not the only food component that may trigger symptoms experienced by this group of patients. The term ‘non-coeliac wheat sensitivity’ has been proposed as a more accurate term, allowing inclusion of other non-gluten wheat components such as fructans and amylase–trypsin inhibitors. There is inconsistent evidence when evaluating the effects of a gluten challenge in patients with suspected NCGS and there is a need for a standardised procedure to confirm the diagnosis, ultimately enabling the optimisation of clinical care. The present review will give an overview of the different gluten-related disorders and discuss the most recent scientific evidence investigating NCGS.
The probability of developing malignancy in females under 50 years of age is estimated to be 1 in 18; about 5200 females under 40 years of age died of cancer in 2014 in the US, making it the second leading cause of death in women younger than 40 years, and fortunately, a rare cause of maternal mortality.
Eating less frequently is associated with increased obesity risk in older children but data are potentially confounded by reverse causation, where bigger children eat less often in an effort to control their weight. Longitudinal data, particularly in younger children, are scarce. We aimed to determine whether eating frequency (meals and snacks) at 2 years of age is associated with past, current or subsequent BMI.
Cohort analysis of a randomised controlled trial. Eating frequency at 2 years of age was estimated using 48 h diaries that recorded when each child ate meals and snacks (parent-defined) in five-minute blocks. Body length/height and weight were measured at 1, 2 and 3·5 years of age. Linear regression assessed associations between the number of eating occasions and BMI Z-score, before and after adjustment for potential confounding variables.
Prevention of Overweight in Infancy (POI) study, Dunedin, New Zealand.
Children (n 371) aged 1–3·5 years.
On average, children ate 5·5 (sd 1·2) times/d at 2 years of age, with most children (88–89 %) eating 4–7 times/d. Eating frequency at 2 years was not associated with current (difference in BMI Z-score per additional eating occasion; 95 % CI: −0·02; −0·10, 0·05) or subsequent change (0·02; −0·03, 0·06) in BMI. Similarly, BMI at age 1 year did not predict eating frequency at 2 years of age (difference in eating frequency per additional BMI Z-score unit; 95 % CI: −0·03; −0·19, 0·13).
Number of eating occasions per day was not associated with BMI in young children in the present study.
We show results from a positive degree-day (PDD) model of Greenland ice sheet (GrIS) surface mass balance (SMB), 1870–2012, forced with reanalysis data. The model includes an improved daily temperature parameterization as compared with a previous version and is run at 1 km rather than 5 km resolution. The improvements lead overall to higher SMB with the same forcing data. We also compare our model with results from two regional climate models (RCMs). While there is good qualitative agreement between our PDD model and the RCMs, it usually results in lower precipitation and lower runoff but approximately equivalent SMB: mean 1979–2012 SMB (± standard deviation), in Gt a−1, is 382 ± 78 in the PDD model, compared with 379 ± 101 and 425 ± 90 for the RCMs. Comparison with in situ SMB observations suggests that the RCMs may be more accurate than PDD at local level, in some areas, although the latter generally compares well. Dividing the GrIS into seven drainage basins we show that SMB has decreased sharply in all regions since 2000. Finally we show correlation between runoff close to two calving glaciers and either calving front retreat or calving flux, this being most noticeable from the mid-1990s.
Fluvial geomorphology and stratigraphy often reflect past environmental and climate conditions. This study examines the response of Bull Creek, a small ephemeral creek in the Oklahoma panhandle, to environmental conditions through the late Pleistocene and Holocene. Fluvial terraces were mapped and their stratigraphy and sedimentology documented throughout the course of the main valley. Based on their elevations, terraces were broadly grouped into a late-Pleistocene fill terrace (T3) and two Holocene fill-cut terrace sets (T2 and T1). Terrace systems are marked by similar stratigraphies recording the general environmental conditions of the time. Sedimentary sequences preserved in terrace fills record the transition from a perennial fluvial system during the late glacial period and the Younger Dryas to a semiarid environment dominated by loess accumulation and punctuated by flood events during the middle to late Holocene. The highest rates of aeolian accumulation within the valley occurred during the early to middle Holocene. Our data provide significant new information regarding the late-Pleistocene and Holocene environmental history for this region, located between the well-studied Southern and Central High Plains of North America.
Crop yields can be similar in organic and conventional systems even when weed biomass is greater in organic systems. Greater weed tolerance in organic systems may be due to differences in management-driven soil fertility properties. The goal of this experiment was to determine whether soil collected from a long-term organic cropping system with a diverse crop rotation and organic fertility inputs would support higher soil nitrogen (N) resource partitioning, as indicated by overyielding of corn–weed mixtures, than a cropping system with a less diverse crop rotation and inorganic N inputs. A replacement series greenhouse experiment was conducted using corn : smooth pigweed and corn : giant foxtail proportions of 0 : 1, 0.25 : 0.75, 0.5 : 0.5, 0.75 : 0.25, and 1 : 0 and harvested at 29, 40, or 48 d after experiment initiation (DAI). The monoculture density of corn was 4 plants pot−1 and the monoculture density of each weed species was 36 plants pot−1. Corn was consistently more competitive than both weed species at 40 and 48 DAI when soil inorganic N was limiting to growth. Corn–smooth pigweed mixtures had greater shoot biomass and shoot N content than expected based on the shoot biomass and shoot N content of monocultures (i.e., overyielding) at the onset of soil inorganic N limitation, providing some evidence for N resource partitioning. However, soil management effects on overyielding were infrequent and inconsistent among harvest dates and corn–weed mixtures, leading us to conclude that management-driven soil fertility properties did not affect corn–weed N resource partitioning during the early stages of corn growth.