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The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.
In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.
From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.
A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.
This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.
The response of glaciers to climate change has major implications for sea-level change and water resources around the globe. Large-scale glacier evolution models are used to project glacier runoff and mass loss, but are constrained by limited observations, which result in models being over-parameterized. Recent systematic geodetic mass-balance observations provide an opportunity to improve the calibration of glacier evolution models. In this study, we develop a calibration scheme for a glacier evolution model using a Bayesian inverse model and geodetic mass-balance observations, which enable us to quantify model parameter uncertainty. The Bayesian model is applied to each glacier in High Mountain Asia using Markov chain Monte Carlo methods. After 10,000 steps, the chains generate a sufficient number of independent samples to estimate the properties of the model parameters from the joint posterior distribution. Their spatial distribution shows a clear orographic effect indicating the resolution of climate data is too coarse to resolve temperature and precipitation at high altitudes. Given the glacier evolution model is over-parameterized, particular attention is given to identifiability and the need for future work to integrate additional observations in order to better constrain the plausible sets of model parameters.
Background: Biallelic variants in POLR1C are associated with POLR3-related leukodystrophy (POLR3-HLD), or 4H leukodystrophy (Hypomyelination, Hypodontia, Hypogonadotropic Hypogonadism), and Treacher Collins syndrome (TCS). The clinical spectrum of POLR3-HLD caused by variants in this gene has not been described. Methods: A cross-sectional observational study involving 25 centers worldwide was conducted between 2016 and 2018. The clinical, radiologic and molecular features of 23 unreported and previously reported cases of POLR3-HLD caused by POLR1C variants were reviewed. Results: Most participants presented between birth and age 6 years with motor difficulties. Neurological deterioration was seen during childhood, suggesting a more severe phenotype than previously described. The dental, ocular and endocrine features often seen in POLR3-HLD were not invariably present. Five patients (22%) had a combination of hypomyelinating leukodystrophy and abnormal craniofacial development, including one individual with clear TCS features. Several cases did not exhibit all the typical radiologic characteristics of POLR3-HLD. A total of 29 different pathogenic variants in POLR1C were identified, including 13 new disease-causing variants. Conclusions: Based on the largest cohort of patients to date, these results suggest novel characteristics of POLR1C-related disorder, with a spectrum of clinical involvement characterized by hypomyelinating leukodystrophy with or without abnormal craniofacial development reminiscent of TCS.
Modern baleen whales (Mysticeti), the largest animals on Earth, arose from small ancestors around 36.4 million years ago (Ma). True gigantism is thought to have arisen late in mysticete history, with species exceeding 10 m unknown prior to 8 Ma. This view is challenged by new fossils from Seymour Island (Isla Marambio), Antarctica, which suggest that enormous whales once roamed the Southern Ocean during the Late Eocene (c. 34 Ma). The new material hints at an unknown species of the archaic mysticete Llanocetus with a total body length of up to 12 m. The latter is comparable to that of extant Omura's whales (Balaenoptera omurai Wada et al. 2003), and suggests that gigantism has been a re-occurring feature of mysticetes since their very origin. Functional analysis including sharpness and dental wear implies an at least partly raptorial feeding strategy, starkly contrasting with the filtering habit of living whales. The new material markedly expands the size range of archaic mysticetes, and demonstrates that whales achieved considerable disparity shortly after their origin.
Inappropriate use of antibiotics is contributing to a serious antimicrobial resistance problem in Asian hospitals. Despite resource constraints in the region, all Asian hospitals should implement antimicrobial stewardship (AMS) programs to optimize antibiotic treatment, improve patient outcomes, and minimize antimicrobial resistance. This document describes a consensus statement from a panel of regional experts to help multidisciplinary AMS teams design programs that suit the needs and resources of their hospitals. In general, AMS teams must decide on appropriate interventions (eg, prospective audit and/or formulary restriction) for their hospital, focusing on the most misused antibiotics and problematic multidrug-resistant organisms. This focus is likely to include carbapenem use with the goal to reduce carbapenem-resistant gram-negative bacteria. Rather than initially trying to introduce a comprehensive, hospital-wide AMS program, it would be practical to begin by pilot testing a simple program based on 1 achievable core intervention for the hospital. AMS team members must work together to determine the most suitable AMS interventions to implement in their hospitals and how best to put them into practice. Continuous monitoring and feedback of outcomes to the AMS teams, hospital administration, and prescribers will enhance sustainability of the AMS programs.
Ultrasound (US) detects synovitis more accurately than clinical examination (CE) in people with rheumatoid arthritis (RA). This review aimed to investigate the use of US, compared to CE alone, in treatment strategies for RA, and to estimate its potential to be cost-effective in making treatment decisions.
A systematic review was conducted of studies: investigating RA treatment response or strategies that compared US with CE-assessed synovitis; and of tapering RA treatment (1). A model was constructed to investigate the potential cost-effectiveness of US in (i) selecting patients suitable for treatment tapering; and (ii) avoiding treatment escalation (2).
Seven prospective cohort studies suggested US-detected synovitis was significantly associated with a treatment response or tapering failure, whereas in most cases clinical examination alone was not. Two randomized controlled trials (RCTs) identified suggested that US added to the Disease Activity Index (DAS)-based treatment strategies but did not significantly improve primary outcomes, but was associated with improved rate of DAS remission. The evidence showed that some patients (proportions varied widely) who had achieved low disease activity could have treatment tapered, with no, or little, short-term harm to the patient.
The model estimated that an average reduction of 2.5 percent in the costs of biological disease-modifying anti-rheumatic drug (bDMARDs) was sufficient to cover the costs of performing US every three months. This value increased to 4 percent and 13 percent for the costs of conventional disease-modifying anti-rheumatic drug (cDMARDs) depending on the assumed regimen.
Use of US to monitor synovitis could potentially be a cost-effective approach, given that low proportions of patients for whom clinicians consider amending treatment, would need to taper treatment, or remain on therapy without escalation. US could provide clinicians with more confidence in reducing the drug burden. However, there is considerable uncertainty in this conclusion due to lack of robust data relating to key parameters.
This paper re-examines the problem of the flow of a fluid of finite depth over two Gaussian-shaped obstructions on the stream bed. A weakly nonlinear analysis in the form of the Korteweg–de Vries equation is used to compare with the results of the fully nonlinear problem. The main focus is to find waveless subcritical solutions, and contours showing the obstruction height and separation values that result in waveless solutions are found for different Froude numbers and different obstruction widths.
Oxyspirura petrowi is a heteroxenous parasitic nematode that has been reported in high prevalences from birds in the Order Galliformes experiencing population declines in the USA. There is a paucity of information regarding the natural history O. petrowi, including the life cycle and effects of infection on wild bird populations. In order to study the life cycle of this parasite, we collected plains lubber grasshoppers (Brachystola magna) from a field location in Mitchell County, Texas. We found third-stage larvae (L3) in 37.9% (66/174) B. magna. We determined that they were O. petrowi through morphological comparison of L3 from experimentally infected Acheta domesticus and by sequence analysis. Then, we showed that B. magna are a potential intermediate hosts for O. petrowi infections in northern bobwhites (Colinus virginianus) in a laboratory setting by experimental infection. We first detected shedding of eggs in feces using a fecal float technique 52 days post infection. In addition, we recovered 87 O. petrowi from experimentally infected northern bobwhites. Although we detected shedding in feces, recovery of eggs was low (>5 eggs/g). Future work is needed to understand shedding routes and shedding patterns of northern bobwhites infected with O. petrowi.
We examine a problem in which a line sink causes a disturbance to an otherwise uniform flowing stream of infinite depth. We consider the fully non-linear problem with the inclusion of surface tension and find the maximum sink strength at which steady solutions exist for a given stream flow, before examining non-unique solutions. The addition of surface tension allows for a more thorough investigation into the characteristics of the solutions. The breakdown of steady solutions with surface tension appears to be caused by a curvature singularity as the flow rate approaches the maximum. The non-uniqueness in solutions is shown to occur for a range of parameter values in all cases with non-zero surface tension.
There are insufficient data from nationwide surveys on the prevalence of specific psychotic disorders and associated co-morbidities.
The 2010 Australian national psychosis survey used a two-phase design to draw a representative sample of adults aged 18–64 years with psychotic disorders in contact with public treatment services from an estimated resident population of 1 464 923 adults. This paper is based on data from 1642 participants with an International Classification of Diseases (ICD)-10 psychotic disorder. Its aim is to present estimates of treated prevalence and lifetime morbid risk of psychosis, and to describe the cognitive, physical health and substance use profiles of participants.
The 1-month treated prevalence of psychotic disorders was 3.10 cases per 1000 population aged 18–64 years, not accounting for people solely accessing primary care services; lifetime morbid risk was 3.45 per 1000. Mean premorbid intelligence quotient was approximately 0.5 s.d.s below the population mean; current cognitive ability (measured with a digit symbol coding task) was 1.6 s.d.s below the population mean. For both cognitive tests, higher scores were significantly associated with better independent functioning. The prevalence of the metabolic syndrome was high, affecting 60.8% of participants, and pervasive across diagnostic groups. Of the participants, two-thirds (65.9%) were current smokers, 47.4% were obese and 32.4% were sedentary. Of the participants, half (49.8%) had a lifetime history of alcohol abuse/dependence and 50.8% lifetime cannabis abuse/dependence.
Our findings highlight the need for comprehensive, integrative models of recovery to maximize the potential for good health and quality of life for people with psychotic illness.
Glaciers on King George Island, Antarctica, have shown retreat and surface lowering in recent decades, concurrent with increasing air temperatures. A large portion of the glacier perimeter is ocean-terminating, suggesting possible large mass losses due to calving and submarine melting. Here we estimate the ice discharge into the ocean for the King George Island ice cap. L-band synthetic aperture radar images covering the time-span January 2008 to January 2011 over King George Island are processed using an intensity-tracking algorithm to obtain surface velocity measurements. Pixel offsets from 40 pairs of radar images are analysed and inverted to estimate a weighted average surface velocity field. Ice thicknesses are derived from simple principles of ice flow mechanics using the computed surface velocity fields and in situ thickness data. The maximum ice surface speeds reach >225 m a-1, and the total ice discharge for the analysed flux gates of King George Island is estimated to be 0.720 ± 0.428 Gt a−1, corresponding to a specific mass loss of 0.64 ± 0.38 m w.e. a-1 over the area of the entire ice cap (1127 km2).
The subcritical flow of a stream over a bottom obstruction or depression is considered with particular interest in obtaining solutions with no downstream waves. In the linearised problem this can always be achieved by superposition of multiple obstructions, but it is not clear whether this is possible in a full nonlinear problem. Solutions computed here indicate that there is an effective nonlinear superposition principle at work as no special shape modifications were required to obtain wave-cancelling solutions. Waveless solutions corresponding to one or more trapped waves are computed at a range of different Froude numbers and are shown to provide a rather elaborate mosaic of solution curves in parameter space when both negative and positive obstruction heights are included.
Information about glacier volume and ice thickness distribution is essential for many glaciological applications, but direct measurements of ice thickness can be difficult and costly. We present a new method that calculates ice thickness via an estimate of ice flux. We solve the familiar continuity equation between adjacent flowlines, which decreases the computational time required compared to a solution on the whole grid. We test the method on Columbia Glacier, a large tidewater glacier in Alaska, USA, and compare calculated and measured ice thicknesses, with favorable results. This shows the potential of this method for estimating ice thickness distribution of glaciers for which only surface data are available. We find that both the mean thickness and volume of Columbia Glacier were approximately halved over the period 1957–2007, from 281 m to 143 m, and from 294 km3 to 134 km3, respectively. Using bedrock slope and considering how waves of thickness change propagate through the glacier, we conduct a brief analysis of the instability of Columbia Glacier, which leads us to conclude that the rapid portion of the retreat may be nearing an end.
Potential crop yield loss due to early-season weed competition is an important risk associated with postemergence weed management programs. WeedSOFT is a weed management decision support system that has the potential to greatly reduce such risk. Previous research has shown that weed emergence time can greatly affect the accuracy of corn yield loss predictions by WeedSOFT, but our understanding of its predictive accuracy for soybean yield loss as affected by weed emergence time is limited. We conducted experiments at several sites across the Midwestern United States to assess accuracy of WeedSOFT predictions of soybean yield loss associated with mixed-species weed communities established at emergence (VE), cotyledon (VC), first-node (V1), or third-node (V3) soybean. Weed communities across research sites consisted mostly of annual grass species and moderately competitive annual broadleaf species. Soybean yield loss occurred in seven of nine site-years for weed communities established at VE soybean, four site-years for weed communities established at VC soybean, and one site-year for weed communities established at V1 soybean. No soybean yield loss was associated with weed communities established at the V3 stage. Nonlinear regression analyses of predicted and observed soybean yield data pooled over site-years showed that predicted yields were less than observed yields at all soybean growth stages, indicating overestimation of soybean yield loss. Pearson correlation analyses indicated that yield loss functions overestimated the competitive ability of high densities of giant and yellow foxtail with soybean, indicating that adjustments to competitive index values or yield loss function parameters for these species may improve soybean yield loss prediction accuracy and increase the usefulness of WeedSOFT as a weed management decision support system.
A mass-balance model using upper-air meteorological data for input was calibrated with surface mass balance measured mainly during 1977–78 at 67 sites on Columbia Glacier, Alaska, between 135 and 2645 m a.s.l. Root-mean-square error, model vs measured, is 1.0 m w.e. a−1, with r2 = 0.88. A remarkable result of the analysis was that both precipitation and the factor in the positive degree-day model used to estimate surface ablation were constant with altitude. The model was applied to reconstruct glacier-wide components of surface mass balance over 1948–2007. Surface ablation, 4 km3 ice eq. a−1 (ice equivalent), has changed little throughout the period. From 1948 until about 1981, when drastic retreat began, the surface mass balance was positive but changes in glacier geometry were small, so the positive balance was offset by calving, ∼0.9 km3 ice eq. a−1 . During retreat, volume loss of the glacier accounted for 92% of the iceberg production. Calving increased to ∼4.3 km3 ice eq. a−1 from 1982 to 1995, and after that until 2007 to ∼8.0 km3 ice eq. a−1, which was about twice the loss by surface ablation, whereas prior to retreat it was only about a quarter as much. Calving is calculated as the difference between glacier-wide surface mass balance and geodetically determined volume change.
Conventional and reference-surface mass-balance data from Gulkana and Wolverine Glaciers, Alaska, USA, are used to address the questions of how rapidly these glaciers are adjusting (or ‘responding’) to climate, whether their responses are stable, and whether the glaciers are likely to survive in today’s climate. Instability means that a glacier will eventually vanish, or at least become greatly reduced in volume, if the climate stabilizes at its present state. A simple non-linear theory of response is presented for the analysis. The response of Gulkana Glacier is characterized by a timescale of several decades, but its stability and therefore its survival in today’s climate are uncertain. Wolverine seems to be responding to climate more slowly, on the timescale of one to several centuries. Its stability is also uncertain, but a slower response time would make it more susceptible to climate changes.
The ability to accurately estimate herbicide efficacy is critical for any decision-support system used in weed management. Recent efforts by weed scientists in the North Central United States to adopt WeedSOFT across a broad region have resulted in a number of regional research projects designed to assess and improve the predictive capability of WeedSOFT. Field studies were conducted from 2000 to 2002 in Nebraska, Missouri, and Illinois to evaluate herbicide-efficacy predictions made by WeedSOFT in two corn-row spacings. Following crop and weed emergence, input variables, such as weed densities and heights, were entered into WeedSOFT to generate a list of treatments ranked by predicted crop yields. The five treatments evaluated included those predicting highest crop-yield potential (recommended control treatment 1), a 10% yield reduction, a 20% yield reduction, a 10% yield reduction plus cultivation, and cultivation alone. These treatments were applied to corn grown in 38- and 76-cm rows. Generally, treatments applied in 38-cm rows had more accurate herbicide-efficacy predictions compared with 76-cm rows. WeedSOFT provided better control predictions for broadleaf than grass species. WeedSOFT provided excellent herbicide-efficacy predictions for the highest crop-yield potential, which indicates a good potential for practical use of this software for herbicide recommendations.
A field study of cowpea, soybean and maize was made at Ibadan, Nigeria, to determine the uptake of mineral nutrients and quantities removed in crop residues and seed. Concentrations of N, the major cations (K, Ca, Mg and Na) and major anions (P, S and Cl), and the micronutrients (Fe, Mn, Zn and Cu) were determined in shoots harvested at flowering and maturity. Concentrations of excess cations in shoots at flowering were 135 cmolc kg−1 for soybean, 158 cmolc kg−1 for cowpea and 58 cmolc kg−1 for maize. In crop residues and seed at maturity, the values decreased to 75 and 56 cmolc kg−1 respectively for soybean, 68 and 27 cmolc kg−1 respectively for cowpea, and 52 and 10 cmolc kg−1 respectively for maize. Nutrient and excess cation concentrations were also measured in 13 soybean and eight cowpea lines grown in replicated field trials at Fashola in the derived savanna zone and Shika in the northern Guinea savanna zone of Nigeria to assess the variation within these species. Maize, mucuna and lablab were included at these sites. The results are discussed in the context of soil nutrient depletion due to removal of nutrient elements in harvested seed and stover. The contribution of seed and stover removal to the proton (H+) budget and acidification of the soil is also discussed. It is estimated that the quantity of lime required to neutralize the acidity resulting from the removal of 1 t seed is 28 kg for soybean, 14 kg for cowpea and 5 kg for maize. The corresponding values for stover were soybean 35, cowpea 24 and maize 26 kg lime t−1 stover. Given the soil pH buffer capacity at the Ibadan site for the surface 16 cm, the yields obtained and assuming that seed and crop residues are removed, carbon cycle acidification would lead to a fall of 1 pH unit after 75 crops for soybean, 114 crops for cowpea and 68 crops for maize. The inclusion of legumes in cropping systems to increase N supply, and the use of P fertilizer to maximize N-fixation by legumes will raise production, but will inevitably accelerate removal of alkalinity and nutrients in harvested products, and the consequent decline in soil fertility. The data presented in this paper can be used in estimating the lime and fertilizer nutrients needed to maintain soil fertility and sustain yields.
A laboratory bioassay was conducted to describe the effects of cold stratification and solid matrix priming (SMP®) on the germination response of common lambsquarters and Pennsylvania smartweed seeds. Treating seeds of common lambsquarters with a combination of cold stratification and SMP resulted in 78% germination compared with 13% in control seeds. Analogous treatments of Pennsylvania smartweed seeds resulted in 22% germination compared with 1% for control. Improved germination of common lambsquarters and Pennsylvania smartweed seeds suggested that the combination of cold stratification and SMP treatments have potential for improving seed germination in other weed species that exhibit high levels of seed dormancy.