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With the increased use of computer-based tests in clinical and research settings, assessing retest reliability and reliable change of NIH Toolbox-Cognition Battery (NIHTB-CB) and Cogstate Brief Battery (Cogstate) is essential. Previous studies used mostly White samples, but Black/African Americans (B/AAs) must be included in this research to ensure reliability.
Method:
Participants were B/AA consensus-confirmed healthy controls (HCs) (n = 49) or mild cognitive impairment (MCI) (n = 34) adults 60–85 years that completed NIHTB-CB and Cogstate for laptop at two timepoints within 4 months. Intraclass correlations, the Bland-Altman method, t-tests, and the Pearson correlation coefficient were used. Cut scores indicating reliable change provided.
Results:
NIHTB-CB composite reliability ranged from .81 to .93 (95% CIs [.37–.96]). The Fluid Composite demonstrated a significant difference between timepoints and was less consistent than the Crystallized Composite. Subtests were less consistent for MCIs (ICCs = .01–.89, CIs [−1.00–.95]) than for HCs (ICCs = .69–.93, CIs [.46–.92]). A moderate correlation was found for MCIs between timepoints and performance on the Total Composite (r = -.40, p = .03), Fluid Composite (r = -.38, p = .03), and Pattern Comparison Processing Speed (r = -.47, p = .006).
On Cogstate, HCs had lower reliability (ICCs = .47–.76, CIs [.05–.86]) than MCIs (ICCs = .65–.89, CIs [.29–.95]). Identification reaction time significantly improved between testing timepoints across samples.
Conclusions:
The NIHTB-CB and Cogstate for laptop show promise for use in research with B/AAs and were reasonably stable up to 4 months. Still, differences were found between those with MCI and HCs. It is recommended that race and cognitive status be considered when using these measures.
Herbicide drift to sensitive crops can result in significant injury, yield loss, and even crop destruction. When pesticide drift is reported to the Georgia Department of Agriculture (GDA), tissue samples are collected and analyzed for residues. Seven field studies were conducted in 2020 and 2021 in cooperation with the GDA to evaluate the effect of (1) time interval between simulated drift event and sampling, (2) low-dose herbicide rates, and (3) the sample collection methods on detecting herbicide residues in cotton (Gossypium hirsutum L.) foliage. Simulated drift rates of 2,4-D, dicamba, and imazapyr were applied to non-tolerant cotton in the 8- to 9-leaf stage with plant samples collected at 7 or 21 d after treatment (DAT). During collection, plant sampling consisted of removing entire plants or removing new growth occurring after the 7-leaf stage. Visual cotton injury from 2,4-D reached 43% to 75% at 0.001 and 0.004 kg ae ha−1, respectively; for dicamba, it was 9% to 41% at 0.003 or 0.014 kg ae ha−1, respectively; and for imazapyr, it was 1% to 74% with 0.004 and 0.03 kg ae ha−1 rates, respectively. Yield loss was observed with both rates of 2,4-D (11% to 51%) and with the high rate of imazapyr (52%); dicamba did not influence yield. Herbicide residues were detected in 88%, 88%, and 69% of samples collected from plants treated with 2,4-D, dicamba, and imazapyr, respectively, at 7 DAT compared with 25%, 16%, and 22% when samples were collected at 21 DAT, highlighting the importance of sampling quickly after a drift event. Although the interval between drift event and sampling, drift rate, and sampling method can all influence residue detection for 2,4-D, dicamba, and imazapyr, the factor with the greatest influence is the amount of time between drift and sample collection.
An investigation into an outbreak of Salmonella Newport infections in Canada was initiated in July 2020. Cases were identified across several provinces through whole-genome sequencing (WGS). Exposure data were gathered through case interviews. Traceback investigations were conducted using receipts, invoices, import documentation, and menus. A total of 515 cases were identified in seven provinces, related by 0–6 whole-genome multi-locus sequence typing (wgMLST) allele differences. The median age of cases was 40 (range 1–100), 54% were female, 19% were hospitalized, and three deaths were reported. Forty-eight location-specific case sub-clusters were identified in restaurants, grocery stores, and congregate living facilities. Of the 414 cases with exposure information available, 71% (295) had reported eating onions the week prior to becoming ill, and 80% of those cases who reported eating onions, reported red onion specifically. The traceback investigation identified red onions from Grower A in California, USA, as the likely source of the outbreak, and the first of many food recall warnings was issued on 30 July 2020. Salmonella was not detected in any tested food or environmental samples. This paper summarizes the collaborative efforts undertaken to investigate and control the largest Salmonella outbreak in Canada in over 20 years.
Emergency psychiatric care, unplanned hospital admissions, and inpatient health care are the costliest forms of mental health care. According to Statistics Canada (2018), almost 18% (5.3 million) of Canadians reported needing mental health support. However, just above half of this figure (56.2%) have reported their needs were fully met. To further expand capacity and access to mental health care in the province, Nova Scotia Health has launched a novel mental health initiative, the Rapid Access, and Stabilization Program (RASP).
Objectives
This study evaluates the effectiveness and impact of the RASP on high-cost health services utilization (e.g. ED visits, mobile crisis visits, and inpatient treatments) and related costs. It also assesses healthcare partners’ (e.g. healthcare providers, policymakers, community leaders) perceptions and patient experiences and satisfaction with the program and identifies sociodemographic characteristics, psychological conditions, recovery, well-being, and risk measures in the assisted population.
Methods
This is a hypothesis-driven program evaluation study that employs a mixed methods approach. A within-subject comparison will examine health services utilization data from patients attending RASP, one year before and one year after their psychiatry assessment at the program. A controlled between-subject comparison will use historical data from a control population will examine whether possible changes in high-cost health services utilization are associated with the intervention (RASP). The primary analysis involves extracting secondary data from provincial information systems, electronic medical records, and regular self-reported clinical assessments. Additionally, a qualitative sub-study will examine patient experience and satisfaction, and examine health care partners’ impressions.
Results
The results for the primary, secondary, and qualitative outcome measures to be available within 6 months of study completion. We expect that RASP evaluation findings will demonstrate a minimum 10% reduction in high-cost health services utilization and corresponding 10% cost savings, and also a reduction in the wait times for patient consultations with psychiatrists to less than 30 calendar days. In addition, we anticipate that patients, healthcare providers, and healthcare partners would express high levels of satisfaction with the new service.
Conclusions
This study will demonstrate the results of the Mental Health and Addictions Program (MHAP) efforts to provide stepped-care, particularly community-based support, to individuals with mental illnesses. Results will provide new insights into a novel community-based approach to mental health service delivery and contribute to knowledge on how to implement mental health programs across varying contexts.
The presence of Al hydroxy species in solution during the synthesis of lepidocrocite had been previously found to influence the reaction towards goethite formation. However, under certain conditions, which are not unrealistic in terms of the natural soil environment, this influence does not occur, and Al appears to substitute for Fe(III) in the lepidocrocite structure. This substitution causes the unit-cell dimensions to decrease along the “a” direction and to increase along the “b.” From the differential line broadening of X-ray powder diffraction peaks, the incorporation of Al was found to inhibit crystal growth preferentially in the b-axis direction, the hkl peaks being more broadened the higher the value of k relative to h and l. Al-substituted lepidocrocites have been suggested to occur in soils, and although they can be synthesized under conditions approaching those expected in soils, it is considered that their formation in nature is unlikely or restricted to unusual environments.
Aluminum-substituted hematites (Fe2−xAlxO3) were synthesized from Fe-Al coprecipitates at pH 5.5, 7.0, and in 10−1, 10−2, and 10−2 M KOH at 70°C. As little as 1 mole % Al suppressed goethite completely at pH 7 whereas in KOH higher Al concentrations were necessary. Al substitution as determined chemically and by XRD line shift was related to Al addition up to a maximum of 16–17 mole %. The relationship between the crystallographic a0 parameter and Al substitution deviated from the Vegard rule. At low substitution crystallinity of the hematites was improved whereas higher substitution impeded crystal growth in the crystallographic z-direction as indicated by differential XRD line broadening. At still higher Al addition crystal growth was strongly retarded. The initial Al-Fe coprecipitate behaved differently from a mechanical mixture of the respective “hydroxides” and was, therefore, considered an aluminous ferrihydrite.
In the absence of oxygen, Fe(II) chloride, sulfate, and carbonate solutions react at pH 6.5 to 7 with aluminum hydroxide suspensions to form new Fe(II)-Al(III) hydroxy anion compounds of the pyroaurite group. The Fe(II)-Al(III) hydroxy-chloride and -sulfate compounds are isostructural with Fe(II)- Fe(III) “green rust” compounds with A1 essentially substituting for Fe(III). Where CO32- is the only anion in the system, an Fe(II)-Al(III) compound isostructural with hydrotalcite is formed. Either in the dried or wet state, these compounds are unstable in air due to oxidation of Fe(II). Oxidation of the dried sample in air yields akaganeite or aluminous ferrihydrite, whereas, if the sample is maintained in a moist condition and oxidized by air under water, lepidocrocite or aluminous goethite is produced along with small amounts of ferrihydrite. On X-ray powder diffraction, the lepidocrocite so formed commonly shows no diagnostic (020) basal reflection, or one with a markedly reduced intensity. The products of oxidation, and the rapidity of their formation, appear to be dependent on the composition of the initial double hydroxy compound and the conditions under which the oxidation is carried out.
The green colored compounds commonly observed in gleyed soils also rapidly become yellow brown on exposure to air, and difficulty arises in the identification of the Fe oxide phases assumed to be present. Similar conditions and reactants to those involved in the formation of the compounds described above are expected in these soils, and it is suggested that Fe(II)-Al(III) members of the pyroaurite group may form in such an environment.
The influence of Al on the products formed by aerial oxidation at pH 5.5-7 and 20°C of Fe(II) chloride, sulfate and carbonate solutions, was examined. In all cases Al at levels Al/Al + Fe = 0.09−0.30 inhibited the formation of y phases (lepidocrocite and maghemite) in favor of goethite under conditions where, in the absence of Al, these y phases formed. The influence of Al in these laboratory studies was supported by field observations.
At higher levels of Al, ferrihydrite formation was favored. This effect of Al was seen to be the result of a slowing down in the hydrolysis/oxidation rate of the Fe(II) system.
The presence of Al not only changed the direction of mineral formation, but also caused the formation of Al substitued goethites which resembled in particle size and morphology the natural aluminiferous goethite extracted from a soil.
The mechanism of the transformation of lepidocrocite (γFeOOH) to goethite (αFeOOH) has previously been established and the effect of silicate on the transformation was investigated. Rather than completely inhibiting the reaction, as had been suggested, the presence of Si was found to merely retard the nucleation stage of the transformation. There was found to be no decrease in the dissolution rate of the lepidocrocite due to surface adsorption of Si.
Si has no effect if introduced after the nucleation stage, and under conditions of pH and temperature where the dissolution rate of the lepidocrocite largely determines the rate of transformation, the presence of Si has a reduced effect. The results show that Si is adsorbed and incorporated into the goethite structure, and due to its retarding effect on the nucleation, larger crystals of goethite are formed, many of which are twinned.
It is inferred from the results that the apparent stability of lepidocrocite occurring in soils in association with goethite cannot be attributed solely to the presence of Si in the soil system.
The conversion of lepidocrocite (-γFeOOH) to its more stable polymorph, goethite (αFeOOH) was followed by observing changes in crystal morphology, oxalate solubility, surface area and X-ray diffraction. In conjunction, kinetics were measured as functions of surface area, temperature, alkalinity and seeding with goethite crystals.
The results suggest that the transformation is not topochemical, but proceeds through the solution phase. The main steps governing the rate of transformation are, (1) the dissolution of lepidocrocite, and (2) the formation of goethite nuclei and subsequent growth. Either of these processes can be rate-determining under appropriate conditions.
Amid resurgent geopolitical fissures and in the aftermath of the Covid-19 pandemic, there is a growing awareness in the sector of the need for, and concern about, national and international collaboration in archaeological projects. This article reflects on present-day challenges for international collaboration in central Eurasian archaeology and furthers a much-needed discussion about (re)integrating local narratives with inter-regional trends in future research. Responsible and practical proposals for bridging collaborator differences in institutional or publishing obligations, language capacities and access to resources are discussed.
Operative cancellations adversely affect patient health and impose resource strain on the healthcare system. Here, our objective was to describe neurosurgical cancellations at five Canadian academic institutions.
Methods:
The Canadian Neurosurgery Research Collaborative performed a retrospective cohort study capturing neurosurgical procedure cancellation data at five Canadian academic centres, during the period between January 1, 2014 and December 31, 2018. Demographics, procedure type, reason for cancellation, admission status and case acuity were collected. Cancellation rates were compared on the basis of demographic data, procedural data and between centres.
Results:
Overall, 7,734 cancellations were captured across five sites. Mean age of the aggregate cohort was 57.1 ± 17.2 years. The overall procedure cancellation rate was 18.2%. The five-year neurosurgical operative cancellation rate differed between Centre 1 and 2 (Centre 1: 25.9%; Centre 2: 13.0%, p = 0.008). Female patients less frequently experienced procedural cancellation. Elective, outpatient and spine procedures were more often cancelled. Reasons for cancellation included surgeon-related factors (28.2%), cancellation for a higher acuity case (23.9%), patient condition (17.2%), other factors (17.0%), resource availability (7.0%), operating room running late (6.4%) and anaesthesia-related (0.3%). When clustered, the reason for cancellation was patient-related in 17.2%, staffing-related in 28.5% and operational or resource-related in 54.3% of cases.
Conclusions:
Neurosurgical operative cancellations were common and most often related to operational or resource-related factors. Elective, outpatient and spine procedures were more often cancelled. These findings highlight areas for optimizing efficiency and targeted quality improvement initiatives.
Obesity is a significant health issue in Aotearoa; effective and pragmatic strategies to facilitate weight loss are urgently required. Growing recognition of the circadian rhythm’s impact on metabolism has popularised diets like time-restricted eating (TRE)(1). The 16:8 TRE method involves limiting food intake to an 8-hour daily eating window and can lead to weight loss without other substantial changes to diet(2). Nonetheless, TRE requires accountability and tolerating hunger for short periods. Continuous glucose monitors (CGM) are small wearable biofeedback devices that measure interstitial glucose levels scanned via smartphones. By providing immediate feedback on the physiological effects of eating and fasting, CGM use may promote adherence to TRE(3). This pilot study aimed to 1) investigate how CGM affects adherence to TRE and 2) assess the feasibility of CGM use while undertaking TRE. This two-arm randomised controlled trial enrolled healthy adults from Dunedin, assigning them to TRE-only or TRE+CGM groups for 14 days. Successful adherence to TRE was defined a priori as maintaining an 8-hour eating window on 80% of days. CGM feasibility was defined a priori as scanning the glucose monitor thrice daily on 80% of days. Secondary outcomes included well-being, anthropometry, glucose levels, and overall TRE and CGM experiences via semi-structured interviews. Twenty-two participants were randomised into two groups: TRE-only (n = 11) and TRE+CGM (n = 11, with n = 2 excluded from analysis post-randomisation for medical reasons). Participants had a diverse range of ethnicities, the mean age was 32 (+/-14.9) years, and 55% were female. The TRE+CGM group adhered to the 8-hour eating window for an average of 10.0 days (range 2-14) compared with 8.6 days (range 2-14) in the TRE-only group. Both groups had similar mean eating window durations of 8.1 hours. Five (56%) participants in the TRE+CGM group achieved the a priori criteria for TRE adherence, compared to 3 (27%) in the TRE-only group. Participants in the TRE+CGM group performed an average of 8.2 (+/-5.6) daily scans, with n = 7 (78%) of participants meeting the a priori CGM feasibility criteria. Neither group reported consistent adverse psychological impacts in DASS-21 and WHO-5 scores. Interviews highlighted that CGM increased hunger tolerance during fasting as participants felt reassured by their normal glucose levels. CGM aided TRE accountability by acting as a biological tracker of food intake. Participants reported that TRE led to improved energy and self-efficacy, a more productive daily routine, and healthier food choices. Promisingly, 72% of participants would use CGM and undertake TRE in future. This study demonstrates that using CGM while undertaking TRE is feasible and can improve adherence by enhancing hunger tolerance and accountability. Overall, participants experienced increased awareness of eating habits and physiological mechanisms. Over the longer term, this simple and synergistic approach may be a helpful weight loss strategy.
Although food insecurity affects a significant proportion of young children in New Zealand (NZ)(1), evidence of its association with dietary intake and sociodemographic characteristics in this population is lacking. This study aims to assess the household food security status of young NZ children and its association with energy and nutrient intake and sociodemographic factors. This study included 289 caregiver and child (1-3 years old) dyads from the same household in either Auckland, Wellington, or Dunedin, NZ. Household food security status was determined using a validated and NZ-specific eight-item questionnaire(2). Usual dietary intake was determined from two 24-hour food recalls, using the multiple source method(3). The prevalence of inadequate nutrient intake was assessed using the Estimated Average Requirement (EAR) cut-point method and full probability approach. Sociodemographic factors (i.e., socioeconomic status, ethnicity, caregiver education, employment status, household size and structure) were collected from questionnaires. Linear regression models were used to estimate associations with statistical significance set at p <0.05. Over 30% of participants had experienced food insecurity in the past 12 months. Of all eight indicator statements, “the variety of foods we are able to eat is limited by a lack of money,” had the highest proportion of participants responding “often” or “sometimes” (35.8%). Moderately food insecure children exhibited higher fat and saturated fat intakes, consuming 3.0 (0.2, 5.8) g/day more fat, and 2.0 (0.6, 3.5) g/day more saturated fat compared to food secure children (p<0.05). Severely food insecure children had lower g/kg/day protein intake compared to food secure children (p<0.05). In comparison to food secure children, moderately and severely food insecure children had lower fibre intake, consuming 1.6 (2.8, 0.3) g/day and 2.6 (4.0, 1.2) g/day less fibre, respectively. Severely food insecure children had the highest prevalence of inadequate calcium (7.0%) and vitamin C (9.3%) intakes, compared with food secure children [prevalence of inadequate intakes: calcium (2.3%) and vitamin C (2.8%)]. Household food insecurity was more common in those of Māori or Pacific ethnicity; living in areas of high deprivation; having a caregiver who was younger, not in paid employment, or had low educational attainment; living with ≥2 other children in the household; and living in a sole-parent household. Food insecure young NZ children consume a diet that exhibits lower nutritional quality in certain measures compared to their food-secure counterparts. Food insecurity was associated with various sociodemographic factors that are closely linked with poverty or low income. As such, there is an urgent need for poverty mitigation initiatives to safeguard vulnerable young children from the adverse consequences of food insecurity.
The formation of fine-grained magnetite (~0.1 μm) at pH 7 and 25°C from aeration of Fe(II) chloride solutions is presented. The magnetite converted at 105°C to maghemite with poorly developed superstructure lines. Under the experimental conditions employed, as the initial [Cl]/[Fe] ratio was increased from the stoichiometric value of 2, the final product contained increasing amounts of lepidocrocite. The degree of crystallinity of this phase, as measured by the width at half height of the 020 X-ray diffraction peak, also increased with this ratio. The hydrolysis rate (base consumption to maintain pH) showed a plateau whose position and extent changed with the initial [Cl]/[Fe] ratio. Through this plateau region the Eh decreased to a minimum value the position of which was directly related to the [Cl]/[Fe] value. The formation of lepidocrocite rather than magnetite is likely due to the high [Cl] where there would be increased difficulty for neighboring OH to condense and eliminate H2O. The formation of Fe-O-Fe bonds in this condensation would be impeded by Cl substitution for OH either in the first formed green rust stage or during its oxidation.
Diffractograms of lepidocrocites formed from the oxidation of Fe(II) chloride solutions at pH 7 and 25°C showed differential line broadening with (0k0) reflections being much sharper than (hk0) or (hkl). As the initial [Cl]/[Fe] ratio was increased from 2, crystallinity increased in all axial directions, as defined by the width at half height of diffraction peaks. At [Cl]/[Fe] ratios greater than ~8, the crystallinity did not increase further, and for reflections involving the a-axis direction, it appeared to decrease. Increased [Cl]/[Fe] ratios changed the rate of the oxidation/hydrolysis reactions. These variations reflect changes in the stability and/or composition of the intermediate green rust phase, (Fe(II)Fe(III) hydroxychloride) in the high [Cl] environment. The influence of the [Cl]/[Fe] ratio was related to the experimental conditions employed, especially where they influenced the rate of oxidation.
We demonstrate the importance of radio selection in probing heavily obscured galaxy populations. We combine Evolutionary Map of the Universe (EMU) Early Science data in the Galaxy and Mass Assembly (GAMA) G23 field with the GAMA data, providing optical photometry and spectral line measurements, together with Wide-field Infrared Survey Explorer (WISE) infrared (IR) photometry, providing IR luminosities and colours. We investigate the degree of obscuration in star-forming galaxies, based on the Balmer decrement (BD), and explore how this trend varies, over a redshift range of $0<z<0.345$. We demonstrate that the radio-detected population has on average higher levels of obscuration than the parent optical sample, arising through missing the lowest BD and lowest mass galaxies, which are also the lower star formation rate (SFR) and metallicity systems. We discuss possible explanations for this result, including speculation around whether it might arise from steeper stellar initial mass functions in low mass, low SFR galaxies.