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.
Prevention of Clostridioides difficile infection (CDI) is a national priority and may be facilitated by deployment of the Targeted Assessment for Prevention (TAP) Strategy, a quality improvement framework providing a focused approach to infection prevention. This article describes the process and outcomes of TAP Strategy implementation for CDI prevention in a healthcare system.
Hospital A was identified based on CDI surveillance data indicating an excess burden of infections above the national goal; hospitals B and C participated as part of systemwide deployment. TAP facility assessments were administered to staff to identify infection control gaps and inform CDI prevention interventions. Retrospective analysis was performed using negative-binomial, interrupted time series (ITS) regression to assess overall effect of targeted CDI prevention efforts. Analysis included hospital-onset, laboratory-identified C. difficile event data for 18 months before and after implementation of the TAP facility assessments.
The systemwide monthly CDI rate significantly decreased at the intervention (β2, −44%; P = .017), and the postintervention CDI rate trend showed a sustained decrease (β1 + β3; −12% per month; P = .008). At an individual hospital level, the CDI rate trend significantly decreased in the postintervention period at hospital A only (β1 + β3, −26% per month; P = .003).
This project demonstrates TAP Strategy implementation in a healthcare system, yielding significant decrease in the laboratory-identified C. difficile rate trend in the postintervention period at the system level and in hospital A. This project highlights the potential benefit of directing prevention efforts to facilities with the highest burden of excess infections to more efficiently reduce CDI rates.
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
It is well established that dicamba can cause severe injury to soybean that is not resistant to dicamba. Dicamba-resistant (DR) cotton became available in 2015, followed by DR soybean in 2016; in late 2016 came the release of new dicamba formulations approved for topical use in cotton and soybeans. Until this approval, use of dicamba was limited to primarily corn, small grains, range and pasture, and eco-fallow acres. Hence, studies were conducted in 2015 and 2016 to examine off-target movement of two dicamba formulations using non-DR soybean as a bio-indicator. Diglycolamine (DGA) and N,N-Bis(3-aminopropyl)methylamine (BAPMA) dicamba were applied simultaneously at 560 g ae ha–1 in the center of two side-by-side 8-ha fields to vegetative glufosinate-resistant soybean. On the same day, a rate response experiment was established encompassing nine different dicamba rates of each formulation. Results from the rate response experiment indicate that soybean is equally sensitive to DGA and BAPMA dicamba. In 2015, a rain event occurring 6 to 8 h after application of the large drift trial probably limited off-target movement by incorporating some of the herbicide into the soil. As a result, secondary drift was less in 2015 than in 2016. However, minimal secondary injury (<5%) occurred 12 m farther into DGA dicamba plots in 2015. In 2016, secondary movement was decreased by 72 m when BAPMA dicamba was used compared to DGA dicamba. Appreciable secondary movement of both DGA and BAPMA dicamba is possible following in-crop applications of either formulated product to soybean in early to mid-summer. Additionally, the risk for secondary movement of BAPMA dicamba is slightly less than for DGA dicamba.
It is well established that soybean that does not contain the dicamba-resistant (DR) trait is highly sensitive to off-target exposure to dicamba. However, there is limited information on the effect of low doses of dicamba plus glyphosate mixtures on dicamba-sensitive soybean—a mixture likely to be used on a vast acreage of dicamba/glyphosate-resistant soybean. The objective of this research was to examine leaf and pod malformation, along with height and yield effects, when dicamba, glyphosate, or a mixture of the two was applied to soybean sensitive to both dicamba and glyphosate at sublethal doses. Field applications were made at three growth stages (R1, R3, and R5) at multiple locations. Two glyphosate rates (1/64 and 1/256 of the labeled rate of 870 g ae ha−1) and two dicamba rates (1/64 and 1/256 of the labeled rate of 560 g ae ha−1) were used. Adding glyphosate to dicamba increased leaf malformation by 6% more than dicamba alone when applied at the R1 soybean growth stage. After R3 applications, pod malformation was 10% greater in treatments containing dicamba and glyphosate than dicamba alone. Applications at R5 showed minimal leaf and pod malformation. Seed from field trials was planted in the greenhouse to evaluate the offspring. The number of offspring plants showing dicamba-like symptomology was not increased with the addition of glyphosate to dicamba. Overall, injury to offspring was similar in dicamba alone and dicamba plus glyphosate treatments; however, the number of plants injured increased when parent plants were exposed to sublethal doses of dicamba at R3 and R5 compared with R1 growth-stage exposure. Vigor was reduced in dicamba-containing treatments, but not glyphosate-alone treatments. Glyphosate addition to dicamba had no effect on vigor of soybean offspring. Although there is increased injury to parent plants when glyphosate is added to dicamba, this research demonstrates that glyphosate does not contribute to the negative effects of dicamba on soybean offspring.
C-reactive protein (CRP) is a candidate biomarker for major depressive disorder (MDD), but it is unclear how peripheral CRP levels relate to the heterogeneous clinical phenotypes of the disorder.
To explore CRP in MDD and its phenotypic associations.
We recruited 102 treatment-resistant patients with MDD currently experiencing depression, 48 treatment-responsive patients with MDD not currently experiencing depression, 48 patients with depression who were not receiving medication and 54 healthy volunteers. High-sensitivity CRP in peripheral venous blood, body mass index (BMI) and questionnaire assessments of depression, anxiety and childhood trauma were measured. Group differences in CRP were estimated, and partial least squares (PLS) analysis explored the relationships between CRP and specific clinical phenotypes.
Compared with healthy volunteers, BMI-corrected CRP was significantly elevated in the treatment-resistant group (P = 0.007; Cohen's d = 0.47); but not significantly so in the treatment-responsive (d = 0.29) and untreated (d = 0.18) groups. PLS yielded an optimal two-factor solution that accounted for 34.7% of variation in clinical measures and for 36.0% of variation in CRP. Clinical phenotypes most strongly associated with CRP and heavily weighted on the first PLS component were vegetative depressive symptoms, BMI, state anxiety and feeling unloved as a child or wishing for a different childhood.
CRP was elevated in patients with MDD, and more so in treatment-resistant patients. Other phenotypes associated with elevated CRP included childhood adversity and specific depressive and anxious symptoms. We suggest that patients with MDD stratified for proinflammatory biomarkers, like CRP, have a distinctive clinical profile that might be responsive to second-line treatment with anti-inflammatory drugs.
Declaration of interest
S.R.C. consults for Cambridge Cognition and Shire; and his input in this project was funded by a Wellcome Trust Clinical Fellowship (110049/Z/15/Z). E.T.B. is employed half time by the University of Cambridge and half time by GlaxoSmithKline; he holds stock in GlaxoSmithKline. In the past 3 years, P.J.C. has served on an advisory board for Lundbeck. N.A.H. consults for GlaxoSmithKline. P.d.B., D.N.C.J. and W.C.D. are employees of Janssen Research & Development, LLC., of Johnson & Johnson, and hold stock in Johnson & Johnson. The other authors report no financial disclosures or potential conflicts of interest.
The re-emergence of debates on the decolonisation of knowledge has revived interest in the National Question, which began over a century ago and remains unresolved. Tensions that were suppressed and hidden in the past are now being openly debated. Despite this, the goal of one united nation living prosperously under a constitutional democracy remains elusive. This edited volume examines the way in which various strands of left thought have addressed the National Question, especially during the apartheid years, and goes on to discuss its relevance for South Africa today and in the future. Instead of imposing a particular understanding of the National Question, the editors identified a number of political traditions and allowed contributors the freedom to define the question as they believed appropriate – in other words, to explain what they thought was the Unresolved National Question. This has resulted in a rich tapestry of interweaving perceptions. The volume is structured in two parts. The first examines four foundational traditions: Marxism-Leninism (the Colonialism of a Special Type thesis); the Congress tradition; the Trotskyist tradition; and Africanism. The second part explores the various shifts in the debate from the 1960s onwards, and includes chapters on Afrikaner nationalism, ethnic issues, black consciousness, feminism, workerism and constitutionalism. The editors hope that by revisiting the debates not popularly known among the scholarly mainstream, this volume will become a catalyst for an enriched debate on our identity and our future.
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.
Previous studies have demonstrated that several major psychiatric disorders are influenced by shared genetic factors. This shared liability may influence clinical features of a given disorder (e.g. severity, age at onset). However, findings have largely been limited to European samples; little is known about the consistency of shared genetic liability across ethnicities.
The relationship between polygenic risk for several major psychiatric diagnoses and major depressive disorder (MDD) was examined in a sample of unrelated Han Chinese women. Polygenic risk scores (PRSs) were generated using European discovery samples and tested in the China, Oxford, and VCU Experimental Research on Genetic Epidemiology [CONVERGE (maximum N = 10 502)], a sample ascertained for recurrent MDD. Genetic correlations between discovery phenotypes and MDD were also assessed. In addition, within-case characteristics were examined.
European-based polygenic risk for several major psychiatric disorder phenotypes was significantly associated with the MDD case status in CONVERGE. Risk for clinically significant indicators (neuroticism and subjective well-being) was also associated with case–control status. The variance accounted for by PRS for both psychopathology and for well-being was similar to estimates reported for within-ethnicity comparisons in European samples. However, European-based PRS were largely unassociated with CONVERGE family history, clinical characteristics, or comorbidity.
The shared genetic liability across severe forms of psychopathology is largely consistent across European and Han Chinese ethnicities, with little attenuation of genetic signal relative to within-ethnicity analyses. The overall absence of associations between PRS for other disorders and within-MDD variation suggests that clinical characteristics of MDD may arise due to contributions from ethnicity-specific factors and/or pathoplasticity.
Current trends in the beef industry focus on selecting production traits with the purpose of maximizing calf weaning weight; however, such traits may ultimately decrease overall post-weaning productivity. Therefore, the objective of this study was to evaluate the effects of actual milk yield in mature beef cows on their offspring’s dry matter intake (DMI), BW, average daily gain, feed conversion ratio (FCR) and residual feed intake (RFI) during a ~75-day backgrounding feeding trial. A period of 24-h milk production was measured with a modified weigh-suckle-weigh technique using a milking machine. After milking, cows were retrospectively classified as one of three milk yield groups: Lower (6.57±1.21 kg), Moderate (9.02±0.60 kg) or Higher (11.97±1.46 kg). Calves from Moderate and Higher milk yielding dams had greater (P<0.01) BW from day 0 until day 75 at the end of the backgrounding feeding phase; however, day 75 BW were not different (P=0.36) between Lower and Moderate calves. Body weight gain was greater (P=0.05) for Lower and Moderate calves from the day 0 BW to day 35 BW compared with Higher calves. Overall DMI was lower (P=0.03) in offspring from Lower and Moderate cows compared with their Higher milking counterparts. With the decreased DMI, FCR was lower (P=0.03) from day 0 to day 35 in calves from Lower and Moderate milk yielding dams. In addition, overall FCR was lower (P=0.02) in calves from Lower and Moderate milk yielding dams compared with calves from Higher milk yielding dams. However, calving of Lower milk yielding dams had an increased (P=0.04) efficiency from a negative RFI value compared with calves from Moderate and Higher milking dams. Results from this study suggest that increased milk production in beef cows decreases feed efficiency during a 75-day post-weaning, backgrounding period of progeny.
We present results from a multiwavelength study of the blazar PKS 1954–388 at radio, UV, X-ray, and gamma-ray energies. A RadioAstron observation at 1.66 GHz in June 2012 resulted in the detection of interferometric fringes on baselines of 6.2 Earth-diameters. This suggests a source frame brightness temperature of greater than 2 × 1012 K, well in excess of both equipartition and inverse Compton limits and implying the existence of Doppler boosting in the core. An 8.4-GHz TANAMI VLBI image, made less than a month after the RadioAstron observations, is consistent with a previously reported superluminal motion for a jet component. Flux density monitoring with the Australia Telescope Compact Array confirms previous evidence for long-term variability that increases with observing frequency. A search for more rapid variability revealed no evidence for significant day-scale flux density variation. The ATCA light-curve reveals a strong radio flare beginning in late 2013, which peaks higher, and earlier, at higher frequencies. Comparison with the Fermi gamma-ray light-curve indicates this followed ~ 9 months after the start of a prolonged gamma-ray high-state—a radio lag comparable to that seen in other blazars. The multiwavelength data are combined to derive a Spectral Energy Distribution, which is fitted by a one-zone synchrotron-self-Compton (SSC) model with the addition of external Compton (EC) emission.
Forest carbon sequestration plays an important role in reducing the build-up of greenhouse gases that are known to contribute to global climate change. However, private landowners will supply less carbon sequestration than would be socially desirable if they are unable to capture the economic value of sequestration. We examine the viability of offering landowners property tax subsidies for forest carbon sequestration (referred to as a ‘tax-based subsidy approach’). Waiving property taxes on forestland provides incentives for landowners to afforest non-forested land and/or sustain forests that are at risk of deforestation. We focus on 17 Tennessee counties and one Kentucky county, constituting one of 179 Bureau of Economic Analysis areas in the United States, as a case study. Higher forestland net return from waiving property taxes increases the share of forestland in the 18 counties, which in turn increases the accumulation of carbon in the forest ecosystem, suggesting that this is a viable approach. The annualized county-level cost of supplying forest carbon sequestration using a tax-based subsidy ranges between US$15.56 and US$563.58 per carbon tonne across the 18 counties. Relevant government agencies can use these estimates to target selected counties for more cost-effective adoption of the county-level tax-based subsidy approach.