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This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.
We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.
Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.
These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.
Coronavirus disease 2019 (COVID-19) has migrated to regions that were initially spared, and it is likely that different populations are currently at risk for illness. Herein, we present our observations of the change in characteristics and resource use of COVID-19 patients over time in a national system of community hospitals to help inform those managing surge planning, operational management, and future policy decisions.
To determine risk factors for mortality among COVID-19 patients admitted to a system of community hospitals in the United States.
Retrospective analysis of patient data collected from the routine care of COVID-19 patients.
System of >180 acute-care facilities in the United States.
All admitted patients with positive identification of COVID-19 and a documented discharge as of May 12, 2020.
Determination of demographic characteristics, vital signs at admission, patient comorbidities and recorded discharge disposition in this population to construct a logistic regression estimating the odds of mortality, particular for those patients characterized as not being critically ill at admission.
In total, 6,180 COVID-19+ patients were identified as of May 12, 2020. Most COVID-19+ patients (4,808, 77.8%) were admitted directly to a medical-surgical unit with no documented critical care or mechanical ventilation within 8 hours of admission. After adjusting for demographic characteristics, comorbidities, and vital signs at admission in this subgroup, the largest driver of the odds of mortality was patient age (OR, 1.07; 95% CI, 1.06–1.08; P < .001). Decreased oxygen saturation at admission was associated with increased odds of mortality (OR, 1.09; 95% CI, 1.06–1.12; P < .001) as was diabetes (OR, 1.57; 95% CI, 1.21–2.03; P < .001).
The identification of factors observable at admission that are associated with mortality in COVID-19 patients who are initially admitted to non-critical care units may help care providers, hospital epidemiologists, and hospital safety experts better plan for the care of these patients.
Characteristics of DSM-IV attention-deficit/hyperactivity disorder (ADHD) in adults can also be found as part of other psychiatric disorders. This study investigated the specificity of adult ADHD features in relation to patients with borderline personality disorder (BPD), a syndrome which shares some of its intrinsic features with ADHD and often co-occurs with ADHD. A group of 20 adult patients selected on the basis of a diagnosis of ADHD and 20 patients selected on the basis of a diagnosis of BPD were assessed by the self-report Attention Deficit Scales for Adults (ADSA). The two groups were matched for age, verbal IQ and gender. Of the nine ADSA scales, seven showed significant inter-group differences, in particular involving attention, organisation and persistence. The ‘Consistency/Long-Term’ scale, which mainly reflects impaired task and goal persistence, was the best discriminator between the groups. Furthermore, ratings on this scale correlated significantly with the error score of a computer-administered task of spatial working memory, the performance of which has been reported to be impaired in patients with ADHD. The results provide further validation for the ADSA scales and support a previous claim that ‘long-term consistencies’, i.e., related to task and goal persistence, is ‘the centrepiece behavioural issue’ for adults with ADHD.
Fluctuating bee (Hymenoptera: Apoidea) populations jeopardise pollination services. Nesting habitat for solitary bees is potentially limited in many agroecosystems, but the provision of artificial nests could augment bee communities and the pollination services they provide. We investigated whether cavity-nesting bees (Hymenoptera: Megachilidae) in lowbush blueberry (Vaccinium angustifolium Aiton (Ericaceae)) fields would use artificial trap nests. Different nest designs were compared, as was nesting occupancy between fruit-bearing and vegetative fields. Milk carton nests had significantly more uptake by and emergence of Osmia Panzer and Megachile Latreille than wooden nests. Only 3% of wooden nests had at least one occupied nesting tube versus 73% of milk carton nests, with a total of 34% nesting tubes occupied. Bee emergence was significantly higher in nesting tubes from fruit-bearing fields than vegetative fields. Osmia and Megachile emergence was low from milk carton nests, with bees emerging from less than 10% of occupied nesting tubes, in large part due to parasitism. Overturned clay lids were tested as potential nesting sites for Osmia inermis Zetterstedt, but only 3% of lids had nesting evidence. Our results suggest that certain artificial nests have potential for encouraging communities of cavity-nesting bees, but further study on nest design and handling protocols is needed.
OBJECTIVES/SPECIFIC AIMS: To build a multisite de-identified database of female adolescents, aged 12–21 years (January 2011–December 2012), and their subsequent offspring through 24 months of age from electronic health records (EHRs) provided by participating Community Health. METHODS/STUDY POPULATION: We created a community-academic partnership that included New York City Community Health Centers (n=4) and Hospitals (n=4), The Rockefeller University, The Sackler Institute for Nutrition Science and Clinical Directors Network (CDN). We used the Community-Engaged Research Navigation model to establish a multisite de-identified database extracted from EHRs of female adolescents aged 12–21 years (January 2011–December 2012) and their offspring through 24 months of age. These patients received their primary care between 2011 and 2015. Clinical data were used to explore possible associations among specific measures. We focused on the preconception, prenatal, postnatal periods, including pediatric visits up to 24 months of age. RESULTS/ANTICIPATED RESULTS: The analysis included all female adolescents (n=122,556) and a subset of pregnant adolescents with offspring data available (n=2917). Patients were mostly from the Bronx; 43% of all adolescent females were overweight (22%) or obese (21%) and showed higher systolic and diastolic blood pressure, blood glucose levels, hemoglobin A1c, total cholesterol, and triglycerides levels compared with normal-weight adolescent females (p<0.05). This analysis was also performed looking at the nonpregnant females and the pregnant females separately. Overall, the pregnant females were older (mean age=18.3) compared with the nonpregnant females (mean age=16.5), there was a higher percentage of Hispanics among the pregnant females (58%) compared with the nonpregnant females (43.9%). There was a statistically significant association between the BMI status of mothers and infants’ birth weight, with underweight/normal-weight mothers having more low birth weight (LBW) babies and overweight/obese mothers having more large babies. The odds of having a LBW baby was 0.61 (95% CI: 0.41, 0.89) lower in obese compared with normal-weight adolescent mothers. The risk of having a preterm birth before 37 weeks was found to be neutral in obese compared with normal-weight adolescent mothers (OR=0.81, 95% CI: 0.53, 1.25). Preliminary associations are similar to those reported in the published literature. DISCUSSION/SIGNIFICANCE OF IMPACT: This EHR database uses available measures from routine clinical care as a “rapid assay” to explore potential associations, and may be more useful to detect the presence and direction of associations than the magnitude of effects. This partnership has engaged community clinicians, laboratory, and clinical investigators, and funders in study design and analysis, as demonstrated by the collaborative development and testing of hypotheses relevant to service delivery. Furthermore, this research and learning collaborative is examining strategies to enhance clinical workflow and data quality as well as underlying biological mechanisms. The feasibility of scaling-up these methods facilitates studying similar populations in different Health Systems, advancing point-of-care studies of natural history and comparative effectiveness research to identify service gaps, evaluate effective interventions, and enhance clinical and data quality improvement.
OBJECTIVES/SPECIFIC AIMS: To build a multisite deidentified database of female adolescents, aged 12–21 years (January 2011–December 2012), and their subsequent offspring through 24 months of age from electronic health records (EHRs) provided by participating Community Health. METHODS/STUDY POPULATION: We created a community-academic partnership that included New York City Community Health Centers (n=4) and Hospitals (n=4), The Rockefeller University, The Sackler Institute for Nutrition Science and Clinical Directors Network (CDN). We used the Community-Engaged Research Navigation model to establish a multisite deidentified database extracted from EHRs of female adolescents aged 12–21 years (January 2011–December 2012) and their offspring through 24 months of age. These patients received their primary care between 2011 and 2015. Clinical data were used to explore possible associations among specific measures. We focused on the preconception, prenatal, postnatal periods, including pediatric visits up to 24 months of age. RESULTS/ANTICIPATED RESULTS: The preliminary analysis included all female adolescents (n=49,292) and a subset of pregnant adolescents with offspring data available (n=2917). Patients were mostly from the Bronx; 43% of all adolescent females were overweight (22%) or obese (21%) and showed higher systolic and diastolic blood pressure, blood glucose levels, hemoglobin A1c, total cholesterol, and triglycerides levels compared with normal-weight adolescent females (p<0.05). There was a statistically significant association between the BMI status of mothers and infants’ birth weight, with underweight/normal-weight mothers having more low birth weight (LBW) babies and overweight/obese mothers having more large babies. The odds of having a LBW baby was 0.61 (95% CI: 0.41, 0.89) lower in obese compared with normal-weight adolescent mothers. The risk of having a preterm birth before 37 weeks was found to be neutral in obese compared to normal-weight adolescent mothers (OR=0.81, 95% CI: 0.53, 1.25). Preliminary associations are similar to those reported in the published literature. DISCUSSION/SIGNIFICANCE OF IMPACT: This EHR database uses available measures from routine clinical care as a “rapid assay” to explore potential associations, and may be more useful to detect the presence and direction of associations than the magnitude of effects. This partnership has engaged community clinicians, laboratory and clinical investigators, and funders in study design and analysis, as demonstrated by the collaborative development and testing of hypotheses relevant to service delivery.
The Glasgow area has a combination of highly variable superficial deposits and a legacy of heavy industry, quarrying and mining. These factors create complex foundation and hydrological conditions, influencing the movement of contaminants through the subsurface and giving rise locally to unstable ground conditions. Digital geological three-dimensional models developed by the British Geological Survey are helping to resolve the complex geology underlying Glasgow, providing a key tool for planning and environmental management. The models, covering an area of 3200km2 to a depth of 1.2km, include glacial and post-glacial deposits and the underlying, faulted Carboniferous igneous and sedimentary rocks. Control data, including 95,000 boreholes, digital mine plans and published geological maps, were used in model development. Digital outputs from the models include maps of depth to key horizons, such as rockhead or depth to mine workings. The models have formed the basis for the development of site-scale high-resolution geological models and provide input data for a wide range of other applications from groundwater modelling to stochastic lithological modelling.
A new approach is proposed to analyze Bremsstrahlung X-rays that are emitted from laser-produced plasmas (LPP) and are measured by a stack type spectrometer. This new method is based on a spectral tomographic reconstruction concept with the variational principle for optimization, without referring to the electron energy distribution of a plasma. This approach is applied to the analysis of some experimental data obtained at a few major laser facilities to demonstrate the applicability of the method. Slope temperatures of X-rays from LPP are determined with a two-temperature model, showing different spectral characteristics of X-rays depending on laser properties used in the experiments.
A randomized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing eating disorder and obesity risk factors.
A total of 1316 grade 7 and 8 girls and boys (mean age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; the Helping, Encouraging, Listening and Protecting Peers (HELPP) initiative; or control (usual school class). Risk factors were measured at baseline, post-program (5 weeks later), and at the 6- and 12-month follow-ups.
Media Smart girls had half the rate of onset of clinically significant concerns about shape and weight than control girls at the 12-month follow-up. Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up. Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month follow-up. Media Smart and HELPP boys experienced significant benefit on media internalization compared with control boys and these were sustained at the 12-month follow-up in Media Smart boys. A group × time effect found that Media Smart participants reported more physical activity than control and HELPP participants at the 6-month follow-up, while a main effect for group found Media Smart participants reported less screen time than controls.
Media Smart was the only program to show benefit on both disordered eating and obesity risk factors. Whilst further investigations are indicated, this study suggests that this program is a promising approach to reducing risk factors for both problems.
A synthesis of the upper Moscovian sedimentological and palaeontological record of terrestrial habitats across the Variscan foreland and adjacent intramontane basins (an area which is referred to here as Variscan Euramerica) suggests a contraction and progressive westward shift of the coal swamps. These changes can be correlated with pulses of tectonic activity (tectonic phases) resulting from the northwards migration of the Variscan Front. This tectonic activity caused disruption to the landscapes and drainage patterns where the coal swamps were growing, which became less suitable to growth of the dominant plants of the swamps, the arborescent lycopsids. They were progressively replaced by vegetation dominated by marattialean ferns, which through a combination of slower growth and larger canopies resulted in less evapo-transpiration. This in turn caused localised reductions in rainfall, which further affected the ability of the lycopsids to dominate the swamp vegetation. These changes were initially localised and where the coal swamps were able to survive the lycopsids and pteridosperms show little change in either species diversity or biogeography, indicating that at this time there was minimal regional-scale climate change taking place. By Asturian times, however, the process had accelerated and the swamps in Variscan Euramerica became progressively replaced by predominantly conifer and cordaite vegetation that favoured much drier substrates. Except in localised pockets in intramontane basins of the Variscan Mountains, the last development of coal swamps in Variscan Euramerica was of early Cantabrian age. Further west, lycopsid-dominated coal swamps persisted for a little longer. The last remnants of the lycopsid-dominated coal swamps in the Illinois Basin disappeared probably by middle-late Cantabrian times, as the cycle of contracting wetlands and regional reductions in rainfall generated its own momentum, and no longer needed the impetus of tectonic instability. This tectonically-driven decline in the Euramerican coal swamps was probably responsible for an annual increase in atmospheric CO2 of c. 0.37 ppm, and may have been implicated in the marked increase in global temperatures near the Moscovian – Kasimovian boundary, and the onset of the Late Pennsylvanian interglacial.
Majority cycling and related social choice paradoxes are often thought to threaten the meaningfulness of democracy. Deliberation can protect against majority cycles—not by inducing unanimity, which is unrealistic, but by bringing preferences closer to single-peakedness. We present the first empirical test of this hypothesis, using data from Deliberative Polls. Comparing preferences before and after deliberation, we find increases in proximity to single-peakedness. The increases are greater for lower- versus higher-salience issues and for individuals who seem to have deliberated more versus less effectively. They are not merely a by-product of increased substantive agreement (which in fact does not generally increase). Our results are important, quite apart from their implications for majority cycling, because single-peakedness can be naturally interpreted in terms of an underlying issue dimension, which can both clarify the debate and allow a majority-winning alternative to be interpreted as a median choice and thus as an attractive “compromise.”
The vertebrate fossil record of Cement Creek Cave, Colorado, spans from ≫ 45,000 yr ago to the present and represents the richest stratified series of high-elevation (≫ 2900 m) mammal remains known from the late Quaternary of North America. Stable carbon and oxygen isotope analyses of tooth enamel were used to assess potential ecological responses of two species found commonly throughout the cave, Yellow-bellied marmots (Marmota flaviventris) and Bushy-tailed woodrats (Neotoma cinerea), to late Quaternary climate and environmental changes of the Southern Rocky Mountains. Results indicate that despite such perturbations, the dietary ecologies of both species were maintained across this period. Neither taxon shifted to consuming C4 taxa or different C3 functional groups; similarly, no significant shifts in surface water use were detected. Variations in enamel δ13C were observed, however, that represent the physiological responses of high-elevation plants to changing levels of late Quaternary atmospheric CO2. While our findings extend both the geographic and elevational record of this plant CO2 response, they simultaneously highlight the ecological stability of high-elevation M. flaviventris and N. cinerea during climate changes of late Quaternary magnitude.
The formal commissioning of the IRWG occurred at the 1991 Buenos Aires General Assembly, following a Joint Commission meeting at the IAU GA in Baltimore in 1988 that identified the problems with ground-based infrared photometry. The meeting justification, papers, and conclusions, can be found in Milone (1989). In summary, the challenges involved how to explain the failure to achieve the milli-magnitude precision expected of infrared photometry and an apparent 3% limit on system transformability. The proposed solution was to redefine the broadband Johnson system, the passbands of which had proven so unsatisfactory that over time effectively different systems proliferated, although bearing the same “JHKLMNQ” designations; the new system needed to be better positioned and centered in the spectral windows of the Earth's atmosphere, and the variable water vapour content of the atmosphere needed to be measured in real time to better correct for atmospheric extinction.
The UK was one of few European countries to document a substantial wave of pandemic (H1N1) 2009 influenza in summer 2009. The First Few Hundred (FF100) project ran from April–June 2009 gathering information on early laboratory-confirmed cases across the UK. In total, 392 confirmed cases were followed up. Children were predominantly affected (median age 15 years, IQR 10–27). Symptoms were mild and similar to seasonal influenza, with the exception of diarrhoea, which was reported by 27%. Eleven per cent of all cases had an underlying medical condition, similar to the general population. The majority (92%) were treated with antiviral drugs with 12% reporting adverse effects, mainly nausea and other gastrointestinal complaints. Duration of illness was significantly shorter when antivirals were given within 48 h of onset (median 5 vs. 9 days, P=0·01). No patients died, although 14 were hospitalized, of whom three required mechanical ventilation. The FF100 identified key clinical and epidemiological characteristics of infection with this novel virus in near real-time.
Division IX provides a forum for astronomers engaged in the planning, development, construction, and calibration of optical and infrared telescopes and instrumentation, as well as observational procedures including data processing. A few years ago, discussions were started about changes in the structure of Division IX, with the aim of bringing it more in line with today's world of large coordinated projects and multi-national observatories. The course of this process, and further steps to be taken in the period from 2009 to 2012, were at the focus of the deliberations at the business meeting of Division IX at the IAU General Assembly in Rio de Janeiro.