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We cross-sectionally investigated irregular breakfast consumption and food timing patterns in relation to weight status and inflammation among 644 participants in the Cancer Prevention Study-3 Diet Assessment Sub-study. Breakfast consumption, and the individual means and the intra-individual standard deviation (iSD) of time at first intake of the day, duration of daily intake window, and midpoint of daily intake window were collected via six 24-hour recalls and examined in relation to body mass index (BMI), waist circumference (WC), and inflammation (GlycA). Compared to consuming breakfast on all six recalls, linear regression models showed those who consumed breakfast on 5 or 4 of the days had a 1.29 (95% CI: 0.19, 2.38) and 1.64 kg/m2 (95% CI: 0.12, 3.16) higher BMI; no association for consuming breakfast ≤3 days. 1-hour later in the average time of first intake was associated with a 0.44 kg/m2 higher BMI (95% CI: 0.04, 0.84). A 1-hour increase in the iSD of first intake, was associated with a 1.12 (95% CI: 0.49, 1.75) higher BMI; iSD in duration and midpoint of intake window were significant prior to additional adjustment for iSD in first intake. 1-hour increases in iSD for first intake time (β: 0.15; 95% CI: 0.04, 0.26) and midpoint of intake window (β: 0.16; 95% CI: 0.02, 0.31) were associated with higher GlycA. No associations were observed for WC independent of BMI. The results provide evidence that irregularity in breakfast consumption and daily intake timing patterns, particularly early in the day, may be related to weight status and inflammation.
We report a summary of Portuguese families and siblings research under the umbrella of the Portuguese Healthy Family Project. Families lived in mainland Portugal, as well as in the Azores and Madeira islands. All samples comprise children and adolescents (9–20 years) and their parents (27–57 years). Recruitment procedures and phenotypes were detailed. Familial resemblance in body shape and composition, metabolic syndrome, physical fitness, physical activity and sedentary behaviors are presented, as well as future research avenues.
An experimental technique for assessing film cooling performance is proposed which can determine both film effectiveness and heat transfer coefficient distributions from a single infrared experiment. First, the film effectiveness is determined in the experiment’s steady-state phase on a series of film-cooled nozzle guide vane leading edge geometries made of a low thermal conductivity foam. Then, the effectiveness is used to calculate the distribution of the transient phase driving gas temperatures, which is applied to a finite element conduction model. Heat transfer coefficients are guessed and iteratively refined until the surface temperature histories predicted by the finite element model match those which were experimentally observed. Unlike conventional methods based on one-dimensional analytical heat transfer solutions, this approach does not require assumptions about the material thickness underlying the test surface or the uniformity with depth of its initial temperature distribution. This relieves certain experimental constraints and reduces uncertainty in results.
Work in sociolinguistic typology and creole studies has established the theory that intensive language contact involving second language acquisition by adults tends to lead to grammatical simplification. This theory is built on many anecdotal case studies, including developments in the history of Continental North Germanic associated with contact with Middle Low German. In this paper, we assess the theory by examining two changes in the history of Norwegian: the loss of coda /Cr/ clusters and the loss of prepositional genitives. If the theory is correct, these changes should have been innovated in centers of contact with Middle Low German. We find that both changes in fact spread into southeastern Norwegian from Swedish. Since contact with Low German also took place in Sweden and Denmark, this is consistent with the theory. It opens questions for future research about the role of dialect contact in simplificatory change in North Germanic.
We present the case of a 17-year-old boy with a cardiac venous malformation. This case highlights the diagnostic challenges of such tumours and demonstrates the potential efficacy of a watch-and-wait management approach.
Fatigue syndromes (FSs) affect large numbers of individuals, yet evidence from epidemiological studies on adverse outcomes, such as premature death, is limited.
Cohort study involving 385 general practices in England that contributed to the Clinical Practice Research Datalink (CPRD) with linked inpatient Hospital Episode Statistics (HES) and Office for National Statistics (ONS) cause of death information. A total of 10 477 patients aged 15 years and above, diagnosed with a FS during 2000–2014, were individually matched with up to 20 comparator patients without a history of having a FS. Prevalence ratios (PRs) were estimated to compare the FS and comparison cohorts on clinical characteristics. Adjusted hazard ratios (HRs) for subsequent adverse outcomes were estimated from stratified Cox regression models.
Among patients diagnosed with FSs, we found elevated baseline prevalence of: any psychiatric illness (PR 1.77; 95% CI 1.72–1.82), anxiety disorders (PR 1.92; 1.85–1.99), depression (PR 1.89; 1.83–1.96), psychotropic prescriptions (PR 1.68; 1.64–1.72) and comorbid physical illness (PR 1.28; 1.23–1.32). We found no significant differences in risks for: all-cause mortality (HR 0.99; 0.91–1.09), natural death (HR 0.99; 0.90–1.09), unnatural death (HR 1.00; 0.59–1.72) or suicide (HR 1.68; 0.78–3.63). We did, however, observe a significantly elevated non-fatal self-harm risk: HR 1.83; 1.56–2.15.
The absence of elevated premature mortality risk is reassuring. The raised prevalence of mental illness and increased non-fatal self-harm risk indicate a need for enhanced assessment and management of psychopathology associated with fatigue syndromes.
Both India and Nepal are prone to a wide range of natural and man-made disasters. Almost 85% of India’s area is vulnerable to one or more hazards, and more than 80% of the total population of Nepal is at risk of natural hazards. In terms of the number of people affected in reported disastrous events, India is in the top 10 and Nepal is in the top 20 globally. Over the last two decades, India and Nepal have taken steps to establish their respective National Disaster Management organizations, which provide essential disaster responses. However, key gaps still remain in trained clinical capacity for managing impacts from various disasters. Our review of the region has shown that large parts of the population suffer injuries, diseases, disabilities, psychosocial, and other health-related problems from disasters.
Develop disaster medicine clinical capacity to reduce morbidities and mortalities from disasters.
Independent published data and work undertaken by the lead author in various disasters in India and Nepal since 1993 formed the basis of establishing the Faculty of Disaster Medicine for South Asia. The Faculty of Disaster Medicine - India and Nepal (FDMIN) was launched from Pune in March 2015. This initiative is supported by the National Association of Primary Care (UK), Public Health England, Faculty of Pre-hospital Care of Royal College of Surgeons - Edinburgh and CRIMEDIM (Novara) - Italy.
FDMIN has international expert advisors and has outlined 16 modules training curriculum for health care professionals. FDMIN currently has partnerships for teaching disaster medicine program with 3 medical universities and 12 major health care providers. Six pilot training programmes have been conducted in Pune, Delhi, Chennai, and Kochin. Work is underway to submit an application to the Indian regulatory bodies for approval to establish a post-graduate diploma and Master’s for Disaster Medicine.
Satellite imagery is used to show that the world's second largest emperor penguin colony, at Halley Bay, has suffered three years of almost total breeding failure. Although, like all emperor colonies, there has been large inter-annual variability in the breeding success at this site, the prolonged period of failure is unprecedented in the historical record. The observed events followed the early breakup of the fast ice in the ice creeks that the birds habitually used for breeding. The initial breakup was associated with a particularly stormy period in September 2015, which corresponded with the strongest El Niño in over 60 years, strong winds, and a record low sea-ice year locally. Conditions have not recovered in the two years since. Meanwhile, during the same three-year period, the nearby Dawson-Lambton colony, 55 km to the south, has seen a more than tenfold increase in penguin numbers. The authors associate this with immigration from the birds previously breeding at Halley Bay. Studying this ‘tale of two cities’ provides valuable information relevant to modelling penguin movement under future climate change scenarios.
Determining infectious cross-transmission events in healthcare settings involves manual surveillance of case clusters by infection control personnel, followed by strain typing of clinical/environmental isolates suspected in said clusters. Recent advances in genomic sequencing and cloud computing now allow for the rapid molecular typing of infecting isolates.
To facilitate rapid recognition of transmission clusters, we aimed to assess infection control surveillance using whole-genome sequencing (WGS) of microbial pathogens to identify cross-transmission events for epidemiologic review.
Clinical isolates of Staphylococcus aureus, Enterococcus faecium, Pseudomonas aeruginosa, and Klebsiella pneumoniae were obtained prospectively at an academic medical center, from September 1, 2016, to September 30, 2017. Isolate genomes were sequenced, followed by single-nucleotide variant analysis; a cloud-computing platform was used for whole-genome sequence analysis and cluster identification.
Most strains of the 4 studied pathogens were unrelated, and 34 potential transmission clusters were present. The characteristics of the potential clusters were complex and likely not identifiable by traditional surveillance alone. Notably, only 1 cluster had been suspected by routine manual surveillance.
Our work supports the assertion that integration of genomic and clinical epidemiologic data can augment infection control surveillance for both the identification of cross-transmission events and the inclusion of missed and exclusion of misidentified outbreaks (ie, false alarms). The integration of clinical data is essential to prioritize suspect clusters for investigation, and for existing infections, a timely review of both the clinical and WGS results can hold promise to reduce HAIs. A richer understanding of cross-transmission events within healthcare settings will require the expansion of current surveillance approaches.
Every economic explanation assumes maximization. How strange, then, that few economists accept one of maximization's most straightforward implications: every observed institution is efficient. My aim is to persuade economists of this fact and thus to dissuade them from making illogical claims about social welfare. To frame my argument, I consider the “property rights approach” to institutions developed by Yoram Barzel. I speculate that economists resist what maximization implies about institutional efficiency because they think that efficiency-always precludes them from improving the world, and hope of improving the world is what attracted them to economics in the first place. But, besides being inconsistent, resistance is unnecessary: efficiency-always does not preclude economists, or anyone else, from improving the world.
We present a conditional space–time proper orthogonal decomposition (POD) formulation that is tailored to the eduction of the average, rare or intermittent events from an ensemble of realizations of a fluid process. By construction, the resulting spatio-temporal modes are coherent in space and over a predefined finite time horizon, and optimally capture the variance, or energy of the ensemble. For the example of intermittent acoustic radiation from a turbulent jet, we introduce a conditional expectation operator that focuses on the loudest events, as measured by a pressure probe in the far field and contained in the tail of the pressure signal’s probability distribution. Applied to high-fidelity simulation data, the method identifies a statistically significant ‘prototype’, or average acoustic burst event that is tracked over time. Most notably, the burst event can be traced back to its precursor, which opens up the possibility of prediction of an imminent burst. We furthermore investigate the mechanism underlying the prototypical burst event using linear stability theory and find that its structure and evolution are accurately predicted by optimal transient growth theory. The jet-noise problem demonstrates that the conditional space–time POD formulation applies even for systems with probability distributions that are not heavy-tailed, i.e. for systems in which events overlap and occur in rapid succession.
We report on the concept of an innovative source to produce polarized proton/deuteron beams of a kinetic energy up to several GeV from a laser-driven plasma accelerator. Spin effects have been implemented into the particle-in-cell (PIC) simulation code VLPL (Virtual Laser Plasma Lab) to make theoretical predictions about the behavior of proton spins in laser-induced plasmas. Simulations of spin-polarized targets show that the polarization is conserved during the acceleration process. For the experimental realization, a polarized HCl gas-jet target is under construction using the fundamental wavelength of a Nd:YAG laser system to align the HCl bonds and simultaneously circularly polarized light of the fifth harmonic to photo-dissociate, yielding nuclear polarized H atoms. Subsequently, their degree of polarization is measured with a Lamb-shift polarimeter. The final experiments, aiming at the first observation of a polarized particle beam from laser-generated plasmas, will be carried out at the 10 PW laser system SULF at SIOM, Shanghai.