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Underrepresentation of people from racial and ethnic minoritized groups in clinical trials threatens external validity of clinical and translational science, diminishes uptake of innovations into practice, and restricts access to the potential benefits of participation. Despite efforts to increase diversity in clinical trials, children and adults from Latino backgrounds remain underrepresented. Quality improvement concepts, strategies, and tools demonstrate promise in enhancing recruitment and enrollment in clinical trials. To demonstrate this promise, we draw upon our team’s experience conducting a randomized clinical trial that tests three behavioral interventions designed to promote equity in language and social-emotional skill acquisition among Latino parent–infant dyads from under-resourced communities. The recruitment activities took place during the COVID-19 pandemic, which intensified the need for responsive strategies and procedures. We used the Model for Improvement to achieve our recruitment goals. Across study stages, we engaged strategies such as (1) intentional team formation, (2) participatory approaches to setting goals, monitoring achievement, selecting change strategies, and (3) small iterative tests that informed additional efforts. These strategies helped our team overcome several barriers. These strategies may help other researchers apply quality improvement tools to increase participation in clinical and translational research among people from minoritized groups.
The Ediacaran Subcommission of the International Commission on Stratigraphy is diligently working toward the goal of subdividing the Ediacaran Period into precise and useful chronostratigraphic units. As emphasized by Xiao and colleagues in 2016, one of the most effective tools in this endeavor will be the use of index fossils. Our special issue serves as a presentation of ongoing research efforts aimed at advancing this task and contains explorations into taxonomy, taphonomy, and the diversity of life during the Ediacaran Period.
The migration of interlayer Fe3+ cations into the structure of heated montmorillonite and Laponite has been studied by electron spin resonance (ESR), Mössbauer spectroscopy, and magnetic susceptibility measurements. The intensity of the ESR signal corresponding to interlayer Fe3+ in air-dried montmorillonite and Laponite increased linearly as the amount of interlayer Fe3+ increased. Changes in the spectra after thermal treatment indicate that Fe3+ cations migrated into the pseudohexagonal cavities of dehydrated montmorillonite and Laponite. The electrostatic interaction between the Fe3+ and the oxygen atoms defining the entrance to these cavities and the proton of the structural OH groups at the bottom of the cavities differ for the two smectites. Ferric cations were apparently bound more strongly within the pseudohexagonal cavities of the dehydrated montmorillonite than within the cavities of Laponite, because the montmorillonite did not rehydrate after heating. The differences in the binding of Fe3+ cations within the pseudohexagonal cavities of montmorillonite and Laponite were probably due to variations in the ability of the protons of the structural OH groups to reorient. An additional electronic interaction occurred in the heated Laponite, in which small cations were able to promote the formation of structural defects, which gave rise to a sharp ESR signal at g = 2.00. No evidence for the penetration of Fe3+ cations into the vacant octahedral sites of montmorillonite was found.
This study generates new insights on the role of initial impressions in assessment centers. Drawing from the “thin slices” of behavior paradigm in personality and social psychology, we investigate to what extent initial impressions of assessees—based on different slices of assessment center exercises (i.e., two minutes at the beginning, middle, and end of AC exercises)—are consistent across and within AC exercises, and are relevant for predicting assessment center performance and job performance. Employed individuals (N = 223) participated in three interactive assessment center exercises, while being observed and evaluated by trained assessors. Based upon video-recordings of all assessment center exercises, a different, untrained group of raters subsequently provided ratings of their general initial impressions of assessees for the beginning, middle, and end of each exercise. As criterion measure, supervisors rated assessees’ job performance. Results show that initial impressions in assessment centers are (a) relatively stable, (b) consistently predict assessment center performance across different slices of behavior (i.e., across the three time points and exercises), and (c) mostly relate to job performance.
Plant-based diets have emerged as athletic performance enhancers for various types of exercise. Therefore, the present study evaluated the effectiveness of plant-based diets on aerobic and strength/power performances, as well as on BMI of physically active individuals. This systematic review and meta-analysis was conducted and reported according to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A systematic search of electronic databases, including PubMed, Web of Science and SPORTDiscus, was performed. On the basis of the search and inclusion criteria, four and six studies evaluating the effects of plant-based diets on aerobic and strength/power performances in humans were, respectively, included in the systematic review and meta-analysis. Plant-based diets had a moderate but positive effect on aerobic performance (0·55; 95 % CI 0·29, 0·81) and no effect on strength/power performance (–0·30; 95 % CI −0·67, 0·07). The altogether analyses of both aerobic and strength/power exercises revealed that athletic performance was unchanged (0·01; 95 % CI −0·21, 0·22) in athletes who adopted plant-based diets. However, a small negative effect on BMI (–0·27; 95 % CI −0·40, –0·15) was induced by these diets. The results indicate that plant-based diets have the potential to exclusively assist aerobic performance. On the other hand, these diets do not jeopardise strength/power performance. Overall, the predicted effects of plant-based diets on physical performance are impactless, even though the BMI of their adherents is reduced.
The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.
Methods
Participants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.
Results
COVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).
Conclusions
COVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.
A Mass Casualty Incident response (MCI) full scale exercise (FSEx) assures MCI first responder (FR) competencies. Simulation and serious gaming platforms (Simulation) have been considered to achieve and maintain FR competencies. The translational science (TS) T0 question was asked: how can FRs achieve similar MCI competencies as a FSEx through the use of MCI simulation exercises?
Methods:
T1 stage (Scoping Review): PRISMA-ScR was conducted to develop statements for the T2 stage modified Delphi (mD) study. 1320 reference titles and abstracts were reviewed with 215 full articles progressing for full review leading to 97 undergoing data extraction.
T2 stage (mD study): Selected experts were presented with 27 statements derived from T1 data with instruction to rank each statement on a 7-point linear numeric scale, where 1 = disagree and 7 = agree. Consensus amongst experts was defined as a standard deviation ≤ 1.0.
Results:
After 3 mD rounds, 19 statements attained consensus and 8 did not attain consensus.
Conclusions:
MCI simulation exercises can be developed to achieve similar competencies as FSEx by incorporating the 19 statements that attained consensus through the TS stages of a scoping review (T1) and mD study (T2), and continuing to T3 implementation, and then T4 evaluation stages.
To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms.
Design:
An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used.
Setting:
Spanish older adults with metabolic syndrome (MetS).
Participants:
A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS.
Results:
Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)).
Conclusions:
According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.
Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors.
Methods
8996 healthcare workers evaluated on 5 May–7 September 2020 (baseline) were invited to a second web-based survey (October–December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview.
Results
4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar.
Conclusions
Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565
This work aimed to investigate the effects of early progeny exposure to methylglyoxal (MG), programming for metabolic dysfunction and diabetes-like complications later in life. At delivery (PN1), the animals were separated into two groups: control group (CO), treated with saline, and MG group, treated with MG (20 mg/kg of BW; i.p.) during the first 2 weeks of the lactation period. In vivo experiments and tissue collection were done at PN90. Early MG exposure decreased body weight, adipose tissue, liver and kidney weight at adulthood. On the other hand, MG group showed increased relative food intake, blood fructosamine, blood insulin and HOMA-IR, which is correlated with insulin resistance. Besides, MG-treated animals presented dyslipidaemia, increased oxidative stress and inflammation. Likewise, MG group showed steatosis and perivascular fibrosis in the liver, pancreatic islet hypertrophy, increased glomerular area and pericapsular fibrosis, but reduced capsular space. This study shows that early postnatal exposure to MG induces oxidative stress, inflammation and fibrosis markers in pancreas, liver and kidney, which are related to metabolic dysfunction features. Thus, nutritional disruptors during lactation period may be an important risk factor for metabolic alterations at adulthood.
The Ediacaran tubular fossils Cloudina, Sinotubulites, and Conotubus are taxonomically revised with type materials. It is proposed that Aulophycus lucianoi Beurlen and Sommer, 1957, is not a senior synonym of Cloudina hartmannae Germs, 1972. Instead, most of its syntypes may be assigned to Sinotubulites or other taxa. Lectotypes of Sinotubulites baimatuoensis Chen et al., 1981, and Conotubus hemiannulatus Zhang and Lin in Lin et al., 1986, are designated from rediscovered syntypes. Sinotubulites baimatuoensis Chen et al., 1981, is reported from the Mooifontein Member of Nama Group at Aar Farm, Namibia. Cloudina waldei Hahn and Pflug, 1985, is assigned to Sinotubulites baimatuoensis, and thus its occurrence range is extended to Brazil. The lectotype of Conotubus hemiannulatus shows corrugations and annulations on the surface distinguishing it from Cloudina and other collared Ediacaran tubular fossils. Based on the taxonomic revision, we propose a Cloudina hartmannae Interval Zone for the terminal Ediacaran with the upper boundary defined by the first appearance datum of Protohertzina anabarica (i.e., the index fossil of the early Cambrian Anabarites trisulcatus-Protohertzina anabarica Assemblage Zone).
Much work has been done to understand the settling dynamics of spherical particles in a homogeneous and stratified fluid. However, the effects of shape anisotropy on the settling dynamics of a particle in a stratified fluid are not completely understood. To this end, we perform numerical simulations for settling oblate and prolate spheroids in a stratified fluid. We present the results for the Galileo number, $Ga$, in the range 80–250 and the Richardson number, $Ri$, in the range 0–10. We find that both the oblate and prolate spheroids reorient to the edge-wise and partially edge-wise orientations, respectively, as they settle in a stratified fluid completely different from the steady-state broad-side on orientation observed in a homogeneous fluid. We observe that reorientation instabilities emerge when the velocity magnitudes of the spheroids fall below a particular threshold. We also report the enhancement of the drag on the particle from stratification. The torque due to buoyancy effects tries to orient the spheroid in an edge-wise orientation while the hydrodynamic torque tries to orient it to a broad-side on orientation. Below the velocity threshold, the buoyancy torque dominates; resulting in the onset of reorientation instability. Finally, the asymmetry in the distribution of the baroclinic vorticity generation term around the spheroids explains the onset of the reorientation instability.
The paper presents the results of one international study due by our team in the period of restrictions imposed by Covid-19, between March and June 2020.
Objectives
To inform the population about the risks concerning the excessiv use of internet To prevent the effects of those behaviors which affects the global functioning of individuals
Methods
Questionnaire applied to a number of 549 subjects, 18 to 60 years old, 217 from Romania and 332 from other European and Asian countries
Results
The results allowed us to verify the assumption that there is a change in communications needs of individuals, as well gender and age differences in terms of time spent on the internet during the covid period.
Conclusions
The issue of psycho-education regarding the awareness of dangers and the traps of the virtual era remain relevant.
The reputation of the Normans is rooted in warfare, faith and mobility. They were simultaneously famed as warriors, noted for their religious devotion, and celebrated as fearless travellers. In the Middle Ages few activities offered a better conduit to combine warfare, religiosity, and movement than crusading and pilgrimage. However, while scholarship is abundant on many facets of the Norman world, it is a surprise that the Norman relationship with crusading and pilgrimage, so central in many ways to Norman identity, has hitherto not received extensive treatment. The collection here seeks to fill this gap. It aims to identify what was unique or different about the Normans and their relationship with crusading and pilgrimage, as well as how and why crusade and pilgrimage were important to the Normans. Particular focus is given to Norman participation in the First Crusade, to Norman interaction in later crusading initiatives, to the significance of pilgrimage in diverse parts of the Norman world, and finally to the ways in which crusading and pilgrimage were recorded in Norman narrative. Ultimately, this volume aims to assess, in some cases to confirm, and in others to revise the established paradigm of the Normans as crusaders par excellence and as opportunists who used religion to serve other agendas.
Dr Kathryn Hurlock is Senior Lecturer in Medieval History at Manchester Metropolitan University; Dr Paul Oldfield is Lecturer in Medieval History at the University of Manchester.
Contributors: Andrew Abram, William M. Aird, Emily Albu, Joanna Drell, Leonie Hicks, Natasha Hodgson, Kathryn Hurlock, Alan V. Murray, Paul Oldfield, David S. Spear, Lucas Villegas-Aristizábal.
In the Ediacaran marine succession of the Cerro Negro Formation (Tandilia System, NE Argentina), abundant microbially induced sedimentary structures indicate general conditions of substrate biostabilization. Numerous discoidal structures in this succession were previously interpreted as moulds of soft-tissue holdfasts of sessile organisms, within the form genus Aspidella. In this study, we performed a detailed re-analysis of some of these features and discuss two alternative hypotheses to explain their genesis: (1) as the result of soft-sediment deformation and fluid injection structures; and (2) as structures of active animal–sediment interaction (i.e. trace fossils). We show that the dome-shaped discs are internally laminated, with a cylindrical to a funnel-shaped vertical tube at their central region. The presence of these downwards vertical extensions and other intricate internal arrangements cannot be explained under the taphonomic spectrum of discoidal fossils, but shows striking similarities to Intrites-like structures and other sand-volcano-like pseudofossils (e.g. Astropolithon). However, some structures are hard to distinguish from vertical dwelling burrows with funnel-shaped apertures and thick-lined walls, commonly produced by suspension- and detritus-feeding invertebrates (e.g. Skolithos isp., Monocraterion isp. and, less likely, Rosselia isp.). Since reliable age constraints are unavailable, and further investigation concerning other palaeobiological indicators is needed, the most parsimonious hypothesis is that of a structure derived from fluid-escape processes. Our study demonstrates the importance of detailed investigation on discoidal structures in either upper Ediacaran or lower Cambrian strata.
Several sag-type basins apparently developed from rift systems, but there is no consensus about how and if these grabens influenced the sedimentation of the post-rift thermal subsidence phase. The Ediacaran Jaibaras Rift Basin is one of the best-exposed sedimentary records among the NE Brazil late Precambrian – early Cambrian rift system, cropping out at the eastern margin of the intracratonic Parnaíba Basin and extending below it towards the west. Here we present detrital zircon U–Pb ages of rocks from the Jaibaras (Aprazível Formation) and Parnaíba (Ipu Formation) basins, in order to understand the provenance patterns, maximum depositional ages (MDA) and age relationship between these units. The MDA for the Aprazível Formation (c. 499 ± 5 Ma) indicates a Cambrian age for the upper part of the Jaibaras Basin. The bulk U–Pb data indicate that the Ipu Formation started to deposit during late Cambrian and/or Early Ordovician time, despite its MDA (c. 528 ± 11 Ma) being older than that of the Aprazível Formation. Detrital zircon provenance suggests that the primary source areas for the early deposits of the Parnaíba Basin were mountains related to the Brasiliano Orogeny to the south and SE (e.g. Rio Preto and Riacho do Pontal metamorphic belts). Finally, our data emphasize the key change in source areas from the rift to the initial deposition of the intracratonic phase, indicating major depositional style changes between both basins after the Gondwana assembly.