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 firstname.lastname@example.org
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.
The majority of paediatric Clostridioides difficile infections (CDI) are community-associated (CA), but few data exist regarding associated risk factors. We conducted a case–control study to evaluate CA-CDI risk factors in young children. Participants were enrolled from eight US sites during October 2014–February 2016. Case-patients were defined as children aged 1–5 years with a positive C. difficile specimen collected as an outpatient or ⩽3 days of hospital admission, who had no healthcare facility admission in the prior 12 weeks and no history of CDI. Each case-patient was matched to one control. Caregivers were interviewed regarding relevant exposures. Multivariable conditional logistic regression was performed. Of 68 pairs, 44.1% were female. More case-patients than controls had a comorbidity (33.3% vs. 12.1%; P = 0.01); recent higher-risk outpatient exposures (34.9% vs. 17.7%; P = 0.03); recent antibiotic use (54.4% vs. 19.4%; P < 0.0001); or recent exposure to a household member with diarrhoea (41.3% vs. 21.5%; P = 0.04). In multivariable analysis, antibiotic exposure in the preceding 12 weeks was significantly associated with CA-CDI (adjusted matched odds ratio, 6.25; 95% CI 2.18–17.96). Improved antibiotic prescribing might reduce CA-CDI in this population. Further evaluation of the potential role of outpatient healthcare and household exposures in C. difficile transmission is needed.
To evaluate the long-term safety and tolerability of deutetrabenazine in patients with tardive dyskinesia (TD) at 2years.
In the 12-week ARM-TD and AIM-TD studies, deutetrabenazine showed clinically significant improvements in Abnormal Involuntary Movement Scale scores compared with placebo, and there were low rates of overall adverse events (AEs) and discontinuations associated with deutetrabenazine.
Patients who completed ARM-TD or AIM-TD were included in this open-label, single-arm extension study, in which all patients restarted/started deutetrabenazine 12mg/day, titrating up to a maximum total daily dose of 48mg/day based on dyskinesia control and tolerability. The study comprised a 6-week titration period and a long-term maintenance phase. Safety measures included incidence of AEs, serious AEs (SAEs), and AEs leading to withdrawal, dose reduction, or dose suspension. Exposure-adjusted incidence rates (EAIRs; incidence/patient-years) were used to compare AE frequencies for long-term treatment with those for short-term treatment (ARM-TD and AIM-TD). This analysis reports results up to 2 years (Week106).
343 patients were enrolled (111 patients received placebo in the parent study and 232 received deutetrabenazine). There were 331.4 patient-years of exposure in this analysis. Through Week 106, EAIRs of AEs were comparable to or lower than those observed with short-term deutetrabenazine and placebo, including AEs of interest (akathisia/restlessness [long-term EAIR: 0.02; short-term EAIR range: 0–0.25], anxiety [0.09; 0.13–0.21], depression [0.09; 0.04–0.13], diarrhea [0.06; 0.06–0.34], parkinsonism [0.01; 0–0.08], somnolence/sedation [0.09; 0.06–0.81], and suicidality [0.02; 0–0.13]). The frequency of SAEs (EAIR 0.15) was similar to those observed with short-term placebo (0.33) and deutetrabenazine (range 0.06–0.33) treatment. AEs leading to withdrawal (0.08), dose reduction (0.17), and dose suspension (0.06) were uncommon.
These results confirm the safety outcomes seen in the ARM-TD and AIM-TD parent studies, demonstrating that deutetrabenazine is well tolerated for long-term use in TD patients.
Presented at: American Academy of Neurology Annual Meeting; April 21–27, 2018, Los Angeles, California,USA
Funding Acknowledgements: Funding: This study was supported by Teva Pharmaceuticals, Petach Tikva, Israel
To evaluate long-term efficacy of deutetrabenazine in patients with tardive dyskinesia (TD) by examining response rates from baseline in Abnormal Involuntary Movement Scale (AIMS) scores. Preliminary results of the responder analysis are reported in this analysis.
In the 12-week ARM-TD and AIM-TD studies, the odds of response to deutetrabenazine treatment were higher than the odds of response to placebo at all response levels, and there were low rates of overall adverse events and discontinuations associated with deutetrabenazine.
Patients with TD who completed ARM-TD or AIM-TD were included in this open-label, single-arm extension study, in which all patients restarted/started deutetrabenazine 12mg/day, titrating up to a maximum total daily dose of 48mg/day based on dyskinesia control and tolerability. The study comprised a 6-week titration and a long-term maintenance phase. The cumulative proportion of AIMS responders from baseline was assessed. Response was defined as a percent improvement from baseline for each patient from 10% to 90% in 10% increments. AlMS score was assessed by local site ratings for this analysis.
343 patients enrolled in the extension study (111 patients received placebo in the parent study and 232 patients received deutetrabenazine). At Week 54 (n=145; total daily dose [mean±standard error]: 38.1±0.9mg), 63% of patients receiving deutetrabenazine achieved ≥30% response, 48% of patients achieved ≥50% response, and 26% achieved ≥70% response. At Week 80 (n=66; total daily dose: 38.6±1.1mg), 76% of patients achieved ≥30% response, 59% of patients achieved ≥50% response, and 36% achieved ≥70% response. Treatment was generally well tolerated.
Patients who received long-term treatment with deutetrabenazine achieved response rates higher than those observed in positive short-term studies, indicating clinically meaningful long-term treatment benefit.
Presented at: American Academy of Neurology Annual Meeting; April 21–27, 2018, Los Angeles, California, USA.
Funding Acknowledgements: This study was supported by Teva Pharmaceuticals, Petach Tikva, Israel.
The development of laser wakefield accelerators (LWFA) over the past several years has led to an interest in very compact sources of X-ray radiation – such as “table-top” free electron lasers. However, the use of conventional undulators using permanent magnets also implies system sizes which are large. In this work, we assess the possibilities for the use of novel mini-undulators in conjunction with a LWFA so that the dimensions of the undulator become comparable with the acceleration distances for LWFA experiments (i.e., centimeters). The use of a prototype undulator using laser machining of permanent magnets for this application is described and the emission characteristics and limitations of such a system are determined. Preliminary electron propagation and X-ray emission measurements are taken with a LWFA electron beam at the University of Michigan.
Gas production from the in vitro digestion of forage with buffered rumen fluid can be measured and used to determine forage digestibility and fermentation kinetics. Rumen micro-organisms ferment carbohydrate to gases (CO2 and CH4) and volatile fatty acids (VFA). The VFA produced also cause CO2 to be released from the C02-bicarbonate buffer. Theodorou et al. (1994) introduced the principle of measuring gas production by pressure increase using an electronic pressure transducer and sealed gas-tight culture bottles. Gases accumulate in the head space of the culture bottles as fermentation proceeds. The gas is measured and then released at regular intervals throughout the fermentation. This procedure was automated (Davies et al., 1995). The automated pressure evaluation system (APES) has advantages over the manual pressure transducer technique (Theodorou et al., 1994) in that it is less labour intensive and has been shown to be more sensitive to food characteristics (Davies et al., 1995). The APES, used in this work, has been improved to include new switches and a filtering system. It has been used here to determine the fermentation characteristics of various ruminant foods: ryegrass, wheat grain and ryegrass silage.
The properties of the acoustic modes are sensitive to magnetic activity. The unprecedented long-term Kepler photometry, thus, allows stellar magnetic cycles to be studied through asteroseismology. We search for signatures of magnetic cycles in the seismic data of Kepler solar-type stars. We find evidence for periodic variations in the acoustic properties of about half of the 87 analysed stars. In these proceedings, we highlight the results obtained for two such stars, namely KIC 8006161 and KIC 5184732.
We report the breeding success of four species of burrow-nesting petrels at sub-Antarctic Marion Island where house mice Mus musculus are the sole introduced mammal. Feral cats Felis catus were present on Marion for four decades from 1949, killing millions of seabirds and greatly reducing petrel populations. Cats were eradicated by 1991, but petrel populations have shown only marginal recoveries. We hypothesize that mice are suppressing their recovery through depredation of petrel eggs and chicks. Breeding success for winter breeders (grey petrels Procellaria cinerea (34±21%) and great-winged petrels Pterodroma macroptera (52±7%)) were lower than for summer breeders (blue petrels Halobaena caerulea (61±6%) and white-chinned petrels Procellaria aequinoctialis (59±6%)) and among winter breeders most chick fatalities were of small chicks up to 14 days old. We assessed the extent of mouse predation by monitoring the inside of 55 burrow chambers with video surveillance cameras (4024 film days from 2012–16) and recorded fatal attacks on grey (3/18 nests filmed, 17%) and great-winged petrel chicks (1/19, 5%). Our results show that burrow-nesting petrels are at risk from mouse predation, providing further motivation for the eradication of mice from Marion Island.
Farmed red deer (Cervus elaphus) are highly seasonal animals, showing a marked winter inappetance followed by excellent growth from turnout in spring. The quality of grazed herbage has been demonstrated to have a significant impact upon growth during the grazing season. For example, performance is improved by the provision of a sward surface height of 8 - 10 cm compared with a sward height of 5 - 6 cm (Davies et al, 1998). The objective of this study was to assess whether deer performance could be further enhanced by providing white clover (Trifolium repens) swards (C) either in early, late or throughout the grazing season compared with perennial ryegrass (Lolium perenne) swards (G).
Nutritional manipulation during the dry period can alter subsequent animal responses to feeding in terms of milk yield and composition. Previous research has shown interesting differences in milk production and composition due to energy or protein supply in the dry period (Moorby et al., 1996). The objective of this experiment was to test the interaction between energy and protein supplies during the dry period on subsequent milk production and composition. Effects on live weight gains and condition scores are reported in a separate summary (Jaurena et al., 2001).
Previous results have shown that during late gestation even under conditions of live weight (LW) gain, maternal body protein can be in negative balance due to the highly demanding gravid uterus and udder. It has also been claimed that current feeding standards underpredict dry cow nitrogen (N) requirement. Considering that it is not possible to measure maternal body N status independently of the requirements of the conceptus and the udder, estimation of conceptus and udder N requirements by mathematical models can help to predict maternal N requirement. The aim of this study was to assess cow N requirement during late gestation by predicting maternal N balance through a mathematical model. Previous results related with this study were presented in Jaurena et al, (2001).
Farmed red deer (Cervus elaphus) are highly seasonal animals and thus the majority of venison is available during the autumn and winter months. To compete with other red meats, alternative marketing systems for venison need to be developed. Previous ADAS trials have shown that red deer can be finished intensively at 10-12 months of age by extending day length (Davies et al, 1995) but it incurs increased feed costs. An alternative strategy to lower production costs is to reduce growth rates and finish deer at 24-26 months of age. Preliminary trials have shown (Davies and Deakin 1998) that silage only diets, during the second winter, are not sufficient to maintain body weight and a small supplement is required. However the type of supplement needs further investigation. The objective of this study was to examine the effect of feeding high energy and protein diets to yearling deer during their second winter, on winter growth and subsequent performance at grass.
Energy and protein supply during the dry period can affect subsequent milk production and composition (Moorby et al., 1996). Grass silage is a common ingredient of dry cow diets, but although it is usually adequate in crude protein concentration (CP), a high proportion is frequently in non-protein forms. Red clover silage has shown interesting characteristics that would increase true protein supply to ruminants (Broderick et al., 2000), which could avoid the use of more expensive concentrate supplements. The objective of this experiment was to compare red clover and ryegrass silage when fed as the sole source of forage to dry cows with a diet comprising ryegrass silage and a protein supplement.
Body fat and protein reserves at calving can affect milk production and composition (Garnsworthy, 1988; Moorby et al., 1996). Milk producers frequently feed their dry cows with a low quality diet to prevent them from becoming too fat before calving. However, the cow must nourish the foetus and develop mammary secretory tissues, which can be a problem if she is offered a low protein diet. This experiment was designed to test the interaction between energy and protein supplies during the dry period on changes in live weight (LW), condition score (CS) and muscle Longissimus dorsi depth (LD). Subsequent milk production and composition data are reported in a separate summary (Jaurena et al., 2001).
A two-beam Martin-Puplett polarizing interferometer has been used in the rapid-scan mode on the 15 meter JCMT in conjunction with the facility detector, UKT14, to survey the solar sub-millimeter and millimeter spectrum in the four wavebands at 7-11, 11-15, 21-24 and 27-30 cm–1 to a spectral resolution of 0.01 cm–1 and at spatial resolutions of 19″, 16″, 7″ and 6″, respectively. Overall atmospheric transmission through these windows has been evaluated by comparison with synthetic spectra generated with FASCOD/HITRAN. A search has been made for contributions to these spectra from high-n transitions of H and heavier elements by several methods, including the comparison of solar with lunar and limb with disk center spectra.
In western North America, the Western Stemmed Tradition (WST) is contemporaneous with, but technologically different from, the Clovis Paleoindian Tradition as initially defined from the Great Plains and American Southwest. The foundational principles of WST lithic technology have not been as clearly delineated as those of their fluted and unfluted Paleoindian Tradition technological counterparts, largely due to the paucity of extensive WST lithic assemblages recovered from intact buried contexts. Recent excavations at the Cooper's Ferry site, located in western Idaho, revealed a stratified series of WST components spanning the late Pleistocene to early Holocene periods. The study of these components offers a unique opportunity to evaluate current expectations about WST lithic technology. Here, we describe the discovery, context, and contents of a new cache of 14 WST projectile points from the Cooper's Ferry site that provide clues about WST lithic reduction patterns and the design of early stemmed projectile points. We employ several novel methods of lithic analysis based on three-dimensional digital scanning technology and geometric morphometry and, in doing so, seek to demonstrate new ways of studying stone tools through the use of next-generation methods of lithic analysis applied to exploring the poorly known technological details of the WST.
We conducted a prospective cohort study between 1 January 2010 and 31 December 2012 at five adult and paediatric academic medical centres to identify factors associated with persistent methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Adults and children presenting to ambulatory settings with a MRSA skin and soft tissue infection (i.e. index cases), along with household members, performed self-sampling for MRSA colonisation every 2 weeks for 6 months. Clearance of colonisation was defined as two consecutive negative sampling periods. Subjects without clearance by the end of the study were considered persistently colonised and compared with those who cleared colonisation. Of 243 index cases, 48 (19·8%) had persistent colonisation and 110 (45·3%) cleared colonisation without recurrence. Persistent colonisation was associated with white race (odds ratio (OR), 4·90; 95% confidence interval (CI), 1·38–17·40), prior MRSA infection (OR 3·59; 95% CI 1·05–12·35), colonisation of multiple sites (OR 32·7; 95% CI 6·7–159·3). Conversely, subjects with persistent colonisation were less likely to have been treated with clindamycin (OR 0·28; 95% CI 0·08–0·99). Colonisation at multiple sites is a risk factor for persistent colonisation and may require more targeted decolonisation efforts. The specific effect of clindamycin on MRSA colonisation needs to be elucidated.
A field study was conducted in 2014 and 2015 in Arkansas, Illinois, Indiana, Ohio, Tennessee, Wisconsin, and Missouri to determine the effects of tillage system and herbicide program on season-long emergence of Amaranthus species in glufosinate-resistant soybean. The tillage systems evaluated were deep tillage (fall moldboard plow followed by (fb) one pass with a field cultivator in the spring), conventional tillage (fall chisel plow fb one pass with a field cultivator in the spring), minimum tillage (one pass of a vertical tillage tool in the spring), and no-tillage (PRE application of paraquat). Each tillage system also received one of two herbicide programs; PRE application of flumioxazin (0.09 kg ai ha–1) fb a POST application of glufosinate (0.59 kg ai ha−1) plus S-metolachlor (1.39 kg ai ha–1), or POST-only applications of glufosinate (0.59 kg ha−1). The deep tillage system resulted in a 62, 67, and 73% reduction in Amaranthus emergence when compared to the conventional, minimum, and no-tillage systems, respectively. The residual herbicide program also resulted in an 87% reduction in Amaranthus species emergence compared to the POST-only program. The deep tillage system, combined with the residual program, resulted in a 97% reduction in Amaranthus species emergence when compared to the minimum tillage system combined with the POST-only program, which had the highest Amaranthus emergence. Soil cores taken prior to planting and herbicide application revealed that only 28% of the Amaranthus seed in the deep tillage system was placed within the top 5-cm of the soil profile compared to 79, 81, and 77% in the conventional, minimum, and no-tillage systems. Overall, the use of deep tillage with a residual herbicide program provided the greatest reduction in Amaranthus species emergence, thus providing a useful tool in managing herbicide-resistant Amaranthus species where appropriate.
The evolution of a tandem accelerator 14C dating system at Chalk River is recounted. Background problems and sources of instability are discussed and solutions are described. Details of sample chemistry and source preparation are presented.
The Chalk River Tandem Accelerator Mass Spectrometry System has reached a state of reliable measurement of 14C using 2 to 5mg elemental carbon prepared by Mg reduction of CO2. For two comparisons of a near-modern unknown with the NBS oxalic acid standard we obtain a total error of ∼±4.5%, consisting of a random system error of about ±3.5% combined with the statistical counting error. Measurements have been made on 70 samples in 30 days of running time during the past year. Samples included deep rock carbonates, cosmogenic 14C in meteorites, charcoal from earthquake fault zones, collagen of bone artifacts and fossil beetle-fragments.
An Accelerator Mass Spectrometry system has been developed using the 14UD tandem accelerator at the Australian National University. It has been used for 36Cl measurements on groundwater samples from the Murray Basin in southeastern Australia. Measurements of 14C have also been made on the same groundwaters. The information can be combined with stable isotope ratios and other data to illustrate the occurrence of processes such as radioactive decay and local recharge in different aquifers.