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Junglerice is becoming more prevalent in Tennessee, Arkansas and Mississippi row crop fields. The evolution of glyphosate-resistant junglerice populations is one reason for the increase. Another possible explanation is that glyphosate and clethodim grass activity is being antagonized by dicamba. This question has led to research to examine if sequential applications alleviate antagonism observed with dicamba plus glyphosate and/or clethodim mixtures and determine if 24 h, 72 h or 168 h sequential treatments of those herbicides can improve junglerice control. Glyphosate + clethodim applications provided >90% junglerice control. The observed levels of antagonism varied by whether the location of the test was in the greenhouse or the field and the timing of applications. In the greenhouse, clethodim + dicamba provided excellent control while in the field the same treatment showed over a 30% reduction in junglerice control compared with clethodim alone. However, control was restored by using a mixture of glyphosate + clethodim without dicamba. The environment at the time of application and relative glyphosate-resistance (GR) level of the junglerice influenced the overall control of these sequential applications. Clethodim applied first followed by dicamba at 72 or 168 h, better control was observed compared with applying dicamba followed by clethodim. Overall, mixing glyphosate + clethodim provided the most complete junglerice control regardless of timing. These data confirm that leaving dicamba out of the spray tank will mitigate herbicide antagonism on junglerice control. These data would also indicate that avoiding dicamba and glyphosate mixtures will also improve the consistency of control with glyphosate-susceptible junglerice.
The ‘second victim phenomenon’ is a term attributed to the traumatic effect a medical error can have on healthcare professionals. Patient safety incidents have been shown to occur in as many as one in seven patients in hospital. These incidents cause significant, potentially devastating, trauma to patients and their relatives, and can have deep and long-lasting effects on the health professionals involved. These incidents can have a negative impact on doctors’ emotional wellbeing; their professional practice in relation to this impact has not been extensively investigated in surgical trainees.
A survey of UK otolaryngology trainees was conducted to investigate the effects of complications and medical errors on trainees, and examine how these are discussed within departments.
Results and conclusion
The findings suggest that further training is required and would be warmly received by otolaryngology trainees as part of higher surgical training.
Junglerice has become a major weed in the mid-south and other areas of the United States. Glyphosate resistance has been documented in junglerice populations and is part of the reason for the increase in its prevalence. However, reduced junglerice control with glyphosate + dicamba and clethodim + dicamba mixtures has been observed in many production fields where glyphosate resistance has not yet evolved. Therefore, research was conducted to assess reduced junglerice control with glyphosate and clethodim when applied with dicamba. Adding dicamba to the spray tank with glyphosate reduced junglerice control by 27%. Adding dicamba to the spray tank with clethodim reduced junglerice control by 11%. The use of Turbo Teejet Induction (TTI) nozzles reduced junglerice control an additional 8% compared to applications with an air induction extended range (AIXR) nozzle. When a drift reduction agent (DRA) was added to dicamba mixtures with glyphosate or clethodim, junglerice control was reduced 36%. Junglerice control was similar with the glyphosate + dicamba treatment compared to the glyphosate + 2,4-D mixture. There was no interaction between nozzles and herbicide treatment. Regardless of herbicide treatment junglerice control was always lower when applied with the ultracourse TTI nozzle. Many applicators in Tennessee prefer to make one application of glyphosate + dicamba in a mixture to save time (authors’ personal experience). These results show that the addition of dicamba to glyphosate or clethodim applied with labeled nozzles and a DRA results in reduced junglerice control and should be avoided.
Junglerice has become a major weed in Tennessee cotton and soybean fields. Glyphosate has been relied on to control these accessions over the past two decades, but in recent years cotton and soybean producers have reported junglerice escapes after glyphosate + dicamba and/or clethodim applications. In the growing seasons of 2018 and 2019, a survey was conducted of weed escapes in dicamba-resistant (DR) crops. Junglerice was the most prevalent weed escape in these DR (Roundup Ready Xtend®) cotton and soybean fields in both years of the study. In 2018 and 2019, junglerice was found 76% and 64% of the time in DR cotton and soybean fields, respectively. Progeny from junglerice seeds collected during this survey was screened for glyphosate and clethodim resistance. Seventy percent of the junglerice accessions tested had an effective relative resistance factor to glyphosate of 3.1 to 8.5. In all, 13% of the junglerice accessions could no longer be effectively controlled with glyphosate. This research also showed that all sampled accessions could still be controlled with clethodim in a greenhouse environment, but less control was observed in the field. These data also suggest that another cause for the poor junglerice control is dicamba antagonism of glyphosate and clethodim activity.
This article aims at predicting the oscillation frequency of open-channel lateral cavities, which are common sheltered zones of riverine environments, and have important ecological impact. Using a theoretical analysis based on an existing model for acoustic cavities and a free-surface lateral cavity experiment, we show that the vortex shedding in the mixing layer between the cavity and the open channel is always constrained by gravity waves even for low Froude numbers (
). This expands previous results from the literature showing the impact of gravity waves on the vortex shedding frequency for high Froude number (
). Measurements of the free-surface oscillation and transverse velocity oscillation frequencies reveal a unique frequency along the mixing layer, equal to the free-surface oscillation frequency anywhere in the cavity. Hence, it is shown that the vortex shedding frequency in an open-channel lateral cavity always equals a match between a natural frequency of the cavity and a solution of the feedback model developed herein for low to moderate Froude numbers.
The prevalence of many diseases in pigs displays seasonal distributions. Despite growing concerns about the impacts of climate change, we do not yet have a good understanding of the role that weather factors play in explaining such seasonal patterns. In this study, national and county-level aggregated abattoir inspection data were assessed for England and Wales during 2010–2015. Seasonally-adjusted relationships were characterised between weekly ambient maximum temperature and the prevalence of both respiratory conditions and tail biting detected at slaughter. The prevalence of respiratory conditions showed cyclical annual patterns with peaks in the summer months and troughs in the winter months each year. However, there were no obvious associations with either high or low temperatures. The prevalence of tail biting generally increased as temperatures decreased, but associations were not supported by statistical evidence: across all counties there was a relative risk of 1.028 (95% CI 0.776–1.363) for every 1 °C fall in temperature. Whilst the seasonal patterns observed in this study are similar to those reported in previous studies, the lack of statistical evidence for an explicit association with ambient temperature may possibly be explained by the lack of information on date of disease onset. There is also the possibility that other time-varying factors not investigated here may be driving some of the seasonal patterns.
Evidence suggests that early trauma may have a negative effect on cognitive functioning in individuals with psychosis, yet the relationship between childhood trauma and cognition among those at clinical high risk (CHR) for psychosis remains unexplored. Our sample consisted of 626 CHR children and 279 healthy controls who were recruited as part of the North American Prodrome Longitudinal Study 2. Childhood trauma up to the age of 16 (psychological, physical, and sexual abuse, emotional neglect, and bullying) was assessed by using the Childhood Trauma and Abuse Scale. Multiple domains of cognition were measured at baseline and at the time of psychosis conversion, using standardized assessments. In the CHR group, there was a trend for better performance in individuals who reported a history of multiple types of childhood trauma compared with those with no/one type of trauma (Cohen d = 0.16). A history of multiple trauma types was not associated with greater cognitive change in CHR converters over time. Our findings tentatively suggest there may be different mechanisms that lead to CHR states. Individuals who are at clinical high risk who have experienced multiple types of childhood trauma may have more typically developing premorbid cognitive functioning than those who reported minimal trauma do. Further research is needed to unravel the complexity of factors underlying the development of at-risk states.
Acute tonsillitis represents a significant proportion of admissions to ENT departments nationally. Given current hospital pressures, it is vital to look for safe alternatives to admission. This study explores the safe management of patients in an ambulatory medical unit, without the need for admission.
A retrospective review of 48 patients’ notes was carried out. Following the development and implementation of a guideline for acute tonsillitis, a prospective re-audit of 41 patients was carried out, measuring length of stay, overnight admissions and re-admissions.
The rate of overnight admission following implementation of the guideline fell from 0.75 to 0.29, and average length of stay dropped from 19.2 to 9.5 hours. There were two re-admissions in each cycle of the audit, which represents a non-significant increase.
The tonsillitis guideline has significantly reduced admissions and length of stay. Re-admissions remain low, demonstrating that this is a safe and cost-effective intervention.
Water exposures in healthcare settings and during healthcare delivery can place patients at risk for infection with water-related organisms and can potentially lead to outbreaks. We aimed to describe Centers for Disease Control and Prevention (CDC) consultations involving water-related organisms leading to healthcare-associated infections (HAIs).
Retrospective observational study.
We reviewed internal CDC records from January 1, 2014, through December 31, 2017, using water-related terms and organisms, excluding Legionella, to identify consultations that involved potential or confirmed transmission of water-related organisms in healthcare. We determined plausible exposure pathways and routes of transmission when possible.
Of 620 consultations during the study period, we identified 134 consultations (21.6%), with 1,380 patients, that involved the investigation of potential water-related HAIs or infection control lapses with the potential for water-related HAIs. Nontuberculous mycobacteria were involved in the greatest number of investigations (n = 40, 29.9%). Most frequently, investigations involved medical products (n = 48, 35.8%), and most of these products were medical devices (n = 40, 83.3%). We identified a variety of plausible water-exposure pathways, including medication preparation near water splash zones and water contamination at the manufacturing sites of medications and medical devices.
Water-related investigations represent a substantial proportion of CDC HAI consultations and likely represent only a fraction of all water-related HAI investigations and outbreaks occurring in US healthcare facilities. Water-related HAI investigations should consider all potential pathways of water exposure. Finally, healthcare facilities should develop and implement water management programs to limit the growth and spread of water-related organisms.
As demonstrated by neuroimaging data, the human brain contains systems that control responses to threat. The revised Reinforcement Sensitivity Theory of personality predicts that individual differences in the reactivity of these brain systems produce anxiety and fear-related personality traits. Here we discuss some of the challenges in testing this theory and, as an example, present a pilot study that aimed to dissociate brain activity during pursuit by threat and goal conflict. We did this by translating the Mouse Defense Test Battery for human fMRI use. In this version, dubbed the Joystick Operated Runway Task (JORT), we repeatedly exposed 24 participants to pursuit and goal conflict, with and without threat of electric shock. The runway design of JORT allowed the effect of threat distance on brain activation to be evaluated independently of context. Goal conflict plus threat of electric shock caused deactivation in a network of brain areas that included the fusiform and middle temporal gyri, as well as the default mode network core, including medial frontal regions, precuneus and posterior cingulate gyrus, and laterally the inferior parietal and angular gyri. Consistent with earlier research, we also found that imminent threat activated the midbrain and that this effect was significantly stronger during the simple pursuit condition than during goal conflict. Also consistent with earlier research, we found significantly greater hippocampal activation during goal conflict than pursuit by imminent threat. In conclusion, our results contribute knowledge to theories linking anxiety disorders to altered functioning in defensive brain systems and also highlight challenges in this research domain.
Following an extensive contact tracing exercise at a school in a London borough with one of highest tuberculosis (TB) rates in England, we estimated the background prevalence of latent TB infection to be significantly less than the widely accepted 10%. We screened 271 pupils aged 14–15 years in two groups: 96 pupils in group 1 had significant exposure (>8 h/week in the same room) to a case of infectious TB and 175 in group 2 who had minimal exposure. In group 1, 26% were diagnosed with latent or active TB, compared to 6.3% in group 2. Risk factors for TB infection (e.g. previous exposure or link to high-prevalence communities) were analysed using a cohort study design. In the univariable analysis only being in contact group 1 was statistically significantly associated with being a case (OR 5.25, 95%, P < 0.001). In the multivariable model contact group 1 remained significantly associated with being a case (adjusted OR 4.40, P = 0.001). We concluded that the 6.3% yield of TB infection in contact group 2 is either similar to or higher than the background prevalence rate of latent TB infection (LTBI) in this high TB prevalence London borough. Other parts of England with lower TB prevalence are likely to have even lower LTBI rates.
To assess the association between food insecurity and depression symptom severity stratified by sex, and test for evidence of effect modification by social network characteristics.
A population-based cross-sectional study. The nine-item Household Food Insecurity Access Scale captured food insecurity. Five name generator questions elicited network ties. A sixteen-item version of the Hopkins Symptom Checklist for Depression captured depression symptom severity. Linear regression was used to estimate the association between food insecurity and depression symptom severity while adjusting for potential confounders and to test for potential network moderators.
In-home survey interviews in south-western Uganda.
All adult residents across eight rural villages; 96 % response rate (n 1669).
Severe food insecurity was associated with greater depression symptom severity (b=0·4, 95 % CI 0·3, 0·5, P<0·001 for women; b=0·3, 95 % CI 0·2, 0·4, P<0·001 for men). There was no evidence of effect modification by social network factors for women. However, for men who are highly embedded within in their village social network, and (separately) for men who have few poor contacts in their personal network, the relationship between severe food insecurity and depression symptoms was stronger than for men on the periphery of their village social network, and for men with many poor personal network contacts, respectively.
In this population-based study from rural Uganda, food insecurity was associated with mental health for both men and women. Future research is needed on networks and food insecurity-related shame in relation to depression symptoms among food-insecure men.
When Abdul Halim Sharar (1860-1926) set sail for England to ensure the Eton College-bound son of Viqar-ul Omrah (Prime Minister of the Nizam of Hyderabad, 1894–1901) received an Indo-Islamic education, it was Sharar's first foray outside of India. Like many previous Indian travelers he found his experiences to be eye opening. Inspired by his sojourns in England, Italy, France, and Spain, he serially published his travelogues upon his return to India in 1896. Providing examples of the failures and successes of industrialization, such accounts were evocative in their detail. They provided middle class Indians with global and historical perspectives of the changes brought by colonialism, industrialization, and urbanization in European and Indian cities. Drawing from Sharar's and other travelers’ accounts of the period, this essay examines the use of literature to humanize Lucknow's urban landscape, not only to transform the city, but also the relationship between the city and its inhabitants into one of sympathy and affection.
It is increasingly essential for medical researchers to be literate in statistics, but the requisite degree of literacy is not the same for every statistical competency in translational research. Statistical competency can range from ‘fundamental’ (necessary for all) to ‘specialized’ (necessary for only some). In this study, we determine the degree to which each competency is fundamental or specialized.
We surveyed members of 4 professional organizations, targeting doctorally trained biostatisticians and epidemiologists who taught statistics to medical research learners in the past 5 years. Respondents rated 24 educational competencies on a 5-point Likert scale anchored by ‘fundamental’ and ‘specialized.’
There were 112 responses. Nineteen of 24 competencies were fundamental. The competencies considered most fundamental were assessing sources of bias and variation (95%), recognizing one’s own limits with regard to statistics (93%), identifying the strengths, and limitations of study designs (93%). The least endorsed items were meta-analysis (34%) and stopping rules (18%).
We have identified the statistical competencies needed by all medical researchers. These competencies should be considered when designing statistical curricula for medical researchers and should inform which topics are taught in graduate programs and evidence-based medicine courses where learners need to read and understand the medical research literature.
School attendance rates in sub-Saharan Africa are among the lowest worldwide, placing children at heightened risk for poor educational and economic outcomes. One understudied risk factor for missed schooling is household water insecurity, which is linked to depression among women and may increase children's water-fetching burden at the expense of educational activities, particularly among children of depressed caregivers. In this study conducted in rural Uganda, we assessed the association between household water insecurity and child school participation and the mediating pathways behind these associations.
We conducted a population-based, cross-sectional study of female household heads (N = 257) and their children ages 5–17 (N = 551) in the rural regions surrounding the town of Mbarara, in southwestern Uganda. We used multivariable linear regressions to estimate the association between water insecurity and missed schooling. We then assessed the extent to which the association was mediated by caregiver depression.
Among children, water insecurity had a statistically significant association with the number of missed school days (a standard deviation increase in water insecurity resulted in 0.30 more missed school days in the last week). The estimated association was partially mediated by caregiver depression. When stratified by sex, this mediating pathway remained significant for boys, but not among girls.
Water insecurity is a risk factor for missed schooling among children in rural Uganda. Caregiver depression partially mediated this relationship. Also addressing caregiver mental health in water insecure families may more fully address the needs of sub-Saharan African families and promote educational participation among youth.
Introduction: The current study examined the level of agreement in expired-air carbon monoxide (CO) values, focusing especially on those confirming abstinence, between the two most commonly used CO monitors, the Vitalograph BreathCO and the Bedfont piCO+ Smokerlyzer.
Methods: Expired-air samples were collected via both monitors from adult dependent smokers (44 M, 34 F) participating in studies using CO values to confirm abstinence durations of: 24 hours, 12 hours, or no abstinence. All met DSM-IV nicotine dependence criteria and had a mean (SD) Fagerström Test of Cigarette Dependence score of 5.1 (1.8). Paired data collected across multiple visits were analyzed by regression-based Bland–Altman method of Limits of Agreement (LoA).
Findings: Analysis indicated a lack of agreement in CO measurement between monitors. Overall, the Bedfont monitor gave mean (±SEM) readings 3.83 (±0.23) ppm higher than the Vitalograph monitor. Mean differences between monitors were larger for those ad lib smoking (5.65 ± 0.38 ppm) than those abstaining 12–24 hours (1.71 ± 0.13 ppm). Yet, there also was not consistent agreement in classification of 24-hour abstinence between monitors.
Conclusions: Systematic differences in CO readings demonstrate these two very common monitors may not result in interchangeable values, and reported outcomes in smoking research based on CO values may depend on the monitor used.
Concern has been expressed recently that Se may increase the risk of type 2 diabetes, but this has not been tested in a randomised-controlled trial (RCT) in pregnant women. We took advantage of having stored plasma samples from the Se in Pregnancy Intervention (SPRINT) RCT of Se supplementation in pregnancy to test the effect of Se supplementation on a marker of insulin resistance in UK pregnant women. Because our blood samples were not fasted, we measured plasma adiponectin concentration, a recognised marker of insulin resistance that gives valid measurements in non-fasted samples, as diurnal variability is minor and there is no noticeable effect of food intake. In SPRINT, 230 primiparous UK women were randomised to treatment with Se (60 μg/d) or placebo from 12 weeks of gestation until delivery. We hypothesised that supplementation with Se at a nutritional level would not exacerbate the fall in adiponectin concentration that occurs in normal pregnancy, indicating the lack of an adverse effect on insulin resistance. Indeed, there was no significant difference between the two groups in the change in adiponectin from 12 to 35 weeks (P=0·938), nor when the analysis was restricted to the bottom or top quartiles of baseline whole-blood Se (P=0·515 and 0·858, respectively). Cross-sectionally, adiponectin concentration was not associated with any parameter of Se status, either at 12 or 35 weeks. It is reassuring that a nutritional dose of Se had no adverse effect on the concentration of adiponectin, a biomarker of insulin resistance, in pregnant women of modest Se status.
To describe key characteristics of the dietary habits of Samoans residing in Logan, Queensland and to compare these characteristics with comparable populations.
Dietary intake was measured using a self-administered structured questionnaire between December 2012 and March 2013. Demographic characteristics included age and sex. Questionnaire results were compared with data from samples of Brisbane residents of similar social and economic characteristics and Pacific Islanders in New Zealand. The association between demographic characteristics and diet was investigated.
Logan, Queensland, Australia.
Samoans aged 16 years and older.
A total of 207 Samoans participated, ninety-six (46 %) of whom were male. Of the participants, seventy-nine (38 %) were aged 16–29 years, sixty-three (30 %) were aged 30–49 years and sixty-five (31 %) were aged ≥50 years. Younger adults were significantly more likely to eat hamburgers, pizza, cakes, savoury pastries, potato crisps, sweets and soft drinks (all variables P<0·001). Among Samoans, 44·7 % consumed two or more pieces of fruit daily, compared with 43·8 % of comparable Brisbane residents (relative risk=1·0; 95 % CI 0·8, 1·2). Three or more servings of vegetables each day were consumed by 9·2 % of Samoans compared with 36·6 % of comparable Brisbane residents (relative risk=3·8; 95 % CI 2·5, 6·0).
Samoans are consuming significantly fewer vegetables and more discretionary foods than other populations. Socio-economic factors, length of stay in Australia and cultural practices may impact upon Samoans’ diets. Further comprehensive studies on Samoans’ dietary habits in Australia are recommended.
In the second half of the nineteenth century an increasing number of Indians entered the world of volunteerism and public activism. One such individual was the prolific Urdu writer Abdul Halim Sharar (1860–1926), who served as the secretary for a short-lived voluntary association, the Anjuman-e Dar-us-Salam, during the late 1880s in Lucknow, India. Using readers’ letters as printed in Sharar's widely circulating monthly periodical, Dil Gudāz, this article seeks to understand the reasons behind the increasing role of volunteerism as part and parcel of a modern sharīf Muslim identity in the post-1857 period. Having adopted the role of a community activist, Sharar began using his periodical, soon after its inception, to mobilize and recruit his readers to participate in what he described as a passionate movement sweeping through the ‘Islami pablik’. Both rhetorical and descriptive, such an idea provided hope for a divided and struggling community to overcome the divisions that were central to their many challenges in a post-1857 world. Through the study of the vicissitudes and challenges faced by Sharar and his fellow activists, this article underscores the ways in which public activism and volunteerism simultaneously represented the possibility for Muslims to use their own resources to bring about real social and political change, and also reminded them of their shortcomings and the limits of an informal activism. This article seeks to show that ultimately, even such ‘failed’ and ephemeral attempts were foundational for more effective mass mobilization efforts in the following decades and into the twentieth century.
A series of research reports has indicated that the use of substances such as cannabis, alcohol and tobacco are higher in youth at clinical high risk (CHR) of developing psychosis than in controls. Little is known about the longitudinal trajectory of substance use, and findings on the relationship between substance use and later transition to psychosis in CHR individuals are mixed.
At baseline and 6- and 12-month follow-ups, 735 CHR and 278 control participants completed the Alcohol and Drug Use Scale and a cannabis use questionnaire. The longitudinal trajectory of substance use was evaluated with linear mixed models.
CHR participants endorsed significantly higher cannabis and tobacco use severity, and lower alcohol use severity, at baseline and over a 1-year period compared with controls. CHR youth had higher lifetime prevalence and frequency of cannabis, and were significantly younger upon first use, and were more likely to use alone and during the day. Baseline substance use did not differentiate participants who later transitioned to psychosis (n = 90) from those who did not transition (n = 272). Controls had lower tobacco use than CHR participants with a prodromal progression clinical outcome and lower cannabis use than those with a psychotic clinical outcome at the 2-year assessment.
In CHR individuals cannabis and tobacco use is higher than in controls and this pattern persists across 1 year. Evaluation of clinical outcome may provide additional information on the longitudinal impact of substance use that cannot be detected through evaluation of transition/non-transition to psychosis alone.