Adhering to a Mediterranean diet (MD) is associated with reduced CVD risk. This study aimed to explore methods of increasing MD adoption in a non-Mediterranean population at high risk of CVD, including assessing the feasibility of a developed peer support intervention. The Trial to Encourage Adoption and Maintenance of a MEditerranean Diet was a 12-month pilot parallel group RCT involving individuals aged ≥ 40 year, with low MD adherence, who were overweight, and had an estimated CVD risk ≥ 20 % over ten years. It explored three interventions, a peer support group, a dietician-led support group and a minimal support group to encourage dietary behaviour change and monitored variability in Mediterranean Diet Score (MDS) over time and between the intervention groups, alongside measurement of markers of nutritional status and cardiovascular risk. 118 individuals were assessed for eligibility, and 75 (64 %) were eligible. After 12 months, there was a retention rate of 69 % (peer support group 59 %; DSG 88 %; MSG 63 %). For all participants, increases in MDS were observed over 12 months (P < 0·001), both in original MDS data and when imputed data were used. Improvements in BMI, HbA1c levels, systolic and diastolic blood pressure in the population as a whole. This pilot study has demonstrated that a non-Mediterranean adult population at high CVD risk can make dietary behaviour change over a 12-month period towards an MD. The study also highlights the feasibility of a peer support intervention to encourage MD behaviour change amongst this population group and will inform a definitive trial.

To investigate the current epidemiology of melioidosis in Yangon, Myanmar, between June 2017 and May 2019 we conducted enhanced surveillance for melioidosis in four tertiary hospitals in Yangon, where the disease was first discovered in 1911. Oxidase-positive Gram-negative rods were obtained from the microbiology laboratories and further analysed at the Department of Medical Research. Analysis included culture on Ashdown agar, the three disc sensitivity test (gentamicin, colistin and co-amoxiclav), latex agglutination, API 20 NE, antibiotic susceptibility testing, and a subset underwent molecular confirmation with a Burkholderia pseudomallei specific assay. Twenty one of 364 isolates (5.7%) were confirmed as B. pseudomallei and were mostly susceptible to the antibiotics used in standard therapy for melioidosis. Ten patients were from Yangon Region, nine were from Ayeyarwaddy region, and one each was from Kayin and Rakhine States. A history of soil contact was given by seven patients, five had diabetes mellitus and one had renal insufficiency. The patients presented with septicaemia (12 cases), pneumonia (three cases), urinary tract infection (two cases) and wound infection (four cases). Eighteen patients survived to hospital discharge. This study highlights the likelihood that melioidosis may be far more common, but underdiagnosed, in more rural parts of Myanmar as in other countries in SE Asia.

Antarctica's ice shelves modulate the grounded ice flow, and weakening of ice shelves due to climate forcing will decrease their ‘buttressing’ effect, causing a response in the grounded ice. While the processes governing ice-shelf weakening are complex, uncertainties in the response of the grounded ice sheet are also difficult to assess. The Antarctic BUttressing Model Intercomparison Project (ABUMIP) compares ice-sheet model responses to decrease in buttressing by investigating the ‘end-member’ scenario of total and sustained loss of ice shelves. Although unrealistic, this scenario enables gauging the sensitivity of an ensemble of 15 ice-sheet models to a total loss of buttressing, hence exhibiting the full potential of marine ice-sheet instability. All models predict that this scenario leads to multi-metre (1–12 m) sea-level rise over 500 years from present day. West Antarctic ice sheet collapse alone leads to a 1.91–5.08 m sea-level rise due to the marine ice-sheet instability. Mass loss rates are a strong function of the sliding/friction law, with plastic laws cause a further destabilization of the Aurora and Wilkes Subglacial Basins, East Antarctica. Improvements to marine ice-sheet models have greatly reduced variability between modelled ice-sheet responses to extreme ice-shelf loss, e.g. compared to the SeaRISE assessments.

Neonatal aortic thrombosis is a rare occurrence but can be life-threatening. Most aortic thrombosis in neonates is related to umbilical artery catheters. A case of a neonate with a spontaneous aortic thrombosis is described here along with a comprehensive review of the literature for cases of neonatal aortic thrombosis not related to any intravascular device or procedure. The aetiologies of these spontaneous thromboses and the relevance of hypercoagulable disorders are discussed. The cases were analysed for odds of death by treatment method adjusted for era. The reference treatment method was thrombolysis and anticoagulation. No other treatment modality had significantly lower odds than the reference. Surgery alone had higher odds for death than the reference, but this may be confounded by severity of case. The management recommendations for clinicians encountering neonates with spontaneous neonatal aortic thrombosis are discussed.

Watermelon [Citrullus lanatus (Thunb.) Matsum & Nakai] grafting is commonly used for management of diseases caused by soilborne pathogens; however, little research exists describing the effect of grafting on the weed-competitive ability of watermelon. Field experiments determined the response in yield, fruit number, and fruit quality of grafted and nongrafted watermelon exposed to increasing densities of Palmer amaranth (Amaranthus palmeri S. Watson). Grafting treatments included ‘Exclamation’ triploid (seedless) watermelon grafted on two interspecific hybrid squash rootstocks ‘Carnivor’ and ‘Kazako’, with nongrafted Exclamation as the control. Weed treatments included A. palmeri at densities of 1, 2, 3, and 4 A. palmeri plants per watermelon planting hole (0.76-m row) and a weed-free control. Increasing A. palmeri densities caused significant reductions (P <0.05) in marketable watermelon yield and marketable fruit number. Watermelon yield reduction was described by a rectangular hyperbola model, and 4 A. palmeri plants planting hole−1 reduced marketable yield 41%, 38%, and 65% for Exclamation, Carnivor, and Kazako, respectively. Neither grafting treatment nor A. palmeri density had a biologically meaningful effect on soluble solids content or on the incidence of hollow heart in watermelon fruit. Amaranthus palmeri seed and biomass production was similar across weed population densities, but seed number per female A. palmeri decreased according to a two-parameter exponential decay equation. Thus, increasing weed population densities resulted in increased intraspecific competition among A. palmeri plants. While grafting may offer benefits for disease resistance, no benefits regarding weed-competitive ability were observed, and a consistent yield penalty was associated with grafting, even in weed-free treatments.

Field experiments determined the critical period for weed control (CPWC) in grafted and nongrafted watermelon [Citrullus lanatus (Thumb.) Matsum. & Nakai] grown in plasticulture. Transplant types included ‘Exclamation’ seedless watermelon as the nongrafted control as well as Exclamation grafted onto two interspecific hybrid squash (ISH) rootstocks, ‘Carnivor’ and ‘Kazako’. To simulate weed emergence throughout the season, establishment treatments (EST) consisted of two seedlings each of common purslane (Portulaca oleracea L.), large crabgrass [Digitaria sanguinalis (L.) Scop.], and yellow nutsedge (Cyperus esculentus L.) transplanted in a 15 by 15 cm square centered on watermelon plants at 0, 2, 3, 4, and 6 wk after watermelon transplanting (WATr) and remained until the final watermelon harvest at 11 WATr. To simulate weed control at different times in the season, removal treatments (REM) consisted of two seedlings of the same weed species transplanted in a 15 by 15 cm square centered on watermelon plants on the same day of watermelon transplanting and allowed to remain until 2, 3, 4, 6, and 11 WATr, at which time they were removed. Season-long weedy and weed-free controls were included for both EST and REM studies in both years. For all transplant types, aboveground biomass of weeds decreased as weed establishment was delayed and increased as weed removal was delayed. The predicted CPWC for nongrafted Exclamation and Carnivor required only a single weed removal between 2.3 and 2.5 WATr and 1.9 and 2.6 WATr, respectively, while predicted CPWC for Kazako rootstock occurred from 0.3 to 2.6 WATr. Our study results suggest that weed control for this mixed population of weeds would be similar between nongrafted Exclamation and Exclamation grafted onto Carnivor. But the observed CPWC of Exclamation grafted onto Kazako suggests that CPWC may vary with specific rootstock–scion combinations.

Field studies were conducted to determine watermelon tolerance and yield response when treated with bicyclopyrone preplant (PREPLANT), POST, and POST-directed (POST-DIR). Treatments consisted of two rates of bicyclopyrone (37.5 and 50 g ai ha–1), fomesafen (175 g ai ha–1), S-metolachlor (802 g ai ha–1), and a nontreated check. Preplant treatments were applied to formed beds 1 d prior to transplanting and included bicyclopyrone (37.5 and 50 g ha–1) and fomesafen (175 g ha–1), and new polyethylene mulch was subsequently laid above treated beds. POST and POST-DIR treatments were applied 14 ± 1 d after watermelon transplanting and included bicyclopyrone (37.5 and 50 g ha–1) POST and POST-DIR, and S-metolachlor (802 g ai ha–1) POST-DIR. POST-DIR treatments were applied to row middles, ensuring that no herbicide contacted watermelon vines or polyethylene mulch. At 2 wk after transplanting (WAT), 15% foliar bleaching was observed in watermelon treated with bicyclopyrone (50 g ha–1) PRE. At 3 WAT, bicyclopyrone (37.5 and 50 g ha–1) POST caused 16% and 17% foliar bleaching and 8% and 9% crop stunting, respectively. At 4 WAT, initial injury had subsided and bicyclopyrone (37.5 and 50 g ha–1) POST caused 4% and 4% foliar bleaching and 4% and 8% crop stunting, respectively. No symptoms of bleaching or stunting were observed at 6- and 8-WAT ratings. Watermelon total yield, marketable yield, total fruit number, marketable fruit number, and average fruit size were unaffected by herbicide treatments. Therefore, registration of bicyclopyrone (37.5 and 50 g ha–1) PREPLANT, POST, and POST-DIR would offer watermelon producers a safe herbicide option and a novel mode of action for weed management.

Introduction: Tobacco use is common among people who have been in prison. The relationship between social stressors, risky health behaviours, and smoking cessation has not been studied in people recently released from prison. Studying this relationship could yield information that guides strategic and cost-effective tobacco cessation interventions for an under-resourced population.

Methods: One hundred and forty-three smokers were interviewed 7 to 21 days after they had been released from USA prisons. Independent variables included employment status, housing security, relationship problems, educational achievement, risky drinking behaviour, recent drug use, history of drug dependence, and depression. The primary outcome was ‘trying to quit smoking.’ Data were analysed using Pearson chi-square tests and single and multivariable logistic regression models.

Results: Of those who had to quit smoking due to tobacco-free prison policies, 98% reported relapsing on tobacco after release. Trying to quit smoking was associated with the absence of risky drinking behaviour in the past 30 days (adjusted odds ratio [AOR] 6.44, 95% confidence interval [CI] 2.02–20.48).

Conclusions: The absence of risky drinking behaviour is associated with trying to quit smoking among people recently released from prison. Further research may determine whether interventions addressing risky alcohol use can reduce smoking relapse.

We analyzed birth order differences in means and variances of height and body mass index (BMI) in monozygotic (MZ) and dizygotic (DZ) twins from infancy to old age. The data were derived from the international CODATwins database. The total number of height and BMI measures from 0.5 to 79.5 years of age was 397,466. As expected, first-born twins had greater birth weight than second-born twins. With respect to height, first-born twins were slightly taller than second-born twins in childhood. After adjusting the results for birth weight, the birth order differences decreased and were no longer statistically significant. First-born twins had greater BMI than the second-born twins over childhood and adolescence. After adjusting the results for birth weight, birth order was still associated with BMI until 12 years of age. No interaction effect between birth order and zygosity was found. Only limited evidence was found that birth order influenced variances of height or BMI. The results were similar among boys and girls and also in MZ and DZ twins. Overall, the differences in height and BMI between first- and second-born twins were modest even in early childhood, while adjustment for birth weight reduced the birth order differences but did not remove them for BMI.