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 email@example.com
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.
Depressive symptoms are highly prevalent among partnered dementia caregivers, but the mechanisms are unclear. This study examined the mediating role of loneliness in the association between dementia and other types of care on subsequent depressive symptoms.
Prospective data from partnered caregivers were drawn from the English Longitudinal Study of Aging. The sample consisted of 4,672 partnered adults aged 50–70 living in England and Wales, followed up between 2006–2007 and 2014–2015. Caregiving was assessed across waves 3 (2006–2007), 4 (2008–2009), and 5 (2010–2011), loneliness at wave 6 (2012–2013), and subsequent depressive symptoms at wave 7 (2014–15). Multivariable logistic regression models were used to assess the association between caregiving for dementia and depressive symptoms compared to caregiving for other illnesses (e.g., diabetes, coronary heart disease (CHD), cancer, and stroke). Binary mediation analysis was used to estimate the indirect effects of caregiving on depressive symptoms via loneliness.
Care for a partner with dementia was associated with higher odds of depressive symptoms at follow-up compared to those not caring for a partner at all (odds ratio [OR] = 2.6, 95% confidence intervals [CI]: 1.4, 5.1). This association was partially mediated by loneliness (34%). Care for a partner with other conditions was also associated with higher odds of depressive symptoms compared to non-caregiving partners (OR = 1.7, 95% CI: 1.2, 2.5), but there was no evidence of an indirect pathway via loneliness.
Loneliness represents an important contributor to the relationship between dementia caregiving and subsequent depressive symptoms; therefore, interventions to reduce loneliness among partnered dementia caregivers should be considered.
Introduction: Emergency department (ED) crowding is a major problem across Canada. We studied the ability of artificial intelligence methods to improve patient flow through the ED by predicting patient disposition using information available at triage and shortly after patients’ arrival in the ED. Methods: This retrospective study included all visits to an urban, academic, adult ED between May 2012 and June 2019. For each visit, 489 variables were extracted including triage data that had been collected for use in the Canadian Triage Assessment Scale (CTAS) and information regarding laboratory tests, radiological tests, consultations and admissions. A training set consisting of all visits from April 2012 up to December 2018 was used to train 5 classes of machine learning models to predict admission to the hospital from the ED. The models were trained to predict admission at the time of the patient's arrival in the ED and every 30 minutes after arrival until 6 hours into their ED stay. The performance of models was compared using the area under the ROC curve (AUC) on a test set consisting of all visits from January 2019 to June 2019. Results: The study included 536,332 visits and the admission rate was 15.0%. Gradient boosting models generally outperformed other machine learning models. A gradient boosting model using all available data at 2 hours after patient arrival in the ED yielded a test set AUC 0.92 [95% CI 0.91-0.93], while a model using only data available at triage yielded an AUC 0.90 [95% CI 0.89-0.91]. The quality of predictions generally improved as predictions were made later in the patient's ED stay leading to an AUC 0.95 [95% CI 0.93-0.96] at 6 hours after arrival. A gradient boosting model with 20 variables available at 2 hours after patient arrival in the ED yielded an AUC 0.91 [95% CI 0.89-0.93]. A gradient boosting model that makes predictions at 2 hours after arrival in ED using only variables that are available at all EDs in the province of Quebec yielded an AUC 0.91 [95% 0.89-0.92]. Conclusion: Machine learning can predict admission to a hospital from the ED using variables that area collected as part of routine ED care. Machine learning tools may potentially be used to help ED physicians to make faster and more appropriate disposition decisions, to decrease unnecessary testing and alleviate ED crowding.
Antiferroelectrics have been studied for decades, with most research focused on PbZrO3 or related compounds obtained through chemical substitution. Although there are several important antiferroelectrics found in AVO4 (A=Dy, Bi), orthorhombic ABC semiconductors (e.g., MgSrSi) and hydrogen-bonded antiferroelectric materials, experimentally demonstrated antiferroelectrics are far less common. Furthermore, antiferroelectrics have potential applications in energy storage and for strain and force generators. In recent years, hybrid improper ferroelectrics have been intensively studied, along which the hybrid improper antiferroelectric phase was proposed and demonstrated in (001) Ruddlesden−Popper A3B2O7 thin films from first-principles calculations. Later, the hybrid improper antiferroelectric phase was discovered experimentally in several Ruddlesden−Popper perovskites in bulk. Across the hybrid improper ferroelectric-antiferroelectric phase transition, several interesting phenomena were also predicted. In this snapshot review, we describe recent progress in hybrid improper antiferroelectricity.
The Murchison Widefield Array (MWA) is an open access telescope dedicated to studying the low-frequency (80–300 MHz) southern sky. Since beginning operations in mid-2013, the MWA has opened a new observational window in the southern hemisphere enabling many science areas. The driving science objectives of the original design were to observe 21 cm radiation from the Epoch of Reionisation (EoR), explore the radio time domain, perform Galactic and extragalactic surveys, and monitor solar, heliospheric, and ionospheric phenomena. All together
programs recorded 20 000 h producing 146 papers to date. In 2016, the telescope underwent a major upgrade resulting in alternating compact and extended configurations. Other upgrades, including digital back-ends and a rapid-response triggering system, have been developed since the original array was commissioned. In this paper, we review the major results from the prior operation of the MWA and then discuss the new science paths enabled by the improved capabilities. We group these science opportunities by the four original science themes but also include ideas for directions outside these categories.
The characteristics and dynamics of the uniform-momentum zones (UMZ) and UMZ interfaces in a fully developed turbulent pipe flow are studied using direct numerical simulation at
. The multiple UMZs detected from the probability density functions of the instantaneous streamwise velocity following de Silva et al. (J. Fluid Mech., vol. 786, 2016, pp. 309–331) showed similarities to both turbulent channel and boundary layer flows (TBL): the hierarchical structural distribution of thinner UMZs with thinner interfaces nearer the wall, accompanied with sharper and larger jumps in the streamwise velocity at the UMZ interface. The conditional average results indicate that channel and pipe are very similar quantitatively whereas pipe and TBL display significant discrepancies. The innermost UMZs in pipe flow exhibit different behaviours to the other UMZs in pipes. The contortion of the UMZ interface representing the meandering of coherent motions with high- and low-momentum streaks is examined three-dimensionally. The meandering of UMZ in both two and three dimensions intensifies away from the wall and is always wavier in the azimuthal direction than the streamwise direction. The UMZs in the near-wall region capture the small-scale velocity fluctuation of the near-wall cycle and show asymmetric modulation of
sweeps. The asymmetric modulation of ejections over sweeps decreases from the wall towards the pipe centre and the opposite trend of elevated
sweeps is observed for the innermost UMZs. Near the wall, the ejection regions are very spiky compared to the flat sweep regions whereas, in the pipe centre, the large-scale ejections are relatively flat and the sweep regions are spikier.
l-Carnitine is essential for mitochondrial β-oxidation and has been used as a lipid-lowering feed additive in humans and farmed animals. d-Carnitine is an optical isomer of l-carnitine and dl-carnitine has been widely used in animal feeds. However, the functional differences between l- and d-carnitine are difficult to study because of the endogenous l-carnitine background. In the present study, we developed a low-carnitine Nile tilapia model by treating fish with a carnitine synthesis inhibitor, and used this model to investigate the functional differences between l- and d-carnitine in nutrient metabolism in fish. l- or d-carnitine (0·4 g/kg diet) was fed to the low-carnitine tilapia for 6 weeks. l-Carnitine feeding increased the acyl-carnitine concentration from 3522 to 10 822 ng/g and alleviated the lipid deposition from 15·89 to 11·97 % in the liver of low-carnitine tilapia. However, as compared with l-carnitine group, d-carnitine feeding reduced the acyl-carnitine concentration from 10 822 to 5482 ng/g, and increased lipid deposition from 11·97 to 20·21 % and the mRNA expression of the genes involved in β-oxidation and detoxification in the liver. d-Carnitine feeding also induced hepatic inflammation, oxidative stress and apoptosis. A metabolomic investigation further showed that d-carnitine feeding increased glycolysis, protein metabolism and activity of the tricarboxylic acid cycle and oxidative phosphorylation. Thus, l-carnitine can be physiologically utilised in fish, whereas d-carnitine is metabolised as a xenobiotic and induces lipotoxicity. d-Carnitine-fed fish demonstrates increases in peroxisomal β-oxidation, glycolysis and amino acid degradation to maintain energy homeostasis. Therefore, d-carnitine is not recommended for use in farmed animals.
Polarimetric studies of pulsars at low radio frequencies provide important observational insights into the pulsar emission mechanism and beam models, and probe the properties of the magneto-ionic interstellar medium (ISM). Aperture arrays are the main form of next-generation low-frequency telescopes, including the Murchison Widefield Array (MWA). These require a distinctly different approach to data processing (e.g. calibration and beamforming) compared to traditional dish antennas. As the second paper of this series, we present a verification of the MWA’s pulsar polarimetry capability, using two bright southern pulsars, PSRs J0742–2822 and J1752–2806. Our observations simultaneously cover multiple frequencies (76–313 MHz) and were taken at multiple zenith angles (ZA) during a single night for each pulsar. We show that the MWA can be reliably calibrated for ZA ≲45° and frequencies ≲270 MHz. We present the polarimetric profiles for PSRs J0742–2822 and J1752–2806 at frequencies lower than 300 MHz for the first time, along with an analysis of the linear polarisation degree and pulse profile evolution with frequency. For PSR J0742–2822, the measured degree of linear polarisation shows a rapid decrease at low frequencies, in contrast with the generally expected trend, which can be attributed to depolarisation effects from small-scale, turbulent, magneto-ionic ISM components. This effect has not been widely explored for pulsars in general and will be further investigated in future work.
We introduce CRYSTAL, a multi-agent AI system for crystal-structure phase mapping. CRYSTAL is the first system that can automatically generate a portfolio of physically meaningful phase diagrams for expert-user exploration and selection. CRYSTAL outperforms previous methods to solve the example Pd-Rh-Ta phase diagram, enabling the discovery of a mixed-intermetallic methanol oxidation electrocatalyst. The integration of multiple data-knowledge sources and learning and reasoning algorithms, combined with the exploitation of problem decompositions, relaxations, and parallelism, empowers AI to supersede human scientific data interpretation capabilities and enable otherwise inaccessible scientific discovery in materials science and beyond.
Pathogenesis of pregnancy toxemia (PT) is believed to be associated with the disruption of lipid metabolism. The present study aimed to explore the underlying mechanisms of lipid metabolism disorder in the livers of ewes with PT. In total, 10 pregnant ewes were fed normally (control group) whereas another 10 were subjected to 70% level feed restriction for 15 days to establish a pathological model of PT. Results showed that, as compared with the controls, the levels of blood β-hydroxybutyrate (BHBA), non-esterified fatty acids (NEFAs) and cholesterol were greater (P<0.05) and blood glucose level was lower (P<0.05) in PT ewes. The contents of NEFAs, BHBA, cholesterol and triglyceride were higher (P<0.05) and glycerol content was lower (P<0.05) in hepatic tissues of PT ewes than those of the controls. For ewes with PT, excessive fat vacuoles were observed in liver sections stained with hematoxylin–eosin; furthermore, inner structures of hepatocytes including nuclei, mitochondria and endoplasmic reticulum were damaged seriously according to the results of transmission electron microscope. Real-time PCR data showed that compared with the controls, the expression of hepatic genes involved in fatty acid oxidation (FAO) and triglyceride synthesis (TGS) was enhanced (P<0.05) whereas that related to acetyl-CoA metabolism (ACM) was repressed (P<0.05) in PT ewes. Generally, our results showed that negative energy balance altered the expression of genes involved in FAO, ACM and TGS, further caused lipid metabolism disorder in livers, resulting in PT of ewes. Our findings may provide the molecular basis for novel therapeutic strategies against this systemic metabolic disease in sheep.
Nitrogen (N) is a difficult nutrient to manage in organic farming systems, and yield reductions related to N deficiency have been reported in organic systems. Legume-based cover crops offer opportunities for biologically fixed N; however, improved quantification of N contribution is needed for cost-effective N management. A 2-yr experiment was conducted near Corvallis, OR, USA, in 2007 and 2008 to (1) evaluate biomass production and N accumulation from selected cover crop treatments, (2) compare the effects of fall-planted cover crops on broccoli [(Brassica oleraceae L. (Italica group)] yield, (3) estimate the quantity of feather meal-N replaced by cover crops. Cover crop treatments included common vetch (Vicia sativa L.), phacelia (Phacelia tanacetifolia Benth), oats (Avena sativa L.) and the mixtures phacelia plus vetch, oats plus vetch and a no-cover crop (fallow) treatment as the control. Using feather meal as an N source, four rates of N fertilizer (0, 100, 200 and 300 kg N ha−1) were randomized within each cover crop treatment in a randomized, split-plot design. Cover crop biomass and N accumulation differed between the 2 yr of the study. In 2007, total biomass accumulation ranged from 5000 to 10,000 kg ha−1, whereas in 2008, cover crop accumulation was 1500 to 5000 kg ha−1. Biomass of both phacelia and vetch (in mixtures or as sole crops) was reduced by 80% from 2007 to 2008, whereas oat biomass and weed biomass in the fallow plots was reduced by only 40% between the 2 yr. The accumulation of N was also reduced in 2008, with vetch (either as a sole crop or in mixtures) contributing less than a third of total N produced in 2007. In 2007, vetch and vetch-based cover crop mixtures increased broccoli yield compared with the fallow, providing 100–135 kg fertilizer equivalent N ha−1. But due to decreased cover crop biomass and N accumulation in 2008, vetch and vetch-based mixtures failed to increase broccoli yield, providing <20 kg N ha−1 fertilizer equivalence. In 2007, oats grown as a sole cover crop reduced broccoli yield when no supplemental N was applied. In 2008, both phacelia and oats reduced broccoli yield at all N levels, with estimated N fertilizer equivalence values of −80 to −95 kg N ha−1. Although legume and legume mixtures increased broccoli yield in only 1 yr of the experiment, addition of vetch to the mixtures reduced yield loss in both years compared with oats and phacelia grown as sole crops.
Introduction: Deep vein thrombosis (DVT) can lead to significant morbidity and mortality if not diagnosed and treated promptly. Currently, few methods aside from venous duplex scanning can rule out DVT in patients presenting to the Emergency Department (ED). Current screening tools, including the use of the subjective Wells score, frequently leads to unnecessary investigations and anticoagulation. In this study, we sought to determine whether two-site compression point-of-care ultrasound (POCUS) combined with a negative age-adjusted D-dimer test can accurately rule out DVT in ED patients irrespective of the modified Wells score. Methods: This is a single-center, prospective observational study in the ED of the Jewish General Hospital in Montreal. We are recruiting a convenience sample of patients presenting to the ED with symptoms suggestive of DVT. All enrolled patients are risk-stratified using the modified Wells criteria for DVT, then undergo two-site compression POCUS, and testing for age-adjusted D-dimer. Patients with DVT unlikely according to modified Wells score, negative POCUS and negative age-adjusted D-dimer are discharged home and receive a three-month phone follow-up. Patients with DVT likely according to modified Wells score, a positive POCUS or a positive age-adjusted D-dimer, will undergo a venous duplex scan. A true negative DVT is defined as either a negative venous duplex scan or a negative follow-up phone questionnaire for patients who were sent home without a venous duplex scan. Results: Of the 42 patients recruited thus far, the mean age is 56 years old and 42.8% are male. Twelve (28.6%) patients had DVT unlikely as per modified Wells score, negative POCUS and negative age-adjusted D-dimer and were discharged home. None of these patients developed a DVT on three-month follow-up. Thirty patients (71.4%) had either a DVT likely as per modified Wells score, a positive POCUS or a positive age-adjusted D-dimer and underwent a venous duplex scan. Of those, six patients had a confirmed DVT (3 proximal & 3 distal). POCUS detected all proximal DVTs, while combined POCUS and age-adjusted D-dimer detected all proximal and distal DVTs. None of the patients with a negative POCUS and age-adjusted D-dimer were found to have a DVT. Conclusion: Two-site compression POCUS combined with a negative age-adjusted D-dimer test appears to accurately rule out DVT in ED patients without the need for follow-up duplex venous scan. Using this approach would alleviate the need to calculate the Wells score, and also reduce the need for radiology-performed duplex venous scan for many patients.
Increasing evidence has demonstrated that the environmental conditions experienced by parents can shape offspring phenotypes. Here, we examined the effects of the photoperiod and temperature experienced by parents on the incidence of diapause in their progeny in the cabbage beetle, Colaphellus bowringi, using three experiments. The first experiment examined parental diapause incidence under different photoperiods at 25°C and the incidence of diapause in progeny from both non-diapausing and diapausing parents under the same rearing conditions. The results revealed that the incidence of diapause among progeny was exactly opposite to that of their parents, i.e., higher parental diapause incidence led to lower progeny diapause incidence, showing a negative relationship in diapause incidence between the parental generation and the progeny generation. The incidence of diapause among progeny produced by diapausing parents was higher than that in progeny produced by non-diapausing parents. The second experiment examined parental diapause incidence at different temperatures under LD 12:12 and the incidence of diapause in progeny from both non-diapausing and diapausing parents under the same rearing conditions. Similarly, the incidence of diapause in progeny was also opposite to that of their parents. However, the incidence of diapause in progeny produced by non-diapausing parents was different from that in progeny produced by diapausing parents. In the third experiment, naturally diapausing adults were maintained at a constant temperature of 9, 28°C or the mean daily summer temperature of 27.84°C under continuous darkness for 3 months of dormancy. After dormancy, the progeny of these post-diapause parents were reared under different photoperiods at 25°C. The results showed that the incidence of diapause among progeny was higher when their parents experienced high temperatures than when they experienced low temperatures. All results demonstrate that the photoperiod and temperature experienced by parents may significantly affect the diapause incidence among progeny.
Radiocarbon (14C) in dissolved inorganic carbon (DIC) was measured for water samples collected from six deep stations in the Kuroshio Extension (KE) region in the northwestern North Pacific in April–May 2015. Vertical profiles of Δ14C-DIC indicate that bomb-produced 14C was present from the surface to ~1500 m water depth. Large variations in Δ14C-DIC values (300‰) were observed at 500 m water depth among the stations and the differences were likely controlled by transport and mixing dynamics of different water masses in the region. The major Pacific western boundary currents, such as Kuroshio and Oyashio and regional mesoscale eddies, could play important roles affecting the observed Δ14C-DIC variability. The depth profiles of both Δ14C-DIC and DIC concentrations can be predicted by the solution mixing model and can be used as conservative tracers of water mass movement and water parcel homogenization in the ocean.
The Murchison Widefield Array, and its recently developed Voltage Capture System, facilitates extending the low-frequency range of pulsar observations at high-time and -frequency resolution in the Southern Hemisphere, providing further information about pulsars and the ISM. We present the results of an initial time-resolved census of known pulsars using the Murchison Widefield Array. To significantly reduce the processing load, we incoherently sum the detected powers from the 128 Murchison Widefield Array tiles, which yields ~10% of the attainable sensitivity of the coherent sum. This preserves the large field-of-view (~450 deg2 at 185 MHz), allowing multiple pulsars to be observed simultaneously. We developed a WIde-field Pulsar Pipeline that processes the data from each observation and automatically folds every known pulsar located within the beam. We have detected 50 pulsars to date, 6 of which are millisecond pulsars. This is consistent with our expectation, given the telescope sensitivity and the sky coverage of the processed data (~17 000 deg2). For 10 pulsars, we present the lowest frequency detections published. For a subset of the pulsars, we present multi-frequency pulse profiles by combining our data with published profiles from other telescopes. Since the Murchison Widefield Array is a low-frequency precursor to the Square Kilometre Array, we use our census results to forecast that a survey using the low-frequency component of the Square Kilometre Array Phase 1 can potentially detect around 9 400 pulsars.
Optimal nitrogen (N) management for maize in the film-mulched production systems that are widely used in dryland agriculture is difficult because top-dressing N is impractical. The current research determined how matching N supply and demand was achieved before and after silking stages, when single applications of controlled release urea (CRU) were combined with conventional urea in film-mulched maize production. The CRU: urea mixture was applied in a 1 : 2 or 2 : 1 ratio and all three fertilizer regimes (urea alone and CRU: urea at 1 : 2 or 2 : 1) were applied at N rates of 180 and 240 kg/ha over 2 years. The 1 : 2 CRU: urea mixture, applied once at 180 kg N/ha, was found to synchronize N supply with demand, thereby reducing N losses. The highest grain yields (11·8–12·0 t/ha), N uptake (232–239 kg/ha), N recovery (65·8–67·7%) and high net economic return were achieved with this regime. These results indicate that a single application of a mixture of CRU and urea can synchronize N supply with demand and provide higher yields and profits than conventional N fertilization in film-mulched maize systems.
The North China Craton (NCC) is one of the classic examples of decratonization through extensive lithospheric destruction during Mesozoic time. Among the various pulses of magmatism associated with cratonic erosion are the rare mafic intrusions in the Yanshan Belt. Here we investigate the Shangzhuang layered intrusion belonging to this suite, which is characterized by compositional layering with troctolite, noritic gabbro and gabbro/gabbroic anorthosite/gabbrodiorite from the bottom to top. The different lithologies of this intrusion exhibit close field relationships, similar chemical patterns and overall identical Lu–Hf isotopes indicating a co-magmatic nature. The fine-grained gabbros occurring near the margin of the intrusion display U–Pb ages similar to those of the other rocks and are considered to represent the composition of the parent magma, characterized by Fe, Mg and Ti enrichment. The magma was sourced from low-degree partial melting of spinel lherzolite sub-continental lithospheric mantle, which had been enriched by crust–mantle interaction and metasomatic fluids derived from the Mongolian oceanic slab subduction beneath the NCC during Late Palaeozoic time. In addition, limited asthenospheric or deeper-mantle materials were also locally mixed with the enriched mantle as the final source component. Our zircon U–Pb data constrain the emplacement age of this intrusion as c. 128–123 Ma in Early Cretaceous time, and correlates with the regional extensional tectonics between c. 135 and 115 Ma in the eastern and central NCC. Mantle upwelling associated with this event resulted in the thermal and chemical erosion of the lithospheric mantle, and emplacement of the parent magma of this layered intrusion.
Introduction: Undiagnosed deep vein thrombosis (DVT) can lead to significant morbidity and mortality, including death from DVT-associated massive pulmonary embolism (PE). While several validated clinical prediction rules, blood test and imaging modalities exist to investigate a potential DVT, there is currently a lack of rapid, accessible and reliable methods to exclude the possibility of DVT without resorting to formal venous duplex scanning. Currently, the use in the ED of a validated clinical prediction rule combined to either a high-sensitivity D-dimer test or ultrasonography of the lower extremities has a poor predictive value, as 75-90% of patients suspected of DVT have a negative formal venous duplex scan. Compression bedside ultrasound has however recently been shown to be a safe, rapid and accurate method for the diagnosis of proximal DVT in the emergency department with a high sensitivity and specificity (combined sensitivity and specificity of 96.1% and 96.8%, respectively1). Research question: In the present study, we will primarily assess whether two-site compression POCUS combined with a negative age-adjusted D-dimer test can accurately rule out DVT in ED patients regardless of the Wells criteria. Methods: This is a single-center, prospective, observational study carried out over one year in the Emergency Department of the Jewish General Hospital in Montreal, Quebec. We aim to enroll a convenience sample of 475 patients aged 18 years and older presenting to the ED with symptoms suggestive of a DVT. All enrolled patients will receive the standard of care required for a lower leg DVT presentation. After calculating Patients DVT risk using modified wells criteria, all patients will undergo POCUS for DVT followed by a D-dimer test. Based on their results, patients will either undergo formal duplex scanning, or will be discharged without further testing and receive a three-month phone follow-up. A true negative lower leg DVT will be defined as follows: (1) Negative follow-up phone questionnaire for patients who were sent home with no formal duplex venous scanning. (2) Negative formal duplex venous scanning for patients who were deemed likely to have lower leg DVT using the Wells score, with a negative D-dimer and POCUS. Age adjusted DVT was added to account for below knee DVT and avoid the need for patients to return for fellow up duplex study in 1 week. To estimate our technique’s sensitivity with a 4% margin of error with 95% confidence intervals, 92 confirmed DVT patients are needed. We expect to recruit a total 475 patients within one-year period at the JGH (95 DVT-positive patients and 380 DVT-negative patients). Impact: The use of compression bedside ultrasound with a negative age-adjusted D-dimer test to rule out DVT in the ED may accelerate the decision regarding patient disposition and significantly decrease the length of patient stay in the ED. In addition, it may help avoid unnecessary medical interventions and diagnostic tests, thus representing potential quality of care and cost-saving improvements as well.
The fruit of Ligustrum lucidum (FLL, Nuzhenzi in Chinese) is an important traditional medicine, and have attracted significant research attention because of their various biological activities. However, there are few research reports available on the use of FLL as a feed additive in livestock nutrition, particularly in layers. This study was conducted to determine the effects of supplementation of the diet of laying hens with FLL on laying performance, egg quality and blood metabolites. A total of 360 72-week-old hens were allocated to three dietary treatments (eight replications of 15 hens/treatment group) and were fed either a control diet or a diet supplemented with an inclusion level of 0.25% or 0.50% of FLL powder in the final feed, until 78 weeks of age. Hens were housed in a three-tier cage system. Feed and water were provided ad libitum. Blood samples and eggs were collected at the end of the experiment. The results showed that dietary supplementation with FLL did not affect egg weight, feed conversion ratio, eggshell thickness, albumen height, egg yolk color, eggshell breaking strength or egg shape index. However, FLL supplementation significantly decreased (P<0.001) mortality, cracked-egg rate and blood serum levels of cholesterol, low-density lipoprotein cholesterol, triglycerides and alanine aminotransferase, and increased (P<0.001) blood serum levels of high-density lipoprotein cholesterol. No differences in serum levels of total protein, albumin, glucose, calcium, aspartate aminotransferase or alkaline phosphatase were observed in hens fed FLL compared with the control group. It can be concluded that FLL, at a supplementation level of 0.25% final feed, can be used as an effective feed additive to improve the performance of laying hens during the late laying period.