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A battery of 32 tests was administered to a sample including 144 Air Force Officer Candidates and 139 Air Cadets. The factor analysis, using Thurstone's complete centroid method and Zimmerman's graphic method of orthogonal rotations, revealed 12 interpretable factors. The non-reasoning factors were interpreted as verbal comprehension, numerical facility, perceptual speed, visualization, and spatial orientation. The factors derived from reasoning tests were identified as general reasoning, logical reasoning, education of perceptual relations, education of conceptual relations, education of conceptual patterns, education of correlates, and symbol substitution. The logical-reasoning factor corresponds to what has been called deduction, but eduction of correlates is perhaps closer to an ability actually to make deductions. The area called induction appears to resolve into three eduction-of-relations factors. Reasoning factors do not appear always to transcend the type of test material used.
Passive oxygenation with non-rebreather face mask (NRFM) has been used during cardiac arrest as an alternative to positive pressure ventilation (PPV) with bag-valve-mask (BVM) to minimize chest compression disruptions. A dual-channel pharyngeal oxygen delivery device (PODD) was created to open obstructed upper airways and provide oxygen at the glottic opening. It was hypothesized for this study that the PODD can deliver oxygen as efficiently as BVM or NRFM and oropharyngeal airway (OPA) in a cardiopulmonary resuscitation (CPR) manikin model.
Methods:
Oxygen concentration was measured in test lungs within a resuscitation manikin. These lungs were modified to mimic physiologic volumes, expansion, collapse, and recoil. Automated compressions were administered. Five trials were performed for each of five arms: (1) CPR with 30:2 compression-to-ventilation ratio using BVM with 15 liters per minute (LPM) oxygen; continuous compressions with passive oxygenation using (2) NRFM and OPA with 15 LPM oxygen, (3) PODD with 10 LPM oxygen, (4) PODD with 15 LPM oxygen; and (5) control arm with compressions only.
Results:
Mean peak oxygen concentrations were: (1) 30:2 CPR with BVM 49.3% (SD = 2.6%); (2) NRFM 47.7% (SD = 0.2%); (3) PODD with 10 LPM oxygen 52.3% (SD = 0.4%); (4) PODD with 15 LPM oxygen 62.7% (SD = 0.3%); and (5) control 21% (SD = 0%). Oxygen concentrations rose rapidly and remained steady with passive oxygenation, unlike 30:2 CPR with BVM, which rose after each ventilation and decreased until the next ventilation cycle (sawtooth pattern, mean concentration 40% [SD = 3%]).
Conclusions:
Continuous compressions and passive oxygenation with the PODD resulted in higher lung oxygen concentrations than NRFM and BVM while minimizing CPR interruptions in a manikin model.
Antimicrobial resistance (AMR) renders many bacterial infections untreatable and results in substantial morbidity and mortality worldwide. Understanding antibiotic use in clinical settings including hospitals is critical to optimize antibiotic use and prevent resistance.
Design:
Hospital antibiotic point prevalence survey (PPS).
Methods:
The study was conducted in two large, teaching hospitals in Addis Ababa, Ethiopia. We performed two survey rounds in December 2021 and January 2022 through real-time chart review using the World Health Organization PPS methodology. Data were collected using a web-based database, and descriptive statistics were performed to analyze antibiotic use by various characteristics.
Results:
Among 1020 hospitalized patients, 318 (32%) were ≤14 years and 370 (36%) had surgery during the current hospitalization. A total of 662 (65%) were receiving an antibiotic on the day of survey and 346 (39%) were receiving ≥2 antibiotics. A community-acquired infection (43%) was the most common indication for an antibiotic followed by surgical prophylaxis (27%) and hospital-acquired infection (23%). Antibiotic use was highest among those ≤24 months in age and among patients in trauma, surgical, and pediatric wards. Cephalosporin (42%) and penicillin (16%) antibiotics were the most frequently prescribed classes. Only 11% of patients on antibiotics had samples collected for microbiological testing; hence, almost all antibiotic therapy was empiric.
Conclusions:
Despite global and national efforts to improve antimicrobial stewardship, antibiotic use remains high in urban teaching hospitals in Ethiopia. Implementation of antimicrobial stewardship activities and microbiology utilization are needed to guide antimicrobial selection and curtail antibiotic overuse.
Emerging evidence suggests that routine physical activity may improve exercise capacity, long-term outcomes, and quality of life in individuals with Fontan circulation. Despite this, it is unclear how active these individuals are and what guidance they receive from medical providers regarding physical activity. The aim of this study was to survey Fontan patients on personal physical activity behaviours and their cardiologist-directed physical activity recommendations to set a baseline for future targeted efforts to improve this.
Methods:
An electronic survey assessing physical activity habits and cardiologist-directed guidance was developed in concert with content experts and patients/parents and shared via a social media campaign with Fontan patients and their families.
Results:
A total of 168 individuals completed the survey. The median age of respondents was 10 years, 51% identifying as male. Overall, 21% of respondents spend > 5 hours per week engaged in low-exertion activity and only 7% spend > 5 hours per week engaged in high-exertion activity. In all domains questioned, pre-adolescents reported higher participation rates than adolescents. Nearly half (43%) of respondents reported that they do not discuss activity recommendations with their cardiologist.
Conclusions:
Despite increasing evidence over the last two decades demonstrating the benefit of exercise for individuals living with Fontan circulation, only a minority of patients report engaging in significant amounts of physical activity or discussing activity goals with their cardiologist. Specific, individualized, and actionable education needs to be provided to patients, families, and providers to promote and support regular physical activity in this patient population.
Maternal diet may modulate human milk microbiota, but the effects of nutritional supplements are unknown. We examined the associations of prenatal diet and supplement use with milk microbiota composition. Mothers reported prenatal diet intake and supplement use using self-administered food frequency and standardised questionnaires, respectively. The milk microbiota was profiled using 16S rRNA gene sequencing. Associations of prenatal diet quality, dietary patterns, and supplement use with milk microbiota diversity and taxonomic structure were examined using Wilcoxon signed-rank tests and multivariable models adjusting for relevant confounders. A subset of 645 mothers participating in the CHILD Cohort Study (originally known as the Canadian Healthy Infant Longitudinal Development Study) provided one milk sample between 2 and 6 months postpartum and used prenatal multivitamin supplements ≥4 times a week. After adjusting for confounders, vitamin C supplement use was positively associated with milk bacterial Shannon diversity (β = 0.18, 95% CI = 0.05, 0.31) and Veillonella and Granulicatella relative abundance (β = 0.54; 95% CI = 0.05, 1.03 and β = 0.44; 95% CI = 0.04, 0.84, respectively), and negatively associated with Finegoldia relative abundance (β = –0.31; 95% CI = –0.63, –0.01). Fish oil supplement use was positively associated with Streptococcus relative abundance (β = 0.26; 95% CI = 0.03, 0.50). Prenatal diet quality and dietary patterns were not associated with milk microbiota composition. Prenatal vitamin C and fish oil supplement use were associated with differences in the milk microbiota composition. Future studies are needed to confirm our findings and elucidate mechanisms linking maternal supplement use to milk microbiota and child health.
At low levels of hydration, exchangeable D+ in montmorillonite interacts with lattice OH groups and quantitatively converts AlMgOH groups to AlMgOD. Hydroxyl groups coordinated to two Al ions undergo a slower exchange, the extent of which is restricted by octahedral Fe3+ ions. The OH stretching vibration of AlMgOH groups in montmorillonite is assigned an unusually high frequency (3687 cm−1) compared with that of the same group in phengites (3602 cm−1).
Dementia in-patient units (DIU) are mental health wards that care for people living with dementia (PLWD) whose symptoms are causing severe distress or potential risk. DIUs look after some of the most vulnerable and unwell people in society, yet they are environments that are underresearched: a recent systematic review revealed only 36 articles worldwide relating to DIUs. To better understand research priorities in DIUs, we undertook a two-round online Delphi survey of PLWD with experience of DIUs, their carers and professionals who work in DIUs.
Results
Ten research priorities were described and ranked. The top three were how to use non-pharmacological techniques to manage non-cognitive symptoms of dementia, supporting families and better understanding of how to discharge PLWD safely and healthily.
Clinical implications
This is the first Delphi consensus to describe DIU research priorities. This paper will help researchers focus on the areas that matter most to people who use DIUs.
Infrared and Mössbauer spectroscopy show that the extent of the reduction of nontronite is dependent on the chemical composition of the nontronite and on the nature of the reducing agent. Hydrazine reversibly reduces about 10% of the iron in all of the nontronites studied irrespective of composition and it is suggested that the resulting ferrous iron occurs only in distorted octahedral sites. Similar conclusions are reached for the dithionite reduction of the nontronites containing little tetrahedral iron, but for those with more than one in eight silicons replaced by iron, changes brought about by dithionite treatment are irreversible due to dissolution of appreciable quantities of iron. Results from both spectroscopic techniques suggest that iron in tetrahedral sites is preferentially dissolved and that up to 80% of the structural iron can be reduced.
Evidence is presented for the formation in these extensively reduced nontronites of a small amount of a mica-like phase resembling celadonite or glauconite, and, as dithionite is used for the pretreatment of soils, the implication of this observation is briefly discussed.
The use of deuterated hydrazine as a reducing agent has enabled the nontronite absorption band near 850 cm-1 to be assigned to a Si-O (apical) stretching vibration, which is inactive in the infrared for perfect hexagonal symmetry, but which is activated by distortions in the tetrahedral layer.
Mössbauer and i.r. spectra of a series of nontronites show that Fe3+ and Al3+ are distributed between tetrahedral and octahedral sites. The Mössbauer results have reaffirmed the occupation by Fe3+ of octahedral sites at which these ions are coordinated to pairs of OH groups in both cis and trans configurations. The distribution of Fe3+ between these two sites varies considerably but in all of the nontronites some Fe3+ occurs in the trans site in contrast to the all cis occupancy of the centro-symmetric structure proposed by Mering and Oberlin (1967). In one of the nontronites the distribution of Fe3+ between these two sites approaches that in the ideal non-centrosymmetric structure proposed for montmorillonite.
The adsorption of sodium, chloride, and phosphate ions by allophane, imogolite, and halloysite has been studied in relation to the surface structure of the mineral samples. The high adsorption of phosphate (>200 μmole/g) and chloride (10–30 meq/100 g at pH 4) by allophane is ascribed to the small particle size of allophane, its high surface area (∼800 m2/g), and the presence at the surface of Al-OH-Al groups and defect sites. In contrast, halloysite has a relatively large particle size and a Si-O-Si surface. Accordingly, the adsorption of phosphate (5–10 μmole/g) and chloride (1 meq/100 g) by halloysite is very much lower as compared with allophane. Phosphate adsorption by halloysite is also related to particle morphology and the number of edge sites. Thus, a sample consisting entirely of spheroidal particles adsorbed only 5 μmole/g at a solution concentration of 1 × 10−4 M, whereas the tubular types of comparable surface area adsorbed 7–10 μmole/g at the same concentration. This is because spheroidal halloysite particles have few, if any, edge sites at which phosphate can adsorb. The relative degree of order and hydration of halloysite, as indicated by infrared spectroscopy, also affects phosphate adsorption. However, this factor is apparently less important than particle morphology and surface structure. Although imogolite also has an Al-OH-Al surface, it contains relatively few defect sites where phosphate can adsorb. Consequently, much less phosphate (120 μmole/g) was adsorbed as compared with allophane.
Globally, human house types are diverse, varying in shape, size, roof type, building materials, arrangement, decoration and many other features. Here we offer the first rigorous, global evaluation of the factors that influence the construction of traditional (vernacular) houses. We apply macroecological approaches to analyse data describing house features from 1900 to 1950 across 1000 societies. Geographic, social and linguistic descriptors for each society were used to test the extent to which key architectural features may be explained by the biophysical environment, social traits, house features of neighbouring societies or cultural history. We find strong evidence that some aspects of the climate shape house architecture, including floor height, wall material and roof shape. Other features, particularly ground plan, appear to also be influenced by social attributes of societies, such as whether a society is nomadic, polygynous or politically complex. Additional variation in all house features was predicted both by the practices of neighouring societies and by a society's language family. Collectively, the findings from our analyses suggest those conditions under which traditional houses offer solutions to architects seeking to reimagine houses in light of warmer, wetter or more variable climates.
From the safety inside vehicles, Knowsley Safari offers visitors a close-up encounter with captive olive baboons. As exiting vehicles may be contaminated with baboon stool, a comprehensive coprological inspection was conducted to address public health concerns. Baboon stools were obtained from vehicles, and sleeping areas, inclusive of video analysis of baboon–vehicle interactions. A purposely selected 4-day sampling period enabled comparative inspections of 2662 vehicles, with a total of 669 baboon stools examined (371 from vehicles and 298 from sleeping areas). As informed by our pilot study, front-line diagnostic methods were: QUIK-CHEK rapid diagnostic test (RDT) (Giardia and Cryptosporidium), Kato–Katz coproscopy (Trichuris) and charcoal culture (Strongyloides). Some 13.9% of vehicles were contaminated with baboon stool. Prevalence of giardiasis was 37.4% while cryptosporidiosis was <0.01%, however, an absence of faecal cysts by quality control coproscopy, alongside lower than the expected levels of Giardia-specific DNA, judged RDT results as misleading, grossly overestimating prevalence. Prevalence of trichuriasis was 48.0% and strongyloidiasis was 13.7%, a first report of Strongyloides fuelleborni in UK. We advise regular blanket administration(s) of anthelminthics to the colony, exploring pour-on formulations, thereafter, smaller-scale indicator surveys would be adequate.
With the increase in hectares planted to auxin-resistant cotton, the number of preplant, at-plant, and postplant applications of dicamba and 2,4-D choline to aid in the control of troublesome broadleaf weeds, including glyphosate-resistant Palmer amaranth, has increased. More dicamba and 2,4-D choline applications mean an increased risk of off-target movement. Field studies were conducted in 2019 to 2021 at the Texas Tech University New Deal Research Farm to evaluate dicamba-resistant cotton response to various rates of 2,4-D choline when applied at four growth stages (first square [FS] + 2 wk, first bloom [FB], FB + 2 wk, and FB + 4 wk). Applications of 2,4-D choline were applied at 1,060 (1X), 106 (1/10X), 21 (1/50X), 10.6 (1/100X), 2.1 (1/500X), and 1.06 (1/1000X) g ae ha−1 to Deltapine 1822 XF cotton. Relative to the nontreated control, yield losses were observed in all years at FS + 2 wk and FB from rates of 2,4-D choline ≥ 1/100X. At the FB + 4 wk application, only the 1X rate of 2,4-D choline resulted in a yield reduction in all three years. Micronaire, fiber length, and uniformity were negatively influenced by the 1/10X and 1X rates of 2,4-D choline at various timings in 2019, 2020, and 2021. In addition, short fiber content, neps, and seed coat neps increased where micronaire, fiber length, and uniformity were negatively impacted.
The Diabetes Prevention Program (DPP) is a widely implemented 12-month behavioural weight loss programme for individuals with prediabetes. The DPP covers nutrition but does not explicitly incorporate cooking skills education. The objective of the current study is to describe food and cooking skills (FACS) and strategies of recent DPP participants.
Design:
Photo-elicitation in-depth interviews were conducted from June to August, 2021.
Setting:
Baltimore, MD, USA.
Participants:
Thirteen Black women who participated in DPP.
Results:
The DPP curriculum influenced participants’ healthy cooking practices. Many participants reported shifting from frying foods to air-frying and baking foods to promote healthier cooking and more efficient meal preparation. Participants also reported that their participation in DPP made them more mindful of consuming fruits and vegetables and avoiding foods high in carbohydrates, fats, sugars and Na. With respect to food skills, participants reported that they were more attentive to reading labels and packaging on foods and assessing the quality of ingredients when grocery shopping.
Conclusions:
Overall, participants reported changing their food preferences, shopping practices and cooking strategies to promote healthier eating after completing the DPP. Incorporating hands-on cooking skills and practices into the DPP curriculum may support sustained behaviour change to manage prediabetes and prevent development of type 2 diabetes among participants.
A dynamical understanding of the physical process of surface gravity wave breaking remains an unresolved problem in fluid dynamics. Conceptually, breaking can be described by inception and onset, where breaking inception is the initiation of unknown irreversible processes within a wave crest that precede the visible manifestation of breaking onset. In the search for an energetic indicator of breaking inception, we use an ensemble of non-breaking and breaking crests evolving within unsteady wave packets simulated in a numerical wave tank to investigate the evolution of each term in the kinetic energy balance equation. We observe that breaking onset is preceded by around one quarter of a wave period by a rapid increase in the rate of convergence of kinetic energy that triggers an irreversible acceleration of the kinetic energy growth rate. This energetic signature, which is present only for crests that subsequently break, arises when the kinetic energy growth rate exceeds a critical threshold. At this point the additional kinetic energy convergence cannot be offset by converting excess kinetic energy to potential energy or by dissipation through friction. Our results suggest that the ratio of the leading terms of the kinetic energy balance equation at the time of this energetic signature is proportional to the strength of the breaking crest. Hence this energetic inception point both predicts the occurrence of breaking onset and indicates the strength of the breaking event.
Only 6 to 8 % of the UK adults meet the daily recommendation for dietary fibre. Fava bean processing lead to vast amounts of high-fibre by-products such as hulls. Bean hull fortified bread was formulated to increase and diversify dietary fibre while reducing waste. This study assessed the bean hull: suitability as a source of dietary fibre; the systemic and microbial metabolism of its components and postprandial events following bean hull bread rolls. Nine healthy participants (53·9 ± 16·7 years) were recruited for a randomised controlled crossover study attending two 3 days intervention sessions, involving the consumption of two bread rolls per day (control or bean hull rolls). Blood and faecal samples were collected before and after each session and analysed for systemic and microbial metabolites of bread roll components using targeted LC-MS/MS and GC analysis. Satiety, gut hormones, glucose, insulin and gastric emptying biomarkers were also measured. Two bean hull rolls provided over 85 % of the daily recommendation for dietary fibre; but despite being a rich source of plant metabolites (P = 0·04 v. control bread), these had poor systemic bioavailability. Consumption of bean hull rolls for 3 days significantly increased plasma concentration of indole-3-propionic acid (P = 0·009) and decreased faecal concentration of putrescine (P = 0·035) and deoxycholic acid (P = 0·046). However, it had no effect on postprandial plasma gut hormones, bacterial composition and faecal short chain fatty acids amount. Therefore, bean hulls require further processing to improve their bioactives systemic availability and fibre fermentation.
The purpose of this document is to highlight practical recommendations to assist acute-care hospitals in prioritization and implementation of strategies to prevent healthcare-associated infections through hand hygiene. This document updates the Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals through Hand Hygiene, published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.
Malformed trilobite specimens present important insight into understanding how this extinct arthropod group recovered from developmental or moulting malfunctions, pathologies, and injuries. Previously documented examples of malformed trilobite specimens are often considered in isolation, with few studies reporting on multiple malformations in the same species. Here we report malformed specimens of the ellipsocephaloid trilobite Estaingia bilobata from the Emu Bay Shale Konservat-Lagerstätte (Cambrian Series 2, Stage 4) on Kangaroo Island, South Australia. Ten malformed specimens exhibiting injuries, pathologies, and a range of teratologies are documented. Furthermore, five examples of mangled exoskeletons are presented, indicative of predation on E. bilobata. Considering the position of malformed and normal specimens of E. bilobata in bivariate space, we demonstrate that the majority of malformed specimens cluster among the larger individuals. Such specimens may exemplify larger forms successfully escaping predation attempts, but could equally represent individuals exhibiting old injuries that were made during earlier (smaller) growth stages that have healed through subsequent moulting events. The available evidence from the Emu Bay Shale suggests that this small, extremely abundant trilobite likely played an important role in the structure of the local ecosystem, occupying a low trophic level and being preyed upon by multiple durophagous arthropods. Furthermore, the scarcity of malformed E. bilobata specimens demonstrates how rarely injuries, developmental malfunctions, and pathological infestations occurred within the species.