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Many data-driven patient risk stratification models have not been evaluated prospectively. We performed and compared the prospective and retrospective evaluations of 2 Clostridioides difficile infection (CDI) risk-prediction models at 2 large academic health centers, and we discuss the models’ robustness to data-set shifts.
Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation tool designed to probe the strength of inhibitory and excitatory neurotransmission in the cortex. Combined with electromyography, paired-pulse TMS paradigms have revealed a deficit in inhibition mediated by GABA-A receptors in patients with schizophrenia. Combined TMS-electroencephalography (TMS-EEG) provides a more detailed examination of cortical excitability and may shed more light into the pathophysiology of schizophrenia. Of the various peaks of the TMS-evoked EEG signal, responses at 45 (N45) and 100 ms (N100) likely reflect GABA-A and GABA-B receptor-mediated inhibition, respectively. Responses at 25 ms (P25) are affected by voltage-gated channel ligands, whereas glutamatergic processes may be related to the P70 component. We here aim to systematically investigate the role of these neural processes in patients with schizophrenia by using TMS-EEG.
TMS-evoked EEG potentials (TEPs) were recorded in patients with schizophrenia (n = 19) and in age-matched healthy controls (n = 17). 150 TMS pulses at 90% of resting motor threshold were applied over the left primary motor cortex during EEG recording. Differences in TEPs between the two groups were analysed for all electrodes and for time windows corresponding to each TEP (P25: 0.015-0.035 ms; N45: 0.035-0.06 ms; P70: 0.035-0.06 ms; N100: 0.09-0.14ms) by applying multiple independent sample t-tests. Further, a cluster-based permutation analysis approach was implemented to correct for multiple comparisons.
Compared to controls, patients showed amplitude reduction for the P25 (negative and positive cluster; p < 0.001 and p = 0.04, respectively), N45 (negative and positive cluster; p < 0.001 and p = 0.001, respectively) and P70 component (negative and positive cluster; p = 0.04 and p = 0.004, respectively).
There results extend on previous literature about impairment of GABA-A receptor mediated inhibition in schizophrenia, as demonstrated by the N45 amplitude reduction, whereas no significant differences in GABA-B index (i.e., N100) were revealed. Our results also showed that, although specific mechanisms underlying P25 and P70 have not been fully elucidated yet, excitatory neurotransmission is altered in this clinical population. To conclude, TMS-EEG may provide a more comprehensive view of the inhibitory and excitatory mechanisms involved in the pathophysiology of schizophrenia.
The aim of the current study was to establish whether the neighbourhood food environment, characterised by the healthiness of food outlets, the diversity of food outlets and fast-food outlet density within a 500 m or 1000 m street network buffer around the home address, contributed to ethnic differences in diet quality.
Cross-sectional cohort study.
Amsterdam, the Netherlands.
Data on adult participants of Dutch, South-Asian Surinamese, African Surinamese, Turkish and Moroccan descent (n total 4728) in the HELIUS study were analysed.
The neighbourhood food environment of ethnic minority groups living in Amsterdam is less supportive of a healthy diet and of less diversity than that of participants of Dutch origin. For example, participants of Turkish, Moroccan and South-Asian Surinamese descent reside in a neighbourhood with a significantly higher fast-food outlet density (≤1000 m) than participants of Dutch descent. However, we found no evidence that neighbourhood food environment characteristics directly contributed to ethnic differences in diet quality.
Although ethnic minority groups lived in less healthy food environments than participants of ethnic Dutch origin, this did not contribute to ethnic differences in diet quality. Future research should investigate other direct or indirect consequences of residing in less supportive food environments and gain a better understanding of how different ethnic groups make use of their neighbourhood food environment.
The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.
In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.
From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.
A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.
This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.
Many biological processes are partitioned among organs and tissues, necessitating tissue-specific or organ-specific analysis (particularly for comparative -omics studies). Standardised techniques for tissue identification and dissection are therefore imperative for comparing among studies. Here we describe dissection protocols for isolating six key tissues/organs from larvae of the Asian longhorned beetle, Anoplophora glabripennis (Motschulsky) (Coleoptera: Cerambycidae): the supraoesophageal ganglion, posterior midgut, hindgut, Malpighian tubules, fat body, and thoracic muscle. We also describe how to extract haemolymph and preserve whole larvae for measurements such as protein, lipid, and carbohydrate content. We include dissection protocols for both fresh-killed and previously frozen specimens. Although this protocol is developed for A. glabripennis, it should allow standardised tissue collection from larvae of other cerambycids and be readily transferrable to other beetle taxa with similar larval morphology.
The aim of this study was to develop and externally validate a simple-to-use nomogram for predicting the survival of hospitalised human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients (hospitalised person living with HIV/AIDS (PLWHAs)). Hospitalised PLWHAs (n = 3724) between January 2012 and December 2014 were enrolled in the training cohort. HIV-infected inpatients (n = 1987) admitted in 2015 were included as the external-validation cohort. The least absolute shrinkage and selection operator method was used to perform data dimension reduction and select the optimal predictors. The nomogram incorporated 11 independent predictors, including occupation, antiretroviral therapy, pneumonia, tuberculosis, Talaromyces marneffei, hypertension, septicemia, anaemia, respiratory failure, hypoproteinemia and electrolyte disturbances. The Likelihood χ2 statistic of the model was 516.30 (P = 0.000). Integrated Brier Score was 0.076 and Brier scores of the nomogram at the 10-day and 20-day time points were 0.046 and 0.071, respectively. The area under the curves for receiver operating characteristic were 0.819 and 0.828, and precision-recall curves were 0.242 and 0.378 at two time points. Calibration plots and decision curve analysis in the two sets showed good performance and a high net benefit of nomogram. In conclusion, the nomogram developed in the current study has relatively high calibration and is clinically useful. It provides a convenient and useful tool for timely clinical decision-making and the risk management of hospitalised PLWHAs.
A scalable battery recycling strategy to recover and regenerate solid electrolytes and cathode materials in spent all solid-state batteries, reducing energy consumption and greenhouse gases.
With the rapidly increasing ubiquity of lithium-ion batteries (LIBs), sustainable battery recycling is a matter of growing urgency. The major challenge faced in LIB sustainability lies with the fact that the current LIBs are not designed for recycling, making it difficult to engineer recycling approaches that avoid breaking batteries down into their raw materials. Thus, it is prudent to explore new approaches to both fabricate and recycle next-generation batteries before they enter the market. Here, we developed a sustainable design and scalable recycling strategy for next-generation all solid-state batteries (ASSBs). We use the EverBatt model to analyze the relative energy consumption and environmental impact compared to conventional recycling methods. We demonstrate efficient separation and recovery of spent solid electrolytes and electrodes from a lithium metal ASSB and directly regenerate them into usable formats without damaging their core chemical structure. The recycled materials are then reconstituted to fabricate new batteries, achieving similar performance as pristine ASSBs, completing the cycle. This work demonstrates the first fully recycled ASSB and provides critical design consideration for future sustainable batteries.
Distillers dried grains with solubles (DDGS) are highly susceptible to lipid oxidation because DDGS contain about 10% crude fat, which is largely composed of polyunsaturated fatty acids. l-carnitine serves an important function in fatty acids β-oxidation, and also has antioxidant properties. The objective of this study was to examine the effects of l-carnitine in the DDGS diet of gestating and lactating sows on reproductive performance, milk composition and antioxidant status of sows and their offspring. One hundred and twenty sows (Landrace×Large white, mean parity 4.2, initial BW 230 kg) were randomly allotted to 1 of 4 dietary treatments (n=30 sows/treatment). Treatments were arranged as a 2×2 factorial with two levels of dietary DDGS (0 v. 250 g/kg in gestating diets and 400 g/kg in lactating diets) and two levels of dietary l-carnitine (0 v. 100 mg/kg in gestating diets and 0 v. 200 mg/kg in lactating diets). Distillers dried grains with solubles had no significant effect on litter size but significantly reduced the birth weights and weaning weights of piglets (P<0.05). Distillers dried grains with solubles reduced the antioxidant enzyme activities (P<0.05) and increased the malondialdehyde level in the plasma of sows on day 60 of gestation (P=0.004) and day 14 of lactation (P=0.008). The compositions of colostrum and milk were not affected by inclusion of DDGS and dietary l-carnitine (P>0.05). Supplementing the diets with l-carnitine had no significant effect of total litter size (P>0.05) but increased the number of piglets born alive and piglets weaned, birth weight and weaning weight of piglets and litter weight at birth and weaning (P<0.05). l-carnitine supplementation also increased the concentration of l-carnitine in milk and l-carnitine status of piglets (P<0.05). The antioxidant enzyme activities of new born and weaning piglets were increased (P<0.05) by maternal dietary l-carnitine but this did not extend to finishing pigs. In conclusion, including DDGS in the sows diet could induce oxidative stress, which may be associated with the reduced individual birth and weaning weight of piglets. Dietary l-carnitine supplementation improved the antioxidant and l-carnitine status of sows, which may be associated with the improved reproduction and piglet performance and the antioxidant status of piglets at birth and weaning. There were no interactions between DDGS and l-carnitine.
Pressure ridges impact the mass, energy and momentum budgets of the sea-ice cover and present an obstacle to transportation through ice-infested waters. Quantifying ridge characteristics is important for understanding total sea-ice mass and for improving the representation of sea-ice dynamics in high-resolution models. Multi-sensor measurements collected during annual Operation IceBridge (OIB) airborne surveys of the Arctic provide new opportunities to assess the sea ice at the end of winter. We present a new methodology to derive ridge sail height from high-resolution OIB Digital Mapping System (DMS) visible imagery. We assess the efficacy of the methodology by mapping the full sail height distribution along 12 pressure ridges in the western and central Arctic. Comparisons against coincident Airborne Topographic Mapper (ATM) elevation anomalies are used to demonstrate the methodology and evaluate DMS-derived sail heights. Sail heights and elevation anomalies were correlated at 0.81 or above. On average mean and maximum sail height agreed with ATM elevation to within 0.11 and 0.49 m, respectively. Of the ridges mapped, mean sail height ranged from 0.99 to 2.16 m, while maximum sail height ranged from 2.1 to 4.8 m. DMS also delivered higher sampling along ridge crests than coincident ATM data.
In developing countries, problems such as malnutrition and food insecurity are shifting from rural to urban areas because of rapid urbanization. However, regional variations in alimental food consumption within urban settings have often been ignored. Using survey data, our study examines regional patterns of expenditure on fresh vegetables, fruits, and peanut products in urban households of Ghana. After accounting for socioeconomic and demographic factors, food expenditure on fresh vegetables and peanut products and income elasticity vary significantly across major cities. Food distributors may adjust their marketing strategies, while policy makers should pay attention to possible disparities in urban areas.
Suicide-related behaviours are common in schizophrenia and are significantly associated with premature death. The objective of this meta-analysis study was to estimate the pooled prevalence of suicide-related behaviours in schizophrenia patients in China.
The relevant literature was searched systematically via the relevant electronic databases (PubMed, Embase, PsycINFO, Chinese National Knowledge Infrastructure, Wanfang Databases and Chinese Biological Medical Literature Database) from their inception until 14 September 2016. Only original studies that reported the prevalence of suicide-related behaviours including suicidal ideation (SI), suicide plan, suicide attempt (SA) and completed suicide were selected.
Nineteen articles met the inclusion criteria and were analysed. The pooled lifetime prevalence of SI and SA were 25.8% (95% CI 14.7–41.1%) and 14.6% (95% CI 9.1–22.8%), respectively. The 1-month prevalence of SI was 22.0% (95% CI 18.2–26.4%). Subgroup analyses of lifetime SI and SA showed that gender, sample size, survey year, study location and source of patients have no significant mediating effects on the results.
Suicide-related behaviours are common in Chinese schizophrenia patients. Due to the high mortality risk, regular screening and effective suicide prevention programmes are warranted.
Mast cells (MCs) are granulated cells of haematopoietic lineage and constitute a major sensory arm of the immune system. MCs dually guard hosts and regulate immune responses against invading pathogens. This property of the MCs is attributed to their adaptability to detect stress signals and pathogens, and the production of signal specific mediators to engage immune cells for clearance of infectious agents. Pathogen-specific signals establish basis for the initiation of adoptive immune responses. These immune regulatory roles of MCs have opened avenues to engage different MCs activators which culminate in effective passive immunisation. The molecular mechanisms and dynamics of functionalities of MCs in host defences have been extensively characterised in mammals and rodents, and research on MCs in avian species is emerging. This review surveys the development, morphology and distribution of MCs in different tissues of the poultry and highlight areas that can be exploited for disease control and prevention.
Dendritic cells (DCs) are antigen-presenting cells (APCs) with the unique ability to induce both innate immune responses and a highly specific acquired immunity. DCs are crucial to induce immunity, and their maturation and functions are influenced by microbial and environmental stimuli. Chicken DCs are composed of several subtypes including bursal secretory dendritic cells (BSDCs), follicular dendritic cells (FDCs), and thymic dendritic cells (TDCs). DC maturation depends on the nature of the perturbation and permits unique and efficient immune responses for each pathogen. DCs differentially recognise the viruses, bacteria, parasite and fungi and specifically regulate the immune response. Dendritic cells (DCs) are ‘nature's adjuvants’ and, as such represent an essential component of any vaccination strategy. The understanding of DC regulatory mechanisms opens a new horizon for the development of new vaccines and their targeting with the vaccination for elicitation of better immunity levels. The following review summarises the current state of knowledge of DCs and their specific functions during host pathogens interaction.
Integrated weed management (IWM) relies upon multiple chemical, physical, or biological weed management techniques to achieve an acceptable level of weed control. Agents that selectively suppress weeds but not crops and that can be manipulated in agriculture will be promising components for inclusion in IWM. We used a meta-analytic approach to investigate the potential of arbuscular mycorrhizal fungi (AMF) to contribute to IWM. We quantified the effect of crop and weed host status (strong and weak AMF hosts are divided in this study by a 10% root length colonization threshold), AMF diversity (single vs. mixed), and soil N and P fertility management on plant mycorrhizal growth responses (MGRs). Our results indicated that weak host weeds had consistently lower MGRs than strong host crops in both controlled and field conditions. Moreover, these differences in MGRs between weak host weeds and strong host crops were more pronounced under mixed AMF inoculum and low N and P nutrient availability. In contrast, MGR of strong host weeds was not different from strong host crops in general. However, we observed a wide range of MGRs among strong host weeds, some of which had much lower MGRs than strong host crops. In addition, in the presence of N and P fertilizers, strong host crops had a stronger positive response to AMF than strong host weeds. Thus, our meta-analysis indicates that AMF have potential to contribute to weed control by direct and indirect pathways: directly suppress weak host weeds, and indirectly suppress some strong host weeds mediating by competitive effects exerted by strong host crops. We suggest that management practices affecting AMF diversity and crop and weed mycorrhizal responses could be chosen to improve the contribution of AMF to IWM. Better understanding is needed of crop–weed–AMF interactions and management practices that enhance this form of weed management.