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 firstname.lastname@example.org
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.
The Maintain Your Brain trial (MYB) is one of the largest internet-delivered multidomain RCT designed to target modifiable risk factors for dementia. It comprises four intervention modules: physical activity, nutrition, mental health, and cognitive training. This paper explains the MYB Nutrition Module, which is a fully online intervention promoting the adoption of the ‘traditional’ Mediterranean Diet (MedDiet) pattern for those participants reporting dietary intake that does not indicate adherence to a Mediterranean-type cuisine or those who have chronic diseases/risk factors for dementia known to benefit from this type of diet. Participants who were eligible for the Nutrition Module were assigned to one of the three diet streams: Main, Malnutrition, and Alcohol group, according to their medical history and adherence to the MedDiet at baseline. A short dietary questionnaire was administered weekly during the first 10 weeks and then monthly during the 3-year follow-up to monitor whether participants adopted or maintained the MedDiet pattern during the intervention. As the Nutrition Module is a fully online intervention, resources that promoted self-efficacy, self-management, and process of change were important elements to be included in the module development. The Nutrition Module is unique in that it is able to individualize the dietary advice according to both the medical and dietary history of each participant; the results from this unique intervention will contribute substantively to the evidence that links the Mediterranean-type diet with cognitive function and the prevention of dementia and will increase our understanding of the benefits of a MedDiet in a Western country.
The initial period of construction of the Spanish railway network is often criticized for its radial structure, centered on Madrid. In this article, the authors describe the role of the state during the initial stage of railway network construction and confirm that although the political will to construct a centralist network certainly influenced its morphology, other social and economic criteria were also influential. With regard to the political motives behind the radial network, the authors argue that part of this interest could have come in response to perceived needs to strengthen the presence of the Spanish state throughout its national territory and to promote a process of state-building. Finally, it must be stressed that the central hypothesis of our article is that the radial structure of the network was a natural consequence of the strategic geographical position of the country’s capital and of the distribution of economic activity within Spanish territory. The article proposes two methodological approaches for evaluating the extent to which the radial design of the network was justified, bearing in mind the locations of Spain’s most productive regions. The results of these two exercises suggest that the radial configuration with which the Spanish rail network was originally designed probably arose naturally as a result of the distribution of economic activity within the country and of the relative advantage that this bestowed on certain regions due to their geographic position.
Interactions between smooth muscle cells (SMCs) and biomaterials must not result in phenotype changes as this may generate uncontrolled multiplication processes and occlusions in vascular grafts. The aim of this study was to relate the hydrolytic stability and biocompatibility of polyurethanes (PUs) on SMCs. A higher polycaprolactone (PCL) concentration was found to improve the hydrolytic stability of the material and the adhesion of SMCs. A material with 5% polyethylene glycol, 90% PCL, and 5% pentaerythritol presented high cell viability and adhesion, suggesting a contractile phenotype in SMCs depending on the morphology. Nevertheless, all PUs retained their elastic modulus over 120 days, similar to the collagen of native arteries (~10 MPa). Furthermore, aortic SMCs did not present toxicity (viability over 80%) and demonstrated adherence without any abnormal cell multiplication processes, which is ideal for the function to be fulfiled in situ in the vascular grafts.
Carmen made its debut in the Spanish Americas when the local networks of opera were at their apex, with a constant stream of singers from Europe and a desire for new repertoires outside the main staples of Italian opera. In this chapter, considering sources from across the region, we discuss four layers of Carmen’s reception in the Americas. First, the reception of the opera beyond the stage, in the form of vocal scores, arrangements for military bands and isolated numbers. Second, the perception of Carmen as a French opera, and the way it served as a vehicle for French opera companies in the final decades of the nineteenth century. Third, the idea of Carmen as Spanish, and how different countries considered that hispanicity as part of their own culture and theatrical expectations. Finally, we discuss how the habanera in Carmen was perceived as part of a larger contemporary debate on the transatlantic popularity of the habanera as a musical genre, its origins, ethnicity and its moral and musical character.
Intravenous tissue-type plasminogen activator (IVtPA) is a proven treatment for acute ischemic stroke; however, diabetes mellitus (DM) and previous cerebral infarction (PCI) were considered relative contraindications for thrombolysis within the 3–4.5 h period.
The study aimed to determine the safety and efficacy of IVtPA among diabetic patients with PCI presenting with acute ischemic stroke.
Studies which evaluated the outcome of IVtPA in terms of symptomatic intracerebral hemorrhage (sICH), functional outcome in modified Rankin scale, and death among diabetic patients with PCI presenting with acute ischemic stroke within the 3–4.5 h period were systematically searched until July 2019. Screening and eligibility criteria were applied. Risk of bias was evaluated using the Newcastle–Ottawa Scale. Odds ratios (ORs) with 95% confidence interval (CI) were used to compare measures of treatment effect. Mantel–Haenszel method and random-effects model were also employed.
Four registry-based studies with a total of 44,572 patients were included for quantitative synthesis. Giving IVtPA among DM+/PCI+ patients did not result in significantly increased rate of sICH (OR, 1.09; 95% CI, 0.88, 1.36) compared to No DM+/PCI+ patients. However, there was significantly higher mortality (OR, 1.81; 95% CI, 1.60, 2.06) in the DM+/PCI+ group. Conversely, among those who survived, the DM+/PCI+ patients were more functionally independent at 3 months (OR, 0.76; 95% CI, 0.61, 0.94).
Limited evidence suggests that thrombolysis in DM+/PCI+ patients does not result in significantly higher incidence of sICH and may improve functional independence. However, the significantly higher mortality in this group warrants an assessment of the individualized risk–benefit ratio in the use of IVtPA.
To assess the validity of self-reported height and weight by parents of 4-year-old children and subjective weight perception.
Descriptive cross-sectional study.
Paediatric population living in the Autonomous Community of Madrid.
Children born in 2008–2009 examined at 47–59 months of age. Data were collected by paediatricians of the Madrid Primary Care Physicians Sentinel Network. Parents reported weight and height data. Prevalence of weight status categories was calculated using WHO and International Obesity Task Force (IOTF) reference criteria. Sensitivity, specificity and positive predictive value (PPV) were estimated. The appraisal of their child’s weight perception and parental misperception were assessed.
For 2914 children, reported height was underestimated by −1·38 cm, weight by −0·25 kg and BMI was overestimated by +0·41 kg/m2 on average. The prevalence of obesity estimated with reported data was 2·7 times higher than that calculated with measured data (16·2 v. 6·0 %) according to WHO classification, and 3·6 times higher with IOTF classification. Sensitivity to identify obesity was 70·5 %, specificity was 87·3 % and PPV was 26·2 % (WHO classification). Half of the parents of pre-schoolers with obesity failed to identify their child’s weight status. Parental misperception among children classified as having overweight or obesity reached 93·0 and 58·8 %, respectively.
Parents underestimated children’s height and weight, leading to an overestimation of the prevalence of obesity. Small inaccuracies in reported measures have an important effect for the estimation of population prevalences. Parents’ report of child weight status is unreliable. Parental awareness and acknowledgement of child weight status should be improved.
Previous literature on partisan campaign behavior shows that third-party candidates do not have the same presence online as major-party candidates, and these differences have been linked regularly to campaign finance. Twitter, however, has changed the online campaigning game. Because Twitter essentially is free, third-party candidates can even the playing field with major-party candidates who have more financial resources. The question asked in this article is whether this is actually the case. Evans, Cordova, and Sipole (2014) showed that in 2012, third-party candidates were less likely to have accounts on Twitter; however, those who had accounts tweeted more often than major party candidates. This article updates those findings to consider the behavior of third-party candidates during the 2014 and 2016 congressional races. Using a dataset of all candidates for both the US House and the US Senate, we show that the gap has begun to close between major- and minor-party candidates on Twitter. Third-party candidates, however, continue to have a different way of communicating with their followers on Twitter when compared to Democrats and Republicans.
Breast-feeding habits are related to the nutritional status and the risk of illness and death in children under 2 years of age. For the first 6 months, infants should be exclusively breast-fed. This study aimed to evaluate the relationship between the infant’s nutritional status and human milk intake by breast-fed infants at high altitude. A quantitative, descriptive, correlational study was conducted including mother/baby pairs of infants aged 2–6 months. The amount of human milk consumed by the infants was assessed by the deuterium oxide dose-to-mother technique. The lipid content of human milk was measured by creamatocrit, and anthropometric measurements were performed. A total of eighteen mother/baby pairs were assessed. The mean human milk intake was 888 (sd 149) g/d, and the intake of water from other sources was 24·3 (sd 29·8) g/d. The lipid content in human milk was 41 (sd 12) g/l. The infant’s nutritional indicators were normal in all cases. A moderate positive correlation was found between milk volume and z scores weight-for-length r 0·58 (P=0·01), BMI-for-age r 0·56 (P=0·01) and weight-for-age r 0·45 (P=0·05). There was no correlation with length-for-age z score. The mean of breast milk intake in this study was similar to that found in other studies in the world. The lipid content is comparable to similar studies and was within the normal range. Children older than 3 months showed signs of stunting despite adequate volume and lipid content of breast milk.
To compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypes
As part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.
The study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.
Clinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.
The objective of this research was to explore the influence that weed decision threshold (DT; expressed as plants m−2), weed spatial distribution patterns, and spatial resolution of sampling have on potential reduction in herbicide use under site-specific weed management. As a case study, a small plot located in a typical corn field in central Spain was used, constructing very precise distribution maps of the major weeds present. These initial maps were used to generate herbicide prescription maps for each weed species based on different DTs and sampling resolutions. The simulation of herbicide prescription maps consisted of on/off spraying decisions based on information from two different approaches for weed detection: ground-based vs. aerial sensors. In general, simulations based on ground sensors resulted in higher herbicide savings than those based on aerial sensors. The extent of herbicide reductions derived from patch spraying was directly related to the density and the spatial distribution of each weed species. Herbicide savings were potentially high (up to 66%) with relatively sparse patchy weed species (e.g., johnsongrass) but were only moderate (10 to 20%) with abundant and regularly distributed weed species (e.g., velvetleaf). However, DT has proven to be a key factor, with higher DTs resulting in reductions in herbicide use for all the weed species and all sampling procedures and resolutions. Moreover, increasing DT from 6 to 12 plants m−2 resulted in additional herbicide savings of up to 50% in the simulations for johnsongrass and up to 28% savings in the simulations for common cocklebur. Nonetheless, since DT determines the accuracy of patch spraying, the consequences of using higher DTs could be leaving areas unsprayed, which could adversely affect crop yields and future weed infestations, including herbicide-resistant weeds. Considering that the relationship between DT and accuracy of herbicide application depends on weed spatial pattern, this work has demonstrated the possibility of using higher DT values in weeds with a clear patchy distribution compared with weeds distributed regularly.
To characterise clusters of individuals based on adherence to dietary recommendations and to determine whether changes in Healthy Eating Index (HEI) scores in response to a personalised nutrition (PN) intervention varied between clusters.
Food4Me study participants were clustered according to whether their baseline dietary intakes met European dietary recommendations. Changes in HEI scores between baseline and month 6 were compared between clusters and stratified by whether individuals received generalised or PN advice.
Individuals in cluster 1 (C1) met all recommended intakes except for red meat, those in cluster 2 (C2) met two recommendations, and those in cluster 3 (C3) and cluster 4 (C4) met one recommendation each. C1 had higher intakes of white fish, beans and lentils and low-fat dairy products and lower percentage energy intake from SFA (P<0·05). C2 consumed less chips and pizza and fried foods than C3 and C4 (P<0·05). C1 were lighter, had lower BMI and waist circumference than C3 and were more physically active than C4 (P<0·05). More individuals in C4 were smokers and wanted to lose weight than in C1 (P<0·05). Individuals who received PN advice in C4 reported greater improvements in HEI compared with C3 and C1 (P<0·05).
The cluster where the fewest recommendations were met (C4) reported greater improvements in HEI following a 6-month trial of PN whereas there was no difference between clusters for those randomised to the Control, non-personalised dietary intervention.
The overall objective of this study was to identify common patterns in the
spatial distribution of the major weed species present in the corn-growing
region of central Spain, exploring the scale dependence of these patterns
and the possible associations or dissociations between individual species.
Weed density was assessed in 16 commercial fields using digital images
acquired in a 9-m by 9-m sampling grid. A set of six species was found in
all the fields: black nightshade, common cocklebur, fierce thornapple,
johnsongrass, purple nutsedge, and velvetleaf. Spatial analysis by distance
indices and inverse distance weighting interpolation methods were performed
to create weed distribution maps. The results showed aggregated spatial
distribution patterns for all individual species regardless their life
cycle, annual or perennial. Some associations and dissociations among
species were found in the analysis of interactions. Nevertheless, the
spatial patterns of co-occurrence of weed species were field-specific and
therefore cannot be considered general patterns of weed co-occurrence. In
order to explore the scale dependence of these results, an additional study
was conducted in an experimental field located in the same area using a
1.0-m by 0.75-m sampling grid. Although this resolution allowed for a better
definition of the positions of the weed patches and weed-free gaps, the
results obtained revealed similar patterns to those observed with a coarser
The interest of organic farmers in adopting conservation agriculture principles, including minimal soil disturbance, permanent soil cover and crop rotation has been growing since the early 2000s. However, currently there is no network for organic farmers practicing conservation agriculture, and a lack of knowledge on how organic farmers implement conservation agriculture in practice. Consequently, few technical references are available for organic farmers when they start applying conservation agriculture practices, in particular on controlling weeds without the use of herbicides. The main objectives of this study were: (1) to explore the diversity of conservation agriculture techniques (i.e., reduced tillage, no-tillage and green manures) practiced among European farmers, and (2) to identify farmers’ main strategies for implementing conservation agriculture and the agronomic and environmental factors that determine these strategies. Strategies were identified by analyzing survey results on: (1) the type and degree of use of conservation agriculture practices by farmers, and (2) the effects it produces in terms of soil disturbance and soil cover (low, medium and high). We carried out a survey of 159 European organic farmers and collected 125 data sets on management of winter-sown crops. Among the conservation agriculture practices, reduced tillage was used by 89%, no-tillage by 27% and green manure by 74% of the 159 interviewed farmers. Green manures were more frequently used in northern Europe than in the south (below 45°N). Most of the farmers used crop rotations, with a mean duration of 6 years. A wide diversity of conservation agriculture practices were used, with farmers rarely using all three techniques (no-till, reduced till and green manures) within one system. The range of practices was grouped into five strategies ranging from intensive non-inversion tillage without soil cover to very innovative techniques with no-tillage and intercrops. The five strategies for conservation agriculture could be grouped into two larger categories based on weed control approach: (1) intensification of the mechanical work without soil inversion or (2) biological regulation of weeds with cover crops. The diversity of strategies identified in this study shows that organic farmers use innovative approaches to implement conservation agriculture without herbicides. This study's findings will help organic farmers to experiment with innovative practices based on conservation agriculture principles and also benefit conventional farmers who use conservation agriculture practices and would like to reduce or eliminate the use of herbicides.
Joint-use libraries are created between public (also known as community) libraries and university libraries; between public schools and public libraries; between community colleges and universities; and between any library organizations wishing to collaborate on the delivery of library services. These collaborations exist as a result of institutions of higher education and other entities making the bold decision to work across organizational boundaries for the benefit of their library communities to make best use of limited resources. The joint organizations that are created embrace a broader view of mission and vision than do organizations with a more traditional and sometimes insular view of their reason for being. Joint-use libraries exist with a variety of different models of administration and funding, of varying sizes and in different geographic locations.
In August 2003 the 475,000 square foot (44,000 square meters) Dr Martin Luther King, Jr. Library (King Library), a joint-use library created by San José State University (SJSU) and the City of San José, opened to serve their respective communities. The grand opening was met with applause and rave reviews by the close to 12,000 people who were on hand for the festivities that day. As the tenyear anniversary looms (August 2013), the King Library has provided stellar library services, technological innovation and access to print and digital collections for the fifth largest campus in the California State University (CSU) system, the third largest city in California and the tenth largest city in the USA. A review of the planning process employed to develop this joint library and an exploration of the accompanying staffing issues, user perceptions, budgetary matters and other factors are instructive in understanding the operation of such a library. These observations can provide a foundation for predictions for the next ten years of collaboration in light of exponential technological advances, innovation in higher education and the ‘new normal’ of decreased tax-generated funding for public libraries and state-supported universities in the USA.
Natural dissemination of johnsongrass seeds as well as the effect of combine
harvesting on this process were studied in corn fields. The estimation of
natural dispersal was carried out by two different methods, collecting seeds
throughout the season using seed traps and sampling soil–surface seed
abundance before harvest using a vacuum device. Both methods showed the same
dispersal pattern. A minimum of 84.6% was dispersed in the first 2 m from
the focus and a maximum of 1.6% was dispersed beyond the first 5 m. An
average of 76.3% of these dispersed seeds were lost or buried after shedding
but before harvest. Seed dispersal by the combine harvester was estimated
from the difference between soil–surface seed abundance in the same sites
pre and postharvest. Although the quantity of seeds dispersed by the combine
was similar to those dispersed by natural factors, dispersal distances were
significantly higher. Around 90% of the dispersed seeds were found in the
first 5 m forward and backward of the combine direction from the infestation
source, and 1.6% of the seeds were found beyond 22 m forward and 10 m
backward of the combine direction from the infestation source. A large
proportion of the seeds dispersed were dormant or not viable. It is
concluded that the major role of sexual reproduction in johnsongrass
population dynamics may be to spread the risks, promoting dispersal in time
In the last decades there was a growing interest in developing new light-weight intermetallic alloys, which are able to substitute the heavy superalloys at a certain temperature range. At present a new Ti-Al-Nb-Mo family, called TNM™ alloys, is being optimized to fulfill the challenging requirements. The aim of the present work was to study the microscopic mechanisms of defect mobility at high temperature in TNM alloys in order to contribute to the understanding of their influence on the mechanical properties and hence to promote the further optimization of these alloys. Mechanical spectroscopy has been used to study the internal friction and the dynamic modulus up to 1460 K of a TNM alloy under different thermal treatments. These measurements allow to follow the microstructural evolution during in-situ thermal treatments. A relaxation process has been observed at about 1050 K and was characterized as a function of temperature and frequency in order to obtain the activation parameters of the responsible mechanism. In particular, the activation enthalpy has been determined to be H= 3 eV. The results are discussed and an atomic mechanism is proposed to explain the observed relaxation process.
The temperature effect on the magnetoelectric response of hybrid magnetostrictive/piezoelectric laminated composites in the range from room temperature up to 85 ºC is presented. The samples analyzed consisted of alternating, stacked, layers of a magnetostrictive amorphous metal, and a piezoelectric polymer, bonded to each other with an epoxy. The maximum magnetoelectric effect was observed when the composites were driven at their electromechanical resonance. First, we present results on the fabricability of the laminated composite sensor consisting on Vitrovac 4040® (Fe39Ni39Mo4Si6B12) as the magnetostrictive amorphous component and two different piezoelectric polymers: poly(vinylidene fluoride) (PVDF) and 2,6(β-CN)APB/ODPA (poli 2,6) polyimide, a new type of high temperature piezoelectric polymer. At room temperature induced magnetoelectric voltages of 79.6 and 0.35 V/cm.Oe were measured when using PVDF and poli 2,6 polyimide respectively as the piezoelectric components. When heating, we have observed that the magnetoelectric response of the PVDF-containing device quickly decayed to about 5 V/cm.Oe, while for the poli 2,6- containing one it remained almost constat. We discuss the advantage of using this new piezoelectric polymer due to its good performance at high temperatures, making these magnetoelectric laminate composites suitable for high temperature applications.