Energy density of foods and beverages in the Australian food supply: influence of macronutrients and comparison to dietary intake.

OBJECTIVES: The energy density (ED) of the diet is considered an important determinant of total energy intake and thus energy balance and weight change. We aimed to compare relationships between ED and macronutrient content in individual food and beverage items as well as population diet in a typical Western country. DESIGN: Nutrient data for 3673 food items and 247 beverage items came from the Australian Food and Nutrient database (AusNut). Food and beverage intake data came from the 1995 Australian National Nutrition Survey (a 24-h dietary recall survey in 13 858 people over the age of 2). Relationships between ED and macronutrient and water content were analysed by linear regression with 95% prediction bands. RESULTS: For both individual food items and population food intake, there was a positive relationship between ED and percent energy as fat and negative relationships between ED and percent energy as carbohydrate and percent water by weight. In all cases, there was close agreement between the slopes of the regression lines between food items and dietary intake. There were no clear relationships between ED and macronutrient content for beverage items. Carbohydrate (mostly sucrose) contributed 91, 47, and 25% of total energy for sugar-based, fat-based, and alcohol-based beverages respectively. CONCLUSIONS: The relationship between ED and fat content of foods holds true across both population diets and individual food items available in the food supply in a typical Western country such as Australia. As high-fat diets are associated with a high BMI, population measures with an overall aim of reducing the ED of diets may be effective in mediating the growing problem of overweight and obesity

Cascading failures in networks of heterogeneous node behavior

Variability in the dynamical function of nodes comprising a complex network impacts upon cascading failures that can compromise the network's ability to operate. Node types correspond to sources, sinks or passive conduits of a current ow, applicable to renewable electrical power micro-grids containing a variable number of intermittently operating generators and consumers of power. The resilience to cascading failures of ensembles of synthetic networks with di_erent topology is examined as a function of the edge current carrying capacity and mix of node types, together with exemplar real-world networks. Whilst a network with homogeneous node type can be resilient to failure, one with identical topology but heterogeneous node function can be strongly susceptible to failure. For networks with similar numbers of sources, sinks and passive nodes the mean resilience decreases as networks become more disordered. Nevertheless all network topologies have enhanced regions of resilience, accessible by manipulation of node composition and functionality

A Revised Historical Light Curve of Eta Carinae and the Timing of Close Periastron Encounters

The historical light curve of the 19th century "Great Eruption" of etaCar provides a striking record of violent instabilies encountered by the most massive stars. We report and analyze newly uncovered historical estimates of the visual brightness of etaCar during its eruption, and we correct some mistakes in the original record. The revised light curve looks substantially different from previous accounts: it shows two brief eruptions in 1838 and 1843 that resemble modern supernova impostors, while the final brightening in December 1844 marks the time when etaCar reached its peak brightness. We consider the timing of brightening events as they pertain to the putative binary system in etaCar: (1) The brief 1838 and 1843 events peaked within weeks of periastron if the pre-1845 orbital period is shorter than at present due to the mass loss of the eruption. Each event lasted only 100 days. (2) The main brightening at the end of 1844 has no conceivable association with periastron, beginning more than 1.5yr afterward. It lasted 10yr, with no obvious influence of periastron encounters during that time. (3) The 1890 eruption began to brighten at periastron, but took over 1yr to reach maximum and remained there for almost 10yr. A second periastron passage midway through the 1890 eruption had no effect. While evidence for a link between periastron encounters and the two brief precursor events is compelling, the differences between the three cases above make it difficult to explain all three phenomena with the same mechanism.Comment: 11 pages, 4 figures. submitted to MNRAS on october 12. updated reference

Signs of deterioration in infants discharged home following congenital heart surgery in the first year of life: a qualitative study

AIMS: To describe the ways in which parents recognise and make decisions about their child's symptoms following discharge home after congenital heart interventions in the first year of life and their experiences of seeking help. METHODS: This was a qualitative study involving semistructured interviews with parents. Twenty-one parents were recruited to the study. Parents all had a child who had congenital heart surgery in their first year of life between September 2009 and October 2013 at one of three UK cardiac centres; the children had either died or were readmitted as an emergency following initial discharge. RESULTS: Some parents were unable to identify any early warning signs. Others described symptoms of deterioration including changes in feeding and appearance, respiratory distress and subtle behavioural changes that may not be routinely highlighted to parents at discharge. Several barriers to accessing prompt medical assistance were identified including parents feeling that their concerns were not taken seriously, long wait times and lack of protocols at A&E. CONCLUSIONS: Our study highlights behavioural symptoms as being a potentially underemphasised sign of deterioration and identifies a number of barriers to parents accessing support when they are concerned. It is important that parents are encouraged to seek advice at the earliest opportunity and that those health professionals at the front line have access to the information they need in order to respond in an appropriate and timely way. A role for home monitoring was also noted as potentially useful in identifying at risk children who appear clinically well

Analysis of Automated Fault Detection and Diagnostics Records as an Indicator of HVAC Fault Prevalence: Methodology and Preliminary Results

Faults in commercial buildings can cause energy waste and other performance problems such as reduced occupant comfort, reduced equipment longevity, and increased noise. However, it is currently unknown how commonly faults occur in different equipment types. This paper describes a method to estimate the prevalence of faults in air handling units, air terminal units, and rooftop units and the use of three metrics for summarizing results. This method was developed by the authors as part of a study which includes data from several automated fault detection and diagnostics (AFDD) data providers, providing a large sample with a wide range of building types, geographical locations, and equipment types. This dataset includes fault diagnoses from thousands of buildings throughout the United States, as well as anonymized metadata describing the building and equipment characteristics. The number of fault records is on the order of 106. We describe here how the data from different data providers can be processed and unified using a common taxonomy, and illustrate three metrics that can provide insights using this type of data. The methods developed for this study are illustrated here with preliminary data. This work supports a multi-year, multi-institutional project that will provide insight into the drivers of fault prevalence; for example, whether prevalence is correlated with characteristics like building type, building size, and geographical location (including related factors like local climate and utility rates). We discuss some of the challenges of harmonizing disparate outputs from multiple AFDD providers, the usefulness of applying a unifying fault taxonomy, and provide preliminary figures that illustrate three fault prevalence metrics

Ultrasound-guided large-core needle biopsies of breast lesions: analysis of 962 cases to determine the number of samples for reliable tumour classification

The objective of this one-institutional study was to determine the number of large-core needle biopsies (LCNB), under three-dimensional ultrasound (3D-US) validation, that are sufficient to obtain a reliable histological diagnosis of a sonographically detectable breast lesion. Over an 28-month period, 962 sonographically guided LCNB were performed under 3D-US validation to assess 962 breast lesions. All biopsies were carried out with an automated core biopsy device fitted with 14-gauge (22 mm excursion) needles. Data of 962 biopsied breast lesions were gathered. Surgical follow-up was available for 659 lesions. Breast malignancies were diagnosed by ultrasound-guided LCNB with a sensitivity of 98.2% by performing three cores per lesion. In few cases, the open surgical specimen revealed the presence of invasive carcinomas in contrast to initial LNCB-based classification as ductal carcinomas in situ (DCIS, 11 lesions), lobular carcinoma in situ (one lesion), and atypical ductal hyperpasia (one lesion). Owing to disagreement between classification based on breast-imaging and histological findings, eight of these tumours were subsequently excised. Of the lesions that were removed at the patients' requests despite benign LCNB diagnosis, two were infiltrating carcinoma and one a DCIS. We demonstrate that three 3D-US-guided percutaneous core specimens are sufficient to achieve tissue for a reliable histological assessment of sonographically detectable breast lesions and allow the detection of malignancies with high sensitivity and low rate of false-negative diagnoses

Structural Diversity of Ultralong CDRH3s in Seven Bovine Antibody Heavy Chains

Antigen recognition by mammalian antibodies represents the most diverse setting for protein-protein interactions, because antibody variable regions contain exceptionally diverse variable gene repertoires of DNA sequences containing combinatorial, non-templated junctional mutational diversity. Some animals use additional strategies to achieve structural complexity in the antibody combining site, and one of the most interesting of these is the formation of ultralong heavy chain complementarity determining region 3 loops in cattle. Repertoire sequencing studies of bovine antibody heavy chain variable sequences revealed that bovine antibodies can contain heavy chain complementarity determining region 3 (CDRH3) loops with 60 or more amino acids, with complex structures stabilized by multiple disulfide bonds. It is clear that bovine antibodies can achieve long, peculiarly structured CDR3s, but the range of diversity and complexity of those structures is poorly understood. We determined the atomic resolution structure of seven ultralong bovine CDRH3 loops. The studies, combined with five previous structures, reveal a large diversity of cysteine pairing variations, and highly diverse globular domains

Service use preceding and following first referral for psychiatric emergency care at a short-stay crisis unit: A cohort study across three cities and one rural area in England

Background: Internationally, hospital-based short-stay crisis units have been introduced to provide a safe space for stabilisation and further assessment for those in psychiatric crisis. The units typically aim to reduce inpatient admissions and psychiatric presentations to emergency departments. Aims: To assess changes to service use following a service user’s first visit to a unit, characterise the population accessing these units and examine equality of access to the units. Methods: A prospective cohort study design (ISCTRN registered; 53431343) compared service use for the 9 months preceding and following a first visit to a short-stay crisis unit at three cities and one rural area in England. Included individuals first visited a unit in the 6 months between 01/September/2020 and 28/February/2021. Results: The prospective cohort included 1189 individuals aged 36 years on average, significantly younger (by 5–13 years) than the population of local service users (<.001). Seventy percent were White British and most were without a psychiatric diagnosis (55%–82% across sites). The emergency department provided the largest single source of referrals to the unit (42%), followed by the Crisis and Home Treatment Team (20%). The use of most mental health services, including all types of admission and community mental health services was increased post discharge. Social-distancing measures due to the COVID-19 pandemic were in place for slightly over 50% of the follow-up period. Comparison to a pre-COVID cohort of 934 individuals suggested that the pandemic had no effect on the majority of service use variables. Conclusions: Short-stay crisis units are typically accessed by a young population, including those who previously were unknown to mental health services, who proceed to access a broader range of mental health services following discharge