Zooplankton from the Bering, Chukchi, and Beaufort seas and a transect across the Arctic Ocean were collected from 369 stations on 18 cruises in the years 1985–1990 and 1993–1995. Carbon and nitrogen ...isotope ratio analyses were performed on the major taxonomic groups present—calanoid copepods, euphausiids and chaetognaths. The sampled waters around Alaska were divided into 11 subregions based on water mass characteristics and the zooplankton statistically tested for significant differences in the isotope ratios. Within all regions, copepods were significantly more depleted in 13C than euphausiids (average δ13C difference for copepods = -1.1 ‰ than euphausiids), but showed no significant differences from euphausiids in δ15N except in the eastern Alaskan Beaufort Sea where copepods were relatively enriched in 15N. The greatest variability in isotope ratios was among geographic regions. All taxa tested were 13C-depleted in the eastern Beaufort Sea, the Arctic Ocean and in deep waters of the southwestern Bering Sea relative to the continental shelf waters of the Bering and Chukchi seas. The maximum enrichments were found in the southwestern Chukchi Sea and central Bering Sea shelf waters. The advection of water northward through the Bering Strait was evident as a plume of enriched zooplankton extending to the shelf break in the Arctic Ocean. In contrast, the δ15N within taxa generally increased moving northward from the deep Bering Sea to the Chukchi Sea and eastward into the Beaufort Sea. The δ15N values for chaetognaths were 2.5 to 3 ‰ more enriched than copepods or euphausiids in all locations, consistent with their carnivorous diet. Comparisons of zooplankton isotope ratios among years and cruises within the same region revealed no significant differences. Low δ15N and δ13C values in zooplankton of the pelagic Bering Sea are presumed to result from the isotopic discrimination arising in the presence of high nutrient abundances and slow phytoplankton growth rates whereas depleted values in coastal waters of the Canadian Beaufort Sea presumably derive from Mackenzie River inputs of terrestrially derived carbon and nitrogenous nutrients with low 15N and 13C abundances. The geographic heterogeneity in isotope ratios over short distances indicates a need for caution in the interpretation of isotope ratios in marine mammals and birds with regard to trophic status and habitat usage.
The roles of iron and light in controlling biomass and primary productivity are clearly established in the Southern Ocean. However, their influence on net community production (NCP) and carbon export ...remains to be quantified. To improve our understanding of NCP and carbon export production in the Subantarctic Zone (SAZ) and the northern reaches of the Polar Frontal Zone (PFZ), we conducted continuous onboard determinations of NCP as part of the Sub-Antarctic Sensitivity to Environmental Change (SAZ-Sense) study, which occurred in January–February 2007. Biological O2 supersaturation was derived from measuring O2/Ar ratios by equilibrator inlet mass spectrometry. Based on these continuous measurements, NCP during the austral summer 2007 in the Australian SAZ was approximately 43 mmol O2 m−2 d−1. NCP showed significant spatial variability, with larger values near the Subtropical front, and a general southward decrease. For shallower mixed layers (<50 m), dissolved Fe concentrations and Fe sufficiency, estimated from variable fluorescence, correlated strongly with NCP. The strong correlation between NCP and dissolved Fe may be difficult to interpret because of the correlation of dissolved Fe to MLD and because the concentration of iron may not be a good indicator of its availability. At stations with deeper mixed layers, NCP was consistently low, regardless of iron sufficiency, consistent with light availability also being an important control of NCP. Our new observations provide independent evidence for the critical roles of iron and light in mediating carbon export from the Southern Ocean mixed layer.
Traditionally, safety and improving safety in the treatment of pregnant women has involved identifying risks that lead to errors or adverse events, and implementing strategies to mitigate potential ...harm. There is research that suggests that other factors such as a lack of service, lack of care or a lack of quality also contribute to participants feeling unsafe. Currently there is no evidence-based research on the psychological aspects of the safety of massage during pregnancy.
The present study aim was to investigate women's perceptions and experiences of the safety of massage during pregnancy. This included exploring what attributes of the clinician or practice and events that occur during the massage helped pregnant women feel safe.
Phone interview with participants from Victoria, New South Wales and Queensland.
20 women who received massage whilst pregnant.
Qualitative design using thematic analysis.
There were five main themes related to safety and massage: 1) Autonomy- able to voice my needs and be heard; 2) Pregnancy massage is more than just a massage; 3) When my therapist is experienced and qualified, I feel safer; 4) The continuity of the massage industry's message about the safety of massage; and 5) Decision-making around massage safety.
Safety is made up of not only the treatment that massage therapists provide, but also the environment they provide it in and how they administer both the treatment and the consultation. The lack of cohesion in messaging about the safety of massage during pregnancy makes women doubt the safety of massage.
Automated closed-loop control delivery of insulin, also known as the artificial pancreas, is emerging as a treatment option for type 1 diabetes, which is considered generally superior to ...sensor-augmented insulin pump therapy. Evening and overnight closed-loop control might account for most of the benefits of 24/7 continuous closed-loop control; however, to our knowledge, no direct comparison of these systems has yet been done. In this study, we sought to compare different configurations of a closed-loop control system with activation of automated insulin delivery during the evening and overnight hours compared with continuous 24/7 closed-loop control, and both treatment modalities compared with sensor-augmented insulin pump use.
In this randomised crossover trial at the University of Virginia (Charlottesville, VA, USA), we randomly assigned (1:1) participants aged 18 to up to 70 years with a diagnosis of type 1 diabetes for at least 1 year to one of two sequences of four 8-week treatment sessions: sensor-augmented insulin pump therapy, evening and overnight closed-loop control, continuous 24/7 closed-loop control, and evening and overnight closed-loop control (group A) or evening and overnight closed-loop control, continuous 24/7 closed-loop control, evening and overnight closed-loop control, and sensor-augmented pump therapy (group B). Randomisation was done by non-clinical study staff using a computer-generated sequence of Bernoulli trials. The primary outcome of the study was the difference in the percentage of time continuous glucose monitored glucose was less than 3·9 mmol/L (70 mg/dL) during sensor-augmented pump therapy compared with evening and overnight closed-loop control. Our overall analysis followed a modified intention-to-treat approach, with all available data for participants who had completed at least two study sessions included in the analysis, regardless of actual use of a closed-loop control device. The trial was registered with ClinicalTrials.gov, NCT02679287.
Between April 21, 2016, and June 1, 2018, we assessed 103 patients for eligibility and 93 were randomly assigned to group A (n=47) or group B (n=46). Our final analysis included 80 participants who had completed at least two study phases (40 in group A and 40 in group B). Compared with sensor-augmented pump therapy sessions, evening and overnight closed-loop control sessions reduced the mean overall (day and night) percentage of time blood glucose was less than 70 mg/dL (3·9 mmol/L) from 4·0% (SD 3·3) to 2·2% (1·8), an absolute difference of −1·8% (95% CI 1·2–2·4; p<0·0001). This was accompanied by an overall reduction in HbA1c from mean 7·4% (SD 1·0) at baseline to 7·1% (0·9) at the end of the study, resulting in an absolute difference of −0·3% (95% CI 0·1–0·4%; p<0·0001). We observed no cases of diabetic ketoacidosis. There were three cases of hyperglycaemia with ketosis that did not meet the criteria for diabetic ketoacidosis, all of which were treated at home with insulin and oral fluid, without known malfunction of the investigational device. There were five cases of severe hypoglycaemia attributed to user-directed boluses without malfunction of the investigational device.
In type 1 diabetes, evening and overnight closed-loop control was superior to sensor-augmented pump therapy, achieving most of the glycaemic benefits of 24/7 continuous closed-loop control. Our findings could offer people with type 1 diabetes more flexibility in treatment options with use of automated insulin delivery systems at varying times of day.
National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases. Roche, Tandem Diabetes Care, and Dexcom provided material support.
Summary Background Handwashing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic. However, the role of handwashing is ...debated, and no good randomised evidence exists among adults in non-deprived settings. We aimed to assess whether an internet-delivered intervention to modify handwashing would reduce the number of RTIs among adults and their household members. Methods We recruited individuals sharing a household by mailed invitation through general practices in England. After consent, participants were randomised online by an automated computer-generated random number programme to receive either no access or access to a bespoke automated web-based intervention that maximised handwashing intention, monitored handwashing behaviour, provided tailored feedback, reinforced helpful attitudes and norms, and addressed negative beliefs. We enrolled participants into an additional cohort (randomised to receive intervention or no intervention) to assess whether the baseline questionnaire on handwashing would affect handwashing behaviour. Participants were not masked to intervention allocation, but statistical analysis commands were constructed masked to group. The primary outcome was number of episodes of RTIs in index participants in a modified intention-to-treat population of randomly assigned participants who completed follow-up at 16 weeks. This trial is registered with the ISRCTN registry, number ISRCTN75058295. Findings Across three winters between Jan 17, 2011, and March 31, 2013, we enrolled 20 066 participants and randomly assigned them to receive intervention (n=10 040) or no intervention (n=10 026). 16 908 (84%) participants were followed up with the 16 week questionnaire (8241 index participants in intervention group and 8667 in control group). After 16 weeks, 4242 individuals (51%) in the intervention group reported one or more episodes of RTI compared with 5135 (59%) in the control group (multivariate risk ratio 0·86, 95% CI 0·83–0·89; p<0·0001). The intervention reduced transmission of RTIs (reported within 1 week of another household member) both to and from the index person. We noted a slight increase in minor self-reported skin irritation (231 4% of 5429 in intervention group vs 79 1% of 6087 in control group) and no reported serious adverse events. Interpretation In non-pandemic years, an effective internet intervention designed to increase handwashing could have an important effect in reduction of infection transmission. In view of the heightened concern during a pandemic and the likely role of the internet in access to advice, the intervention also has potential for effective implementation during a pandemic. Funding Medical Research Council.
Here, a search for the exotic meson X(5568) decaying into the B$0\atop{s}$π± final state is performed using data corresponding to 9.6 fb-1 from $p\bar{p}$ collisions at $\sqrt{s}$ = 1960 GeV recorded ...by the Collider Detector at Fermilab. No evidence for this state is found and an upper limit of 6.7% at the 95% confidence level is set on the fraction of B$0\atop{s}$ produced through the X(5568)→B$0\atop{s}$π± process.
As a contribution to the study of equatorial Pacific biogeochemistry, we measured the O
2
/Ar ratio and the triple isotope composition (
18
O,
17
O, and
16
O) of O
2
along six meridional lines in the ...equatorial Pacific (8°N–8°S at 95°W, 110°W, 125°W, 140°W, 155°W, and 170°W). O
2
/Ar ratios and δ
18
O were close to equilibrium values within the mixed layer and followed the general trend of increasing δ
18
O with decreasing O
2
/Ar at greater depths. The
17
Δ (≈δ
17
O–0.5δ
18
O) constrains the fraction of photosynthetic O
2
;
17
Δ was slightly elevated with respect to equilibrium within the mixed layer due to local photosynthetic production. In aphotic zone waters above 250 m depth the average
17
Δ values were higher than in the mixed layer. There are four sources of this photosynthetic signal in the dark ocean: production in the euphotic zone prior to subduction in the distant source regions, production below the mixed layer during travel to the equatorial zone, diapycnal mixing with shallower waters bearing photosynthetic O
2
, and accumulation of photosynthetic O
2
produced at very low rates below the 1% light level. Our results also constrain biological production rates within the mixed layer at several locations along 95°W and 110°W. Our average rate of
14
C production (53 ± 34 mmol C m
−2
d
−1
) agreed well with other estimates in the equatorial Pacific, while our average rate of net C production (6.9 ± 6.2 mmol C m
−2
d
−1
) and
f
ratio (0.12 ± 0.11) were somewhat lower than other estimates. Adding δ
18
O and
17
Δ as tracers to three‐dimensional biogeochemical ocean GCMs and comparing results with observations will extend our understanding of metabolic rates in the study region.
Massage is the largest complementary medicine profession in Australia, in terms of public utilisation, practitioner distribution, and number of practitioners, and is being increasingly integrated ...into the Australian health care system. However, despite the increasing importance of massage therapists in Australian health care delivery, or the increased practice and education obligations this may entail, there has been little exploration of practice, research, and education characteristics of the Australian massage therapist workforce.
To identify practice, research, and education characteristics among the Australian massage therapist workforce.
The Australian massage therapy profession.
301 randomly selected members of the Association of Massage Therapists (Australia).
A 15-item, cross-sectional telephone survey.
Massage therapists' demographic information, practice characteristics, and education and research characteristics.
Most respondents (73.8%) worked 20 hours per week or less practising massage, nearly half of all respondents (46.8%) treated fewer than 10 massage clients per week, and over three-quarters (81.7%) of respondents were self-employed. Massage therapy was the sole source of income for just over half (55.0%) of the study respondents. Only 5.7% of respondents earned over the average wage ($50,000) through their massage activities. Nearly half of all respondents (43.3%) reported regularly exceeding their continuing professional education (CPE) quota mandated by their professional association. However, 21.1% reported struggling to achieve their CPE quota each year. Over one-third of respondents (35.6%) were not interested in acquiring further CPE points beyond minimum requirements. Respondents were significantly more likely to have an active approach to research if they had higher income (p = .015). Multivariate analysis showed factors associated with access to CPE to be the only significant predictors for increased CPE.
The massage profession in Australia remains largely part-time and practitioners earn less than the average Australian wage. The factors that underlie research and education involvement appear to be highly individualised and, therefore, policies targeting specific groups may be arbitrary and ineffective.
We present a search for the standard model Higgs boson produced in association with a Z boson, using up to 7.9 fb - 1 of integrated luminosity from p p i?12 collisions collected with the CDF II ...detector. We utilize several novel techniques, including multivariate lepton selection, multivariate trigger parametrization, and a multi-stage signal discriminant consisting of specialized functions trained to distinguish individual backgrounds. By increasing acceptance and enhancing signal discrimination, these techniques have significantly improved the sensitivity of the analysis above what was expected from a larger dataset alone. We observe no significant evidence for a signal, and we set limits on the ZH production cross section. For a Higgs boson with mass 115 GeV / c 2 , we expect (observe) a limit of 3.9 (4.8) times the standard model predicted value, at the 95% credibility level.
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