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With generous support from the National Science Foundation, we have spent the past four years developing an archaeological radiocarbon database for the United States. Here, we highlight the importance of spatial data for open-access, national-scale archaeological databases and the development of paleodemography research. We propose a new method for analyzing radiocarbon time series in the context of paleoclimate models. This method forces us to confront one of the central challenges to realizing the full potential of national-scale databases: the quality of the spatial data accompanying radiocarbon dates. We seek to open a national discussion on the use of spatial data in open-source archaeological databases.
The Pugh Method of Controlled Convergence is evaluated based on social choice theory, both from an axiomatic basis, and by examining all possible cases of attribute ranks for a range of numbers of alternatives and numbers of attributes. The evaluation shows that, for a typical Pugh application, concept selection varies with the arbitrary choice of datum or is simply incorrect in about one-third of the cases. While there are merits to the iteration steps and creation of new alternatives within the Pugh method, a simpler and more expressive concept ranking procedure can give far superior results.
Concerns exist over the long-term consequences of subclavian artery ligation in subclavian flap repair for coarctation of the aorta. We sought to analyse upper limb structural and functional performance in adults who have had surgery in childhood for coarctation of the aorta, using either subclavian flap repair or end to end aortic anastomosis.
Two-group observational design using anatomical and upper limb functional performance measures. Purposive sampling from our specialist adult congenital heart disease database of patients who received subclavian flap repair or end to end anastomosis for coarctation of the aorta as children. Upper limb measurements were completed using MRI and blood flow velocity with ultrasound imaging. Bilateral standardised upper limb functional testing of assessment of strength, dexterity and a standardised self-report of upper limb disability was completed.
Eighteen right-handed patients, 9 with subclavian repair, (38 ± 12 years, 78% males) were studied. Age at repair was 4.7 ± 5.9 years; mean time from initial repair 32 ± 9 years. The subclavian group had a larger difference between right and left when compared the end to end anastomosis group in: lower arm muscle mass (94.5 ± 42.3 mls versus 37.8 ± 94.5 mls, p = 0.008), lower arm maximal cross-sectional area, (5.9 ± 2.8 cm2 versus 2.9 ± 2.6 cm2, p = 0.038) and grip strength (14.7 ± 8.3 lbs versus 5.9 ± 5.3 lbs, p = 0.016) There were no significant functional differences between groups.
In adults with repaired coarctation of the aorta, those with subclavian flap repair had a greater right to left arm muscle mass and grip strength differential when compared to those with end to end anastomosis repair.
First-degree heart block is a minor manifestation of acute rheumatic fever. Second and third degree heart block and junctional rhythms occur less commonly. We report patients presenting with these latter three electrocardiographic abnormalities and investigate their diagnostic utility.
Patients admitted to our centre meeting the 2014 New Zealand Rheumatic Fever Guideline Diagnostic Criteria for rheumatic fever over a 5-year period from January 2010 to December 2014 were identified. Clinical, haematologic, electrocardiographic, and echocardiographic records were reviewed. Electrocardiograms (ECG) were considered abnormal if there was second- or third-degree atrioventricular block or junctional rhythms. Comparative data from patients with advanced conduction abnormalities without a diagnosis of rheumatic fever during the same time period were reviewed.
A total of 201 patients met inclusion criteria for rheumatic fever. Of these, 17 (8.5%) had transient abnormalities of atrioventricular conduction, 5 (2.5%) with second or third-degree atrioventricular block, and 12 (6%) junctional rhythms. The remaining 173 (86%) patients had evidence of rheumatic valvulitis at presentation. Only one patient without rheumatic fever was found to have advanced conduction abnormalities over the study period, from a total of 3702 ECG.
This large contemporary cohort of acute rheumatic fever shows that 8.5% of cases had either advanced atrioventricular block or junctional rhythms both highly suggestive of the diagnosis in our population.
Both the title and the contents of Gower's Cinkante Balades firmly situate the work in the dominant strand of the French courtly lyric of the fourteenth and early fifteenth centuries, as it was practiced and defined by the major poets of the era—Machaut, Deschamps, and Froissart—and as it was sustained by their many followers, including, among Gower's contemporaries, Oton de Granson, who spent much of his career in England; Christine de Pizan, who may have begun writing ballades at about the same time as Gower; the aristocratic poets who contributed to the Livre des cent balades, to whose work Gower probably makes a bow in his choice of the round number cinkante; and also many anonymous writers, such as the poets whose works appear alongside those of their better-known peers in the Pennsylvania chansonnier, which was copied at just about the same time as the manuscript in which the Cinkante Balades is contained. Gower's relation to this tradition is complex. While he clearly adopted many of the most recognizable conventions of form, diction, and theme, he equally clearly made his own choices, some with an eye to the design of his collection as a whole, some as part of an ongoing dialogue with the poets whose works he knew, and some because of his own understanding of the expressive function of the lyric. There is a great deal of variety in the Cinkante Balades for anyone who reads them closely, but because of the choices that Gower made, the work also has some distinctive qualities that set it apart from every earlier collection of ballades.
The date and the order of composition of the poems that now make up the Cinkante Balades must remain unknown, but there is evidence that, like the contents of the manuscript in which they appear, their present arrangement is the result of at least some effort to give shape and order to the collection. The ordering is particularly evident at the end. The last four poems (48–51) switch from personal address to more general reflections on the nature of love, the last three in the voice of the poet, and the last of these turns to a different sort of love entirely as the poet speaks of his affection for the Blessed Virgin in what was clearly intended as the conclusion.
Spectrum analysis in the ultrasoft X-ray region is complicated by the fact that this radiation is almost totally absorbed in any medium. This has necessitated spectrometer components which minimize this effect. Nondispersive and total reflection techniques, though high in speed, lack good resolution and in the case of the latter, are usually restricted to analysis of elements differing by at least three atomic numbers.
Diffracting media which have proven successful are the long-chain organic crystals and gratings at grazing incidence. The grating is superior to the organic crystal concerning resolution and dispersion and has proven to be comparable arid in some cases better for peak intensity and line-to-background ratios.
Lightly-ruled gratings have been used for many years, but little attention has been given the blazed grating until recently. Since the critical angle of total reflection for a given material is wavelength-dependent, it may be utilized to discriminate against shorter wavelengths and thus improve line-to-background ratios. The optimum conditions for sensitivity, then, would be to relate the input angle to the blaze angle and vary the input angle as a function of wavelength, thereby maximizing the line intensity or the line-to-backgrourid ratio as required.
Several gratings with varying blaze angles and surface finishes are evaluated with O Kα (23.7Å) and C Kα (44Å) radiation.
The importance of groove profile is emphasized by comparing the profile as determined by the electron microscope with the experimental evidence. The variation of diffraction efficiency with wavelength and input angle is then considered theoretically and compared with experimental results.
The importance of operating within the blaze angle is emphasized by a series of measurements of ultrasoft X-rays obtained with a new grazing-incidence, grating spectrometer, A formula to maximize output intensity has been derived which predicts a variation of input angle with changes of wavelength. The spectrometer is designed to utilize this function. The grating spectrometer was installed into an Applied Research Laboratories Analyst's Microprobe. Since the AMX furnishes an utt.rasoft spectrometer with a fatty acid pseudocrystal as standard equipment, it is possible to compare the two systems simultaneously on the same sample at the same wavelength. The grating and crystal systems are compared for peak intensity and line-to-background ratio.
Two aluminized gratings with different blaze angles, 1° and 7.55′, and a barium stearate monolayer crystal were compared for first-order X-ray line spectra from oxygen (23.707 Å) to beryllium (113 Å). The peak intensities for the gratings were found to be greater than for the monolayer crystal when the same detector, source, and excitation conditions were used. Line-to-background ratios and halfwidths were comparable.
Functional neurological disorder (FND), previously known as conversion disorder, is common and often results in substantial distress and disability. Previous research lacks large sample sizes and clinical surveys are most commonly derived from neurological settings, limiting our understanding of the disorder and its associations in other contexts. We sought to address this by analysing a large anonymised electronic psychiatric health record dataset.
Data were obtained from 322 patients in the South London and Maudsley NHS Foundation Trust (SLaM) who had an ICD-10 diagnosis of motor FND (mFND) (limb weakness or disorders of movement or gait) between 1 January 2006 and 31 December 2016. Data were collected on a range of socio-demographic and clinical factors and compared to 644 psychiatric control patients from the same register.
Weakness was the most commonly occurring functional symptom. mFND patients were more likely to be female, British, married, employed pre-morbidly, to have a carer and a physical health condition, but less likely to have had an inpatient psychiatric admission or to receive benefits. No differences in self-reported sexual or physical abuse rates were observed between groups, although mFND patients were more likely to experience life events linked to inter-personal difficulties.
mFND patients have distinct demographic characteristics compared with psychiatric controls. Experiences of abuse appear to be equally prevalent across psychiatric patient groups. This study establishes the socio-demographic and life experience profile of this understudied patient group and may be used to guide future therapeutic interventions designed specifically for mFND.
Based on Chinese constitutional analysis, political science, and law and society studies, we argue that work extending the application of popular constitutionalism to authoritarian states applies in Vietnam, as popular constitutionalism targets sites relevant to constitutional reform. We contend that popular constitutionalism located in authoritarian states requires three factors: a tradition of activism, space for reformist and pragmatic dialogue targeting constitutional change, and the political need for legitimacy. This article analyses activism in Vietnam, focusing on the lodging of Petition 72 with the Constitutional Amendment Drafting Commission in 2013, and the resulting responses. We conclude that this activism was pivotal in advocating for new constitutional norms, evidencing popular constitutionalism in Vietnam. The long history of Vietnamese scholar activism, the relative space for governance debates, and the political need for legitimacy made this possible. We also note that popular constitutionalism faces constraints in authoritarian states, which may shape its trajectory.
A theorem of Burgess and Stephenson asserts that in an exchange ring with central idempotents, every maximal left ideal is also a right ideal. The proof uses sheaf-theoretic techniques. In this paper, we give a short elementary proof of this important theorem.
Hospital environmental surfaces are frequently contaminated by microorganisms. However, the causal mechanism of bacterial contamination of the environment as a source of transmission is still debated. This prospective study was performed to characterize the nature of multidrug-resistant organism (MDRO) transmission between the environment and patients using standard microbiological and molecular techniques.
Prospective cohort study at 2 academic medical centers.
A prospective multicenter study to characterize the nature of bacterial transfer events between patients and environmental surfaces in rooms that previously housed patients with 1 of 4 ‘marker’ MDROs: methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, and MDR Acinetobacter baumannii. Environmental and patient microbiological samples were obtained on admission into a freshly disinfected inpatient room. Repeat samples from room surfaces and patients were taken on days 3 and 7 and each week the patient stayed in the same room. The bacterial identity, antibiotic susceptibility, and molecular sequences were compared between organisms found in the environment samples and patient sources.
We enrolled 80 patient–room admissions; 9 of these patients (11.3%) were asymptomatically colonized with MDROs at study entry. Hospital room surfaces were contaminated with MDROs despite terminal disinfection in 44 cases (55%). Microbiological Bacterial Transfer events either to the patient, the environment, or both occurred in 12 patient encounters (18.5%) from the microbiologically evaluable cohort.
Microbiological Bacterial Transfer events between patients and the environment were observed in 18.5% of patient encounters and occurred early in the admission. This study suggests that research on prevention methods beyond the standard practice of room disinfection at the end of a patient’s stay is needed to better prevent acquisition of MDROs through the environment.
The field of psychiatry would benefit significantly from developing objective biomarkers that could facilitate the early identification of heterogeneous subtypes of illness. Critically, although machine learning pattern recognition methods have been applied recently to predict many psychiatric disorders, these techniques have not been utilized to predict subtypes of posttraumatic stress disorder (PTSD), including the dissociative subtype of PTSD (PTSD + DS).
Using Multiclass Gaussian Process Classification within PRoNTo, we examined the classification accuracy of: (i) the mean amplitude of low-frequency fluctuations (mALFF; reflecting spontaneous neural activity during rest); and (ii) seed-based amygdala complex functional connectivity within 181 participants [PTSD (n = 81); PTSD + DS (n = 49); and age-matched healthy trauma-unexposed controls (n = 51)]. We also computed mass-univariate analyses in order to observe regional group differences [false-discovery-rate (FDR)-cluster corrected p < 0.05, k = 20].
We found that extracted features could predict accurately the classification of PTSD, PTSD + DS, and healthy controls, using both resting-state mALFF (91.63% balanced accuracy, p < 0.001) and amygdala complex connectivity maps (85.00% balanced accuracy, p < 0.001). These results were replicated using independent machine learning algorithms/cross-validation procedures. Moreover, areas weighted as being most important for group classification also displayed significant group differences at the univariate level. Here, whereas the PTSD + DS group displayed increased activation within emotion regulation regions, the PTSD group showed increased activation within the amygdala, globus pallidus, and motor/somatosensory regions.
The current study has significant implications for advancing machine learning applications within the field of psychiatry, as well as for developing objective biomarkers indicative of diagnostic heterogeneity.