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The first episode of psychosis is a critical period in the emergence of cardiometabolic risk.
We set out to explore the influence of individual and lifestyle factors on cardiometabolic outcomes in early psychosis.
This was a prospective cohort study of 293 UK adults presenting with first-episode psychosis investigating the influence of sociodemographics, lifestyle (physical activity, sedentary behaviour, nutrition, smoking, alcohol, substance use) and medication on cardiometabolic outcomes over the following 12 months.
Rates of obesity and glucose dysregulation rose from 17.8% and 12%, respectively, at baseline to 23.7% and 23.7% at 1 year. Little change was seen over time in the 76.8% tobacco smoking rate or the quarter who were sedentary for over 10 h daily. We found no association between lifestyle at baseline or type of antipsychotic medication prescribed with either baseline or 1-year cardiometabolic outcomes. Median haemoglobin A1c (HbA1c) rose by 3.3 mmol/mol in participants from Black and minority ethnic (BME) groups, with little change observed in their White counterparts. At 12 months, one-third of those with BME heritage exceeded the threshold for prediabetes (HbA1c >39 mmol/mol).
Unhealthy lifestyle choices are prevalent in early psychosis and cardiometabolic risk worsens over the next year, creating an important window for prevention. We found no evidence, however, that preventative strategies should be preferentially directed based on lifestyle habits. Further work is needed to determine whether clinical strategies should allow for differential patterns of emergence of cardiometabolic risk in people of different ethnicities.
Declaration of interest
F.G. has received honoraria for advisory work and lectures or CME activity support from Roche, BMS, Lundbeck, Otsuka, Janssen and Sunovion, is a collaborator on an NHS Innovations project co-funded by Janssen and has a family member with professional links to Lilly and GSK, including shares. R.M.M. has received honoraria for lectures from Lundbeck, Otsuka, Janssen and Sunovian. M.D.F. has received honoraria for lectures from Janssen and Sunovian. Z.A. has received honoraria for advisory work and lectures from Roche, Sanofi, Lilly and Otsuka. O.H. has received investigator-initiated research funding from and/or participated in advisory/speaker meetings organised by Astra-Zeneca, Autifony, Biogen, BMS, Eli Lilly, Heptares, Jansenn, Lundbeck, Lyden-Delta, Otsuka, Servier, Sunovion, Rand and Roche. D.T. has received funding for lectures and research from Janssen, Otsuka, Servier, Lundbeck, Sunovion.
We have observed the G23 field of the Galaxy AndMass Assembly (GAMA) survey using the Australian Square Kilometre Array Pathfinder (ASKAP) in its commissioning phase to validate the performance of the telescope and to characterise the detected galaxy populations. This observation covers ~48 deg2 with synthesised beam of 32.7 arcsec by 17.8 arcsec at 936MHz, and ~39 deg2 with synthesised beam of 15.8 arcsec by 12.0 arcsec at 1320MHz. At both frequencies, the root-mean-square (r.m.s.) noise is ~0.1 mJy/beam. We combine these radio observations with the GAMA galaxy data, which includes spectroscopy of galaxies that are i-band selected with a magnitude limit of 19.2. Wide-field Infrared Survey Explorer (WISE) infrared (IR) photometry is used to determine which galaxies host an active galactic nucleus (AGN). In properties including source counts, mass distributions, and IR versus radio luminosity relation, the ASKAP-detected radio sources behave as expected. Radio galaxies have higher stellar mass and luminosity in IR, optical, and UV than other galaxies. We apply optical and IR AGN diagnostics and find that they disagree for ~30% of the galaxies in our sample. We suggest possible causes for the disagreement. Some cases can be explained by optical extinction of the AGN, but for more than half of the cases we do not find a clear explanation. Radio sources aremore likely (~6%) to have an AGN than radio quiet galaxies (~1%), but the majority of AGN are not detected in radio at this sensitivity.
Around 30% of individuals with schizophrenia remain symptomatic and significantly impaired despite antipsychotic treatment and are considered to be treatment resistant. Clinicians are currently unable to predict which patients are at higher risk of treatment resistance.
To determine whether genetic liability for schizophrenia and/or clinical characteristics measurable at illness onset can prospectively indicate a higher risk of treatment-resistant psychosis (TRP).
In 1070 individuals with schizophrenia or related psychotic disorders, schizophrenia polygenic risk scores (PRS) and large copy number variations (CNVs) were assessed for enrichment in TRP. Regression and machine-learning approaches were used to investigate the association of phenotypes related to demographics, family history, premorbid factors and illness onset with TRP.
Younger age at onset (odds ratio 0.94, P = 7.79 × 10−13) and poor premorbid social adjustment (odds ratio 1.64, P = 2.41 × 10−4) increased risk of TRP in univariate regression analyses. These factors remained associated in multivariate regression analyses, which also found lower premorbid IQ (odds ratio 0.98, P = 7.76 × 10−3), younger father's age at birth (odds ratio 0.97, P = 0.015) and cannabis use (odds ratio 1.60, P = 0.025) increased the risk of TRP. Machine-learning approaches found age at onset to be the most important predictor and also identified premorbid IQ and poor social adjustment as predictors of TRP, mirroring findings from regression analyses. Genetic liability for schizophrenia was not associated with TRP.
People with an earlier age at onset of psychosis and poor premorbid functioning are more likely to be treatment resistant. The genetic architecture of susceptibility to schizophrenia may be distinct from that of treatment outcomes.
Perceived discrimination (PD) is reliably and strongly associated with partisan identity (PID) among US immigrant minorities such as Latinos and Asian Americans. Yet whether PD causes PID remains unclear, since it is possible that partisanship influences perceptions of discrimination or that other factors drive the observed association. Here, we assess the causal influence of group-level PD on PID using five experiments with Latino and Asian American adults. These experiments varied in important ways: they took place inside and outside the lab, occurred prior to and during Donald Trump’s presidential campaign, and tested different manifestations of PD and partisan attitudes (total n = 2,528). These efforts point to a simple but unexpected conclusion: our experiments and operationalizations do not support the claim that group-targeted PD directly causes PID. These results have important implications for understanding partisanship among immigrants and their co-ethnics and the political incorporation of Latinos and Asian Americans.
This article examines the significant place of the 99th (Lanarkshire) Regiment of Foot as part of the shared history of Australia and New Zealand through the 1840s and 1850s, including its role in frontier conflict with Aboriginal peoples in Queensland and Māori peoples in New Zealand. This preliminary comparison explores the role and experiences of detachments of the British Army’s 99th Regiment on three different colonial frontiers during the 1840s transitional period: the end of convict transportation and the opening of free settlement in Moreton Bay in 1842–48; the short-lived North Australia colony (later Gladstone) in 1847; and New Zealand’s North Island in 1845–47.
Recent years have seen a renaissance of conjoint survey designs within social science. To date, however, researchers have lacked guidance on how many attributes they can include within conjoint profiles before survey satisficing leads to unacceptable declines in response quality. This paper addresses that question using pre-registered, two-stage experiments examining choices among hypothetical candidates for US Senate or hotel rooms. In each experiment, we use the first stage to identify attributes which are perceived to be uncorrelated with the attribute of interest, so that their effects are not masked by those of the core attributes. In the second stage, we randomly assign respondents to conjoint designs with varying numbers of those filler attributes. We report the results of these experiments implemented via Amazon's Mechanical Turk and Survey Sampling International. They demonstrate that our core quantities of interest are generally stable, with relatively modest increases in survey satisficing when respondents face large numbers of attributes.
Special educator attrition is a major problem in the United States (US) and in many countries worldwide. In the present study, we investigated the experiences of 5 highly successful special education teachers serving students with autism spectrum disorder in the central Florida area of the US with particular attention to factors associated with teacher retention. A phenomenological research design was employed to identify factors leading participants to persevere where others have not. A representative sample was included of multiple teachers in classrooms of varying grade levels and school districts across central Florida as part of a funded project by the Office of Special Education Services and the U.S. Department of Education. Findings include that teachers of students with ASD who are involved in extracurricular activities may show a lowered burnout rate.
is a smooth complex algebraic variety. A necessary condition for a complex topological vector bundle on
(viewed as a complex manifold) to be algebraic is that all Chern classes must be algebraic cohomology classes, that is, lie in the image of the cycle class map. We analyze the question of whether algebraicity of Chern classes is sufficient to guarantee algebraizability of complex topological vector bundles. For affine varieties of dimension
, it is known that algebraicity of Chern classes of a vector bundle guarantees algebraizability of the vector bundle. In contrast, we show in dimension
that algebraicity of Chern classes is insufficient to guarantee algebraizability of vector bundles. To do this, we construct a new obstruction to algebraizability using Steenrod operations on Chow groups. By means of an explicit example, we observe that our obstruction is nontrivial in general.
We measure the cosmic star formation history out to z = 1.3 using a sample of 918 radio-selected star-forming galaxies within the 2-deg2 COSMOS field. To increase our sample size, we combine 1.4-GHz flux densities from the VLA-COSMOS catalogue with flux densities measured from the VLA-COSMOS radio continuum image at the positions of I < 26.5 galaxies, enabling us to detect 1.4-GHz sources as faint as 40 μJy. We find that radio measurements of the cosmic star formation history are highly dependent on sample completeness and models used to extrapolate the faint end of the radio luminosity function. For our preferred model of the luminosity function, we find the star formation rate density increases from 0.017 M⊙ yr−1 Mpc−3 at z ∼ 0.225 to 0.092 M⊙ yr−1 Mpc−3 at z ∼ 1.1, which agrees to within 40% of recent UV, IR and 3-GHz measurements of the cosmic star formation history.
All patients undergoing tympanomastoid surgery should be assessed post-operatively for a ‘dead ear’; however, tuning forks are frequently inaccessible.
To demonstrate that smartphone-based vibration applications provide equivalent accuracy to tuning forks when performing Weber's test.
Data were collected on lay participants with no underlying hearing loss. Earplugs were used to simulate conductive hearing loss. Both the right and left ears were tested with the iBrateMe vibration application on an iPhone and using a 512 Hz tuning fork.
Occluding the left ear, the tuning fork lateralised to the left in 18 out of 20 cases. In 20 out of 20 cases, sound lateralised to the left with the iPhone (chi-square test, p = 0.147). Occluding the right ear, the tuning fork lateralised to the right in 19 out of 20 cases. In 19 out of 20 cases, sound lateralised to the right with the iPhone (chi-square test, p > 0.999).
Smartphone-based vibration applications represent a viable, more accessible alternative to tuning forks when assessing for conductive hearing loss. They can therefore be utilised on the ward round, in patients following tympanomastoid surgery, for example.
This review examines the metabolic adaptations that occur in response to negative energy balance and their potential putative or functional impact on appetite and food intake. Sustained negative energy balance will result in weight loss, with body composition changes similar for different dietary interventions if total energy and protein intake are equated. During periods of underfeeding, compensatory metabolic and behavioural responses occur that attenuate the prescribed energy deficit. While losses of metabolically active tissue during energy deficit result in reduced energy expenditure, an additional down-regulation in expenditure has been noted that cannot be explained by changes in body tissue (e.g. adaptive thermogenesis). Sustained negative energy balance is also associated with an increase in orexigenic drive and changes in appetite-related peptides during weight loss that may act as cues for increased hunger and food intake. It has also been suggested that losses of fat-free mass (FFM) could also act as an orexigenic signal during weight loss, but more data are needed to support these findings and the signalling pathways linking FFM and energy intake remain unclear. Taken together, these metabolic and behavioural responses to weight loss point to a highly complex and dynamic energy balance system in which perturbations to individual components can cause co-ordinated and inter-related compensatory responses elsewhere. The strength of these compensatory responses is individually subtle, and early identification of this variability may help identify individuals that respond well or poorly to an intervention.