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The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model.
Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed.
The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage.
The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.
Network providers either attempt to handle massive distributed denial-of-service attacks themselves or redirect traffic to third-party scrubbing centers. If providers adopt the first option, it is sensible to counter such attacks in their infancy via provider collaborations deploying distributed security mechanisms across multiple domains in an attack path. This motivated our work presented in this paper. Specifically, we investigate the establishment of trusted federations among adjacent and disjoint network domains, that is, autonomous systems (ASes) that collectively mitigate malicious traffic. Our approach is based on Distributed Ledger Technologies for signaling, coordination, and orchestration of a collaborative mitigation schema via appropriate blockchain-based smart contracts. Reputation scores are used to rank ASes based on their mitigation track record. The allocation of defense resources across multiple collaborators is modeled as a combinatorial optimization problem considering reputation scores and network flow weights. Malicious flows are mitigated using programmable network data paths within the eXpress Data Path (XDP) framework; this enables operators with enhanced packet processing throughput and advanced filtering flexibility. Our schema was implemented in a proof-of-concept prototype and tested under realistic network conditions.
Every year, 71% of all deaths globally are due to NCDs. Over 85% of these deaths occur in low- and middle-income countries (LMICs), with 36% of all reported deaths in Rwanda attributed to NCDs. Approximately 24 million lives are lost each year in LMICs due to emergency medical conditions. The collaboration between VCU and the EMS Rwanda designed and implemented a pre-hospital medical emergencies training course and train-the-trainers program to address the rise of NCDs.
During the course, pre and post 50 assessment questions were administered. Two cohorts participated 25 prehospital staff identified by EMS to form an instructor core and 19 emergency staff from public hospitals who are likely to respond to local emergencies in the community. A two-day EMCC was developed using established best practices. The Instructor core completed EMCC 1 and a one-day educator course and then taught the second cohort (EMCC2). Student’s t-test and matched paired t-tests were used to evaluate the assessments.
Mean score on EMCC 1 was 43% (SD: 20) compared to 85% (SD: 5) on post-course assessment. Pre-assessment failure rate was 88%. Mean scores for EMCC 2 were 45% (SD: 14) and 81% (SD: 10) on post-assessment. Pre-assessment score was low (50%). A paired t-test comparing pre-course to post-course assessment means demonstrated an increase by 42% (SD 30) for EMCC 1 (p<0.001) and 37% (SD: 14) for EMCC 2 (p<0.001) with 95% confidence. No items had to be removed from analysis based on the discrimination index (di).
NCDs often present as emergencies such as myocardial infarction and stroke. Effective management of these in the prehospital setting is essential to optimal outcomes. This study effectively implemented a training program in Kigali, Rwanda and created an instructor core to allow scale-up of effective pre-hospital services across the country.
The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) reported that the risks of breast cancer treatment in woman smokers may outweigh the benefits. The data used doses from published reports using a variety of treatment techniques. In our study, the risks of lung cancer and heart disease were determined from a modern era tangential-only technique.
Methods and materials
Doses to the lung and heart were obtained for tangential radiotherapy to the breast or chest wall. The risk of lung cancer incidence and cardiac mortality were calculated by taking the ratio of our doses to those published by the EBCTG.
A total of 77 women were identified meeting our inclusion criteria. The mean combined whole lung dose was 2·0 Gy. The mean whole heart dose was 0·9 Gy. The estimated risk of lung cancer and cardiac mortality in a 50-year-old life-long smoker was estimated to be 1·5 and <1%, respectively.
Tangential only radiotherapy delivered substantially lower doses to the combined whole lung and whole heart than those reported by the EBCTCG. In this cohort, the risks of radiation induced lung cancer and heart disease are outweighed by the benefits of radiotherapy even in those that are smokers.
The Alaska Peninsula is a landscape defined by volcanic, tectonic, and glacial processes, and life throughout is conditioned on the interactions among them. During the middle Holocene (ca. 4100–3600 yr ago), intense caldera-forming eruptions of the Aniakchak and Veniaminof volcanoes changed the shape of the central portion of the Peninsula dramatically, and had significant and perhaps devastating impacts on both terrestrial and marine biota. Here we evaluate the severity of these impacts by tracking human settlement patterns using 75 unique radiocarbon (14C) age determinations on buried cultural features from the central Alaska Peninsula. Coastal regions were re-colonized within a few hundred years while river systems most proximate to the volcanoes were uninhabited for up to 1500 years following the most severe eruptions. Patterns of human settlement may also document previously unrecorded landscape change throughout the region, and further contribute to our understanding of post-volcanic ecological succession.
In the last decades, numerous observational and computational studies have shown that the global flare distribution is a power-law with a slope less than 2. In these studies, active regions are treated as statistically indistinguishable. To test this, we identify and separately analyze the flares produced by ten individual active regions (2006-2016). In five regions, we find a single power-law distribution, with a slope of a < 2. In the other five, we find a broken double power-law distribution, with slopes a1 < 2 and a2 > 2.
Explanations for the use of pots as practical domestic tools permeate the literature of technological adoption and change. While many arguments focus on the economic merits of pots, few have attempted to trace the conditions that promote or deter the adoption of pottery. This is especially true for the use of pottery by mobile peoples. We adapt an established model of technological investment to draw attention to three key variables affecting pottery adoption: manufacturing time, utility, and use time. We use the logic of this model to examine how social and environmental contexts, specifically residential mobility in marginal environments, impacts use of and investment in ceramic technology. We further illustrate how the model can be used to reveal seasonal patterns of behavior from the spatial distribution of pottery discarded by mobile foragers and herders.
The objective of the study was to investigate the effect of season on the fatty acid and terpene composition in ewe milk. A total of 760 samples of bulk sheep milk were collected during winter (147 samples), spring (314 samples) and summer (299 samples) of 2011, from 90 commercial farms of dairy sheep from the prefecture of Grevena, Greece. Regarding fatty acid composition, summer samples had higher concentrations of α-linolenic acid, cis-9, trans 11- CLA, trans-11, C18 : 1 and PUFAs but lower content of saturated fatty acids particularly C12 : 0, C14 : 0 and C16 : 0. The winter milk had the lowest content of terpenes, in particular sesquiterpenes, compared to spring and summer milk. The terpene profile of milk samples, in all three seasons, revealed the presence of monoterpenes: a-pinene, b-pinene and D-limonene, especially with a higher frequency of appearance in summer. The most common and abundant sesquiterpenes found in milk samples were β-caryophyllene and α-caryophyllene with a higher frequency of appearance in summer. In conclusion, the available pastures in semi-extensive farming systems can contribute to the production of high quality milk.
Here we report findings to optimize and standardize conditions to attenuate metacercariae of Opisthorchis viverrini by ionizing radiation to elicit protective immune responses to challenge infection. Metacercariae were gamma-irradiated and the ability of irradiated metacercariae to prevent patent infection of challenge metacercariae in hamsters was determined, as well as their ability to induce a host antibody response. Metacercariae irradiated in a dose-dependent manner, with 3, 5, 10, 12, 20, 25 and 50 Gray, were used to infect Syrian golden hamsters by stomach gavage to ascertain the effect of irradiation on ability of the worms to establish infection. In addition, other hamsters were infected with metacercariae irradiated with 20–50 Gray, followed by challenge with intact/wild-type (non-irradiated) metacercariae to determine the protective effect as established by the numbers of adult flukes, eggs of O. viverrini in hamster faeces and anti-O. viverrini antibody titres. Significantly fewer worms were recovered from hamsters immunized with metacercariae irradiated at 20, 25 and 50 Gray than from control hamsters infected with intact metacercariae or 0 Gray, and the worms showed damaged reproductive organs. Faecal egg numbers were decreased significantly in hamsters immunized with 25 and 50 Gray metacercariae of O. viverrini. Moreover, hamsters administered metacercariae that were protected elicited a robust, specific anti-fluke immunoglobulin G response compared to control hamsters, suggesting a role for antibody in protection elicited by radiation-attenuated metacercariae.
Most neuropsychological batteries, especially those most often used, are unsuitable for the assessment of patients with severe dementia. The Severe Impairment Battery (SIB) was developed for the evaluation of preserved cognitive functions in these patients. The aim of this study was to formulate a Greek version of the SIB and to conduct a first assessment of its use of patients with mild, moderate, or severe Alzheimer's disease (AD), compared to the Mini-Mental State Examination (MMSE).
A convenience sample of 42 dementia patients according to DSM-IV-TR criteria and 23 healthy participants was selected. Patients were assessed twice using a Greek translation of the SIB and the Greek version of MMSE. Patients were divided into three severity groups based on grouped by Clinical Dementia Rating (CDR) score and the SIB and MMSE scores were compared.
The validity of the SIB was confirmed by evaluating the correlation coefficients between the SIB and Greek-MMSE, grouped by CDR, which were found to be significant. Cronbach's α for the total SIB score and each subscale score showed high significance, and the item-total correlation for each subscale was also acceptable. The test-retest correlation for the total SIB score and subscale scores were significant. The total SIB score and subscale scores were examined according to CDR.
The Greek SIB is reliable and valid in differentiating patients with moderate or severe dementia, whereas MMSE loses sensitivity due to a floor and ceiling effect.
A review of recently published temporal data from Shuidonggou Locality 1 indicates that a 40–43 cal ka date for the inception of Initial Upper Paleolithic (IUP) blade-oriented technologies in East Asia is warranted. Comparison of the dates from Shuidonggou to other Asian IUP dates in Korea, Siberia, and Mongolia supports this assertion, indicating that the initial appearance of the IUP in East Asia generally corresponds in time to the fluorescence of the IUP in eastern Europe and western Asia. This conclusion preliminarily suggests that either a version of the IUP originated independently in East Asia just prior to 40 cal ka, or more likely, that an early, initial diffusion of the IUP into East Asia occurred ∼41 cal ka, a hypothesis consistent with current estimates for the evolution or arrival of modern humans in the region.
In this paper we prove a certain
-estimate for multilinear Fourier multiplier operators with multipliers of limited smoothness. As a consequence, we extend the result of Calderón and Torchinsky in the linear theory to the multilinear case. The sharpness of our results and some related estimates in Hardy spaces are also discussed.
In a seminal article, J. R. Morgan asserts that the greater part of Heliodorus' Aethiopica explores ‘the antithesis between true love and various corrupt or otherwise unsatisfactory alternatives’. This it does not only through Cnemon's novella, which is narrated mainly in the first two books of the novel, but also through the incident involving the Persian queen Arsake, which to a certain extent replicates Cnemon's story. This narrative duplication is enhanced by the fact that both stories are intertextually related to the myth of Phaedra. Building on Morgan's argument, my contention is that the antithesis between pure love, conditioned by sophrosyne, and illicit desire permeates the entire novel and does not exclusively concern the primary couple or the persons involved in the abovementioned episodes, but relates to almost all the main characters. More importantly, it is precisely this antithesis that constitutes the most fundamental component of the work's structural principle or thesis.
We obtain weighted norm inequalities for maximal truncated operators of multi-linear singular integrals with non-smooth kernels in the sense of Duong et al. This class of operators extends the class of multi-linear Calderón-Zygmund operators introduced by Coifman and Meyer and includes the higher-order commutators of Calderón. The weighted norm inequalities obtained in this work are with respect to the new class of multiple weights of Lerner et al. The key ingredient in the proof is the introduction of a new multi-sublinear maximal operator that plays the role of the Hardy-Littlewood maximal function in a version of Cotlar's inequality. As applications of these results, new weighted estimates for the mth order Calderón commutators and their maximal counterparts are deduced.