To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Norwood surgery has been available in Sweden since 1993. In this national cohort study, we analysed transplantation-free survival after Norwood surgery for hypoplastic left heart syndrome with aortic atresia.
Patients were identified from the complete national cohort of live-born with hypoplastic left heart syndrome/aortic atresia 1993–2010. Analysis of survival after surgery was performed using Cox proportional hazards models for the total cohort and for birth period and gender separately. Thirty-day mortality and inter-stage mortality were analysed. Patients were followed until September 2016.
The 1993–2010 cohort consisted of 208 live-born infants. Norwood surgery was performed in 121/208 (58%). The overall transplantation-free survival was 61/121 (50%). The survival was higher in the late period (10-year survival 63%) than in the early period (10-year survival 40%) (p = 0.010) and lower for female (10-year survival 34%) than for male patients (10-year survival 59%) (p = 0.002). Inter-stage mortality between stages I and II decreased from 23 to 8% (p = 0.008). For male patients, low birthweight in relation to gestational age was a factor associated with poor outcome.
The survival after Norwood surgery for hypoplastic left heart syndrome/aortic atresia improved by era of surgery, mainly explained by improved survival between stages I and II. Female gender was a significant risk factor for death or transplantation. For male patients, there was an increased risk of death when birthweight was lower than expected in relation to gestational age.
Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus colonization of the adenoids and nasopharynx in 103 preschool children who underwent adenoidectomy for recurrent upper respiratory tract infections was examined. Bacterial interactions and risk factors for bacterial colonization of the nasopharynx and adenoids, separately, were analysed statistically. The prevalence of simultaneous isolation from both anatomical sites was 45·6% for S. pneumoniae, 29·1% for H. influenzae, 15·5% for M. catarrhalis and 18·4% for S. aureus. Three pathogens were significantly more frequent together from adenoid samples; nasopharyngeal swabs more often yielded a single organism, but without statistical significance. M. catarrhalis and S. aureus significantly more frequently co-existed with S. pneumoniae and H. influenzae than with each other and a positive association of S. pneumoniae and H. influenzae in adenoid samples was evident. Several differences between risk factors for nasopharyngeal and adenoid colonization by the individual pathogens were observed. We conclude that the adenoids and nasopharynx appear to differ substantially in colonization by pathogenic microbes but occurrence of H. influenzae and S. pneumoniae in the nasopharynx could be predictive of upper respiratory tract infections.
Dominant frequencies and coherent structures are investigated in a turbulent, three-dimensional and separated diffuser flow at (based on bulk velocity and inflow-duct height), where mean flow characteristics were first studied experimentally by Cherry, Elkins and Eaton (Intl J. Heat Fluid Flow, vol. 29, 2008, pp. 803–811) and later numerically by Ohlsson et al. (J. Fluid Mech., vol. 650, 2010, pp. 307–318). Coherent structures are educed by proper orthogonal decomposition (POD) of the flow, which together with time probes located in the flow domain are used to extract frequency information. The present study shows that the flow contains multiple phenomena, well separated in frequency space. Dominant large-scale frequencies in a narrow band (where is the inflow-duct height and is the bulk velocity), yielding time periods , are deduced from the time signal probes in the upper separated part of the diffuser. The associated structures identified by the POD are large streaks arising from a sinusoidal oscillating motion in the diffuser. Their individual contributions to the total kinetic energy, dominated by the mean flow, are, however, small. The reason for the oscillating movement in this low-frequency range is concluded to be the confinement of the flow in this particular geometric set-up in combination with the high Reynolds number and the large separated zone on the top diffuser wall. Based on this analysis, it is shown that the bulk of the streamwise root mean square (r.m.s.) value arises due to large-scale motion, which in turn can explain the appearance of two or more peaks in the streamwise r.m.s. value. The weak secondary flow present in the inflow duct is shown to survive into the diffuser, where it experiences an imbalance with respect to the upper expanding corners, thereby giving rise to the asymmetry of the mean separated region in the diffuser.
Semiconductor-based thermistors are very attractive sensor materials for uncooled thermal infrared (IR) bolometers. Very large scale heterogeneous integration of MEMS is an emerging technology that allows the integration of epitaxially grown, high-performance IR bolometer thermistor materials with pre-processed CMOS-based integrated circuits for the sensor read-out. Thermistor materials based on alternating silicon (Si) and silicon-germanium (SiGe) epitaxial layers have been demonstrated and their performance is continuously increasing. Compared to a single layer of silicon or SiGe, the temperature coefficient of resistance (TCR) can be strongly enhanced to about 3 %/K, by using thin alternating layers. In this paper we report on the optimization of alternating Si/SiGe layers by advanced physically based simulations, including quantum mechanical corrections. Our simulation framework provides reliable predictions for a wide range of SiGe layer compositions, including concentration gradients. Finally, our SiGe thermistor layers have been evaluated in terms of low-frequency noise performance, in order to optimize the bolometer detectivity.
To assess the dependence on fish consumption of families and its impact on nutritional status and neurodevelopment of pre-school children.
Cross-sectional study that measured children’s hair mercury (HHg) as an indicator of family fish consumption, growth (anthropometric Z-scores, WHO standards) and neurological (Gesell developmental scores (GDS)) development.
Traditional living conditions among families residing in the area adjacent to the Samuel Dam (Western Amazon) hydroelectric reservoir.
Two hundred and forty-nine pre-school children (1–59 months of age) from families transitioning from the traditional Amazonian lifestyle.
Family fish consumption was significantly correlated with children’s HHg concentration (Spearman’s r = 0·246, P < 0·0001); however, HHg had no significant association with growth (Z-scores). Overall, the prevalence of severe malnutrition, i.e. stunting (height-for-age Z-score (HAZ) ≤ −3), underweight (weight-for-age Z-score (WAZ) ≤ −3) and wasting (weight-for-height Z-score (WHZ) ≤ −3) was 5·2 % (n 13), 0 % and 0·8 % (n 2), respectively. The prevalence of moderate stunting (HAZ ≥ −3 to ≤ −2), underweight (WAZ ≥ −3 to ≤ −2) and wasting (WHZ ≥ −3 to ≤ −2) was 8·8 % (n 22), 2·4 % (n 6) and 4·8 % (n 12), respectively. Although 76 % of the children showed adequate GDS (>85), multiple regression analysis showed that fish consumption (as HHg) had no impact on GDS, but that some variables did interact significantly with specific domains (motor and language development).
The study showed that the families’ shift in fish consumption had no negative impact on the growth of young children and that ensuing methylmercury exposure has not been a noticeable neurodevelopmental hindrance.
Ice-marginal Hidden Creek Lake, Alaska, USA, outbursts annually over the course of 2–3 days. As the lake fills, survey targets on the surface of the ‘ice dam’ (the glacier adjacent to the lake) move obliquely to the ice margin and rise substantially. As the lake drains, ice motion speeds up, becomes nearly perpendicular to the face of the ice dam, and the ice surface drops. Vertical movement of the ice dam probably reflects growth and decay of a wedge of water beneath the ice dam, in line with established ideas about jökulhlaup mechanics. However, the distribution of vertical ice movement, with a narrow (50–100 m wide) zone where the uplift rate decreases by 90%, cannot be explained by invoking flexure of the ice dam in a fashion analogous to tidal flexure of a floating glacier tongue or ice shelf. Rather, the zone of large uplift-rate gradient is a fault zone: ice-dam deformation is dominated by movement along high-angle faults that cut the ice dam through its entire thickness, with the sense of fault slip reversing as the lake drains. Survey targets spanning the zone of steep uplift gradient move relative to one another in a nearly reversible fashion as the lake fills and drains. The horizontal strain rate also undergoes a reversal across this zone, being compressional as the lake fills, but extensional as the lake drains. Frictional resistance to fault-block motion probably accounts for the fact that lake level falls measurably before the onset of accelerated horizontal motion and vertical downdrop. As the overall fault pattern is the same from year to year, even though ice is lost by calving, the faults must be regularly regenerated, probably by linkage of surface and bottom crevasses as ice is advected toward the lake basin.
It has been shown, by imaging gold (200) planes, that it is possible
to achieve better than 0.20-nm structural resolution in cryo-transmission
electron microscopy (cryo-TEM). This has been done using commercially
available cryo equipment and using a 300-kV field emission gun (FEG) TEM.
The images of 15-nm gold particles embedded in amorphous frozen water
clearly show the (111) planes (separated by 0.235 nm) in gold. Fourier
transform demonstrates the presence of (200) planes in the image, proving
a resolution of better than 0.20 nm. The experimental results are
supported by image simulations using the multislice method. These
simulations suggest that it should be possible to achieve the same
resolution even in smaller particles and particles of lighter elements.
The crucial experimental problem to overcome is keeping the thickness of
the amorphous film low and to work at low electron dose conditions.
Among Joel Feinberg's almost innumerable achievements are his development and defense of the sovereign-right conception of autonomy and its corresponding rejection of hard legal paternalism. According to Feinberg, a competent individual's voluntary, self-regarding conduct falls within the protected realm of sovereign self-rule and is therefore immune from coercive, paternalistic interference by the state. It does not matter whether the self-harm the state wants to prevent is big or the coercion needed to prevent it is small. The coercive interference would be illegitimate because “sovereignty is an all or nothing concept; one is entitled to absolute control of whatever is within one's domain however trivial it may be.”
Ice-dammed Hidden Creek Lake, Alaska, USA, outbursts annually in about 2–3 days. As the lake fills, a wedge of water penetrates beneath the glacier, and the surface of this ‘ice dam’ rises; the surface then falls as the lake drains. Detailed optical surveying of the glacier near the lake allows characterization of ice-dam deformation. Surface uplift rate is close to the rate of lake-level rise within about 400 m of the lake, then decreases by 90% over about 100 m. Such a steep gradient in uplift rate cannot be explained in terms of ice-dam flexure. Moreover, survey targets spanning the zone of steep uplift gradient move relative to one another in a nearly reversible fashion as the lake fills and drains. Evidently, the zone of steep uplift gradient is a fault zone, with the faults penetrating the entire thickness of the ice dam. Fault motion is in a reverse sense as the lake fills, but in a normal sense as the lake drains. As the overall fault pattern is the same from year to year, even though ice is lost by calving, the faults must be regularly regenerated, probably by linkage of surface and bottom crevasses as ice is advected toward the lake basin.
To estimate the burden of disease due to congenital toxoplasmosis in Sweden the incidence of primary infections during pregnancy and birth prevalence of congenital toxoplasmosis in 40978 children born in two regions in Sweden was determined. Women possibly infected during pregnancy were identified based on: 1, detection of specific IgG based on neonatal screening of the phenylketonuria (PKU) card blood spot followed by retrospective testing of stored prenatal samples to detect women who acquired infection during pregnancy and follow up of their children to 12 months; 2, detection of specific IgM on the PKU blood spot.
The birth prevalence of congenital toxoplasmosis was 0·73/10000 (95% CI 0·15–2·14) (3/40978).
The incidence of primary infection during pregnancy was 5·1/10000 (95% CI 2·6–8·9) susceptible pregnant women. The seroprevalence in the southern part was 25·7% and in the Stockholm area 14·0%.
The incidence of infection during pregnancy was low, as the birth prevalence of congenital toxoplasmosis. Neonatal screening warrants consideration in view of the low cost and feasibility.
Marked seasonal reproduction is a widespread phenomenon in seaweeds in temperate waters strongly influenced by seasonal variations. In the Baltic Sea, however, the perennial brown alga Fucus vesiculosus exhibits two periods of reproduction: early summer (May–June) or late autumn (September–November). In this study, we compared the geographical distribution, the reproductive biology and the recruitment success for F. vesiculosus that reproduce during either of these two periods on the east coast of Sweden. Both monocultures and mixed populations of summer- and autumn-reproducing F. vesiculosus occurred along the mainland coast from the southern parts of the Stockholm archipelago to the southernmost part of Sweden. F. vesiculosus reproduced only during summer around the coasts of the large islands of Öland and Gotland. After reproduction, in July and January respectively, plants that reproduced in summer abscised their receptacles and part of their branches, while plants reproducing in autumn abscised only their receptacles. In laboratory experiments, short-day treatments (light:dark 8:16 h) were shown to initiate receptacles in summer-reproducing plants, whereas plants reproducing in autumn initiated receptacles independently of short- or long-day (light:dark 16:8 h) treatment. Plants reproducing during summer produced more eggs (21·0×104 eggs/g−1 frond mass) of smaller size (0·067 mm) than plants reproducing during autumn (8·9×104 eggs/g−1 frond mass, egg size 0·070 mm). However, recruitment success in the field was similar irrespective of the period of reproduction. The differences in the photoperiodic response, the differences in reproductive output and egg size between summer and autumn plants, and the observation that a single individual kept the same pattern of reproduction over a period of at least three reproductive seasons, may indicate that the two strategies of reproduction in F. vesiculosus are expressions of two distinct genotypes.
Superlattices of TiC/VC have been deposited on MgO(001) substrates by simultaneous direct current metal magnetron sputtering and C60 evaporation in the temperature range 200–800 °C. Thin superlattices (approximately 1000 Å) deposited at 400 °C exhibited an epitaxial growth with abrupt interfaces while films deposited at 200 °C showed a partial loss of epitaxy. At 800 °C roughening by surface diffusion started to degrade the superlattices and introduced a columnar microstructure. A loss of epitaxy was observed for thicker (>7000 Å) superlattice films deposited at 400 °C. The results suggest that this observation is due to difficulties in depositing epitaxial VC.
Herpes simplex type 1 (HSV-1) and 2 (HSV-2) infections are common in pregnant women; the symptoms – if any – are generally mild. However, HSV infection during pregnancy can result in transmission of the virus to the neonate, sometimes with serious disease and severe sequelae in the child (Nahmias et al., 1983; Koskiniemi et al., 1989; Malm et al., 1991; Azazi et al., 1990; Whitley & Arvin, 1995). Prevention is difficult, as the majority of HSV infections during pregnancy are atypical or silent. Furthermore, in the neonate vague symptoms are often not recognizable as herpes simplex disease, and early treatment of an infected child is therefore usually not an option.
Transmission of herpes simplex virus infection to the neonate is rare, which makes identification of risk factors for transmission and evaluation of preventive strategies difficult. Although results from large multicentre studies and the use of improved virological diagnostic tools have contributed to knowledge, formulation of evidence-based recommendations for prevention and management is still not possible. Management of HSV infection in pregnant women and children may also be influenced by non-medical factors, such as anxiety.
The prevalence of herpes infection – genital and oral – varies by populations of pregnant women and so does the risk of neonatal herpes. Preventive strategies should be guided by the incidence of neonatal infections. For an estimate of the real rate of neonatal herpes, surveillance studies based on active search for neonatal infections have to be undertaken in collaboration between neonatologists and virological laboratories.
Nanometer-sized particles of W are of interest in semiconductor device research, where such particles may store electrons inside heteroepitaxially defined structures. In this paper, we present results concerning W particles produced by thermal decomposition of tungsten hexacarbonyl. By the described method, it was possible to produce size-selected, single-crystalline W particles in the size range between 15 and 60 nm. The sintering behavior of the particles was studied between ambient temperatures and 1900 °C. The particle morphology and structure were examined with high-resolution transmission electron microscopy and electron diffraction techniques. Particles sintered at the highest temperatures typically were single crystals, with well-developed facets. Some problems concerning a yield reducing charging mechanism are discussed.