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Excavations at Amheida between 2004 and 2006 revealed a large, late antique domicile, dubbed the “House of Serenos,” filled with an astonishing array of decorated plaster – a rare find in terms of quantity as well as the subject matter of the paintings in the house’s main reception room. Showcasing lively figural scenes drawn from Greco-Roman mythology in an era when one might expect instead Christian iconography, the visual program of this house reveals much about the sophisticated visual and literary culture at play in a city that could otherwise be considered a backwater given its distance from the major metropolitan centers of the Nile. This chapter surveys therefore the extraordinary corpus of late antique wall painting from Amheida’s House of Serenos alongside other examples of decorated plaster from the Great Oasis in order to interrogate the role played by artistic practice and visual culture in general in articulating the social, political, and religious dynamics of late antique Egypt.
The National Academies of Sciences (NAS) emphasize the need for interdisciplinary team science (TS) training, but few training resources are available. COALESCE, an open-access tool developed with National Institutes of Health support and located at teamscience.net, is considered a gold standard resource but has not previously been evaluated. COALESCE launched four learning modules in 2011. The Science of TS (SciTS) module, an interactive encyclopedia, introduces foundational concepts. Three scenario-based modules simulate TS challenges in behavioral, clinical, and basic biomedical sciences. This study examined user characteristics, usage patterns, and effects of completing the four modules on TS knowledge, attitudes, and skills.
Repeated measures ANOVA tested for pre-post changes in performance and compared learning by users with biomedical versus other disciplinary backgrounds.
From 2011 through 2017, the site attracted 16,280 new users who engaged in 6461 sessions that lasted more than 1 min. The modal registrant identified as working in a biomedical field (47%), in an academic institution (72%), and expressed greater interest in the practice than the SciTS (67%). Those completing pre- and post-tests (n = 989) showed significant improvement in knowledge, attitudes, and skills after taking all scenario-based modules (p < 0.005); knowledge and attitudes were unchanged after the SciTS encyclopedia. Biomedical and other health professionals improved comparably.
Evaluation of the TS training tool at teamscience.net indicates broad dissemination and positive TS-related outcomes. Site upgrades implemented between 2018 and 2020, including adding five new modules, are expected to increase the robustness and accessibility of the COALESCE training resource.
Reductions in insulin sensitivity in periparturient dairy cows develop as a means to support lactation; however, excessive mobilization of fatty acids (FA) increases the risk for peripartal metabolic disorders. Our objectives were to investigate the effect of prepartum body condition score (BCS) on systemic glucose and insulin tolerance, and to compare direct and indirect measurements of insulin sensitivity in peripartal lean and overweight dairy cows. Fourteen multiparous Holstein cows were allocated into two groups according to their BCS at day −28 prepartum: lean (n = 7; BCS ≤ 3.0) or overweight; (n = 7; BCS ≥ 4.0). Liver biopsies were performed on day −27, −14 and 4, relative to expected parturition. Intravenous insulin or glucose tolerances tests were performed following each liver biopsy. Relative to lean cows, overweight cows exhibited lower dry matter intake, lost more BCS and displayed increased plasma FA and β-hydroxybutyrate concentrations and elevated liver lipid content during peripartum. Glucose clearance rate was lower for all cows postpartum. Prepartum BCS had minimal effects on insulin and glucose tolerance; however, the ability of the cow to restore blood glucose levels following an insulin challenge was suppressed by increased BCS. Glucose-dependent parameters of insulin and glucose tolerance were not correlated with surrogate indices of insulin sensitivity. We conclude that prepartum BCS had minimal effect on systemic insulin sensitivity following parturition. The observed inconsistency between surrogate indices of insulin sensitivity and direct measurements of insulin and glucose tolerance adds support to growing concerns regarding their usefulness as tools to estimate systemic insulin action in periparturient cows.
The SALT Triage system has been advocated as an easy-to-use sorting and treatment system for mass casualty incidents (MCI). Minimally injured (GREEN) patients tend to be in the majority and may cause impediments to access and treatment of the most critically injured (RED). By identifying flaws in MCI communications that impair effective patient care, responders can be more effective.
To discover strategies that effectively manage the minimally injured and leverage their help, increasing triage efficiency and treatment of the immediate casualties.
Direct observation, after-action debriefing, and literature search.
The literature was vague regarding recommendations on a bystander and trained provider communication best practices. Feedback from standardized patients (actors) and participants during a structured debriefing following a 2018 American Society of Anesthesiology MCI exercise suggested that triaging providers under stress may communicate poorly, contributing to increased patient anxiety, disruptive behavior, and less effective team dynamics during a disaster. Strategies suggested include: eye contact; therapeutic touch (culturally appropriate); using slow, clear, reassuring speech; clearly explaining what is happening and why (sickest (RED and YELLOW) first priority, minimal (GREEN) next, expectant (BLACK) last); acknowledging their emotional state and their grief (not ignoring them); assigning nontechnical tasks to those capable of helping (putting pressure on a wound, moving casualties, or comforting the injured, dying, and the emotionally distraught).
Bystander engagement has been repeatedly identified as a means to increase the capacity of first responders to provide care to patients during an MCI. Utilization and management of the minimally injured and any uninjured bystanders and responders can become a force multiplier for the triage/treating responders. Developing a best practice dialogue to be used in training first responders could help improve many of these issues and augment current MCI training programs.
People of Turkish ethnicity constitute Germany’s largest immigrant group but only a small percentage have naturalized as German citizens This article explores the historical foundation of Turkish migration to Germany and the legislative attempts made by both Germany and Turkey to accommodate these people with one foot in each country. It argues that only by abandoning its long-held prejudice against dual citizenship can Germany increase the naturalization rate of all foreigners in its country, not just those from Turkey.
This study explores how participation in direct and intermediated marketing channels and key operational factors influence agricultural producers’ financial performance. Accordingly, we divide the sample of local and regional food marketers into quartiles segmented by profitability performance as an initial exploration of how strong and weak performance may vary across scale, location, and choice of direct and intermediated channels. Moreover, other financial metrics that vary across types of producers and performance-based quartiles are analyzed. This paper provides initial evidence that participation in direct and intermediated markets may allow farms of any scale of sales volume to be financially viable.
Recent studies indicate that the dynamics of fast-flowing, marine-terminating outlet glaciers of the Greenland ice sheet may be sensitive to climate and ocean forcing on sub-annual timescales. Observations of seasonal behavior of these glaciers at such high temporal resolution, however, are currently few. Here we present observations of front position, flow speed, near-surface air temperature and ocean conditions for six large marine-terminating glaciers in the Uummannaq region of West Greenland, to investigate controls on short-term glacier dynamics. As proposed by other studies, we find that seasonal front advance and retreat correlates with the formation and disappearance of an ice melange. Our data suggest that high sea-surface temperature, anomalously low sea-ice concentration and reduced melange formation in early 2003 have triggered multi-year retreat of several glaciers in the study area, which is consistent with other regions in Greenland. Of the stable glaciers, only Rink Isbræ exhibits a seasonal speed variation that correlates with variations in front position, with the others undergoing mid-summer deceleration that indicates the effects of subglacial meltwater discharge and drainage system evolution. Drainage of supraglacial lakes and water-filled crevasses results in substantial decreases in speed (40–60%) on fast-flowing glaciers. Our results demonstrate that attempts to model ice-sheet evolution must take into account short-timescale flow dynamics resulting from drainage events and oceanographic conditions.
The next generation of radio telescopes will have unprecedented sensitivity and time-resolution offering exciting new capabilities in time-domain science. However, this will result in very large numbers of pulsar and transient event candidates and the associated data rates will be technically challenging in terms of data storage and signal processing. Automated detection and classification techniques are therefore required and must be optimized to allow high-throughput data processing in real time. In this paper we provide a summary of the emerging machine learning techniques being applied to this problem.
We explored 3 general classroom teachers’ experiences of including a child with Down syndrome in their early years classrooms. Located at 3 different Australian school settings, 1 teacher was the head of a Preparatory class, 1 was a Year 3 teacher, and the third was a teacher of a split Preparatory/Year 1 class. Interview data were drawn from a larger study, in which data were gathered over a 5-month period through class observations and teacher interviews. The findings indicate that although there were highly inclusive experiences identified in the school sites, the school context played an important role in the inclusion of the child. Teachers indicated that receiving targeted information about Down syndrome and collaborative support from parents, teaching colleagues, and their wider school enabled them to work more inclusively with their student with Down syndrome in their classroom.
No empirical work has systematically explored perceptions of humanness of people with dementia and of older adults and the variables that could improve these perceptions. We thus investigated the role of contact and perspective taking in improving perceptions of humanness of these social groups. To do so, we developed a new concept, humanness standards, defined as the amount of evidence of ability impairment needed to conclude that elderly people and those with dementia have lost personhood.
We used a cross-sectional survey design (n = 619) to assess participants’ humanness standards and perceptions of uniquely human characteristics and human nature characteristics of two social groups (people with dementia and older adults). Half the participants (n = 311) completed a survey about people with dementia and half (n = 308) assessed older adults.
People with dementia were perceived as possessing humanness characteristics to a lesser extent than were older adults. For both groups, contact predicted enhanced perceptions of humanness characteristics. Participants’ degree of contact with individuals with dementia also predicted humanness standards, but only under low perspective-taking conditions. As predicted, for older adults, participants set the highest humanness impairment thresholds in the high contact/high perspective-taking condition.
We conclude that while social programs that bring persons with dementia and other individuals in contact could change humanness standards and perceptions of humanness characteristics of people with dementia, in the case of elderly adults, the contact must be supplemented by variables that facilitate taking the perspective of the person.
Carbapenem-resistant Enterobacteriaceae (CRE) are a significant clinical and public health concern. Understanding the distribution of CRE colonization and developing a coordinated approach are key components of control efforts. The prevalence of CRE in the District of Columbia is unknown. We sought to determine the CRE colonization prevalence within healthcare facilities (HCFs) in the District of Columbia using a collaborative, regional approach.
This study included 16 HCFs in the District of Columbia: all 8 acute-care hospitals (ACHs), 5 of 19 skilled nursing facilities, 2 (both) long-term acute-care facilities, and 1 (the sole) inpatient rehabilitation facility.
Inpatients on all units excluding psychiatry and obstetrics-gynecology.
CRE identification was performed on perianal swab samples using real-time polymerase chain reaction, culture, and antimicrobial susceptibility testing (AST). Prevalence was calculated by facility and unit type as the number of patients with a positive result divided by the total number tested. Prevalence ratios were compared using the Poisson distribution.
Of 1,022 completed tests, 53 samples tested positive for CRE, yielding a prevalence of 5.2% (95% CI, 3.9%–6.8%). Of 726 tests from ACHs, 36 (5.0%; 95% CI, 3.5%–6.9%) were positive. Of 244 tests from long-term-care facilities, 17 (7.0%; 95% CI, 4.1%–11.2%) were positive. The relative prevalence ratios by facility type were 0.9 (95% CI, 0.5–1.5) and 1.5 (95% CI, 0.9–2.6), respectively. No CRE were identified from the inpatient rehabilitation facility.
A baseline CRE prevalence was established, revealing endemicity across healthcare settings in the District of Columbia. Our study establishes a framework for interfacility collaboration to reduce CRE transmission and infection.
Poor utilization of amino acids contributes to losses of milk protein yield in dairy cows exposed to heat stress (HS). Our objective was to test the effect of essential amino acids on milk production in lactating dairy cows exposed to short-term HS conditions. To achieve this objective, 12 multiparous, lactating Holstein cows were assigned to two environments (thermoneutral (THN) or HS) from days 1 to 14 in a split-plot type cross-over design. All cows received 0 g/day of essential amino acids from days 1 to 7 (negative control (NC)) followed by an intravenous infusion of l-methionine (12 g/day), l-lysine (21 g/day), l-leucine (35 g/day), l-isoleucine (15 g/day) and l-valine (15 g/day, methionine, lysine and branched-chain amino acids (ML+BCAA)) from days 8 to 14. The basal diet was composed of ryegrass silage and hay, and a concentrate mix. This diet supplied 44 g of methionine, 125 g of lysine, 167 g of leucine, 98 g of isoleucine and 109 g of valine per day to the small intestine of THN cows. Temperature–humidity index was maintained below 66 for the THN environment, whereas the index was maintained above 68, peaking at 76, for 14 continuous h/day for the HS environment. Heat stress conditioning increased the udder temperature from 37.0°C to 39.6°C. Cows that received the ML+BCAA treatment had greater p.m. rectal and vaginal temperatures (0.50°C and 0.40°C, respectively), and respiration rate (8 breaths/min) compared with those on the NC treatment and exposed to a HS environment. However, neither NC nor ML+BCAA affected rectal or vaginal temperatures and respiration rates in the THN environment. Compared with THN, the HS environment reduced dry matter intake (1.48 kg/day), milk yield (2.82 kg/day) and milk protein yield (0.11 kg/day). However, compared with NC, the ML+BCAA treatment increased milk protein percent by 0.07 points. For the THN environment, the ML+BCAA treatment increased concentrations of milk urea nitrogen. For the HS environment, the ML+BCAA treatment decreased plasma concentrations of arginine, ornithine and citrulline; however, differences were not observed for the THN environment. In summary, HS elicited expected changes in production; however, infusions of ML+BCAA failed to increase milk protein yield. Lower dry matter intake and greater heat load in response to ML+BCAA contributed to the lack of response in milk production in HS cows. The ML+BCAA treatment may have reduced the breakdown of muscle protein in heat-stressed cows.
In 1964 (Solar Cycle 20; SC 20), Patrick McIntosh began creating hand-drawn synoptic maps of solar magnetic features, based on Hα images. These synoptic maps were unique in that they traced magnetic polarity inversion lines, and connected widely separated filaments, fibril patterns, and plage corridors to reveal the large-scale organization of the solar magnetic field. Coronal hole boundaries were later added to the maps, which were produced, more or less continuously, into 2009 (i.e., the start of SC 24). The result was a record of ~45 years (~570 Carrington rotations), or nearly four complete solar cycles of synoptic maps. We are currently scanning, digitizing and archiving these maps, with the final, searchable versions publicly available at NOAA's National Centers for Environmental Information. In this paper we present preliminary scientific studies using the archived maps from SC 23. We show the global evolution of closed magnetic structures (e.g., sunspots, plage, and filaments) in relation to open magnetic structures (e.g., coronal holes), and examine how both relate to the shifting patterns of large-scale positive and negative polarity regions.
The few studies evaluating data on resource utilisation following the Fontan operation specifically are outdated. We sought to evaluate resource utilisation and factors associated with increased resource use after the Fontan operation in a contemporary, large, multi-institutional cohort. This retrospective cohort study of children who had the Fontan between January, 2004 and June, 2013 used the Pediatric Health Information Systems Database. Generalised linear regression analyses evaluated factors associated with resource use. Of 2187 Fontan patients included in the study, 62% were males. The median age at Fontan was 3.2 years (inter-quartile range (IQR): 2.6–3.8). The median length of stay following the Fontan was 9 days (IQR: 7–14). The median costs and charges in 2012 dollars for the Fontan operation were $93,900 (IQR: $67,800–$136,100) and $156,000 (IQR: $112,080–$225,607), respectively. Postoperative Fontan mortality (30 days) was 1% (n=21). Factors associated with increased resource utilisation included baseline and demographic factors such as region, race, and renal anomaly, factors at the bidirectional Glenn such as seizures, valvuloplasty, and surgical volume, number of admissions between the bidirectional Glenn and the Fontan, and factors at the Fontan such as surgical volume and age at Fontan. The most strongly associated factors for both increased Fontan length of stay and increased Fontan charges were number of bidirectional Glenn to Fontan admissions (p<0.001) and Fontan surgical volume per year (p<0.001). As patient characteristics and healthcare-related delivery variables accounted for most of the factors predicting increased resource utilisation, changes should target healthcare delivery factors to reduce costs in this resource-intensive population.