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 email@example.com
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.
The lower extremity fascial compartments include three gluteal, three thigh, four calf, and nine of the foot. These compartments contain muscles, nerves, and blood vessels.
The compartments of the buttock include the gluteus maximus, the gluteus medius/minimus, and the extension of the fascia lata of the thigh into the gluteal region. The sciatic nerve is the only major neurovascular structure in the compartments of the buttock.
The thigh has three compartments:
The anterior compartment contains the quadriceps femoris and sartorius muscles, as well as the femoral vessels and femoral nerve.
The posterior compartment contains the biceps femoris, semitendinosus, and semimembranosus muscles and the sciatic nerve.
The medial compartment contains the adductor muscle group and the gracilis muscle.
The lower leg has four leg compartments:
The anterior compartment: Contains the tibialis anterior muscle, extensor halluces muscle, extensor digitorum longus muscle, the anterior tibial artery, and the deep peroneal nerve.
The lateral compartment: Contains the peroneus longus and brevis muscles, and the superficial peroneal nerve.
The superficial posterior compartment: Contains the gastrocnemius muscle, soleus muscles, plantaris muscle, and the sural nerve.
The deep posterior compartment: Contains the flexor hallucis longus muscle, flexor digitorum longus muscle, tibialis posterior muscles, popliteus muscle, the posterior tibial artery, and the tibial nerve.
The foot contains a total of nine compartments, including four interosseous (medial, lateral, deep, and superficial central) and the adductor hallucis compartments that may require decompression in crush injuries to the foot. The medial, lateral, and superficial compartments pass through the entire length of the foot, while the interosseous compartments and the calcaneal compartments are confined to the forefoot and the hind foot, respectively.
The physics of a rotary wing in forward flight are highly complex, particularly when flow separation is involved. The purpose of this work is to assess the role of three-dimensional (3-D) vortex dynamics, with a focus on Coriolis forces, in the evolution of vortices in the reverse flow region of a rotating wing. High-fidelity numerical simulations were performed to recreate the flow about a representative rotating wing in forward flight. A vorticity transport analysis was performed to quantify and compare the magnitudes of 2-D flow physics, vortex tilting and Coriolis effects in the resulting flow fields. Three-dimensional vortex dynamics was found to have a very small impact on the growth and behaviour of vortices in the reverse flow region; in fact, the rate of vortex growth was successfully modelled using a simple 2-D vortex method. The small role of 3-D physics was attributed to the Coriolis and vortex tilting terms being approximately equal and opposite to one another. This ultimately lead to vortex behaviour that more closely resembled a surging wing as opposed to a conventional rotating wing, a feature unique to the reverse flow region.
The Fontan procedure is the final stage of surgical palliation for a single-ventricle circulation. Significant complications are common including rhythm disturbance necessitating implantation of a permanent pacemaker. This has been widely considered a negative prognostic indicator.
This single-centre, retrospective case control study involved all patients who underwent the Fontan procedure at the Leeds Congenital Heart Unit between 1990 and 2015 and have had regular follow-up in Yorkshire and Humber, United Kingdom. 167 Fontan patients were identified of which 2 were excluded for having a pre-procedure pacemaker. Of the remainder, 23 patients required a pacemaker. Outcomes were survival, early and late complications, need for further intervention and oxygen saturation in long-term follow-up.
There was no difference in survival (30-day survival pacemaker 92.6%, sinus rhythm 90.5%, p = 0.66, 1-year pacemaker 11.1%, sinus rhythm 10.1%, p = 1). The pacemaker group was more likely to have cerebral or renal complications in the first-year post-procedure (acute kidney injury: sinus rhythm 0.8%, pacemaker 19.1%, p = 0.002). No difference was observed in longer term complications including protein losing enteropathy (sinus rhythm 3.5%, pacemaker 0% p = 1). There was no difference in saturations between the two groups at follow-up. Paced patients were more likely to have required further intervention, with a higher incidence of cardiopulmonary bypass procedures (sinus rhythm 6.3%, pacemaker 35%, p < 0.001).
Despite an increase in early complications and the need for further interventions, pacemaker requirement does not appear to affect long-term survival following the Fontan procedure.
Architected materials play an essential role in achieving next-generation electrochemical systems with unprecedented power and energy capabilities. The geometry and chemistry of architected materials can be engineered to address key areas of performance, including electrochemical kinetics and mechanics. Electrochemical kinetics impact key metrics such as power density, efficiency, and lifetime in batteries, fuel cells, and sensors. Additionally, electrochemical reactions can dramatically change material composition, which may result in large strains (in the hundreds of percent) that cause mechanical failure. In this article, we summarize advances in energy storage offered by architected materials and highlight fabrication methods used to realize these advances. We also discuss electrochemistry as an enabling tool for architected materials with functionality beyond energy storage and sensing.
This article examines two intertwined topics on architected materials with imperfections—their mechanics and optimum design. We first discuss the main factors that control defect sensitivity along with a range of strategies for defect characterization. The potency of both as-designed and as-manufactured defects on their macroscopic response is highlighted with an emphasis on those caused by additive manufacturing technology. As a natural extension of defect sensitivity, we describe the design approaches for architected materials with particular focus on systematic tools of topology optimization. Recent extensions to formally incorporate imperfections in the optimization formulation are discussed, where the ultimate goal is to generate architectures that are flaw-tolerant and perform robustly in the presence of imperfections. We conclude with an outlook on the field, highlighting potential areas of future research.
The crystal structure of cefprozil monohydrate has been solved and refined using synchrotron X-ray powder diffraction data and optimized using density functional techniques. Cefprozil monohydrate crystallizes in space group P21 (#4) with a = 11.26513(6), b = 11.34004(5), c = 14.72649(11) Å, β = 90.1250(4)°, V = 1881.262(15) Å3, and Z = 4. Although a reasonable fit was obtained using an orthorhombic model, closer examination showed that many peaks were split and/or had shoulders, and thus the true symmetry was monoclinic. DFT calculations revealed that one carboxylic acid proton moved to an amino group. The structure thus contains one ion pair and one pair of neutral molecules. This protonation was confirmed by infrared spectroscopy. There is an extensive array of hydrogen bonds resulting in a three-dimensional network. The powder pattern has been submitted to ICDD® for inclusion in the Powder Diffraction File™.
Research participants want to receive results from studies in which they participate. However, health researchers rarely share the results of their studies beyond scientific publication. Little is known about the barriers researchers face in returning study results to participants.
Using a mixed-methods design, health researchers (N = 414) from more than 40 US universities were asked about barriers to providing results to participants. Respondents were recruited from universities with Clinical and Translational Science Award programs and Prevention Research Centers.
Respondents reported the percent of their research where they experienced each of the four barriers to disseminating results to participants: logistical/methodological, financial, systems, and regulatory. A fifth barrier, investigator capacity, emerged from data analysis. Training for research faculty and staff, promotion and tenure incentives, and funding agencies supporting dissemination of results to participants were solutions offered to overcoming barriers.
Study findings add to literature on research dissemination by documenting health researchers’ perceived barriers to sharing study results with participants. Implications for policy and practice suggest that additional resources and training could help reduce dissemination barriers and increase the return of results to participants.
In Canada, recreational use of cannabis was legalized in October 2018. This policy change along with recent publications evaluating the efficacy of cannabis for the medical treatment of epilepsy and media awareness about its use have increased the public interest about this agent. The Canadian League Against Epilepsy Medical Therapeutics Committee, along with a multidisciplinary group of experts and Canadian Epilepsy Alliance representatives, has developed a position statement about the use of medical cannabis for epilepsy. This article addresses the current Canadian legal framework, recent publications about its efficacy and safety profile, and our understanding of the clinical issues that should be considered when contemplating cannabis use for medical purposes.
The crystal structure of prednicarbate has been solved and refined using synchrotron X-ray powder diffraction data, and optimized using density functional techniques. Prednicarbate crystallizes in space group P212121 (#19) with a = 7.69990(3), b = 10.75725(3), c = 31.36008(11) Å, V = 2597.55(1) Å3, and Z = 4. In the crystal structure the long axis of the steroid ring system lies roughly parallel to the c-axis. The oxygenated side chains are orientated roughly perpendicular to the steroid ring system and are adjacent to each other, parallel to the ab-plane. The only traditional hydrogen bond donor in the prednicarbate molecule is the hydroxyl group O32–H33, but this does not participate in an O–H···O hydrogen bond. The nearest oxygen atoms to O32 are symmetry-related O32 at 4.495 Å, precluding the expected O–H···O hydrogen bond. The powder pattern has been submitted to ICDD® for inclusion in the Powder Diffraction File™.
Thin CdTe photovoltaic device efficiencies show significant improvement with the incorporation of a CdSeTe alloy layer deposited between a MgZnO emitter and CdTe absorber. CdTe and CdSeTe/CdTe devices fabricated by close-space sublimation with a total absorber thickness of 1.5 µm are studied using microscopy measurements and show minimal diffusion of Se into the CdTe. Current loss analysis shows that the CdSeTe layer is the primary absorber in the CdSeTe/CdTe structure, and fill factor loss analysis shows that ideality-factor reduction is the dominant mechanism of fill factor loss. Improvement in the CdSeTe/CdTe absorber quality compared to CdTe is also reflected in spectral and time-resolved photoluminescence measurements. Current density vs. voltage measurements show an increase in current density of up to 2 mA/cm2 with the addition of CdSeTe due to a band gap shift from 1.5 to 1.42 eV for CdTe and CdSeTe/CdTe absorbers respectively. Voltage deficit is lower with the incorporation of the CdSeTe layer, corroborated by improved electroluminescence intensity. The addition of CdSeTe into CdTe device structures has increased device efficiencies from 14.7% to 15.6% for absorbers with a total thickness less than two microns.
Organismal metabolic rates reflect the interaction of environmental and physiological factors. Thus, calcifying organisms that record growth history can provide insight into both the ancient environments in which they lived and their own physiology and life history. However, interpreting them requires understanding which environmental factors have the greatest influence on growth rate and the extent to which evolutionary history constrains growth rates across lineages. We integrated satellite measurements of sea-surface temperature and chlorophyll-a concentration with a database of growth coefficients, body sizes, and life spans for 692 populations of living marine bivalves in 195 species, set within the context of a new maximum-likelihood phylogeny of bivalves. We find that environmental predictors overall explain only a small proportion of variation in growth coefficient across all species; temperature is a better predictor of growth coefficient than food supply, and growth coefficient is somewhat more variable at higher summer temperatures. Growth coefficients exhibit moderate phylogenetic signal, and taxonomic membership is a stronger predictor of growth coefficient than any environmental predictor, but phylogenetic inertia cannot fully explain the disjunction between our findings and the extensive body of work demonstrating strong environmental control on growth rates within taxa. Accounting for evolutionary history is critical when considering shells as historical archives. The weak relationship between variation in food supply and variation in growth coefficient in our data set is inconsistent with the hypothesis that the increase in mean body size through the Phanerozoic was driven by increasing productivity enabling faster growth rates.
Refractory depression is a major contributor to the economic burden of depression. Radically open dialectical behaviour therapy (RO DBT) is an unevaluated new treatment targeting overcontrolled personality, common in refractory depression, but it is not yet known whether the additional expense of RO DBT is good value for money.
To estimate the cost-effectiveness of RO DBT plus treatment as usual (TAU) compared with TAU alone in people with refractory depression (trial registration: ISRCTN85784627).
We undertook a cost-effectiveness analysis alongside a randomised trial evaluating RO DBT plus TAU versus TAU alone for refractory depression in three UK secondary care centres. Our economic evaluation, 12 months after randomisation, adopted the perspective of the UK National Health Service (NHS) and personal social services. It evaluated cost-effectiveness by comparing the net cost of RO DBT with the net gain in quality-adjusted life-years (QALYs), estimated using the EQ-5D-3L measure of health-related quality of life.
The additional cost of RO DBT plus TAU compared with TAU alone was £7048 and was associated with a difference of 0.032 QALYs, yielding an incremental cost-effectiveness ratio (ICER) of £220 250 per QALY. This ICER was well above the National Institute for Health and Care Excellence (NICE) upper threshold of £30 000 per QALY. A cost-effectiveness acceptability curve indicated that RO DBT had a zero probability of being cost-effective compared with TAU at the NICE £30 000 threshold.
In its current resource-intensive form, RO DBT is not a cost-effective use of resources in the UK NHS.
Declaration of interest
R.H. is co-owner and director of Radically Open Ltd, the RO DBT training and dissemination company. D.K. reports grants outside the submitted work from the National Institute for Health Research (NIHR). T.L. receives royalties from New Harbinger Publishing for sales of RO DBT treatment manuals, speaking fees from Radically Open Ltd, and a grant outside the submitted work from the Medical Research Council. He was co-director of Radically Open Ltd between November 2014 and May 2015 and is married to Erica Smith-Lynch, the principal shareholder and one of two directors of Radically Open Ltd. H.O'M. reports personal fees outside the submitted work from the Charlie Waller Institute and Improving Access to Psychological Therapy. S.R. provides RO DBT supervision through her company S C Rushbrook Ltd. I.R. reports grants outside the submitted work from NIHR and Health & Care Research Wales. M. Stanton reports personal fees outside the submitted work from British Isles DBT Training, Stanton Psychological Services Ltd and Taylor & Francis. M. Swales reports personal fees outside the submitted work from British Isles DBT Training, Guilford Press, Oxford University Press and Taylor & Francis. B.W. was co-director of Radically Open Ltd between November 2014 and February 2015.
My first day as a temporary employee at the actuarial consulting firm Harold, Adams, McNutt & Joy, LLP, was in many respects just another day at the office, another day of precarious work in a gig economy. My workstation was familiar, though not my own: it featured a slightly outdated personal computer, a laser printer, a telephone, a lamp, and various supplies all hemmed in by grey cubicle walls, pinned with a few personal photographs and work-related charts (fig. 1). I followed instructions left by the desk's usual inhabitant, sticky notes pasted to my computer monitor directing me to open folders on the computer, listen to audio recordings, and monitor my phone. A woman's voice played from computer speakers or the phone receiver, she identified herself as Sarah Jane Tully and trained me to fill out the actuarial tables that would consume my workday. Emails arrived from coworkers, letting me know when clients had died and which tables needed updating. Entering their data into spreadsheets, I watched their mortality become obscured by the computational logic of insurers. I filled downtime between tasks by poking around Sarah Jane's computer. I hoped (mischievously) to find evidence of corporate malfeasance, but only uncovered her vacation plans; I empathized with the modesty of her middle-class beach fantasies. Occasionally the printer sprang to life, delivering love notes meant for someone else, full of lustful details. These I perused bemusedly. When I updated actuarial charts, the printer would provide brief biographies: names, images, and narratives of those who had passed on a single sheet of paper. These absorbed me totally. I read them closely and internalized the details of the images, before the digital bleating of a new email in my inbox would break the reverie and return me to the day's work.
This was my experience of the play Temping in its initial run at Dixon Place in New York City in August 2014. Directed by Michael Rau, written by Michael Yates Crowley, and designed by Asa Wember, Temping is a production of Wolf 359, a self-described “Narrative Technology Company” that has been staging original works authored and often performed by Crowley in the United States and Europe since 2007.