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.
Depression is a common, serious, but under-recognised problem in multiple sclerosis (MS). The primary objective of this study was to assess whether a rapid visual analogue screening tool for depression could operate as a quick and reliable screening method for depression, in patients with MS.
Patients attending a regional MS outpatient clinic completed the Emotional Thermometer 7 tool (ET7), the Hospital Anxiety and Depression Scale – Depression Subscale (HADS-D) and the Major Depression Inventory (MDI) to establish a Diagnostic and Statistical Manual, 4th edition (DSM-IV) diagnosis of Major Depression. Full ET7, briefer subset ET4 version and depression and distress thermometers alone were compared with HADS-D and MDI. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and receiver operating characteristic (ROC) curve were calculated to compare the performance of all the screening tools.
In total, 190 patients were included. ET4 performed well as a ‘rule-out’ screening step (sensitivity 0.91, specificity 0.72, NPV 0.98, PPV 0.32). ET4 performance was comparable to HADS-D (sensitivity 0.96, specificity 0.77, NPV 0.99, PPV 0.37) without need for clinician scoring. The briefer ET4 performed as well as the full ET7.
ET are quick, sensitive and useful screening tools for depression in this MS population, to be complemented by further questioning or more detailed psychiatric assessment where indicated. Given that ET4 and ET7 perform equally well, we recommend the use of ET4 as it is briefer. It has the potential to be widely implemented across busy neurology clinics to assist in depression screening in this under diagnosed group.
Li[Lix/3Mn2x/3M1−x]O2 (M = Ni, Mn, Co) (HE-NMC) materials, which can be expressed as a combination of trigonal LiTMO2 (TM = transition metal) and monoclinic Li2MnO3 phases, are of great interest as high capacity cathodes for lithium-ion batteries. However, structural stability prevents their commercial adoption. To address this, Si doping was applied, resulting in improved stability. Raman and differential capacity analyses suggest that silicon doping improves the structural stability during electrochemical cycling. Furthermore, the doped material exhibits a 10% higher capacity relative to the control. The superior capacity likely results from the increased lattice parameters as determined by X-ray diffraction (XRD) and the lower resistance during the first cycle found by impedance and direct current resistance (DCR) measurements. Density functional theory (DFT) predictions suggest that the observed lattice expansion is an indication of increased oxygen vacancy concentration and may be due to the Si doping.
Altitudinal gradients provide tractable, replicated systems in which to study changes in species richness and community composition over relatively short distances. Previously, richness was often assumed to follow a monotonic decline with altitude, but recent meta-analyses show that more complex patterns, including mid-altitude richness peaks, are also prevalent in birds. In this study, we used point counts to survey birds at multiple altitudes on three mountains on the island of Borneo in Sundaland, an area for which quantitative analyses of avian altitudinal distribution are unavailable. In total we conducted 1088 point counts and collected associated habitat data at 527 locations to estimate species richness by altitude on Mt Mulu (2376 m), Mt Pueh (1550 m) and Mt Topap Oso (1450 m). On Mulu, the only mountain with an intact habitat gradient, bird species richness peaks at 600 m. Richness appeared to peak at 600 m on Totap Oso as well, but on Pueh it peaked several hundred metres higher. The richness peak on Mulu differs from that predicted by null models and is instead caused by the overlap of distinct lowland and montane avifaunas, supporting the faunal overlap hypothesis. This finding provides further evidence that a lack of coincidence between peak turnover and peak richness is not sufficient evidence to rule out faunal overlap as a causal factor.
Introduction: Syncope is responsible for up to 5% of emergency department visits. Vasovagal syncope (VVS) is the most common subtype and can have significant quality of life implications as it is often recurrent. Clinicians treating VVS have limited treatment options available to them and often struggle with prognostication. The aim of our study was to identify patient-specific determinants of VVS improvement or cessation. Methods: Patients (pts) from the Prevention of Syncope Trials (POST) 1 and 2 were included in this study. All patients had VVS according to tilt table testing or a diagnostic point score. Patients had fainted ≥1 time in the previous year and all were followed for up to 1 year after enrollment. Data are presented as median (IQR). Complete responders (CR) did not faint in follow-up; partial responders (PR) fainted ≥1/year less than prior year but did not stop; and non-responders (NR) did not improve or stop. Results: There were 392 patients: 126 males, median age 34 (23,50) who had fainted for 10 (3,22) years and followed for a median of 363 (148,376) days. There were 225 CR (57%), 120 PR (31%) and 47 NR (12%). PR subjects were younger: 27 (24,33) years compared to CR (36 (32,42)) years and NR (36 (29,47)) years (p<0.05). Receiver operator characteristic analysis showed age predicted PR (AUC=0.62). Lifetime fainting frequency was 0.67 (0.14,2.00) faints per year, increasing to 4 (2,10) faints in the pre-year and decreasing to 0 (0,1.9) faints in the post-year (p<0.0001). Pts had similar syncope frequency in the distant past (PR, 1.14 faints/year; CR, 0.68 faints/year; NR, 0.58 faints/year) but PR pts worsened markedly prior to enrollment. PR subjects fainted much more in the prior year: 10 (6,18) faints compared CR (3 (2,3) faints, p<0.0001) and NR (2 (2,4) faints, p<0.05). Receiver operator characteristic analysis showed prior year faints predicted PR well (AUC=0.81). There was no significant interaction with treatment (metoprolol in POST 1, fludrocortisone in POST 2). Conclusion: After specialist consultation, 57% of VVS patients stop fainting and 31% improve incompletely without a significant treatment effect. Patients who will improve incompletely can be accurately selected based on younger age and more frequent syncope. Older patients with less frequent syncope are 83% likely to stop fainting. These findings will help counsel pts and select candidates for medical therapy.
The Numeniini is a tribe of 13 wader species (Scolopacidae, Charadriiformes) of which seven are Near Threatened or globally threatened, including two Critically Endangered. To help inform conservation management and policy responses, we present the results of an expert assessment of the threats that members of this taxonomic group face across migratory flyways. Most threats are increasing in intensity, particularly in non-breeding areas, where habitat loss resulting from residential and commercial development, aquaculture, mining, transport, disturbance, problematic invasive species, pollution and climate change were regarded as having the greatest detrimental impact. Fewer threats (mining, disturbance, problematic native species and climate change) were identified as widely affecting breeding areas. Numeniini populations face the greatest number of non-breeding threats in the East Asian-Australasian Flyway, especially those associated with coastal reclamation; related threats were also identified across the Central and Atlantic Americas, and East Atlantic flyways. Threats on the breeding grounds were greatest in Central and Atlantic Americas, East Atlantic and West Asian flyways. Three priority actions were associated with monitoring and research: to monitor breeding population trends (which for species breeding in remote areas may best be achieved through surveys at key non-breeding sites), to deploy tracking technologies to identify migratory connectivity, and to monitor land-cover change across breeding and non-breeding areas. Two priority actions were focused on conservation and policy responses: to identify and effectively protect key non-breeding sites across all flyways (particularly in the East Asian- Australasian Flyway), and to implement successful conservation interventions at a sufficient scale across human-dominated landscapes for species’ recovery to be achieved. If implemented urgently, these measures in combination have the potential to alter the current population declines of many Numeniini species and provide a template for the conservation of other groups of threatened species.
Introduction: Short-term risk of arrhythmia or death among emergency department (ED) syncope patients with atrial fibrillation/flutter (AFF) has not been reported in the literature. Our objectives were to assess the incidence and the independent risk of 30-day arrhythmia or death for syncope patients with AFF after ED disposition. Methods: We conducted a prospective study at 6 Canadian academic EDs to include adults with syncope. We collected demographic, clinical and ECG characteristics while our outcome assessments were completed by medical records review and by telephone follow-up of patients after 30 days. Primary outcome was arrhythmia or death within 30-days after ED disposition and secondary outcomes included non-arrhythmic cardiac and non-cardiac outcomes. We performed descriptive and logistic regression analyses. Results: We enrolled 4,266 patients: mean age 53.4 years, 55.4% females, and 8.5% with AFF. After excluding those with outcomes in the ED, lost to follow-up and those with other non-sinus rhythms, 3,417 patients in the sinus and 280 patients in the AFF groups were analyzed. The incidence of arrhythmia or death was significantly higher in the AFF group (Relative Risk 5.1; 95% CI 3.1-8.4; p<0.0001) but there were no significant differences in secondary outcomes between the groups. The unadjusted odds ratio for 30-days arrhythmia or deaths among ED syncope patients with AFF was 5.4 (95% CI 3.2- 9.2). After adjusting for important baseline risk factors by multivariable analysis, the odds ratio for arrhythmia or death in patients with AFF was 1.5 (95% CI 0.8-2.7). Conclusion: The risk of AFF for 30-day arrhythmia or death among syncope patients after ED disposition is higher but is attenuated when adjusted for important patient characteristics. Future research should assess long-term outcomes among syncope patients with AFF to guide follow-up after ED discharge.
Illegal killing/taking of birds is a growing concern across the Mediterranean. However, there are few quantitative data on the species and countries involved. We assessed numbers of individual birds of each species killed/taken illegally in each Mediterranean country per year, using a diverse range of data sources and incorporating expert knowledge. We estimated that 11–36 million individuals per year may be killed/taken illegally in the region, many of them on migration. In each of Cyprus, Egypt, Italy, Lebanon and Syria, more than two million birds may be killed/taken on average each year. For species such as Blackcap Sylvia atricapilla, Common Quail Coturnix coturnix, Eurasian Chaffinch Fringilla coelebs, House Sparrow Passer domesticus and Song Thrush Turdus philomelos, more than one million individuals of each species are estimated to be killed/taken illegally on average every year. Several species of global conservation concern are also reported to be killed/taken illegally in substantial numbers: Eurasian Curlew Numenius arquata, Ferruginous Duck Aythya nyroca and Rock Partridge Alectoris graeca. Birds in the Mediterranean are illegally killed/taken primarily for food, sport and for use as cage-birds or decoys. At the 20 worst locations with the highest reported numbers, 7.9 million individuals may be illegally killed/taken per year, representing 34% of the mean estimated annual regional total number of birds illegally killed/taken for all species combined. Our study highlighted the paucity of data on illegal killing/taking of birds. Monitoring schemes which use systematic sampling protocols are needed to generate increasingly robust data on trends in illegal killing/taking over time and help stakeholders prioritise conservation actions to address this international conservation problem. Large numbers of birds are also hunted legally in the region, but specific totals are generally unavailable. Such data, in combination with improved estimates for illegal killing/taking, are needed for robustly assessing the sustainability of exploitation of birds.
During the Cretaceous and Paleogene, the Indian subcontinent was isolated as it migrated north from the east coast of Africa to collide with Asia. As it passed over the Reunion hotspot in the late Maastrichtian–early Danian, a series of lava flows extruded, known as the Deccan Traps. Also during this interval, there was a major mass-extinction event at the Cretaceous–Paleogene boundary, punctuated by a meteorite impact at Chicxulub, Mexico. What were the biological implications of these changes in paleogeography and the extensive volcanism in terms of biodiversity, evolution, and biogeography? By combining chronostratigraphic, paleosol, and paleobotanical data, an understanding of how the ecosystems and climates changed and the relative contributions of the Chicxulub impact, Deccan Traps volcanism, and paleogeographic isolation can be gained. Understanding relative ages of paleobotanical localities is crucial to determining floristic changes, and is challenging because different methods (e.g., magnetostratigraphy, radiometric dating, vertebrate and microfossil biostratigraphy) sometimes give conflicting answers, or have not been done for paleobotanical localities. Climatic data can be obtained quantitatively by studying paleosol geochemistry, as well as qualitatively by examining functional traits and nearest living relatives of fossil plants. An additional challenge is revising macrofossil data, which includes some confidently identified taxa and others with uncertain affinities. This is important for understanding ecosystem composition both spatially and temporally, as well as the biogeographic implications of an isolated India.
This study investigates Sr surface segregation behavior and phase formation in La0.6Sr0.4Co0.2Fe0.8O3-δ (LSCF), a commonly used cathode material for solid oxide fuel cells (SOFCs). (100)-oriented LSCF thin films were deposited on (110)-oriented NdGaO3 (NGO) substrates by Pulsed Laser Deposition (PLD). The samples were annealed in atmospheres with various CO2 partial pressures at 800°C. Using the synchrotron technique of Total Reflection X-ray Fluorescence (TXRF), surface segregation in these thin films were quantified. The morphological changes at the surface were examined by AFM studies. The kinetics and thermodynamics of the segregation are discussed.
In this paper we report the properties of the anodic silicon dioxide film formed using light-induced anodisation (LIA) method and its potential to be used as surface passivation layer of p-type silicon surfaces of silicon solar cells. The high uniformity of the formed oxide is possibly due to the uniform drift of the positive charge carriers in the silicon to the surface being anodised. The oxide grows at higher rate than that in nitric acid, an oxide layer with thickness of 18 nm can be formed by anodising for 10 min with 15 V bias in 0.5 M sulphuric acid. After annealing in oxygen and then forming gas at 400 °C for 30 min, an average effective carrier lifetime of 120 μs was measured by quasi-steady state photoluminance on 180 μm p-type 3-5 Ohm cm Cz silicon wafers, with a value of 110 μs being measured for the same wafers passivated by a thermally-grown oxide of the same thickness. The properties of the anodic silicon dioxide layers formed by LIA have been characterized by ellipsometry, x-ray photoelectron spectroscopy, quasi-steady state photoluminance and Fourier transform infrared spectroscopy.
We report on the EPICA Dronning Maud Land (East Antarctica) deep drilling operation. Starting with the scientific questions that led to the outline of the EPICA project, we introduce the setting of sister drillings at NorthGRIP and EPICA Dome C within the European ice-coring community. The progress of the drilling operation is described within the context of three parallel, deep-drilling operations, the problems that occurred and the solutions we developed. Modified procedures are described, such as the monitoring of penetration rate via cable weight rather than motor torque, and modifications to the system (e.g. closing the openings at the lower end of the outer barrel to reduce the risk of immersing the drill in highly concentrated chip suspension). Parameters of the drilling (e.g. core-break force, cutter pitch, chips balance, liquid level, core production rate and piece number) are discussed. We also review the operational mode, particularly in the context of achieved core length and piece length, which have to be optimized for drilling efficiency and core quality respectively. We conclude with recommendations addressing the design of the chip-collection openings and strictly limiting the cable-load drop with respect to the load at the start of the run.
The surface passivation of Si wafer by AlOx thin films grown by mist CVD in an open-air atmosphere was studied with a view to improving the effect of high-performance c-Si solar cells. In AlOx thin film grown at a temperature above 400°C by mist CVD, the OH bonding did not remain in the film and the breakdown field (EBD) was over 6 MV/cm. In Si wafers passivated by AlOx thin films grown by mist CVD at growth temperature above 400°C, the negative fixed charge density (Qf) at the interface was higher than 1012 cm-2 and the surface recombination velocity (Seff) was 44.4 cm/s. These results show that mist CVD, which is fundamentally an environmentally friendly technique, may be suitable for the fabrication of a passivation film on Si surfaces designed to improve the effect of high-performance c-Si solar cells.
The n-type GaN has stability problem of the surface anodic corrosion during the photoelectrochemical reaction for H2 generation. The photoelectrochemical surface stabilities of n-type GaN dependent on the electrolytes were investigated. The flatband potential in HCl obtained from Mott-Schottky plot shifted 0.1 V to positive direction compared with that in H2SO4. The variation of saturated photocurrent of 1 to 3 cycles in H2SO4 was much larger than that of HCl, NaOH and KOH. The surface morphologies also changed by the electrolytes. These results show the absorbed materials on the GaN electrode surface during the photoelectrochemical reactions were changed by the electrolyte and affected the surface reactions.
Surface-induced aromatic stabilization (SIAS), a recently proposed mechanism leading to a formation of charge-transfer (CT) states at organic/metal (O/M) interfaces [G. Heimel, et al., Nat. Chem.5, 187 (2013)], was investigated for an aromatic hydrocarbon, diindenoperylene (DIP), by means of synchrotron radiation-based ultraviolet photoelectron spectroscopy (UPS). By employing DIP and noble metal substrates (Ag and Cu), we confirmed the formation of CT states, indicating that an inclusion of a specific functional group with a hetero-atom within adsorbate molecules as suggested before is not necessarily required for the formation of CT states mediated by the SIAS. With a comparison of the mother and analogue molecules, perylene and PTCDA, we discuss the structural requirement for the realization of the SIAS.
Increasing interest in the photocatalytic activity of TiO2 has led to considerations of using TiO2 nanoparticles in energy generation. In order to better understand the electron-hole relaxation of nano scale TiO2 structures, it is important to start with an understanding of TiO2 synthesis building blocks. The solvated titanium (IV) ion is a precursor found in synthesis methods of colloidal TiO2 nanostructures. This simplest test compound may reflect some common basic electronic features for larger structures composed of Ti(IV) coordinated with oxygen. For this computational study, a model of Ti(OH)4 with tetrahedral coordination was created. To simulate the electronic properties of a solution of Ti(IV), the model was surrounded with 27 H2O molecules. The model was explored by means of standard density functional theory (DFT) molecular dynamics (MD) followed by nonadiabatic electron dynamics computed with Reduced Density Matrix approach combined with “on-the-fly coupling”. Results were generated with Vienna ab initio Simulation Package (VASP) using the Perdew-Burke-Ernzerhof (PBE) functional, plane wave basis set, and projector augmented wave (PAW) potentials. The absorption spectra, MD, and electron-hole relaxation rates are presented for the Ti(OH)4 model at various ambient temperatures. The electron-hole relaxation rates show a non-linear dependence on temperature and were found to be near the same order of magnitude as electron-hole relaxation rates in bulk TiO2 calculations. A video of the geometry optimization can be found online.
The first UK epizootic of highly pathogenic (HP) H5N1 influenza in wild birds occurred in 2008, in a population of mute swans that had been the subject of ornithological study for decades. Here we use an innovative combination of ornithological, phylogenetic and immunological approaches to investigate the ecology and age structure of HP H5N1 in nature. We screened samples from swans and waterbirds using PCR and sequenced HP H5N1-positive samples. The outbreak's origin was investigated by linking bird count data with a molecular clock analysis of sampled virus sequences. We used ringing records to reconstruct the age-structure of outbreak mortality, and we estimated the age distribution of prior exposure to avian influenza. Outbreak mortality was low and all HP H5N1-positive mute swans in the affected population were <3 years old. Only the youngest age classes contained an appreciable number of individuals with no detectable antibody responses to viral nucleoprotein. Phylogenetic analysis indicated that the outbreak strain circulated locally for ∼1 month before detection and arrived when the immigration rate of migrant waterbirds was highest. Our data are consistent with the hypothesis that HP H5N1 epizootics in wild swans exhibit limited mortality due to immune protection arising from previous exposure. Our study population may represent a valuable resource for investigating the natural ecology and epidemiology of avian influenza.