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High-fat diet (HFD) consumption leads to metabolic disorders, gastrointestinal dysfunction and intestinal dysbiosis. Antibiotics also disrupt the composition of intestinal microbiota. The aim of the present study was to investigate the impact of a short-term feeding with HFD on oxidative status, enteric microbiota, intestinal motility and the effects of antibiotics and/or melatonin treatments on diet-induced hepato-intestinal dysfunction and inflammation. Male Sprague–Dawley rats were pair-fed with either standard chow or HFD (45 % fat) and were given tap water or melatonin (4 mg/kg per d) or melatonin plus antibiotics (ABX; neomycin, ampicillin, metronidazole; each 1 g/l) in drinking water for 2 weeks. On the 14th day, colonic motility was measured and the next day intestinal transit was assessed using charcoal propagation. Trunk blood, liver and intestine samples were removed for biochemical and histopathological evaluations, and faeces were collected for microbiota analysis. A 2-week HFD feeding increased blood glucose level and perirenal fat weight, induced low-level hepatic and intestinal inflammation, delayed intestinal transit, led to deterioration of epithelial tight junctions and overgrowth of colonic bacteria. Melatonin intake in HFD-fed rats reduced ileal inflammation, colonic motility and perirenal fat accumulation. ABX abolished increases in fat accumulation and blood glucose, reduced ileal oxidative damage, suppressed HFD-induced overgrowth in colonic bacteria, and reversed HFD-induced delay in intestinal transit; however, hepatic neutrophil accumulation, hepatic injury and dysfunction were further enhanced. In conclusion, the results demonstrate that even a short-term HFD ingestion results in hepato-intestinal inflammatory state and alterations in bacterial populations, which may be worsened with antibiotic intake, but alleviated by melatonin.
Chest pain is the second most common reason for referral to paediatric cardiologists after benign heart murmurs. Aetiology frequently depends on non-cardiac reasons. In addition, individuals may experience non-cardiac chest pain which is idiopathic or of unknown origin. The aim of this study is to examine psychological symptoms in children and adolescents with medically unexplained chest pain.
A total of 76 patients (ages 8–18 years) were included in the study, who were referred to the paediatric cardiology department with the complaint of chest pain but did not have any detected cardiac aetiology or any other organic causes of chest pain. The control group was composed of 51 healthy volunteers. Self-evaluation scales were given to both groups which included Beck Anxiety Inventory and Children’s Depression Inventory. Also parents of both groups completed the Conner’s Parent Rating Scale for assessment of Attention-deficit/hyperactivity disorder.
Anxiety scores of the non-cardiac chest pain group were significantly higher compared to controls. No significant differences were found between patients and controls in terms of attention-deficit/hyperactivity disorder and depression scores. In patient group, patterns were similar for boys and girls and for children and adolescents; except girls scored significantly higher than boys in children’s depression inventory.
In children and adolescents, non-cardiac chest pain is associated with increased levels of anxiety. These results show the importance of psychiatric evaluation in non-cardiac chest pain patients. Larger controlled studies are needed to determine the prevalence and impact of attention-deficit/hyperactivity disorder and depression in children and adolescents with non-cardiac chest pain.
In this paper, we revisit the Earnings, Cover (the ratio of earnings over dividends) and Price/Earnings (P/E) Ratio models which we introduced in Part 4 of this series. Although we suggested that the significant decline in the Earnings Index over 2015-2016 might be followed by dividends and share prices, this has not happened. Instead, Earnings have risen substantially over the years 2016 to 2018. Therefore, we revise our models based on the updated data and compare the new set of models with the one in Part 4 as well as with themselves. We then compare different methods for forecasting Dividends and Share Prices.
This study reports the first assessment of published comments in the family medicine literature using structured codes, which produced commentary annotations that will be the foundation of a knowledge base of appraisals of family medicine trials. Evidence appraisal occurs in a variety of formats and serves to shed light on the quality of research. However, scientific discourse generally and evidence appraisal in particular has not itself been analyzed for insights. A search strategy was devised to identify all journal comments indexed in PubMed linked to controlled intervention studies published in a recent 15-year period in major family medicine journals. A previously developed structured representation in the form of a list of appraisal concepts was used to formally annotate and categorize the journal comments through an iterative process. Trends in family medicine evidence appraisal were then analyzed. A total of 93 comments on studies from five journals over 15 years were included in the analysis. Two thirds of extracted appraisals were negative criticisms. All appraisals of measurement instruments were negative (100%). The participants baseline characteristics, the author discussions, and the design of the interventions were also criticized (respectively 91.7%, 84.6% and 83.3% negative). In contrast, appraisals of the scientific basis of the studies were positive (81.8%). The categories with the most appraisals were, most generally, those focused on the study design, and most specifically, those focused on the scientific basis. This study provides a new data-driven approach to review scientific discourse regarding the strengths and limitations of research within academic family medicine. This methodology can potentially generalize to other medical domains. Structured appraisal data generated here will enable future clinical, scientific, and policy decision-making and broader meta-research in family medicine.
First-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes.
We conducted, using two different samples for discovery (n = 336 controls and 649 siblings of patients with psychotic disorder) and replication (n = 1208 controls and 1106 siblings), an analysis of association between PRS on the one hand and psychopathological and cognitive intermediate phenotypes of schizophrenia on the other in a sample at average genetic risk (healthy controls) and a sample at higher than average risk (healthy siblings of patients). Two subthreshold psychosis phenotypes, as well as a standardised measure of cognitive ability, based on a short version of the WAIS-III short form, were used. In addition, a measure of jumping to conclusion bias (replication sample only) was tested for association with PRS.
In both discovery and replication sample, evidence for an association between PRS and subthreshold psychosis phenotypes was observed in the relatives of patients, whereas in the controls no association was observed. Jumping to conclusion bias was similarly only associated with PRS in the sibling group. Cognitive ability was weakly negatively and non-significantly associated with PRS in both the sibling and the control group.
The degree of endophenotypic expression of schizophrenia polygenic risk depends on having a sibling with psychotic disorder, suggestive of underlying gene–environment interaction. Cognitive biases may better index genetic risk of disorder than traditional measures of neurocognition, which instead may reflect the population distribution of cognitive ability impacting the prognosis of psychotic disorder.
This study is aimed at establishing a linear holding (LH) procedure instead of a conventional air holding stack to minimize the effects of airborne delays in terms of air traffic management and fuel consumption. This paper uses both actual flight data and the Base of Aircraft Database (BADA) model to obtain fuel consumption for level flight and descent segments, separately.
The total fuel savings obtained by using actual flight data (16%) and the BADA model (10%) indicate that the LH is found to be more advantageous compared to a conventional holding procedure. Furthermore, the recommended LH procedure could be a promising solution for keeping aircraft in a narrow area that could be considered to be an effective method for airspace usage.
This study aimed to evaluate the long-term results of ossiculoplasty using bone cement.
Forty patients (24 females and 16 males; mean age: 34.1 ± 11.8 years; range, 9–54 years) with chronic otitis media with perforation but without cholesteatoma who had undergone incudostapedial rebridging ossiculoplasty using bone cement were evaluated retrospectively. Pre-operative and post-operative audiograms were evaluated. Bone conduction, air conduction and air–bone gaps were calculated according to international guidelines.
There was a mean reduction in pre-operative and post-operative air conduction (12.30 ± 11.98 dB), and this result was significant (p = 0.0001). There was a mean reduction in pre-operative and post-operative bone conduction (4.30 ± 6.69 dB), and this result was significant (p < 0.0001). The pre-operative air–bone gap was 27.65 dB and decreased to 19.65 dB during follow-up (p = 0.0001). No adverse reactions or complications were observed.
Bone cement is reliable for the repair of incudostapedial-joint defects.
Small and medium-sized enterprises are affected by changing development, production and selling paradigms in globalized industries, where innovation is a driver for sustainable competitiveness. However, innovating is highly challenging for small and medium-sized enterprises, as human resources are very limited and know-how are often highly specialized. It is often unclear which fields and factors provide the capability to innovate and which measures or methods can be applied to promote innovation based on existing competencies.
For this reason, the aim of this paper is to present a framework to support the innovation capability of SMEs by identifying promising fields for innovation and providing suitable innovation methods. A particular focus in this paper is a methodology for the description and identification of fields to foster the innovation capability in SMEs as a part of the introduced framework.
Anthracycline chemotherapeutic agents carry the well-recognised risk of cardiac toxicity. The aim of this study was to determine the long-term effect of anthracycline chemotherapy on the biventricular function in childhood cancer survivors using tissue Doppler imaging and two-dimensional speckle tracking echocardiography.
Patients and Methods:
The study included 45 survivors of childhood cancers and 50 healthy age-matched control patients. Cardiac function was prospectively studied with conventional echocardiography, tissue Doppler imaging, and speckle tracking echocardiography after completion of treatment. The same analysis was performed on matched controls.
There was no difference in age, gender, height, and weight between the study and control groups. The mean anthracycline dose was 240 ± 106 mg/m2 and the mean remission duration was 8.2 ± 5 years (1–20 years) in the study group. Conventional echocardiography showed similar ejection fraction, shortening fraction, and left ventricle end-diastolic diameter in both groups. Mitral lateral and septal tissue Doppler imaging showed normal but according to control group relatively sub-normal systolic and diastolic function in patient group. The global longitudinal and circumferential strain and strain rates were significantly lower in the patient group compared to control group. Correlation analysis revealed a negative and significant correlation between total anthracycline dose and global longitudinal and circumferential strain and strain rates.
Sub-clinical systolic and diastolic dysfunction may not be detected by conventional echocardiographic methods which are frequently used in daily practice. Sub-clinical systolic and diastolic dysfunction may be detected more sensitively by echocardiographic method such as speckle tracking echocardiography in childhood cancer survivors.
In this study, the differences between calculated and measured dose values were then analysed to assess the performance, in terms of accuracy, of the tested treatment planning system (TPS) algorithms applied to calculate electron beam dose targeted and non-targeted the breast region.
Materials and methods:
The beryllium oxide (BeO) dosimeters placed on the female RANDO phantom were irradiated 12 MeV electron energy with medical linear accelerator and repeatedly read in the Risø thermoluminescence (TL)/optically stimulated luminescence (OSL) system via OSL method at least three times.
For electron treatment, one made quantitative comparisons of the dose distributions calculated by TPSs with those from the measurements by OSL at various points in the RANDO phantom.
The mean dose measured from the dosimeters placed on the female RANDO phantom target left breast region was 160 cGy and non-target right breast region was 1·2 cGy. Analysis of Generalised Gaussian Pencil Beam (GGPB) and Electron Monte Carlo (eMC) algorithms for determined region mean point dose values, respectively, 174 and 164 cGy. Two algorithms for non-targeted region calculated same point dose values of 0·2 cGy.
The results of this study showed that BeO dosimeters can be used with OSL method in radiotherapy applications and it is a very important tool for the determination of targeted/non-targeted absorbed dose.
Public health (PH) and nursing students are an underutilized demographic in disaster response. Knowledge of the disaster response phase may enhance student understanding of preparedness, and provide response capabilities.
A single four-hour simulation-based training session, with toxicologists as instructors, can effectively improve PH and nursing student knowledge and skills in chemical and radiation response, despite minimal prior experience.
A convenience sample was used to test PH and nursing students in a response training program. An introductory lecture and simulation training reviewed: mass casualty care, triage, personal protective equipment, decontamination, and chemical and radiation exposure toxidromes. An examination was administered pre-training, and then post-training, to evaluate relevant training, knowledge, risk perception, and comfort in response capabilities to chemical and radiation incidents.
Forty-two students attended the course; 39 were included in the study. Seventy-two percent (n=28) of participants had no prior disaster training. Overall, there were significant differences between the pre-test and post-test scores for all students [95% CI: 5.4 (4.7-6.1); p<0.0001, paired t-test]; maximum score 15/15. Comparing scores of nursing and PH students, despite statistical difference in pre-test scores (median, IQR: 9.0 (7.5-10±2.0); 7.0 (5.7-9.0) respectively; p=0.048, Mann Whitney U-test), there were no statistical differences in post-test scores (median, IQR: 14.0 (13.0-14.0); 13.0 (12.0-14.0), respectively, Mann Whitney U-test). All students recognized nerve agent toxidrome and performed SALT triage after the training (p <0.0001, McNemar test). Subjectively, participant comfort level in responding to a chemical or radiological incident improved (p <0.0001, McNemar test). Individual risk perception for chemical or radiological disasters did not improve after training.
Improvement of knowledge and comfort was demonstrated, irrespective of previous experience. Simulation-based training of chemical and radiation disaster preparedness, led by medical toxicologists, is an effective means of educating PH and nursing students, with minimal prior fluency.
Conventional algorithm for treatment of pericarditis and prevention of recurrences consists of non-steroid anti-inflammatory drugs and/or colchicine, followed by corticosteroids in resistant patients. Anakinra has emerged as a promising and safe treatment modality for steroid-dependent idiopathic recurrent pericarditis. However, the efficacy and safety of canakinumab, another anti-interleukin-1 agent, has not been assessed up to date. Herein, we present development of an anaphylactic reaction due to anakinra and a successful subsequent treatment with canakinumab for the first time in the literature.
Antimicrobial textiles received considerable attention due to public health and personal hygiene concerns. On the other hand, pathogenic microorganisms gain immunity against existing antibacterial products. For these reasons, new and stronger antibacterial agents need to be developed immediately. In this work, silver nanowires (Ag NWs) were decorated onto conventional fabrics via facile and scalable dip and dry method. Antimicrobial activity of the nanowire-decorated fabrics was investigated against a Gram-positive coccus (Staphylococcus aureus), a Gram-negative bacillus (Escherichia coli), a Gram-positive and spore-forming bacillus (Bacillus cereus), and a yeast-like fungus (Candida albicans) via disk diffusion and time–dependent killing methods. The effect of Ag NW content was investigated, and the decorated fabrics showed promising antibacterial activity even with a small amount of Ag NW decoration (0.095 mg/cm2). Moreover, decorated fabrics maintained their activity for 24 h. This work shows that Ag NW-modified fabrics can be used as antimicrobial textiles against a wide spectrum of bacteria.
To investigate oxidative stress parameters [total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), paraoxonase (PON), arylesterase (ARE) and thiol-disulphide homeostasis] in patients who were diagnosed as having somatic symptom disorder in accordance with Diagnostic and Statistical Manual of Mental Disorders-5.
The study included 41 medication-free patients with somatic symptom disorder and 47 age, sex, and sociodemographic-matched healthy individuals. The patients were administered the Patient Health Questionnaire-15, Somatic Symptom Amplification Scale, Beck Depression Inventory, and Beck Anxiety Inventory. TOS, TAS, OSI, PON, ARE thiol, disulphide levels, and routine biochemical parameters were compared between the two groups.
TOS, OSI, disulphide levels, disulphide/native thiol, and disulphide/total thiol ratios were found significantly higher in the patient group compared with the control group (p < 0.001). There was no significant difference in PON, ARE, and TAS parameters between the two groups (p > 0.05).
This study showed that the level of oxidants increased and oxidative balance was impaired in somatic symptom disorder. Oxidative stress may play a role in the aetiopathogenesis of this disorder. This is the first study to report an association between oxidative stress and somatic symptom disorder.
This article revisits Anthony Sherley’s Relation of his trauels into Persia (1613), reading the text within the larger context of early modern Eurasia. It highlights the ways in which at least one European traveler sought and found not alterity, but commensurable structures, social roles, political ideologies, and personal motivations in the Islamic polities to the east and emphasized these connections to his European readers. Furthermore, in making the case that Sherley’s narrative is informed by local actors in Safavid Persia, it maintains that a certain level of Eastern knowledge is present within Western texts from this period and awaits scholarly excavation.
This article analyzes the extent to which Turkey’s irregular migration governance has evolved since the 1990s and the most salient factors in that process. Relying on the methods of process tracing and political ethnography, the article demonstrates that, since the early 1990s, Turkey’s irregular migration governance has been driven by the following factors: 1) responses to the European Union’s (EU) attempts to control migration through externalization; 2) Turkey’s national security concerns, which increased with the advent of mass migration from the Middle East; and 3) the increase in the number of irregular migrants on Turkish territory. The Syrian mass migration that began in 2011 gave momentum to the evolution of irregular migration governance in line with the long-term externalization on the part of the EU. Our analysis sheds light on the interconnectedness of irregular and mass migration, as well as on the outcomes of interactions between international politics and national migration governance. Thus, the article provides insights that will prove valuable for migration studies, EU studies, and studies on Turkish foreign policy.
The development of complex systems ensembles that operate in uncertain environments is a major challenge. The reason for this is that system designers are not able to fully specify the system during specification and development and before it is being deployed. Natural swarm systems enjoy similar characteristics, yet, being self-adaptive and being able to self-organize, these systems show beneficial emergent behaviour. Similar concepts can be extremely helpful for artificial systems, especially when it comes to multi-robot scenarios, which require such solution in order to be applicable to highly uncertain real world application. In this article, we present a comprehensive overview over state-of-the-art solutions in emergent systems, self-organization, self-adaptation, and robotics. We discuss these approaches in the light of a framework for multi-robot systems and identify similarities, differences missing links and open gaps that have to be addressed in order to make this framework possible.