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.
No standardized surveillance criteria exist for surgical site infection after breast tissue expander (BTE) access. This report provides a framework for defining postaccess BTE infections and identifies contributing factors to infection during the expansion period. Implementing infection prevention guidelines for BTE access may reduce postaccess BTE infections.
Lies and half-truths are commonplace in US politics. While there is a growing literature examining questionable statements, relatively little attention has been given to the consequences that befall the sources. We address this gap by looking at how a candidate’s sex shapes citizens’ reactions to a factually dubious statement. We argue and show that subjects from the opposing party display a greater desire and tendency to punish a female candidate. Subjects from the candidate’s same party, however, appear to be more forgiving when the candidate is portrayed as a woman versus a man. In total, our findings suggest that gender and partisan biases may operate in tandem to both help and harm female political candidates who “misspeak.”
To evaluate the implementation of the national health promotion programme (through nutritional education and Fe supplementation) among female high-school students in Iran and to assess the application of the crosswise model (CM) for evaluating the programme’s implementation.
Two cross-sectional surveys in female high-school students, one using the direct questioning (DQ) method and the other using the CM, were conducted. Two survey questionnaires used to collect the data contained questions about three aspects of the programme: delivering the Fe supplements, consuming them and holding nutritional training sessions.
Female high schools, West Azerbaijan Province, Iran.
A sample of 2180 students, of whom 1740 were surveyed by the CM and 440 were interviewed by DQ.
The CM resulted in estimates that were consistently lower than the estimates of the DQ. The proportion of students in the DQ and CM who reported receiving the pills weekly and on a regular basis was 73·2 and 22·5 %, respectively. About 43 and 31 % of students in the DQ and CM surveys reported consuming all pills delivered to them. In the DQ method, only 12 % of students who reported the number of pills consumed had taken the complete dose (sixteen pills).
Implementation of the Fe supplementation programme in female high schools was poor and insufficient, so that it seems unsuccessful in reducing Fe-deficiency anaemia in adolescent girls. The CM might be considered for evaluating the health programme’s implementation at high schools.
The aim of the present study was to evaluate the prevalence of vitamin B12 (B12) deficiency in kidney transplant recipients (KTR) and its possible association with B12 dietary intake, body adiposity and immunosuppressive drugs. In this cross-sectional study, we included 225 KTR, aged 47·50 (sd 12·11) years, and 125 (56 %) were men. Serum levels of B12 were determined by chemiluminescent microparticle intrinsic factor assay and the cut-off of 200 pg/ml was used to stratify KTR into B12-sufficient or B12-deficient group. B12 dietary intake was evaluated by three 24 h dietary recalls and was considered adequate when ≥2·4 μg/d. Body adiposity was estimated after taking anthropometric measures and using the dual-energy X-ray absorptiometry (DXA) method. B12 deficiency was seen in 14 % of the individuals. B12-deficient group, compared with the B12-sufficient group, exhibited lower intake of B12 (median 2·42 (interquartile range (IQR) 1·41–3·23) v. 3·16 (IQR 1·94–4·55) μg/d, P = 0·04) and higher values of waist circumference (median 96·0 (IQR 88·0–102·5) v. 90·0 (IQR 82·0–100·0) cm, P = 0·04). When the analysis included only women, B12 deficiency was associated with higher total and central body adiposity measurements obtained with anthropometry (BMI, body adiposity index, waist and neck circumferences) and DXA (total and trunk body fat). Among individuals with adequate intake of B12, the deficiency of this vitamin was more frequently seen in those using mycophenolate mofetil (MMF) (17 %) v. azathioprine (2 %), P = 0·01. In conclusion, the prevalence of B12 deficiency in KTR was estimated as 14 % and was associated with reduced intake of B12 as well as higher adiposity, especially in women, and with the use of MMF.
Use of heroin in self-management of Restless Leg Syndrome (RLS) has not heretofore been described. Such a case is presented.
Case study: This 29 years old right handed male presented with a long history of major depressive disorder, generalized anxiety disorder and opioid dependence. The Patient felt compelled to take quetiapine since was the only drug found to be effective in controlling racing thoughts, Major Depressive Disorder with psychotic features. Prior to use of quetiapine the patient never experienced RLS. Quetiapine in doses ranging from 25mg to 300mg a day precipitated severe RLS whereby he was forced to move his leg all night long leading to poor sleep quality. The RLS was unresponsive to Gabapentin and Benztropine, however it was eliminated with a variety of opioids including hydrocodone, buprenorphine, buprenorphine/naloxone. Particularly sensitive to heroin, 1/2 twenty dollar bag, self-administered IV prior to sleep eliminated the RLS immediately, but when injected more than four hours before sleep it had no effect. RLS acted only when induced with quetiapine, since he wished to continue quetiapine to control his mood, he felt compelled to self-medicate with heroin to stop RLS side effects. He showed no other signs of extrapyramidal symptomatology or evidence of any other movement disorder.
Abnormalities in physical examination: General: Abundance of tattoos on body and face. Cranial Nerve (CN): CN I: Alcohol Sniff Test: 7cm (anosmia). CN II: Anisocoria OD 5mm OS 2mm. Motor Examination: drift testing: right pronator drift. Cerebellar: Finger to Nose: end point dysmetria bilaterally. Low amplitude high frequency tremor in both upper extremities on extension. Sensory Examination: decreased graphesthesia in both upper extremities. Reflexes: 3+ knee jerks, absent ankle jerks, positive jaw jerk, bilateral palmomental reflex is present.
This patient has a long history of quetiapine use due to his major depressive disorder with psychotic features and subsequent self-administration of IV heroin reportedly to reduce the symptoms of quetiapine-induced RLS. Heroin elevates dopamine levels in forebrain by blocking inhibitory GABA interneurons near the ventral tegmental area, leading to activation of mesocorticolimbic dopaminergic neurons (Nakagawa 2008, Steidl 2011). The time frame of opioid administration has a critical impact on its efficacy in improving RLS symptoms. However, the drug’s effects only up to 3 to 6hours (Buchfuhrer 2012). In this case administration of heroin more than 4hours before sleep would not alleviate the RLS symptoms. Patient chose the time of injection, not for hedonic pleasure of heroin, but rather to prevent RLS symptoms. In those with heroin dependence, the possibility that is a result of self-medication of underlying movement disorder warrants additional investigation. In those with RLS who are unresponsive to other treatment modalities, a trial of opioids maybe worthwhile.
A diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services.
To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis.
Structural brain images of 75 participants were included: 32 female individuals with DID and 43 matched healthy controls. Individuals with DID were recruited from psychiatry and psychotherapy out-patient clinics. Probabilistic pattern classifiers were trained to discriminate cohorts based on measures of brain morphology.
The pattern classifiers were able to accurately discriminate between individuals with DID and healthy controls with high sensitivity (72%) and specificity (74%) on the basis of brain structure. These findings provide evidence for a biological basis for distinguishing between DID-affected and healthy individuals.
We propose a pattern of neuroimaging biomarkers that could be used to inform the identification of individuals with DID from healthy controls at the individual level. This is important and clinically relevant because the DID diagnosis is controversial and individuals with DID are often misdiagnosed. Ultimately, the application of pattern recognition methodologies could prevent unnecessary suffering of individuals with DID because of an earlier accurate diagnosis, which will facilitate faster and targeted interventions.
Declaration of interest
The authors declare no competing financial interests.
Little is known about the genetic and morphological characters of Taenia ovis. The purpose of the present study was to characterize sheep isolates of T. ovis using rostellar hook morphometry as well as mitochondrial genes sequence analysis. Ninety sheep specimens of Cysticercus ovis were collected from 18 slaughterhouses in Iran. The mean ± s.d. for total length of large and small hooks were 174.1 ± 6.4 and 116.7 ± 5.4 µm, respectively. CO1 and 12S rRNA sequence analysis showed 11 and nine haplotypes, respectively. The level of pairwise nucleotide variations between individual haplotypes of CO1 and 12S rRNA genes were 0.3–1.1 and 0.2–1.0%, respectively. Level of nucleotide variation in CO1 and 12S rRNA between T. ovis haplotypes from present study and eight other Taenia species was found to be 11.3–17.8 and 5.3–16.3%, respectively. Phylogenetic analysis clustered all T. ovis isolates into a single clade comprised of the all CO1 and 12S rRNA haplotypes. CO1 nucleotide difference between T. ovis ovis and T. asiatica was 13.6% that is lesser than the corresponding difference between T. ovis ovis and T. ovis krabbei, warranting the designation of two separate species as T. ovis and T. krabbei. Interclass correlation coefficients showed that there was no significant association between rostellar hook length variation and the variability of the mitochondrial genes.
Pick-and-place applications need to perform rigid body displacements that combine translations along three independent directions and rotations around one fixed direction (Schoenflies motions). Such displacements constitute a four-dimensional (4-D) subgroup (Schoenflies subgroup) of the 6-D displacement group. The four-degrees of freedom (dof) manipulators whose end effector performs only Schoenflies motions are named Schoenflies-motion generators (SMGs). The most known SMGs are the serial robots named SCARA. In the literature, parallel manipulators (PMs) have also been proposed as SMGs. Here, a novel single-loop SMG of type 2PRPU is studied. Its position analysis, singularity loci and workspace are addressed to provide simple analytic and geometric tools that are useful for the design. The proposed single-loop SMG is not overconstrained, its actuators are on or near the base and its end effector can perform a complete rotation. These features solve the main drawbacks that parallel SMG architectures have in general and make the proposed SMG a valid design alternative.
An ultrasonic device was designed to fabricate relatively small vacuum chill castings of FeAl-based alloys with improved microstructure. A special hot-rolling procedure preventing thermal shocks was used for the thermomechanical treatment of cast alloys.
The efficiency of ultrasonic vacuum casting is manifested by improved microstructure of hot-rolled iron aluminides Fe – 40 at.% Al with addition of C or Zr and B or Zr and B with 1 wt.% of Y2O3 particles.
This study presents a new kinetostatic model for humanoid robots (HRs). Screw theory, together with Assur virtual chains and Davies' method, provides the required tools for the proposal of both the kinematic and static parts of the kinetostatic model. Our kinetostatic model is able to estimate the forces and couples generated at the axes of each joint of the robot, as well as one unknown contact condition between the robot and the environment around it. The proposed model is also very versatile and free of fixed coordinates and, therefore, it allows for an estimate of a great amount of information on the HR. Some results, obtained from computer simulation, are presented to validate the versatility of the proposed technique.
In strawberry production, a balanced and accurate irrigation schedule is essential, because of the high sensitivity of strawberry plants to water deficits and waterlogging. The optimal irrigation management strategy can, however, only be obtained by an accurate crop monitoring system. To replace the current visual inspection methods, which are subjective, time consuming and labour-intensive, the performance of the COmpact hyperSpectral Imaging system (COSI) mounted on an RPAS (Remotely Piloted Aircraft System) was evaluated. The study, focusing on different irrigation treatments in strawberry cultivation, unraveled the potential of the COSI system, to monitor field variations, even at small scale. Growth inhibition and differences in plant physiology due to water deficit could be detected. As such, the COSI system has shown potential for steering irrigation management decisions in strawberry cultivation.
The 2012 contest between Barack Obama and Mitt Romney included fierce dialogue about women and issues typically connected to them. The inflammatory comments that conservative radio-show host Rush Limbaugh made about female law student Sandra Fluke and the Affordable Health Care Act's (ACA) requirements that all workplaces cover contraceptives were central topics in the news. The controversy literally followed Romney in the form of “Pillamina,” a human-sized costume designed to look like a pack of birth control pills that shadowed the candidate's summer swing state tour. While “Pillamina” was the work of Planned Parenthood's Action Fund, the Obama campaign also took aim at Romney on this issue, running a television commercial featuring “Dawn and Alex,” two women talking about how out of touch Romney is with women's health issues. The Romney campaign's attempts to counter these attacks and shift the focus of conversation were largely thwarted, as questionable comments from Republican Senate candidates Todd Akin and Richard Mourdock brought the issue of abortion to the forefront. Both of these statements added fuel to the narrative that Republicans are out of touch with women's needs. And Romney himself contributed to the problem, as his notorious “binders full of women” debate response broadened the scope of the issue from reproductive rights to more general issues about gender equality. Altogether, these Republican comments and positions opened the door for Democrats on the campaign trail to attack the party, and a popular conclusion is that this “War on Women” narrative hurt the Republican Party and played an integral part in Obama's victory.
Recent studies suggest that supplemental Ca (SC) increases the risk of cardiovascular events, whereas dietary Ca (DC) decreases the risk of cardiovascular events. Although frequently consumed with meals, it remains unclear whether Ca can mitigate or aggravate the deleterious effects of a high-fat meal on cardiovascular risk factors. This study aimed to evaluate the effects of SC or DC on blood pressure (BP) and microvascular function (MVF) in the postprandial period in obese women challenged with a high-fat meal. In this cross-over controlled trial, sixteen obese women aged 20–50 years were randomly assigned to receive three test meals (2908 kJ (695 kcal); 48 % fat): high DC (HDCM; 547 mg DC), high SC (HSCM; 500 mg SC–calcium carbonate) and low Ca (LCM; 42 mg DC). BP was continuously evaluated from 15 min before to 120 min after meals by digital photoplethysmography. Before and 120 min after meals, participants underwent evaluation of serum Ca and microvascular flow after postocclusive reactive hyperaemia (PORH) by laser speckle contrast imaging. Ionised serum Ca rose significantly only after HSCM. Systolic BP increased after the three meals, whereas diastolic BP increased after LCM and HDCM. Hyperaemia peak, hyperaemia amplitude and AUC evaluated after PORH decreased with LCM. After HDCM, there was a reduction in hyperaemia peak and hyperaemia amplitude, whereas HSCM decreased only hyperaemia peak. However, comparative analyses of the effects of three test meals on serum Ca, BP and MVF revealed no significant meal×time interaction. This study suggests that in obese women SC and DC do not interfere with the effects of a high-fat meal on BP and MVF.
Astronomy in Prague has long been associated with Charles University, since its founding in 1348. After a long and complicated history, “The State Observatory” was established in the former Jesuit college of Klementinum. The polar height was measured at this location in the last century, during the periods 1889 – 1892, 1895 – 1899 and 1900 – 1904. The observations were made by Gerstner, Laska, Spitaler and others, under the leadership of Prof. Lad. Weinek. The measurements were performed with a transit instrument. The inspection was made in the Archive of Academy of Sciences, where practically all the observations are still preserved.