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Airway management is of paramount importance in trauma resuscitations; in fact, virtually all management algorithms begin with the assessment and protection of the airway. Trauma airways are often compromised and among the most difficult to manage due to hemodynamic instability from multi-organ dysfunction, cervical trauma, or direct trauma to airway structures.
The study of the recorded artefact from a musicological perspective continues to unfold through contemporary research. Whilst an understanding of the scientific elements of recorded sound is well documented, the exploration of the production and the artistic nature of this endeavour is still developing. This article explores phenomenological aspects of producing heavy metal music from the perspective of seven renowned producers working within the genre. Through a series of interviews and subsequent in-depth analysis, particular sonic qualities are identified as key within the production of this work: impact; energy; precision; and extremity. A conceptual framework is then put forward for understanding the production methodology of recorded heavy metal music, and how developing technology has influenced the production of the genre.
This chapter thinks through the implications of authorship for publishing in terms of marketing over the last 150 years, mainly in the UK fiction industry. The UK Chartered Institute of Marketing does not define what marketing is, but the American Marketing Association describes it as “the activity, set of institutions, and processes for creating, communicating, delivering, and exchanging offerings that have value for customers, clients, partners, and society at large.”1 This does not imply that marketing lies entirely in the hands of marketers – or indeed of any one person or organization (such as a publisher): while marketers may devise strategies and objectives, the role of chance in the achievement of results is commonly recognized. Marketing, furthermore, goes well beyond the generation of advertising copy: it embraces product design, pricing, and targeted communications at specific times in particular places so as to manage relationships key for sales.
This article examines key barriers to business sustainability discussed at a multidisciplinary conference held at the Harvard Business School in 2018. Drawing on perspectives from both the historical and business literatures, speakers debated the historical success of and future opportunities for voluntary business actions to advance sustainability. Roadblocks include misaligned incentives, missing institutions, inertia of economic systems, and the concept of sustainability itself. Overcoming these roadblocks will require systematic interventions and alternative normative concepts.
Australia’s laid-back, sun-drenched beach lifestyle has been a celebrated and prominent part of its official popular culture for nigh on a century, and the images and motifs associated with this culture have become hallmarks of the country’s collective identity. Though these representations tend towards stereotype, for many Australians the idea of a summer holiday at the beach is one that is intensely personal and romanticised – its image is not at all urbanised. As Douglas Booth observed, for Australians the beach has become a ‘sanctuary at which to abandon cares – a place to let down one’s hair, remove one’s clothes […] a paradise where one could laze in peace, free from guilt, drifting between the hot sand and the warm sea, and seek romance’.1 Beach holidays became popular in the interwar years of the twentieth century, but the most intense burst of activity – both in touristic promotion and in the development of tourism infrastructure – accompanied the postwar economic boom, when family incomes were able to meet the cost of a car and, increasingly, a cheap block of land by the beach upon which a holiday home could be erected with thrift and haste. In subtropical southeast Queensland, the postwar beach holiday became the hallmark of the state’s burgeoning tourism industry; the state’s southeast coastline in particular benefiting from its warm climate and proximity to the capital, Brisbane. It was here – along the evocatively named Gold Coast (to Brisbane’s south) and Sunshine Coast (to its north)  – that many families experienced their first taste of what is now widely celebrated as the beach lifestyle . As one reflection has it:
In the era before motels and resorts, a holiday at the Gold and Sunshine coasts usually meant either pitching a tent and camping by the beach or staying in a simple cottage owned by family or friends […] Simplicity, informality, individuality […] were the hallmarks of these humble places.2
Report the efficacy of open-label amphetamine extended-release oral suspension (AMPH EROS) for the treatment of children with ADHD.
AMPH EROS has a 1-hr onset of effect and a duration of action of 13hours and was approved by FDA for treatment of ADHD in children aged 6–17 years based on a double-blind, placebo-controlled efficacy and safety study in children aged 6–12 years with ADHD. A significant treatment difference in change from pre-dose SKAMP-combined score was observed at the primary endpoint of 4hours post-dose (p<0.0001) and each post-dose time point assessed (1, 2, 4, 6, 8, 10, 12, 13hours).
Data reported here are from the 5-week, open-label dose optimization period. These efficacy data support the primary endpoint result.
Males and females aged 6 to 12 years with ADHD enrolled and began open-label treatment with 2.5 mg or 5mg/day of AMPH EROS titrated in 2.5–10mg/day increments until optimal dose (maximum 20mg/day). Doses could be decreased for tolerability. Subjects took morning AMPH EROS for 5weeks. Other efficacy outcomes during the open-label dose optimization phase: ADHD-RS (ADHD-Rating Scale), CGI-S (Clinical Global Impression of Severity), CGI-I (CGI-of Improvement) and CPRS (Conners’ Parent Rating Scale). All subjects were assessed for safety.
For the ITT population (n=99): treatment with AMPH EROS was associated with a mean change in ADHD-RS-IV (baseline to end of the open-label dose optimization; week 6) of 28.2 (±9.03) (Baseline score = 41.3±7.95). 90.9% of subjects had a change from baseline to open-label week 6 of ≥50% in the ADHD-RS-IV total score and were defined as responders. The CGI-S scores decreased continuously from baseline, with a high 4.8 at baseline to a low of 2.0 at open-label week 6. The percentage of subjects classified as moderately ill or greater correspondingly decreased from 97% at Baseline to 1% at open-label week 6. The decrease in the CGI-I over the study was similar to the change in CGI-S scores. CPRS for most categories decreased continuously from Baseline to open-label week 6. Mean change from baseline to open-label week 6 on the CPRS inattention T-score subscale was –25.3 (±14.38) and –24.4 (±13.87).
Adverse events (>5%) reported during dose optimization were decreased appetite, insomnia, affect lability, upper abdominal pain, mood swings and headache.
AMPH EROS was effective in reducing symptoms of ADHD in this open-label dose optimization. The AE profile of AMPH EROS was consistent with those of other amphetamine products.
Funding Acknowledgements: This work was funded by Tris Pharma, Inc.
Objectives: The aim of this study was to investigate alterations in functional connectivity, white matter integrity, and cognitive abilities due to sports-related concussion (SRC) in adolescents using a prospective longitudinal design. Methods: We assessed male high school football players (ages 14–18) with (n=16) and without (n=12) SRC using complementary resting state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI) along with cognitive performance using the Immediate Post-Concussive Assessment and Cognitive Testing (ImPACT). We assessed both changes at the acute phase (<7 days post-SRC) and at 21 days later, as well as, differences between athletes with SRC and age- and team-matched control athletes. Results: The results revealed rs-fMRI hyperconnectivity within posterior brain regions (e.g., precuneus and cerebellum), and hypoconnectivity in more anterior areas (e.g., inferior and middle frontal gyri) when comparing SRC group to control group acutely. Performance on the ImPACT (visual/verbal memory composites) was correlated with resting state network connectivity at both time points. DTI results revealed altered diffusion in the SRC group along a segment of the corticospinal tract and the superior longitudinal fasciculus in the acute phase of SRC. No differences between the SRC group and control group were seen at follow-up imaging. Conclusions: Acute effects of SRC are associated with both hyperconnectivity and hypoconnectivity, with disruption of white matter integrity. In addition, acute memory performance was most sensitive to these changes. After 21 days, adolescents with SRC returned to baseline performance, although chronic hyperconnectivity of these regions could place these adolescents at greater risk for secondary neuropathological changes, necessitating future follow-up. (JINS, 2018, 24, 781–792)
Objectives: As the number of adolescents and young adults (AYAs) surviving congenital heart disease (CHD) grows, studies of long-term outcomes are needed. CHD research documents poor executive function (EF) and cerebellum (CB) abnormalities in children. We examined whether AYAs with CHD exhibit reduced EF and CB volumes. We hypothesized a double dissociation such that the posterior CB is related to EF while the anterior CB is related to motor function. We also investigated whether the CB contributes to EF above and beyond processing speed. Methods: Twenty-two AYAs with CHD and 22 matched healthy controls underwent magnetic resonance imaging and assessment of EF, processing speed, and motor function. Volumetric data were calculated using a cerebellar atlas (SUIT) developed for SPM. Group differences were compared with t tests, relationships were tested with Pearson’s correlations and Fisher’s r to z transformation, and hierarchical regression was used to test the CB’s unique contributions to EF. Results: CHD patients had reduced CB total, lobular, and white matter volume (d=.52–.99) and poorer EF (d=.79–1.01) compared to controls. Significant correlations between the posterior CB and EF (r=.29–.48) were identified but there were no relationships between the anterior CB and motor function nor EF. The posterior CB predicted EF above and beyond processing speed (ps<.001). Conclusions: This study identified a relationship between the posterior CB and EF, which appears to be particularly important for inhibitory processes and abstract reasoning. The unique CB contribution to EF above and beyond processing speed alone warrants further study. (JINS, 2018, 24, 939–948)
Tomato (Solanum lycopersicum) fruit quality and yield are highly dependent on adequate uptake of nutrients. Potassium, magnesium and calcium are essential elements that influence fruit quality traits such as colour, uniformity of ripening, hollow fruit, fruit shape, firmness and acidity. Sodium is not an essential element for tomato and can detrimentally compete with the absorption of potassium and calcium. Daily intakes of potassium, magnesium and calcium in human diets are typically below healthful levels, while sodium intake is often excessive. The objective of this study was to compare 52 diverse commercially important varieties of tomato for concentrations of potassium, magnesium, calcium and sodium in fruits. The tomatoes were produced in replicated plots in Geneva, NY in 2010 and 2011. Multiple fruits per plot were harvested vine-ripe, homogenized and assayed for cations. Analysis of variance showed significant differences among the 52 varieties for all four traits, i.e. cation concentrations (df = 51, P < 0.0001–0.0034) and no significant differences between years for any trait (df = 1, P = 0.3432–0.6770). Factor analysis showed a strong interrelationship between potassium and magnesium that was independent of calcium and sodium. Potassium and magnesium were highly significantly correlated with each other (r = 0.64, P < 0.0001). No other correlations between pairs of traits were observed. Results supported a genetic basis for potassium, magnesium, calcium and sodium concentrations that was consistent across environments (i.e. years). Results can contribute to the development of cultivars with favourable cation profiles in terms of human health and fruit quality.