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Drawing on the new institutional theory and the resources based view of the firm (RBV), this study tries to shed light upon the idea that isomorphic organizational changes seek legitimacy over efficiency. Using data from 102 Spanish companies and employing partial least squares, a variance-based structural equation modeling technique, this study concludes that both objectives are achievable simultaneously when firms implement total quality management (TQM) as an integrative stream of both theories. Furthermore, empirical results reveal that: (i) institutional pressures (IP) condition significantly the implementation of TQM, (ii) TQM exerts a double mediating role in the IP-legitimacy and IP-efficiency relationships, and (iii) both efficiency and legitimacy objectives are achieved by means of TQM. However, we observe a dual phenomenon: (i) while we find a significant positive effect of TQM on overall performance (OP) via efficiency and (ii) we failed to find support for the TQM-OP link via legitimacy.
This paper examines how monuments with ‘local’ idiosyncrasies are key in processes of place-making and how, through persistence, such places can engage in supra-local and even ‘global’ dynamics. Departing from a detailed revision of its context, materiality and iconography, we show how a remarkable Iberian ‘warrior’ stela brings together the geo-strategic potential of a unique site, located literally between the Mediterranean and the Atlantic worlds, the century-long dialogue between shared and local identities and the power of connectivity of inexorable global processes. Previous approaches to Iberian late prehistoric stelae have had problems in developing bottom-up, theoretically informed and empirically sound approaches to their simultaneously local and supra-local character. The remarkable site of Almargen provides the opportunity to explore this issue. Located in Lands of Antequera (Málaga), a region with a strong tradition of landscape-making through monuments going back to the Late Neolithic, the Almargen ‘warrior’ stela serves us to explore the notion of ‘glocalization’, which embodies persistent local engagements with material culture, sites and landscapes on the one hand, and their connections with wider regional and even ‘global’ worlds on the other.
Hernia is defined as the protrusion of one or several internal organs through an opening in the cavity that contains them due to a tissue defect, abdominal wall surgery by means of synthetic meshes is the most common method used for hernia repair, however, postsurgical effects can range from some discomfort, to chronic pain and even the reappearance of the hernia due to a poor mechanical adaptability between the synthetic tissue and the host tissue. The knowledge of the mechanical properties of the materials involved in hernia repair is fundamental in the understanding and subsequent solution of this type of problems. In this work, experimental data were obtained by means of uniaxial tensile tests in two perpendicular directions of commercial meshes used in hernia repair. The tests were carried out on the UniVert® machine of the CellScale® brand. Anisotropic mechanical behavior is observed due to the structure of the mesh and the interaction between each of the yarns that make it up. The data found vary with respect to the direction of traction and also has non-linear hyperelastic behavior, so the adjustment of curves was made through a hyperelastic model in the COMSOL Multiphysics® software through the Levenberg-Marquardt Algorithm for the characterization of these materials.
Based on stratigraphic excavation data and associated radiocarbon dates we argue that the pre-Hispanic city of Cerro Jazmín, in the Mixteca Alta region of Oaxaca, underwent a period of political change between the Late Formative (300 b.c.–a.d. 50) and the Terminal Formative periods (a.d. 50–300). This shift is reflected in the city's layout and in the timing of construction and use of two different monumental sectors. During the city's Late Formative occupation, we found evidence of more exclusionary feasting activity taking place in a secluded monumental sector called the Sunken Courtyards near the hilltop. In the Terminal Formative, however, monumental construction expanded in the more accessible Tres Cerritos sector where larger and accessible public areas were the focus of activity. We argue that changes in the city's layout, along with the differing patterns of feasting, suggest that the city's leaders went from a more exclusionary form of government to a more collective political strategy during the Terminal Formative period. Despite of these efforts monumental construction largely stopped and the city's population declined by the start of the Classic period (a.d. 300).
This study aimed to evaluate the associations between the muscle mass to visceral fat (MVF) ratio and cardiometabolic risk factors in a large population of college students in Colombia and to propose cut-off points of this index for the metabolic syndrome (MetS). A total of 1464 young adults recruited from the FUPRECOL (Asociación de la Fuerza Prensil con Manifestaciones Tempranas de Riesgo Cardiovascular en Jóvenes y Adultos Colombianos) study were categorised into four groups based on their MVF ratio. Muscle mass and visceral fat level of the participants were measured using a bioelectrical impedance analysis. Cardiometabolic risk factors including lifestyle characteristics, anthropometry, blood pressure and biochemical parameters were assessed. The prevalence of moderate to severe obesity, hypertension and the MetS was higher in subjects in quartile (Q)1 (lower MVF ratio) (P <0·001). ANCOVA revealed that the subjects in Q1 had higher cardiometabolic disturbances, including altered anthropometry, blood pressure, muscle strength and biochemical parameters after adjusting for age and sex compared with young adults in higher MVF ratio quartiles (P <0·001). Muscular mass and physical activity levels were significantly lower in subjects with a lower MVF ratio (P <0·001). The receiver operating characteristic curve analyses indicated that in men the best MVF ratio cut-off point for detecting the MetS was 18·0 (AUC 0·83, sensitivity 78 % and specificity 77 %) and for women, the MVF ratio cut-off point was 13·7 (AUC 0·85, sensitivity 76 % and specificity 87 %). A lower MVF ratio is associated with a higher risk cardiometabolic profile in early adulthood, supporting that the MVF ratio could be used as a complementary screening tool that may help clinicians identify young adults at high cardiometabolic risk.
To investigate whether amnestic mild cognitive impairment (aMCI) identified with visual memory tests conveys an increased risk of Alzheimer’s disease (risk-AD) and if the risk-AD differs from that associated with aMCI based on verbal memory tests.
4,771 participants aged 70.76 (SD = 6.74, 45.4% females) from five community-based studies, each a member of the international COSMIC consortium and from a different country, were classified as having normal cognition (NC) or one of visual, verbal, or combined (visual and verbal) aMCI using international criteria and followed for an average of 2.48 years. Hazard ratios (HR) and individual patient data (IPD) meta-analysis analyzed the risk-AD with age, sex, education, single/multiple domain aMCI, and Mini-Mental State Examination (MMSE) scores as covariates.
All aMCI groups (n = 760) had a greater risk-AD than NC (n = 4,011; HR range = 3.66 – 9.25). The risk-AD was not different between visual (n = 208, 17 converters) and verbal aMCI (n = 449, 29 converters, HR = 1.70, 95%CI: 0.88, 3.27, p = 0.111). Combined aMCI (n = 103, 12 converters, HR = 2.34, 95%CI: 1.13, 4.84, p = 0.023) had a higher risk-AD than verbal aMCI. Age and MMSE scores were related to the risk-AD. The IPD meta-analyses replicated these results, though with slightly lower HR estimates (HR range = 3.68, 7.43) for aMCI vs. NC.
Although verbal aMCI was most common, a significant proportion of participants had visual-only or combined visual and verbal aMCI. Compared with verbal aMCI, the risk-AD was the same for visual aMCI and higher for combined aMCI. Our results highlight the importance of including both verbal and visual memory tests in neuropsychological assessments to more reliably identify aMCI.
The aim of this study was to develop and to assess a specific Multi-Criteria Decision Analysis (MCDA) framework to evaluate new drugs in an hospital pharmacy and therapeutics committee (P&TC) setting.
A pilot criteria framework was developed based on the EVIDEM (Evidence and Value: Impact on DEcisionMaking) framework, together with other relevant criteria, and assessed by a group of P&TC's members. The weighting of included criteria was done using a 5-point weighting technique. Two drugs were chosen by evaluation: an orphan-drug for Gaucher disease, and a nonorphan drug for the treatment of inflammatory bowel disease. Evidence matrices were developed, and value contribution of each drug was evaluated by P&TC's members. An agreed final framework was obtained through a discussion between the P&TC's members.
After criteria assessment, the pilot framework included eight quantitative criteria: “disease severity,” “unmet needs,” “comparative efficacy/effectiveness,” “comparative safety/tolerability,” “comparative patient-reported outcomes,” “comparative cost consequences-cost of treatment,” “comparative cost consequences-other medical costs,” and “quality of evidence”; and one contextual criterion: “opportunity costs and affordability.” The most valued criteria were: “comparative safety/tolerability,” “disease severity,” and “comparative efficacy/effectiveness.” When assessing the drugs most valued characteristics of the MCDA were the possibility that all team may contribute to drug assessment by means of scoring the matrices and the discussion to reach a consensus in drug positioning and value decision making.
The reflective MCDA would integrate quantitative and qualitative criteria relevant for a P&TC setting, allowing reflective discussions based on the criteria weighting score.
Gilding threads collected from Spanish and Portuguese palaces and from the embroideries and adornments of sculptures of the Virgin and Christ that form part of Sevillian Holy Week were analyzed and compared (20 artifacts were evaluated). The study covered a broad time period with examples from the 13th to 14th centuries, 18th to 20th centuries, and also including modern embroideries. A combination of scanning electron microscopy and energy-dispersive X-ray spectroscopy was used. The knowledge of the layered structures of the threads has provided very valuable information regarding the manufacturing techniques. The different metal threads found in the embroidery studied consisted of gold, silver, copper, and alloys of these metals and aluminium. The fabrication procedures often differed in the different workshops and changed with time. In the modern embroideries, a decrease of precious metal concentration was detected. The threads were wound around a core of silk threads.
Four new malformations observed in blue shark embryos in the western coast of Baja California Sur, Mexico are reported in this study. The embryos of blue shark samples were obtained on board the industrial fishing boat ‘Damasta’; the organisms were frozen and transferred to CIBNOR Fish Ecology Laboratory where the corresponding measurements were taken and malformations observed. The first malformation was the presence of one nostril in two female embryos that showed short and crushed snouts. The second one was observed in a female with two jaws and the middle portion of the column trunk in screw-shape. The third one was an embryo with dicephaly, two separate vertebral columns, two first dorsal fin pairs, absence of the second dorsal fin, five pelvic fins and two joint caudal fins. The fourth malformation observed was an embryo with incomplete development and undifferentiated sex. Malformations are still a mystery and also an object of study because they affect different organisms, not only sharks but also fish. It is highly relevant to know the causes and perform further studies to understand if the origin is either genetic or anthropogenic.
To compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypes
As part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.
The study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.
Clinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.
The Short Obsessive–Compulsive Disorder Screener (SOCS) is recommended by the National Institute for Health and Care Excellence as a suitable and validated screening tool for 11- to 15-year olds. Despite its excellent sensitivity and specificity in detecting obsessive–compulsive disorder (OCD), it has limitations.
To empirically examine whether the SOCS is suitable for assessing OCD symptoms across a wide age range of children and adolescents and to provide new data about its psychometric properties.
Participants were 94 patients (9–19 years) with OCD, and 880 healthy controls.
The results supported the SOCS' unidimensional factor structure and metric invariance across samples. It showed good reliability in terms of internal consistency and temporal stability. Furthermore, it had significantly high correlations with other OCD measures and an acceptable sensitivity and specificity for detecting OCD.
The SOCS is a brief screening tool suitable for detecting OCD in children and adolescents.
Despite the higher proportion of foreclosures and home evictions executed in Spain, compared to other countries, and the known link between social exclusion and mental health problems, studies exploring this association in Spain remain scarce. This study investigated the link between the process of home eviction and the appearance of symptomatology of post-traumatic stress disorder (PTSD), anxiety, depression, and perceived stress. Two hundred and five people affected by the process of home eviction were assessed using a structured interview that included three validated assessment instruments for PTSD, perceived stress, anxiety and depression. Analysis involved comparison with the normative groups that formed the validation studies together with regression analysis to determine the major psychological and socio-demographic predictors of perceived stress. Of the participants, 95.1% reported that they were experiencing the process of home eviction with fear, helplessness, or horror. In PTSD symptomatology, they scored higher than the normative PTSD group in symptoms of avoidance (t = 5.01; p < .05), activation (t = 5.48; p < .01), and total score (t = 4.15; p < .05). Of this subgroup, 72.5% fulfilled the DSM-IV symptom criteria for PTSD. The major predictor of perceived stress was PTSD symptomatology (B = .09; p < .001). The process of home eviction in Spain is having an alarming impact on mental health of affected people calling for effective measures to provide psychological and social support.
The synthesis of egg-white (EW) capped silver nanoparticles (NPs) was carried-out in a one-step reaction using crude EWs, which is a reagent that can be easily found. These NPs were applied for the colorimetric detection of Hg2+ ions in solution. The results showed a blue shift of the surface plasmon absorption due to the decrease in Ag NP size upon incorporating Hg through the formation of an Ag–Hg amalgam shell. The probe was used for the selective determination of Hg2+ ions in tap water with excellent selectivity and sensitivity with a detection limit of about 300 nM.
We present new data on a class of ceramics called Tiltepec yellow wares, dated to the Late and Terminal Formative period occupations at Cerro Jazmín, Oaxaca (300 BC– AD 300). Evidence from 27 radiocarbon-dated ceramic assemblages indicates that Tiltepec yellow wares are a distinct ceramic type. Instrumental Neutron Activation Analysis (INAA) results further confirm the wares’ identification. Defining Tiltepec yellow wares as a type apart from Classic-period orange ceramics allows the reassessment of the regional settlement sequence, previously understood to indicate widespread settlement abandonment in the Terminal Formative period. The new data suggest that Cerro Jazmín had a more continuous urban occupation than previously thought.
A remarkable stela from Montoro, southern Spain, is unique in its morphology, epigraphic traits and landscape context. A programme of chemical characterisation, digital imaging, and geo-lithological and epigraphic analyses were conducted to determine its age and significance, and the results were integrated with data from archaeological investigations of the surrounding area. This multi-faceted approach allowed the stela to be interpreted within the context of early interactions between literate Mediterranean societies of the Late Bronze Age and Iron Age and non-literate Iberian societies. A key outcome of this research is a wider understanding of the complex patterns in the use and perception of early scripts.
To investigate dietary sources of Ca and vitamin D (VitD) intakes, and the associated sociodemographic and lifestyle factors, among European adolescents.
Linear regression mixed models were used to examine sex-specific associations of Ca and VitD intakes with parental education, family affluence (FAS), physical activity and television (TV) watching while controlling for age, Tanner stage, energy intake and diet quality.
The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA)Cross-Sectional Study.
Adolescents aged 12·5–17·5 years (n 1804).
Milk and cheese were the main sources of Ca (23 and 19 % contribution to overall Ca intake, respectively). Fish products were the main VitD source (30 % contribution to overall VitD intake). Ca intake was positively associated with maternal education (β=56·41; 95 % CI 1·98, 110·82) and negatively associated with TV viewing in boys (β=–0·43; 95 % CI −0·79, −0·07); however, the significance of these associations disappeared when adjusting for diet quality. In girls, Ca intake was positively associated with mother’s (β=73·08; 95 % CI 34·41, 111·74) and father’s education (β=43·29; 95 % CI 5·44, 81·14) and FAS (β=37·45; 95 % CI 2·25, 72·65). This association between Ca intake and mother’s education remained significant after further adjustment for diet quality (β=41·66; 95 % CI 0·94, 82·38). Girls with high-educated mothers had higher Ca intake.
Low-educated families with poor diet quality may be targeted when strategizing health promotion programmes to enhance dietary Ca.
Pollen and seed dispersal are key ecological processes, directly impacting the spatial distribution, abundance and genetic structure of plant populations; yet, pollen- and seed-dispersal distances are poorly known. We used molecular markers to identify the parental origin (n = 152 adult trees) of 177 Spondias radlkoferi (Anacardiaceae) seeds deposited by the spider monkey (Ateles geoffroyi) in latrines located beneath 17 sleeping-trees in two continuous forest sites (CF) and two forest fragments (FF) in the Lacandona rain forest, Mexico. We estimated mean parent-offspring (PO) distances per latrine and, for those seeds (54% of seeds) with more than one candidate parent (i.e. the potential maternal and parental parents), we also estimated parent-parent (PP) distances per latrine, and tested if PO and PP distances differed between forest types. Global PO and PP distances per latrine averaged 682 m (range = 83–1741 m) and 610 m (range = 74–2339 m), respectively, and did not differ significantly between CF and FF. This suggests that pollen dispersal is extensive in both forest types and that long seed dispersal distances (>100 m) are common, thus supporting the hypothesis that the spider monkey is an effective seed disperser of S. radlkoferi in continuous and fragmented forests.
Several characteristics of Totoaba macdonaldi Perciformes: Sciaenidae, including migratory movements along temperature gradients make it vulnerable to oxidative stress. Oxidative stress can also be associated with reproduction. The objectives of the present study were to examine oxidative stress indicators in liver of totoaba throughout the seasons (spring, autumn and winter), and the associated fluctuations in superficial sea temperature (SST, °C), as well as to evaluate possible variations between sexes and reproductive maturity stages. A total of 173 liver samples from totoaba captured in the Gulf of California, Mexico, were obtained from April 2010 to February 2013. Superoxide radical production (O2•−), lipid peroxidation (TBARS) levels, and activity of antioxidant enzymes; superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione S-transferase (GST) were quantified spectrophotometrically. Generalized linear models (GLM) were used to determine which factors contribute to explain O2•− production and TBARS levels. The significant predictive variables were the seasons, which were significant in all applied models, as well as SOD and CAT activities. In general, enzyme activity was higher in immature totoaba; this was not seasonally modified. Low temperatures in winter were associated with high O2•− production and TBARS levels, particularly in totoaba that are not yet reproductively mature. Seasonal changes in sea surface temperature did not affect the oxidative stress indicators in mature totoaba (both males and females); this suggests that mature totoaba are less sensitive to temperature changes from an oxidative stress perspective.