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.
Shiga toxin-producing Escherichia coli (STEC) infections are a significant public health issue, with foodborne transmission causing >1 million illnesses worldwide each year. We conducted a systematic review and meta-analysis (PROSPERO registry # CRD42017074239), to determine the relative association of different food types with sporadic illnesses caused by STEC. Searches were conducted from 01 August to 30 September 2017, using bibliographic and grey literature databases, websites and expert consultation. We identified 22 case-control studies of sporadic STEC infection in humans, from 10 countries within four World Health Organization subregions, from 1985 to 2012. We extracted data from 21 studies, for 237 individual measures in 11 food categories and across three status types (raw or undercooked, not raw and unknown). Beef was the most significant food item associated with STEC illness in the Americas and Europe, but in the Western Pacific region, chicken was most significant. These findings were not significantly moderated by the raw or cooked status of the food item, nor the publication year of the study. Data from the African, South-East Asian and Eastern Mediterranean subregions were lacking and it is unclear whether our results are relevant to these regions.
During the 1st week of life the energy contained in the body of the average piglet increases by a factor between four and five. To achieve this increase the piglet must ingest metabolizable energy (ME) at a rate which is about four times its maintenance requirement. Well over half the ME supplied in the milk of the sow is in the form of emulsified fat. Whilst the piglet is being suckled, its intake is controlled by litter size, availability of teats and productiveness of the mammary gland. At 3 weeks of age the normal piglet requires about 7.8 MJ digestible energy to sustain a live growth rate of 280 g/day. At this stage the growth comprises about 40 g protein and about 68 g fat. This means that the required intake for a newly weaned piglet on a typical starter diet should be about 475 g/day. In practice such intakes are rarely achieved for several days, therefore weaning causes severe disruption of intake and of the growth curve and there are other factors involved including social disturbance and stress. Further problems are caused by the provision of diets which are unsuited to the physiology of the piglet's immature digestive tract. The sudden loss of the IgA component and indeed other protective factors contained in the dam's milk can be extremely serious, and the reduction in food intake is effectively a defence strategy by the piglet to cope with its new circumstances and try to maintain physiological homoeostasis. In some circumstances the use of antibacterial agents, organic acids or probiotics may be beneficial, but the approach is less reliable than careful formulation of the diet to avoid provocative ingredients such as soya-bean and rapeseed meal.
There is a need to identify pig finishing systems that meet the requirements of both pig producers and society. These require that a system is economically efficient, but also takes due account of animal welfare, food safety and environmental considerations. As part of an integrated investigation, this study assessed the environmental implications (gaseous emissions and waste output and composition) of giving pigs either dry or liquid feed, when housed in either fully-slatted or straw-based accommodation.
There is a need to identify finishing systems for pigs that meet the requirements of both pig producers and society. These require that a system is economically efficient, but also takes due account of animal welfare, food safety and environmental considerations. As part of an integrated investigation, this study assessed the effects of giving pigs either dry or liquid feed when housed in either fully-slatted or straw-based accommodation on the microbial status of the pig and its finishing environment, with particular reference to gut health and food safety.
Selection for efficiency of lean growth has lead to a marked reduction in fat gain and voluntary food intake (VFI) of modern genotypes. There is concern that future improvements in lean growth rate may be limited by appetite. Moreover, the ability of lean genotypes to adjust their VFI in response to variations in nutrient density is not well known. Such genotypes may fail to compensate their intake in response to marginal reductions in nutrient density, which could affect growth performance. The aim was to evaluate the VFI and growth performance of ‘White’ and Meishan cross growing pigs in response to incremental reductions in dietary energy content.
There is a need to identify finishing systems for pigs that meet the requirements of both pig producers and society. These require that a system is economically efficient, but also takes due account of animal welfare, food safety and environmental considerations. As part of an integrated investigation, this study assessed the health and welfare implications of giving pigs either dry or liquid feed when housed in either fully-slatted or straw-based accommodation.
Fetal growth restriction (FGR) and preterm birth are frequent co-morbidities, both are independent risks for brain injury. However, few studies have examined the mechanisms by which preterm FGR increases the risk of adverse neurological outcomes. We aimed to determine the effects of prematurity and mechanical ventilation (VENT) on the brain of FGR and appropriately grown (AG, control) lambs. We hypothesized that FGR preterm lambs are more vulnerable to ventilation-induced acute brain injury. FGR was surgically induced in fetal sheep (0.7 gestation) by ligation of a single umbilical artery. After 4 weeks, preterm lambs were euthanized at delivery or delivered and ventilated for 2 h before euthanasia. Brains and cerebrospinal fluid (CSF) were collected for analysis of molecular and structural indices of early brain injury. FGRVENT lambs had increased oxidative cell damage and brain injury marker S100B levels compared with all other groups. Mechanical ventilation increased inflammatory marker IL-8 within the brain of FGRVENT and AGVENT lambs. Abnormalities in the neurovascular unit and increased blood–brain barrier permeability were observed in FGRVENT lambs, as well as an altered density of vascular tight junctions markers. FGR and AG preterm lambs have different responses to acute injurious mechanical ventilation, changes which appear to have been developmentally programmed in utero.
Our understanding of the complex relationship between schizophrenia symptomatology and etiological factors can be improved by studying brain-based correlates of schizophrenia. Research showed that impairments in value processing and executive functioning, which have been associated with prefrontal brain areas [particularly the medial orbitofrontal cortex (MOFC)], are linked to negative symptoms. Here we tested the hypothesis that MOFC thickness is associated with negative symptom severity.
This study included 1985 individuals with schizophrenia from 17 research groups around the world contributing to the ENIGMA Schizophrenia Working Group. Cortical thickness values were obtained from T1-weighted structural brain scans using FreeSurfer. A meta-analysis across sites was conducted over effect sizes from a model predicting cortical thickness by negative symptom score (harmonized Scale for the Assessment of Negative Symptoms or Positive and Negative Syndrome Scale scores).
Meta-analytical results showed that left, but not right, MOFC thickness was significantly associated with negative symptom severity (βstd = −0.075; p = 0.019) after accounting for age, gender, and site. This effect remained significant (p = 0.036) in a model including overall illness severity. Covarying for duration of illness, age of onset, antipsychotic medication or handedness weakened the association of negative symptoms with left MOFC thickness. As part of a secondary analysis including 10 other prefrontal regions further associations in the left lateral orbitofrontal gyrus and pars opercularis emerged.
Using an unusually large cohort and a meta-analytical approach, our findings point towards a link between prefrontal thinning and negative symptom severity in schizophrenia. This finding provides further insight into the relationship between structural brain abnormalities and negative symptoms in schizophrenia.
Identifying youth who may engage in future substance use could facilitate early identification of substance use disorder vulnerability. We aimed to identify biomarkers that predicted future substance use in psychiatrically un-well youth.
LASSO regression for variable selection was used to predict substance use 24.3 months after neuroimaging assessment in 73 behaviorally and emotionally dysregulated youth aged 13.9 (s.d. = 2.0) years, 30 female, from three clinical sites in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Predictor variables included neural activity during a reward task, cortical thickness, and clinical and demographic variables.
Future substance use was associated with higher left middle prefrontal cortex activity, lower left ventral anterior insula activity, thicker caudal anterior cingulate cortex, higher depression and lower mania scores, not using antipsychotic medication, more parental stress, older age. This combination of variables explained 60.4% of the variance in future substance use, and accurately classified 83.6%.
These variables explained a large proportion of the variance, were useful classifiers of future substance use, and showed the value of combining multiple domains to provide a comprehensive understanding of substance use development. This may be a step toward identifying neural measures that can identify future substance use disorder risk, and act as targets for therapeutic interventions.
To compare the microbiological efficacy, turnaround time, cost, convenience, and patient and user tolerance of Tristel Trio Wipes, PeraSafe solution and Cidex OPA solution for the high-level disinfection of flexible nasendoscopes.
Flexible nasendoscopes were used in routine clinical encounters. They were then disinfected with one of the three disinfectant methods. Surveillance cultures were taken before and after each disinfection process. Data relating to each of the study parameters were recorded.
Positive bacterial cultures were discovered on nasendoscopes disinfected with PeraSafe and Cidex OPA. Tristel Trio Wipes have no capital outlay cost, the lowest running cost, the greatest convenience and the fastest turnaround time. PeraSafe had a faster turnaround time than Cidex OPA, and lower running costs.
Tristel Trio Wipes are equal to PeraSafe and Cidex OPA in terms of microbiological efficacy. Turnaround time and cost are dramatically reduced when using Tristel Trio Wipes compared to the other disinfectant methods.
Coral skeletal radiocarbon records reflect seawater ∆14C and are useful for reconstructing the history of water mass movement and ventilation in the tropical oceans. Here, we reconstructed the inter-annual variability in central equatorial Pacific surface water ∆14C from 1922–1956 using near-monthly 14C measurements in a Porites sp. coral skeleton (FI5A) from the windward side of Fanning Island (3°54′32′′N, 159°18'88′′W). The most pronounced feature in this record is a large, positive shift in the ∆14C between 1947 and 1956 that coincides with the switch of the Pacific Decadal Oscillation (PDO) from a positive to a negative phase in the mid-1940s. Although the absolute ∆14C values from 1950–1955 in FI5A differ from the ∆14C values of another coral core collected from the opposite side of the island, both records show a large, positive shift in their ∆14C records at that time. The relative increase in the ∆14C of each record is consistent with the premise that a common mechanism is controlling the ∆14C records within each coral record. Overall, the Fanning ∆14C data support the notion that a significant amount of subtropical seawater is arriving at the Equator, but does not allow us to determine the mechanism for its transport.
To examine the delivery and assessment of psychiatry at undergraduate level in the six medical schools in the Republic of Ireland offering a medical degree programme.
A narrative description of the delivery and assessment of psychiatry at undergraduate level by collaborative senior faculty members from all six universities in Ireland.
Psychiatry is integrated to varying degrees across all medical schools. Clinical experience in general adult psychiatry and sub-specialities is provided by each medical school; however, the duration of clinical attachment varies, and the provision of some sub-specialities (i.e. forensic psychiatry) is dependent on locally available resources. Five medical schools provide ‘live’ large group teaching sessions (lectures), and all medical schools provide an array of small group teaching sessions. Continuous assessment encompasses 10–35% of the total assessment marks, depending on the medical school. Only one medical school does not provide a clinical examination in the form of an Objective Structured Clinical Examination with viva examinations occurring at three medical schools.
Many similarities exist in relation to the delivery of psychiatry at undergraduate level in Ireland. Significant variability exists in relation to assessment with differences in continuous assessment, written and clinical exams and the use of vivas noted. The use of e-learning platforms has increased significantly in recent years, with their role envisaged to include cross-disciplinary teaching sessions and analysis of examinations and individual components within examinations which will help refine future examinations and enable greater sharing of resources between medical schools.
Cardiopulmonary resuscitation (CPR) is an inherently traumatic procedure. Successful resuscitations are often complicated by iatrogenic injuries to structures of the neck, thorax, or abdomen. Rib and sternal fractures are the most frequently induced injuries. However, rare and life-threatening trauma to vital organs such as the heart may also occur during CPR. We describe a novel case of CPR-associated right ventricular rupture in a woman with acute-on-chronic pulmonary embolism and no known pre-existing cardiac disease. We propose that chest compressions in the setting of elevated right ventricular pressure resulted in cardiac rupture, in this case.
The Rosetta Radio Science Investigations (RSI) experiment was selected by the European Space Agency to be included in the International Rosetta Mission to comet P/Wirtanen (launch in 2003, arrival and operational phase at the comet 2011–2013). The RSI science objectives address fundamental aspects of cometary physics such as the mass and bulk density of the nucleus, the gravity field, non-gravitational forces, the size and shape, the internal structure, the composition and roughness of the nucleus surface, the abundance of large dust grains and the plasma content in the coma and the combined dust and gas mass flux on the orbiter. RSI will make use of the radio subsystem of the Rosetta spacecraft.