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To disrupt cycles of health inequity, traceable to dietary inequities in the earliest stages of life, public health interventions should target improving nutritional wellbeing in preconception/pregnancy environments. This requires a deep engagement with pregnant/postpartum people (PPP) and their communities (including their health and social care providers, HSCP). We sought to understand the factors that influence diet during pregnancy from the perspectives of PPP and HSCP, and to outline intervention priorities.
Design:
We carried out thematic network analyses of transcripts from ten focus group discussions (FGD) and one stakeholder engagement meeting with PPP and HSCP in a Canadian city. Identified themes were developed into conceptual maps, highlighting local priorities for pregnancy nutrition and intervention development.
Setting:
FGD and the stakeholder meeting were run in predominantly lower socioeconomic position (SEP) neighbourhoods in the sociodemographically diverse city of Hamilton, Canada.
Participants:
All local, comprising twenty-two lower SEP PPP and forty-three HSCP.
Results:
Salient themes were resilience, resources, relationships and the embodied experience of pregnancy. Both PPP and HSCP underscored that socioeconomic-political forces operating at multiple levels largely determined the availability of individual and relational resources constraining diet during pregnancy. Intervention proposals focused on cultivating individual and community resilience to improve early-life nutritional environments. Participants called for better-integrated services, greater income supports and strengthened support programmes.
Conclusions:
Hamilton stakeholders foregrounded social determinants of inequity as main factors influencing pregnancy diet. They further indicated a need to develop interventions that build resilience and redistribute resources at multiple levels, from the household to the state.
Patients with ABI present with a relatively higher risk of developing psychotic illness. A co-morbid psychotic illness may pose multiple challenges in rehabilitation of these patients. The medical literature provides limited information on the nature, presentation, diagnosis, course, and prognosis of psychotic disorders after ABI.
Methods:
Clinically generated data was used to study the prevalence and nature of co-morbid psychotic illness and cause of ABI amongst inpatients requiring multidisciplinary neurobehavioral rehabilitation. The data were collected in an anonymized fashion and analyzed using SPSS version 16.
Results:
We examined data from 64 patients (51 Male, 13 Female). The age range was 21-61 years (Mean 39, S.D. 10.6). 40% patients had a history of mental illness or self harm prior to ABI. 16% had sustained their ABI as a result of suicide attempts. 12% had history of schizophrenia or bipolar mood disorder prior to ABI.
A third (33%) had a Post-ABI diagnosis of a psychotic illness. The most common diagnosis was organic psychosis (21%) followed by schizophrenia (9%) and bipolar mood disorder (3%). The factors that influenced diagnostic differentiation in organic or non-organic psychotic illness included consideration of past psychiatric history, family history, psychopathology, and course of the disorder. The overall patient group showed a significant difference in post admission and latest HONOS-Secure (P< 0.01) and HONOS ABI (P< 0.01) ratings, showing improvement in outcomes during rehabilitation programme. This difference persisted when sub-groups of psychotic and non-psychotic patients were analysed separately.
Patients with acquired brain injury and other neuropsychiatric conditions may present with a significant risk of violence.
Objectives
To conduct a qualitative evaluation of violence to inform risk assessment, patient management, service planning, and workforce training in neuropsychiatry
Aims
To provide thematic or qualitative categories based exploration of violence to enhance understanding of risk factors and risk presentations while clarifying the nature and types of violence in this patient population.
Methods
A service evaluation exercise was conducted using routinely collected clinical information for patient group admitted at a neuropsychiatric service. Data files were converted in word format and transferred on qualitative analysis software NVIV0-8. This software was used for further qualitative analysis through creating free nodes in order to generate qualitative themes or categories of violence in this patient population.
Results
65 Male and 23 Female patients were admitted at the time of this review (working age adults). The qualitative data analysis using NVIVO-8 generated qualitative categories of violence in this patient population
1. Violent Offending: Wounding, murder, criminal damage, sexual offending, arson
2. Institutional violence: Directed towards patients and staff included, scratching, biting, slapping, punching, kicking, grabbing, groping.
3. Sexual Violence: Stalking, rubbing, groping, exposing, masturbating, person directed sexual threats.
4. Types of Violence: Impulsive violence, instrumental violence, grudges based violence, opportunistic violence, predatory violence, erotic violence
Conclusions
Qualitative categorisation of violence amongst a neuropsychiatric population is feasible and provides supportive evidence for further clinical practice and guideline development in violence risk assessment for this patient population.
Patients with Acquired Brain Injury (ABI) present with a range of physical health problems. Co-morbid physical conditions can complicate these patients’ rehabilitation and also may lead to secondary disabilities. The medical literature provides limited information on the prevalence of physical health issues in patients with ABI.
Methods:
We surveyed health records of 64 patients receiving multi-disciplinary rehabilitation at a tertiary Brain Injury Rehabilitation service. The data was collected in an anonymized fashion and analyzed using SPSS version 16.
Results:
We analysed data from 64 patients (51 Male, 13 Female). The age range was 21-61 years (Mean 39, S.D. 10.6). Epilepsy was the commonest co-existing physical health condition (47%) amongst these patients. Chronic constipation (20%), peptic ulcer disease (14%), Insulin dependent diabetes mellitus (11%), Asthma/COPD (9%), recurrent urinary tract infection (8%) and hypothyroidism (8%) were the co-existing conditions for which the patients needed treatment. Also dysphasia (38%), dysartheria (34%), dysphagia (28%) and mobility difficulties (37%) were common in this patient group.
Conclusions:
These findings have implications for continuing medical education needs for psychiatrists and other health care professionals working in this field. The findings also highlight the need for improved communication and working relationship between psychiatric and general hospital based specialities in order to implement holistic delivery of care for patients with ABI.
Brain Metastases (BM) represent a leading cause of cancer mortality. While metastatic lesions contain subclones derived from their primary lesion, their functional characterization has been limited by a paucity of preclinical models accurately recapitulating the stages of metastasis. This work describes the isolation of a unique subset of metastatic stem-like cells from primary human patient samples of BM, termed brain metastasis initiating cells (BMICs). Utilizing these BMICs we have established a novel patient-derived xenograft (PDX) model of BM that recapitulates the entire metastatic cascade, from primary tumor initiation to micro-metastasis and macro-metastasis formation in the brain. We then comprehensively interrogated human BM to identify genetic regulators of BMICs using in vitro and in vivo RNA interference screens, and validated hits using both our novel PDX model as well as primary clinical BM specimens. We identified SPOCK1 and TWIST2 as novel BMIC regulators, where in our model SPOCK1 regulated BMIC self-renewal and tumor initiation, and TWIST2 specifically regulated cell migration from lung to brain. A prospective cohort of primary lung cancer specimens was used to establish that SPOCK1 and TWIST2 were only expressed in patients who ultimately developed BM, thus establishing both clinical and functional utility for these gene products. This work offers the first comprehensive preclinical model of human brain metastasis for further characterization of therapeutic targets, identification of predictive biomarkers, and subsequent prophylactic treatment of patients most likely to develop BM. By blocking this process, metastatic lung cancer would effectively become a localized, more manageable disease.
We evaluated use of the periodically rotated overlapping parallel lines with enhanced reconstruction diffusion-weighted imaging sequence, compared with conventional echo planar magnetic resonance imaging, in the detection of middle-ear cholesteatoma.
Material and methods:
Sixteen patients awaiting second-stage combined approach tympanoplasty and three patients awaiting first-stage combined approach tympanoplasty underwent magnetic resonance imaging with both (1) the periodically rotated overlapping parallel lines with enhanced reconstruction sequence (i.e. non echo planar imaging) and (2) the array spatial sensitivity encoding technique sequence (i.e. echo planar imaging). Two neuroradiologists independently evaluated the images produced by both sequences. Radiology findings were correlated with surgical findings.
Results and analysis:
Seven cholesteatomas were found at surgery. Neither of the assessed imaging sequences were able to detect cholesteatoma of less than 4 mm. Rates for sensitivity, specificity, and positive and negative predictive values are presented.
Conclusion:
Decisions on whether or not to operate for cholesteatoma cannot be made based on the two imaging sequences assessed, as evaluated in this study. Other contributing factors are discussed, such as the radiological learning curve and technical limitations of the magnetic resonance imaging equipment.
The Canadian MOST satellite is a unique platform for observations of bright transiting exoplanetary systems. Providing nearly continuous photometric observations for up to 4 weeks, MOST can produce important observational data to help us learn about the properties of exosolar planets. We review our current observations of HD 209458 and HD 189733 with implications for the albedo and our progress towards detecting reflected light from an exoplanet.
We have measured transit times for HD 189733 passing in front of its bright (V = 7.67) chromospherically active and spotted parent star. Nearly continuous broadband photometry of this system was obtained with the MOST (Microvariability & Oscillations of STars) space telesope during 21 days in August 2006, monitoring 10 consecutive transits. We have used these data to search for deviations from a constant orbital period which can indicate the presence of additional planets in the system that are as yet undetected by Doppler searches. We find no variations above the level of ±45 s, ruling out planets in the Earth-to-Neptune mass range in a number of resonant orbits. We find that a number of complications can arise in measuring transit times for a planet transiting an active star with large star spots. However, such transiting systems are also useful in that they can help to constrain and test spot models. This has implications for the large number of transiting systems expected to be discovered by the CoRoT and Kepler missions.
Very massive stars (${\gtrsim} 20$ M$_{\odot}$) are rare but important components of galaxies. Products of core nucleosynthesis from these stars are distributed into the circumstellar environment via wind-driven mass loss. Explosive nucleosynthesis after core collapse further enriches the galactic medium. Clusters of such stars can produce galactic chimneys which can pierce the galactic disk and chemically enrich intergalactic space. Such processes are vitally important to the chemical evolution of the early Universe, when the stellar mass function was much more weighted to massive stars.
Very massive stars are difficult to study, since they are formed in distant clusters which yield problems of sensitivity and source crowding. A relatively new tool for studying these systems is via high spatial, spectral and temporal resolution observations in the X-ray band. In this note we describe some recent progress in studying mechanisms by which very massive stars produce X-ray emission.
A novel, low-cost, phased-array antenna that uniquely incorporates bulk phase shifting using voltage-tunable dielectric (VTD) material is presented. The array does not contain an individual phase shifter at each radiating element. This paper presents the antenna concept and describes how it can be used as a low-cost phased array. The VTDs that are used in this antenna are described. The measured antenna patterns of a prototype phased array demonstrating electronic beam scanning at 10 GHz are also presented.
This review describes the features of glomus jugulare tumours with metastases. There were 100 sites of metastasis in the 53 cases previously reported. The sites of metastasis may be summarized as bone (33), lungs (23), lymph nodes (19), liver (nine) and other (16). Metastases presented up to 30 years after the initial treatment. The mean age of patients was 45 years and the sex ratio was approximately two females to one male, with no significant difference compared to non-metastatic tumours. There was a significantly higher incidence of pain and a significantly lower incidence of hearing loss at presentation compared to non-metastatic tumours. The commonest treatment was a combination of surgery and radiotherapy. The duration of symptoms before diagnosis was significantly shorter and the rates of persistent or recurrent local disease and death were significantly higher than for non-metastatic tumours. This review highlights the fact that glomus jugulare tumours are not always benign.
Glomus jugulare tumours are classically described as benign tumours with a long time course often measured in decades. Although these tumours may be locally invasive, most cases are histologically benign and metastases are rare. The case of a malignant glomus jugulare tumour with a particularly aggressive pattern of spread is presented. At the time of surgery, which was within 12 months of the development of symptoms, intracranial spread and metastasis to cervical lymph nodes had already occurred, demonstrating that glomus jugulare tumours are not always benign.
We introduce a new polarimeter unit which, mounted at the Cassegrain focus of any telescope and fiber-connected to a fixed CCD spectrograph, is able to measure all Stokes parameters I, Q, U and V photon-noise limited across spectral lines of bright stellar targets and other point sources in a quasi-simultaneous manner. We briefly outline the technical design of the polarimeter unit and the linear algebraic Mueller calculus for obtaining polarization parameters of any point source. In addition, practical limitations of the optical elements are discussed. We present first results obtained with our spectropolarimeter for three prototype hot-star.
A case of chrondrosarcoma of the petrous temporal bone is presented. Chondrosarcomas rarely occur intracranially and typically present as a petrous apex mass. The dilemmas faced in the diagnosis and treatment of petrous apex chondrosarcomas are discussed. This case also gives interesting insight into the natural history of this tumour.
We studied the nucleation of Cu deposited by an electroless bath. A Pd seed layer was sputtered onto a (100) Si substrate and analyzed with GIX, STM, and AFM. The seed layer was then placed in varying ED-Cu bath conditions and also analyzed using GIX, STM, and AFM. GIX analysis results show a (111) texture for the Pd seed layer as well as the ED-Cu layer. The seed layer's influence on the deposited Cu grain's texture was found to be inconclusive.
A fully encapsulated copper interconnect with CoWP barrier and protection layer can be produced by conformai electroless CoWP barrier layer deposition at the bottom and on the sidewalls of trenches and selective electroless CoWP deposition on in-laid Cu lines. The electroless CoWP deposition is an autocatalytic reaction with activation energy of about 0.985 eV. Deposition rate of about 10 nm/min at 80°C and average surface roughness of 5 nm for 200 nm thick films were measured. CoWP layer with resistivity of 25 μOhms·cm was obtained. Resistivity of electroless CoWP films was decreased from 25 μOhms·cm to 20 μOhms·cm after annealing in vacuum with 10−7 torr at 400°C for 30 min. The RBS spectra of the Cu/CoWP/Co/Si structure formed by electroless CoWP barrier and Cu deposition and annealed at 400°C for 60 min in vacuum 10−7torr showed no interdiffusion in deposited films.
The structure and phase behavior of halides have been investigated on single crystals of Ag and Au using synchrotron x-ray scattering techniques. The adlayer coverages are potential dependent. For all halides studied we found that with increasing potential, at a critical potential, a disordered adlayer transforms into an ordered structure. Often these ordered phases are incommensurate and exhibit potential-dependent lateral separations (electrocom-pression). We have analyzed the electrocompression in terms of a model which includes lateral interactions and partial charge. A continuous compression is not observed for Br on Ag(100). Rather, we find that the adsorption is site-specific (lattice gas) in both the ordered and disordered phases. The coverage increases with increasing potential and at a critical potential the disordered phase transforms to a well-ordered commensurate structure.
Amorphous Fe80B20 alloy films with a large quantity of plastics (polymethyl methacrylate: PMMA) are prepared using a combined technique of electrochemical plating and spin coating. The embedding of amorphous alloys into PMMA plastics is expected to reduce the effective conductivities of alloy films, and hence to improve their magnetomechanical coupling coefficients at high frequency by reducing effective eddy-current losses. Preparation conditions for obtaining Fe100−XBX (X=20±5at%) films with amorphous structure are determined, and the composite films are formed in accordance with the plating conditions. The resultant composite films are studied by examining their surface states and magnetic properties.
Metallic nanowires are synthesized by electrochemical growth in nanopores of either track-etched polycarbonate membranes or anodized aluminum films. The potentiostatic growth is systematically investigated for track-etched membranes with nominal pore diameters dN between 10 and 80 nm. For this model system, the cross-section of the metallic wires is found to vary: the wire diameter, which is argued to directly reflect the pore diameter, is observed to be substantially larger in the middle than at both ends. Therefore, the pores are not cylindrical with constant cross-section, but appear to be ‘cigar-like’. Inside the membranes, the pores are wider by up to a factor 3.
The aluminum oxide template has successfully been used to prepare a colloidal suspension of gold needles (anisotropie metallic colloid) by growing Au wires in the pores, dissolving the aluminum oxide and finally stabilizing and dispersing the ‘nano-rods’ in water. Visible near-infrared absorption spectroscopy reveal two absorption maxima caused by the anisotropy of these scatterers. The maxima can be assigned to a longitudional and transversal plasma resonance.