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In patients with β-lactam allergies, administration of non–β-lactam surgical prophylaxis is associated with increased risk of infection. Although many patients self-report β-lactam allergies, most are unconfirmed or mislabeled. A quality improvement process, utilizing a structured β-lactam allergy tool, was implemented to improve the utilization of preferred β-lactam surgical prophylaxis.
The northern lobe of the White River Ash (WRAn) is part of a bilobate distribution of tephras that originated from the Wrangell Volcanic Field near the border of Alaska, USA, and Yukon, Canada. It is distributed across northeastern Alaska and the northwestern portion of the Yukon. The timing of this eruption has seen little critical analysis relative to the younger and more extensive eastern lobe eruption of the White River Ash. We compiled 38 radiocarbon (14C) dates from above and below the WRAn, and employed several statistical approaches to identify and eliminate or down-weight outliers, combine dates, and different Bayesian models, to provide a revised age estimate for the timing of the WRAn tephra deposition. Our results indicate that the most accurate modeled age estimate for the northern lobe of the White River Ash deposition is between 1689 and 1560 cal BP, with a mean and median of 1625 and 1623 cal BP, respectively. This age range is 90 to 200 years younger than previous age estimates.
Group-based physical activity (PA) in community-based settings represents a promising avenue for promoting healthy ageing, however, lower levels of adherence have been found to be associated with aspects of social disadvantage. Providers are in a key position to provide important insights about strategies to improve adherence, however, few studies have examined their perspectives. In this study, 30 community service providers were interviewed, and 42 older people participated in focus groups to identify actions perceived as effective for promoting adherence to organised PA, with a focus on factors relevant to older people experiencing socio-economic disadvantage, social isolation, living with a disability or from culturally and linguistically diverse backgrounds. Data were analysed thematically. Adherence barriers included deteriorating health, lack of belonging and loss of motivation. Helpful strategies for addressing deteriorating health included maintaining programme flexibility, facilitating access to health and other services, and supporting participants to adapt to acquired limitations. Belonging can be fostered by creating positive and inclusive experiences, ensuring safe and stigma-free environments, providing opportunities to forge personal connections and demonstrating care. Motivation may be enhanced by ensuring activities are of interest and functional benefit, programme settings are suitable and appealing, and enjoyment is prioritised. In conclusion, a range of strategies is likely to be necessary to mitigate risks to adherence and support continued participation in organised PA among socially disadvantaged older people.
Bog bodies are among the best-known archaeological finds worldwide. Much of the work on these often extremely well-preserved human remains has focused on forensics, whereas the environmental setting of the finds has been largely overlooked. This applies to both the ‘physical’ and ‘cultural’ landscape and constitutes a significant problem since the vast spatial and temporal scales over which the practice appeared demonstrate that contextual assessments are of the utmost importance for our explanatory frameworks. In this article we develop best practice guidelines for the contextual analysis of bog bodies, after assessing the current state of research and presenting the results of three recent case studies including the well-known finds of Lindow Man in the United Kingdom, Bjældskovdal (Tollund Man and Elling Woman) in Denmark, and Yde Girl in the Netherlands. Three spatial and chronological scales are distinguished and linked to specific research questions and methods. This provides a basis for further discussion and a starting point for developing approaches to bog body finds and future discoveries, while facilitating and optimizing the re-analysis of previous studies, making it possible to compare deposition sites across time and space.
We describe the motivation and design details of the ‘Phase II’ upgrade of the Murchison Widefield Array radio telescope. The expansion doubles to 256 the number of antenna tiles deployed in the array. The new antenna tiles enhance the capabilities of the Murchison Widefield Array in several key science areas. Seventy-two of the new tiles are deployed in a regular configuration near the existing array core. These new tiles enhance the surface brightness sensitivity of the array and will improve the ability of the Murchison Widefield Array to estimate the slope of the Epoch of Reionisation power spectrum by a factor of ∼3.5. The remaining 56 tiles are deployed on long baselines, doubling the maximum baseline of the array and improving the array u, v coverage. The improved imaging capabilities will provide an order of magnitude improvement in the noise floor of Murchison Widefield Array continuum images. The upgrade retains all of the features that have underpinned the Murchison Widefield Array’s success (large field of view, snapshot image quality, and pointing agility) and boosts the scientific potential with enhanced imaging capabilities and by enabling new calibration strategies.
Labour standards provisions within the Trade and Sustainable Development (TSD) chapters of EU Free Trade Agreements (FTAs) are presented as a key element of the EU's commitment to a ‘value-based trade agenda’. But criticism of TSD chapters has led the European Commission to commit to improving their implementation and enforcement, creating a critical juncture in the evolution of the EU's trade–labour linkage. This contribution synthesizes findings from academic studies that have examined the effectiveness of labour standards provisions in EU FTAs. It then considers the reform agenda as presented by the European Commission, and explains how some of the proposals could tackle failures identified. However, it also argues that there are various limitations with the Commission's current proposals, and outlines how legal obligations and institutional mechanisms created by trade agreements could better be harnessed to improve working conditions and rights at work around the world.
Now in its thirteenth season, Music We'd Like to Hear is an established presence in London's new music calendar. And true to form, the second concert in this year's triple bill, named (UN)PREDICTABLE, programmed a host of new works, including the UK premieres of Makiko Nishikaze's trio-stella and Alvin Lucier's Twonings, the world premiere of Paul Newland's things that happen again (again), and Tom Johnson's Predictables, all performed by Mira Benjamin (violin), Anton Lukoszevieze (cello), and Philip Thomas (piano).
While numerous maps of Greenland ice flow velocity exist, most have gaps in coverage and/or accuracy is limited. We processed a large volume of synthetic aperture radar and Landsat 8 imagery collected between 1995 and 2015 to produce a nearly complete map of ice flow velocity for Greenland at a far greater accuracy than most prior products. We evaluated the accuracy of this map by comparing it with a variety of measured and estimated velocities. For the slow-moving interior of the ice sheet, where estimates are determined from interferometric phase, the errors are ~2 m a−1 or better. For coastal areas, where estimates are determined entirely from speckle- or feature-tracking methods, errors are 2–3 m a−1, which is in good agreement with the estimated formal errors. Especially for the slow-moving majority of the ice sheet, this map provides an important source of data for numerous types of glaciological studies.
OBJECTIVES/SPECIFIC AIMS: Patients with locally advanced pancreatic cancer typically have poor outcomes, with a median survival of ~16 months. Novel methods to improve local control are needed. Nab-paclitaxel (abraxane) has shown efficacy in pancreatic cancer and is FDA approved for metastatic disease in combination with gemcitabine. Nab-paclitaxel is also a promising radiosensitizer based on laboratory studies, but it has never been clinically tested with definitive radiotherapy for locally advanced disease. METHODS/STUDY POPULATION: We performed a phase 1 study using a 3+3 dose-escalation strategy to determine the safety and tolerability of dose escalated nab-paclitaxel with fractionated radiotherapy for patients with unresectable or borderline resectable pancreatic cancer. Following induction chemotherapy with 2 cycles of nab-paclitaxel and gemcitabine, patients were treated with weekly nab-paclitaxel and daily radiotherapy to a dose of 52.5 Gy in 25 fractions. Final dose-limiting toxicity (DLT) determination was performed at day 65 after the start of radiotherapy. RESULTS/ANTICIPATED RESULTS: Nine patients received nab-paclitaxel at a dose level of either 100 mg/m2 (n=3) or 125 mg/m2 (n=6). One DLT (grade 3 neuropathy) was observed in a patient who received 125 mg/m2 of nab-paclitaxel. Other grade 3 toxicities included fatigue (11%), anemia (11%), and neutropenia (11%). No grade 4 toxicities were observed. With a median follow-up of 8 months (range 5–28 months), median survival was 19 months and median progression-free survival was 10 months. Following chemoradiation, 3 patients underwent surgical resection, all with negative margins and limited tumor viability. Of the 3 patients, 2 initially had borderline resectable tumors and 1 had an unresectable tumor. Tumor (SMAD-4, Caveolin-1) and peripheral (circulating tumor cells and microvesicles) biomarkers were collected and are being analyzed. DISCUSSION/SIGNIFICANCE OF IMPACT: The combination of fractionated radiation and weekly nab-paclitaxel was safe and well tolerated. This regimen represents a potentially promising therapy for patients with unresectable and borderline resectable pancreatic cancer and warrants further investigation.
Discovery of the non-native Anoplophora glabripennis Motschulsky (Coleoptera: Cerambycidae) in Ontario, Canada, in 2003 led to the implementation of an eradication programme. The plan consisted of removing all infested trees and all trees belonging to a genus considered suitable for complete development of this wood-borer that were found within 400 m of an infested tree; however, many of the trees within that 400 m belonged to genera for which suitability for development of A. glabripennis was questionable or unknown. We visually inspected over 3000 such trees annually for the three years following removal of infested trees. All but one tree were unattacked: an ash (Fraxinus excelsior Linnaeus (Oleaceae)) tree had signs of oviposition and early-instar development, but not of adult emergence. Before that survey, we had found only one other species with questionable suitability, a little leaf linden (Tilia cordata Miller (Malvaceae)) that had many signs of oviposition, but no evidence of full development, suggesting resistance to A. glabripennis. Both of these trees were within 200 m of the most heavily infested maple (Acer platanoides Linnaeus (Sapindaceae)) tree found in that infestation, suggesting that colonisation of trees with questionable or unknown suitability might occur mostly where population pressure is high.
Glaciers in Greenland are changing rapidly. To better understand these changes, we have produced a series of seven synthetic aperture radar (SAR) backscatter mosaics for seven winters during the period from 2000 to 2013. Six of the mosaics were created using RADARSAT Fine-Beam data and the seventh used ALOS-PALSAR Fine-Beam Single-Polarization data. The RADARSAT mosaics are radiometrically calibrated and capture changes in the backscatter coefficient related to melt and other events, particularly the strong melting in the summer of 2012. Comparison of features in the ascending-orbit ALOS mosaic and the descending-orbit RADARSAT mosaics indicate that in areas of smooth to moderate topography their locations are consistent to within a few tens of meters. The locations of features identifiable in the RADARSAT mosaics, which were collected with the same imaging parameters, generally agree to within better than the 20 m posting of the data. With such geometric accuracy, these data establish a record of change in Greenland for the early part of the 21st century, thus providing a baseline that can be compared with new radar and optical datasets.
The long-distance transport of the bluestones from south Wales to Stonehenge is one of the most remarkable achievements of Neolithic societies in north-west Europe. Where precisely these stones were quarried, when they were extracted and how they were transported has long been a subject of speculation, experiment and controversy. The discovery of a megalithic bluestone quarry at Craig Rhos-y-felin in 2011 marked a turning point in this research. Subsequent excavations have provided details of the quarrying process along with direct dating evidence for the extraction of bluestone monoliths at this location, demonstrating both Neolithic and Early Bronze Age activity.
To determine if total lifetime physical activity (PA) is associated with better cognitive functioning with aging and if cerebrovascular function mediates this association. A sample of 226 (52.2% female) community dwelling middle-aged and older adults (66.5±6.4 years) in the Brain in Motion Study, completed the Lifetime Total Physical Activity Questionnaire and underwent neuropsychological and cerebrovascular blood flow testing. Multiple robust linear regressions were used to model the associations between lifetime PA and global cognition after adjusting for age, sex, North American Adult Reading Test results (i.e., an estimate of premorbid intellectual ability), maximal aerobic capacity, body mass index and interactions between age, sex, and lifetime PA. Mediation analysis assessed the effect of cerebrovascular measures on the association between lifetime PA and global cognition. Post hoc analyses assessed past year PA and current fitness levels relation to global cognition and cerebrovascular measures. Better global cognitive performance was associated with higher lifetime PA (p=.045), recreational PA (p=.021), and vigorous intensity PA (p=.004), PA between the ages of 0 and 20 years (p=.036), and between the ages of 21 and 35 years (p<.0001). Cerebrovascular measures did not mediate the association between PA and global cognition scores (p>.5), but partially mediated the relation between current fitness and global cognition. This study revealed significant associations between higher levels of PA (i.e., total lifetime, recreational, vigorous PA, and past year) and better cognitive function in later life. Current fitness levels relation to cognitive function may be partially mediated through current cerebrovascular function. (JINS, 2015, 21, 816–830)
Obesity is a growing problem in India, the dietary determinants of which have been studied using an ‘individual food/nutrient’ approach. Examining dietary patterns may provide more coherent findings, but few studies in developing countries have adopted this approach. The present study aimed to identify dietary patterns in an Indian population and assess their relationship with anthropometric risk factors.
FFQ data from the cross-sectional sib-pair Indian Migration Study (IMS; n 7067) were used to identify dietary patterns using principal component analysis. Mixed-effects logistic regression was used to examine associations with obesity and central obesity.
The IMS was conducted at four factory locations across India: Lucknow, Nagpur, Hyderabad and Bangalore.
The participants were rural-to-urban migrant and urban non-migrant factory workers, their rural and urban resident siblings, and their co-resident spouses.
Three dietary patterns were identified: ‘cereals–savoury foods’ (cooked grains, rice/rice-based dishes, snacks, condiments, soups, nuts), ‘fruit–veg–sweets–snacks’ (Western cereals, vegetables, fruit, fruit juices, cooked milk products, snacks, sugars, sweets) and ‘animal-food’ (red meat, poultry, fish/seafood, eggs). In adjusted analysis, positive graded associations were found between the ‘animal-food’ pattern and both anthropometric risk factors. Moderate intake of the ‘cereals–savoury foods’ pattern was associated with reduced odds of obesity and central obesity.
Distinct dietary patterns were identified in a large Indian sample, which were different from those identified in previous literature. A clear ‘plant food-based/animal food-based pattern’ dichotomy emerged, with the latter being associated with higher odds of anthropometric risk factors. Longitudinal studies are needed to further clarify this relationship in India.
Dual-energy X-ray absorptiometry (DXA) and isotope dilution technique have been used as reference methods to validate the estimates of body composition by simple field techniques; however, very few studies have compared these two methods. We compared the estimates of body composition by DXA and isotope dilution (18O) technique in apparently healthy Indian men and women (aged 19–70 years, n 152, 48 % men) with a wide range of BMI (14–40 kg/m2). Isotopic enrichment was assessed by isotope ratio mass spectroscopy. The agreement between the estimates of body composition measured by the two techniques was assessed by the Bland–Altman method. The mean age and BMI were 37 (sd 15) years and 23·3 (sd 5·1) kg/m2, respectively, for men and 37 (sd 14) years and 24·1 (sd 5·8) kg/m2, respectively, for women. The estimates of fat-free mass were higher by about 7 (95 % CI 6, 9) %, those of fat mass were lower by about 21 (95 % CI − 18, − 23) %, and those of body fat percentage (BF%) were lower by about 7·4 (95 % CI − 8·2, − 6·6) % as obtained by DXA compared with the isotope dilution technique. The Bland–Altman analysis showed wide limits of agreement that indicated poor agreement between the methods. The bias in the estimates of BF% was higher at the lower values of BF%. Thus, the two commonly used reference methods showed substantial differences in the estimates of body composition with wide limits of agreement. As the estimates of body composition are method-dependent, the two methods cannot be used interchangeably.
Griffith University is set across five campuses in south-east Queensland, Australia, and has a student population of 43,000. The School of Languages and Linguistics (LAL) offers programs in linguistics, international English, Chinese, Italian, Japanese and Spanish, as well as English language enhancement courses. Research strands reflect the staff's varied scholarly interests, which include academic language and learning, sociolinguistics, second language learning/acquisition and teaching, computer assisted language learning (CALL) and language corpora. This report offers a summary of research recently published or currently underway within LAL.