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 firstname.lastname@example.org
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.
Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age.
Within the ENIGMA-MDD network, severity and subtypes of CM using the Childhood Trauma Questionnaire were assessed and structural magnetic resonance imaging data from patients with MDD and healthy controls were analyzed in a mega-analysis comprising a total of 3872 participants aged between 13 and 89 years. Cortical thickness and surface area were extracted at each site using FreeSurfer.
CM severity was associated with reduced cortical thickness in the banks of the superior temporal sulcus and supramarginal gyrus as well as with reduced surface area of the middle temporal lobe. Participants reporting both childhood neglect and abuse had a lower cortical thickness in the inferior parietal lobe, middle temporal lobe, and precuneus compared to participants not exposed to CM. In males only, regardless of diagnosis, CM severity was associated with higher cortical thickness of the rostral anterior cingulate cortex. Finally, a significant interaction between CM and age in predicting thickness was seen across several prefrontal, temporal, and temporo-parietal regions.
Severity and type of CM may impact cortical thickness and surface area. Importantly, CM may influence age-dependent brain maturation, particularly in regions related to the default mode network, perception, and theory of mind.
Introduction: Patients with Heart failure (HF) experience frequent decompensation necessitating multiple emergency department (ED) visits and hospitalizations. If patients are able to receive timely interventions and optimize self-management, recurrent ED visits may be reduced. In this feasibility study, we piloted the application of home telemonitoring to support the discharge of HF patients from hospital to home. We hypothesized that TEC4Home would decrease ED revisits and hospital admissions and improve patient health outcomes. Methods: Upon discharge from the ED or hospital, patients with HF received a blood pressure cuff, weight scale, pulse oximeter, and a touchscreen tablet. Participants submitted measurements and answered questions on the tablet about their HF symptoms daily for 60 days. Data were reviewed by a monitoring nurse. From November 2016 to July 2017, 69 participants were recruited from Vancouver General Hospital (VGH), St. Pauls Hospital (SPH) and Kelowna General Hospital (KGH). Participants completed pre-surveys at enrollement and post-surveys 30 days after monitoring finished. Administrative data related to ED visits and hospital admissions were reviewed. Interviews were conducted with the monitoring nurses to assess the impact of monitoring on patient health outcomes. Results: A preliminary analysis was conducted on a subsample of participants (n=22) enrolled across all 3 sites by March 31, 2017. At VGH and SPH (n=14), 25% fewer patients required an ED visit in the post-survey reporting compared to pre-survey. During the monitoring period, the monitoring nurse observed seven likely avoided ED admissions due to early intervention. In total, admissions were reduced by 20% and total hospital length of stay reduced by 69%. At KGH (n=8), 43% fewer patients required an ED visit in the post-survey reporting compared to the pre-survey. Hospital admissions were reduced by 20% and total hospital length of stay reduced by 50%. Overall, TEC4Home participants from all sites showed a significant improvement in health-related quality of life and in self-care behaviour pre- to 90 days post-monitoring. A full analysis of the 69 patients will be complete in February 2018. Conclusion: Preliminary findings indicate that home telemonitoring for HF patients can decrease ED revisits and improve patient experience. The length of stay data may also suggest the potential for early discharge of ED patients with home telemonitoring to avoid or reduce hospitalization. A stepped-wedge randomized controlled trial of TEC4Home in 22 BC communities will be conducted in 2018 to generate evidence and scale up the service in urban, regional and rural communities. This work is submitted on behalf of the TEC4Home Healthcare Innovation Community.
Multidrug-resistant organisms (MDROs) are increasingly reported in residential care homes for the elderly (RCHEs). We assessed whether implementation of directly observed hand hygiene (DOHH) by hand hygiene ambassadors can reduce environmental contamination with MDROs.
From July to August 2017, a cluster-randomized controlled study was conducted at 10 RCHEs (5 intervention versus 5 nonintervention controls), where DOHH was performed at two-hourly intervals during daytime, before meals and medication rounds by a one trained nurse in each intervention RCHE. Environmental contamination by MRDOs, such as methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter species (CRA), and extended-spectrum β-lactamse (ESBL)–producing Enterobacteriaceae, was evaluated using specimens collected from communal areas at baseline, then twice weekly. The volume of alcohol-based hand rub (ABHR) consumed per resident per week was measured.
The overall environmental contamination of communal areas was culture-positive for MRSA in 33 of 100 specimens (33%), CRA in 26 of 100 specimens (26%), and ESBL-producing Enterobacteriaceae in 3 of 100 specimens (3%) in intervention and nonintervention RCHEs at baseline. Serial monitoring of environmental specimens revealed a significant reduction in MRSA (79 of 600 [13.2%] vs 197 of 600 [32.8%]; P<.001) and CRA (56 of 600 [9.3%] vs 94 of 600 [15.7%]; P=.001) contamination in the intervention arm compared with the nonintervention arm during the study period. The volume of ABHR consumed per resident per week was 3 times higher in the intervention arm compared with the baseline (59.3±12.9 mL vs 19.7±12.6 mL; P<.001) and was significantly higher than the nonintervention arm (59.3±12.9 mL vs 23.3±17.2 mL; P=.006).
The direct observation of hand hygiene of residents could reduce environmental contamination by MDROs in RCHEs.
Central nervous system infections (CNSI) are a leading cause of death and long-term disability in children. Using ICD-10 data from 2005 to 2015 from three central hospitals in Ho Chi Minh City (HCMC), Vietnam, we exploited generalized additive mixed models (GAMM) to examine the spatial-temporal distribution and spatial and climatic risk factors of paediatric CNSI, excluding tuberculous meningitis, in this setting. From 2005 to 2015, there were 9469 cases of paediatric CNSI; 33% were ⩽1 year old at admission and were mainly diagnosed with presumed bacterial CNSI (BI) (79%), the remainder were >1 year old and mainly diagnosed with presumed non-bacterial CNSI (non-BI) (59%). The urban districts of HCMC in proximity to the hospitals as well as some outer districts had the highest incidences of BI and non-BI; BI incidence was higher in the dry season. Monthly BI incidence exhibited a significant decreasing trend over the study. Both BI and non-BI were significantly associated with lags in monthly average temperature, rainfall, and river water level. Our findings add new insights into this important group of infections in Vietnam, and highlight where resources for the prevention and control of paediatric CNSI should be allocated.
Evidence suggests that autism and schizophrenia share similarities in genetic, neuropsychological and behavioural aspects. Although both disorders are associated with theory of mind (ToM) impairments, a few studies have directly compared ToM between autism patients and schizophrenia patients. This study aimed to investigate to what extent high-functioning autism patients and schizophrenia patients share and differ in ToM performance.
Thirty high-functioning autism patients, 30 schizophrenia patients and 30 healthy individuals were recruited. Participants were matched in age, gender and estimated intelligence quotient. The verbal-based Faux Pas Task and the visual-based Yoni Task were utilised to examine first- and higher-order, affective and cognitive ToM. The task/item difficulty of two paradigms was examined using mixed model analyses of variance (ANOVAs). Multiple ANOVAs and mixed model ANOVAs were used to examine group differences in ToM.
The Faux Pas Task was more difficult than the Yoni Task. High-functioning autism patients showed more severely impaired verbal-based ToM in the Faux Pas Task, but shared similar visual-based ToM impairments in the Yoni Task with schizophrenia patients.
The findings that individuals with high-functioning autism shared similar but more severe impairments in verbal ToM than individuals with schizophrenia support the autism–schizophrenia continuum. The finding that verbal-based but not visual-based ToM was more impaired in high-functioning autism patients than schizophrenia patients could be attributable to the varied task/item difficulty between the two paradigms.
The excellent preservation of calcareous invertebrates and phosphatic vertebrates in the Lower Oxford Clay provides a good opportunity for paleooceanographic reconstruction based on stable isotopic abundances. We present here our initial results and interpretations on carbon and oxygen isotopic analyses on fossils of different depth habitats. Benthic fossils include epifaunal oysters and infaunal nuculacean bivalves. We also analyzed “pendant” bivalves whose depth habitat is uncertain. Fossil nekton are represented by ammonites and belemnites. Organisms that inhabited the uppermost part of the water column are represented by marine reptiles, such as icthyosaurs and plesiosaurs, and probable pelagic fish.
The oxygen isotopic compositions of calcareous benthos and nekton overlap substantially (δ180 = −2 to +1 permil vs. PDB). The wide scatter in δ180 values probably reflects physiological (non-equilibrium) effects in calcification rather than paleoenvironmental variations. Mean δ180 values for oysters, pendant bivalves, and belemnites (all calcitic) and nuculacean bivalves (aragonitic) correspond to precipitation at isotopic equilibrium with non-glacial seawater at temperatures of 15°-18°. The mean isotopic paleotemperature for ammonites (aragonitic) is slightly higher (20°) but is probably not significantly different from those for other calcareous macro-invertebrates. Preliminary oxygen isotopic results on phosphate extracted from bones, teeth, and gill rays correspond to paleotemperatures of 20°–25°.
Carbon isotopic results are limited to data from calcareous benthos and nekton. δ 13C values for individual taxa are quite variable (+2 to +5 permil for aragonitic fossils, 0 to +3 permil for calcitic fossils), suggesting physiological isotope effects. Nonetheless, mean δ 13C values are consistent with calcification in seawater having a carbon isotopic composition similar to that of modern average seawater. The presumably high flux of 13C-depleted CO2 into bottom waters from the diagenesis of sedimentary organic matter is not recorded in the carbon isotopic composition of benthic fossils.
Thermal stratification implied by the oxygen isotopic record suggests the penetration of cool, nutrient-rich waters into the Lower Oxford Clay sea. Upward advection of deep waters together with runoff from adjacent landmasses must have provided sufficient nutrients to maintain the inferred high productivity of surface waters. The influence of productivity on the carbon isotopic composition of surface waters will be tested by the analysis of calcareous phytoplankton.
S.-W. Ho, Institute for Telecommunications Research, University of South Australia,
T. Chan, Institute for Telecommunications Research, University of South Australia,
A. Grant, Myriota, Adelaide, Australia,
C. Uduwerelle, Institute for Telecommunications Research, University of South Australia
Shannon's fundamental bound for perfect secrecy says that the source entropy cannot be larger than the entropy of the secret key initially shared by the sender and the legitimate receiver. Massey gave an information theoretic proof of this result, and his proof does not require independence of the key and the source message. By further assuming independence, some stronger results, which govern the probability distributions of the key and the ciphertext, can be shown. These results illustrate that the key entropy is not less than the logarithm of the message sample size in any cipher achieving perfect secrecy, even if the source distribution is fixed. The same bound also applies to the entropy of the ciphertext. These results still hold if the source message has been compressed before encryption.
The above observation leads to different research problems studied in this chapter. When the source distribution is non-uniform, the entropy of the key is required to be strictly greater than the source entropy, and hence some randomness in the key is wasted. To deal with this problem, this chapter investigates cipher systems that contain residual secret randomness after they are used. A collection of such systems can be used to generate a new secret key. The aforementioned entropy bound only gives the minimum size of the pre-shared secret key. A new measure for key consumption, i.e., the entropy difference between the pre-shared secret key and the newly generated key, is proposed and justified in this chapter. Key consumption is shown to be bounded below by the source entropy, and the lower bound can be achieved by the codes proposed in this chapter. Furthermore, the existence of a fundamental tradeoff between the expected key consumption and the number of channel uses for conveying a ciphertext is shown.
Cipher systems with perfect secrecy were studied by Shannon in his seminal paper  (see also ). With reference to Fig. 2.1, a cipher system is defined by three components: a source message U, a ciphertext X, and a key R. Here, R is the collection of secret randomness shared only by the sender and the legitimate receiver.
Depression is one of the most common mental disorders and identifying effective treatment strategies is crucial for the control of depression. Well-conducted systematic reviews (SRs) and meta-analyses can provide the best evidence for supporting treatment decision-making. Nevertheless, the trustworthiness of conclusions can be limited by lack of methodological rigour. This study aims to assess the methodological quality of a representative sample of SRs on depression treatments.
A cross-sectional study on the bibliographical and methodological characteristics of SRs published on depression treatments trials was conducted. Two electronic databases (the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects) were searched for potential SRs. SRs with at least one meta-analysis on the effects of depression treatments were considered eligible. The methodological quality of included SRs was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. The associations between bibliographical characteristics and scoring on AMSTAR items were analysed using logistic regression analysis.
A total of 358 SRs were included and appraised. Over half of included SRs (n = 195) focused on non-pharmacological treatments and harms were reported in 45.5% (n = 163) of all studies. Studies varied in methods and reporting practices: only 112 (31.3%) took the risk of bias among primary studies into account when formulating conclusions; 245 (68.4%) did not fully declare conflict of interests; 93 (26.0%) reported an ‘a priori’ design and 104 (29.1%) provided lists of both included and excluded studies. Results from regression analyses showed: more recent publications were more likely to report ‘a priori’ designs [adjusted odds ratio (AOR) 1.31, 95% confidence interval (CI) 1.09–1.57], to describe study characteristics fully (AOR 1.16, 95% CI 1.06–1.28), and to assess presence of publication bias (AOR 1.13, 95% CI 1.06–1.19), but were less likely to list both included and excluded studies (AOR 0.86, 95% CI 0.81–0.92). SRs published in journals with higher impact factor (AOR 1.14, 95% CI 1.04–1.25), completed by more review authors (AOR 1.12, 95% CI 1.01–1.24) and SRs on non-pharmacological treatments (AOR 1.62, 95% CI 1.01–2.59) were associated with better performance in publication bias assessment.
The methodological quality of included SRs is disappointing. Future SRs should strive to improve rigour by considering of risk of bias when formulating conclusions, reporting conflict of interests and authors should explicitly describe harms. SR authors should also use appropriate methods to combine the results, prevent language and publication biases, and ensure timely updates.
Experiments on the National Ignition Facility show that multi-dimensional effects currently dominate the implosion performance. Low mode implosion symmetry and hydrodynamic instabilities seeded by capsule mounting features appear to be two key limiting factors for implosion performance. One reason these factors have a large impact on the performance of inertial confinement fusion implosions is the high convergence required to achieve high fusion gains. To tackle these problems, a predictable implosion platform is needed meaning experiments must trade-off high gain for performance. LANL has adopted three main approaches to develop a one-dimensional (1D) implosion platform where 1D means measured yield over the 1D clean calculation. A high adiabat, low convergence platform is being developed using beryllium capsules enabling larger case-to-capsule ratios to improve symmetry. The second approach is liquid fuel layers using wetted foam targets. With liquid fuel layers, the implosion convergence can be controlled via the initial vapor pressure set by the target fielding temperature. The last method is double shell targets. For double shells, the smaller inner shell houses the DT fuel and the convergence of this cavity is relatively small compared to hot spot ignition. However, double shell targets have a different set of trade-off versus advantages. Details for each of these approaches are described.
VLA observations in the (J, K)=(3,3) line of ammonia reveal new structures in the Galactic center region. An approximate ring of emission is centered on the central ionized streamers. This ring, seen previously in millimeter-wave interferometer maps, is very clumpy in the ammonia emission, with size scales ≲10″ (0.4 pc). The clumps show good spatial and velocity agreement with the ionized gas, and are warm with brightness temperatures exceeding 30 K. A comparison of the (3,3) to (1,1) ratio indicates considerably higher gas temperatures. This circumnuclear ring may not be the dominant feature in the mass distribution of the circumnuclear gas. A streamer, immediately to the south of the Galactic center, connects the gas complex at lII= −4′ (~10 pc) directly to the Galactic center. This streamer may define the path for gas flow into the nuclear region.
A 3′ × 6′ field centered ~4′ south of the Galactic center and a ~2′ × 4′ field east of the Galactic center have been mapped using the 4–1 → 30 E line (36.169 GHz) of methanol (CH3OH). Line profiles typically consist of broad (~10–20 km s−1) components, as well as narrow (~1 km s−1), spike-like components. The narrow features are bright and unresolved with 60″ resolution, and are probably due to maser activity. We found maser activity immediately adjacent to the non-thermal “wisp” (SgrA-E) ~4′ south of SgrA-West, the secondary knot at SgrA-F, and the eastern edge of SgrA-East. Position-velocity diagrams suggest that the molecular material has been shocked to a higher velocity in the same vicinities. We propose that the maser activity, and the shift in velocity south of the Galactic center, heretofore interpreted as an increasingly steep velocity gradient toward the Galactic center, may be due to the impact of a SNR and the resulting shock of the ambient molecular material. The dynamical effects on the molecular gas of such a shock may have implications on gas feeding toward the nucleus.
The inner few hundred parsecs of the Milky Way, the Central Molecular Zone (CMZ), is our closest laboratory for understanding star formation in the extreme environments (hot, dense, turbulent gas) that once dominated the universe. We present an update on the first large-area survey to expose the sites of star formation across the CMZ at high-resolution in submillimeter wavelengths: the CMZoom survey with the Submillimeter Array (SMA). We identify the locations of dense cores and search for signatures of embedded star formation. CMZoom is a three-year survey in its final year and is mapping out the highest column density regions of the CMZ in dust continuum and a variety of spectral lines around 1.3 mm. CMZoom combines SMA compact and subcompact configurations with single-dish data from BGPS and the APEX telescope, achieving an angular resolution of about 4″ (0.2 pc) and good image fidelity up to large spatial scales.
Carbapenem-resistant Acinetobacter baumannii (CRAB) with diverse multilocus sequence typing emerged among our nursing home residents (6.5%) with a high background rate of MRSA (32.2%). Rectal swabs yielded a higher rate of CRAB detection than axillary or nasal swabs. Bed-bound status, use of adult diapers, and nasogastric tube were risk factors for CRAB colonization.
From the photoinduced transport of energy that accompanies photosynthesis to the transcontinental transmission of optical data that enable the Internet, our world relies and thrives on optical signals. To highlight the importance of optics to society, the United Nations designated 2015 as “The International Year of Light and Light-based Technologies.” Although conventional optical technologies are limited by diffraction, plasmons—collective oscillations of free electrons in a conductor—allow optical signals to be tailored with nanoscale precision. Following decades of fundamental research, several plasmonic technologies have now emerged on the market, and numerous industrial breakthroughs are imminent. This article highlights recent industrially relevant advances in plasmonics, including plasmonic materials and devices for energy; for medical sensing, imaging, and therapeutics; and for information technology. Some of the most exciting industrial applications include solar-driven water purifiers, cell phone Raman spectrometers, high-density holographic displays, photothermal cancer therapeutics, and nanophotonic integrated circuits. We describe the fundamental scientific concepts behind these and related technologies, as well as the successes and challenges associated with technology transfer.
Our previous observations established the small angular size and high brightness temperature of emission from the v=1, J=1-0 transition of SiO from the circumstellar envelopes of the supergiant VX Sgr and the Mira variable R Cas. We performed a second VLBI experiment on the SiO masers in several late type stars on 31 Oct.-2 Nov. 1978 to compare the physical characteristics of the SiO masers in the v=1 and v=2 states. With an energy separation of 1258 cm-1 (an equivalent temperature of 1753 K) between the two vibrational states, differences in excitation and pumping of the maser states may lead to different maser properties.
Synovial sarcoma is a high-grade, soft tissue, malignant disease associated with poor outcome. Typically, synovial sarcoma involves the extremities, with less than 10 per cent of cases occurring in the head and neck region. Synovial sarcoma of the paranasal sinuses is a rare entity. This paper presents a case of an elderly patient with synovial sarcoma of the ethmoidal sinus.
An 80-year-old woman who had right epistaxis underwent nasal endoscopy and biopsy. The pathology indicated synovial sarcoma and the patient underwent endoscopic excision of the tumour.
Synovial sarcoma of the ethmoidal sinus is very rare. Patients should undergo excision of the tumour with post-operative radiotherapy. However, the prognosis remains poor and usually the patient succumbs to death within a year.
Transparent films of platinum nanoparticles on graphene nanohybrids were synthesized in a two-step process. Reduction of homogeneously dispersed Pt precursor and graphene in water and solution coating/annealing afforded thin films with high catalytic performance as counter electrodes in dye-sensitized solar cells (DSSC). The requisite dispersant consisting of poly(oxyethylene)-(POE) segments and cyclic imide functionalities allowed the in-situ reduction of dihydrogen hexachloroplatinate by ethanol and the formation of nanohybrids of graphene-supported Pt nanoparticles at 4.0 nm diameter. Characterizations of polymeric dispersants by Fourier-transform infrared spectroscopy, thermogravimetric analysis, and nanohybrids by transmission electron microscope were performed. After screening various compositions of Pt/graphene, the nanohybrid film at the specific ratio of 5/1 by weight was fabricated into a counter electrode (CE) for DSSC by the solution casting method. The evaluation of cell performance demonstrated the most improved power conversion efficiency of 8.00%. This is significant achievement in comparison with 7.14% for the DSSC with the conventional platinum sputtered CE. Furthermore, the solution casting method allows the preparation of transparent CE films that are suitable for using as rear-illuminated DSSC. The approach was proven to be feasible by measuring the cell efficiency under rear light illumination. The power efficiency up to 7.01%, comparable to 8.00% by a normally front illumination, has been accomplished. In contrast, the rear illumination at merely 2.36% efficiency was obtained for the DSSC with sputtered platinum CE. Analyses of cyclic voltammetry, electrochemical impedance spectra were well correlated to the high efficiency of the performance caused by this nanohybrid film.
X-ray photoelectron spectroscopy (XPS) has been used to investigate grain boundary diffusion of Cu and Cr through 1000 Å thick Co films in the temperature range of 325°C to 400°C. Grain boundary diffusivities were determined by modeling the accumulation of Cu or Cr on Co surfaces as a function of time at fixed annealing temperature. The grain boundary diffusivity of Cu through Co is characterized by a diffusion coefficient, D0gb, of 2 × 104 cm2/sec and an activation energy, Ea,gb, of 2.4 eV. Similarly, Cr grain boundary diffusion through Co thin films occurs with a diffusion coefficient, Do,gb, of 6 × 10-2cm2/sec and an activation energy, Ea,gb of 1.8 eV. The Co film microstructure has been investigated before and after annealing by x-ray diffraction and transmission electron Microscopy. Extensive grain growth and texturing of the film occurred during annealing for Co deposited on a Cu underlayer. In contrast, the microstructure of Co deposited on a Cr underlayer remained relatively unchanged upon annealing. Magnetometer Measurements have shown that increased in-plane coercivity Hc, reduced remanence squareness S, and reduced coercive squareness S* result from grain boundary diffusion of Cu and Cr into the Co films.