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.
The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain—rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items’ correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression.
Social centers for older people.
664 Chinese older adults with chronic pain.
Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed.
For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms.
The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.
Rabies is one of the major public health problems in China, and the mortality rate of rabies remains the highest among all notifiable infectious diseases. A meta-analysis was conducted to investigate the post-exposure prophylaxis (PEP) vaccination rate and risk factors for human rabies in mainland China. The PubMed, Web of Science, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical and Wanfang databases were searched for articles on rabies vaccination status (published between 2007 and 2017). In total, 10 174 human rabies cases from 136 studies were included in this meta-analysis. Approximately 97.2% (95% confidence interval (CI) 95.1–98.7%) of rabies cases occurred in rural areas and 72.6% (95% CI 70.0–75.1%) occurred in farmers. Overall, the vaccination rate in the reported human rabies cases was 15.4% (95% CI 13.7–17.4%). However, among vaccinated individuals, 85.5% (95% CI 79.8%–83.4%) did not complete the vaccination regimen. In a subgroup analysis, the PEP vaccination rate in the eastern region (18.8%, 95% CI 15.9–22.1%) was higher than that in the western region (13.3%, 95% CI 11.1–15.8%) and this rate decreased after 2007. Approximately 68.9% (95% CI 63.6–73.8%) of rabies cases experienced category-III exposures, but their PEP vaccination rate was 27.0% (95% CI 14.4–44.9%) and only 6.1% (95% CI 4.4–8.4%) received rabies immunoglobulin. Together, these results suggested that the PEP vaccination rate among human rabies cases was low in mainland China. Therefore, standardised treatment and vaccination programs of dog bites need to be further strengthened, particularly in rural areas.
Using time-resolved laser-scanning confocal microscopy and ultrafast optical pump/THz probe spectroscopy, we measure photoluminescence (PL) and THz-conductivity in perovskite micro-crystals and films. PL quenching and lifetime variations occur from local heterogeneity. Ultrafast THz-spectra measure sharp quantum transitions from excitonic Rydberg states, providing weakly bound excitons with a binding energy of ~13.5 meV at low temperatures. Ab-initio electronic structure calculations give a direct band gap of 1.64 eV, a dielectric constant of ~18, heavy electrons, and light holes, resulting in weakly bound excitons, consistent with the binding energies from the experiment. The complementary spectroscopy and simulations reveal fundamental insights into perovskite light-matter interactions.
Introduction: Survival from cardiac arrest has been linked to the quality of resuscitation care. Unfortunately, healthcare providers frequently underperform in these critical scenarios, with a well-documented deterioration in skills weeks to months following advanced life support courses. Improving initial training and preventing decay in knowledge and skills are a priority in resuscitation education. The spacing effect has repeatedly been shown to have an impact on learning and retention. Despite its potential advantages, the spacing effect has seldom been applied to organized education training or complex motor skill learning where it has the potential to make a significant impact. The purpose of this study was to determine if a resuscitation course taught in a spaced format compared to the usual massed instruction results in improved retention of procedural skills. Methods: EMS providers (Paramedics and Emergency Medical Technicians (EMT)) were block randomized to receive a Pediatric Advanced Life Support (PALS) course in either a spaced format (four 210-minute weekly sessions) or a massed format (two sequential 7-hour days). Blinded observers used expert-developed 4-point global rating scales to assess video recordings of each learner performing various resuscitation skills before, after and 3-months following course completion. Primary outcomes were performance on infant bag-valve-mask ventilation (BVMV), intraosseous (IO) insertion, infant intubation, infant and adult chest compressions. Results: Forty-eight of 50 participants completed the study protocol (26 spaced and 22 massed). There was no significant difference between the two groups on testing before and immediately after the course. 3-months following course completion participants in the spaced cohort scored higher overall for BVMV (2.2 ± 0.13 versus 1.8 ± 0.14, p=0.012) without statistically significant difference in scores for IO insertion (3.0 ± 0.13 versus 2.7± 0.13, p= 0.052), intubation (2.7± 0.13 versus 2.5 ± 0.14, p=0.249), infant compressions (2.5± 0.28 versus 2.5± 0.31, p=0.831) and adult compressions (2.3± 0.24 versus 2.2± 0.26, p=0.728) Conclusion: Procedural skills taught in a spaced format result in at least as good learning as the traditional massed format; more complex skills taught in a spaced format may result in better long term retention when compared to traditional massed training as there was a clear difference in BVMV and trend toward a difference in IO insertion.
Achieving adequate fertility is essential in any dairy unit, but is compromised by genetic selection for increased yield. Selection has altered the somatotrophic axis and resulted in cows which mobilise more body tissue for milk production in early lactation, thus prolonging both the depth and duration of the post partum negative energy balance. Poor energy status is reflected in altered metabolic parameters including raised urea and decreased insulin-like growth factor-I (IGF-I) and insulin concentrations, which adversely affect ovarian cyclicity and early embryo survival. Attempts to optimise the diet in terms of energy and protein content have generally been aimed at increasing milk production further rather than improving fertility. Advances in biosensor technology now provide us with the opportunity to monitor production, fertility and health parameters of each cow. Integration of this information should improve the timing for inseminations and could assist in selecting diets more suited to the needs of the individual cow. Genetic selection may in future be used to produce cows optimised for a particular type of management system. In both cases we need a greater understanding of the rules governing nutrient partitioning at different stages of the cows' life cycle to ensure that diets selected are cost effective and achieve an appropriate balance in promoting production, reproduction and health.
To study the association between gastrointestinal colonization of carbapenemase-producing Enterobacteriaceae (CPE) and proton pump inhibitors (PPIs).
We analyzed 31,526 patients with prospective collection of fecal specimens for CPE screening: upon admission (targeted screening) and during hospitalization (opportunistic screening, safety net screening, and extensive contact tracing), in our healthcare network with 3,200 beds from July 1, 2011, through December 31, 2015. Specimens were collected at least once weekly during hospitalization for CPE carriers and subjected to broth enrichment culture and multiplex polymerase chain reaction.
Of 66,672 fecal specimens collected, 345 specimens (0.5%) from 100 patients (0.3%) had CPE. The number and prevalence (per 100,000 patient-days) of CPE increased from 2 (0.3) in 2012 to 63 (8.0) in 2015 (P<.001). Male sex (odds ratio, 1.91 [95% CI, 1.15–3.18], P=.013), presence of wound or drain (3.12 [1.70–5.71], P<.001), and use of cephalosporins (3.06 [1.42–6.59], P=.004), carbapenems (2.21 [1.10–4.48], P=.027), and PPIs (2.84 [1.72–4.71], P<.001) in the preceding 6 months were significant risk factors by multivariable analysis. Of 79 patients with serial fecal specimens, spontaneous clearance of CPE was noted in 57 (72.2%), with a median (range) of 30 (3–411) days. Comparing patients without use of antibiotics and PPIs, consumption of both antibiotics and PPIs after CPE identification was associated with later clearance of CPE (hazard ratio, 0.35 [95% CI, 0.17–0.73], P=.005).
Concomitant use of antibiotics and PPIs prolonged duration of gastrointestinal colonization by CPE.
We calibrated portions of the radiocarbon time scale with combined 230Th, 231Pa, 14C measurements of corals collected from Espiritu Santo, Vanuatu and the Huon Peninsula, Papua New Guinea. The new data map 14C variations ranging from the current limit of the tree-ring calibration [11,900 calendar years before present (cal BP), Kromer and Spurk 1998, now updated to 12,400 cal B P, see Kromer et al., this issue], to the 14C-dating limit of 50,000 cal BP, with detailed structure between 14 to 16 cal kyr BP and 19 to 24 cal kyr BP. Samples older than 25,000 cal BP were analyzed with high-precision 231Pa dating methods (Pickett et al. 1994; Edwards et al. 1997) as a rigorous second check on the accuracy of the 230Th ages. These are the first coral calibration data to receive this additional check, adding confidence to the age data forming the older portion of the calibration. Our results, in general, show that the offset between calibrated and 14C ages generally increases with age until about 28,000 cal BP, when the recorded 14C age is nearly 6800 yr too young. The gap between ages before this time is less; at 50,000 cal BP, the recorded 14C age is 4600 yr too young. Two major 14C-age plateaus result from a 130 drop in Δ14C between 14–15 cal kyr BP and a 700 drop in Δ14C between 22–25 cal kyr BP. In addition, a large atmospheric Δ14C excursion to values over 1000 occurs at 28 cal kyr BP. Between 20 and 10 cal kyr BP, a component of atmospheric Δ14C anti-correlates with Greenland ice δ18O, indicating that some portion of the variability in atmospheric Δ14C is related to climate change, most likely through climate-related changes in the carbon cycle. Furthermore, the 28-kyr excursion occurs at about the time of significant climate shifts. Taken as a whole, our data indicate that in addition to a terrestrial magnetic field, factors related to climate change have affected the history of atmospheric 14C.
A field experiment was conducted to quantify changes in soil aggregation and aggregate-associated soil organic carbon (SOC) concentration 1, 3, 5 and 10 years after abandoned, salinized land in the Manasi River Basin was reclaimed for cotton (Gossypium hirsutum L.). Results showed that reclamation significantly increased SOC concentrations and SOC stocks. Specifically, 10 years of cotton production increased SOC concentrations by 45% in the 0–60 cm depth and SOC stocks by 35%. The SOC concentrations and stocks decreased as soil depth increased. Reclamation time, season and soil depth had significant interaction effects on SOC. The SOC concentrations were significantly and positively correlated with available soil nitrogen and available soil phosphorus. Compared with abandoned farmland, macro-aggregate-associated (>250 µm) SOC concentrations in the 0–60 cm depth increased by 47% after 5 years of cotton production and by 53% after 10 years of cotton production. The contribution of macro-aggregate-associated SOC to total SOC in the 0–60 cm depth increased by 87% after 5 years of cotton production and by 69% after 10 years of cotton production. The findings indicate that soil aggregates were more stable after abandoned, salinized farmland was reclaimed for cotton production. Furthermore, cotton production can increase SOC concentrations and sequester C in this arid area.
Her X-1 is an X-ray pulsar with a rotation period of 1.24 s and a binary period of 1.7d (Tananbaum et al. 1972). The 1.7 d variations in optical and ultraviolet flux are attributed to X-ray heating of the companion star and disk (e.g. Howarth & Wilson 1983, hereafter HW83). The system displays a 35 d period, attributed to the effects of a tilted, precessing, accretion disk. Optical and ultraviolet flux variations continue unchanged throughout. This work is motivated by the following reasons:
• The observed IUE spectra have significantly flatter slopes than those predicted by previous models (e.g. HW83).
• The observed strength of the Balmer jump is anomalously low compared to that expected for a normal B star (Anderson et al. 1994).
• HST observations obtained by Anderson et al. (1994) in order to study emission lines have yielded high quality spectra of the continuum emission from HZ Her, enabling for the first time detailed model fitting efforts.
The Cosmic Background Explorer, launched November 18, 1989, has nearly completed its first full mapping of the sky with all three of its instruments: a Far Infrared Absolute Spectrophotometer (FIRAS) covering 0.1 to 10 mm, a set of Differential Microwave Radiometers (DMR) operating at 3.3, 5.7, and 9.6 mm, and a Diffuse Infrared Background Experiment (DIRBE) spanning 1 to 300 µm in ten bands. A preliminary map of the sky derived from DIRBE data is presented. Initial cosmological implications include: a limit on the Comptonization y parameter of 10−3, on the chemical potential μ parameter of 10−2, a strong limit on the existence of a hot smooth intergalactic medium, and a confirmation that the dipole anisotropy has the spectrum expected from a Doppler shift of a blackbody. There are no significant anisotropies in the microwave sky detected, other than from our own galaxy and a cosθ dipole anisotropy whose amplitude and direction agree with previous data. At shorter wavelengths, the sky spectrum and anisotropies are dominated by emission from ‘local’ sources of emission within our Galaxy and Solar System. Preliminary comparison of IRAS and DIRBE sky brightnesses toward the ecliptic poles shows the IRAS values to be significantly higher than found by DIRBE at 100 μm. We suggest the presence of gain and zero-point errors in the IRAS total brightness data. The spacecraft, instrument designs, and data reduction methods are described.
Floral organ development influences plant reproduction and crop yield. The mechanism of floral organ specification is generally conserved in angiosperms as demonstrated by the ‘ABC’ model. However, mechanisms underlying the development of floral organs in specific groups of species such as grasses remain unclear. In the genus Oryza (rice), a spikelet consists of a fertile floret sub-tended by a lemma, a palea, two sterile lemmas and rudimentary glumes. To understand how the lemma is formed, a curve-shaped lemma-distortion1 (ld1) mutant was identified. Genetic analysis confirmed that the ld1 mutant phenotype was due to a single recessive gene mutation. Using a large F2 population, the LD1 gene was mapped between markers Indel-7-15 and Indel-7-18, which encompassed a region of 15·6 kilo base pairs (kbp). According to rice genome annotations, two putative genes, LOC_Os07g32510 and LOC_Os07g32520, were located in this candidate region. However, DNA sequencing results indicated only 1 base pair (bp) substitution (T⇨C) was found in LOC_Os07g32510 between the wild-type and the ld1 mutant. Thus LOC_Os07g32510, encoding a DNA binding with one zinc finger (DoF) containing protein, was the candidate gene for LD1. Further analysis showed that mutation of the amino acid cysteine (C) to arginine (R) was likely to lead to zinc finger protein deactivation. Phylogenetic and conservation analysis of the gene from different species revealed that cysteine was critical to LD1 function. As a new gene controlling lemma development, the study of LD1 could provide insights into rice floral organ formation mechanisms.
Arginine kinase (AK) is an important regulation factor of energy metabolism in invertebrate. An arginine kinase gene, named HaAK, was identified to be differentially expressed between Cry1Ac-susceptible (96S) and Cry1Ac-resistant (Bt-R) Helicoverpa armigera larvae using cDNA-amplification fragment length polymorphism analysis. The full-length open reading frame sequence of HaAK gene with 1068 bp was isolated from H. armigera. Quantitative reverse transcription polymerase chain reaction assay revealed that HaAK gene is specifically expressed in multiple tissues and at larval developmental stages. The peak expression level of HaAK was detected in the midgut of the fifth-instar larvae. Moreover, the expression of HaAK was obviously down-regulated in Bt-R larvae. We further constructed a dsRNA vector directly targeting HaAK and employed RNAi technology to control the larvae. The feeding bioassays showed that minute quantities of dsRNA could greatly increase the larval mortality and delay the larval pupation. Silencing of HaAK significantly retarded the larval development, indicating that HaAK is a potential target for RNA interference-based pest management.
We determined the prevalence and seasonality of infections by Fasciola of goats and bovine species (cattle and water buffalo) in Hubei and Anhui provinces of China. Faecal samples were collected at 2- to 3-month intervals from 200 goats in Hubei province and from 152 bovine species in Anhui province. All faecal samples were examined for the presence of parasites. We determined the nucleotide sequences of the first and second internal transcribed spacers (ITS-1 and ITS-2) of the nuclear ribosomal DNA (rDNA) of 39 Fasciola worms from Anhui province. The prevalence of Fasciola infection in goats ranged between 3.5 and 37.0%, with mean eggs per gram (EPG) ranging between 29.0 and 166.0. Prevalence and EPG exhibited downward trends over time with significant differences. The prevalence of Fasciola infection in cattle ranged between 13.3 and 46.2% (mean EPG, 36.4–100.0), and that of water buffalo ranged between 10.3 and 35.4% (mean EPG, 25.0–89.6), with a higher prevalence of infection and EPG from June to October compared with December to March. Analysis of ITS-1 and ITS-2 sequences revealed that F. hepatica and F. gigantica were present in all bovine species of Anhui province and that F. gigantica mainly infected water buffalo. This is the first demonstration of Fasciola infection in Hubei province and detection of F. hepatica and F. gigantica in Anhui province. The present study of Hubei province shows that mass treatment of livestock with closantel sodium injections in April and August/September controlled Fasciola infection effectively.
In Taiwan, avian influenza virus (AIV) subtypes H5N2, H6N1 and H7N3 have been identified in domestic poultry, and several strains of these subtypes have become endemic in poultry. To evaluate the potential of avian-to-human transmission due to occupational exposure, an exploratory analysis of AIV antibody status in poultry workers was conducted. We enrolled 670 poultry workers, including 335 live poultry vendors (LPVs), 335 poultry farmers (PFs), and 577 non-poultry workers (NPWs). Serum antibody titres against various subtypes of viruses were analysed and compared. The overall seropositivity rates in LPVs and PFs were 2·99% (10/335) and 1·79% (6/335), respectively, against H5N2; and 0·6% (2/335) and 1·19% (4/335), respectively, for H7N3 virus. Of NPWs, 0·35% (2/577) and 0·17% (1/577) were seropositive for H5N2 and H7N3, respectively. Geographical analysis revealed that poultry workers whose workplaces were near locations where H5N2 outbreaks in poultry have been reported face greater risks of being exposed to viruses that result in elevated H5N2 antibody titres. H6N1 antibodies were detected in only one PF, and no H7N9 antibodies were found in the study subjects. Subclinical infections caused by H5N2, H6N1 and H7N3 viruses were thus identified in poultry workers in Taiwan. Occupational exposure is associated with a high risk of AIV infection, and the seroprevalence of particular avian influenza strains in humans reflects the endemic strains in poultry in this region.
The growth of thin films of chemical vapour deposition (CVD) diamond onto flat samples of pure Zr has been studied using various CVD growth conditions in a hot filament reactor. We find that although growth is straightforward, adhesion of the diamond layer onto the Zr is poor, with the diamond layer often delaminating upon cooling. SIMS depth profiles show this to be due to the presence of a strongly-bonded native oxide on the Zr surface which is not removed in the reducing H2 atmosphere during CVD. This, plus the lack of any substantial carbide interfacial layer to ‘glue’ the diamond onto the surface, together with a poor thermal expansion mismatch between Zr and diamond, and the Zr hcp-to-bcc phase transition at ∼860°C, all lead to poor adhesion. Some of these difficulties can be reduced by depositing at lower temperature (<500°C) at the cost of poorer quality diamond.
To assess the effectiveness of infection control preparedness for human infection with influenza A H7N9 in Hong Kong.
A descriptive study of responses to the emergence of influenza A H7N9.
A university-affiliated teaching hospital.
Healthcare workers (HCWs) with unprotected exposure (not wearing N95 respirator during aerosol-generating procedure) to a patient with influenza A H7N9.
A bundle approach including active and enhanced surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and extensive contact tracing for HCWs with unprotected exposure was implemented. Seventy HCWs with unprotected exposure to an index case were interviewed especially regarding their patient care activities.
From April 1, 2013, through May 31, 2014, a total of 126 (0.08%) of 163,456 admitted patients were tested for the H7 gene by reverse transcription-polymerase chain reaction per protocol. Two confirmed cases were identified. Seventy (53.8%) of 130 HCWs had unprotected exposure to an index case, whereas 41 (58.6%) and 58 (82.9%) of 70 HCWs wore surgical masks and practiced hand hygiene after patient care, respectively. Sixteen (22.9%) of 70 HCWs were involved in high-risk patient contacts. More HCWs with high-risk patient contacts received oseltamivir prophylaxis (P=0.088) and significantly more had paired sera collected for H7 antibody testing (P<0.001). Ten (14.3%) of 70 HCWs developed influenza-like illness during medical surveillance, but none had positive results by reverse transcription-polymerase chain reaction. Paired sera was available from 33 of 70 HCWs with unprotected exposure, and none showed seroconversion against H7N9.
Despite the delay in airborne precautions implementation, no patient-to-HCW transmission of influenza A H7N9 was demonstrated.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
The influence of TiO2 addition to LF refining slag on Ti-stabilized stainless
steel was evaluated using a vacuum induction furnace at 1873 K. The effect of
CaO-SiO2-MgO-Al2O3 basic slags with different TiO2 contents on the titanium loss,
aluminum loss and total oxygen content in the steel was studied. It was observed that the
oxidation rate of Ti first decreases and then increases with the increase in the content
of TiO2 in slag and
reaches the minimum when 8%TiO2 is added to the slag. However, the change in the
oxidation rate of Al shows the opposite tendency. The total oxygen in the molten steel
remains unchanged with time when 8%TiO2 is added to the slag, and the total oxygen of the
others increases monotonically with time. The activities of TiO2 and Al2O3 from the calculation of the ion
and molecule coexistence theory (IMCT) in the initial slag present the same change
tendency, and both first increase and then decrease with the gradual increase in
TiO2 in the slag
and reach the maximum when 8%TiO2 is added to the slag. The results of a kinetic analysis
showed that the rate-determining step of the oxidation of Ti in the steel is the mass
transfer on the slag side, and the rate-determining step of the oxidation of Al in the
steel is the mass transfer on the metal side.