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Crystal structure and electronic structure of YMnO3 were investigated by X-ray diffraction and transmission electron microscopy related techniques. According to the density of states (DOS), the individual interband transitions to energy loss peaks in the low energy loss spectrum were assigned. The hybridization of O 2p with Mn 3d and Y 4d analyzed by the partial DOS was critical to the ferroelectric nature of YMnO3. From the simulation of the energy loss near-edge structure, the fine structure of O K-edge was in good agreement with the experimental spectrum. The valence state of Mn (+3) in YMnO3 was determined by a comparison between experiment and calculations.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Structural characterization and X-ray reference powder pattern determination have been conducted for the Co- and Zn-containing tridymite derivatives Ba(Co1−xZnx)SiO4 (x = 0.2, 0.4, 0.6, 0.8). The bright blue series of Ba(Co1−xZnx)SiO4 crystallized in the hexagonal P63 space group (No. 173), with Z = 6. While the lattice parameter “a” decreases from 9.126 (2) Å to 9.10374(6) Å from x = 0.2 to 0.8, the lattice parameter “c” increases from 8.69477(12) Å to 8.72200(10) Å, respectively. Apparently, despite the similarity of ionic sizes of Zn2+ and Co2+, these opposing trends are due to the framework tetrahedral tilting of (ZnCo)O4. The lattice volume, V, remains comparable between 626.27 Å3 and 626.017 (7) Å3 from x = 0 to x = 0.8. UV-visible absorption spectrum measurements indicate the band gap of these two materials to be ≈3.3 and ≈3.5 eV, respectively, therefore potential UV photocatalytic materials. Reference powder X-ray diffraction patterns of these compounds have been submitted to be included in the Powder Diffraction File (PDF).
Background: The Saskatchewan Spine Pathway (SSP) facilitates timelier imaging and more appropriate surgical referrals. In this prospective study, pre- and post-operative wait times, satisfaction, and outcomes were compared between SSP and conventionally referred surgical patients. Methods: A prospective matched cohort comparison of 150 patients (SSP group n=75; conventional group n=75) undergoing elective lumbar surgery for mechanical back and leg pain between 2011 and 2016 was performed with 1 year follow-up. Outcomes were measured with patient questionnaires, Oswestry disability index (ODI), visual analogue back and leg pain scores (VAS), and EuroQol Group 5 –Dimension self-report (EQ5D). Results: Baseline measures were the same in both groups. Wait times to see the surgeon and for surgery were the same, and wait time for MRI was significantly shorter for the SSP group (p<0.001). SSP patients utilized more non-operative treatment strategies such as physiotherapy (p<0.04), and had higher satisfaction with pre-surgical care (p=0.03). Good surgical outcomes were obtained in both groups with no significant differences. Conclusions: There are minimal differences in post-surgical outcomes for SSP patients versus conventionally referred patients; however, the SSP facilitates significantly shorter wait times for MRI and non-operative treatment strategies. Pre-surgical patient satisfaction is significantly higher among SSP patients.
Background: People of aboriginal ancestry are more likely to suffer traumatic spinal cord injury (TSCI) compared to other Canadians; however, outcome studies are limited. This study aims to compare aboriginal and non-aboriginal populations with acute TSCI with respect to: pre-injury baseline, injury severity, treatment, outcomes, and length-of-stay characteristics. Methods: This was a retrospective analysis of 159 patients with TSCI prospectively enrolled in the prospective Rick Hansen Spinal Cord Injury Registry (RHSCIR), Saskatoon site between February 13, 2010 and December 17, 2016. Results: Sixty-two patients consented to the full dataset, which includes ethnic background: 21 ‘aboriginal’ (33.9%); 41 ‘non-aboriginal’ (66.1%). Aboriginal patients were younger, had fewer medical comorbidities and had similar severity of neurological injury and similar outcomes compared to non-aboriginal patients. However, the time to discharge to the community was significantly longer (median 104.0 days versus 38.5 days, p=0.021). While 35% of non-aboriginal patients were discharged home from the acute care site, no aboriginal patients were transferred home directly. Conclusions: This study suggests a need for better allocation of resources for transition to the community for First Nations patients with TSCI in Saskatchewan. We plan a further study to assess outcomes from TSCI for First Nations patients across Canada.
Ultrasound applications are widespread, and their utility in resource-limited environments are numerous. In disasters, the use of ultrasound can help reallocate resources by guiding decisions on management and transportation priorities. These interventions can occur on-scene, at triage collection points, during transport, and at the receiving medical facility. Literature related to this specific topic is limited. However, literature regarding prehospital use of ultrasound, ultrasound in combat situations, and some articles specific to disaster medicine allude to the potential growth of ultrasound utilization in disaster response.
To evaluate the utility of point-of-care ultrasound in a disaster response based on studies involving ultrasonography in resource-limited environments.
A narrative review of MEDLINE, MEDLINE InProcess, EPub, and Embase found 20 articles for inclusion.
Experiences from past disasters, prehospital care, and combat experiences have demonstrated the value of ultrasound both as a diagnostic and interventional modality.
Current literature supports the use of ultrasound in disaster response as a real-time, portable, safe, reliable, repeatable, easy-to-use, and accurate tool. While both false positives and false negatives were reported in prehospital studies, these values correlate to accepted false positive and negative rates of standard in-hospital point-of-care ultrasound exams. Studies involving austere environments demonstrate the ability to apply ultrasound in extreme conditions and to obtain high-quality images with only modest training and real-time remote guidance. The potential for point-of-care ultrasound in triage and management of mass casualty incidents is there. However, as these studies are heterogeneous and observational in nature, further research is needed as to how to integrate ultrasound into the response and recovery phases.
Finite-amplitude wave groups with multiple near-resonances are investigated to extend the existing results due to Liu et al. (J. Fluid Mech., vol. 835, 2018, pp. 624–653) from steady-state wave groups in deep water to steady-state wave groups in finite water depth. The slow convergence rate of the series solution in the homotopy analysis method and extra unpredictable high-frequency components in finite water depth make it hard to obtain finite-amplitude wave groups accurately. To overcome these difficulties, a solution procedure that combines the homotopy analysis method-based analytical approach and Galerkin method-based numerical approaches has been used. For weakly nonlinear wave groups, the continuum of steady-state resonance from deep water to finite water depth is established. As nonlinearity increases, the frequency bands broaden and more steady-state wave groups are obtained. Finite-amplitude wave groups with steepness no less than
are obtained and the resonant sets configuration of steady-state wave groups are analysed in different water depths. For waves in deep water, the majority of non-trivial components appear around the primary ones due to four-wave, six-wave, eight-wave or even ten-wave resonant interactions. The dominant role of four-wave resonant interactions for steady-state wave groups in deep water is demonstrated. For waves in finite water depth, additional non-trivial high-frequency components appear in the spectra due to three-wave, four-wave, five-wave or even six-wave resonant interactions with the components around the primary ones. The amplitude of these high-frequency components increases further as the water depth decreases. Resonances composed by components only around the primary ones are suppressed while resonances composed by components around the primary ones and from the high-frequency domain are enhanced. The spectrum of steady-state resonant wave groups changes with the water depth and the significant role of three-wave resonant interactions in finite water depth is demonstrated.
An experiment was conducted to determine the effects of supplementing different amounts of daidzein in a diet on the growth performance, blood biochemical parameters and meat quality of finishing beef cattle. Thirty finishing Xianan steers were distributed in three groups equilibrated by weight and fed three different dietary treatments (concentrate ratio = 80%): (1) control; (2) 500 mg/kg daidzein and (3) 1000 mg/kg daidzein, respectively. Steers were slaughtered after an 80-day feeding trial. Results showed that daidzein supplementation had no effect on the final body weight, average daily gain and feed conversion rate of steers. Steers fed with 1000 mg/kg daidzein had greater dry matter intake than those fed with control diets. Compared with the control group, the 1000 mg/kg daidzein group had a higher fat thickness, lower shear force and lightness. The pH, drip loss, cooking loss, redness (a*), yellowness (b*), moisture, ash, crude protein and intramuscular fat of the Longissimus dorsi muscle were unaffected by daidzein supplementation. Compared with the control group, the 1000 mg/kg daidzein group significantly increased the serum concentrations of insulin, free fatty acid and Glutamic-pyruvic transaminase. The 500 mg/kg daidzein group significantly increased the serum concentration of tetraiodothyronine compared with the control group. Supplemental daidzein did not affect the blood antioxidant ability and blood immune parameters in serum. In conclusion, daidzein supplementation above 500 mg/day modifies feed intake and metabolic and hormonal profile, with positive and negative effects on meat quality.
When Hurricane Harvey landed along the Texas coast on August 25, 2017, it caused massive flooding and damage and displaced tens of thousands of residents of Harris County, Texas. Between August 29 and September 23, Harris County, along with community partners, operated a megashelter at NRG Center, which housed 3365 residents at its peak. Harris County Public Health conducted comprehensive public health surveillance and response at NRG, which comprised disease identification through daily medical record reviews, nightly “cot-to-cot” resident health surveys, and epidemiological consultations; messaging and communications; and implementation of control measures including stringent isolation and hygiene practices, vaccinations, and treatment. Despite the lengthy operation at the densely populated shelter, an early seasonal influenza A (H3) outbreak of 20 cases was quickly identified and confined. Influenza outbreaks in large evacuation shelters after a disaster pose a significant threat to populations already experiencing severe stressors. A holistic surveillance and response model, which consists of coordinated partnerships with onsite agencies, in-time epidemiological consultations, predesigned survey tools, trained staff, enhanced isolation and hygiene practices, and sufficient vaccines, is essential for effective disease identification and control. The lessons learned and successes achieved from this outbreak may serve for future disaster response settings. (Disaster Med Public Health Preparedness. 2019;13:97-101)
To investigate the effects of friendly competition on hand hygiene compliance as part of a multimodal intervention program.
Prospective observational study in which the primary outcome was hand hygiene compliance. Differences were analyzed using the Pearson χ2 test. Odds ratios (ORs) with 95% confidence interval were calculated using multilevel logistic regression.
Observations were performed in 9 public hospitals and 1 rehabilitation center in Rotterdam, Netherlands.
From 2014 to 2016, at 5 time points (at 6-month intervals) in 120 hospital wards, 20,286 hand hygiene opportunities were observed among physicians, nurses, and other healthcare workers (HCWs).
The multimodal, friendly competition intervention consisted of mandatory interventions: monitoring and feedback of hand hygiene compliance and optional interventions (ie, e-learning, kick-off workshop, observer training, and team training). Hand hygiene opportunities, as formulated by the World Health Organization (WHO), were unobtrusively observed at 5 time points by trained observers. Compliance data were presented to the healthcare organizations as a ranking.
The overall mean hand hygiene compliance at time point 1 was 42.9% (95% confidence interval [CI], 41.4–44.4), which increased to 51.4% (95% CI, 49.8–53.0) at time point 5 (P<.001). Nurses showed a significant improvement between time points 1 and 5 (P<.001), whereas the compliance of physicians and other HCWs remained unchanged. In the multilevel logistic regressions, time points, type of ward, and type of HCW showed a significant association with compliance.
Between the start and the end of the multimodal intervention program in a friendly competition setting, overall hand hygiene compliance increased significantly.
A multichannel calorimeter system is designed and constructed which is capable of delivering single-shot and broad-band spectral measurement of terahertz (THz) radiation generated in intense laser–plasma interactions. The generation mechanism of backward THz radiation (BTR) is studied by using the multichannel calorimeter system in an intense picosecond laser–solid interaction experiment. The dependence of the BTR energy and spectrum on laser energy, target thickness and pre-plasma scale length is obtained. These results indicate that coherent transition radiation is responsible for the low-frequency component (
1 THz) of BTR. It is also observed that a large-scale pre-plasma primarily enhances the high-frequency component (
3 THz) of BTR.
An approach is presented for solving membrane vibration problems using an integrated scheme consisting of the Craig-Bampton (CB) reduction technique and a 2D dynamic infinite element modeling (DIEM) method. In the proposed CB-DIEM scheme, the substructure domain is partitioned into multiple layers of geometrically-similar infinite elements (IEs) which use only the data of the boundary nodes. A convergence criterion based on the first invariant of the DIEM mass matrix is used to determine the optimal parameters of the CB-DIEM scheme, namely the proportionality ratio and number of layers in the DIEM partitioning process and the number of retained frequency modes in the CB reduction method. Furthermore, in implementing the CB method, the inversion of the global stiffness matrix is calculated using only the stiffness matrix of the first element layer. Having reduced the DIEM model, a coupled DIE-FE algorithm is employed to model the dynamic problems of the full structure, which removes the respective methods disadvantages while keeping their advantages. The validity and performance of the proposed CB-DIEM method are investigated by means of three illustrative problems.
Muons produced by the Bethe–Heitler process from laser wakefield accelerated electrons interacting with high
materials have velocities close to the laser wakefield. It is possible to accelerate those muons with laser wakefield directly. Therefore for the first time we propose an all-optical ‘Generator and Booster’ scheme to accelerate the produced muons by another laser wakefield to supply a prompt, compact, low cost and controllable muon source in laser laboratories. The trapping and acceleration of muons are analyzed by one-dimensional analytic model and verified by two-dimensional particle-in-cell (PIC) simulation. It is shown that muons can be trapped in a broad energy range and accelerated to higher energy than that of electrons for longer dephasing length. We further extrapolate the dependence of the maximum acceleration energy of muons with the laser wakefield relativistic factor
and the relevant initial energy
. It is shown that a maximum energy up to 15.2 GeV is promising with
on the existing short pulse laser facilities.
Starchy grain is usually supplemented to diets containing low-quality forage to provide sufficient energy for ruminant animals. Ruminal degradation of grain starch mainly depends on the hydrolysis of the endosperm, which may be variable among grain sources. This study was conducted to investigate the influence of endosperm structure of wheat and corn on in vitro rumen fermentation and nitrogen (N) utilization of rice straw. The 3×4 factorial design included three ratios of concentrate to forage (35:65, 50:50 and 65:35) and four ratios of wheat to corn starch (20:80, 40:60, 60:40 and 80:20). The endosperm structure was detected by scanning electronic microscopy and a confocal laser scanning microscopic. An in vitro gas test was performed to evaluate the rumen fermentation characteristics and N utilization. Starch granules were embedded in the starch–protein matrix in corn, but more granules were separated from the matrix in the wheat endosperm. With the increasing ratio of wheat, rate and extent of gas production, total volatile fatty acids, and ammonia N increased linearly (P<0.01), but microbial protein concentration decreased (quadratic, P<0.01), with the maximum value at a ratio of 40% wheat. The efficiency of N utilization decreased linearly (P<0.01). Rumen fermentation and N utilization were significantly affected by the concentrate-to-forage ratio (P<0.01). Significant interactions between the concentrate-to-forage ratio and the wheat-to-corn ratio were detected in total volatile fatty acids and the efficiency of N utilization (P<0.01). In summary, the starch–protein matrix and starch granules in the wheat and corn endosperm mixture play an important role in the regulation of rumen fermentation and N utilization under low-quality forage.
A new optical delivery system has been developed for the (scanning) transmission electron microscope. Here we describe the in situ and “rapid ex situ” photothermal heating modality of the system, which delivers >200 mW of optical power from a fiber-coupled laser diode to a 3.7 μm radius spot on the sample. Selected thermal pathways can be accessed via judicious choices of the laser power, pulse width, number of pulses, and radial position. The long optical working distance mitigates any charging artifacts and tremendous thermal stability is observed in both pulsed and continuous wave conditions, notably, no drift correction is applied in any experiment. To demonstrate the optical delivery system’s capability, we explore the recrystallization, grain growth, phase separation, and solid state dewetting of a Ag0.5Ni0.5 film. Finally, we demonstrate that the structural and chemical aspects of the resulting dewetted films was assessed.
A nonlinear station-keeping control method for a multi-vectored propeller airship under unknown wind field with thrust saturation is developed, which is composed of three modules: nonlinear model predictive controller (NMPC), disturbance observer (DOB) and tracking differentiator (TD). The nonlinear kinematics and dynamics models are introduced, and the wind effect is considered by the wind-induced aerodynamic force. Based on both models, an explicit NMPC is designed. Then a nonlinear DOB is introduced to estimate the wind disturbance. A TD, showing the relationship between the maximum propulsion force and the maximum flight acceleration, is proposed to handle the thrusts’ amplitude saturation. Stability analysis shows that the closed-loop system is globally asymptotically stable. Simulations for a multi-vectored propeller airship are conducted to demonstrate the robustness and effectiveness of the proposed method.
Objectives: Essential tremor (ET) confers an increased risk for developing both amnestic and non-amnestic mild cognitive impairment (MCI). Yet, the optimal measures for detecting mild cognitive changes in individuals with this movement disorder have not been established. We sought to identify the cognitive domains and specific motor-free neuropsychological tests that are most sensitive to mild deficits in cognition as defined by a Clinical Dementia Rating (CDR) of 0.5, which is generally associated with a clinical diagnosis of MCI. Methods: A total of 196 ET subjects enrolled in a prospective, longitudinal, clinical-pathological study underwent an extensive motor-free neuropsychological test battery and were assigned a CDR score. Logistic regression analyses were performed to identify the neuropsychological tests which best identified individuals with CDR of 0.5 (mild deficits in cognition) versus 0 (normal cognition). Results: In regression models, we identified five tests in the domains of Memory and Executive Function which best discriminated subjects with CDR of 0.5 versus 0 (86.9% model classification accuracy). These tests were the California Verbal Learning Test II Total Recall, Logical Memory II, Verbal-Paired Associates I, Category Switching Fluency, and Color-Word Inhibition. Conclusions: Mild cognitive difficulty among ET subjects is best predicted by combined performance on five measures of memory and executive function. These results inform the nature of cognitive dysfunction in ET and the creation of a brief cognitive battery to assess patients with ET for cognitively driven dysfunction in life that could indicate the presence of MCI. (JINS, 2018, 24, 1084–1098)