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.
Research points to postprandial glucose and TAG measures as preferable assessments of cardiovascular risk as compared with fasting values. Although elevated postprandial glycaemic and lipaemic responses are thought to substantially increase chronic disease risk, postprandial glycaemia and lipaemia have historically only been considered separately. However, carbohydrates and fats can generally ‘compete’ for clearance from the stomach, small intestine, bloodstream and within the peripheral cell. Further, there are previous data demonstrating that the addition of carbohydrate to a high-fat meal blunts the postprandial lipaemic response, and the addition of fat to a high-carbohydrate meal blunts the postprandial glycaemic response. Thus, postprandial glycaemia and lipaemia are interrelated. The purpose of this brief review is 2-fold: first, to review the current evidence implicating postprandial glycaemia and lipaemia in chronic disease risk, and, second, to examine the possible utility of a single postprandial glycaemic and lipaemic summative value, which will be referred to as the metabolic load index. The potential benefits of the metabolic load index extend to the clinician, patient and researcher.
Emergency department (ED) crowding is a significant problem in Canada and has been associated with decreased quality of care in general and pediatric emergency departments (PEDs). Although boarding of admitted patients in the ED is the main contributor to adult ED overcrowding, factors involved in PED crowding may be different. The objective of this study was to report the trend in PED services use and to document the degree of overcrowding experienced in a Canadian PED.
A retrospective cohort study was conducted using administrative data from a tertiary care PED from 2002 to 2011. The primary outcome was PED use (total volume of visits and case severity per triage levels using the Canadian Triage and Acuity Scale [CTAS] score and admissions). Secondary outcomes included measures of PED overcrowding, such as rates of patients leaving without being seen (LWBS) and length of stay (LOS).
Total volumes increased by 30% over the 10-year study period, whereas hospitalizations remained stable at approximately 10%. Trends in CTAS levels did not indicate meaningful changes in the severity of cases treated at our PED. LWBS proportions among CTAS 3, CTAS 4, and CTAS 5 groups and LOS for all CTAS groups progressively and statistically increased from year to year.
Over the course of the study period, there was a substantial increase in PED visits,which likely contributed to the worsening markers of PED flow outcomes. Further study into the effects of PED crowding on patient outcomes is warranted.
The Vista Variables in the Vía Láctea (VVV) ESO Public Survey is an ongoing time-series, near-infrared (IR) survey of the Galactic bulge and an adjacent portion of the inner disk, covering 562 square degrees of the sky, using ESO's VISTA telescope. The survey has provided superb multi-color photometry in 5 broadband filters (Z, Y, J, H, and Ks), leading to the best map of the inner Milky Way ever obtained, particularly in the near-IR. The main part of the survey, which is focused on the variability in the Ks-band, is currently underway, with bulge fields observed between 34 and 73 times, and disk fields between 34 and 36 times. When the survey is complete, bulge (disk) fields will have been observed up to a total of 100 (60) times, providing unprecedented depth and time coverage in the near-IR. Here we provide a first overview of stellar variability in the VVV data.
Gases in microfluidic structures or devices are often in a non-equilibrium state. The conventional thermodynamic models for fluids and heat transfer break down and the Navier-Stokes-Fourier equations are no longer accurate or valid. In this paper, the extended thermodynamic approach is employed to study the rarefied gas flow in microstructures, including the heat transfer between a parallel channel andpressure-driven Poiseuille flows through a parallel microchannel andcircular microtube. The gas flow characteristics are studied and it is shown that the heat transfer in the non-equilibrium state no longer obeys the Fourier gradient transport law. In addition, the bimodal distribution of streamwise and spanwise velocity and temperature through a long circular microtube is captured for the first time.
The Magellanic System represents one of the best places to study the formation and evolution of galaxies. Photometric surveys of various depths, areas and wavelengths have had a significant impact on our understanding of the system; however, a complete picture is still lacking. VMC (the VISTA near-infrared YJKs survey of the Magellanic System) will provide new data to derive the spatially resolved star formation history and to construct a three-dimensional map of the system. These data combined with those from other ongoing and planned surveys will give us an absolutely unique view of the system opening up the doors to truly new science!
Hospital readmissions are a current target of initiatives to reduce healthcare costs. This study quantified the association between having a clinical culture positive for 1 of 3 prevalent hospital-associated organisms and time to hospital readmission.
Retrospective cohort study.
Patients and Setting.
Adults admitted to an academic, tertiary care referral center from January 1, 2001, through December 31, 2008.
The primary exposure of interest was a clinical culture positive for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), or Clostridium difficile obtained more than 48 hours after hospital admission during the index hospital stay. The primary outcome of interest was time to readmission to the index facility. Multivariable Cox proportional hazards models were used to model the adjusted association between positive clinical culture result and time to readmission and to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
Among 136,513 index admissions, the prevalence of hospital-associated positive clinical culture result for 1 of the 3 organisms of interest was 3%, and 35% of patients were readmitted to the index facility within 1 year after discharge. Patients with a positive clinical culture obtained more than 48 hours after hospital admission had an increased hazard of readmission (HR, 1.40; 95% CI, 1.33–1.46) after adjusting for age, sex, index admission length of stay, intensive care unit stay, Charlson comorbidity index, and year of hospital admission.
Patients with healthcare-associated infections may be at increased risk of hospital readmission. These findings may be used to impact health outcomes after discharge from the hospital and to encourage better infection prevention efforts.
This study estimated the frequency of exposure of meat workers to carcasses infected with Leptospira serovars Hardjobovis or Pomona in a sheep-only abattoir in New Zealand. A stochastic spreadsheet model was developed to assess the daily risk of exposure of eviscerators, meat inspectors and offal handlers to live leptospires in sheep carcasses from May to November 2004 (high-risk period), and from December 2004 to June 2005 (low-risk period). The average sheep processed per day were 225 for an eviscerator, 374 for a meat inspector, and 1123 for an offal handler. The median daily exposures during high- and low-risk periods were 11 [95% distribution interval (DI) 5–19] and three (95% DI 1–8) infected carcasses/day for eviscerators, 18 (95% DI 9–29) and six (95% DI 2–12) for meat inspectors, and 54 (95% DI 32–83) and 18 (95% DI 8–31) for offal handlers, respectively. Stochastic risk modelling provided evidence that processing of sheep carcasses exposed meat workers regularly to live leptospires with substantial seasonal variation.
The epidemiology of human campylobacteriosis is complex but in recent years understanding of this disease has advanced considerably. Despite being a major public health concern in many countries, the presence of multiple hosts, genotypes and transmission pathways has made it difficult to identify and quantify the determinants of human infection and disease. This has delayed the development of successful intervention programmes for this disease in many countries including New Zealand, a country with a comparatively high, yet until recently poorly understood, rate of notified disease. This study investigated the epidemiology of Campylobacter jejuni at the genotype-level over a 3-year period between 2005 and 2008 using multilocus sequence typing. By combining epidemiological surveillance and population genetics, a dominant, internationally rare strain of C. jejuni (ST474) was identified, and most human cases (65·7%) were found to be caused by only seven different genotypes. Source association of genotypes was used to identify risk factors at the genotype-level through multivariable logistic regression and a spatial model. Poultry-associated cases were more likely to be found in urban areas compared to rural areas. In particular young children in rural areas had a higher risk of infection with ruminant strains than their urban counterparts. These findings provide important information for the implementation of pathway-specific control strategies.
Field studies were conducted in 2005 at five locations throughout Illinois to determine the effect of maturity date and canopy width characteristics of selected glyphosate-resistant soybean cultivars on competitive ability against weeds. Natural weed populations at all sites were allowed to compete with the soybean cultivars until the V1, V3, V5, or V7 growth stage and then removed with an application of glyphosate. Light-interception readings, weed control ratings, and soybean yield were all measured to compare cultivars. Cultivars of later maturities tended to withstand early season weed competition better and attained higher yields when weeds were removed at later timings than those of earlier maturity. Although canopy width differed moderately among cultivars in some cases, canopy width had no effect on the ability of soybeans to compete with weeds. Thus, choosing soybean cultivars of later maturity might provide more flexibility in weed management and might reduce losses due to weeds, but that benefit needs to be balanced with yield potential.
Planting date of soybean may be one factor that affects the crop's ability to compete with weeds. Field experiments were conducted over 3 yr at two locations in Illinois to determine whether planting date affects optimal weed management strategies and the critical time of weed removal (CTWR) in glyphosate-resistant soybean. Across planting dates, a PRE application of metolachlor plus metribuzin followed by a single glyphosate application at a 10- or 20-cm weed height at Monmouth or at a 20-cm weed height at Urbana was effective at protecting yield. At Monmouth, higher yields occurred with sequential glyphosate applications than with a single application in the early planting in 2 yr when weeds were removed at a height of 10 cm. Across planting dates, highest yields at Monmouth occurred with a single glyphosate application when weeds were 20 to 30 cm tall. At Urbana, the CTWR was not affected by planting date and occurred between 176 and 290 growing-degree days (GDD) after planting, corresponding to the V1 to V2 stage of soybean development and a weed height of 11 to 19 cm. Applying glyphosate near the CTWR at Urbana (10-cm weed height) required a sequential application to prevent yield loss with early and middle planting dates in 1 of 3 yr. Overall, planting date did not affect optimal weed management strategies at either location.
The establishment of the UK Applied Aerodynamics Consortium in 2004 brought together many of the UK’s leading research groups to tackle challenging aerodynamic problems on the national computing facility, HPCx. This paper provides a brief history of some early pioneers of numerical simulation and highlights some key contributions to development in parallel processing that laid the foundations for today’s researchers. The transition from vector to massively parallel processing is discussed from a UK viewpoint along with technological barriers that could have a significant impact on future systems. Solutions to these barriers are already being sought and the paper discussed some of the novel technologies that may be deployed in the future. In its short history, the consortium has made substantial progress and this is briefly discussed with several highlights that illustrate the scientific output. Although a number of challenges are identified, particularly with respect to developing a comprehensive visualisation capability, the consortium is well placed to build upon its initial success.
We report on an approach towards integrated complementary-like circuits based on organic ambipolar transistors. In particular, we show that ambipolar transport can be achieved within a single transistor channel using gold electrodes and a solution processable polymer-small molecule blend as the electroactive material. To demonstrate the suitability of these devices for practical utilisation in logic circuits we realise complementary-like voltage inverters comprised entirely of ambipolar transistors. Moreover, by integrating several such inverters we are able to demonstrate more complex circuits such as ring oscillators.
Novel poly(3,6-hexyl-2,7-N-octylcarbazole) derivatives and poly(diindolocarbazole)s were synthesized. Optical, electrochemical, electrical and thermoelectric properties were investigated. Band structure calculations were used to predict which polymers were promising as thermoelectric materials. The best combination of Seebeck coefficient and conductivity (power factor) was 9,4 x10-8 Wm-1K-2 with a copolymer of carbazole and thiophene. This corresponds to a ZT at room temperature of 0.0003. Optimization of the polymer structure and doping level should lead to an increased ZT.
We use ultraviolet photoelectron spectroscopy to investigate the effect of oxygen and air exposure on the electronic structure of pentacene thin films. It is found that O2 and water do not react noticeably with pentacene, whereas singlet oxygen/ozone readily oxidize the organic compound. Also, we obtain no evidence for considerable p-type doping of pentacene by O2 at low pressure. However, oxygen exposure lowers the hole injection barrier at the interface between Au and pentacene by 0.25 eV, presumably due to a modification of the Au surface.
Spin polarized charge carrier injection and transport in non-magnetic semiconductors is a key enabling mechanism for spin based electronic data processing. We present theoretical models to describe spin injection and spin transport in structures consisting of a ferromagnetic metal injector, a thin semiconductor layer, and a ferromagnetic metal collector. The semiconductors considered are conjugated polymers (e.g. PPV), small-molecule organic molecular crystals (e.g. pentacene), and inorganic semiconductors (e.g. silicon). In thermal equilibrium the charge carriers in these semiconductors are not spin polarized. Efficient spin injection requires that the semiconductor be driven far out of local thermal equilibrium. Since carrier mobilities (and other relevant parameters) in polymers, organic molecular crystals, and inorganic semiconductors differ by many orders of magnitude, their charge carrier injection characteristics differ significantly.
We describe how the composition of an organic - based magnet can be controlled by varying the Chemical Vapor Deposition (CVD) conditions. A study was conducted for the Co2(CO)8/ TCNE system to form cobalt tetracyanoethylene [Co(TCNE)x, x∼2, a paramagnetic material], and for the V(CO)6/ TCNEx system to form vanadium tetracyanoethylene [V(TCNE)x, x∼2, a ferrimagnetic material]. Thin V(TCNE)x, x∼2 films (∼0.05-0.5 μm) with room temperature conductivity of 10-4<σRT<10-3S/cm and magnetic ordering temperature Tc of up to ∼400K were deposited. The V(TCNE)x, x∼2 thin films have the potential for incorporation in a spin-valve device as one of the magnetic contacts, and are promising candidates to form optically controlled magnetic-based structures.
The DC characteristics of a Schottky contact between regioregular poly (3-hexylthiophene) and aluminum are studied in forward and reverse bias regimes. Current-voltage curves of the junction in reverse bias show a resistive path in parallel with the expected Schottky contact. This is the sign of a nonuniform junction between the metal and semiconductor that exhibits ohmic behavior in some regions. Reduction of this parallel resistance and degradation of the Schottky junction are observed over a period of two weeks. Accumulation of undesired ions in the polymer or diffusion of aluminum atoms into the semiconductor are two possible mechanisms which may explain the time dependent behavior of these Schottky junctions.
Polypyrrole exhibits actuation under electrochemical doping and undoping of the polymer matrix. Active strain and x-ray diffraction measurements are performed in order to correlate the microscopic and macroscopic structural changes occurring during actuation. Under galvanostatic reduction, the film shows first a linear contraction with oxidation state due to expulsion of small anions. At 50% of the as-grown doping level, the film reverses direction and begins to expand, possibly due to incorporation of the larger cations. X-ray diffraction, however, does not show a linear contraction or expansion in the crystalline portions of the polymer. The polymer crystallites go through a sudden contraction in one dimension of approximately 14%, and otherwise remain constant. The contraction in the polypyrrole crystals occurs at the 50% doping level, and may be correlated with the reversal of macroscopic actuation.