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The mammal family Tenrecidae (Afrotheria: Afrosoricida) is endemic to Madagascar. Here we present the conservation priorities for the 31 species of tenrec that were assessed or reassessed in 2015–2016 for the IUCN Red List of Threatened Species. Six species (19.4%) were found to be threatened (4 Vulnerable, 2 Endangered) and one species was categorized as Data Deficient. The primary threat to tenrecs is habitat loss, mostly as a result of slash-and-burn agriculture, but some species are also threatened by hunting and incidental capture in fishing traps. In the longer term, climate change is expected to alter tenrec habitats and ranges. However, the lack of data for most tenrecs on population size, ecology and distribution, together with frequent changes in taxonomy (with many cryptic species being discovered based on genetic analyses) and the poorly understood impact of bushmeat hunting on spiny species (Tenrecinae), hinders conservation planning. Priority conservation actions are presented for Madagascar's tenrecs for the first time since 1990 and focus on conserving forest habitat (especially through improved management of protected areas) and filling essential knowledge gaps. Tenrec research, monitoring and conservation should be integrated into broader sustainable development objectives and programmes targeting higher profile species, such as lemurs, if we are to see an improvement in the conservation status of tenrecs in the near future.
Targeted screening for carbapenem-resistant organisms (CROs), including carbapenem-resistant Enterobacteriaceae (CRE) and carbapenemase-producing organisms (CPOs), remains limited; recent data suggest that existing policies miss many carriers.
Our objective was to measure the prevalence of CRO and CPO perirectal colonization at hospital unit admission and to use machine learning methods to predict probability of CRO and/or CPO carriage.
We performed an observational cohort study of all patients admitted to the medical intensive care unit (MICU) or solid organ transplant (SOT) unit at The Johns Hopkins Hospital between July 1, 2016 and July 1, 2017. Admission perirectal swabs were screened for CROs and CPOs. More than 125 variables capturing preadmission clinical and demographic characteristics were collected from the electronic medical record (EMR) system. We developed models to predict colonization probabilities using decision tree learning.
Evaluating 2,878 admission swabs from 2,165 patients, we found that 7.5% and 1.3% of swabs were CRO and CPO positive, respectively. Organism and carbapenemase diversity among CPO isolates was high. Despite including many characteristics commonly associated with CRO/CPO carriage or infection, overall, decision tree models poorly predicted CRO and CPO colonization (C statistics, 0.57 and 0.58, respectively). In subgroup analyses, however, models did accurately identify patients with recent CRO-positive cultures who use proton-pump inhibitors as having a high likelihood of CRO colonization.
In this inpatient population, CRO carriage was infrequent but was higher than previously published estimates. Despite including many variables associated with CRO/CPO carriage, models poorly predicted colonization status, likely due to significant host and organism heterogeneity.
Timely identification of multidrug-resistant gram-negative infections remains an epidemiological challenge. Statistical models for predicting drug resistance can offer utility where rapid diagnostics are unavailable or resource-impractical. Logistic regression–derived risk scores are common in the healthcare epidemiology literature. Machine learning–derived decision trees are an alternative approach for developing decision support tools. Our group previously reported on a decision tree for predicting ESBL bloodstream infections. Our objective in the current study was to develop a risk score from the same ESBL dataset to compare these 2 methods and to offer general guiding principles for using each approach.
Using a dataset of 1,288 patients with Escherichia coli or Klebsiella spp bacteremia, we generated a risk score to predict the likelihood that a bacteremic patient was infected with an ESBL-producer. We evaluated discrimination (original and cross-validated models) using receiver operating characteristic curves and C statistics. We compared risk score and decision tree performance, and we reviewed their practical and methodological attributes.
In total, 194 patients (15%) were infected with ESBL-producing bacteremia. The clinical risk score included 14 variables, compared to the 5 decision-tree variables. The positive and negative predictive values of the risk score and decision tree were similar (>90%), but the C statistic of the risk score (0.87) was 10% higher.
A decision tree and risk score performed similarly for predicting ESBL infection. The decision tree was more user-friendly, with fewer variables for the end user, whereas the risk score offered higher discrimination and greater flexibility for adjusting sensitivity and specificity.
Using samples collected for VRE surveillance, we evaluated unit admission prevalence of carbapenem-resistant Enterobacteriaceae (CRE) perirectal colonization and whether CRE carriers (unknown to staff) were on contact precautions for other indications. CRE colonization at unit admission was infrequent (3.9%). Most CRE carriers were not on contact precautions, representing a reservoir for healthcare-associated CRE transmission.
Psychotropic medication use and psychiatric symptoms during pregnancy each are associated with adverse neurodevelopmental outcomes in offspring. Commonly, studies considering medication effects do not adequately assess symptoms, nor evaluate children when the effects are believed to occur, the fetal period. This study examined maternal serotonin reuptake inhibitor and polypharmacy use in relation to serial assessments of five indices of fetal neurobehavior and Bayley Scales of Infant Development at 12 months in N = 161 socioeconomically advantaged, non-Hispanic White women with a shared risk phenotype, diagnosed major depressive disorder. On average fetuses showed the expected development over gestation. In contrast, infant average Bayley psychomotor and mental development scores were low (M = 84.10 and M = 89.92, range of normal limits 85–114) with rates of delay more than 2–3 times what would be expected based on this measure's normative data. Controlling for prenatal and postnatal depressive symptoms, prenatal medication effects on neurobehavioral development were largely undetected in the fetus and infant. Mental health care directed primarily at symptoms may not address the additional psychosocial needs of women parenting infants. Speculatively, prenatal serotonin reuptake inhibitor exposure may act as a plasticity rather than risk factor, potentially enhancing receptivity to a nonoptimal postnatal environment in some mother–infant dyads.
Selenium is an essential nutrient for dairy cattle, being a key component of the anti-oxidative protection mechanism. With over 20 seleno-proteins being identified in the body as important nutrients or co-factors for the physiological processes involving production, health and fertility, the need for ensuring a selenium supply which is both efficacious and safe has increased dramatically. Key roles of selenium include supporting the immune function and fertility. In terms of reproduction its main action is to protect the developing embryo from oxidative damage. Concern over the sufficiency of selenium supply has increased in recent years and it is well recognised that the British Isles is deficient in selenium as measured in soils and crops. As a consequence, the animal is totally dependent for its selenium supply on concentrated feedstuffs and mineral supplements. There is a cautious approach to dietary supplementation of selenium because of its toxicity even though a legal limit of 0.50 mg/kg in dairy complete feeds applies. It is also recognised that traditional sources of selenium (sodium selenite) have limited availability and utilisation within the animal. Considerable research effort has been directed at evaluating the key selenium metabolite “L-Selenomethionine” as a potential dietary selenium source. Much of the naturally supplied selenium from feedingstuffs is in this form. Supplying a significant proportion of selenium in the organic methionine form has been found to both reduce potential toxicity problems and boost absorption. The aim of this trial was to compare two selenium supplements, selenium selenite (inorganic) and selenium metalosate (organic) in the dairy cows diet and investigate effects on milk yield, milk composition and hygiene, and fertility.
Machines that learn and think like people must be able to learn from others. Social learning speeds up the learning process and – in combination with language – is a gateway to abstract and unobservable information. Social learning also facilitates the accumulation of knowledge across generations, helping people and artificial intelligences learn things that no individual could learn in a lifetime.
This paper describes the first results from an experiment to measure the fracture toughness of ice. Two experimental techniques have been used; fracture of pre-notched rectangular specimens in three- and four-point bending, and from the observation of the cracks which form underneath an indenter forced into the ice surface. In the latter test the indenter behaves like a wedge. We have observed that for indenters with large interior angles the plastic zone beneath the indenter may itself behave like a wedge. Data obtained over a range of temperatures has been compared with the little other data available. We find a decrease of fracture toughness as the temperature is lowered, which is the reverse of that observed by H. W. Liu and L. W. Loop.
The suggestion that patches of basal ice may freeze to the bed of a glacier due to certain regelation effects has been tested in the laboratory by applying high hydrostatic pressures to ice samples at the pressure-melting point. During compression, ice temperatures follow the pressure-melting point closely, but after rapid decompression the ice temperature at first returns only half to three-quarters of the way to the pressure-melting point, after which it appears to warm by thermal conduction from outside the ice sample. If the moving ice at the base of a glacier behaves in the same way as it is exposed to changing pressure fields, frozen patches at bedrock are to be expected.
Records of strain variations in a tunnel beneath Glacier d’Argentière show two types of strain events. The first is a rapid jump or offset in the recorded strain, while the second are strain excursions, initiated by a change in strain over a period up to ten seconds, followed by a gradual recovery to the original strain over some minutes. It is suggested that the offset events are due to nearby stress release due to fracturing of frozen patches of ice at the bedrock while the strain-excursion events show the more distant adjustment of the glacial bed to the former events due to the time lags associated with changes of water-film thickness and regelation heat flow.
One of the most conspicuous phenomena in the Arctic Is the fracture of sea ice. It is scarcely possible to travel far without seeing a variety of fracture forms, produced both by natural processes and by human activity.
At strain-rates below about 10−4 s−1, deformation is dominated by creep, but at higher strain-rates fracture is much more important. One of the reasons for this is the very low fracture toughness of ice. The movements of ice in contact with offshore structures often induce strain-rates well beyond the level at which fracture begins, and so offshore structures will often operate in the fracture regime, and it is fracture processes which will determine the design loads. We consider the different modes of repeated fracture that will occur, and classify them into distinct mechanisms of crushing, spalling, and radial and circumferential cracking. Experimental and field observations are plotted on a deformation mode map. A theoretical treatment of radial cracking confirms that very low loads can propagate cracks to long distances; these loads are small by comparison with those calculated from theoretical models that treat ice as a plastically-deforming continuum.
Measurements of surface strain and vertical heave responses to swell were made on a tabular ice island in Kong Oscars Fjord, east Greenland, in September 1978. At two sites surface strain was measured with a wire strainmeter of 2 m gauge length, and heave was measured with a vertical accelerometer. While the first site was occupied a simultaneous measurement of ambient wave energy was made with a wave buoy. The results show that the ice island flexes and heaves in response to the longest component only of the forcing wave field, at periods above 16 s, and with a mean strain amplitude of the order of 5 × 10−7. The results are compared with theoretical calculations of the response of a thick floating beam. In the light of the theory, the flexural behaviour of tabular icebergs and sea-ice floes is considered and their critical size ranges in relation to sea state are estimated.
The identification of the factors that influence the persistence of psychiatric disorder may assist practitioners to focus on young people who are particularly prone to poor outcomes, but population-based samples of sufficient size are rare.
This secondary analysis combined data from two large, population-based cross-sectional surveys in Great Britain (1999 and 2004) and their respective follow-ups (2002 and 2007), to study homotypic persistence among the 998 school-age children with psychiatric disorder at baseline. Psychiatric disorder was measured using the Development and Well-Being Assessment applying DSM-IV criteria. Factors relating to the child, family, and the severity and type of psychopathology at baseline were analysed using logistic regression.
Approximately 50% of children with at least one psychiatric disorder were assigned the same diagnostic grouping at 3-year follow-up. Persistent attention-deficit/hyperactivity disorder and anxiety were predicted by poor peer relationship scores. Persistent conduct disorder was predicted by intellectual disability, rented housing, large family size, poor family function and by severer baseline psychopathology scores.
Homotypic persistence was predicted by different factors for different groups of psychiatric disorders. Experimental research in clinical samples should explore whether these factors also influence response to interventions.
Nickel–molybdenum (Ni–Mo) materials are widely used functional oxide catalysts for the hydrogen evolution reaction. In this work, we investigate the high activity of Ni–Mo by depositing size-controlled Ni nanocrystals (NCs) onto Mo substrates. We observe a synergistic increase in catalytic activity that does not scale with the Ni–Mo interface length. This evidence points to a bulk electronic interaction of the two metals that is separate from the mechanism of enhancement seen in conventionally co-deposited Ni–Mo electrocatalysts. In addition to elucidating the catalytic behavior of the Ni–Mo system, this work offers a general NC-based paradigm for investigating fundamental interactions and synergistic effects in electrocatalytic materials.
Several studies in the last decade have explored dramatic instances of refractive fringing in dynamic spectra. We draw attention to a subtler but more widespread refractive effect: wisp-like structures extending (either linearly or with curvature) outward from the origin in the secondary spectrum plane. We have employed a simple pinhole screen simulation to investigate this phenomenon. It appears that the presence of one or more wisps in a secondary spectrum indicates a clump of scattering material that is significantly offset from the optical axis. Unlike the dramatic fringing events that have been investigated in the past, however, the interference that gives rise to a wisp is interference between rays within a scattering clump rather than between two major ray bundles. Furthermore, the scattering clump must be significantly elongated along the direction of pulsar motion. The range of fringe spacings that this produces, all with a similar slope in the secondary spectrum, gives rise to the linear extent of the wisp in the secondary spectrum.
Techniques for preventing crazyweed toxicity in livestock have generally fallen into two categories: excluding livestock access to infested ranges during early spring and fall, and controlling crazyweed populations through herbicide application. Although picloram has been used to control crazyweed effectively in the past, aminopyralid has shown efficacy at lower application rates, exhibits less potential off-target movement, and has been classified as a reduced-risk product. Differences in the response of silky crazyweed and nontarget grasses and forbs to picloram + 2,4-D and aminopyralid + 2,4-D were investigated. Picloram + 2,4-D was applied at a rate of 0.3 kg ae ha−1 picloram + 1.1 kg ae ha−1 2,4-D, and aminopyralid + 2,4-D was applied at a rate of 0.1 kg ae ha−1 aminopyralid + 1.2 kg ae ha−1 2,4-D. Silky crazyweed canopy cover, number of flowering stalks, plant size, and biomass decreased 15 mo after herbicide treatments (MAT) with average percentage of relative reductions of 92, 95, 90, and 99%, respectively. Crazyweed density decreased by 1.5 ± 0.2 SE plants m−2 and 1.3 ± 0.2 plants m−2, a relative reduction of 95 and 80%, 15 MAT in aminopyralid + 2,4-D– and picloram + 2,4-D–treated plots, respectively. Plots treated with aminopyralid + 2,4-D had 4% lower nontarget forb canopy cover than did picloram + 2,4-D plots 15 MAT. Grass biomass remained similar within treatments over time for control, aminopyralid + 2,4-D and picloram +2,4-D plots, and was similar in all plots 15 MAT. Plots treated with herbicides had, on average, 11% greater grass cover than did control plots 15 MAT (aminopyralid + 2,4-D: 89%; picloram + 2,4-D: 85%; control: 76%).
Suicide is a devastating public health problem and very few biological treatments have been found to be effective for quickly reducing the intensity of suicidal ideation (SI). We have previously shown that a single dose of ketamine, a glutamate N-methyl-d-aspartate (NMDA) receptor antagonist, is associated with a rapid reduction in depressive symptom severity and SI in patients with treatment-resistant depression.
We conducted a randomized, controlled trial of ketamine in patients with mood and anxiety spectrum disorders who presented with clinically significant SI (n = 24). Patients received a single infusion of ketamine or midazolam (as an active placebo) in addition to standard of care. SI measured using the Beck Scale for Suicidal Ideation (BSI) 24 h post-treatment represented the primary outcome. Secondary outcomes included the Montgomery–Asberg Depression Rating Scale – Suicidal Ideation (MADRS-SI) score at 24 h and additional measures beyond the 24-h time-point.
The intervention was well tolerated and no dropouts occurred during the primary 7-day assessment period. BSI score was not different between the treatment groups at 24 h (p = 0.32); however, a significant difference emerged at 48 h (p = 0.047). MADRS-SI score was lower in the ketamine group compared to midazolam group at 24 h (p = 0.05). The treatment effect was no longer significant at the end of the 7-day assessment period.
The current findings provide initial support for the safety and tolerability of ketamine as an intervention for SI in patients who are at elevated risk for suicidal behavior. Larger, well-powered studies are warranted.
Helicobacter pylori infection is a major cause of peptic ulcer and is also associated with chronic gastritis, mucosa-associated lymphoid tissue (MALT) lymphoma, and adenocarcinoma of the stomach. Guidelines have been developed in the United States and Europe (areas with low prevalence) for the diagnosis and management of this infection, including the recommendation to ‘test and treat’ those with dyspepsia. A group of international experts performed a targeted literature review and formulated an expert opinion for evidenced-based benefits and harms for screening and treatment of H. pylori in high-prevalence countries. They concluded that in Arctic countries where H. pylori prevalence exceeds 60%, treatment of persons with H. pylori infection should be limited only to instances where there is strong evidence of direct benefit in reduction of morbidity and mortality, associated peptic ulcer disease and MALT lymphoma and that the test-and-treat strategy may not be beneficial for those with dyspepsia.