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Introduction: Gastroenteritis accounts for 1.7 million emergency department visits by children annually in the United States. We conducted a double-blind trial to determine whether twice daily probiotic administration for 5 days, improves outcomes. Methods: 886 children aged 348 months with gastroenteritis were enrolled in six Canadian pediatric emergency departments. Participants were randomly assigned to twice daily Lactobacillus rhamnosus R0011 and Lactobacillus helveticus R0052, 4.0 x 109 CFU, in a 95:5 ratio or placebo. Primary outcome was development of moderate-severe disease within 14 days of randomization defined by a Modified Vesikari Scale score 9. Secondary outcomes included duration of diarrhea and vomiting, subsequent physician visits and adverse events. Results: Moderate-severe disease occurred in 108 (26.1%) participants administered probiotics and 102 (24.7%) participants allocated to placebo (OR 1.06; 95%CI: 0.77, 1.46; P=0.72). After adjustment for site, age, and frequency of vomiting and diarrhea, treatment assignment did not predict moderate-severe disease (OR, 1.11, 95%CI, 0.80 to 1.56; P=0.53). In the probiotic versus placebo groups, there were no differences in the median duration of diarrhea [52.5 (18.3, 95.8) vs. 55.5 (20.2, 102.3) hours; P=0.31], vomiting [17.7 (0, 58.6) vs. 18.7 (0, 51.6) hours; P=0.18], physician visits (30.2% vs. 26.6%; OR 1.19; 95% CI0.87. 1.62; P=0.27), or adverse events (32.9% vs. 36.8%; OR 0.83; 95%CI 0.62. 1.11; P=0.21). Conclusion: In children presenting to an emergency department with gastroenteritis, twice daily administration of 4.0 x 109 CFU of a Lactobacillus rhamnosus/helveticus probiotic does not prevent development of moderate-severe disease or improvements in other outcomes measured.
Introduction: Community Paramedics (CPs) require access to timely blood analysis in the field to guide treatment and transport decisions. Point of care testing (POCT), as opposed to traditional laboratory analysis, may offer a solution, but limited research exists on CP POCT. The objective of this study is to compare the validity of two POCT devices (Abbott i-STAT® and Alere epoc®) and their use by CPs in the community. Methods: In a CP programme responding to 6,000 annual patient care events, a split sample validation of POCT against traditional laboratory analysis for seven analytes (sodium, potassium, chloride, creatinine, hemoglobin, hematocrit, and glucose) was conducted on a consecutive sample of patients. The difference of proportion of discrepant results between POCT and laboratory was compared using a two sample proportion test. Usability was analysed by survey of CP experience, an expert heuristic evaluation of devices, a review of device-logged errors, coded observations of POCT use during quality control testing, and a linear mixed effects model of Systems Usability Scale (SUS) adjusted for CP clinical and POCT experience. Results: Of 1,649 CP calls for service screened for enrollment, 174 had a blood draw, with 108 patient care encounters (62.1%) enrolled from 73 participants. Participants had a mean age of 58.7 years (SD16.3); 49% were female. In 4 of 646 (0.6%) individual comparisons, POCT reported a critical value that the laboratory did not; with no statistically significant difference in the number of discrepant critical values reported with epoc® compared to i-STAT®. There were no instances of the laboratory reporting a critical value when POCT did not. In 88 of 1,046 (8.4%) individual comparisons, the a priori defined acceptable difference between POCT and the laboratory was exceeded; occurring more often in epoc® (10.7%;95%CI:8.1%,13.3%) compared to i-STAT® (6.1%;95%CI:4.1%,8.2%)(p=0.007). Eighteen of 19 CP surveys were returned, with 11/18 (61.1%) preferring i-STAT® over epoc®. The i-STAT® had a higher mean SUS score (higher usability) compared to the epoc® (84.0/100 vs. 59.6/100; p=0.011). Fewer field blood analysis device-logged errors occurred in i-STAT® (7.8%;95%CI:2.9%,12.7%) compared to epoc® (15.5%;95%CI:9.3%,21.7%) although not statistically significant (p=0.063). Conclusion: CP programs can expect valid results from POCT. Usability assessment suggests a preference for i-STAT.
An updated compilation of published and new data of major-ion (Ca, Cl, K, Mg, Na, NO3, SO4) and methylsulfonate (MS) concentrations in snow from 520 Antarctic sites is provided by the national ITASE (International Trans-Antarctic Scientific Expedition) programmes of Australia, Brazil, China, Germany, Italy, Japan, Korea, New Zealand, Norway, the United Kingdom, the United States and the national Antarctic programme of Finland. The comparison shows that snow chemistry concentrations vary by up to four orders of magnitude across Antarctica and exhibit distinct geographical patterns. The Antarctic-wide comparison of glaciochemical records provides a unique opportunity to improve our understanding of the fundamental factors that ultimately control the chemistry of snow or ice samples. This paper aims to initiate data compilation and administration in order to provide a framework for facilitation of Antarctic-wide snow chemistry discussions across all ITASE nations and other contributing groups. The data are made available through the ITASE web page (http://www2.umaine.edu/itase/content/syngroups/snowchem.html) and will be updated with new data as they are provided. In addition, recommendations for future research efforts are summarized.
We report on an effort to identify further members of the dwarf carbon class and new members of a putative dwarf S group in the general field through determination of proper motions of catalogued stars. Examination of nearly 1500 C stars and over 300 S stars reveals some interesting false alarms but no new dwarf members of these classes.
We describe a program of determining proper motions from digitized scans of Palomar Oschin Schmidt telescope plates at the Space Telescope Science Institute. Our method is most useful over 11 ≲ V ≲ 18 and .
In an attempt to distill what we know about the effects of workplace mindfulness-based training, Hyland, Lee, and Mills (2015) cast a wide net with regard to the array of studies included in their review. For example, they include studies that investigate the benefits associated with workplace mindfulness training (e.g., Wolever et al., 2012) as well as training conducted for patients within primary care settings (e.g., Allen, Bromley, Kuyken, & Sonnenberg, 2009). In addition, their review includes studies based on self-reports of individual differences in mindfulness traits/skills (e.g., Hafenbrack, Kinias, & Barsade, 2014). Reviewing a broad cross-section of research is helpful to illustrate the wide-ranging nature of mindfulness research but also has the potential to obfuscate what we know about mindfulness as it pertains to workers and workplaces.
Depression and diabetes commonly co-occur; however, the strength of the physiological effects of diabetes as mediating factors towards depression is uncertain.
We analyzed extensive clinical, epidemiological and laboratory data from n = 2081 Mexican Americans aged 35–64 years, recruited from the community as part of the Cameron County Hispanic Cohort (CCHC) divided into three groups: Diagnosed (self-reported) diabetes (DD, n = 335), Undiagnosed diabetes (UD, n = 227) and No diabetes (ND, n = 1519). UD participants denied being diagnosed with diabetes, but on testing met the 2010 American Diabetes Association and World Health Organization definitions of diabetes. Depression was measured using the Center for Epidemiological Studies – Depression (CES-D) scale. Weighted data were analyzed using dimensional and categorical outcomes using univariate and multivariate models.
The DD group had significantly higher CES-D scores than both the ND and UD (p ⩽ 0.001) groups, whereas the ND and UD groups did not significantly differ from each other. The DD subjects were more likely to meet the CES-D cut-off score for depression compared to both the ND and UD groups (p = 0.001), respectively. The UD group was also less likely to meet the cut-off score for depression than the ND group (p = 0.003). Our main findings remained significant in models that controlled for socio-demographic and clinical confounders.
Meeting clinical criteria for diabetes was not sufficient for increased depressive symptoms. Our findings suggest that the ‘knowing that one is ill’ is associated with depressive symptoms in diabetic subjects.
We carried out an extensive photometric and spectroscopic investigation of the SPB binary, HD 25558 (see Fig. 1 for the time and geographic distribution of the observations). The ~2000 spectra obtained at 13 observatories during 5 observing seasons, the ground-based multi-colour light curves and the photometric data from the MOST satellite revealed that this object is a double-lined spectroscopic binary with a very long orbital period of about 9 years. We determined the physical parameters of the components, and have found that both lie within the SPB instability strip. Accordingly, both components show line-profile variations consistent with stellar pulsations. Altogether, 11 independent frequencies and one harmonic frequency were identified in the data. The observational data do not allow the inference of a reliable orbital solution, thus, disentangling cannot be performed on the spectra. Since the lines of the two components are never completely separated, the analysis is very complicated. Nevertheless, pixel-by-pixel variability analysis of the cross-correlated line profiles was successful, and we were able to attribute all the frequencies to the primary or secondary component. Spectroscopic and photometric mode-identification was also performed for several of these frequencies of both binary components. The spectroscopic mode-identification results suggest that the inclination and rotation of the two components are rather different. While the primary is a slow rotator with ~6 d rotation period, seen at ~60° inclination, the secondary rotates fast with ~1.2 d rotation period, and is seen at ~20° inclination. Our spectropolarimetric measurements revealed that the secondary component has a magnetic field with at least a few hundred Gauss strength, while no magnetic field was detected in the primary.
The detailed analysis and results of this study will be published elsewhere.
In recent years both the prevalence and duration of breast-feeding have decreased, especially in urban areas of the developing world (McCann et al., 1981). While the majority of births in these areas continue to be attended by traditional birth attendants, the proportion of mothers giving birth in hospitals is increasing. The potential for hospital personnel and practices to affect infant feeding preferences is likely to increase as the trend towards hospital births continues.
The objective of this study is to learn if participants with Parkinson disease (PD), when compared to normal controls, are impaired in making simultaneous but independent right and left hand movements. Participants were tested with Luria's Alternating Hand Postures (AHP) test and modified AHP tests. Twelve PD participants without dementia and twelve matched controls were assessed for their ability to perform the parallel AHP test (both hands remaining in the same coronal plane) and with modifications of this test into swimming (alternative arm extension with finger extension and arm flexion with finger flexion) and reverse swimming (alternative arm extension—finger flexion and arm flexion—finger extension) movements. The participants with PD were significantly impaired when performing the parallel and the reverse swimming movements AHP tests, but not impaired on the swimming movements AHP test. Swimming movements may be phylogenetically and ontogenetically more primitive and not as heavily dependent on frontal-basal ganglia networks; thus performance of swimming movements during the parallel AHP test may decrease this test's sensitivity. (JINS, 2011, 17, 702–708)
We examined the Cu(In,Ga)Se2 thin-film growth from (In,Ga)2Se3 precursors and found that the evolution of the microstructure and intrinsic native defects depends on the compositional changes that occur as the film transitions from being Cu rich to In(Ga) rich.
Hydrogenated microcrystalline silicon (m c-Si:H) solar cells with different thicknesses were deposited on specular stainless steel substrates and on textured Ag/ZnO back reflectors using RF and modified very high frequency glow discharge at various deposition rates. Raman spectra and X-ray diffraction patterns exhibit a significant increase of microcrystalline volume fraction and in grain size with film thickness. Atomic force microscopy reveals an increase in the size of microstructural features and the surface roughness with increasing thickness. Based on these results, we believe that the increase of the microcrystalline phase with thickness is the main reason for the deterioration of cell performance with the thickness of the intrinsic layer. To overcome this problem, we have developed a procedure of varying the hydrogen dilution ratio during deposition. Using this method, we have been successful in controlling the microstructure evolution and achieved an initial active-area efficiency of 8.4% for a c-Si:H single-junction solar cell, and 13.6% for an a-Si:H/a-SiGe:H/m c-Si:H triple-junction solar cell.
The structure of a-Si:H, deposited at rates in excess of 100Å/s by the hot wire chemical vapor deposition (HWCVD) technique, has been examined by x-ray diffraction (XRD), Raman spectroscopy, H evolution, and small-angle x-ray scattering (SAXS). As the film deposition rate (Rd) is increased, we find that the XRD, Raman and the H evolution peak curves are invariant with Rd, and exhibit structure consistent with state-of-the-art, compact a-Si:H films deposited at low Rd. The only exception is the SAXS signal, which increases by a factor of ∼100 over that for our best low Rd films. We relate changes in the film electronic structure (Urbach edge) to the increase in the SAXS signals. We also note the invariance of the saturated defect density versus Rd, and discuss possible reasons why the increase in the SAXS does not play a role in the Staebler-Wronski Effect for this type of material. Finally, device results are presented.
The structure of thin film SiN, deposited by the hot wire chemical vapor deposition (HWCVD) technique using SiH4 and NH3 gas mixtures, has been examined as a function of the amount of H2 dilution of the gas mixture. For NH3/SiH4 gas ratios > 0.5/1, all films are a-SiN:H. While H2 dilution does not change the basic film structure, in that the films are amorphous with all dilutions, H2 dilution does increase the efficiency of NH3 dissociation in the gas phase, and causes a further reduction in the already small amount of N-H bonding in a-SiN:H films deposited by HWCVD. For NH3/SiH4 gas ratios typically <0.5/1 and with high H2 dilution, the first deposition of µc-SiN is demonstrated. X-ray diffraction (XRD) measurements demonstrate that the structure of these films consists of silicon crystallites embedded in an a-SiN:H matrix. An upper limit for N incorporation with the preservation of microcrystallinity was found, beyond which the films again became amorphous. The existence of this limit is explained in terms of structural disorder in the a-SiN:H tissue brought about by N incorporation.
The role of alloying elements such as Cr and Al in the formation and stability of the nitride phases formed due to N ion implantation into metallic iron was studied by conversion electron Mössbauer spectroscopy (CEMS). The thermal stability of nitride phases upon 1 h annealing was greatly increased as a result of co-implanting either Cr or Al with N as compared to pure α-Fe implanted only with N.
In order to help establish the role of Cr in high-dose, high-dose-rate, elevated temperature N implantation of austenitic (fcc) stainless steels, similar implantations into fee Ni80Fe20 and Ni80Cr20 alloys have been made and characterized by Auger depth profiling and X-ray diffraction. For the Ni-Fe alloy a shallow layer fcc(∼ 0.2 μm) containing an ordered fee γ'-(Ni0.8Fe0.4)4N phase is induced. In contrast, for the Ni-Cr alloy a much thicker N-containing layer (∼ 0.2 μm) is produced consisting primarily of a high-N solid solution fee phase. The fractions of the implanted N retained in Ni-Fe and Ni-Cr were approximately 10 and 100%, respectively. The mechanisms by which Cr is promoting the deep migration and high retention of N in solid solution are proposed.
Photothermal deflection spectroscopy, infrared, and Raman measurements are presented for a series of a-SiC:H samples containing different amounts of microstructure. The Urbach edge is seen to widen systematically as the film microstructure increases, but the width of the Raman transverse optical mode remains unchanged. We argue that the increase in Urbach edge width with increasing C content is due entirely to the increase in microstructure. In addition, from the invariance of the Raman measurements with increasing microstructure and the assumed sensitivity of the Raman technique to surface states on the interior surfaces of these microstructural features, we are able to place lower limits on the size of these features. Such sizes are corroborated by preliminary small angle xray scattering measurements on identically prepared samples.