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Simulation plays an integral role in the Canadian healthcare system with applications in quality improvement, systems development, and medical education. High-quality, simulation-based research will ensure its effective use. This study sought to summarize simulation-based research activity and its facilitators and barriers, as well as establish priorities for simulation-based research in Canadian emergency medicine (EM).
Simulation-leads from Canadian departments or divisions of EM associated with a general FRCP-EM training program surveyed and documented active EM simulation-based research at their institutions and identified the perceived facilitators and barriers. Priorities for simulation-based research were generated by simulation-leads via a second survey; these were grouped into themes and finally endorsed by consensus during an in-person meeting of simulation leads. Priority themes were also reviewed by senior simulation educators.
Twenty simulation-leads representing all 14 invited institutions participated in the study between February and May, 2018. Sixty-two active, simulation-based research projects were identified (median per institution = 4.5, IQR 4), as well as six common facilitators and five barriers. Forty-nine priorities for simulation-based research were reported and summarized into eight themes: simulation in competency-based medical education, simulation for inter-professional learning, simulation for summative assessment, simulation for continuing professional development, national curricular development, best practices in simulation-based education, simulation-based education outcomes, and simulation as an investigative methodology.
This study summarized simulation-based research activity in EM in Canada, identified its perceived facilitators and barriers, and built national consensus on priority research themes. This represents the first step in the development of a simulation-based research agenda specific to Canadian EM.
Band contrast (BC) is a qualitative measure of electron back-scattered diffraction (EBSD), which is derived from the intensity of the Kikuchi bands. The BC is dependent upon several factors including scanning electron microscope measurement parameters, EBSD camera setup, and the specimen itself (lattice defect and grain orientation). In this study, the effective factors for BC variations and the feasibility of using BC variations for the quantification of microstructure evolutions have been investigated. In addition, the effects of the lattice defect and the grain orientation on the BC variations are studied. Next, a shear-deformed microstructure of 316L stainless steel, which contains nanosized grains and a large portion of twin boundaries, is revealed by BC map and histogram. Recovery and recrystallization of shear-deformed 316L stainless steel are displayed by BC variations during isothermal annealing at 700 and 800°C, respectively. It is observed that the BC turns bright as the shear-deformed crystal structure is recovered or recrystallized.
The paper presents theoretical and numerical results on the identifiability, i.e. the
unique identification for the one-dimensional sine-Gordon equation. The identifiability
for nonlinear sine-Gordon equation remains an open question. In this paper we establish
the identifiability for a linearized sine-Gordon problem. Our method consists of a careful
analysis of the Laplace and Fourier transforms of the observation of the system, conducted
at a single point. Numerical results based on the best fit to data method confirm that the
identification is unique for a wide choice of initial approximations for the sought test
parameters. Numerical results compare the identification for the nonlinear and the
Atypical antipsychotics are widely used in bipolar mania. However, the
efficacy of atypical antipsychotics in bipolar depression has not been
To evaluate olanzapine monotherapy in patients with bipolar
Patients with bipolar depression received olanzapine (5–20mg/day,
n = 343) or placebo (n = l71) for 6
weeks. The primary outcome was change from baseline to end-point in
Montgomery-Åsberg Depression Rating Scale (MADRS) total score. Secondary
outcomes included: Clinical Global impression - Bipolar Version (CGI-BP)
scale, 17-item Hamilton Rating Scale for Depression (HRSD-17) and Young
Mania Rating Scale (YMRS) scores, and the rate of response (≥50%
reduction in MADRS at end-point), recovery (MADRS ≤12 for ≥4 weeks plus
treatment completion) and remission (MADRS ≤8). The trial was registered
with ClinicalTrials.gov (NCT00510146).
Olanzapine demonstrated: significantly greater
(P<0.04) improvements on MADRS (least-squares mean
change -13.82 v. -11.67), HRSD-17 and YMRS total scores
and all CGI-BP subscale scores v. placebo; significantly
(P≤0.05) more response and remission, but not
recovery; significantly (P<0.01) greater mean
increases in weight, fasting cholesterol and triglycerides; and
significantly more (P<0.001) patients gained ≥7% body
Olanzapine monotherapy appears to be efficacious in bipolar depression.
Additional long-term studies are warranted to confirm these results.
Safety findings were consistent with the known safety profile of
Contrary to concerns that fructose may have adverse metabolic effects, there is evidence that small, ‘catalytic’ doses ( ≤ 10 g/meal) of fructose decrease the glycaemic response to high-glycaemic index meals in human subjects. To assess the longer-term effects of ‘catalytic’ doses of fructose, we undertook a meta-analysis of controlled feeding trials. We searched MEDLINE, EMBASE, CINAHL and the Cochrane Library. Analyses included all controlled feeding trials ≥ 7 d featuring ‘catalytic’ fructose doses ( ≤ 36 g/d) in isoenergetic exchange for other carbohydrates. Data were pooled by the generic inverse variance method using random-effects models and expressed as mean differences (MD) with 95 % CI. Heterogeneity was assessed by the Q statistic and quantified by I2. The Heyland Methodological Quality Score assessed study quality. A total of six feeding trials (n 118) met the eligibility criteria. ‘Catalytic’ doses of fructose significantly reduced HbA1c (MD − 0·40, 95 % CI − 0·72, − 0·08) and fasting glucose (MD − 0·25, 95 % CI − 0·44, − 0·07). This benefit was seen in the absence of adverse effects on fasting insulin, body weight, TAG or uric acid. Subgroup and sensitivity analyses showed evidence of effect modification under certain conditions. The small number of trials and their relatively short duration limit the strength of the conclusions. In conclusion, this small meta-analysis shows that ‘catalytic’ fructose doses ( ≤ 36 g/d) may improve glycaemic control without adverse effects on body weight, TAG, insulin and uric acid. There is a need for larger, longer ( ≥ 6 months) trials using ‘catalytic’ fructose to confirm these results.
Using data from two recent surveys, we analyze the relationship between Big Five personality traits and political participation. We examine forms of participation that differ in domain (local politics vs. national campaigns) as well as in the amount of conflict involved, whether they are likely to yield instrumental benefits, and whether they are likely to be viewed as a duty—characteristics that may affect the relationships between dispositional personality traits and political activity. We find relationships between personality traits and: (1) both self-reported and actual turnout (measured using administrative records), (2) overreporting of turnout, and (3) a variety of other modes of participation. The effect of personality on political participation is often comparable to the effects of factors that are central in earlier models of turnout, such as education and income. Consistent with our theoretical expectations, these relationships vary depending on personality-relevant characteristics of each participatory act.
Previous research on personality traits and political attitudes has largely focused on the direct relationships between traits and ideological self-placement. There are theoretical reasons, however, to suspect that the relationships between personality traits and political attitudes (1) vary across issue domains and (2) depend on contextual factors that affect the meaning of political stimuli. In this study, we provide an explicit theoretical framework for formulating hypotheses about these differential effects. We then leverage the power of an unusually large national survey of registered voters to examine how the relationships between Big Five personality traits and political attitudes differ across issue domains and social contexts (as defined by racial groups). We confirm some important previous findings regarding personality and political ideology, find clear evidence that Big Five traits affect economic and social attitudes differently, show that the effect of Big Five traits is often as large as that of education or income in predicting ideology, and demonstrate that the relationships between Big Five traits and ideology vary substantially between white and black respondents.
We report on a direct epitaxial growth approach for the heterogeneous integration of high speed III-V devices with Si CMOS logic on a common Si substrate. InP-based heterojunction bipolar transistor (HBTs) structures were successfully grown on patterned Si-on-Lattice-Engineered-Substrate (SOLES) substrates using molecular beam epitaxy. DC and RF performance similar to those grown on lattice-matched InP were achieved in growth windows as small as 15×15μm2. This truly planar approach allows tight device placement with InP-HBTs to Si CMOS transistors separation as small as 2.5 μm, and the use of standard wafer level multilayer interconnects. A high speed, low power dissipation differential amplifier was designed and fabricated, demonstrating the feasibility of using this approach for high performance mixed signal circuits such as ADCs and DACs.
Nanoporous electrodes, such as those made from carbon or gold, can capture and release ionic analytes at concentrations near 1 mole per liter of pore volume through capacitive charging or electrochemically reversible adsorption. In vitro studies suggest that this phenomenon can be the basis for a noninvasive, precise, and programmable drug delivery method. It would eliminate the need for bulk fluid delivery to target tissue and require only a thin electrical connection, minimizing pain and tissue disruption. We have designed effective gold electrode assemblies and observed the depletion and release phenomena using electrochemical methods and charged dyes.
Our direct growth approach of integrating compound semiconductors (CS) and silicon CMOS is based on a unique silicon template wafer with an embedded CS template layer of Germanium (Ge). It enables selective placement of CS devices in arbitrary locations on a Silicon CMOS wafer for simple, high yield, monolithic integration and optimal circuit performance. HBTs demonstrate a peak current gain cutoff frequency ft of 170GHz at a nominal collector current density of 2mA/μm2. To the best of our knowledge this represents the first demonstration of an InP-based HBT fabricated on a silicon wafer.
self-injury is a defining feature of lesch–nyhan disease (lnd) but does not occur in the less severely affected lesch–nyhan variants (lnv). the aim of this study was to quantify behavioral and emotional abnormalities in lnd and lnv. thirty-nine informants rated 22 patients with lnd (21 males, 1 female), 11 males with lnv, and 11 healthy controls (hc; 10 males, 1 female) using two well-validated rating scales. the age of patients with lnd ranged from 12 years 7 months to 38 years 3 months (mean 22y 11mo; sd 7y 8mo), whereas the age range of those with lnv was 12 years 9 months to 65 years (mean 30y 7mo; sd 15y 2mo), and the healthy controls were aged 12 years 4 months to 31 years 3 months (mean 17y 10mo; sd 5y 7mo). behavioral ratings were based on the child behavior checklist and the american association on mental retardation's adaptive behavior scale – residential and community, 2nd edition. statistical analyses revealed that patients with lnd showed severe self-injury together with problematic aggression, anxious-depressed symptoms, distractibility, motor stereotypes, and disturbing interpersonal behaviors. patients with lnv were rated as being intermediate between the hc and lnd groups on all behavior scales. although the lnv group did not differ from hcs on most scales, their reported attention problems were as severe as those found in lnd. we conclude that self-injurious and aggressive behaviors are nearly universal and that other behavioral abnormalities are common in lnd. although patients with lnv typically do not self-injure or display severe aggression, attention problems are common and a few patients demonstrate other behavioral anomalies.
We investigated the effects of the substrate temperature (Ts) on the crystallization and the development of texture of Mn-Zn ferrite thin films on SiO2/Si (100) under ion bombardment during ion beam sputtering. As-deposited films showed ferrimagnetic properties in spite of their crystallographic structure of wustite. The crystallographic structure of as-deposited films changed from (111) wustite structure to (222) spinel structure as oxygen partial pressure increased. The (222) preferred orientation seems to originate from oxygen-deficit ambient and preferential resputtering of oxygen ions in films during sputtering. The interplanar distance of the films deposited without oxygen flow decreased with increasing Ts due to release of compressive stress. The saturation Magnetization (Ms) of the film had maximum value at about 275°C, while the resistivity was almost of the same value irrespective of Ts. The unusual fact that crystallization and preferred orientation were less progressed at higher Ts was discussed.
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