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Background: Motor evoked potentials (MEP’S) measure myelin/axonal integrity of the central nervous system. MEP’s reliability and correlation to conventional clinical measures in multiple sclerosis (MS) patients have yet to be demonstrated. Alemtuzumab is a high efficacy therapy used in patients with MS. Its longitudinal impact on electrophysiological measures has yet to be examined. Methods: This is a single center, observational study. 10 patients with MS who received their first cycle of alemtuzumab within less than 3 months were evaluated with both clinical and MEP’s measures at baseline and every 6 months thereafter for 36 months. MEP’s were repeated two weeks after every time point. We report our preliminary analyses. Results: Patient follow-up ranges from 6 to 36 months. The intraclass correlation coefficient (ICC) between two consecutive time points were good with values of 0.774 for the biceps and 0.867 for the tibialis anterior with p values less than 0.0005 for both. The correlation for the biceps MEP’s to the 9 hole peg test (9HPT) was 0.51 with p less than 0.0005 and for the tibialis anterior MEP’s to the 6 minute walk test (6MWT) was -0.411 with p=0.01. Conclusions: Our preliminary analyses demonstrate that MEP results are reproducible and correlate with clinical measures.
Recent developments in U.S-Cuba relations have resulted in a proliferating global interest in Cuba, including its legal regime. This comprehensive Guide aims to fill a noticeable void in the availability of information in English on this enigmatic jurisdiction's legal order, and on how to conduct research related to it. Covered topics include “The Constitution,” “Legislation and Codes,” “The Judiciary,” “Cuba in the International Arena,” and “The Legal Profession.” A detailed section on “Cuban Legal Materials in U.S. and Canadian Libraries” is also featured. Although the Guide emphasizes sources in English and English-language translation, materials in Spanish are likewise included as English-language equivalents are often unavailable. The Guide's 12 authors are members of the Latin American Law Interest Group of the American Association of Law Libraries’ Foreign, Comparative, and International Law Special Interest Section (FCIL-SIS).
The consequences of minor trauma involving a head injury (MT-HI) in independent older adults are largely unknown. This study assessed the impact of a head injury on the functional outcomes six months post-injury in older adults who sustained a minor trauma.
This multicenter prospective cohort study in eight sites included patients who were aged 65 years or older, previously independent, presenting to the emergency department (ED) for a minor trauma, and discharged within 48 hours. To assess the functional decline, we used a validated test: the Older Americans’ Resources and Services Scale. The cognitive function of study patients was also evaluated. Finally, we explored the influence of a concomitant injury on the functional decline in the MT-HI group.
All 926 eligible patients were included in the analyses: 344 MT-HI patients and 582 minor trauma without head injury. After six months, the functional decline was similar in both groups: 10.8% and 11.9%, respectively (RR=0.79 [95% CI: 0.55–1.14]). The proportion of patients with mild cognitive disabilities was also similar: 21.7% and 22.8%, respectively (RR=0.91 [95% CI: 0.71–1.18]). Furthermore, for the group of patients with a MT-HI, the functional outcome was not statistically different with or without the presence of a co-injury (RR=1.35 [95% CI: 0.71–2.59]).
This study did not demonstrate that the occurrence of a MT-HI is associated with a worse functional or cognitive prognosis than other minor injuries without a head injury in an elderly population, six months after injury.
It has been shown in previous studies that a miscibility gap exists in the hypo-stoichiometric region UO2-PuO2-Pu2O3 with one phase poor in oxygen, and the other with an O/M (Oxygen to Metal ratio) close to 2.00. Data on the evolution of this region in temperature, especially in the vicinity of the oxygen content corresponding to the highest temperature at which the gap can be observed, is scarce. A high temperature X-ray diffractometer with a dedicated gas control setup was used to study the described region in-situ. We have observed reflections of the two cubic phases, with one increasing and the other decreasing in intensity during the thermal plateaus lasting up to 20 h. We compare the calculated lattice parameters with literature. We estimated the O/M evolution of our samples from a comparison of phase fractions values obtained by Rietveld refinement and calculations using the Calphad method.
The relationship of meal and snacking patterns with overall dietary intake and relative weight in children is unclear. The current study was done to examine how eating, snack and meal frequencies relate to total energy intake and diet quality.
The cross-sectional associations of eating, meal and snack frequencies with total energy intake and diet quality, measured by the Healthy Eating Index 2005 (HEI-2005), were examined in separate multivariable mixed models. Differences were examined between elementary school-age participants (9–11 years) and adolescents (12–15 years).
Two non-consecutive 24 h diet recalls were collected from children attending four schools in the greater Boston area, MA, USA.
One hundred and seventy-six schoolchildren, aged 9–15 years.
Overall, 82 % of participants consumed three daily meals. Eating, meal and snack frequencies were statistically significantly and positively associated with total energy intake. Each additional reported meal and snack was associated with an 18·5 % and a 9·4 % increase in total energy intake, respectively (P<0·001). The relationships of eating, meal and snack frequencies with diet quality differed by age category. In elementary school-age participants, total eating occasions and snacks increased HEI-2005 score. In adolescents, each additional meal increased HEI-2005 score by 5·40 points (P=0·01), whereas each additional snack decreased HEI-2005 score by 2·73 points (P=0·006).
Findings suggest that snacking increases energy intake in schoolchildren. Snacking is associated with better diet quality in elementary school-age children and lower diet quality in adolescents. Further research is needed to elucidate the role of snacking in excess weight gain in children and adolescents.
Determine the prevalence of extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae (ESBL-PE) contamination of food and colonization of food handlers in a hospital kitchen and compare retrieved ESBL-PE strains with patient isolates.
A 2,200-bed tertiary care university hospital in Switzerland.
Raw and prepared food samples were obtained from the hospital kitchen, with a comparator group from local supermarkets. Fecal samples collected from food handlers and selectively pre-enriched homogenized food samples were inoculated onto selective chromogenic media. Phenotypic confirmation of ESBL production was performed using the double disk method. Representative ESBL-PE were characterized using polymerase chain reaction (PCR) and sequencing for blaCTX-M, blaSHV, and blaTEM genes, and Escherichia coli strains were typed using phylotyping, repetitive element palindromic PCR, and multilocus sequence typing. Meat samples were screened for antibiotic residues using liquid chromatography time-of-flight mass spectrometry.
Sixty (92%) of the raw chicken samples were ESBL-PE positive, including 30 (86%) of the hospital samples and all supermarket samples. No egg, beef, rabbit, or cooked chicken samples were ESBL-PE positive. No antibiotic residues were detected. Six (6.5%) of 93 food handlers were ESBL-PE carriers. ESBL-PE strains from chicken meat more commonly possessed blaCTX-M-1 and blaCTX-M-2, whereas blaCTX-M-14and blaCTX-M-15 were predominant among strains of human origin. There was partial overlap in the sequence type of E. coli strains of chicken and human origin. No E. coli ST131 strains or blaCTX-M-15 genes were isolated from meat.
Although there is significant ESBL-PE contamination of delivered chicken meat, current preventive strategies minimize risks to food handlers, hospital staff, and patients.
Nuclear weapons proliferation is at the top of the news these days. Most recent reports have focused on the nuclear efforts of Iran and North Korea, but they also typically warn that those two acute diplomatic headaches may merely be the harbingers of a much darker future. Indeed, foreign policy sages often claim that what worries them most is not the small arsenals that Tehran and Pyongyang could build for themselves, but rather the potential that their reckless behavior could catalyze a process of runaway nuclear proliferation, international disorder, and, ultimately, nuclear war.
Glutamine may be a precursor for NO synthesis, which may play a crucial role in bacterial translocation (BT). The goal of the present study was to investigate the potential effects of glutamine on BT and the immunological response in an experimental model of NO synthase inhibition by NG-nitro-L-arginine methyl ester (l-NAME). Mice were randomly assigned to four groups: sham; intestinal obstruction (IO); IO+500 mg/kg per d glutamine (GLN); IO+GLN plus 10 mg/kg per d l-NAME (GLN/LN). The groups were pretreated for 7 d. BT was induced by ileal ligation and was assessed 18 h later by measuring the radioactivity of 99mTc-Escherichiacoli in the blood and organs. Mucosal damage was determined using a histological analysis. Intestinal permeability (IP) was assessed by measuring the levels of 99mTc-diethylenetriaminepentaacetic acid in the blood at 4, 8 and 18 h after surgery. IgA and cytokine concentrations were determined by ELISA in the intestinal fluid and plasma, respectively. BT was increased in the GLN/LN and IO groups than in the GLN and sham groups. IP and intestinal mucosa structure of the sham, GLN and GLN/LN groups were similar. The GLN group had the highest levels of interferon-γ, while IL-10 and secretory IgA levels were higher than those of the IO group but similar to those of the GLN/LN group. The present results suggest that effects of the glutamine pathway on BT were mediated by NO. The latter also interferes with the pro-inflammatory systemic immunological response. On the other hand, IP integrity preserved by the use of glutamine is independent of NO.
Genetic disturbances in folate metabolism may increase risk for congenital heart defects. We examined the association of heart defects with four polymorphisms in folate-related genes (methylenetetrahydrofolate reductase (MTHFR) c.677C > T, MTHFR c.1298A > C, methionine synthase reductase (MTRR) c.66A > G, and reduced folate carrier (SLC19A1) c.80A > G) in a case–control study of children (156 patients, 69 controls) and mothers of children with heart defects (181 patients, 65 controls), born before folic acid fortification. MTRR c.66A > G in children modified odds ratios for overall heart defects, specifically ventricular septal defect and aortic valve stenosis (p-value below 0.05). The 66GG and AG genotypes were associated with decreased odds ratios for heart defects (0.42, 95% confidence interval (0.18–0.97) and 0.39 (0.18–0.84), respectively). This overall association was driven by decreased risk for ventricular septal defect for 66GG and AG (odds ratio 0.32 (0.11–0.91) and 0.25 (0.09–0.65)) and decreased odds ratio for aortic valve stenosis for 66AG (0.27 (0.09–0.79)). The association of ventricular septal defect and 66AG remained significant after correction for multiple testing (p = 0.0044, multiple testing threshold p = 0.0125). Maternal MTHFR 1298AC genotype was associated with increased odds ratio for aortic valve stenosis (2.90 (1.22–6.86), p = 0.0157), but this association did not meet the higher multiple testing threshold. No association between MTHFR c.677C > T or SLC19A1 c.80A > G and heart defect risk was found. The influence of folate-related polymorphisms may be specific to certain types of heart defects; larger cohorts of mothers and children with distinct sub-classes are required to adequately address risk.
In this book I have presented in-depth studies of four country cases: Iraq, China, Yugoslavia, and Argentina. I chose these historical cases due to their value for theory-testing. One of the key reasons why they were valuable was the availability of minutely detailed information on their nuclear programs’ internal dynamics. As a result, in the case study chapters we have been able to witness the multiple pathways via which nuclear weapons project efficiency can be helped or hampered by the state’s management approach, and behind that, by its institutions. This would not have been possible if I had chosen to study the “hottest” cases for the proliferation literature at present – cases such as Libya, Pakistan, North Korea, and Iran – since their internal dynamics generally remain quite shrouded in mystery.
However, now that the theory has passed a series of punishing tests, it is worth considering, in a preliminary manner, how the theory might apply to the more recent cases.