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 email@example.com
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.
The economic impact of epilepsy in the USA and other countries has been well documented in terms of direct treatment-related costs. The average annual direct cost of the disease in the USA is typically estimated by comparing the use and cost of healthcare services in large representative samples of people with an epilepsy diagnosis to similar people without epilepsy using claims or medical billing data. The latest studies, reviewed recently by Begley and Durgin , indicate that the average individual with epilepsy and commercial or Medicaid coverage (all ages, genders, seizure types and severity) experiences excess epilepsy-related annual costs in a range between $7659 and $11 354 in 2013 dollars. Only a few of these studies provide separate cost estimates for subpopulations among those with epilepsy, such as individuals with intractable epilepsy. This is problematic for understanding the economic impact of epilepsy because of the variability in how the disease affects people and the effectiveness of existing treatments. As noted in an Institute of Medicine report, ‘Epilepsy is a spectrum of disorders – the epilepsies – with a range of severities, widely differing seizure types and causes, and varying impacts on individuals and their families’ . The existing studies of direct costs in the intractable population reviewed here, though limited in number and methodological rigor, suggest that they are substantially higher than in the general population, but there is no consensus on how much higher.
Here we provide an update of the 2013 report on the Nigerian Twin and Sibling Registry (NTSR). The major aim of the NTSR is to understand genetic and environmental influences and their interplay in psychological and mental health development in Nigerian children and adolescents. Africans have the highest twin birth rates among all human populations, and Nigeria is the most populous country in Africa. Due to its combination of large population and high twin birth rates, Nigeria has one of the largest twin populations in the world. In this article, we provide current updates on the NTSR samples recruited, recruitment procedures, zygosity assessment and findings emerging from the NTSR.
The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
For decades, fructose intake has been recognised as an environmental risk for metabolic syndromes and diseases. Here we comprehensively examined the effects of fructose intake on mice liver transcriptomes. Fructose-supplemented water (34 %; w/v) was fed to both male and female C57BL/6N mice at their free will for 6 weeks, followed by hepatic transcriptomics analysis. Based on our criteria, differentially expressed genes (DEG) were selected and subjected to further computational analyses to predict key pathways and upstream regulator(s). Subsequently, predicted genes and pathways from the transcriptomics dataset were validated via quantitative RT-PCR analyses. As a result, we identified eighty-nine down-regulated and eighty-eight up-regulated mRNA in fructose-fed mice livers. These DEG were subjected to bioinformatics analysis tools in which DEG were mainly enriched in xenobiotic metabolic processes; further, in the Ingenuity Pathway Analysis software, it was suggested that the aryl hydrocarbon receptor (AhR) is an upstream regulator governing overall changes, while fructose suppresses the AhR signalling pathway. In our quantitative RT-PCR validation, we confirmed that fructose suppressed AhR signalling through modulating expressions of transcription factor (AhR nuclear translocator; Arnt) and upstream regulators (Ncor2, and Rb1). Altogether, we demonstrated that ad libitum fructose intake suppresses the canonical AhR signalling pathway in C57BL/6N mice liver. Based on our current observations, further studies are warranted, especially with regard to the effects of co-exposure to fructose on (1) other types of carcinogens and (2) inflammation-inducing agents (or even diets such as a high-fat diet), to find implications of fructose-induced AhR suppression.
Sulfur loss from the surface of MoS2(0001) is observed following the adsorption of methanol on MoS2 at 86 K and subsequent annealing of MoS2 near 300 K. This sulfur loss, at the MoS2 surface, leads to suppression of inverse photoemission features characteristic of the unoccupied states associated with MoS2. This sulfur loss is counteracted by further annealing to 350 K, as is evident in the temperature dependent sulfur to molybdenum integrated X-ray photoemission intensity ratios near 300 to 350 K. Upon further annealing to 350 K, inverse photoemission additionally indicates a reestablishment of characteristic features associated with the unoccupied states of MoS2. These results are indicative of sulfur segregation to the surface and compensation of surface vacancy sites.
Firefighters are routinely exposed to various traumatic events and often experience a range of trauma-related symptoms. Although these repeated traumatic exposures rarely progress to the development of post-traumatic stress disorder, firefighters are still considered to be a vulnerable population with regard to trauma.
To investigate how the human brain responds to or compensates for the repeated experience of traumatic stress.
We included 98 healthy firefighters with repeated traumatic experiences but without any diagnosis of mental illness and 98 non-firefighter healthy individuals without any history of trauma. Functional connectivity within the fear circuitry, which consists of the dorsal anterior cingulate cortex, insula, amygdala, hippocampus and ventromedial prefrontal cortex (vmPFC), was examined using resting-state functional magnetic resonance imaging. Trauma-related symptoms were evaluated using the Impact of Event Scale – Revised.
The firefighter group had greater functional connectivity between the insula and several regions of the fear circuitry including the bilateral amygdalae, bilateral hippocampi and vmPFC as compared with healthy individuals. In the firefighter group, stronger insula–amygdala connectivity was associated with greater severity of trauma-related symptoms (β = 0.36, P = 0.005), whereas higher insula–vmPFC connectivity was related to milder symptoms in response to repeated trauma (β = −0.28, P = 0.01).
The current findings suggest an active involvement of insular functional connectivity in response to repeated traumatic stress. Functional connectivity of the insula in relation to the amygdala and vmPFC may be potential pathways that underlie the risk for and resilience to repeated traumatic stress, respectively.
Introduction: The GridlockED game is a serious game aimed at teaching junior learners about flow and organization in the emergency department(ED). With serious games, the mechanism of learning is thought to be via the gameplay experience. Objectives built into gameplay are aimed at teaching players about a specific concept; in this case, we hoped to teach players about interprofessional collaboration and basic mechanics that drive flow in the ED. However, before a player can be taught, he or she must be engaged and have a positive gameplay experience. From the GridlockED gameplay, we aim to explore how a players gameplay experience related to observed actions while playing the game, including participating in decision making and keeping the team organized. Methods: From April-August 2017, participants were invited to play 4 turns of a GridlockED game session. They were video recorded during gameplay. After playing the game, they were surveyed using the previously derived Game Experience Questionnaire (GEQ) to measure their gameplay experience. The videos were reviewed by two research team members (SH, EJ), tallying various observed game actions. We conducted Pearson correlation between players GEQ total score and their observed actions. Results: A total of 32 participants (13 attendings, 5 senior residents, 10 junior residents, and 4 nurses) played the game. The average total GEQ was 67.2/132 (SD=10.7), suggesting most players had a moderately good gameplay experience. The total GEQ score correlated with component subscores within the questionnaire. Overall observed activity correlated well with each observed action subtype. However, the GEQ total score did not correlate significantly with the total observed action (Pearsons r=0.18,p=0.32). GEQ total score was found to be moderately correlated to an observation that a player participated in determining strategy during gameplay (r=0.36,p=0.04). There was a moderate negative correlation between determining strategy during gameplay and teaching about the game (r=-0.37,p=0.04) or emergency medicine concepts (r=-0.47,p<0.01). Conclusion: The GEQ is internally consistent, but does not have a strong relationship to observed actions, suggesting that game experience does not necessarily correlate with observable actions. This suggests that players may be intellectually stimulated or engaged without necessarily completing any observable actions during gameplay.
Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990–1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.
We analyzed birth order differences in means and variances of height and body mass index (BMI) in monozygotic (MZ) and dizygotic (DZ) twins from infancy to old age. The data were derived from the international CODATwins database. The total number of height and BMI measures from 0.5 to 79.5 years of age was 397,466. As expected, first-born twins had greater birth weight than second-born twins. With respect to height, first-born twins were slightly taller than second-born twins in childhood. After adjusting the results for birth weight, the birth order differences decreased and were no longer statistically significant. First-born twins had greater BMI than the second-born twins over childhood and adolescence. After adjusting the results for birth weight, birth order was still associated with BMI until 12 years of age. No interaction effect between birth order and zygosity was found. Only limited evidence was found that birth order influenced variances of height or BMI. The results were similar among boys and girls and also in MZ and DZ twins. Overall, the differences in height and BMI between first- and second-born twins were modest even in early childhood, while adjustment for birth weight reduced the birth order differences but did not remove them for BMI.
To evaluate the reliability and validity of a standardized measure of healthcare personnel (HCP) influenza vaccination.
Acute care hospitals, long-term care facilities, ambulatory surgery centers, physician practices, and dialysis centers from 3 US jurisdictions.
Staff from 96 healthcare facilities randomly sampled from 234 facilities that completed pilot testing to assess the feasibility of the measure.
Reliability was assessed by comparing agreement between facility staff and project staff on the classification of HCP numerator (vaccinated at facility, vaccinated elsewhere, contraindicated, declined) and denominator (employees, credentialed nonemployees, other nonemployees) categories. To assess validity, facility staff completed a series of case studies to evaluate how closely classification of HCP groups aligned with the measure's specifications. In a modified Delphi process, experts rated face validity of the proposed measure elements on a Likert-type scale.
Percent agreement was high for HCP vaccinated at the facility (99%) and elsewhere (95%) and was lower for HCP who declined vaccination (64%) or were medically contraindicated (64%). While agreement was high (more than 90%) for all denominator categories, many facilities' staff excluded nonemployees for whom numerator and denominator status was difficult to determine. Validity was lowest for credentialed and other nonemployees.
The standardized measure of HCP influenza vaccination yields reproducible results for employees vaccinated at the facility and elsewhere. Adhering to true medical contraindications and tracking decimations should improve reliability. Difficulties in establishing denominators and determining vaccination status for credentialed and other nonemployees challenged the measure's validity and prompted revision to include a more limited group of nonemployees.
Nanocomposites of gold nanoparticles (AuNPs) embedded in polyaniline fibers have been fabricated using a one-pot synthesis approach and in-situ polymerization. By using a combination of inorganic acids (e.g. HCl) and camphorsulfonic acid, polyaniline nanostructured fibers of high aspect ratio with diameters of 150 ± 50 nm and several micrometers in length were obtained. These fibers afforded high electrical conductivity of 4.2 ± 0.5 S/cm. Encapsulation of the AuNPs in the polyaniline fibers afforded nanocomposites with high electrical conductivity and dielectric constant of 34.0 ± 0.5 S/cm and 65.3 ± 5 respectively. The morphology of these materials was analyzed using SEM and HRTEM and electronic properties were analyzed using UV-Vis spectroscopy.
We report a simple synthesis technique to attached poly(N-isopropylacrylamide) on magnetic nanoparticles. Fe3O4 magnetic nanoparticles were prepared using co-precipitation method. Nearly monodisperse nanoparticles were separated by terminating surface of Fe3O4 with dopamine followed by careful centrifugation and decantation. NHS/EDC coupling chemistry was employed to attached the carboxylic acid terminated poly(N-isopropylacrylamide) to amine end of dopamine on surface of the magnetic particles. Analysis of the polymer brush layers was conducted using UV-Vis spectroscopy, ATR−FTIR, and Transmission electron microscopy techniques. The magnetic property was investigated using direct current superconducting quantum interference device (DC-SQUID) method.
The Ultra-Fast Flash Observatory (UFFO), which will be launched onboard the
Lomonosov spacecraft, contains two crucial instruments: UFFO Burst
Alert & Trigger Telescope (UBAT) for detection and localization of Gamma-Ray Bursts
(GRBs) and the fast-response Slewing Mirror Telescope (SMT) designed for the observation
of the prompt optical/UV counterparts. Here we discuss the in-space calibrations of the
UBAT detector and SMT telescope. After the launch, the observations of the standard X-ray
sources such as pulsar in Crab nebula will provide data for necessary calibrations of
UBAT. Several standard stars will be used for the photometric calibration of SMT. The
celestial X-ray sources, e.g. X-ray binaries with bright optical sources
in their close angular vicinity will serve for the cross-calibration of UBAT and SMT.
The UFFO (Ultra-Fast Flash Observatory) is a GRB detector on board the Lomonosov
satellite, to be launched in 2013. The GRB trigger is provided by an X-ray detector,
called UBAT (UFFO Burst Alarm & Trigger Telescope), which detects X-rays from the GRB
and then triggers to determine the direction of the GRB and then alerts the Slewing Mirror
Telescope (SMT) to turn in the direction of the GRB and record the optical photon fluxes.
This report details the calibration of the two components: the MAPMTs and the YSO crystals
and simulations of the UBAT. The results shows that this design can observe a GRB within a
field of view of ±35° and can trigger in a time scale as short as 0.2 – 1.0 s
after the appearance of a GRB X-ray spike.
Ultra-high molecular weight polyethylene/graphite nanocomposites were prepared by high-energy cryogenic milling followed by syntering. Microstructure changes shows that graphite was reduced to graphite nanoplatelets by high-energy cryomilling and partial exfoliation of graphite to few layered graphene nanoplatelets occurred in a small extent. The resulting nanocomposites revealed high electrical conductivity and good mechanical performance. Thermal characterization of the nanocomposites was also carried out by differential scanning calorimetry.
We have investigated BisGMA-TEGDMA dental composites with varying mass fractions of hydroxyapatite and silica filler. Commercially available dental composites with 60% silica filler were synthesized in the presence of nanometer-sized hydroxyapatite crystals. We have compared the mechanical properties of BisGMA-TEGDMA samples filled with silica only and those filled with silica and hydroxyapatite particles. We report on hardness as a function of crystalline content as determined by nanoindentation and microindentation.
We calculated the mobility of two-dimensional electron gas along an n-type interface in LaAlO3/SrTiO3 heterostructure using the linearized Boltzmann equation. By solving the Schrödinger equation with the Poisson equation self-consistently, it was found that the interface remained non-conducting up to four unit cells of LaAlO3 film. For five or higher unit cells, the interface became conducting due to the significant overlap between the SrTiO3 conduction band and the LaAlO3 valence band. The electron gas was localized within 7 nm from the interface and multi-subbands were occupied. The calculated mobility matches reasonably well with available experimental data. It was found that the mobility is limited by the remote ionic charged layers in LaAlO3 at low temperature. At high temperature, the polar optical phonon was found to be the dominant scattering center.
In May 2009, we investigated a hospital outbreak of pandemic H1N1 (pH1N1) infection among healthcare personnel (HCP). Thirteen (65%) of 20 HCP with pH1N1 infection had healthcare-associated cases, which were primarily attributed to transmission among HCP. Eleven (55%) of HCP with pH1N1 infection worked for 1 day or more after the onset of illness. Personnel working with mild illness may have contributed to transmission among HCP.
The Ultra-Fast Flash Observatory (UFFO) is a space mission to detect the early moments of an explosion from Gamma-ray bursts (GRBs), thus enhancing our understanding of the GRB mechanism. It consists of the UFFO Burst & Trigger telescope (UBAT) for the recognition of GRB positions using hard X-ray from GRBs. It also contains the Slewing Mirror Telescope (SMT) for the fast detection of UV-optical photons from GRBs. It is designed to begin the UV-optical observations in less than a few seconds after the trigger. The UBAT is based on a coded-mask X-ray camera with a wide field of view (FOV) and is composed of the coded mask, a hopper and a detector module. The SMT has a fast rotatable mirror which allows a fast UV-optical detection after the trigger. The telescope is a modified Ritchey-Chrétien telescope with the aperture size of 10 cm diameter, and an image intensifier readout by CCD. The UFFO pathfinder is scheduled to launch into orbit on 2012 June by the Lomonosov spacecraft. It is a scaled-down version of UFFO in order to make the first systematic study of early UV/optical light curves, including the rise phase of GRBs. We expect UBAT to trigger ~44 GRBs/yr and expect SMT to detect ~10 GRBs/yr.