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Nutritional therapy is a cornerstone of burns management. The optimal macronutrient intake for wound healing after burn injury has not been identified, although high-energy, high-protein diets are favoured. The present study aimed to identify the optimal macronutrient intake for burn wound healing. The geometric framework (GF) was used to analyse wound healing after a 10 % total body surface area contact burn in mice ad libitum fed one of the eleven high-energy diets, varying in macronutrient composition with protein (P5−60 %), carbohydrate (C20−75 %) and fat (F20−75 %). In the GF study, the optimal ratio for wound healing was identified as a moderate-protein, high-carbohydrate diet with a protein:carbohydrate:fat (P:C:F) ratio of 1:4:2. High carbohydrate intake was associated with lower mortality, improved body weight and a beneficial pattern of body fat reserves. Protein intake was essential to prevent weight loss and mortality, but a protein intake target of about 7 kJ/d (about 15 % of energy intake) was identified, above which no further benefit was gained. High protein intake was associated with delayed wound healing and increased liver and spleen weight. As the GF study demonstrated that an initial very high protein intake prevented mortality, a very high-protein, moderate-carbohydrate diet (P40:C42:F18) was specifically designed. The dynamic diet study was also designed to combine and validate the benefits of an initial very high protein intake for mortality, and subsequent moderate protein, high carbohydrate intake for optimal wound healing. The dynamic feeding experiment showed switching from an initial very high-protein diet to the optimal moderate-protein, high-carbohydrate diet accelerated wound healing whilst preventing mortality and liver enlargement.
We employ global input–output analysis to quantify amplification of exogenous disturbances in compressible boundary layer flows. Using the spatial structure of the dominant response to time-periodic inputs, we explain the origin of steady reattachment streaks in a hypersonic flow over a compression ramp. Our analysis of the laminar shock–boundary layer interaction reveals that the streaks arise from a preferential amplification of upstream counter-rotating vortical perturbations with a specific spanwise wavelength. These streaks are associated with heat-flux striations at the wall near flow reattachment and they can trigger transition to turbulence. The streak wavelength predicted by our analysis compares favourably with observations from two different hypersonic compression ramp experiments. Furthermore, our analysis of inviscid transport equations demonstrates that base-flow deceleration contributes to the amplification of streamwise velocity and that the baroclinic effects are responsible for the production of streamwise vorticity. Finally, the appearance of the temperature streaks near reattachment is triggered by the growth of streamwise velocity and streamwise vorticity perturbations as well as by the amplification of upstream temperature perturbations by the reattachment shock.
Whether maternal obesity and gestational weight gain (GWG) are associated with early-childhood development in low-income, urban, minority populations, and whether effects differ by child sex remain unknown. This study examined the impact of prepregnancy BMI and GWG on early childhood neurodevelopment in the Columbia Center for Children’s Environmental Health Mothers and Newborns study. Maternal prepregnancy weight was obtained by self-report, and GWG was assessed from participant medical charts. At child age 3 years, the Psychomotor Development Index (PDI) and Mental Development Index (MDI) of the Bayley Scales of Infant Intelligence were completed. Sex-stratified linear regression models assessed associations between prepregnancy BMI and pregnancy weight gain z-scores with child PDI and MDI scores, adjusting for covariates. Of 382 women, 48.2% were normal weight before pregnancy, 24.1% overweight, 23.0% obese, and 4.7% underweight. At 3 years, mean scores on the PDI and MDI were higher among girls compared to boys (PDI: 102.3 vs. 97.2, P = 0.0002; MDI: 92.8 vs. 88.3, P = 0.0001). In covariate-adjusted models, maternal obesity was markedly associated with lower PDI scores in boys [b = −7.81, 95% CI: (−13.08, −2.55), P = 0.004], but not girls. Maternal BMI was not associated with MDI in girls or boys, and GWG was not associated with PDI or MDI among either sex (all-P > 0.05). We found that prepregnancy obesity was associated with lower PDI scores at 3 years in boys, but not girls. The mechanisms underlying this sex-specific association remain unclear, but due to elevated obesity exposure in urban populations, further investigation is warranted.
During the summer of 2016, the Hawaii Department of Health responded to the second-largest domestic foodborne hepatitis A virus (HAV) outbreak in the post-vaccine era. The epidemiological investigation included case finding and investigation, sequencing of RNA positive clinical specimens, product trace-back and virologic testing and sequencing of HAV RNA from the product. Additionally, an online survey open to all Hawaii residents was conducted to estimate baseline commercial food consumption. We identified 292 confirmed HAV cases, of whom 11 (4%) were possible secondary cases. Seventy-four (25%) were hospitalised and there were two deaths. Among all cases, 94% reported eating at Oahu or Kauai Island branches of Restaurant Chain A, with 86% of those cases reporting raw scallop consumption. In contrast, a food consumption survey conducted during the outbreak indicated 25% of Oahu residents patronised Restaurant Chain A in the 7 weeks before the survey. Product trace-back revealed a single distributor that supplied scallops imported from the Philippines to Restaurant Chain A. Recovery, amplification and sequence comparison of HAV recovered from scallops revealed viral sequences matching those from case-patients. Removal of product from implicated restaurants and vaccination of those potentially exposed led to the cessation of the outbreak. This outbreak further highlights the need for improved imported food safety.
Background: Unwanted intrusive thoughts of intentionally harming one's infant (intrusive harm thoughts) are common distressing experiences among postpartum mothers and fathers. Aim: To understand infant crying as a stimulus for intrusive harm thoughts and associated emotional responses in prepartum and postpartum mothers and fathers in response to infant cry. Method: Following completion of self-report measures of negative mood and anger, prepartum (n = 48) and postpartum (n = 44) samples of mother and father pairs completed 10 minutes of listening to audio-recorded infant crying. Post-test questionnaires assessed harm thoughts, negative emotions, urges to comfort and flee, and thoughts of shaking as a soothing or coping strategy. Results: One quarter of prepartum and 44% of postpartum parents reported intrusive infant-related harm thoughts following crying. Mothers and fathers did not differ in the likelihood of reporting harm thoughts, nor in the number of thoughts reported. Women reported more internalizing emotions compared with men. Hostile emotions were stronger among postpartum parents, and parents reporting harm thoughts. All parents reported strong urges to comfort the infant. Urges to flee were stronger among parents who reported harm thoughts. The likelihood of using infant shaking as a soothing or coping strategy was minimally endorsed, albeit more strongly by fathers and parents who also reported harm thoughts. Conclusions: In response to crying, harm thoughts are common and are associated with hostile emotions, urges to flee, and increased thoughts of using infant shaking. Reassuringly, the number of participants considering infant shaking as a strategy for soothing or for coping with a crying infant was low.
The primary objectives of the ExoplANETS-A project are to: establish new knowledge on exoplanet atmospheres; establish new insight on influence of the host star on the planet atmosphere; disseminate knowledge, using online, web-based platforms. The project, funded under the EU’s Horizon-2020 programme, started in January 2018 and has a duration ∼3 years. We present an overview of the project, the activities concerning the host stars and some early results on the host stars.
On 27 April 2015, Washington health authorities identified Escherichia coli O157:H7 infections associated with dairy education school field trips held in a barn 20–24 April. Investigation objectives were to determine the magnitude of the outbreak, identify the source of infection, prevent secondary illness transmission and develop recommendations to prevent future outbreaks. Case-finding, hypothesis generating interviews, environmental site visits and a case–control study were conducted. Parents and children were interviewed regarding event activities. Odds ratios (OR) and 95% confidence intervals (CI) were computed. Environmental testing was conducted in the barn; isolates were compared to patient isolates using pulsed-field gel electrophoresis (PFGE). Sixty people were ill, 11 (18%) were hospitalised and six (10%) developed haemolytic uremic syndrome. Ill people ranged in age from <1 year to 47 years (median: 7), and 20 (33%) were female. Twenty-seven case-patients and 88 controls were enrolled in the case–control study. Among first-grade students, handwashing (i.e. soap and water, or hand sanitiser) before lunch was protective (adjusted OR 0.13; 95% CI 0.02–0.88, P = 0.04). Barn samples yielded E. coli O157:H7 with PFGE patterns indistinguishable from patient isolates. This investigation provided epidemiological, laboratory and environmental evidence for a large outbreak of E. coli O157:H7 infections from exposure to a contaminated barn. The investigation highlights the often overlooked risk of infection through exposure to animal environments as well as the importance of handwashing for disease prevention. Increased education and encouragement of infection prevention measures, such as handwashing, can prevent illness.
To determine the length and position of a thyroidectomy scar that is cosmetically most appealing to naïve raters.
Images of thyroidectomy scars were reproduced on male and female necks using digital imaging software. Surgical variables studied were scar position and length. Fifteen raters were presented with 56 scar pairings and asked to identify which was preferred cosmetically. Twenty duplicate pairings were included to assess rater reliability. Analysis of variance was used to determine preference.
Raters preferred low, short scars, followed by high, short scars, with long scars in either position being less desirable (p < 0.05). Twelve of 15 raters had acceptable intra-rater and inter-rater reliability.
Naïve raters preferred low, short scars over the alternatives. High, short scars were the next most favourably rated. If other factors influencing incision choice are considered equal, surgeons should consider these preferences in scar position and length when planning their thyroidectomy approach.
The Dark Energy Survey is undertaking an observational programme imaging 1/4 of the southern hemisphere sky with unprecedented photometric accuracy. In the process of observing millions of faint stars and galaxies to constrain the parameters of the dark energy equation of state, the Dark Energy Survey will obtain pre-discovery images of the regions surrounding an estimated 100 gamma-ray bursts over 5 yr. Once gamma-ray bursts are detected by, e.g., the Swift satellite, the DES data will be extremely useful for follow-up observations by the transient astronomy community. We describe a recently-commissioned suite of software that listens continuously for automated notices of gamma-ray burst activity, collates information from archival DES data, and disseminates relevant data products back to the community in near-real-time. Of particular importance are the opportunities that non-public DES data provide for relative photometry of the optical counterparts of gamma-ray bursts, as well as for identifying key characteristics (e.g., photometric redshifts) of potential gamma-ray burst host galaxies. We provide the functional details of the DESAlert software, and its data products, and we show sample results from the application of DESAlert to numerous previously detected gamma-ray bursts, including the possible identification of several heretofore unknown gamma-ray burst hosts.
We tested a hypothesis that there is no genetic correlation between general factors of intelligence and personality, despite both having been selected for in human evolution. This was done using twin samples from Australia, the United States, the Netherlands, Great Britain, and Croatia, comprising altogether 1,748 monozygotic and 1,329 same-sex dizygotic twin pairs. Although parameters in the model-fitting differed among the twin samples, the genetic correlation between the two general factors could be set to zero, with a better fit if the U.S. sample was excepted.
The ApRES (autonomous phase-sensitive radio-echo sounder) instrument is a robust, lightweight and relatively inexpensive radar that has been designed to allow long-term, unattended monitoring of ice-shelf and ice-sheet thinning. We describe the instrument and demonstrate its capabilities and limitations by presenting results from three trial campaigns conducted in different Antarctic settings. Two campaigns were ice sheet-based – Pine Island Glacier and Dome C – and one was conducted on the Ross Ice Shelf. The ice-shelf site demonstrates the ability of the instrument to collect a time series of basal melt rates; the two grounded ice applications show the potential to recover profiles of vertical strain rate and also demonstrate some of the limitations of the present system.
Ridgway’s Hawk Buteo ridgwayi is a Critically Endangered forest raptor endemic to the island of Hispaniola in the Caribbean. The species is currently limited to a small area on the north-east coast of the island, with fewer than 110 pairs remaining. From 2005 to 2009 we studied its breeding ecology, finding that Ridgway’s Hawks have a clutch size (2.0 ± 0.4 eggs) similar to other tropical raptors and island Buteo species. Fledging rate of 0.64 fledglings per active nest (fledgling nest-1) with pairs raising a single brood per year was also similar to that of other tropical Buteo species. Nest success was 40% (n = 151), with the majority of nest failures caused by human disturbance. The two significant predictors of nest success and fledging rate were related to human persecution: nest height and territory disturbance index. Pairs were able to tolerate human activity in their territory if there was no direct disturbance to the immediate nest area. Conservation planning for Ridgway’s Hawk must focus on community awareness programmes targeting local user groups within Los Haitises National Park regarding the uniqueness and endangered status of the hawk, and effective protection of the remaining karst forest in Los Haitises.
Subterranean clover (Trifolium subterraneum L.) is the most important annual pasture legume in the winter-dominant rainfall areas of Southern Australia. Systematic germplasm collections of subterranean clover from its centre of origin have been made since the 1950s, particularly by Australian scientists, in order to broaden the genetic base of the species. The present study reports on a meta-analysis of the distribution of the world collection of subterranean clovers and their relationships to eco-geographic variables of the collection sites in their native habitat. Diversity hotspots (areas rich in number of accessions and containing a high diversity of sub-species) and also gaps (areas with particular traits un- or under-represented in collections) were identified. This was achieved using a stratified data system to evaluate eco-geographical and agro-morphological data which incorporated three tiers of information for the subterranean clover collection: (1) information from each collection site, including ecological data; (2) information on the phenotypic diversity within each collection site; and (3) plant agro-morphological data from each sample grown under controlled conditions. Correlations were found between some eco-geographic conditions and agronomic performance. These included correlations between latitude and flowering time, mean temperature in winter and winter productivity and precipitation in summer and seed dormancy. The present study concluded that subterranean clover versatility is greater than suggested in the past. The results of the current analysis provide a guide for future collecting missions to specific regions towards areas of maximum diversity (hotspots) and unknown diversity (gaps).
To assess the health of community residents following a coal fly ash spill at the Tennessee Valley Authority Kingston Fossil Plant in Harriman, Tennessee, on December 22, 2008.
A uniform health assessment was developed by epidemiologists at Oak Ridge Associated Universities and medical toxicologists at Vanderbilt University Medical Center. Residents who believed that their health may have been affected by the coal fly ash spill were invited to participate in the medical screening program.
Among the 214 individuals who participated in the screening program, the most commonly reported symptoms were related to upper airway irritation. No evidence of heavy metal toxicity was found.
This is the first report, to our knowledge, regarding the comprehensive health evaluation of a community after a coal fly ash spill. Because this evaluation was voluntary, the majority of residents screened represented those with a high percentage of symptoms and concerns about the potential for toxic exposure. Based on known toxicity of the constituents present in the coal fly ash, health complaints did not appear to be related to the fly ash. This screening model could be used to assess immediate or baseline toxicity concerns after other disasters. (Disaster Med Public Health Preparedness. 2014;0:1–8)
Hexagonal boron nitride (hBN) is a promising material for a range of applications including deep-ultraviolet light emission. Despite extensive experimental studies, some fundamental aspects of hBN remain unknown, such as the type of stacking faults likely to be present and their influence on electronic properties. In this paper, different stacking configurations of hBN are investigated using CASTEP, a pseudopotential density functional theory code. AB-b stacking faults, in which B atoms are positioned directly on top of one another while N atoms are located above the center of BN hexagons, are shown to be likely in conventional AB stacked hBN. Bandstructure calculations predict a single direct bandgap structure that may be responsible for the discrepancies in bandgap type observed experimentally. Calculations of the near edge structure showed that different stackings of hBN are distinguishable using measurements of core-loss edges in X-ray absorption and electron energy loss spectroscopy. AB stacking was found to best reproduce features in the experimental B and N K-edges. The calculations also show that splitting of the 1s to π* peak in the B K-edge, recently observed experimentally, may be accounted for by the presence of AB-b stacking faults.