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Obese subjects have shown a preference for dietary lipids. A recent collection of evidence has proposed that a variant in the CD36 gene plays a significant role in this pathway. We assessed the association between the orosensory detection of a long-chain fatty acid, i.e. oleic acid (OA), and genetic polymorphism of the lipid taste sensor CD36 in obese and normal-weight subjects. Adult participants were recruited in the fasting condition. They were invited to fat taste perception sessions, using emulsions containing OA and according to the three-alternative forced-choice (3-AFC) method. Genomic DNA was used to determine the polymorphism (SNP rs 1761667) of the CD36 gene. Obese (n 50; BMI 34⋅97 (sd 4⋅02) kg/m2) exhibited a significantly higher oral detection threshold for OA (3⋅056 (sd 3⋅53) mmol/l) than did the normal-weight (n 50; BMI 22⋅16 (sd 1⋅81) kg/m2) participants (1⋅20 (sd 3⋅23) mmol/l; P = 0⋅007). There was a positive correlation between OA detection thresholds and BMI in all subjects; evenly with body fat percentage (BF%). AA genotype was more frequent in the obese group than normal-weight group. OA detection thresholds were much higher for AA and AG genotypes in obese subjects compared with normal-weight participants. Higher oral detection thresholds for fatty acid taste are related to BMI, BF% and not always to CD36 genotype.
Studying the dermal skeleton in fish is valuable for phylogenetic specification. The current study describes the detailed structure of the plecostomus dermal skeleton, including its morphogenesis and distribution in the skin. The denticles have a crown and a basal part and are embedded in bony depressions, to which they are attached by denticle ligaments. During denticle morphogenesis, denticle papillae formed from denticle precursor cells align in two cellular layers: an outer ameloblast precursor layer and an inner odontoblast precursor layer. The ameloblast precursors and odontoblast precursors differentiate and secrete enamel and dentine, respectively. We used different histochemical techniques, including Crossmon's trichrome staining, Weigert–Van Gieson staining, periodic acid–Schiff (PAS) staining, combined Alcian blue (AB; pH 2.5)/PAS staining, Weigert–Van Gieson staining, Mallory trichrome staining, and AB staining to distinguish the dentine and denticle ligaments. We used acridine orange to detect lysosome activity during denticle eruption. Transmission electron microscopy was used to detect the denticle ultrastructure, and scanning electron microscopy was used to detect the topographic distributions of different types of dermal tissues in different anatomical regions.
The rapid and accurate clinical assessment of a head-injured patient is crucial. The initial management should be governed by attention to the airway, breathing and circulation according to the principles of the Advanced Trauma Life Support (ATLS) care system. This is vital not only to identify immediately life-threatening injuries but also to prevent secondary cerebral insults. The cervical spine should be immobilised, since patients with a head injury may also harbour a cervical spine injury.1 The level of consciousness and pupil size and reaction should be determined early and at regular intervals when managing patients with TBI.
There has been a continued debate in the last decade about the possible role of polyunsaturated fatty acids especially omega-3 fatty acids in attention deficit hyperactivity disorder (ADHD) either as a causative factor - on deficiency - or as a treatment.
To compare omega-3 fatty acids status in children with ADHD to normal children and to study the efficacy of high dose supplementations of fatty acids on symptoms of ADHD.
Subjects & methods:
40 children diagnosed with ADHD combined type and another 40 normally developing as a control group. All patients were subjected to Mini International Neuropsychiatric Interview for Children, IQ assessment,.Conners' Parent Rating Scale-Revised long version (CPRS-R-L), Vigil continuous performance test. The patients were prescribed omega-3 fatty acid supplement daily dose of 900 mg EPA and 600 mg DHA for 3 months. After end of the 3 months these children were assessed again using the Conners' parent rating scale-revised and Vigil continuous performance test.
Significantly lower levels of EPA and DHA in ADHD group compared to normal control inverse correlation between DHA on one side and Conner's ADHD index; inattentive subtest and total DSMIV indexed on the other side Conners’ ADHD index subscale there was a statistically significant improvement following the treatment.
Low levels of omega 3 may contribute to the symptoms of ADHD. Supplementing omega 3 in the treatment of ADHD could be a useful add on tratment specially in cases demonstrating low serum levels.
According to WHO, suicide is a major public health problem and the most affected age group by suicide in Tunisia is that of over 70 years.
To study the perception of the Tunisian elderly of suicide.
A cross-sectional study was conducted during a 3-month period from October to December 2015. Fifty persons aged at least 65 years participated to the study. We used an anonymous questionnaire with a specific scale: “Attitudes Towards Suicide Questionnaire” (ATTS).
The mean age of our patients was 67.5 years. Sex ratio was 1.27. Most of the participants were married (82%), unemployed (63.2%), with a secondary or high educational level (62%), and low income (73.5%). All participants were believers. As for religious practice, 74.5% of the recruited elderly made the fast and 73.5% were prayers. Among women, 70.8% wore the veil. Concerning the perception of suicide, it was on the dimension of “permissiveness” (M = 1.88) that our participants agreed less. Those who made prayers had lower scores of “permissiveness” (P = 0.032). Women who wore the veil had higher scores on the field of “incomprehensibility” than the unveiled ones (P = 0.047). Furthermore, 68% of our participants believed that suicide is stigmatizing.
It might be time to try to lift the taboo and stigma through information and sensitizing campaigns on suicide. In this direction, studies of perception help to identify, somehow, “automatic thoughts” regarding representations of suicide and to try to develop an “alternative thinking” in the general population.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
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MMS scores for 41 psychiatric patients were analyzed at admission and regularly throughout their stay.
Their average age at admission was 65.7. Thirty-six patients had a diagnosis of chronic psychosis, two with bipolar disorders, one with frontotemportal dementia, two with Korsakoff syndrome.
At admission, 21 (51%) patientsshowed mild cognitive deterioration (score = 18–26), 12 (29%) moderate deterioration (12–17), 6 severe deterioration (0–11), 2 had normal scores (27–30). Over the following years, 28 patients were reassessed:
– 12 (42%) were stable, 7 (25%) had a fluctuating score, 5 (18%) improved;
– 4 (14%) deteriorated over their successive MMS evaluations;
– age, socio-cultural level and psychiatric diagnosis were not associated with change in MMS scores;
– average change between initial and final assessment was +6.0 points for patients with improved score, –7.75 for those showing deterioration;
– 1.28 for those with fluctuating scores, –1.0 for stable patients.
Unstable psychiatric disorders associated with somatic pathologies influenced MMS scores for all patients, particularly for those with MMS deterioration or fluctuation even if this phenomenon could also be observed to a lesser extent in stable patients. By contrast, patients whose MMS scores improved over time were more mentally stable and had no current somatic problems. Multidisciplinary teamwork is important for patients with deteriorating MMS scores.
By illustrating the impact of somatic and psychiatric factors on dementia, the present study underlines the value of multidisciplinary professional care, the role of the family and the importance of long-stay wards.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Suicide in children and adolescents is commonly underreported and studied. It is an interplay area of multiple static (sociodemographic), and modifiable (impulsivity, psychiatric morbidities, adverse life events (ALE), abuse, bullying) variables.
Objectives and aim
To assess and identify relative significance of dependent and independent risk factors in youngsters attempting self-inflicted poisoning.
Consecutive recruitment of patients aged 7–18, with normal IQ, admitted to poison control centre over 13 continuous months, with self-induced poisoning. All were assessed after guardians’ written informed consent for different risk factors identified for suicidal behavior using appropriate scales (PPS, SRRS-Y, FSSCS, BIS-11, J-TCI, Mini-Kid). Controls with no history of suicidal attempt were matched for age, sex and sociodemographics among their families.
One hundred and twenty cases (16.7 years ± 1.6 SD, 91% females) and 100 controls (age 16.4 years ± 1.7 SD, 90.8% females) were assessed. In cases, 90.8% were of low/middle socioeconomic status, 73.5% had previous attempt, average within 10 months, 17.5% planned their attempt, 10.8% had a witnessed attempt. Stressor within 2 days was reported in 75.9%, severe in 40%. Impulsivity was more in its cognitive, planning and motor components (P = 0.001 in each) among attempters. Cases scored more on Novelty seeking, harm avoidance and reward dependence than controls who had more persistence, self-directedness and cooperativeness. Attempters had significantly more past medical and psychiatric history (P = 0.001, 0.05 respectively), 77.5% had a working psychiatric illness, 2% in controls.
Repeated suicidal attempts were the majority, with impulsivity as a predictive risk, especially if psychiatric morbidity or ALE in youths were encountered.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Little information is known about the influence of altitude on child growth in Ethiopia, where most people live in highlands. We investigated the relation of residential altitude with growth faltering (stunting) of infants and young children in Ethiopia. We also examined whether the altitude–growth relationship was independent of the influence of the dietary and non-dietary determinants of growth. We used the data of 26 976 under-5-year-old children included in the Ethiopian Demographic and Health Surveys, conducted from 2005 to 2016. The samples were recruited following a two-stage cluster sampling strategy. Stunting was defined by height-for-age <−2 z-scores. The relationship between residential altitude and stunting was examined by running multiple logistic regression analysis, controlling the effect of covariate dietary and non-dietary variables. The residential altitude of the study participants ranged from −116 to 4500 m above sea level (masl). There was a significant and progressive increase in the prevalence and odds of stunting with increasing altitude (P < 0·001), irrespective of the dietary and non-dietary predictors of stunting. The prevalence of stunting was lowest in lowlands (39 %) and highest in highlands (47 %). Compared with altitude <1000 masl, the odds of stunting was 1·41 times higher at altitude ≥2500 masl (OR 1·41, 95 % CI 1·16, 1·71) and 1·29 times higher at altitude 2000–2499 masl (OR 1·29, 95 % CI 1·11, 1·49). Children living in highlands might be at a higher risk of poor growth. Further studies are warranted to understand the mechanism behind the observed altitude–stunting link and identify strategies to compensate for the growth-faltering effect of living in highlands.
Neonates are at high risk of bleeding after open-heart surgery. We sought to determine pre-operative and intra-operative risk factors for increased bleeding after neonatal open-heart surgery with cardiopulmonary bypass.
We conducted a retrospective cohort study of neonates (0–30 days old) who underwent open-heart surgery with cardiopulmonary bypass from January, 2009, to March, 2013. Cardiac diagnosis; demographic and surgical data; and blood products, haemostatic agents, and anti-thrombotic agents administered before, during, and within 24 hours after surgery were abstracted from the electronic health record and anaesthesia records. The outcome of interest was chest tube output (in ml/kg body weight) within 24 hours. Relationships between chest tube output and putative associated factors were evaluated by unadjusted and adjusted linear regression.
The cohort consisted of 107 neonates, of whom 79% had a Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) Mortality Category of 4 or 5. Median chest tube output was 37 ml/kg (range 9–655 ml/kg). Age, African-American race, and longer durations of surgery and cardiopulmonary bypass each had statistically significant associations with increased chest tube output in unadjusted analyses. In multivariable analysis, African-American race retained an independent, statistically significant association with increased chest tube output; the geometric mean of chest tube output among African-American neonates was 71% higher than that of Caucasians (95% confidence interval, 29–125%; p = 0.001).
Among neonates with CHD undergoing open-heart surgery with cardiopulmonary bypass, African-American race is independently associated with greater chest tube output over the first 24 hours post-operatively.
We previously studied the phenomena of the mesenchymal cell-dependent mode of cartilage growth in quail and catfish. Thus, we selected the two cartilage models in which mesenchymal cells participate in their growth. In such models, cartilage degradation occurred to facilitate cellular invasion. The studies do not explain the nature of the cartilage degrading cells. The current study aims to explore the nature of the cartilage-degrading cells using transmission electron microscopy (TEM) and immunohistochemistry. Samples of cartilage have been isolated from the air-breathing organ of catfish and the cartilage of the prospective occipital bone of quail embryos. Samples have been processed for TEM and immunohistochemistry. We found that two different cell types are involved in cartilage degradation; the macrophage in the cartilage of catfish and mesenchymal cells in the cartilage of the quail. Areas of cellular invasion in both catfish cartilage and quail embryo cartilage had an immunological affinity for MMP-9. In catfish, cartilage-degrading cells had identical morphological features of macrophages, whereas in quail embryos, cartilage-degrading cells were mesenchymal-like cells which had cell processes rich in vesicles and expressed CD117. Further study should consider the role of macrophage and mesenchymal cells during cartilage degradation. This could be valuable to be applied to remove the defective cartilage matrix formed in osteoarthritic patients to improve cartilage repair strategies.
Soiling can lead to severe performance losses of photovoltaic (PV) plants. Within this study, three different anti-soiling coatings (ASC) were applied to three different commercial, solar-grade rolled glasses with different surface structures. Laboratory soiling experiments were performed including wind simulation and a novel rotational force test to assess the influence of different surface structures of the glass substrate on the anti-soiling performance of the coatings. A detailed microscopic evaluation indicates a consistent ranking of the ASC with regard to particle resuspension behavior for both test methods and all substrates. Furthermore, the rotational force test yields a quantitative measure of the median force needed for particle removal from the respective coating, which is independent of the glass substrate surface morphology.
This paper presents a vision-based path planning strategy that aims to reduce the computational time required by a robot to find a feasible path from a starting point to the goal point. The proposed algorithm presents a novel strategy that can be implemented on any well-known path planning algorithm such as A*, D* and probabilistic roadmap (PRM), to improve the swiftness of these algorithms. This path planning algorithm is suitable for real-time scenarios since it reduces the computational time compared to the basis and traditional algorithms. To test the proposed path planning strategy, a tracking control strategy is implemented on a mobile platform. This control strategy consists of three major stages. The first stage deals with gathering information about the surrounding environment using vision techniques. In the second stage, a free-obstacle path is generated using the proposed reduced scheme. In the final stage, a Lyapunov kinematic tracking controller and two Artificial Neural Network (ANN) based-controllers are implemented to track the proposed path by adjusting the rotational and linear velocity of the robot. The proposed path planning strategy is tested on a Pioneer P3-DX differential wheeled mobile robot and an Xtion PRO depth camera. Experimental results prove the efficiency of the proposed path planning scheme, which was able to reduce the computational time by a large percentage which reached up to 88% of the time needed by the basis and traditional scheme, without significant adverse effect on the workability of the basis algorithm. Moreover, the proposed path planning algorithm has improved the path efficiency, in terms of the path length and trackability, challenging the traditional trade-off between swiftness and path efficiency.
To investigate a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak event involving multiple healthcare facilities in Riyadh, Saudi Arabia; to characterize transmission; and to explore infection control implications.
Cases presented in 4 healthcare facilities in Riyadh, Saudi Arabia: a tertiary-care hospital, a specialty pulmonary hospital, an outpatient clinic, and an outpatient dialysis unit.
Contact tracing and testing were performed following reports of cases at 2 hospitals. Laboratory results were confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) and/or genome sequencing. We assessed exposures and determined seropositivity among available healthcare personnel (HCP) cases and HCP contacts of cases.
In total, 48 cases were identified, involving patients, HCP, and family members across 2 hospitals, an outpatient clinic, and a dialysis clinic. At each hospital, transmission was linked to a unique index case. Moreover, 4 cases were associated with superspreading events (any interaction where a case patient transmitted to ≥5 subsequent case patients). All 4 of these patients were severely ill, were initially not recognized as MERS-CoV cases, and subsequently died. Genomic sequences clustered separately, suggesting 2 distinct outbreaks. Overall, 4 (24%) of 17 HCP cases and 3 (3%) of 114 HCP contacts of cases were seropositive.
We describe 2 distinct healthcare-associated outbreaks, each initiated by a unique index case and characterized by multiple superspreading events. Delays in recognition and in subsequent implementation of control measures contributed to secondary transmission. Prompt contact tracing, repeated testing, HCP furloughing, and implementation of recommended transmission-based precautions for suspected cases ultimately halted transmission.
New excavations at the Jebel Moya cemetery in Sudan reveal extensive evidence for Meroitic-era occupation, providing valuable data on contemporaneous diet, migration, exchange and population composition in sub-Saharan Africa.
Coincidence site lattice (CSL) grain boundaries (GBs) are believed to be low-energy, resistant to intergranular fracture, as well as to hydrogen embrittlement. Nevertheless, the behavior of CSL-GBs are generally confused with their angular deviations. In the current study, the effect of angular deviation from the perfect
$\Sigma 3(111)[1\bar 10]$
GBs in α-iron on the hydrogen diffusion and the susceptibility of the GB to hydrogen embrittlement is investigated through molecular static and dynamics simulations. By utilizing Rice–Wang model, it is shown that the ideal GB shows the highest resistance to decohesion below the hydrogen saturation limit. Finally, the hydrogen diffusivity along the ideal GB is observed to be the highest.
BACKGROUND: IGTS is a rare phenomenon of paradoxical germ cell tumor (GCT) growth during or following treatment despite normalization of tumor markers. We sought to evaluate the frequency, clinical characteristics and outcome of IGTS in patients in 21 North-American and Australian institutions. METHODS: Patients with IGTS diagnosed from 2000-2017 were retrospectively evaluated. RESULTS: Out of 739 GCT diagnoses, IGTS was identified in 33 patients (4.5%). IGTS occurred in 9/191 (4.7%) mixed-malignant GCTs, 4/22 (18.2%) immature teratomas (ITs), 3/472 (0.6%) germinomas/germinomas with mature teratoma, and in 17 secreting non-biopsied tumours. Median age at GCT diagnosis was 10.9 years (range 1.8-19.4). Male gender (84%) and pineal location (88%) predominated. Of 27 patients with elevated markers, median serum AFP and Beta-HCG were 70 ng/mL (range 9.2-932) and 44 IU/L (range 4.2-493), respectively. IGTS occurred at a median time of 2 months (range 0.5-32) from diagnosis, during chemotherapy in 85%, radiation in 3%, and after treatment completion in 12%. Surgical resection was attempted in all, leading to gross total resection in 76%. Most patients (79%) resumed GCT chemotherapy/radiation after surgery. At a median follow-up of 5.3 years (range 0.3-12), all but 2 patients are alive (1 succumbed to progressive disease, 1 to malignant transformation of GCT). CONCLUSION: IGTS occurred in less than 5% of patients with GCT and most commonly after initiation of chemotherapy. IGTS was more common in patients with IT-only on biopsy than with mixed-malignant GCT. Surgical resection is a principal treatment modality. Survival outcomes for patients who developed IGTS are favourable.
This work focuses on the syntheses of Zn-enriched PtZn nanoparticle electrocatalysts by solution combustion for ethanol oxidation reaction (EOR). Analytical techniques of x-ray diffraction, transmission electron microscopy (TEM), scanning electron microscopy, TEM/scanning TEM-energy dispersive x-ray spectroscopy, and x-ray photoelectron spectroscopy are used for the characterization of electrocatalysts. Cyclic voltammetry and chronoamperometry are applied for the electrocatalysis of C2H5OH and stability test in an alkaline medium, respectively. Electrochemical data show that PtZn/C has improved electrocatalytic activity by ~2.3 times compared with commercial Pt/C, in addition to having earlier onset potential and better stability for EOR. The variation of fuel amount in the synthesis has affected crystallite sizes, electronic, and electrochemical properties in electrocatalysts.