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Current group-average analysis suggests quantitative but not qualitative cognitive differences between schizophrenia (SZ) and bipolar disorder (BD). There is increasing recognition that cognitive within-group heterogeneity exists in both disorders, but it remains unclear as to whether between-group comparisons of performance in cognitive subgroups emerging from within each of these nosological categories uphold group-average findings. We addressed this by identifying cognitive subgroups in large samples of SZ and BD patients independently, and comparing their cognitive profiles. The utility of a cross-diagnostic clustering approach to understanding cognitive heterogeneity in these patients was also explored.
Hierarchical clustering analyses were conducted using cognitive data from 1541 participants (SZ n = 564, BD n = 402, healthy control n = 575).
Three qualitatively and quantitatively similar clusters emerged within each clinical group: a severely impaired cluster, a mild-moderately impaired cluster and a relatively intact cognitive cluster. A cross-diagnostic clustering solution also resulted in three subgroups and was superior in reducing cognitive heterogeneity compared with disorder clustering independently.
Quantitative SZ–BD cognitive differences commonly seen using group averages did not hold when cognitive heterogeneity was factored into our sample. Members of each corresponding subgroup, irrespective of diagnosis, might be manifesting the outcome of differences in shared cognitive risk factors.
Phyto-oestrogens have been suggested to have a protective effect on hormone-sensitive cancers. However, few studies have investigated the association between dietary phyto-oestrogens and gynaecological cancers. In the present study, we analysed data from two population-based case–control studies of ovarian (1366 cases and 1414 controls) and endometrial (1288 cases and 1435 controls) cancers. Dietary intake information was obtained using a 135-item FFQ, and phyto-oestrogen intake was estimated using published food composition databases. Unconditional logistic regression was used to estimate adjusted OR and 95 % CI. In multivariable analyses, there was a suggestive pattern of inverse associations between increasing intakes of total phyto-oestrogens, isoflavones and enterolignans and the risk of ovarian cancer. However, the results only reached statistical significance for the lignan compounds matairesinol and lariciresinol, where the OR for the highest v. the lowest intake category was 0·72 (95 % CI 0·54, 0·96; P for trend = 0·02) for matairesinol and 0·72 (95 % CI 0·55, 0·96; P for trend = 0·03) for lariciresinol. When the risk of ovarian cancer was assessed by subtype, there was an indication that increasing intakes of phyto-oestrogens may be associated with a decreased risk of mucinous (cases n 158) ovarian tumours (OR for the highest v. the lowest intake category: 0·47 (95 % CI 0·24, 0·93); P for trend = 0·04). However, there were no significant associations with other histological subtypes. In contrast, dietary phyto-oestrogens (total or any subclass) were unrelated to the risk of endometrial cancer cases overall or by subtype.
Growth failure is a common yet complex problem of childhood chronic kidney disease caused by multiple factors encountered due to the primary disease or secondary to the renal impairment. This review seeks to describe the various patho-physiological mechanisms contributing to growth failure in the various stages of childhood with particular emphasis on nutritional problems and endocrine dysfunction encountered whilst managing these children. In addition, we shall examine the role of body composition in chronic kidney disease, their relationship with growth and nutrition and the potential effect of abnormalities in fat mass and lean mass on long-term morbidity and mortality.
Rapid eye movement (REM) sleep behavior disorder (RBD) is a
sleep disturbance that commonly occurs in Dementia with Lewy
bodies (DLB). Retrospective examination of DLB course has shown
that RBD and cognitive decline may precede the onset of
parkinsonism and visual hallucinations. Therefore, some patients
with DLB may initially present with dementia and RBD, but would
not meet current formal criteria for probable DLB at that time.
The purpose of this study is to determine whether patients with
dementia and RBD, who do not have parkinsonism or visual
hallucinations, have cognitive profiles that can be distinguished
from autopsy-confirmed definite AD, but not from clinically
probable DLB. If so, this would support the hypothesis that
the presence of RBD and dementia, as the only presenting symptoms,
reflects the early manifestation of DLB. Results show that early
dementia in probable DLB and dementia with RBD are
neuropsychologically indistinguishable. Both groups differ from
definite AD of a similar early stage with significantly worse
visual perceptual organization, sequencing and letter fluency
but significantly better confrontation naming and verbal memory.
In addition, follow-up data from a subset of patients with dementia
and RBD reveal the subsequent development of parkinsonism or
hallucinations 1 to 6 years later. Results indicate that the
presentation of dementia and RBD is suggestive of underlying
Lewy body disease and not Alzheimer's disease. This provides
further evidence in support of including RBD as one of the core
diagnostic features of DLB. (JINS, 2002, 8, 907–914.)
To study the preparedness New York City for large scale medical disasters using the Year 2000 (Y2K) New Years Eve weekend as a model.
Surveys were sent to the directors of 51 of the 9-1-1-receiving hospitals in New York City before and after the Y2K weekend. Inquiries were made regarding hospital activities, contingencies, protocols, and confidence levels in the ability to manage critical incidents, including weapons of mass destruction (WMD) events. Additional information was collected from New York City governmental agencies regarding their coordination and preparedness.
The pre-Y2K survey identified that 97.8% had contingencies for loss of essential services, 87.0% instituted their disaster plan in advance, 90.0% utilized an Incident Command System, and 73.9% had a live, mock Y2K drill. Potential terrorism influenced Y2K preparedness in 84.8%. The post-Y2K survey indicated that the threat of terrorism influenced future preparedness in 73.3%; 73.3% had specific protocols for chemical; 62.2% for biological events; 51.1% were not or only slightly confident in their ability to manage any potential WMD incidents; and 62.2% felt very or moderately confident in their ability to manage victims of a chemical event, but only 35.6% felt similarly about victims of a biological incident. Moreover, 80% felt there should be government standards for hospital preparedness for events involving WMD, and 84% felt there should be government standards for personal protective and DECON equipment. In addition, 82.2% would require a moderate to significant amount of funding to effect the standards. Citywide disaster management was coordinated through the Mayor's Office of Emergency Management.
Although hospitals were on a heightened state of alert, emergency department directors were not confident in their ability to evaluate and manage victims of WMD incidents, especially biological exposures. The New York City experience is an example for the rest of the nation to underscore the need for further training and education of preparedness plans for WMD events. Federally supported education and training is available and is essential to improve the response to WMD threats.
Zero-water exchange culture tanks were stocked with Penaeus vannamei postlarvae to compare the effects of (i) three dietary phosphorus levels: 0.4, 0.8 and 1.2 %, and (ii) three dietary inorganic phosphorus sources: CaHPO4, Na2HPO4 and NaH2PO4, on postlarvae biological performance, and total reactive phosphorus accumulation in the water (TRPAW). Dietary Ca:P ratio was maintained within a 1:1 to 1:2 ratio. Postlarvae survival was high and not significantly different among treatments. Postlarvae growth was not significantly different, regardless of dietary phosphorus level. TRPAW was significantly higher with increasing level of dietary phosphorus. Dietary inorganic phosphorus source did not have a significant effect on postlarvae growth. No significant differences were found on TRPAW between diets with Na2HPO4 and NaH2PO4 supplementation at equal dietary phosphorus level. TRPAW was significantly lower with CaHPO4 than with Na2HPO4 or NaH2PO4 supplementation at equal dietary phosphorus level. Environmental quality of culture water may be greatly modified through nutritional strategies without negatively affecting shrimp biological performance.
CBA/T6 and DBA/2J mice inoculated with Plasmodium berghei ANKA (PbA) develop cerebral involvement 6–8 days post-inoculation, from which the CBA mice almost invariably die and the DBA mice recover. Dexamethasone (DXM; 80 mg/kg) given to inoculated CBA mice twice, on day 3 and again within 48 h, reduced the cerebral symptoms and prevented death from cerebral malaria. Plasma tumour necrosis factor (TNF) levels, which increased at the time of the cerebral symptoms, were also reduced in these DXM-treated mice. Intravenously administered Evans Blue, a dye which binds to albumin, diffused extensively across the blood-brain barrier only during the period of cerebral symptoms, in proportion to the severity of the cerebral symptoms and the disease. In PbA-infected CBA mice, cerebral symptoms and the amount of Evans Blue diffusing into the brain tissue were both reduced by DXM treatment, but only if the steroid was given on day 3 and again within 48 h. Endotoxin injected intravascularly into PbA-infected DBA mice after day 5 resulted in an exaggeration of cerebral symptoms and death between days 6 and 9. Plasma TNF and the amount of Evans Blue in the brain parenchyma increased above normal levels in these mice. Endotoxin injections had only minor effects on the severity of the cerebral symptoms in PbA-infected CBA mice and did not cause the animals to die sooner.
Performance/safety assessments have been conducted for the Waste Isolation Pilot Plant, a repository for transuranic waste in salt. We challenge two key assumptions in the 1992 Performance Assessment that led to non-conservative results. The predicted release rate of radionuclides appears underestimated due to the use of expert elicited solubilities. The overall release has been underestimated due to the use of improperly elicited human intrusion probabilities.
CBA/T6 mice inoculated with Plasmodium berghei ANKA strain (PbA) exhibited cerebral symptoms and died from cerebral malaria 6–8 days p.i. whereas DBA/2J mice developed (around days 6–9) a non-fatal cerebral malaria, with milder cerebral symptoms, and died between days 15 and 22 from other malaria-related complications. When inoculated with P. berghei K173 (Pb) these mouse strains did not develop cerebral malaria. These mouse/parasite strain combinations were used, in conjunction with the retinal whole-mount technique, to elucidate factors critical in the pathology of murine cerebral malaria. CBA/T6 mice infected with PbA (PbA-CBA mice) demonstrated mild changes in vascular permeability as early as days 2–3, prior to the appearance on day 5 of cerebral symptoms, whereas mice with non-cerebral malaria did not show any vascular permeability changes until the very late stage of the disease (days 14–22). In the PbA infections, progressive deterioration of endothelial barrier properties, demonstrated by Evans' Blue leakage both generally and from specific focal areas, as well as a developing monocytosis and adherence of mononuclear cells to the endothelium of the retinal vessels continued until death (in CBA/T6 mice) or resolution (in DBA/2J mice). Adherent monocytes, particularly in PbA-CBA mice, were associated with reduced Hoechst staining of individual endothelial cells and a banking up proximally of both parasitized and non-parasitized blood cells in the small blood vessels, often with accompanying focal leakage of Evans' Blue from the retinal vessels. The occurrence and severity of these early changes in the microcirculation correlated with the subsequent development of cerebral symptoms. Monocyte margination appeared to be the most significant factor associated with the development of cerebral symptoms.
The history of the first 10 years of the Channel Navigation Information Service (CNIS) from its inception in 1972 has been well-documented in Captain Richard Emden's three papers published in the Journal of the Royal Institute of Navigation. While the purpose of this paper is to discuss the period of consolidation following these first 10 years, it is perhaps appropriate to set out briefly the factors leading up to the introduction of CNIS in the Dover Strait, the operating philosophy and some of the major milestones along the way.
Twenty high contact Queensland Aboriginal children of mean age six years were tested on two measures of capaciy to process information (cf. Case, et al., 1982 and Halford, 1984) and on two newly devised tasks to measure levels of thinking based on cultural knowledge. The results indicated that these children possess capacity to process information that is the same as Caucasian children of the same age. Because these children have underlying capacity to learn tasks to the same level as any other child the results have implications for schooling. It is intended that this initial trial testing will be followed up in a larger study.
Let Mn be a Riemannian manifold of dimension n ≧ 2 and class C3, (gtj) the symmetric matrix of the positive definite metric of Mn, and (gij) the inverse matrix of (gtj), and denote by and R = gijRij the operator of covariant differentiation with respect to gij, the Riemann tensor, the Ricci tensor and the scalar curvature of Mn respectively.
Some time ago, Geoffrey Matthews and others introduced the idea of ‘shopping’ matrices as a method of introducing matrix multiplication in schools, and it recently occurred to me that these shopping matrices might also provide a palatable realisation of something that undergraduates traditionally find pretty indigestible when they first meet it, namely the idea of dual space, and particularly the transpose or adjoint mapping associated with a given linear mapping between two vector spaces.
A typical sixth form book which is introducing vectors may approach the subject in the following manner. Of necessity, this particular introduction is rather condensed, but the reader will almost certainly recognise certain key phrases and be familiar with the general spirit of what is intended.