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.
To determine whether probiotic prophylaxes reduce the odds of Clostridium difficile infection (CDI) in adults and children.
Individual participant data (IPD) meta-analysis of randomized controlled trials (RCTs), adjusting for risk factors.
We searched 6 databases and 11 grey literature sources from inception to April 2016. We identified 32 RCTs (n=8,713); among them, 18 RCTs provided IPD (n=6,851 participants) comparing probiotic prophylaxis to placebo or no treatment (standard care). One reviewer prepared the IPD, and 2 reviewers extracted data, rated study quality, and graded evidence quality.
Probiotics reduced CDI odds in the unadjusted model (n=6,645; odds ratio [OR] 0.37; 95% confidence interval [CI], 0.25–0.55) and the adjusted model (n=5,074; OR, 0.35; 95% CI, 0.23–0.55). Using 2 or more antibiotics increased the odds of CDI (OR, 2.20; 95% CI, 1.11–4.37), whereas age, sex, hospitalization status, and high-risk antibiotic exposure did not. Adjusted subgroup analyses suggested that, compared to no probiotics, multispecies probiotics were more beneficial than single-species probiotics, as was using probiotics in clinical settings where the CDI risk is ≥5%. Of 18 studies, 14 reported adverse events. In 11 of these 14 studies, the adverse events were retained in the adjusted model. Odds for serious adverse events were similar for both groups in the unadjusted analyses (n=4,990; OR, 1.06; 95% CI, 0.89–1.26) and adjusted analyses (n=4,718; OR, 1.06; 95% CI, 0.89–1.28). Missing outcome data for CDI ranged from 0% to 25.8%. Our analyses were robust to a sensitivity analysis for missingness.
Moderate quality (ie, certainty) evidence suggests that probiotic prophylaxis may be a useful and safe CDI prevention strategy, particularly among participants taking 2 or more antibiotics and in hospital settings where the risk of CDI is ≥5%.
We derive an effective macroscale description for the growth of tissue on a porous scaffold. A multiphase model is employed to describe the tissue dynamics; linearisation to facilitate a multiple-scale homogenisation provides an effective macroscale description, which incorporates dependence on the microscale structure and dynamics. In particular, the resulting description admits both interstitial growth and active cell motion. This model comprises Darcy flow, and differential equations for the volume fraction of cells within the scaffold and the concentration of nutrient, required for growth. These are coupled with Stokes-type cell problems on the microscale, incorporating dependence on active cell motion and pore scale structure. The cell problems provide the permeability tensors with which the macroscale flow is parameterised. A subset of solutions is illustrated by numerical simulations.
High definition video from a towed camera system was used to describe the deep-sea benthic habitats within an elongate depression located at the western margin of Rockall Bank in the Hatton–Rockall Basin. At depths greater than 1190 m, an extensive area (10 km long by 1.5 km wide) of what appeared to be reduced sediments, bacterial mats and flocculent matter indicated possible cold-seep habitat. Plumes of sediment-rich fluid were observed alongside raised elongate features that gave topographic relief to the otherwise flat seafloor. In the deepest section of the depression (1215 m) dense flocculent matter was observed suspended in the water column, in places obscuring the seabed. Away from the bacterial mats, the habitat changed rapidly to sediments dominated by tube-dwelling polychaete worms and then to deep-sea sedimentary habitats more typical for the water depth (sponges and burrowing megafauna in areas of gentle slopes, and coral gardens on steeper slopes).
In this article, we consider the spatial homogenisation of a multi-phase model for avascular tumour growth and response to chemotherapeutic treatment. The key contribution of this work is the derivation of a system of homogenised partial differential equations describing macroscopic tumour growth, coupled to transport of drug and nutrient, that explicitly incorporates details of the structure and dynamics of the tumour at the microscale. In order to derive these equations, we employ an asymptotic homogenisation of a microscopic description under the assumption of strong interphase drag, periodic microstructure, and strong separation of scales. The resulting macroscale model comprises a Darcy flow coupled to a system of reaction–advection partial differential equations. The coupled growth, response, and transport dynamics on the tissue scale are investigated via numerical experiments for simple academic test cases of microstructural information and tissue geometry, in which we observe drug- and nutrient-regulated growth and response consistent with the anticipated dynamics of the macroscale system.
Trypanosoma cruzi is a protozoan parasite that infects vertebrates, causing in humans a pathological condition known as Chagas’ disease. The infection of host cells by T. cruzi involves a vast collection of molecules, including a family of 85 kDa GPI-anchored glycoproteins belonging to the gp85/trans-sialidase superfamily, which contains a conserved cell-binding sequence (VTVXNVFLYNR) known as FLY, for short. Herein, it is shown that BALB/c mice administered with a single dose (1 μg/animal, intraperitoneally) of FLY-synthetic peptide are more susceptible to infection by T. cruzi, with increased systemic parasitaemia (2-fold) and mortality. Higher tissue parasitism was observed in bladder (7·6-fold), heart (3-fold) and small intestine (3·6-fold). Moreover, an intense inflammatory response and increment of CD4+ T cells (1·7-fold) were detected in the heart of FLY-primed and infected animals, with a 5-fold relative increase of CD4+CD25+FoxP3+ T (Treg) cells. Mice treated with anti-CD25 antibodies prior to infection, showed a decrease in parasitaemia in the FLY model employed. In conclusion, the results suggest that FLY facilitates in vivo infection by T. cruzi and concurs with other factors to improve parasite survival to such an extent that might influence the progression of pathology in Chagas’ disease.
The increasing need for portable energy storage density due to the growing number of miniaturized and thin devices is driving the current development of energy storage in phones and other portable devices . Figure 3.1 shows the development from the mobile phones of the 1990s to the multimedia centers of two decades later, and the evident development of the devices to thinner and more flexible forms.
The total power consumption will become even more important when more electronic devices are embedded in the environment. Also with standalone devices designed to operate without mains power supply for long periods, like years, there are new requirements. Energy storage and power management are among the top three issues for customers and developers in current and future mobile multimedia portable devices.
Improvements in conventional battery at the current yearly level are not expected to provide enough energy density to meet all the requirements of future multimedia portables. Even though the use of cellular radio frequency (RF) engine power is expected to reduce with integrated circuit (IC) process and intelligent circuit development, the increasing number of radios and integration of new digital radio, video, and multimedia broadcasting (DAB, DVB-H, DMB) and channel decoders represents a significant challenge both in terms of energy consumption and component costs. Adding wireless local area network (WLAN) and local radio capabilities increases the overall power consumption of smartphones that are already suffering from high energy drain due to the high power consumption of 2.5G/3G wireless modules.
Purpose: To evaluate the role of retrograde urethrography in treatment planning for salvage external beam radiotherapy in patients with increasing prostate-specific antigen levels after radical prostatectomy.
Methods and Materials: From July 1988 to December 2002, 173 consecutive patients received external beam radiotherapy for increasing prostate-specific antigen levels after radical prostatectomy. All 173 simulation films were reviewed, and retrograde urethrography was performed in 148 patients (86%). The distance between the line connecting the lower poles of the ischial tuberosities and site of abrupt narrowing of contrast material was measured in all 148 patients. This distance was compared with that measured in 148 consecutive patients with intact prostates who had retrograde urethrography while undergoing treatment planning for definitive radiotherapy.
Results: The mean (median) distance from the line connecting the lower poles of the ischial tuberosities to the abrupt narrowing seen in the urethrogram in patients with increasing prostate-specific antigen levels was 1.54cm (1.50cm) compared with 1.73cm (1.80cm) in those with intact prostates (p = 0.0145).
Conclusion: Retrograde urethrography is important in treatment planning for salvage radiotherapy of the prostate bed after radical prostatectomy to adequately treat the apex of the prostate bed.
In this work, the growth and characterization of GaAsSbN epilayers nearly lattice matched to GaAs, grown in an elemental solid source molecular beam epitaxy (MBE) system with a RF plasma nitrogen source, are discussed. The Sb and N compositions of the nearly lattice matched layers are 2.6% and 6.8%, respectively, as determined by high resolution x-ray diffraction (HRXRD) and secondary ion mass spectroscopy (SIMS) analysis. The layers are found to be fully strained as evidenced by the presence of Pendellosung fringes on the x-ray diffraction spectra.
Effects of in-situ and ex-situ annealing on the low temperature photoluminescence (PL) characteristics are discussed. The 10 K PL peak energy of 1 eV with a FWHM of 18 meV has been achieved on ex-situ annealed samples in N ambient. The temperature dependence of PL peak energy exhibits “S-shaped” behavior in the low temperature regime, indicative of the presence of localized excitons. Raman spectroscopy analysis has been carried out to determine the local structural changes on annealing.
In this paper we report the growth of GaAsSbN/GaAs single quantum well (SQW) heterostructures by molecular beam epitaxy (MBE) and their properties. A systematic study has been carried out to determine the effect of growth conditions, such as the source shutter opening sequence and substrate temperature, on the structural and optical properties of the layers. The substrate temperatures in the range of 450-470 °C were found to be optimal. Simultaneous opening of the source shutters (SS) resulted in N incorporation almost independent of substrate temperature and Sb incorporation higher at lower substrate temperatures.
The effects of ex-situ annealing in nitrogen ambient and in-situ annealing under As overpressure on the optical properties of the layers have also been investigated. A significant increase in photoluminescence (PL) intensity with reduced full width at half maxima (FWHM) in conjunction with a blue shift in the emission energy was observed on annealing the samples. In in-situ annealed samples, the PL line shapes were more symmetric and the temperature dependence of the PL peak energy indicated significant decrease in the exciton localization energy as exhibited by a less pronounced “S-shaped curve”. The “inverted S-shaped curve” observed in the temperature dependence of PL FWHM is also discussed. 1.61 μm emission with FWHM of 25 meV at 20K has been obtained in in-situ annealed GaAsSbN/GaAs SQW grown at 470 °C by SS.
This report, which was sponsored by the Life Board of the Faculty and Institute of Actuaries, was originally published in November 1997.
Because it is referred to several times in the paper ‘Reserving, Pricing and Hedging for Policies with Guaranteed Annuity Options’, and in the discussions of the paper, and because it is not easily accessible elsewhere, it is printed here as a background paper for reference.
In this investigation we have evaluated whether blockade of endothelin receptors influenced the renal haemodynamic and excretory responses to a period of ischaemia and reperfusion in the anaesthetised rat. The renal artery was occluded for 30 min and renal haemodynamic and excretory function followed for 90 min of reperfusion while either saline, the non-selective endothelin 1 receptor (ETA/ETB) antagonist SB209670 or the selective ETA receptor antagonist UK-350,926 was infused. In the post-ischaemic period, renal cortical and medullary perfusions were reduced by 40-50 %. When SB209670 was administered (30 µg kg-1 min-1 I.V.) for 30 min before, during and for 90 min after renal artery occlusion, cortical and medullary perfusions returned to baseline levels, responses different from those obtained during saline infusion (both P < 0.05). In the presence of UK-350,926 (30 µg kg-1 min-1 I.V.), perfusion in the medulla returned to baseline on clamp removal whereas that in the cortex remained depressed (P < 0.05). Renal ischaemia for 30 min decreased glomerular filtration rate during reperfusion and increased urine flow and sodium excretion 5- to 15-fold. UK-350,926 (30 µg kg-1 min-1 I.V.) reduced (P < 0.05) fluid excretion prior to ischaemia but during reperfusion, glomerular filtration rate returned to basal levels and there were progressive increases in fluid excretion which were smaller compared to the saline-treated group (all P < 0.05). The ischaemic challenge may cause release of endothelin, which acts on ETB receptors in the cortex and ETA receptors in the medulla to decrease perfusion. The blunted natriuresis and diuresis during blockade of ETA receptors may result from either a vascular or tubular action of endothelin. Experimental Physiology (2003) 88.4, 483-490.
Epitaxial thin films of PbZr0.52Ti0.48O3 (PZT) were synthesized successfully on SrRuO3/SrTiO3/MgO/TiN/Si heterostructures by pulsed laser deposition. The films were single phase and had (001) orientation. The deposition parameters were varied to obtain the best epitaxial layer for each of the compounds. Transmission electron microscopy indicated good epitaxy for the entire heterostructure and sharp interfaces between the epilayers. Dielectric and P–E hysteresis loop measurements were carried out with evaporated Ag electrodes. The dielectric constant for the films was found to be between 400–450. The value of saturation polarization Ps was between 55–60 μC/cm2, and the coercive field Ec varied from 60–70 kV/cm. Integration of PZT films with silicon will be useful for future memory and micromechanical devices.
Background. It has been argued recently that the attentional dysfunction in schizophrenia occurs as a result of an inability to inhibit automatic attentional shifts to compelling external stimuli. However, this hypothesis is based on performance on paradigms that require overt or covert shifts of spatial attention.
Method. We investigated responses to foveally presented stimuli in patients with schizophrenia and healthy controls as they performed unidimensional and bidimensional versions of the flanker task. In both tasks, centrally presented target stimuli were flanked by peripheral stimuli that were either congruent or incongruent with the behavioural goal of the subject. In the bidimensional task, the flanking stimuli could be congruent and incongruent on multiple stimulus characteristics.
Results. On the unidimensional flanker task, the behavioural goal modulated the responses of the schizophrenia group such that response times (RTs) to target stimuli that were flanked by congruent stimuli were faster than RTs to target stimuli flanked by incongruent stimuli. However, on the bidimensional flanker task, the responses of schizophrenia patients were no longer constrained by the behavioural goal and RTs to both congruent and incongruent stimuli were equivalent.
Conclusions. It appears that the attentional dysfunction in schizophrenia may reflect difficulty in resolving multiple and simultaneous response conflicts. These findings suggest a possible role for the anterior cingulate cortex in the attentional impairments associated with schizophrenia.
We have explored the relationships between specific leaf area calculated for a whole plant and its individual leaves.
Barley was grown in hydroponics in controlled environment cabinets. Plants were harvested on the basis of
physiological age (defined as the number of days after full expansion of leaves on the main stem) and the area and
weight of whole, fully expanded, leaves measured and specific leaf area (SLA) of individual leaves or whole plants
calculated. Specific leaf area calculated for individual leaves (SLAL) varied with leaf position and with leaf age after
full expansion whereas SLA calculated for whole plants (SLAP) varied with plant age. The same conclusions were
reached whether the results were based on total dry weight or dry weight minus soluble carbohydrates (‘structural
weight’). Transferring plants to shade on the day of full expansion of the third leaf on the main stem increased
the SLAP, and also SLAL of leaves 3 and 4 on the main stem (leaf 4 being the younger leaf of the two), because
of a decrease in the ‘structural weight’ of these leaves. However SLAL of leaf 2 (which was older than leaf 3) was
not affected by shading; the effect was confined to leaves developing in the new conditions.
We have been successful in the fabrication of (001) oriented epitaxial PZT films on YBCO/SrTiO3/MgO/TiN/Si heterostructures by pulsed laser deposition. The films were observed to be single phase by X-ray diffraction. The deposition parameters were varied to obtain the best epitaxial layer for each of the compounds. Transmission electron microscopy was employed for understanding of the structure, crystallinity and interfaces for each of these epilayers. Dielectric and P-E hysteresis loop measurements were carried out with evaporated Ag electrodes. The dielectric constant for the films was found to be around 380–400. The value of saturation polarization Ps was between 40–50 μC/cm2 and the coercive field Ec varied from 45–55 kV/cm. Integration of PZT films with silicon will be useful for future memory and micromechanical devices.
In a survey of district plans for Mental Health services (Kingdon, 1988) befriending schemes, where volunteers are recruited to visit isolated and lonely users of psychiatric services, were planned or in existence in 14 of the 127 districts who responded. However, lists of the components of a comprehensive community service (MIND, 1983) and Hirsch (1988) surprisingly do not include references to such schemes, although Griffiths (1988) alludes to them in his recent report. There are moreover no reports in the psychiatric literature of such enterprises. The scheme established by MIND in Bassetlaw (population (103,000) is therefore described.
Liquid phase electroepitaxial technique has been used for the growth of GaSb and GalnAsSb in the composition range corresponding to peak band gap wavelengths of 1.7-2.28μm. The growth rate of these layers were examined as a function of current density. The growth rates of these layers are typically 0.8μm/min. at a current density of 10A/cm2. The quality of the layers was evaluated by x-ray diffraction and room temperature photoluminescence.
Mn-doped In1−x GaxAsyP1−y epilayers lattice matched to InP substrate have been grown by the liquid phase electroepitaxial (LPEE) technique. The variation of growth velocity of the epilayers with current density and the doping characteristics of Mn in the epilayer has been studied. The temperature dependence of the hole concentration and the mobility has been analysed to determine the donor and acceptor densities, thermal activation energy of the level associated with Mn and the dominant scattering mechanisms that limit the hole mobility. The photoluminescence spectra of the doped epilayers are examined at 10K as a function of the excitation level.