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To evaluate the effect of the burden of Staphylococcus aureus colonization of nursing home residents on the risk of S. aureus transmission to healthcare worker (HCW) gowns and gloves.
Multicenter prospective cohort study.
Setting and participants:
Residents and HCWs from 13 community-based nursing homes in Maryland and Michigan.
Residents were cultured for S. aureus at the anterior nares and perianal skin. The S. aureus burden was estimated by quantitative polymerase chain reaction detecting the nuc gene. HCWs wore gowns and gloves during usual care activities; gowns and gloves were swabbed and then cultured for the presence of S. aureus.
In total, 403 residents were enrolled; 169 were colonized with methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA) and comprised the study population; 232 were not colonized and thus were excluded from this analysis; and 2 were withdrawn prior to being swabbed. After multivariable analysis, perianal colonization with S. aureus conferred the greatest odds for transmission to HCW gowns and gloves, and the odds increased with increasing burden of colonization: adjusted odds ratio (aOR), 2.1 (95% CI, 1.3–3.5) for low-level colonization and aOR 5.2 (95% CI, 3.1–8.7) for high level colonization.
Among nursing home patients colonized with S. aureus, the risk of transmission to HCW gowns and gloves was greater from those colonized with greater quantities of S. aureus on the perianal skin. Our findings inform future infection control practices for both MRSA and MSSA in nursing homes.
To evaluate the prevalence of food and beverage marketing on Twitch.tv (Twitch), a social media platform where individuals broadcast live audiovisual material to millions of daily users.
Observational analysis of the prevalence of 238 food and beverage brands in five distinct categories (processed snacks; food delivery services and restaurants; candies, energy drinks/coffees/teas; and sodas and other sugar-sweetened beverages) over the course of 18 months.
Twitch streamer profiles and stream titles between January 2018 and July 2019. Twitch chat room messages during July 2019.
There was a significant increase in brand exposure on Twitch both in stream titles (sodas and candies, P < 0·05) and on streamer profiles (sodas, restaurants/food delivery services, candies, and energy drinks/coffees/teas, P < 0·05) over the 18-month study period. Energy drinks, coffees and teas had the most exposure with 1·08 billion exposure hours from profiles and 83 million exposure hours from titles. Restaurants/food delivery services and sugar-sweetened beverages were the most frequently mentioned products in chat rooms with 1·24 million messages and 1·10 million messages, respectively.
This study is the first to demonstrate the extent by which food and beverage brands garner millions of hours of exposure on Twitch. Future studies should evaluate the impact that this level of exposure to nutrient-poor, energy-dense products may have on behavioural and health outcomes.
Evidence indicates that Antarctic minke whales (AMWs) in the Ross Sea affect the foraging behaviour, especially diet, of sympatric Adélie penguins (ADPEs) by, we hypothesize, influencing the availability of prey they have in common, mainly crystal krill. To further investigate this interaction, we undertook a study in McMurdo Sound during 2012–2013 and 2014–2015 using telemetry and biologging of whales and penguins, shore-based observations and quantification of the preyscape. The 3D distribution and density of prey were assessed using a remotely operated vehicle deployed along and to the interior of the fast-ice edge where AMWs and ADPEs focused their foraging. Acoustic surveys of prey and foraging behaviour of predators indicate that prey remained abundant under the fast ice, becoming successively available to air-breathing predators only as the fast ice retreated. Over both seasons, the ADPE diet included less krill and more Antarctic silverfish once AMWs became abundant, but the penguins' foraging behaviour (i.e. time spent foraging, dive depth, distance from colony) did not change. In addition, over time, krill abundance decreased in the upper water column near the ice edge, consistent with the hypothesis (and previously gathered information) that AMW and ADPE foraging contributed to an alteration of prey availability.
Lithium ion batteries (LIBs) are key components of modern electronics and are regularly utilized as their primary power source. Understanding the electrical and mechanical properties of electrode materials plays a major role in the performance improvement of LIBs. In this article, we provide research using PinPoint™ scanning spreading resistance microscopy (SSRM) to effectively measure both electrical and mechanical properties of LIB electrode surfaces at a much higher quality in a high-vacuum environment than in ambient conditions. The data collected in this experiment demonstrate that this technique is an effective means for measuring the quantitative and qualitative topographical, electrical and mechanical data of advanced materials with improved image quality and data accuracy.
We estimate the ecosystem service value of water supplied by the San Bernardino National Forest in Southern California under climate change projections through the 21st century. We couple water flow projections from a dynamic vegetation model with an economic demand model for residential water originating from the San Bernardino National Forest. Application of the method demonstrates how estimates of consumer welfare changes due to variation in water supply from public lands in Southern California can inform policy and land management decisions. Results suggest variations in welfare changes over time due to alterations in the projected water supply surpluses, shifting demand limited by water supply shortages or surpluses, and price increases. Results are sensitive to future climate projections—in some cases large decreases in welfare due to supply shortages—and to assumptions about the demand model.
No evidence-based therapy for borderline personality disorder (BPD) exhibits a clear superiority. However, BPD is highly heterogeneous, and different patients may specifically benefit from the interventions of a particular treatment.
From a randomized trial comparing a year of dialectical behavior therapy (DBT) to general psychiatric management (GPM) for BPD, long-term (2-year-post) outcome data and patient baseline variables (n = 156) were used to examine individual and combined patient-level moderators of differential treatment response. A two-step bootstrapped and partially cross-validated moderator identification process was employed for 20 baseline variables. For identified moderators, 10-fold bootstrapped cross-validated models estimated response to each therapy, and long-term outcomes were compared for patients randomized to their model-predicted optimal v. non-optimal treatment.
Significant moderators surviving the two-step process included psychiatric symptom severity, BPD impulsivity symptoms (both GPM > DBT), dependent personality traits, childhood emotional abuse, and social adjustment (all DBT > GPM). Patients randomized to their model-predicted optimal treatment had significantly better long-term outcomes (d = 0.36, p = 0.028), especially if the model had a relatively stronger (top 60%) prediction for that patient (d = 0.61, p = 0.004). Among patients with a stronger prediction, this advantage held even when applying a conservative statistical check (d = 0.46, p = 0.043).
Patient characteristics influence the degree to which they respond to two treatments for BPD. Combining information from multiple moderators may help inform providers and patients as to which treatment is the most likely to lead to long-term symptom relief. Further research on personalized medicine in BPD is needed.
To propose a new anthropometric index that can be employed to better predict percent body fat (PBF) among young adults and to compare with current anthropometric indices.
All measurements were taken in a controlled laboratory setting in Seoul (South Korea), between 1 December 2015 and 30 June 2016.
Eighty-seven young adults (18–35 years) who underwent dual-energy x-ray absorptiometry (DXA) were used for analysis. Multiple regression analyses were conducted to develop a body fat index (BFI) using simple demographic and anthropometric information. Correlations of DXA measured PBF (DXA_PBF) with previously developed anthropometric indices and the BFI were analysed. Receiver operating characteristic curve analyses were conducted to compare the ability of anthropometric indices to identify obese individuals.
BFI showed a strong correlation with DXA_PBF (r = 0·84), which was higher than the correlations of DXA_PBF with the traditional (waist circumference, r = 0·49; waist to height ratio, r = 0·68; BMI, r = 0·36) and alternate anthropometric indices (a body shape index, r = 0·47; body roundness index, r = 0·68; body adiposity index, r = 0·70). Moreover, the BFI showed higher accuracy at identifying obese individuals (area under the curve (AUC) = 0·91), compared with the other anthropometric indices (AUC = 0·71–0·86).
The BFI can accurately predict DXA_PBF in young adults, using simple demographic and anthropometric information that are commonly available in research and clinical settings. However, larger representative studies are required to build on our findings.
Studies suggest that alcohol consumption and alcohol use disorders have distinct genetic backgrounds.
We examined whether polygenic risk scores (PRS) for consumption and problem subscales of the Alcohol Use Disorders Identification Test (AUDIT-C, AUDIT-P) in the UK Biobank (UKB; N = 121 630) correlate with alcohol outcomes in four independent samples: an ascertained cohort, the Collaborative Study on the Genetics of Alcoholism (COGA; N = 6850), and population-based cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC; N = 5911), Generation Scotland (GS; N = 17 461), and an independent subset of UKB (N = 245 947). Regression models and survival analyses tested whether the PRS were associated with the alcohol-related outcomes.
In COGA, AUDIT-P PRS was associated with alcohol dependence, AUD symptom count, maximum drinks (R2 = 0.47–0.68%, p = 2.0 × 10−8–1.0 × 10−10), and increased likelihood of onset of alcohol dependence (hazard ratio = 1.15, p = 4.7 × 10−8); AUDIT-C PRS was not an independent predictor of any phenotype. In ALSPAC, the AUDIT-C PRS was associated with alcohol dependence (R2 = 0.96%, p = 4.8 × 10−6). In GS, AUDIT-C PRS was a better predictor of weekly alcohol use (R2 = 0.27%, p = 5.5 × 10−11), while AUDIT-P PRS was more associated with problem drinking (R2 = 0.40%, p = 9.0 × 10−7). Lastly, AUDIT-P PRS was associated with ICD-based alcohol-related disorders in the UKB subset (R2 = 0.18%, p < 2.0 × 10−16).
AUDIT-P PRS was associated with a range of alcohol-related phenotypes across population-based and ascertained cohorts, while AUDIT-C PRS showed less utility in the ascertained cohort. We show that AUDIT-P is genetically correlated with both use and misuse and demonstrate the influence of ascertainment schemes on PRS analyses.
Addresses the role of government in Australia through the life cycle of its automotive industry, from its success in attracting manufacturers, promoting the development of the industry, protecting and supporting, encouraging rationalization – and then being conflicted between that purpose and opening the market to imports, losing its grip on the industry, and finally succumbing to the temptation simply to subsidize it.
Relates the history of the production of automobiles: spectacular growth, the drive for scale accompanied by great waves of concentration among the vehicle builders, the emergence of new players, the globalization of the industry. A surprising result emerges: the unbroken dominance of an oligarchy of vehicle manufacturers, with no Chinese-owned firms in their ranks, despite China’s huge production volumes. Explains how the manufacturers control access to their end markets through their unique system of proprietary distribution channels.
Tracks the life cycle of powered land transport in Australia, and the dominant role taken by the automobile. It follows the growth of cars in service to saturation, the similar growth and saturation of the market for new cars. It describes the huge change in the structure of the market, with the replacement of the traditional large Australian car by more modern small cars and SUVs, driven by the immense changes in Australian society. It tracks the surge of imports, as government policy switched from protecting the national market to opening it to outside competition, and reviews pricing and the controlling effect of the tied distribution channels.
Identifies the emergence, growth, development and failure of the supplier sector in Australia, including much of it being taken over by the global giants of the sector. Responsible, as elsewhere, for 80 per cent of the content and value of the complete car, it was never able to achieve enough local scale and was perpetually threatened by competition from imports.
Discusses the influence of national governments and their long-standing role in regulating the industry, the conflicts that have arisen around safety and environmental protection. Also addresses the role of the industry in national economies, how governments have encouraged the development of national automotive sectors, the means they used to do so and the consequences for the industry. Describes the roles that different countries have been able to play within this global industry.
Tells the development of the vehicle manufacturers in Australia, focusing on their critical relationships with their parent groups. It describes the role each of the ultimate four survivors was allowed to play within these groups, and the consequences for their attempts to build volume and scale through exports.
Building an entire industry more or less from scratch, creating products that were popular and loved for a long time, and keeping all of this going for seventy years was quite an achievement. But, like everything else, it followed a life cycle: was born, matured, aged, declined and finally died. Three score years and ten sounds in a way normal. Could it have gone on longer, perhaps as long as the wider automotive industry itself? In Chapter 7, we concluded that the alternative tracks proposed towards or after the end were dead ends. But there might have been better alternatives, had they been pursued earlier.
Describes the critical and growing role of the supplier sector, its own march to globalization and interrelated sets of global oligarchies, the closed nature of the supply chains, and their highly disciplined functioning, under the leadership and tight control of the vehicle manufacturers.
The story of the Australian light vehicle industry from the very first developments before World War I, through the era of importing vehicles, the imposition of import controls, the decision to create a fully fledged automotive industry, its growth, decline and end, as it lost control of its domestic market and never achieved sufficient export volumes in compensation. The principal reason for its demise is identified as lack of sufficient scale, compared to the global giants, rather than external factors such as labour costs. The impact of its going on the balance of trade and employment is identified as relatively modest. Some unrealistic proposals for reviving it are dismissed.