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Cancer during pregnancy has an incidence of 1/1,000, and when diagnosed, the most common ones are breast cancer (1/10,000), Hodgkin’s lymphoma (1/6,000), and head and neck cancer (1/10,000). If a diagnosis is made during pregnancy, the treatment cannot wait until delivery, and there is concern about the effects that radiotherapy may have on the foetus. The multidisciplinary group has to assess and ethically make decisions with regard to the mother and foetus.
A 35-year-old female, a carrier of Behcet’s disease, underwent 5 years of treatment with hydroxychloroquine, prednisone and low-molecular-weight heparin (the patient being a carrier of Behcet’s disease, there is a high risk for cancer of the oral cavity and oropharynx with an HR of 2·11, so the cancer could be related to the tonsil). The patient’s oncological situation started on December 2017 with a volume increase in preauricular, parotid and right mandibular angle, with a progressive growth. At this time, the foetus was of 17·5 weeks of gestation. An oral cavity tumour that invaded the right retromolar triangle was observed, and upon biopsy, a basaloid squamous cell carcinoma was diagnosed.
Radiotherapy treatment was started at 22 weeks of gestation; intensity-modulated radiation therapy (IMRT) was planned with a dose of 69·96 Gy to the primary tumour and 59·4 Gy to ganglion levels II, III and IV, bilaterally in 33 fractions. At fraction 27 a significant decrease in tumour volume was noted, so adaptive radiotherapy was performed to complete the treatment. Currently the patient has no clinical evidence of tumour pathology.
The risk of radiation exposure in pregnant women (after 20 weeks of gestation), being treated for cancers of the tonsil, reaching the foetus is minimal, with a reduced risk of a few or no effects.
Radiotherapy in tonsil cancer has been shown to be effective in combination with chemotherapy for local control of the disease. In the case of this pregnant patient, radiotherapy, as the only modality, provided local control and little exposure of radiation to the foetus.
First-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes.
We conducted, using two different samples for discovery (n = 336 controls and 649 siblings of patients with psychotic disorder) and replication (n = 1208 controls and 1106 siblings), an analysis of association between PRS on the one hand and psychopathological and cognitive intermediate phenotypes of schizophrenia on the other in a sample at average genetic risk (healthy controls) and a sample at higher than average risk (healthy siblings of patients). Two subthreshold psychosis phenotypes, as well as a standardised measure of cognitive ability, based on a short version of the WAIS-III short form, were used. In addition, a measure of jumping to conclusion bias (replication sample only) was tested for association with PRS.
In both discovery and replication sample, evidence for an association between PRS and subthreshold psychosis phenotypes was observed in the relatives of patients, whereas in the controls no association was observed. Jumping to conclusion bias was similarly only associated with PRS in the sibling group. Cognitive ability was weakly negatively and non-significantly associated with PRS in both the sibling and the control group.
The degree of endophenotypic expression of schizophrenia polygenic risk depends on having a sibling with psychotic disorder, suggestive of underlying gene–environment interaction. Cognitive biases may better index genetic risk of disorder than traditional measures of neurocognition, which instead may reflect the population distribution of cognitive ability impacting the prognosis of psychotic disorder.
This study examined (1) the association of dietary energy density from solid (EDS) and solid plus liquids (EDSL) with adiposity and cardiometabolic risk factors (CRF) in children with overweight and obesity, (2) the effect of under-reporting on the mentioned associations and (3) whether the association between ED and body composition and CRF is influenced by levels of physical activity. In a cross-sectional design, 208 overweight and obese children (8–12-year-old; 111 boys) completed two non-consecutive 24 h recalls. ED was calculated using two different approaches: EDS and EDSL. Under-reporters were determined with the Goldberg method. Body composition, anthropometry and fasting blood sample measurements were performed. Moderate to vigorous physical activity (MVPA) was registered with accelerometers (7-d-register). Linear regressions were performed to evaluate the association of ED with the previously mentioned variables. Neither EDS nor EDSL were associated with body composition or CRF. However, when under-reporters were excluded, EDS was positively associated with BMI (P=0·019), body fat percentage (P=0·005), abdominal fat (P=0·008) and fat mass index (P=0·018), while EDSL was positively associated with body fat percentage (P=0·008) and fat mass index (P=0·026). When stratifying the group according to physical activity recommendations, the aforementioned associations were only maintained for non-compliers. Cluster analysis showed that the low-ED and high-MVPA group presented the healthiest profile for all adiposity and CRF. These findings could partly explain inconsistencies in literature, as we found that different ED calculations entail distinct results. Physical activity levels and excluding under-reporters greatly influence the associations between ED and adiposity in children with overweight and obesity.
We bring examples of toric varieties blown up at a point in the torus that do not have finitely generated Cox rings. These examples are generalizations of our earlier work, where toric surfaces of Picard number 1 were studied. In this article we consider toric varieties of higher Picard number and higher dimension. In particular, we bring examples of weighted projective 3-spaces blown up at a point that do not have finitely generated Cox rings.
The island of Gran Canaria is regularly affected by dust falls due to its proximity to the Saharan desert. Climatic oscillations may affect the Saharan dust input to the island. Geochemical, mineralogical, and textural analysis was performed on a well-developed and representative early Pleistocene paleosol to examine Saharan dust contribution to Gran Canaria. Significant and variable Saharan dust content was identified in addition to weathering products such as iron oxides and clay minerals. Variations in quartz and iron oxide concentrations in the paleosol likely reflect different Saharan dust input in more/less-contrasted rhexistasic/biostatic climatic conditions. Linking the quartz content in Canarian soils, the Ingenio paleosol, and two Canarian loess-like deposits to different ages from the Quaternary, we hypothesized that the dust input should be lower (about 33–38%) throughout the early to middle Pleistocene than during the late Quaternary. The Saharan dust input to the Gran Canaria profile in the Pleistocene persisted in spite of climatic variations.
During the INDEMARES/CHICA 0610, 0211 and 0412 expeditions, carried out in the northern Spanish sector of the Gulf of Cádiz (Spain), samples were collected with a box-corer in 11 mud volcanoes and their adjacent bottoms. Chemoautotrophic communities were found in nine mud volcanoes. Among Decapoda, a rare eucalliacid, belonging to the genus Calliax and related to the Mediterranean infralittoral species C. lobata (de Gaillande and Lagardère 1966), was present in three of them. Data on its morphology, biogeographic distribution, vertical distribution within the burrows, sediment composition, pH and redox potential values (each in 5 cm intervals) are given; information on the chemoautotrophic communities associated with this species are also provided.
Grounded in self-determination theory, the aim of this study was to develop a scale with adequate psychometric properties to assess motivation for teaching and to explain some outcomes of secondary education teachers at work. The sample comprised 584 secondary education teachers. Analyses supported the five-factor model (intrinsic motivation, identified regulation, introjected regulation, external regulation and amotivation) and indicated the presence of a continuum of self-determination. Evidence of reliability was provided by Cronbach’s alpha, composite reliability and average variance extracted. Multigroup confirmatory factor analyses supported the partial invariance (configural and metric) of the scale in different sub-samples, in terms of gender and type of school. Concurrent validity was analyzed by a structural equation modeling that explained 71% of the work dedication variance and 69% of the boredom at work variance. Work dedication was positively predicted by intrinsic motivation (ß = .56, p < .001) and external regulation (ß = .29, p < .001) and negatively predicted by introjected regulation (ß = –.22, p < .001) and amotivation (ß = –.49, p < .001). Boredom at work was negatively predicted by intrinsic motivation (ß = –.28, p < .005) and positively predicted by amotivation (ß = .68, p < .001). The Motivation for Teaching Scale in Secondary Education (Spanish acronym EME-ES, Escala de Motivación por la Enseñanza en Educación Secundaria) is discussed as a valid and reliable instrument. This is the first specific scale in the work context of secondary teachers that has integrated the five-factor structure together with their dedication and boredom at work.
The aim of this study was to develop and to assess a specific Multi-Criteria Decision Analysis (MCDA) framework to evaluate new drugs in an hospital pharmacy and therapeutics committee (P&TC) setting.
A pilot criteria framework was developed based on the EVIDEM (Evidence and Value: Impact on DEcisionMaking) framework, together with other relevant criteria, and assessed by a group of P&TC's members. The weighting of included criteria was done using a 5-point weighting technique. Two drugs were chosen by evaluation: an orphan-drug for Gaucher disease, and a nonorphan drug for the treatment of inflammatory bowel disease. Evidence matrices were developed, and value contribution of each drug was evaluated by P&TC's members. An agreed final framework was obtained through a discussion between the P&TC's members.
After criteria assessment, the pilot framework included eight quantitative criteria: “disease severity,” “unmet needs,” “comparative efficacy/effectiveness,” “comparative safety/tolerability,” “comparative patient-reported outcomes,” “comparative cost consequences-cost of treatment,” “comparative cost consequences-other medical costs,” and “quality of evidence”; and one contextual criterion: “opportunity costs and affordability.” The most valued criteria were: “comparative safety/tolerability,” “disease severity,” and “comparative efficacy/effectiveness.” When assessing the drugs most valued characteristics of the MCDA were the possibility that all team may contribute to drug assessment by means of scoring the matrices and the discussion to reach a consensus in drug positioning and value decision making.
The reflective MCDA would integrate quantitative and qualitative criteria relevant for a P&TC setting, allowing reflective discussions based on the criteria weighting score.
Composites from carbon nanotubes and polymers have been synthesized and studied. The composites were obtained joining carbon nanotubes with polymethyl methacrylate, nylon-6 and polystyrene. The materials were observed through scanning electron microscopy to evaluate the carbon nanotubes dispersion in the polymeric matrices. FTIR and Raman spectroscopies were used to analyze the interactions among functionalized and non-functionalized multiwalled carbon nanotubes and polymers, demonstrating affinity and peculiar spectra behaviors for each composite with different carbon nanotubes loads.
In this Research Communication we assessed factors affecting colostrum quality of dairy Lacaune ewes using the Brix-refractometer. Colostrum from 536 lambings from one commercial intensive dairy Lacaune farm were analysed for the following factors with potential influence in colostrum quality: (1) ewe parity (n = 84–132), (2) length of previous dry period (PDP) (n = 23–214), (3) age at first lambing (AFL) of primiparous ewes (n = 9–88), (4) lambing season (n = 192 or 344), and (5) year (2011–2013, n = 142–203). Parity significantly affected colostrum quality, with primiparous ewes showing the highest Brix refractometer values (22·6 ± 5·6%, P < 0·0001), though values were similar among multiparous ewes. PDP length also significantly affected colostrum quality: ewes with the shortest PDP showed the worst quality (16·8 ± 4·2%, P < 0·0001), with quality gradually rising with PDP length. Colostrum quality was significantly higher in 2011 (21·0 ± 5·2%) than in 2012 or 2013 (P < 0·0001); this likely reflects the several-fold greater proportion of animals with long PDP in 2011. In contrast, neither AFL nor lambing season significantly affected colostrum quality. These results suggest that parity and PDP length can substantially affect ovine colostrum quality of dairy ewes under intensive management conditions and they further show the usefulness of the Brix refractometer for providing a rough estimation of colostrum quality on-farm. However, further studies are needed to determine a validated cut-off Brix value for identifying good-quality colostra in ovine species.
Despite the higher proportion of foreclosures and home evictions executed in Spain, compared to other countries, and the known link between social exclusion and mental health problems, studies exploring this association in Spain remain scarce. This study investigated the link between the process of home eviction and the appearance of symptomatology of post-traumatic stress disorder (PTSD), anxiety, depression, and perceived stress. Two hundred and five people affected by the process of home eviction were assessed using a structured interview that included three validated assessment instruments for PTSD, perceived stress, anxiety and depression. Analysis involved comparison with the normative groups that formed the validation studies together with regression analysis to determine the major psychological and socio-demographic predictors of perceived stress. Of the participants, 95.1% reported that they were experiencing the process of home eviction with fear, helplessness, or horror. In PTSD symptomatology, they scored higher than the normative PTSD group in symptoms of avoidance (t = 5.01; p < .05), activation (t = 5.48; p < .01), and total score (t = 4.15; p < .05). Of this subgroup, 72.5% fulfilled the DSM-IV symptom criteria for PTSD. The major predictor of perceived stress was PTSD symptomatology (B = .09; p < .001). The process of home eviction in Spain is having an alarming impact on mental health of affected people calling for effective measures to provide psychological and social support.
The aim of this research is to ameliorate the dispersion of pristine and functionalized Carbon Nanotubes (CNTs) into polystyrene with hydroxyl end groups (PSOH) matrices using low magnetic fields. The Multi-Walled Carbon Nanotubes (MWCNTs) were synthesized by chemical vapor deposition (CVD) using benzene as carbon source; to produce CNTs with and without functional groups two catalysts were used (stainless steel and ferrocene). The obtained nanotubes contained iron nanoparticles inside. PSOH were synthesized using styrene as monomer, azobisisobutyronitrile as initiator and 2-MeOH as chain transfer agent. The MWCNTs-PSOH matrices were formed using 1.6 wt % of carbon nanotubes into PSOH and ultrasonic mixing for 30 min. The mixing materials were poured into containers and dry at room temperature. While the material was drying, constant magnetic fields of 0.24 T were being applied for 50 min. The MWCNTs-PSOH composites were analysed by SEM, FTIR and Raman spectroscopy. SEM micrographs showed that MWCNTs without functional groups were incorporated in the middle of PSOH. The MWCNTs functionalized perform differently; a better dispersion through the entire polymer matrix was achieved, because the polymer embedded the CNTs. FTIR and Raman spectroscopy showed chemical interaction between PSOH and MWCNTs functionalized. The CNTs dispersion into PSOH was ameliorated through the use of low magnetic fields and functionalization.
The Spanish National Network (REDETS) is a group of eight agencies, units and services, depending on National and Regional Governments that coordinate their work within a common methodological framework, guided by the principles of mutual recognition and cooperation. The necessity of considering a Quality Management System has been detected and, consequently, a common tool for all the members needs to be developed. We describe in this study the process to achieve that goal.
Based on both a review of previous literature and the proposal for a self-evaluating tool, a group of experts from each agency through consensus have developed a tool for self-evaluation in Health Technology Assessment (HTA) agencies. Through the structure described in the handbook of the Andalusian Agency for Healthcare Quality (ACSA), each standard should have a statement or proposal that needs to also include evidence or good practices, and the corresponding evaluation questions. In separate workgroups, the definition of these proposals, evidence and evaluation questions were developed. One face-to-face meeting and two meetings via teleconference were necessary to achieve a final document with all the quality standards.
From a proposed structure of sixty-six standards, the titles, definitions, statements and evidence as well as good practices and evaluation questions were established in workgroups with consensus among all of the members (1 - 3). The final version of the self-assessment tool was composed of sixty-eight standards, grouped in twelve quality criteria structured in four dimensions: I Responsibility, II Clients and Stakeholders, III Production Process, and IV Resources.
Quality management requires an evaluation tool and this version, based on a systematic review and consensus, is a useful and practical instrument for developing a handbook by each member of REDETS. An online version of the tool is in process of development.
The diet and the feeding habits of the common dolphinfish (Coryphaena hippurus) in the Pacific coast of Ecuador was assessed by examining 320 stomachs of individuals ranging from 51 to 149 cm in total length. Fish was the predominant prey group in the diet (Alimentary Index, %AI = 95.39) followed by cephalopods (%AI = 4.13) and crustaceans (%AI = 0.48). Among the 17 prey items that make up the dolphinfish diet, the Exocoetidae family was the most important prey (%AI = 57.13), Dosidicus gigas being the most abundant invertebrate species (%AI = 7.65). Feeding patterns were evaluated using the graphing method of Amundsen, which suggested that this species shows a varying degree of specialization on different prey taxa. Thus, while some species were unimportant and rare (Hippocampus hippocampus, Lagocephalus lagocephalus, Gobiidae and Argonauta sp.), several dolphinfishes showed a high degree of specialization on Scombridae, Pleuroncodes planipes, Portunus xantusii and Opisthonema libertate. Size-related and temporal shifts in dietary composition were investigated by PERMANOVA analysis, which showed wide variations among size classes and periods of capture. The results of this study indicate that the common dolphinfish is an opportunistic feeder, which is capable of consuming a wide variety of schooling epipelagic organisms.
Guinea-Bissau is host to the westernmost subpopulation of the common hippopotamus Hippopotamus amphibius, which is one of only two known populations inhabiting coastal waters. The presence of hippopotamuses causes conflict with rice farmers as a result of crop damage and the absence of effective measures to protect crops. To develop an effective method for protecting rice fields, we studied the patterns of access to flooded and rain-fed rice fields by hippopotamuses and assessed the effect of the installation of electric fences. Hippopotamuses were detected in 54% of the flooded fields (n = 100) and in 31.9% of the rain-fed fields (n = 91). They were detected more frequently in fields on offshore islands than on the mainland, in unfenced than in fenced fields, and in fields closer to running water. Hippopotamuses entered fenced flooded fields less frequently than unfenced, and were detected most frequently at the end of the rainy season and the start of the dry season, and in the period of vegetative stem growth. Electric fences were an effective deterrent and facilitated increased rice production. The maintenance and cost of the electric fencing were acceptable to farmers, and therefore the use of such fencing is recommended to resolve the conflict between hippopotamuses and farmers in Guinea-Bissau and in other areas with similar conditions.
Chitin nanowhiskers were obtained with the purpose to be used as astaxanthin protectors against the photo and thermal degradation. These nanostructures were generated by a freezing/thawing procedure using two stirring methods: mechanical and sonication, which were named as FTM and FTS respectively. Morphological and spectroscopic studies were carried out on chitin nanowhiskers by scanning electronic microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). Through a SEM analysis, chitin fibers were found uniformly spaced and oriented with the width ranged from of 20-40 nm. Furthermore, the nanowhiskers obtained by FTM showed long and flattened structures and bundles of homogeneous sizes, which have the capacity of being sites of stress concentration. In contrast, by FTS, the nanowhiskers showed coarse fibers exhibiting numerous peaks. By comparing the two methods is appreciated that FTS method provides more surface area, giving more sites for functionalization. Fourier transform infrared spectroscopy (FTIR) allowed the determination of free movement of functional groups on the surface of samples obtained by FTM and FTS methods. Significant differences of signals in the spectra indicate that there were more unassociated amides in the nanowhiskers obtained by FTS than by FTM.
In this work, the deposition and photocatalytic response of V2O5 thin films modified with different amounts of Ag (Ag:V2O5) is reported. Films were deposited on glass and silicon substrates (100), using the pulsed laser deposition (PLD) technique. A high purity vanadium target, with a different number of silver pellets attached on it were used. Thin films were characterized by energy dispersive spectroscopy (EDS) to determine the elemental chemical composition; structural changes due to the addition of Ag were monitored by Raman spectroscopy; Optical microscopy was used to observe the surface morphology and UV-Vis spectroscopy was employed to determine optical properties. Photocatalytic response of the prepared films was studied through the degradation of a malachite green solution using a solar irradiation source.
The deposition of PbS thin films by the chemical bath deposition method using sodium citrate as non-toxic complexing agent is presented. As-deposited PbS films and those annealed at 200 and 300 °C in argon atmosphere were formed by tightly compact spherical particles homogeneously distributed along the substrates. The XRD analysis shows that all the films had a galena type cubic crystalline structure. The crystallite size of the as-deposited film was 17 nm which decreased to 14 nm when the film was annealed to 300 °C. Thermal treatments to the films produced a shift of the optical band gap from 1.34 to 1.49 eV. Furthermore, the as-deposited PbS films were photosensitive showing a conductivity of 10-2 Ω-1 cm-1 under illumination. Such a conductivity increased to 10-1 Ω-1 cm-1 with the thermal treatment at 200 °C. The evaluation of the PbS film using a CdS thin film partner as window in the solar cell configuration showed an open circuit voltage of 88 mV and a short current density of 3.5 mA/cm2.
Aluminum titanium oxynitride (TiAlNO) coatings were deposited on 316 steel substrates by the sputtering technique, varying the nitrogen flow from 2.5, 5, 7.5 to 10 sccm, and maintaining constant at 12 sccm the flow argon gas. We used targets of titanium and alumina with 99.995% purity. The hardness and tribological analyses were determined by Vickers microhardness and tribology (tribometer pin-disc), respectively. The results show that the coating with a nitrogen flow of 10 sccm had the lowest volumetric wear (2.047738693 mm3) and the maximum value of hardness (11.2 GPa). Analysis of X-ray diffraction evidenced the presence of three crystalline phases: Ti2N, Al2O3 and TiO2. It can be observed that by increasing the nitrogen flow, the portion of semi-Ti2N phase increases, Al2O3 decreases and TiO2 remains almost constant, and also producing a change in crystallographic orientation with reference to the Ti2N phase. Crystal grain sizes were estimated by X-ray diffraction Fourier line profile analysis using Warren–Averbach method. This analysis showed a grain size between 5 and 15 nm. Raman spectroscopy results show the presence of the TiO2 phase which corroborated the X-ray diffraction results.