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 firstname.lastname@example.org
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.
Background: Adults are at risk of being exposed to influenza from many sources. Healthcare personnel (HCP) have the additional risk of being exposed to ill patients.
To determine whether HCP were at higher risk than adults working in nonhealthcare roles (non-HCP).
Prospective cohort study.
Acute-care hospitals and other businesses in Toronto, Ontario, Canada.
Adults aged 18–69 years were enrolled for 1 or more of the 2010/2011, 2011/2012, and 2012/2013 influenza seasons. Swabs collected during acute respiratory illnesses were tested for influenza and pre- and postseason blood samples were tested for influenza-specific immune response.
The adjusted odds of influenza were similar for HCP and non-HCP (odds ratio [OR], 1.29; 95% confidence interval [CI], 0.63–2.63). Older adults and those vaccinated against influenza had lower odds, and those who shared their workspace and who used corrective eyewear had higher odds of influenza.
HCP and other working adults are at similar risk of influenza infection.
Frozen raw breaded chicken products (FRBCP) have been identified as a risk factor for Salmonella infection in Canada. In 2017, Canada implemented whole genome sequencing (WGS) for clinical and non-clinical Salmonella isolates, which increased understanding of the relatedness of Salmonella isolates, resulting in an increased number of Salmonella outbreak investigations. A total of 18 outbreaks and 584 laboratory-confirmed cases have been associated with FRBCP or chicken since 2017. The introduction of WGS provided the evidence needed to support a new requirement to control the risk of Salmonella in FRBCP produced for retail sale.
A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
Blood samples from normal and Plasmodium berghei infected mice are being analyzed for trace elements by charged particle induced x-rays. Approximately 0.25 ml of the sample (whole blood, washed red cells, or plasma) is dry ashed. The ashes are mounted on a 0.003 inch Kapton foil. The analysis is performed by bombardment of the samples by a beam of 2.0 MeV protons and detection of the characteristic x-rays by a 175-eV-resolution lithium-drifted silicon detector. The data are analyzed by an on-line PDP-9 computer-based data acquisition system. Results indicate an increase in the K, Ca, Cu, and Zn per unit volume of the red cells of the malaria infected mice relative to the amounts measured for uninfected blood, and a decrease in the K, Ca, and Fe and an increase in the Cu per unit volume in the plasma of the infected mice.
Extensive research into human-animal interactions, particularly in the pig industry, has led to the proposal that high fear of humans, through a stress response, can limit an animal’s growth, reproduction and welfare (Hemsworth et al., 1993). In a recent study in the Australian dairy industry, a significant negative between-farm correlation was found between the avoidance of an experimenter by cows in a standard test and milk yield of the farm, suggesting that fear of humans may also have implications for the productivity of dairy cows (Breuer et al., 2000). The behaviour of stockpeople is a likely factor affecting fear of humans in dairy cows (Breuer et al., 2000). It was the aim of this experiment to investigate the effects of handling on the stress physiology and behaviour of dairy heifers.
Observations of the water level in Beaver Lake, an epishelf lake in East Antarctica, show a regular tidal signal that is lagged and attenuated from the tides beneath the adjacent Amery Ice Shelf. The phase lag and amplitude attenuation can be created by a narrow inlet connection between Beaver Lake and the cavity beneath the Amery Ice Shelf. A forced linear damped oscillator is used to determine the inlet dimensions that are required to produce the observed phase lag and amplitude attenuation. The model shows that the observations are consistent with a tidal flow that is restricted by the drag created by flow in the narrow inlet. Analysis shows that the phase lag and amplitude attenuation of the tides in Beaver Lake has increased over the years 1991-2002, probably due to a thickening of the overlying ice shelf. The response is sensitive to subtle variations in the dimensions of the inlet.
Anxiety disorders are common, and cognitive–behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent.
To perform the first genome-wide association study (GWAS) of psychological treatment response in children with anxiety disorders (n = 980).
Presence and severity of anxiety was assessed using semi-structured interview at baseline, on completion of treatment (post-treatment), and 3 to 12 months after treatment completion (follow-up). DNA was genotyped using the Illumina Human Core Exome-12v1.0 array. Linear mixed models were used to test associations between genetic variants and response (change in symptom severity) immediately post-treatment and at 6-month follow-up.
No variants passed a genome-wide significance threshold (P=5×10–8) in either analysis. Four variants met criteria for suggestive significance (P<5×10–6) in association with response post-treatment, and three variants in the 6-month follow-up analysis.
This is the first genome-wide therapygenetic study. It suggests no common variants of very high effect underlie response to CBT. Future investigations should maximise power to detect single-variant and polygenic effects by using larger, more homogeneous cohorts.
Groundwater samples were collected from several different depths in Illinois glacial deposits at a site in east-central Illinois. Dissolved gases were extracted from many of the water samples, measured volumetrically, and analyze by gas chromatography. The DIC was precipitated as barium carbonate and analyzed for both δ13C and 14C. Due to the formation of microbial CH4, some of the DIC had unusually heavy δ13C values of −3 to −1‰. The standard groundwate 14C-age correction models were developed to account for carbonate dissolution as the primary carbon input beneath the soil zone. If the heavy δ13C values observed in this study are used in readily available groundwater dating models without accounting for the effect of microbial methane formation, many of the resultant calculated ages are negaitive (future ages) mathematically unsolvable. Isotopic and analytical result show a positive correlation (r2 = 0.90) between the δ13C of the DIC and the concentration of methane in the groundwater. With this correlation, we were able to correct the δ13C values of the DIC which were altered due to microbial CH4 formation. This adjustment of δ13C values, along with estimation of dead carbon input from the redox processes, allowed us to calculate 14C ages using standard groundwater age correction models.
We have investigated the electrodynamics of magnetic neutron stars accreting from Keplerian disks and the implications for particle acceleration and γ-ray emission by such systems. We argue that the particle density in the magnetospheres of such stars is larger by orders of magnitude than the Goldreich-Julian density, so that the formation of vacuum gaps is unlikely. We show that even if the star rotates slowly, electromotive forces ( EMFs ) of order 1015 V are produced by the interaction of plasma in the accretion disk with the magnetic field of the neutron star. The resistance of the disk-magnetosphere-star circuit is small, and hence these EMFs drive very large conduction currents. Such large currents are likely to produce magnetospheric instabilities, such as relativistic double layers and reconnection events, that can accelerate electrons or ions to very high energies.
Interaction of an accretion disk with the magnetic field of a neutron star produces large electromotive forces, which drive large conduction currents in the disk-magnetosphere-star circuit. Here we argue that such large conduction currents will cause microscopic and macroscopic instabilities in the magnetosphere. If the minimum plasma density in the magnetosphere is relatively low (≲109 cm−3 ), current-driven micro-instabilities may cause relativistic double layers to form, producing voltage differences in excess of 1012 V and accelerating charged particles to very high energies. If instead the plasma density is higher (≳ 109 cm−3 ), twisting of the stellar magnetic field is likely to cause magnetic field reconnection. This reconnection will be relativistic, accelerating plasma in the magnetosphere to relativistic speeds and a small fraction of particles to very high energies. Interaction of these high-energy particles with X-rays, γ-rays, and accreting plasma may produce detectable high-energy radiation.
We previously reported an association between 5HTTLPR genotype and
outcome following cognitive–behavioural therapy (CBT) in child anxiety
(Cohort 1). Children homozygous for the low-expression short-allele
showed more positive outcomes. Other similar studies have produced mixed
results, with most reporting no association between genotype and CBT
To replicate the association between 5HTTLPR and CBT outcome in child
anxiety from the Genes for Treatment study (GxT Cohort 2,
n = 829).
Logistic and linear mixed effects models were used to examine the
relationship between 5HTTLPR and CBT outcomes. Mega-analyses using both
cohorts were performed.
There was no significant effect of 5HTTLPR on CBT outcomes in Cohort 2.
Mega-analyses identified a significant association between 5HTTLPR and
remission from all anxiety disorders at follow-up (odds ratio 0.45,
P = 0.014), but not primary anxiety disorder
The association between 5HTTLPR genotype and CBT outcome did not
replicate. Short-allele homozygotes showed more positive treatment
outcomes, but with small, non-significant effects. Future studies would
benefit from utilising whole genome approaches and large, homogenous
Postnatal depression affects about 10–15% of women in the year after giving birth. Many women and healthcare professionals would like an effective and accessible non-pharmacological treatment for postnatal depression.
Women who fulfilled the International Classification of Diseases (ICD)-10 criteria for major depression in the first 6 months postnatally were randomized to receive usual care plus a facilitated exercise intervention or usual care only. The intervention involved two face-to-face consultations and two telephone support calls with a physical activity facilitator over 6 months to support participants to engage in regular exercise. The primary outcome was symptoms of depression using the Edinburgh Postnatal Depression Scale (EPDS) at 6 months post-randomization. Secondary outcomes included EPDS score as a binary variable (recovered and improved) at 6 and 12 months post-randomization.
A total of 146 women were potentially eligible and 94 were randomized. Of these, 34% reported thoughts of self-harming at baseline. After adjusting for baseline EPDS, analyses revealed a −2.04 mean difference in EPDS score, favouring the exercise group [95% confidence interval (CI) −4.11 to 0.03, p = 0.05]. When also adjusting for pre-specified demographic variables the effect was larger and statistically significant (mean difference = −2.26, 95% CI −4.36 to −0.16, p = 0.03). Based on EPDS score a larger proportion of the intervention group was recovered (46.5% v. 23.8%, p = 0.03) compared with usual care at 6 months follow-up.
This trial shows that an exercise intervention that involved encouragement to exercise and to seek out social support to exercise may be an effective treatment for women with postnatal depression, including those with thoughts of self-harming.
The user-managed inventory (UMI) is an emerging idea for enhancing the current distribution and maintenance system for emergency medical countermeasures (MCMs). It increases current capabilities for the dispensing and distribution of MCMs and enhances local/regional preparedness and resilience. In the UMI, critical MCMs, especially those in routine medical use (“dual utility”) and those that must be administered soon after an incident before outside supplies can arrive, are stored at multiple medical facilities (including medical supply or distribution networks) across the United States. The medical facilities store a sufficient cache to meet part of the surge needs but not so much that the resources expire before they would be used in the normal course of business. In an emergency, these extra supplies can be used locally to treat casualties, including evacuees from incidents in other localities. This system, which is at the interface of local/regional and federal response, provides response capacity before the arrival of supplies from the Strategic National Stockpile (SNS) and thus enhances the local/regional medical responders' ability to provide life-saving MCMs that otherwise would be delayed. The UMI can be more cost-effective than stockpiling by avoiding costs due to drug expiration, disposal of expired stockpiled supplies, and repurchase for replacement.
(Disaster Med Public Health Preparedness. 2012;6:408-414)
We report the growth of silicon nanowires by plasma assisted metal organic chemical vapor deposition. Silicon nanowires grew as three-dimensional networks in which electrical charges and heat can travel over the distance much longer than the mean length of the constituent nanowires. We studied the dependence of thermoelectric properties on two factors; nominal doping concentrations and geometrical factors within the silicon nanowire networks. The silicon nanowire networks show Seebeck coefficients comparable with that of bulk silicon for a given nominal doping concentration, allowing us to control Seebeck coefficients by tuning the doping concentrations. Rather than studying single nanowires, we chose networks of nanowires formed densely across large areas required for large scale production. We also studied the role played by intersections where multiple nanowires were fused to form the nanowire networks. Structural analysis, transport measurement, and modeling based on finite-element analysis were carried out to obtain insights of physical properties at the intersections. Understanding these physical properties of three-dimensional nanowire networks will advance the development of thermoelectric devices.
Precisely measured neutron star masses and especially radii would provide unique constraints on the properties of cold matter at several times nuclear density. Observations using the Rossi X-ray Timing Explorer suggest that such measurements might be possible using thermonuclear X-ray bursts. Here we discuss the prospects for mass and radius constraints, with a particular focus on potential systematic errors.
We give an efficient method based on minimal deterministic finite automata for computing the exact distribution of the number of occurrences and coverage of clumps (maximal sets of overlapping words) of a collection of words. In addition, we compute probabilities for the number of h-clumps, word groupings where gaps of a maximal length h between occurrences of words are allowed. The method facilitates the computation of p-values for testing procedures. A word is allowed to contain other words of the collection, making the computation more general, but also more difficult. The underlying sequence is assumed to be Markovian of an arbitrary order.
Given the methodological limitations of recently published qualitative
reviews of abortion and mental health, a quantitative synthesis was
deemed necessary to represent more accurately the published literature
and to provide clarity to clinicians.
To measure the association between abortion and indicators of adverse
mental health, with subgroup effects calculated based on comparison
groups (no abortion, unintended pregnancy delivered, pregnancy delivered)
and particular outcomes. A secondary objective was to calculate
population-attributable risk (PAR) statistics for each outcome.
After the application of methodologically based selection criteria and
extraction rules to minimise bias, the sample comprised 22 studies, 36
measures of effect and 877 181 participants (163 831 experienced an
abortion). Random effects pooled odds ratios were computed using adjusted
odds ratios from the original studies and PAR statistics were derived
from the pooled odds ratios.
Women who had undergone an abortion experienced an 81% increased risk of
mental health problems, and nearly 10% of the incidence of mental health
problems was shown to be attributable to abortion. The strongest subgroup
estimates of increased risk occurred when abortion was compared with term
pregnancy and when the outcomes pertained to substance use and suicidal
This review offers the largest quantitative estimate of mental health
risks associated with abortion available in the world literature. Calling
into question the conclusions from traditional reviews, the results
revealed a moderate to highly increased risk of mental health problems
after abortion. Consistent with the tenets of evidence-based medicine,
this information should inform the delivery of abortion services.
To determine whether drinking water contaminated with antimicrobial-resistant E. coli is associated with the carriage of resistant E. coli, selected households sending water samples to Ontario and Alberta laboratories in 2005–2006 were asked to participate in a cross-sectional study. Household members aged ⩾12 years were asked to complete a questionnaire and to submit a rectal swab. In 878 individuals, 41% carried a resistant strain of E. coli and 28% carried a multidrug-resistant strain. The risk of carriage of resistant E. coli was 1·26 times higher for users of water contaminated with resistant E. coli. Other risk factors included international travel [prevalence ratio (PR) 1·33], having a child in nappies (PR 1·33), being male (PR 1·33), and frequent handling of raw red meats (PR 1·10). Protecting private water sources (e.g. by improving systems to test and treat them) may help slow the emergence of antimicrobial resistance in E. coli.