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The majority of studies on phonation types have focused on low vowels due to the minimal effects of their first formant on harmonic amplitude. In studies of multiple vowel qualities, reports on the relationship between vowel and voice quality are mixed: some show similar formant frequencies across phonation types (e.g. Abramson, Nye & Luangthongkum 2007, Khan 2012), while others show different formant frequencies depending on voice quality (e.g. Ren 1992, Kuang 2011). Results differ as to whether the degree of non-modal phonation varies (Andruski & Ratliff 2000, Kuang 2011) or does not vary (Esposito 2012, Khan 2012) across different vowel qualities. The present study draws on innovations which allow for more accurate corrections for the effects of formant frequencies on spectral measures (i.e. Hanson 1995, Iseli, Shue & Alwan 2007) to examine the relationship between vowel quality and voice quality, in eight languages – !Xóõ, Burmese, Gujarati, Jalapa de Díaz Mazatec, Mon, Santa Ana del Valle Zapotec, White Hmong, and Yi. While no significant difference in the degree of non-modal phonation due to vowel quality was found, results showed a crosslinguistic pattern in the relationship between vowel quality and voice quality: vowels with higher log(F1) and log(F2) values tended to be produced with creakier phonation, while vowels with lower log(F1) and log(F2) values tended to be produced with breathier phonation, but only on the measure H1*-H2*.
Neuropsychological investigations can help untangle the aetiological and phenomenological heterogeneity of schizophrenia but have scarcely been employed in the context of treatment-resistant (TR) schizophrenia. No population-based study has examined neuropsychological function in the first-episode of TR psychosis.
We report baseline neuropsychological findings from a longitudinal, population-based study of first-episode psychosis, which followed up cases from index admission to 10 years. At the 10-year follow up patients were classified as treatment responsive or TR after reconstructing their entire case histories. Of 145 cases with neuropsychological data at baseline, 113 were classified as treatment responsive, and 32 as TR at the 10-year follow-up.
Compared with 257 community controls, both case groups showed baseline deficits in three composite neuropsychological scores, derived from principal component analysis: verbal intelligence and fluency, visuospatial ability and executive function, and verbal memory and learning (p values⩽0.001). Compared with treatment responders, TR cases showed deficits in verbal intelligence and fluency, both in the extended psychosis sample (t = −2.32; p = 0.022) and in the schizophrenia diagnostic subgroup (t = −2.49; p = 0.017). Similar relative deficits in the TR cases emerged in sub-/sensitivity analyses excluding patients with delayed-onset treatment resistance (p values<0.01–0.001) and those born outside the UK (p values<0.05).
Verbal intelligence and fluency are impaired in patients with TR psychosis compared with those who respond to treatment. This differential is already detectable – at a group level – at the first illness episode, supporting the conceptualisation of TR psychosis as a severe, pathogenically distinct variant, embedded in aberrant neurodevelopmental processes.
Using the recently developed techniques of electron tomography, we have explored the first stages of disfiguring formation of zinc soaps in modern oil paintings. The formation of complexes of zinc ions with fatty acids in paint layers is a major threat to the stability and appearance of many late 19th and early 20th century oil paintings. Moreover, the occurrence of zinc soaps in oil paintings leading to defects is disturbingly common, but the chemical reactions and migration mechanisms leading to large zinc soap aggregates or zones remain poorly understood. State-of-the-art scanning (SEM) and transmission (TEM) electron microscopy techniques, primarily developed for biological specimens, have enabled us to visualize the earliest stages of crystalline zinc soap growth in a reconstructed zinc white (ZnO) oil paint sample. In situ sectioning techniques and sequential imaging within the SEM allowed three-dimensional tomographic reconstruction of sample morphology. Improvements in the detection and discrimination of backscattered electrons enabled us to identify local precipitation processes with small atomic number contrast. The SEM images were correlated to low-dose and high-sensitivity TEM images, with high-resolution tomography providing unprecedented insight into the structure of nucleating zinc soaps at the molecular level. The correlative approach applied here to study phase separation, and crystallization processes specific to a problem in art conservation creates possibilities for visualization of phase formation in a wide range of soft materials.
There is no consensus as to whether magnetic resonance imaging (MRI) should be used as part of the initial clinical evaluation of patients with first-episode psychosis (FEP).
(a) To assess the logistical feasibility of routine MRI; (b) to define the clinical significance of radiological abnormalities in patients with FEP.
Radiological reports from MRI scans of two FEP samples were reviewed; one comprised 108 patients and 98 healthy controls recruited to a research study and the other comprised 241 patients scanned at initial clinical presentation plus 66 healthy controls.
In the great majority of patients, MRI was logistically feasible. Radiological abnormalities were reported in 6% of the research sample and in 15% of the clinical sample (odds ratio (OR) = 3.1, 95% CI 1.26–7.57, χ2(1) = 6.63, P = 0.01). None of the findings necessitated a change in clinical management.
Rates of neuroradiological abnormalities in FEP are likely to be underestimated in research samples that often exclude patients with organic abnormalities. However, the majority of findings do not require intervention.
The nutritional value of meat is an increasingly important factor influencing consumer preferences for poultry, red meat and processed meat products. Intramuscular fat content and composition, in addition to high quality protein, trace minerals and vitamins are important determinants of nutritional value. Fat content of meat at retail has decreased substantially over the past 40 years through advances in animal genetics, nutrition and management and changes in processing techniques. Evidence of the association between diet and the incidence of human non-communicable diseases has driven an interest in developing production systems for lowering total SFA and trans fatty acid (TFA) content and enrichment of n-3 PUFA concentrations in meat and meat products. Typically, poultry and pork has a lower fat content, containing higher PUFA and lower TFA concentrations than lamb or beef. Animal genetics, nutrition and maturity, coupled with their rumen microbiome, are the main factors influencing tissue lipid content and relative proportions of SFA, MUFA and PUFA. Altering the fatty acid (FA) profile of lamb and beef is determined to a large extent by extensive plant and microbial lipolysis and subsequent microbial biohydrogenation of dietary lipid in the rumen, and one of the major reasons explaining the differences in lipid composition of meat from monogastrics and ruminants. Nutritional strategies can be used to align the fat content and FA composition of poultry, pork, lamb and beef with Public Health Guidelines for lowering the social and economic burden of chronic disease.
A selection of elements (Bi, Ca, Cd, Co, Cu, Mn, Na, Sr, U, V, Zn) were measured by high-resolution inductively coupled plasma sector-field mass spectrometry in firn- and ice-core samples from Law Dome, Antarctica, corresponding to the period 4500 BC to AD 1989. Concentrations of rock dust and sea salts were calculated for each sample and then used to determine concentrations of each element originating from crustal and marine aerosol emissions, respectively. Where calculated contributions from crustal and marine aerosol sources failed to account for the total measured concentration of an element, the remainder was apportioned to volcanic and/or anthropogenic sources and defined as an enrichment. On this basis, it was determined that Bi and Cd concentrations in Law Dome ice are overwhelmingly influenced by volcanic emissions (enrichments 150–250x crustal and marine inputs); Co, Cu, Pb and Zn concentrations in Law Dome ice are largely influenced by volcanic emissions (enrichments 16–36x crustal and marine inputs); and Mn, Sr, U and V concentrations in Law Dome ice are minimally influenced by volcanic emissions (enrichments 1.5–4x crustal and marine inputs). During the 20th century, enrichments of Pb and Cu concentrations were observed to be greater than in earlier centuries, consistent with increasing anthropogenic emissions of Pb and Cu in the Southern Hemisphere over that period.
Introduction: Emerging evidence suggests a heightened interest in healthy behaviour changes, including smoking cessation, at the beginning of the week. Evidence from Google searches, quitlines, and cessation websites show greater information-seeking and interest in early week quitting.
Aims: This pilot assesses the comparative effectiveness of a smoking cessation intervention that encourages participants to use Mondays as a day to quit or recommit to quitting smoking.
Methods: We partnered with existing smoking cessation group programs to conduct a quasi-experimental, pre–post study. Both comparison and intervention groups received the same standard-care curriculum from program instructors. Intervention group participants received Monday materials including a wallet card and a mantra card during enrolment. On Mondays, intervention participants received an emailed tip-of-the-week and were encouraged to quit or recommit to quitting. Quit buddies were recommended in both groups, but intervention participants were encouraged to check-in with quit buddies on Mondays. The outcomes of smoking abstinence, number and length of quit attempts, and self-efficacy were assessed at the final program session and three months later.
Results: At the last session, intervention group participants who were still smoking had a higher self-efficacy of quitting in the future, rated their programs as more helpful in quitting smoking, and were more likely to rate quit buddies as very helpful. Differences in self-efficacy were no longer observed at the second follow-up. No differences were observed between intervention and standard group participants in abstinence, number of quits, length of quits, or self-efficacy of staying quit at either follow-up.
Conclusions: Encouraging results from this pilot study indicate that further research is needed to explore how Monday messaging may improve smoking cessation programs.
We sought to evaluate the first-in-man use of a new system for implantation of covered stents in patients with complex structural and CHD.
Methods and results
Retrospective data were collected of the first 13 NuDEL™ delivery systems used in patients. The NuDEL™ comprises a covered Cheatham-Platinum stent mounted on a balloon-in-balloon and pre-loaded in a long delivery sheath. Data were collected from three centres in the United Kingdom and Ireland. A total of 13 covered stents were delivered via 12 NuDEL™ delivery systems in 12 patients. Among them, six patients had coarctation of the aorta, five patients had right ventricular outflow tract stenosis, and one patient had severe stenosis of a Mustard systemic venous baffle. There were no complications, and all the stents were deployed in the desired position with satisfactory haemodynamic results.
The development of a bespoke system of a pre-mounted, pre-loaded covered stent may negate some of the technical challenges that complicate large-calibre stent deployment. Our preliminary results suggest that the NuDEL™ system is a safe and effective means of covered stent deployment in challenging anatomy.
With the rise of ultranationalist organizations throughout Europe, the issue of attitudes and orientations held toward designated "out-groups" has become a critical concern of anxious observers. In Russia the strength registered by Vladimir Zhirinovskii's ultranationalist Liberal Democratic Party during the parliamentary elections of 1993 has been interpreted as a sign of intolerance among the Russian populace. In fact, the success of candidates associated with the Liberal Democratic Party was not only based upon appeals to strengthen the Russian nation against perceived enemies, but also upon promises of a return to price stability and upon Zhirinovskii's anti-establishment, populist program. Nonetheless, Zhirinovskii's success in the 1991 presidential elections (he attracted 7.8% of the electorate) does serve to reaffirm the importance of tracking how attitudes toward groups that have often been targeted as scapegoats in times of social or economic upheaval have evolved in the late Soviet and immediate post-Soviet period. Two major questions concern us here: first, how pervasive among Russians and Ukrainians are perceptions of significant "social distance" between themselves and designated out-groups, most notably the Jewish population; and second, to what extent do these perceptions of distance form part of a cohesive ideology of ultranationalism? Understanding the basis of sentiments toward Jewish populations is particularly important for interpreting the workings of the complex mosaic of the post-Soviet political culture.
Increasingly, archaeological research in Amazonia is revealing complex precolonial occupation in areas around riverine confluences. In 2014, the first site-based archaeological investigations were undertaken in Gurupá, Pará, Brazil, a municipality that spans the region of the Xingu-Amazon confluence. The Portuguese controlled access to Amazonia from 1623 onward through a network of settlements organized around Gurupá. Results from extensive excavations of terra preta sites, landscape archaeology, and analysis of ceramic evidence suggest that this was also a precolonial crossroads. Carrazedo, once a booming historical town (Arapijó), sits atop a significantly larger terra preta site. Excavations in historical and precolonial sectors of Carrazedo found well-preserved remains, including a precolonial house terrace complex. The extent of terra preta and earthworks at Carrazedo indicate that the precolonial occupation was more intensive than the colonial-historical period occupation. Regional survey revealed colonial-historical period sites consistently overlying expansive precolonial sites, the density and extent of which suggest a major precolonial center at the Xingu-Amazon confluence. Overall, ecological and landscape modifications appear to have been more intense in the precolonial past than during later periods. Short- and long-distance settlement networks also differed during the two periods. This as-of-yet understudied region promises to shed new light on deep-time human-environment interactions and spatial organization in the humid tropics of Amazonia.
We retrospectively reviewed all the children with right ventricular outflow tract obstruction, hypoplastic pulmonary annulus, and pulmonary arteries who underwent stenting of the right ventricular outflow tract for hypercyanotic spells at our institution between January, 2008 and December, 2013; nine patients who underwent cardiac catheterisation at a median age of 39 days (range 12–60 days) and weight of 3.6 kg (range 2.6–4.3 kg) were identified. The median number of stents placed was one stent (range 1–4). The median oxygen saturation increased from 60% to 96%. The median right pulmonary artery size increased from 3.3 to 5.5 mm (−2.68 to −0.92 Z-score), and the median left pulmonary artery size increased from 3.4 to 5.5 mm (−1.93 to 0 Z-scores). Among all, one patient developed transient pulmonary haemorrhage, and one patient had pericardial tamponade requiring drainage. Complete repair of tetralogy of Fallot +/− atrioventricular septal defect or double-outlet right ventricle was achieved in all nine patients. Transcatheter stent alleviation of the right ventricular outflow tract obstruction resolves hypercyanotic spells and allows reasonable growth of the pulmonary arteries to facilitate successful surgical repair. This represents a viable alternative to placement of a systemic-to-pulmonary artery shunt, particularly in small neonates.
Designing materials for performance in high-radiation fields can be accelerated through a carefully chosen combination of advanced multiscale modeling paired with appropriate experimental validation. The studies reported in this work, the combined efforts of six universities working together as the Consortium on Cladding and Structural Materials, use that approach to focus on improving the scientific basis for the response of ferritic–martensitic steels to irradiation. A combination of modern modeling techniques with controlled experimentation has specifically focused on improving the understanding of radiation-induced segregation, precipitate formation and growth under radiation, the stability of oxide nanoclusters, and the development of dislocation networks under radiation. Experimental studies use both model and commercial alloys, irradiated with both ion beams and neutrons. Transmission electron microscopy and atom probe are combined with both first-principles and rate theory approaches to advance the understanding of ferritic–martensitic steels.
(See the commentary by Van Schooneveld and Rupp, on pages1100–1102.)
Although prior authorization and prospective audit with feedback are both effective antimicrobial stewardship program (ASP) strategies, the relative impact of these approaches remains unclear. We compared these core ASP strategies at an academic medical center.
We compared antimicrobial use during the 24 months before and after implementation of an ASP strategy change. The ASP used prior authorization alone during the preintervention period, June 2007 through May 2009. In June 2009, many antimicrobials were unrestricted and prospective audit was implemented for cefepime, piperacillin/tazobactam, and vancomycin, marking the start of the postintervention period, July 2009 through June 2011. All adult inpatients who received more than or equal to 1 dose of an antimicrobial were included. The primary end point was antimicrobial consumption in days of therapy per 1,000 patient-days (DOT/1,000-PD). Secondary end points included length of stay (LOS).
In total, 55,336 patients were included (29,660 preintervention and 25,676 postintervention). During the preintervention period, both total systemic antimicrobial use (−9.75 DOT/1,000-PD per month) and broad-spectrum anti-gram-negative antimicrobial use (−4.00 DOT/1,000-PD) declined. After the introduction of prospective audit with feedback, however, both total antimicrobial use (+9.65 DOT/1,000-PD per month; P < .001) and broad-spectrum anti-gram-negative antimicrobial use (+4.80 DOT/1,000-PD per month; P < .001) increased significantly. Use of cefepime and piperacillin/tazobactam both significantly increased after the intervention (P = .03). Hospital LOS and LOS after first antimicrobial dose also significantly increased after the intervention (P = .016 and .004, respectively).
Significant increases in antimicrobial consumption and LOS were observed after the change in ASP strategy.
Infect Control Hosp Epidemiol 2014;35(9):1092-1099