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Standardised developmental screening tools are important for the evaluation and management of developmental disorders in children with CHD; however, psychometric properties and clinical utility of screening tools, such as the Ages & Stages Questionnaires, Third Edition (ASQ-3), have not been examined in the CHD population. We hypothesised that the ASQ-3 would be clinically useful for this population.
ASQ-3 developmental classifications for 163 children with CHD at 6, 12, 24, and/or 36 months of age were compared with those obtained from concurrent developmental testing with the Bayley Scales of Infant and Toddler Development, Third Edition.
When ASQ-3 screening failure was defined as ⩾1 SD below the normative mean, specificity (⩾81.9%) and negative predictive value (⩾81.0%) were high across ASQ-3 areas. Sensitivity was high for gross motor skills (79.6%), increased with age for communication (35.7–100%), and generally decreased with age for problem solving (73.1–50.0%). When ASQ-3 screening failure was defined as ⩾2 SD below the normative mean, specificity (⩾93.6%) and positive predictive value (⩾74.5%) were generally high across ASQ-3 areas, but sensitivity was low (31.1%) to fair (62.8%). The ASQ-3 showed improved accuracy in predicting delays over clinical risk factors alone.
The ASQ-3 appears to be a clinically useful tool for screening development in children with CHD, although its utility varied on the basis of developmental area and time point. Clinicians are encouraged to refer children scoring ⩾1 SD below the normative mean on any ASQ-3 area for formal developmental evaluation.
This review addresses Creutzfeldt–Jakob disease in the context of ENT, and aims to summarise the relevant history, pathophysiology and implications for contemporary practice.
Creutzfeldt–Jakob disease is a rare, fatal, neurodegenerative disorder. It is a prion disease with four different subtypes that can only be definitively diagnosed post-mortem. The main implications for the ENT surgeon lie in the risk of iatrogenic transmission. The three facets of assessing individual patient risk are: patient history; tissue infectivity; and procedure infectivity.
This is a controversial area in medicine, and ENT in particular. This review highlights a clinically applicable approach for everyday use.
EMU is a wide-field radio continuum survey planned for the new Australian Square Kilometre Array Pathfinder (ASKAP) telescope. The primary goal of EMU is to make a deep (rms ∼ 10 μJy/beam) radio continuum survey of the entire Southern sky at 1.3 GHz, extending as far North as +30° declination, with a resolution of 10 arcsec. EMU is expected to detect and catalogue about 70 million galaxies, including typical star-forming galaxies up to z ∼ 1, powerful starbursts to even greater redshifts, and active galactic nuclei to the edge of the visible Universe. It will undoubtedly discover new classes of object. This paper defines the science goals and parameters of the survey, and describes the development of techniques necessary to maximise the science return from EMU.
As Hurricane Katrina bore down on New Orleans in August 2005, the city's mandatory evacuation prompted the exodus of an estimated 80% of its 485,000 residents. According to estimates from the US Centers for Disease Control and Prevention (CDC), at least 18 states subsequently hosted >200,000 evacuees.
In this case study, “Operation Helping Hands” (OHH), the Massachusetts health and medical response in assisting Hurricane Katrina evacuees is described. Operation Helping Hands represents the largest medical response to evacuees in recent Massachusetts history.
The data describing OHH were derived from a series of structured interviews conducted with two leading public health officials directing planning efforts, and a sample of first responders with oversight ofoperations at the evacuation site. Also, a literature review was conducted to identify similar experiences, common challenges, and lessons learned.
Activities and services were provided in the following areas: (1) administration and management;(2) medical and mental health; (3) public health; and (4) social support. This study adds to the knowledge base for future evacuation and shelter planning, and presents a conceptual framework that could be used by other researchers and practitioners to describe the process and out comes of similar operations.
This study provides a description of the planning and implementation efforts of the largest medical evacuee experience in recent Massachusetts history, an effort that involved multiple agencies and partners. The conceptual framework can inform future evacuation and shelter initiatives at the state and national levels, and promotes the overarching public health goal of the highest attainable standard of health for all.
Twin studies of diabetes mellitus can help elucidate genetic and environmental factors in etiology and can provide valuable biological samples for testing functional hypotheses, for example using expression and methylation studies of discordant pairs. We searched the volunteer Australian Twin Registry (19,387 pairs) for twins with diabetes using disease checklists from nine different surveys conducted from 1980–2000. After follow-up questionnaires to the twins and their doctors to confirm diagnoses, we eventually identified 46 pairs where one or both had type 1 diabetes (T1D), 113 pairs with type 2 diabetes (T2D), 41 female pairs with gestational diabetes (GD), 5 pairs with impaired glucose tolerance (IGT) and one pair with MODY. Heritabilities of T1D, T2D and GD were all high, but our samples did not have the power to detect effects of shared environment unless they were very large. Weight differences between affected and unaffected cotwins from monozygotic (MZ) discordant pairs were large for T2D and GD, but much larger again for discordant dizygotic (DZ) pairs. The bivariate genetic analysis (under the multifactorial threshold model) estimated the genetic correlation between body mass index (BMI) and T2D to be 0.46, and the environmental correlation at only 0.06.
An observational study was carried out, using data collected from four areas in the Irish midlands, between 1989 and 2004, to critically evaluate the long-term effects of proactive badger culling and to provide insights into reactive badger culling tuberculosis (TB) prevalence in cattle. Confirmed cattle herd TB incidence is the outcome measure used throughout. Relative to reactive culling, proactive badger culling was associated with a decrease in incidence in each of the 16 years of observation, which encompassed periods of both intensive and less-intensive badger removal. By 2004, we observed a decrease of 22% [95% confidence interval (CI) 15–29, P<0·001] in the entire proactive and 37% (95% CI 25–47, P<0·001), in the inner proactive removal areas. The size of the decrease increased with time (P=0·055). There was a decrease (constant over time) of at least 14% (95% CI 76–97, P=0·013) in incidence in the inner compared to the outer control area (herds ⩽2 km, >2 km, from proactive removal area boundaries, respectively). Incidence in the outer proactive removal area (herds <1·6 km from the proactive removal boundary) was similar to the inner control area (P=0·890). Incidence in the outer control area and total control area, compared to a neighbouring area some distance away, increased over the course of the study. Differences with the total control area were not statistically significant but the outer control area was 11% higher than the neighbouring area by 2004 (borderline significance P=0·057).
A determination of the Hubble Constant (H0) to better than 3% would be the best complement to cosmic microwave background (CMB) data to constrain the equation of state of Dark Energy. Water vapor megamasers provide perhaps the best opportunity for measuring direct distances to galaxies out to about 200 Mpc. We have formed a team of astronomers in the Megamaser Cosmology Project to pursue the ambitious goal of making a precise measurement of H0 by measuring such distances using the techniques pioneered on the disk maser in NGC 4258 by Herrnstein et al (1999). In recent surveys we have made significant progress identifying new maser systems analogous to that in NGC 4258, but more distant. Once the appropriate candidates are identified, two types of observations are necessary to ultimately measure a distance: single-dish monitoring to measure the acceleration of gas in the disk, and sensitive VLBI imaging in order to measure the angular size of the disk, measure the rotation curve, and model radial displacement of the systemic maser features. We have recently obtained preliminary VLBI maps of the masers in two systems, NGC 6323 and UGC 3789. The maser disks in both galaxies were discovered and monitored with the Green Bank Telescope (GBT) and subsequently imaged with the High Sensitivity Array (VLBA + GBT + Effelsberg). In this contribution we present a map of the maser distribution in one of those systems, NGC 6323. The map demonstrates that pc-scale maser disks as distant as ~ 100 Mpc can be imaged with existing telescopes. Results on UGC 3789 will be presented in a later publication.
We present an atlas of extragalactic water vapor masers. As of 2007, one hundred galaxies have been detected as sources of water vapor maser emission, two thirds of them discovered since 2003. Extragalactic water masers fall in at least three categories: those associated with nuclear jets or winds, those in starbursts or star-forming regions, and those in AGN accretion disks. While all maser systems offer the possibility of unique investigations into their physical environments, it is the disk masers that have been most aggressively sought because of their potential for use as precision distance indicators. Type 2 Seyfert and LINER galaxies are hosts to such disk masers. Insingle-dish spectra, disk masers are often revealed by the presence of high-velocity emission features (defined roughly by having anomalous velocities in excess of 200 km s−1). About one third of the extragalactic water masers detected to date show evidence of disk origin. Only a few galaxies are currently identified as jet-type or star-forming type. The remaining systems show only a few narrow doppler components, usually near the systemic velocity, and are difficult to categorize. These unclassified systems are detected toward AGNs and are also possibly associated with disks or winds near the nucleus. Detection rates in large maser surveys are typically 5% or less, but the observing efficiency and sensitivity of the Green Bank Telescope (GBT) allow for short integration times (typically 10 minutes to detect a narrow 30 mJy line) so many galaxies can be searched. Recently, GBT surveys targeting type 2 Seyfert galaxies identified by the SDSS have been the most productive, identifying 17 systems in surveys observed during 2006.
High-precision geochronological techniques have improved in the past decade to the point where volcanic ash beds interstratified with fossil-bearing rocks can be dated to a precision of 0.1% or better. The integration of high-precision U-Pb zircon geochronology with bio/chemo-stratigraphic data brings about new opportunities and challenges toward constructing a fully calibrated time scale for the geologic record, which is necessary for a thorough understanding of the distribution of time and life in Earth history. Successful implementation of geochronology as an integral tool for the paleontologist relies on a basic knowledge of its technical aspects, as well as an ability to properly evaluate and compare geochronologic results from different methods. This paper summarizes the methodology and new improvements in U-Pb zircon geochronology by isotope dilution thermal ionization mass spectrometry, specifically focused on its application to the stratigraphic record.
Fluorinated Single Wall Nanotubes (f-SWNTs) have been processed in polyethylene by an incipient wetting technique to achieve a well dispersed nanocomposite for radiation protection. In some cases, samples were further processed using the rapid prototyping method of extrusion freeform fabrication. Composites were exposed to 40 MeV proton radiation with a flux of about 1.7×107 protons/cm2/sec to a total fluence of 3×1010 protons/cm2.This exposure is consistent with a long-term space mission in low earth orbit. The samples were evaluated by means of Raman spectroscopy and thermogravimetric analysis (TGA). These results were compared to the unexposed composite and unfilled polymer samples. This study has focused on the stability of the nanotube composites when exposed to radiation and prior to hydrogen exposure. It was shown that the stability of the functional group is not constant with SWNTs produced by different processes and that radiation exposure is capable of defluorinating SWNTs in polyethylene.
We have sampled the population of compact (θ ≤ 25") radio sources with spectral indices 1.5 ≤ α ≤ 3.2 (where Sv ∝ v—α) using two large scale radio surveys. This yields a statistically useful sample of 74 radio sources with S1.4GHz ≥ 2.5 mJy and S365MHZ ≥ 200 mJy. The majority of the sources appear to be extragalactic, resembling either high redshift radio galaxies or relic radio galaxies. However, six known pulsars were detected, as well as 16 sources of unknown nature that appear too small and have spectra too steep to be extragalactic. We are using VLBA, pulsar searching, optical/IR spectroscopy, and other techniques to definitively classify these sources. If any are new pulsars, they are potentially very interesting as they were missed by previous surveys.
We are investigating complete samples of southern hemisphere flat spectrum extra-galactic radio sources drawn from the Parkes 2.7 GHz Survey (see Bolton et al. 1979 and references therein). These samples are being used for a variety of investigations, including a determination of the space distribution and luminosity function of radio QSOs, their radio size distribution, as well as the structures of the individual sources. Accurate positions are being determined, as well, in order to establish an extra-galactic position reference frame in the southern hemisphere.
We are investigating a complete sample of flat-spectrum extragalactic radio quasars drawn from the Parkes 2.7 GHz survey. The sample is being used to map the space distribution of radio quasars and to determine their luminosity function. Accurate positions are being measured for a selection of the brighter quasars in order to establish an extragalactic position reference frame in the Southern Hemisphere.
We describe our complete sample of flat-spectrum radio sources with fluxes >0.5 Jy selected from the Parkes 2700 MHz catalogue. The sample covers all right ascensions and declinations from +10° to −45°, but excluding the galactic plane (b < 10°), and contains some 400 sources.
Scattering of radio waves off inhomogeneities in electron density in the interstellar medium can produce an apparent broadening in the angular diameter of an intrinsically compact background radio source. The magnitude and distribution of this effect at low galactic latitudes (|b|<5°) is not well known, although several cases suggest substantial broadening in certain directions, such as the Cygnus X region (Anderson et al. 1972), and the galactic center (Davies, Walsh, and Booth 1976). Large scattering in the plane is consistent with the scintillation properties of pulsars seen through substantial thicknesses (≳ 1 kpc) of the galactic disk.
A wide range of models have been proposed to account for low-frequency (≲ 1 GHz) variability in cosmologically-distant radio sources. To address these models we (Payne et al. 1982) are monitoring the 0.3–1.4 GHz spectra of such sources. Results from three years of monitoring indicate that two distinct types of low-frequency variables may exist.
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