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 email@example.com
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.
Learners preferentially interpret novel nouns at the basic level (‘dog’) rather than at a more narrow level (‘Labrador’). This ‘basic-level bias’ is mitigated by statistics: children and adults are more likely to interpret a novel noun at a more narrow label if they witness ‘a suspicious coincidence’ – the word applied to three exemplars of the same narrow category. Independent work has found that exemplar typicality influences learners’ inferences and category learning. We bring these lines of work together to investigate whether the content (typicality) of a single exemplar affects the level of interpretation of words and whether an atypicality effect interacts with input statistics. Results demonstrate that both four- to five-year-olds and adults tend to assign a narrower interpretation to a word if it is exemplified by an atypical category member. This atypicality effect is roughly as strong as, and independent of, the suspicious coincidence effect, which is replicated.
The causes of the beaching and death of sea turtles have not been fully clarified and continue to be studied. Mild, moderate and severe lesions caused by spirorchiidiosis have been seen for decades in different organs and were recently defined as the cause of death of a loggerhead turtle. In the present study, eyes and optic nerves were analysed in green sea turtles with spirorchiidiosis and no other debilitating factors. Injuries to the optic nerve and choroid layer were described in 235 animals (90%) infected with spirorchiids. Turtles with ocular spirorchiidiosis are approximately three times more likely to be cachectic than turtles with spirorchiidiosis without ocular involvement.
The Society of Academic Emergency Medicine Disaster Medicine Interest Group, the Office of the Assistant Secretary for Preparedness and Response – Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) team, and the National Institutes of Health Library searched disaster medicine peer-reviewed and gray literature to identify, review, and disseminate the most important new research in this field for academics and practitioners.
MEDLINE/PubMed and Scopus databases were searched with key words. Additional gray literature and focused hand search were performed. A Level I review of titles and abstracts with inclusion criteria of disaster medicine, health care system, and disaster type concepts was performed. Eight reviewers performed Level II full-text review and formal scoring for overall quality, impact, clarity, and importance, with scoring ranging from 0 to 20. Reviewers summarized and critiqued articles scoring 16.5 and above.
Articles totaling 1176 were identified, and 347 were screened in a Level II review. Of these, 193 (56%) were Original Research, 117 (34%) Case Report or other, and 37 (11%) were Review/Meta-Analysis. The average final score after a Level II review was 11.34. Eighteen articles scored 16.5 or higher. Of the 18 articles, 9 (50%) were Case Report or other, 7 (39%) were Original Research, and 2 (11%) were Review/Meta-Analysis.
This first review highlighted the breadth of disaster medicine, including emerging infectious disease outbreaks, terror attacks, and natural disasters. We hope this review becomes an annual source of actionable, pertinent literature for the emerging field of disaster medicine.
In the years 1599-1604, Grand Duke Ferdinando I de'Medici ordered state gifts of contemporary Florentine paintings for three influential Spanish noblewomen (Catalina de la Cerda, Marquesa de Denia; Magdalena de Guzmán, Marquesa del Valle; and María de Toledo y Colonna, Duquesa de Alba). The problem of producing images suitable for Spanish usage is discussed in explicit detail, in a series of documents recently discovered in the Archivio di Stato di Firenze.
Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990–1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.
Children with hypoplastic left heart syndrome are at a risk for neurodevelopmental delays. Current guidelines recommend systematic evaluation and management of neurodevelopmental outcomes with referral for early intervention services. The Single Ventricle Reconstruction Trial represents the largest cohort of children with hypoplastic left heart syndrome ever assembled. Data on life events and resource utilisation have been collected annually. We sought to determine the type and prevalence of early intervention services used from age 1 to 4 years and factors associated with utilisation of services.
Data from 14-month neurodevelopmental assessment and annual medical history forms were used. We assessed the impact of social risk and geographic differences. Fisher exact tests and logistic regression were used to evaluate associations.
Annual medical history forms were available for 302 of 314 children. Greater than half of the children (52–69%) were not receiving services at any age assessed, whereas 20–32% were receiving two or more therapies each year. Utilisation was significantly lower in year 4 (31%) compared with years 1–3 (with a range from 40 to 48%) (p<0.001). Social risk factors were not associated with the use of services at any age but there were significant geographic differences. Significant delay was reported by parents in 18–43% of children at ages 3 and 4.
Despite significant neurodevelopmental delays, early intervention service utilisation was low in this cohort. As survival has improved for children with hypoplastic left heart syndrome, attention must shift to strategies to optimise developmental outcomes, including enrolment in early intervention when merited.
A significant minority of people presenting with a major depressive episode (MDE) experience co-occurring subsyndromal hypo/manic symptoms. As this presentation may have important prognostic and treatment implications, the DSM–5 codified a new nosological entity, the “mixed features specifier,” referring to individuals meeting threshold criteria for an MDE and subthreshold symptoms of (hypo)mania or to individuals with syndromal mania and subthreshold depressive symptoms. The mixed features specifier adds to a growing list of monikers that have been put forward to describe phenotypes characterized by the admixture of depressive and hypomanic symptoms (e.g., mixed depression, depression with mixed features, or depressive mixed states [DMX]). Current treatment guidelines, regulatory approvals, as well the current evidentiary base provide insufficient decision support to practitioners who provide care to individuals presenting with an MDE with mixed features. In addition, all existing psychotropic agents evaluated in mixed patients have largely been confined to patient populations meeting the DSM–IV definition of “mixed states” wherein the co-occurrence of threshold-level mania and threshold-level MDE was required. Toward the aim of assisting clinicians providing care to adults with MDE and mixed features, we have assembled a panel of experts on mood disorders to develop these guidelines on the recognition and treatment of mixed depression, based on the few studies that have focused specifically on DMX as well as decades of cumulated clinical experience.
Chemical and structural similarities between poorly preserved charcoal and its contaminants, as well as low radiocarbon concentrations in old samples, complicate 14C age determinations. Here, we characterize 4 fossil charcoal samples from the late Middle Paleolithic and early Upper Paleolithic strata of Kebara Cave, Israel, with respect to the structural and chemical changes that occur when they are subjected to the acid-base-acid (ABA) treatment. Differential thermal analysis and TEM show that acid treatment disrupts the structure, whereas alkali treatment results in the reformation of molecular aggregates. The major changes are ascribed to the formation of salt bridges at high pH and the disruption of the graphite-like crystallites at low pH. Weight losses during the treatments are consistently greater for older samples, implying that they are less well preserved. Based on the changes observed in vitro due to pH fluctuations, various methods for removing contamination, as well as a mechanism for preferential preservation of charcoal in nature, are proposed.
Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.
Methods and results
This study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2 versus lower-risk group=2.96 L/minute/m2, (p<0.01)].
Higher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.
The possibility that life, primitive or advanced, might exist in other places of the Universe has occupied the minds of scientists and lay-people for thousands of years. It is only in the last 25 years, however, that we have finally begun to search for answers to this profound question using experimental techniques. The goal of Astronomy is to understand the origin and evolution of planets, stars, galaxies and of the Universe as a whole. The appearance of life is an integral part of this whole process and our picture of the Universe will never be complete until we will comprehend also the significance of life in the process of Cosmic Evolution.
In view of the limitation on length set by the cost of producing the IAU Reports, the present report can only be a selection of the most important advances during the past three years and not a complete review of the field.
Attempting to pick out a few points of interest, since the last report improvements have been made in recording solar X-ray spectra and in high spatial resolution imaging; the OSO satellite programme continues to produce valuable data. The eclipse experiments planned for March 1970 will, if successful, provide a considerable amount of new information. The solar iron abundance is still a subject of interest in view of the revision of oscillator strengths used in the photospheric analyses. Further interplanetary observations have shown that the general nature of the solar wind at the Earth does not depend on the phase of the solar activity cycle, and have revealed large increases in the abundance of helium in the solar wind following solar flares.
The spectrum of α Orionis is composite and consist of three components: 1) a photospheric spectrum characterized by symmetric absorption lines more or less typical of the spectrum of an M2 supergiant, except for their very great widths; 2) a shell spectrum consisting of P Cygnitype profiles of neutral and singly-ionized metallic lines of very low excitation potential; and 3) asymmetric absorption lines, including Hα Hβ , Fel lines of intermediate excitation potential and the infrared triplet of Ca+, which appear to be formed in a relatively warm layer, probably an extended chromosphere.
We present three separate observational studies of mass flows above the photosphere of α Ori (M2 Ia-Ib). The Ca II infrared triplet lines and Hα are asymmetric showing a systematic blue shift with decreasing residual intensity. These lines remain fixed in wavelength although the weak photospheric lines vary by ±4 km/sec. Observations of the 4.6μ vibration-rotation spectrum of CO show two sharp, cold components expanding at velocities of 10 and 17 km/sec relative to the centre of mass. Direct photographs of the shell in the light of KI λ7699 show that the cold shell is asymmetric and extends outward to at least 50”.
Details of these studies are either in press or will be submitted to “The Astrophysical Journal”.
I have rarely had the pleasure of attending a conference in which the sheer volume of information has been so impressive and the contributions have been so diversified. Ordinarily, an I.A.U. colloquium is quite specialized, but this one might easily have been sponsored by half a dozen commissions and several international scientific unions. Astronomers from many sub-disciplines, atomic physicists, plasma physicists, aerodynamicists and applied mathematicians have come together to unite solar and stellar physics and to learn one another's scientific language. In principle, my task is to summarize more than 100 papers, which is clearly impossible even if I had had two evenings to prepare instead of one. The best I can do is to mention a few of the papers which seem to me to have conveyed the flavor of the conference and to ask the forgiveness of the remaining authors.
Many scientific justifications for space astronomy have been prepared by individuals and committees during the past three decades or more. The first such report that I am aware of, called “Astronomical Advantages of an Extraterrestrial Observatory”, was written by Lyman Spitzer in September 1946, and although its goals were extremely modest by today’s standards, the report did dwell with enthusiasm on the ultimate goal of a large reflecting telescope 4-6 meters in diameter with diffraction-limited optics put into earth-satellite orbit. The latest study, from which I shall quote liberally, has just been published by the Astronomy Committee of the U. S. National Academy of Sciences, and provides the scientific foundation for space astronomy in the 1980’s. Space Astronomy was initiated about one month after the date of publication of Spitzer’s report, when the first high-altitude rocket was launched to observe the sun’s ultraviolet radiation. Since that time, space astronomy has completed two phases and is about to embark on a third. In Phase 1, which lasted until the beginning of Sputnik, observations were made for a few minutes at a time from high-altitude rockets. In the second phase, which is just ending, observations were made with relatively small instruments in earth-orbiting satellites. The observing programs carried out with rockets and small satellites were called experiments because their capabilities and objectives were limited and their lifetimes were short -from a few minutes to about a year.
The newly established Inter-Union Commission on Solar-Terrestrial Physics (IUCSTP) has inquired of selected experts about actions useful in the period of the next solar maximum, which need an organization and coordination on international basis. These inquiries have shown that one of the problems, in which a broad international cooperation might lead to substantial improvement of scientific results, is the coordination of ground-base and space-vehicle observations of the Sun and its active phenomena.
Therefore, in order to help the IUCSTP in its preparatory work, the chairmen of IAU Commissions 10 (Solar Activity) and 44 (Observations from outside the Atmosphere) agreed to hold a joint meeting of these two Commissions during the IAU Assembly in Prague, on ‘Coordination of solar observations made at ground-base Observatories and with space vehicles’. It was anticipated that other IAU members interested in this problem, particularly members of Commissions 12 and 40, would also take part in the discussion.
We analyzed birth order differences in means and variances of height and body mass index (BMI) in monozygotic (MZ) and dizygotic (DZ) twins from infancy to old age. The data were derived from the international CODATwins database. The total number of height and BMI measures from 0.5 to 79.5 years of age was 397,466. As expected, first-born twins had greater birth weight than second-born twins. With respect to height, first-born twins were slightly taller than second-born twins in childhood. After adjusting the results for birth weight, the birth order differences decreased and were no longer statistically significant. First-born twins had greater BMI than the second-born twins over childhood and adolescence. After adjusting the results for birth weight, birth order was still associated with BMI until 12 years of age. No interaction effect between birth order and zygosity was found. Only limited evidence was found that birth order influenced variances of height or BMI. The results were similar among boys and girls and also in MZ and DZ twins. Overall, the differences in height and BMI between first- and second-born twins were modest even in early childhood, while adjustment for birth weight reduced the birth order differences but did not remove them for BMI.
A trend toward greater body size in dizygotic (DZ) than in monozygotic (MZ) twins has been suggested by some but not all studies, and this difference may also vary by age. We analyzed zygosity differences in mean values and variances of height and body mass index (BMI) among male and female twins from infancy to old age. Data were derived from an international database of 54 twin cohorts participating in the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins), and included 842,951 height and BMI measurements from twins aged 1 to 102 years. The results showed that DZ twins were consistently taller than MZ twins, with differences of up to 2.0 cm in childhood and adolescence and up to 0.9 cm in adulthood. Similarly, a greater mean BMI of up to 0.3 kg/m2 in childhood and adolescence and up to 0.2 kg/m2 in adulthood was observed in DZ twins, although the pattern was less consistent. DZ twins presented up to 1.7% greater height and 1.9% greater BMI than MZ twins; these percentage differences were largest in middle and late childhood and decreased with age in both sexes. The variance of height was similar in MZ and DZ twins at most ages. In contrast, the variance of BMI was significantly higher in DZ than in MZ twins, particularly in childhood. In conclusion, DZ twins were generally taller and had greater BMI than MZ twins, but the differences decreased with age in both sexes.
The National Institute of Health and Care Excellence (NICE) in England and Wales recommends the combination of pharmacotherapy and psychotherapy for the treatment of moderate to severe depression. However, the cost-effectiveness analysis on which these recommendations are based has not included psychotherapy as monotherapy as a potential option. For this reason, we aimed to update, augment and refine the existing economic evaluation.
We constructed a decision analytic model with a 27-month time horizon. We compared pharmacotherapy with cognitive–behavioural therapy (CBT) and combination treatment for moderate to severe depression in secondary care from a healthcare service perspective. We reviewed the literature to identify relevant evidence and, where possible, synthesized evidence from clinical trials in a meta-analysis to inform model parameters.
The model suggested that CBT as monotherapy was most likely to be the most cost-effective treatment option above a threshold of £22 000 per quality-adjusted life year (QALY). It dominated combination treatment and had an incremental cost-effectiveness ratio of £20 039 per QALY compared with pharmacotherapy. There was significant decision uncertainty in the probabilistic and deterministic sensitivity analyses.
Contrary to previous NICE guidance, the results indicated that even for those patients for whom pharmacotherapy is acceptable, CBT as monotherapy may be a cost-effective treatment option. However, this conclusion was based on a limited evidence base, particularly for combination treatment. In addition, this evidence cannot easily be transferred to a primary care setting.