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Recent infection testing algorithms (RITA) for HIV combine serological assays with epidemiological data to determine likely recent infections, indicators of ongoing transmission. In 2016, we integrated RITA into national HIV surveillance in Ireland to better inform HIV prevention interventions. We determined the avidity index (AI) of new HIV diagnoses and linked the results with data captured in the national infectious disease reporting system. RITA classified a diagnosis as recent based on an AI < 1.5, unless epidemiological criteria (CD4 count <200 cells/mm3; viral load <400 copies/ml; the presence of AIDS-defining illness; prior antiretroviral therapy use) indicated a potential false-recent result. Of 508 diagnoses in 2016, we linked 448 (88.1%) to an avidity test result. RITA classified 12.5% of diagnoses as recent, with the highest proportion (26.3%) amongst people who inject drugs. On multivariable logistic regression recent infection was more likely with a concurrent sexually transmitted infection (aOR 2.59; 95% CI 1.04–6.45). Data were incomplete for at least one RITA criterion in 48% of cases. The study demonstrated the feasibility of integrating RITA into routine surveillance and showed some ongoing HIV transmission. To improve the interpretation of RITA, further efforts are required to improve completeness of the required epidemiological data.
Listeriosis is a rare but severe foodborne illness which is more common in populations such as pregnant women, and can result in serious complications including miscarriage, prematurity, maternal and neonatal sepsis, and death in the newborn. Population recommendations exist for specific foods and food preparation practices to reduce listeriosis risk during pregnancy. The aim of the present systematic review was to assess the association between listeriosis and these practices during pregnancy to confirm appropriateness of these recommendations. We searched MEDLINE, Embase, CINAHL Plus, Web of Science Core Collection, included articles’ references, and contacted clinical experts. All databases were searched until July 2017. Case–control and cohort studies were included which assessed pregnant women or their newborn offspring with known listeriosis status and a nutritional exposure consistent with international population recommendations for minimising listeriosis. Outcomes included listeriosis with or without pregnancy outcomes. Risk of bias was assessed through the Newcastle–Ottawa Scale. Results were described narratively due to clinical heterogeneity in differences in nutritional exposures. Eleven articles comprising case–control or cross-sectional studies met the inclusion criteria. Cases of maternal, fetal or neonate listeriosis were more likely to have consumed high-risk dairy products, meat products or some fruits during pregnancy in comparison with women without listeriosis. Cases of listeriosis were more likely to have consumed foods that are highlighted in population guidelines to avoid to minimise listeriosis in comparison with those without listeriosis during pregnancy. Further research is warranted assessing means of improving the reach, uptake and generalisability of population guidelines for reducing listeriosis during pregnancy.
Polycystic ovary syndrome (PCOS) is associated with increased psychological distress in clinical populations. We aimed to assess depression, anxiety and perceived stress in women with and without PCOS in a large community-based sample and investigate the role of stress in contributing to and mediating the relationship between PCOS, depression and anxiety.
A cross-sectional analysis was performed from the Australian Longitudinal Study of Women's Health (ALWSH) comparing women with (n = 478) or without (n = 8134) a self-reported diagnosis of PCOS. Main outcome measures were depression, anxiety and perceived stress measured using validated scales. The χ2 and t tests were used to assess differences between groups. Univariable and multivariable regression were performed to determine factors contributing to each outcome.
Women reporting PCOS, compared with women not reporting PCOS, reported higher prevalence of depression (27.3% v. 18.8%), anxiety symptoms (50% v. 39.2%) and greater score for perceived stress (1.01 ± 0.03 v. 0.88 ± 0.01). After adjusting for body mass index, infertility and socio-demographic factors, women with PCOS were still more likely to be depressed, anxious and to have a higher level of perceived stress. There was a high-level mediation effect of stress between PCOS and both depression and anxiety.
Compared with women not reporting PCOS, women reporting PCOS have increased depression, anxiety and perceived stress. Stress may play a role in the association between PCOS, depression and anxiety. Further studies should consider assessment and management of stress in PCOS as it may be relevant for understanding the aetiology and treatment of psychological distress.
OBJECTIVES/SPECIFIC AIMS: Rodent models can be used to study neonatal abstinence syndrome (NAS), but the applicability of findings from the models to NAS in humans is not well understood. The objective of this study was to develop a rat model of norbuprenorphine-induced NAS and validate its translational value by comparing blood concentrations in the norbuprenorphine-treated pregnant rat to those previously reported in pregnant women undergoing buprenorphine treatment. METHODS/STUDY POPULATION: Pregnant Long-Evans rats were implanted with 14-day osmotic minipumps containing vehicle, morphine (positive control), or norbuprenorphine (0.3–3 mg/kg/d) on gestation day 9. Within 12 hours of delivery, pups were tested for spontaneous or precipitated opioid withdrawal by injecting them with saline (10 mL/kg, i.p.) or naltrexone (1 or 10 mg/kg, i.p), respectively, and observing them for well-validated neonatal withdrawal signs. Blood was sampled via indwelling jugular catheters from a subset of norbuprenorphine-treated dams on gestation day 8, 10, 13, 17, and 20. Norbuprenorphine concentrations in whole blood samples were quantified using LC/MS/MS. RESULTS/ANTICIPATED RESULTS: Blood concentrations of norbuprenorphine in rats exposed to 1–3 mg/kg/d of norbuprenorphine were similar to levels previously reported in pregnant women undergoing buprenorphine treatment. Pups born to dams treated with these doses exhibited robust withdrawal signs. Blood concentrations of norbuprenorphine decreased across gestation, which is similar to previous reports in humans. DISCUSSION/SIGNIFICANCE OF IMPACT: These results suggest that dosing dams with 1–3 mg/kg/day norbuprenorphine produces maternal blood concentrations and withdrawal severity similar to those previously reported in humans. This provides evidence that, at these doses, this model is useful for testing hypotheses about norbuprenorphine that are applicable to NAS in humans.
This experiment aimed to assess the effect of different indoor winter growth rates (WGR) followed by different concentrate supplementation levels at pasture on meat quality of 90 bulls. During the first winter, bulls were offered grass silage ad libitum and either 3 kg (WGR3) or 6 kg (WGR6) of concentrates. After turn-out to pasture, bulls were offered: grass without supplementation (PO), grass plus 0.2 predicted dry matter intake (DMI) as concentrates (PL) or grass plus 0.4 predicted DMI as concentrates (PH). After finishing, colour, chemical composition (unaged), instrumental texture and sensory characteristics (14 days of ageing) of longissimus thoracis were measured. WGR6 bulls had heavier carcasses than WGR3 bulls. There was an interaction between WGR and supplementation for instrumental texture and redness (a). Within WGR3, PO beef was the most tender, whereas within WRG6, PL was the most tender. However, these differences were not detected by the sensory panel. Within WGR3, redness was the lowest for PL, whereas within WRG6, PO was the least red. No differences were found for chemical composition. The multivariate analysis highlighted WGR as the main variable affecting meat quality characteristics. In conclusion, variations in growth path exerted minor effects on appearance and instrumental texture which did not affect the perception of bull beef by a trained sensory panel.
Shiga toxin-producing Escherichia coli (STEC) is a significant cause of gastrointestinal infection and the haemolytic-uremic syndrome (HUS). STEC outbreaks are commonly associated with food but animal contact is increasingly being implicated in its transmission. We report an outbreak of STEC affecting young infants at a nursery in a rural community (three HUS cases, one definite case, one probable case, three possible cases and five carriers, based on the combination of clinical, epidemiological and laboratory data) identified using culture-based and molecular techniques. The investigation identified repeated animal contact (animal farming and petting) as a likely source of STEC introduction followed by horizontal transmission. Whole genome sequencing (WGS) was used for real-time investigation of the incident and revealed a unique strain of STEC O26:H11 carrying stx2a and intimin. Following a public health intervention, no additional cases have occurred. This is the first STEC outbreak reported from Israel. WGS proved as a useful tool for rapid laboratory characterization and typing of the outbreak strain and informed the public health response at an early stage of this unusual outbreak.
We have defined the complex bed topography for a section of a small temperate glacier using 50 MHz monostatic short-pulse radar data and a synthetic-aperture array-processing method. The data were collected on a 100 m by 340 m array grid in the upper stem of Gulkana Glacier, central Alaska, U.S.A. The array processing was based on a modified three-dimensional (3-D) Kirchhoff migration integral and implemented with a synthetic-aperture approach that uses sequences of overlapping sub-arrays to generate depth images in vertical planes. Typical sub-array beam patterns are generally <5° at the −6 dB level, giving a flashlight-like searching capability without distorting the wavelet shape. The bed topography was constructed using normal reflections picked from 3-D array depth images. In some instances reflections were imaged outside the data-cover-age area. The bed surface dips steeply, both parallel and transverse to the direction of ice flow. The maximum observed depth is roughly 140 m. The 3-D method resolved bed dips up to 45°. In regions of steepest dip, it improved depth accuracy by 36% compared with raw data, and by 15% compared with standard two-dimensional (2-D) migration. Over 12 dB of signal-to-noise improvement and improved spatial resolution was achieved compared to raw data and 2-D migration. False bottom layering seen in the raw data and in 2-D migrations is not observed in the 3-D array results. Furthermore, loss of bottom reflections is shown by the 3-D migration to be attributable to the dip and curvature of the reflector, and not scattering losses or signal clutter from englacial inclusions.
The Submillimeter Array (SMA) has been used to image the emission from radio recombination lines of hydrogen at subarcsecond angular resolution from the young high-mass star MWC349A in the H26α, H30α, and H31α transitions at 353, 232, and 211 GHz, respectively. Emission was seen over a range of 80 km s−1 in velocity and 50 mas (corresponding to 60 AU for a distance of 1200 pc). The emission at each frequency has two distinct components, one from gas in a nearly edge-on annular disk structure in Keplerian motion, and another from gas lifted off the disk at distances of up to about 25 AU from the star. The slopes of the position-velocity (PV) curves for the disk emission show a monotonic progression of the emission radius with frequency with relative radii of 0.85 ± 0.04, 1, and 1.02 ± 0.01 for the H26α, H30α, and H31α transitions, respectively. This trend is consistent with theoretical excitation models of maser emission from a region where the density decreases with radius and the lower transitions are preferentially excited at higher densities. The mass is difficult to estimate from the PV diagrams because the wind components dominate the emission at the disk edges. The mass estimate is constrained to be only in the range of 10–30 solar masses. The distribution of the wind emission among the transitions is surprisingly different, which reflects its sensitivity to excitation conditions. The wind probably extracts significant angular momentum from the system.
The spatial distribution and polarization characteristics of the SiO (v=1, J=1-0) maser emission from several late type stars have been observed. The spatial distribution, derived from VLBI observations, generally shows a number of emitting regions but no clear velocity pattern or geometry. Some of these regions have well defined polarization characteristics. The results of high spatial resolution polarization measurements of RCas are similar to the lower spatial resolution polarimetry performed on this source.
Information on the structure of the molecular flow within 1″ of IRC-2, in Orion-KL, is sparse. Measurements of the continuum at 7.8μ and 12.5μ show a disk of size and suggest that the center of the disk may be dust free (Lester et al. 1985). Aperture synthesis mapping of water maser shell features (Sylber 1986) has provided information on the scale. Smaller scales can be studied by mapping SiO maser emission. We observed the 43 GHz, v=1, J = 1 → 0, transition of SiO using a 2 station interferometer with a 74 km baseline between Haystack Observatory, Westford, MA and Five College Radio Observatory, New Salem, MA. The fringe spacing was 20 milliarcseconds (mas) and the velocity resolution was 0.25 km-s−1. Our results provide the highest resolution view to date of what is likely to be the inner of IRC-2.
The impact of underlying parental psychological vulnerability on the future mental health of offspring is not fully understood. Using a prospective cohort design, we investigated the association between dysfunctional parental personality traits and risks of offspring self-harm, depression and anxiety.
The association between dysfunctional parental personality traits (monotony avoidance, impulsivity, anger, suspicion, and detachment), measured in both mothers and fathers when offspring were age 9 years, and risk of offspring depression, anxiety and self-harm at age 18 years, was investigated in a population-based cohort (ALSPAC) from over 8000 parents and children.
Higher levels of dysfunctional maternal, but not paternal, personality traits were associated with an increased risk of self-harm, depression, and anxiety in offspring. Maternal associations were best explained by the accumulation of dysfunctional traits. Associations were strongest for offspring depression: Offspring of mothers with three or more dysfunctional personality traits were 2.27 (1.45–3.54, p < 0.001) times as likely to be depressed, compared with offspring of mothers with no dysfunctional personality traits, independently of maternal depression and other variables.
The accumulation of dysfunctional maternal personality traits is associated with the risk of self-harm, depression, anxiety in offspring independently of maternal depression and other confounding variables. The absence of associations for equivalent paternal traits makes a genetic explanation for the findings unlikely. Further research is required to elucidate the underlying mechanism. Mothers with high levels of dysfunctional personality traits may benefit from additional support to reduce the risk of adverse psychological outcomes occurring in their offspring.
Two major types of terrain that formed at or near the bed of Pleistocene continental ice sheets are widespread throughout the prairie region of Canada and the United States. These are (1) glacial-thrust blocks and source depressions and (2) streamlined terrain.
Glacial-thrust terrain formed where the glacier was frozen to the substrate and where elevated pore-water pressure decreased the shear strength of the substrate to a value less than that applied by the glacier. The marginal zone of ice sheets consisted of a frozen-bed zone, no more than 2 to 3 km wide in places, within which glacial-thrust blocks are large and angular. Up-glacier from this zone the thrust blocks are generally smaller and smoothed. Streamlined terrain begins 2 to 3 km behind known ice-margin positions and extends tens of kilometres up-glacier. Streamlined terrain formed in two ways: (1) erosion of the substrate as a consequence of basal sliding in the sub-marginal thawed-bed zone and (2) erosional smoothing accompanied by emplacement of till in the lee of thrust blocks where they were deposited and subsequently exposed to thawed-bed conditions as a result of further advance of the glacier.
This paper has been accepted for publication in full in a future issue of the Journal of Glaciology.
Commonly thought of as a disease of poverty and overcrowding in resource-poor settings globally, scabies is also an important public health issue in residential care facilities for the elderly (RCFE) in high-income countries such as the UK. We compared and contrasted current local Health Protection Team (HPT) guidelines for the management of scabies outbreaks in RCFE throughout England. We performed content analysis on 20 guidelines, and used this to create a quantitative report of their variation in key dimensions. Although the guidelines were generally consistent on issues such as the treatment protocols for individual patients, there was substantial variation in their recommendations regarding the prophylactic treatment of contacts, infection control measures and the roles and responsibilities of individual stakeholders. Most guidelines did not adequately address the logistical challenges associated with mass treatment in this setting. We conclude that the heterogeneous nature of the guidelines reviewed is an argument in favour of national guidelines being produced.
Observations of the angular distribution of the water masers in the nucleus of NGC4258 reveal the presence of a thin molecular disk in nearly perfect Keplerian orbit (Miyoshi et al., 1995; Moran et al., 1995). About 300 galaxies have been searched for nuclear water masers to a limiting sensitivity of about 0.1 Jy (e.g., Braatz, 1996); and 16 masers have been detected. The maser imaged by Miyoshi et al. (1995) offers the best example of disk structure. VLA data of NGC1068 shows evidence of disk structure (Gallimore et al., 1996; Greenhill & Gwinn, 1996) and NGC2639 has drifting features, which may be due to centripetal acceleration (Wilson et al., 1995).
Radio astronomy has seen major advances in both instrumentation and scientific discovery during the last three years. This report is not encyclopedic but is intended to show the breadth of activity in the field. Division X is a technique-based division, and radio telescopes are becoming increasingly more international in character and usage. For these reasons this report devotes considerable attention to advances in instrumentation. More complete information on radio telescopes and scientific advances in the field can be found at the following Web site: http://www.stsci.edu/science/net-resources.html
The relative proper motions of water vapor maser features in the H ɪɪ region IC 133 have been used to determine a distance to the galaxy M33 that is independent of the usual calibrations associated with extragalactic distance estimates, e.g., extinction and metallicity.
We have imaged the H2O maser and 22, 8, & 5 GHz continuum in the nucleus of NGC 3079, using the NRAO VLBA. The maser features are distributed over ~ 2 pc along an axis aligned with the plane of the kpc–scale edge–on molecular disk. The masers are not angularly coincident with any detected continuum emission. The two brightest continuum features, which trace a parsec–scale jet, have similar spectra that peak at frequencies ν > 5 GHz. We also detected faint maser emission along the jet axis.
Objectives: Following pediatric moderate-to-severe traumatic brain injury (msTBI), few predictors have been identified that can reliably identify which individuals are at risk for long-term cognitive difficulties. This study sought to determine the relative contribution of detailed descriptors of injury severity as well as demographic and psychosocial factors to long-term cognitive outcomes after pediatric msTBI. Methods: Participants included 8- to 19-year-olds, 46 with msTBI and 53 uninjured healthy controls (HC). Assessments were conducted in the post-acute and chronic stages of recovery. Medical record review provided details regarding acute injury severity. Parents also completed a measure of premorbid functioning and behavioral problems. The outcome of interest was four neurocognitive measures sensitive to msTBI combined to create an index of cognitive performance. Results: Results indicated that none of the detailed descriptors of acute injury severity predicted cognitive performance. Only the occurrence of injury, parental education, and premorbid academic competence predicted post-acute cognitive functioning. Long-term cognitive outcomes were best predicted by post-acute cognitive functioning. Discussion: The findings suggest that premorbid factors influence cognitive outcomes nearly as much as the occurrence of a msTBI. Furthermore, of youth with msTBI who initially recover to a level of moderate disability or better, a brief cognitive battery administered within several months after injury can best predict which individuals will experience poor long-term cognitive outcomes and require additional services. (JINS, 2016, 22, 1–8)
In her unfinished autobiography, Jean Rhys (1890–1979) describes the birth of her writing career as a quasi-memorial for herself as a person: buying some black exercise books and the red, blue, green and yellow quill pens to ‘cheer up’ her table and banish its bareness, Rhys represents her writing out of her unhappy first love affair as a compulsive purgation of the experience, but one that left her bereft in the recognition that something in her had died. ‘I filled three exercise books and half another, then I wrote: “Oh God, I'm only twenty and I'll have to go on living and living and living.” I knew then that it was finished and that there was no more to say.’ From this genesis of art in inner death, Rhys went on to write five novels and numerous short stories that present a strikingly consistent world view and aesthetic, both of which hearken back to the affective stance she assumes in her earliest writing and then reiterates throughout her work up to and including her posthumously published autobiography. From her despairing diaries written at the age of twenty to her death nearly seventy years later, Rhys examined in meticulously polished prose a set of themes including the workings of the mind and emotion, gender and race relations, colonial history and, as we argue in this introduction, a certain spectrality of existence. Jean Rhys: Twenty- First-Century Approaches examines this cogency of style and world view from the major approaches that have defined Rhys criticism, and brings them together with emerging theoretical work to set the course for Rhys studies in the twenty-first century.
Much has been written about how Rhys's work defies periodisation and transcends categories, in the same way that her characters wander nomadically and live on the edges of what Sasha in Good Morning, Midnight thinks of as ‘you, who represent Society’. She is viewed as a modernist, postcolonial, Caribbean, British and Creole writer – yet to parse these identities is to fall short of the complexity of her work and the ways in which it troubles the very categories through which she is read. For example, the Caribbean where Rhys spent her youth, on the island of Dominica, bubbles up most prominently in her first manuscript and in her last novel alike;…