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.
We compared the fluorescent gel removal rate using fewer high-touch surfaces (HTSs) and rooms and determined the optimum number of HTSs and rooms needed to ensure accuracy using 2,942 HTSs in 228 rooms on 13 units. Randomly selecting 3 HTS in 2 rooms predicted the optimal removal rate.
Some centres favour early intervention for ureteral colic while others prefer trial of spontaneous passage, and relative outcomes are poorly described. Calgary and Vancouver have similar populations and physician expertise, but differing approaches to ureteral colic. We studied 60-day hospitalization and intervention rates for patients having a first emergency department (ED) visit for ureteral colic in these diverse systems.
We used administrative data and structured chart review to study all Vancouver and Calgary patients with an index visit for ureteral colic during 2014. Patient demographics, arrival characteristics and triage category were captured from ED information systems, while ED visits and admissions were captured from linked regional hospital databases. Laboratory results were obtained from electronic health records and stone characteristics were abstracted from diagnostic imaging reports. Our primary outcome was hospitalization or urological intervention from 0 to 60 days. Secondary outcomes included ED revisits, readmissions and rescue interventions. Time to event analysis was conducted and Cox Proportional Hazards modelling was performed to adjust for covariate imbalance.
We studied 3283 patients with CT-defined stones. Patient and stone characteristics were similar for the cities. Hospitalization or intervention occurred in 60.9% of Calgary patients and 31.3% of Vancouver patients (p<0.001). Calgary patients had higher index intervention rates (52.1% v. 7.5%), and experienced more ED revisits and hospital readmissions during follow-up. The data suggest that outcome events were associated with overtreatment of small stones in one city and undertreatment of large stones in the other.
An early interventional approach was associated with higher ED revisit, hospitalization and intervention rates. If these events are markers of patient disability, then a less interventional approach to small stones and earlier definitive management of large stones may reduce system utilization and improve outcomes for patients with acute ureteral colic.
Cardiac involvement has been reported in various mucopolysaccharidoses syndromes. Cardiac valve pathology is the most prominent cardiac manifestation of patients with these syndromes. To date, there have been no reports of early childhood onset of high-grade atrioventricular block in patients with Hunter syndrome. We present a case of a 3-year-old boy with Hunter syndrome who was found to have various degrees of atrioventricular block. This case highlights the importance of early routine cardiac screening for conduction abnormalities and close follow-up in patients with mucopolysaccharidoses syndromes.
The faint, giant haloes observed in many Planetary Nebulae (PNe) are believed to be the remnants of the superwinds ejected by the progenitor asymptotic giant branch stars. Spatially resolved, high spectral resolution observations of [OIII]5007Å line profiles from the haloes of NGC 6543 and NGC 6826 have been obtained with the Manchester echelle spectrometer at the Isaac Newton Telescope. The widths of the observed profiles from NGC 6826 decrease towards the outer edge of the halo which implies a definite radial expansion of this halo. The expansion velocities vexp of the two haloes are derived using both thick and thin shell models.
Objectives: We sought to clarify the nature of self-reported cognitive function among healthy older adults by considering the short-term, within-person association (coupling) of subjective cognitive function with objective cognitive performance. We expected this within-person coupling to differ between persons as a function of self-perceived global cognitive decline and depression, anxiety, or neuroticism. Methods: This was an intensive measurement (short-term longitudinal) study of 29 older adult volunteers between the ages of 65 and 80 years without an existing diagnosis of dementia or mild cognitive impairment. Baseline assessment included neuropsychological testing and self-reported depression, anxiety, and neuroticism, as well as self- and informant-reported cognitive decline (relative to 10 years previously). Intensive within-person measurement occasions included subjective ratings of cognitive function paired with performance on a computerized working memory (n-back) task; each participant attended four or five assessments separated by intervals of at least one day. Statistical analysis was comprised of multilevel linear regression. Results: Comparison of models suggested that both neuroticism and self-rated cognitive decline explained unique variance in the within-person, across-occasion coupling of subjective cognitive function with objective working memory performance. Conclusions: Self-ratings of cognition may accurately reflect day-to-day variations in objective cognitive performance among older adults, especially for individuals lower in neuroticism and higher in self-reported cognitive decline. Clinicians should consider these individual differences when determining the validity of complaints about perceived cognitive declines in the context of otherwise healthy aging. (JINS, 2018, 24, 57–66)
XSHAPE has been developed to aid the better understanding of the 3D morphologies and kinematics of PNe and novae, by producing models which closely predict the observed 2D images and long-slit spectra of these objects. Early successes include plausible simulations for the elliptical PN Sa 2-21 and the nova HR Del.
Supersonic and even hypersonic outflows have been found in a wide variety of PNe using the Manchester Echelle spectrometer (MES; Meaburn et al. 1984). Dramatic examples of these extreme motions found over many years are highlighted here for comparison with their most recent discovery in the bipolar PN, MyCn 18.
IC 4634 is a planetary nebula with a striking point-symmetric morphology. Strings of line-emitting knots, particularly bright in [N II] emerge from its bright Hα core. These strings bend in opposite directions on either side of the nucleus. We have obatined sub-arcsecond monochromatic imagery that neatly reveals its main morphological components. Additionally, we also present a comprehensive kinematic mapping of the nebula, consisting of several long-slit echelle positions across the main components of the nebula.
The nature and origin of the hundreds of ionized knots, with cometary tails, in the Helix planetary nebula are both being unravelled by recent observations. Healey and Huggins (1990, AJ, 100, 511), Meaburn et al (1992, MNRAS, 255, 177) and Walsh and Meaburn (1993, ESO Messenger, 73, 35) all showed, in various ways, that these knots have dense (106 cm–3), dusty, molecular cores with ionized arcs of gas on the surfaces pointing towards the ionizing star. This structure is confirmed in detail by the HST imagery of O'Dell and Handron (1996, ApJ, in press).
We have made multi-wavelength observations of the young planetary nebula NGC 7027. The C-band continuum radio map shown in Figure 1 was obtained from the combination of MERLIN and VLA1 observations (M. Bryce et al., 1996). This map has the highest spatial resolution of any radio images of this object to date and has been compared with the HST archive picture of NGC7027, taken using WFPC2 with a 400 å wide F547N filter, to reveal the differences in the emission at the disparate wavelengths. The two maps, while being superficially different, show emission regions that are similar in size. The contours of radio brightness often coincide with prominent optical features.
Sub-arcsecond resolution radio and optical images of the young planetary nebula BD +30 3639 look superficially very similar, showing a pronounced box-shaped bright nebular shell. However, a detailed comparison at high spatial resolution reveals several regions where the optical emission is obscured by localised dusty regions. The highest resolution radio image to date of this PN, a 6 cm map obtained by combining MERLIN and VLA observations (Bryce et al, 1996) has been compared to the highest resolution optical Hβ image from the Hubble Space Telescope (obtained by J.P. Harrington and collaborators) to reveal the differences in emission which are probably due in the main to dust obscuration at optical wavelengths (Bryce et al, 1996 & Arnaud, Borkowski & Harrington, 1996). New 6 km s–1 resolution, spatially resolved spectra of optical emission lines, obtained using the Utrecht echelle spectrometer on the 4.2 m William Herschell Telescope, show that this nebula is bright in the low ionisation emission lines of [N II] 6548 + 6584 å and also appears to be more spatially extended than in the fainter, high ionisation [O III] 5007 å emission. The velocity ellipse observed from a long slit oriented north-south was found to be tilted, indicating an inclined, elliptical morphology rather than a simple, radially expanding spherical shell and the gaps in the velocity ellipse observed with an east-west slit suggest that the true shape is probably an open ring-like structure rather than a closed shell. A deep exposure of the [N II] 6584 å emission line appears to show a collimated, accelerating flow in an eastward direction away from the central star and extending well beyond the main bright nebular ring. It was also observed in the Hydrogen and [Nii] 6548 å emission lines. The H2 1–0 S(1) image of BD +30 3639 by Graham et al (1993) also shows a feature to the east of the main nebular ring. This may well be related to faint halo structures detected by Harrington and collaborators from their HST images (private communication).
Spatially resolved profiles of the Hα, and [NII] lines have been obtained with the Manchester echelle spectrometer combined with the 2.1 m San Pedro Mártir telescope over the bipolar lobes, the symmetric low ionization knots and the bright core of the planetary nebula KjPn 8. The lobes of this galactic bipolar nebula have the largest angular extent, 14′ × 4′, yet discovered.
On Earth, microorganisms living under intense ultraviolet (UV) radiation stress can adopt endolithic lifestyles, growing within cracks and pore spaces in rocks. Intense UV irradiation encountered by microbes leads to death and significant damage to biomolecules, which also severely diminishes the likelihood of detecting signatures of life. Here we show that porous rocks shocked by asteroid or comet impacts provide protection for phototrophs and their biomolecules during 22 months of UV radiation exposure outside the International Space Station. The UV spectrum used approximated the high-UV flux on the surface of planets lacking ozone shields such as the early Earth. These data provide a demonstration that endolithic habitats can provide a refugium from the worst-case UV radiation environments on young planets and an empirical refutation of the idea that early intense UV radiation fluxes would have prevented phototrophs without the ability to form microbial mats or produce UV protective pigments from colonizing the surface of early landmasses.
With the completion of a careful study of a photographic copy of the original notebook Frederick Cook kept on his attempt to reach the North Pole in 1908, now in Copenhagen, Denmark, many new details have been added that allow a more accurate account of his actual movements and timetable than has been possible previously. Because some records were altered or destroyed by Cook, however, a complete account still necessarily contains an element of speculation, which must be the case when based on the only records that exist of an unwitnessed assertion. But this uncertainty can be controlled to a reasonable degree by the notebook's remaining content in concert with the several other accounts Cook wrote of his expedition. One thing is sure, however: Cook was far behind his published timetable. At the outset, he set his start date back by one full week. He failed to report a number of delays in his journey and left out a lengthy detour that prevented him from reaching land's end at Cape Thomas Hubbard until well past 1 April 1908. This ruled out any chance to reach the North Pole in 1908. Frederick Cook was no fool; he was a veteran explorer. He knew any attempt that late in the season would be suicide. Furthermore his efforts to lay caches that would separate his own return route from that of his Inuit support party indicate that not only had he already given up the idea of making a serious attempt, but also that he was preparing for his eventual hoax of claiming to have reached the North Pole on 21 April 1908 long before he reached the Arctic Ocean.
This study assesses the effect of having informal support available at home on inpatient care use in Switzerland. The main contributions are to consider the availability of care regardless of its source, measured by multiple-adult living arrangements, and to examine this effect by type of inpatient care and source of potential support. A two-part model with region and time fixed effects is estimated to determine the impact of informal care availability on the likelihood of hospitalisation and length of stay, conditional on hospitalisation. The analysis is conducted on a sample of individuals aged 18+ from four waves of the Swiss Household Panel survey (2004–2007). Overall, availability of informal care has no impact on the likelihood of hospitalisation but does significantly reduce length of stay by 1.9 days. Available support has no effect on the shortest stays (up to 10 days), but has a significant impact on acute care stays up to 30 days and longer stays. Additionally, the effect does not significantly vary whether the source of informal support is a spouse only, a spouse and other adults, or other adults only. These results indicate that social changes leading to an expansion in the proportion of one-person households may increase future inpatient care use.