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.
The satiating efficiency of food has been increasingly quantified using the Satiety Quotient (SQ). The SQ integrates both the energy content of food ingested during a meal and the associated change in appetite sensations. This systematic review examines the available evidence regarding its methodological use and clinical utility. A literature search was conducted in six databases considering studies from 1900 to April 2020 that used SQ in adults, adolescents and children. All study designs were included. From the initial 495 references found, fifty-two were included. Of the studies included, thirty-three were acute studies (twenty-nine in adults and four in adolescents) and nineteen were longitudinal studies in adults. A high methodological heterogeneity in the application of the SQ was observed between studies. Five main utilisations of the SQ were identified: its association with (i) energy intake; (ii) anthropometric variables; (iii) energy expenditure/physical activity; (iv) sleep quality and quantity and (v) to classify individuals by their satiety responsiveness (i.e. low and high satiety phenotypes). Altogether, the studies suggest the SQ as an interesting clinical tool regarding the satiety responsiveness to a meal and its changes in responses to weight loss in adults. The SQ might be a reliable clinical indicator in adults when it comes to both obesity prevention and treatment. There is a need for more standardised use of the SQ in addition to further studies to investigate its validity in different contexts and populations, especially among children and adolescents.
Introduction: CAEP recently developed the acute atrial fibrillation (AF) and flutter (AFL) [AAFF] Best Practices Checklist to promote optimal care and guidance on cardioversion and rapid discharge of patients with AAFF. We sought to assess the impact of implementing the Checklist into large Canadian EDs. Methods: We conducted a pragmatic stepped-wedge cluster randomized trial in 11 large Canadian ED sites in five provinces, over 14 months. All hospitals started in the control period (usual care), and then crossed over to the intervention period in random sequence, one hospital per month. We enrolled consecutive, stable patients presenting with AAFF, where symptoms required ED management. Our intervention was informed by qualitative stakeholder interviews to identify perceived barriers and enablers for rapid discharge of AAFF patients. The many interventions included local champions, presentation of the Checklist to physicians in group sessions, an online training module, a smartphone app, and targeted audit and feedback. The primary outcome was length of stay in ED in minutes from time of arrival to time of disposition, and this was analyzed at the individual patient-level using linear mixed effects regression accounting for the stepped-wedge design. We estimated a sample size of 800 patients. Results: We enrolled 844 patients with none lost to follow-up. Those in the control (N = 316) and intervention periods (N = 528) were similar for all characteristics including mean age (61.2 vs 64.2 yrs), duration of AAFF (8.1 vs 7.7 hrs), AF (88.6% vs 82.9%), AFL (11.4% vs 17.1%), and mean initial heart rate (119.6 vs 119.9 bpm). Median lengths of stay for the control and intervention periods respectively were 413.0 vs. 354.0 minutes (P < 0.001). Comparing control to intervention, there was an increase in: use of antiarrhythmic drugs (37.4% vs 47.4%; P < 0.01), electrical cardioversion (45.1% vs 56.8%; P < 0.01), and discharge in sinus rhythm (75.3% vs. 86.7%; P < 0.001). There was a decrease in ED consultations to cardiology and medicine (49.7% vs 41.1%; P < 0.01), but a small but insignificant increase in anticoagulant prescriptions (39.6% vs 46.5%; P = 0.21). Conclusion: This multicenter implementation of the CAEP Best Practices Checklist led to a significant decrease in ED length of stay along with more ED cardioversions, fewer ED consultations, and more discharges in sinus rhythm. Widespread and rigorous adoption of the CAEP Checklist should lead to improved care of AAFF patients in all Canadian EDs.
Several multilingual language production models assume that language control is instigated by conflict monitoring. In turn, conflict adaptation, a control process which makes it easier to resolve interference if previously a high-interference context was detected, should also occur during multilingual production, as it is triggered by conflict monitoring. Because no evidence has been provided for conflict adaptation in the multilingual production literature, we set out to investigate this process using the n-3 effect. Our study showed that the n-3 effect can be observed during multilingual production, and thus provides evidence for conflict adaptation during multilingual production.
Le trouble bipolaire est une pathologie chronique qui nécessite la mise en place de stratégies non médicamenteuses éducatives . Récemment, le concept de Serious game (jeu sérieux)  a fait son apparition dans les programmes d’éducation thérapeutique . BIPOLIFE®, programme d’information ludoéducatif sur le trouble bipolaire accessible sur Internet, a été développé afin de s’intégrer dans la panoplie psychoéducative. BIPOLIFE® consiste à faire évoluer son avatar au quotidien. Ce jeu est basé sur 3 cibles : les règles hygiénodiététiques, l’observance médicamenteuse, le recours au médecin/psychiatre.
Mise en place d’une étude pilote évaluant l’acceptabilité de BIPOLIFE® et son effet sur la connaissance de la maladie auprès de 63 patients bipolaires sur 3 semaines. Les patients ont été évalués avec l’échelle de connaissance du trouble bipolaire et une échelle d’acceptabilité de BIPOLIFE®.
BIPOLIFE® semble être mieux accepté par des jeunes (p = 0,011) et plus efficace sur des hommes (p = 0,043) ayant une moins bonne connaissance de la maladie initiale (p ≤ 0,001). La majorité des patients a rapporté en avoir tiré bénéfice sur leur vie quotidienne, leur connaissance ou leur gestion de la maladie. Les patients ont déclaré que BIPOLIFE® est à conseiller à des personnes souffrant de TB (32 %), à leur proche entourage (32 %) ou au grand public (16 %).
Notre étude montre que BIPOLIFE® est déjà un outil pertinent dans la prise en charge des patients bipolaires. Des études complémentaires sont nécessaires pour évaluer précisément sa place dans les programmes de psychoéducation.
La psychoéducation du trouble bipolaire favorise l’adhésion thérapeutique et le maintien de l’euthymie à 2 ans . Au terme d’un tel programme, les patients peuvent avoir besoin d’aide pour perpétuer la mise en place des apprentissages concernant l’observance thérapeutique, les routines de vie quotidienne, l’évitement des toxiques et le repérage des prodromes thymiques. Le Serious Game BIPOLIFE®, jeu centré sur un avatar souffrant de trouble bipolaire évoluant dans des situations de la vie courante, s’articule aussi autour de ces cibles.
Évaluer la qualité de l’observance thérapeutique par la Medication Adherence Rating Scale (MARS) , les indicateurs de routine de vie et de recours aux soins psychiatriques à 1 et 4 mois de la dernière séance de psychoéducation chez les patients utilisant BIPOLIFE® vs. suivi habituel.
Étude pilote multicentrique randomisée contrôlée à 2 bras (durée : 24 mois) incluant des sujets euthymiques (score de dépression MADRS ≤ 12 et de manie YMRS ≤ 8 depuis 3 mois), bénéficiant d’un programme de psychoéducation. Les patients du groupe « intervention » se connecteront au site BIPOLIFE®, de manière hebdomadaire, pendant un mois (durée de connexion libre). À l’inclusion (dernière séance de psychoéducation), 1 et 4 mois, seront évalués l’attitude vis-à-vis du traitement, la qualité du sommeil, l’indice de masse corporelle, le périmètre ombilical, la consommation de toxiques, le fonctionnement psychosocial et le recours aux soins psychiatriques.
Proposer BIPOLIFE® en add-on de la psychoéducation pour renforcer les compétences acquises lors du programme et le maintien de l’euthymie.
Nowadays, modern Earth Observation systems continuously generate huge amounts of data. A notable example is the Sentinel-2 Earth Observation mission, developed by the European Space Agency as part of the Copernicus Programme, which supplies images from the whole planet at high spatial resolution (up to 10 m) with unprecedented revisit time (every 5 days at the equator). In this data-rich scenario, the remote sensing community is showing a growing interest toward modern supervised machine learning techniques (e.g., deep learning) to perform information extraction, often underestimating the need for reference data that this framework implies. Conversely, few attention is being devoted to the use of network analysis techniques, which can provide a set of powerful tools for unsupervised information discovery, subject to the definition of a suitable strategy to build a network-like representation of image data. The aim of this work is to provide clues on how Satellite Image Time Series can be profitably represented using complex network models, by proposing a methodology to build a multilayer network from such data. This is the first work to explore the possibility to exploit this model in the remote sensing domain. An example of community detection over the provided network in a real-case scenario for the mapping of complex land use systems is also presented, to assess the potential of this approach.
Prenatal exposure to persistent organic pollutants (POPs) has been associated with the development of metabolic syndrome-related diseases in offspring. According to epidemiological studies, father’s transmission of environmental effects in addition to mother’s can influence offspring health. Moreover, maternal prenatal dietary folic acid (FA) may beneficially impact offspring health. The objective is to investigate whether prenatal FA supplementation can overcome the deleterious effects of prenatal exposure to POPs on lipid homeostasis and inflammation in three generations of male rat descendants through the paternal lineage. Female Sprague-Dawley rats (F0) were exposed to a POPs mixture (or corn oil) +/− FA supplementation for 9 weeks before and during gestation. F1 and F2 males were mated with untreated females. Plasma and hepatic lipids were measured in F1, F2, and F3 males after 12-h fast. Gene expression of inflammatory cytokines was determined by qPCR in epididymal adipose tissue. In F1 males, prenatal POPs exposure increased plasma lipids at 14 weeks old and hepatic lipids at 28 weeks old and prenatal FA supplementation decreased plasma total cholesterol at 14 weeks old. Prenatal POPs exposure decreased plasma triglycerides at 14 weeks old in F2 males. No change was observed in inflammatory markers. Our results show an impact of the paternal lineage on lipid homeostasis in rats up to the F2 male generation. FA supplementation of the F0 diet, regardless of POPs exposure, lowered plasma cholesterol in F1 males but failed to attenuate the deleterious effects of prenatal POPs exposure on plasma and hepatic lipids in F1 males.
Background: Migraine is a prevalent and disabling condition with limited understanding in the developing brain. Adults with chronic migraine show structural alterations in pain and sensory processing regions. Similar data is lacking in children and required for early intervention. Methods: Case-control feasibility study assessing structural brain differences between adolescents with chronic migraine and healthy controls using 3T Siemens structural volumetric MRI analysis. Fifteen subjects with chronic migraine were compared to 25 age and sex matched healthy controls. Non-parametric statistics performed (Kruskal-Wallis). Results: Migraine subjects had reduced volumes in total brain (grey and white matter) (KW p <0.03), total thalamus (KW p <0.01) and hippocampal regions (KW p <0.03). Unilateral (right) cerebellar grey matter volumes were significantly reduced in migraine subjects versus controls (KW p<0.05). No significant differences were found in other regions, including basal ganglia, cortical grey matter and brainstem. Conclusions: Total brain, hippocampal and thalamic volumetric reductions are seen in adolescents with chronic migraine. The regions identified are involved in migraine pathogenesis. This volumetric imaging study should improve understanding of the causes and effects of pediatric migraine.
Domestic spying is a cultural construct that refers to the activities of, and debate on, intelligence agencies oriented at the home population of citizens within nations. In the United States, the debate on domestic spying has been especially intense as the country has a long-standing culture and accompanying legal and political framework devoted to protecting individual rights of nonintervention. Unlike several other democratic nations, the United States has no specialized self-standing domestic intelligence agents, with such functions being handled by other agencies of law enforcement and foreign intelligence. This chapter reviews the patterns and dynamics of domestic spying in terms of the historical development of domestic intelligence work and offers a comparative overview of such activities in a number of nations. This comparative-historical outlook should be advantageous both for the analysis of domestic spying as a social problem and in terms of the normative framing of the debate within cultures committed to civil liberties as well as national security.
Introduction: In the province of Québec, roughly 20% of the population lives in rural areas. Rural emergency departments (EDs) face different challenges than their urban counterparts. Yet, few studies have sought to understand these challenges. This study aims to survey Québec’s emergency physicians to: 1) identify problems specific to rural EDs, 2) find solutions for improving accessibility and quality of care offered in rural regions and, 3) rank solutions in order of priority. These results will allow data triangulation with other of our studies that seek to identify challenges faced by rural EDs and potential solutions. Methods: During the 2016 annual conference of the Québec Emergency Physicians’ Association, we asked physicians and residents (including those from urban EDs), to complete a survey about the challenges faced by rural EDs. The survey contained two sections. The first took the form of open-ended questions in which respondents could write three challenges about accessibility and quality of care in rural EDs (objective 1) and three solutions to address these challenges (objective 2). The second section listed 11 potential solutions identified in our previous study. The solutions were ranked based on their priority level on a five-point Likert scale that ranged from “not a priority” to “an absolute priority” (objective 3). We added the total number of points for each solution and produced a ranking list. Results: Ninety-one physicians out of the 417 at the conference completed the survey; 58% came from urban EDs and 42% from rural EDs. Open-ended questions suggest that access to specialists and interfacility transfers are the principal challenges faced by rural EDs. The top five solutions identified as the highest priorities were: 1) care protocols, 2) improvement of interfacility transfers, 3) training with simulators, 4) targeted ultrasound and, 5) implementation of staff retention and recruitment strategies. Conclusion: This study is relevant and useful as roughly a quarter of attendants at the conference spontaneously volunteered to help identify and prioritize solutions to foster the accessibility and quality of care in rural EDs. Furthermore, it represents a stepping stone for our recently-launched wide-scope study, Urgences Rurales 360, that aims to explore problems faced by every of the 28 rural EDs in Québec and the solutions that could be implemented to resolve them.
It is hypothesized that some young supernovae might have the correct properties to accelerate cosmic rays, which in turn might generate gamma-ray emission by-products. We search for gamma-ray excesses towards supernovae in nearby galaxies which were serendipitously within the field of view of the HESS telescopes within a year of the supernova event. HESS cherenkov air-shower data collected between December 2003 and March 2015 were considered and compared to recent catalogs. Nine candidate supernovae were identified and analysed. No significant emission from these supernovae has been found, and upper limits for their very high energy emission are reported.
Understanding, predicting and eventually improving the resistance to fracture of silicate materials is of primary importance to design new glasses that would be tougher, while retaining their transparency. However, the atomic mechanism of the fracture in amorphous silicate materials is still a topic of debate. In particular, there is some controversy about the existence of ductility at the nano-scale during the crack propagation. Here, we present simulations of the fracture of three archetypical silicate glasses using molecular dynamics. We show that the methodology that is used provide realistic values of fracture energy and toughness. In addition, the simulations clearly suggest that silicate glasses can show different degrees of ductility, depending on their composition.
The objective of the Apollon project is the generation of 10 PW peak power pulses of 15 fs at 1 shot/minute. In this paper the Apollon facility design, the technological challenges and the current progress of the project will be presented.
The present study examined the influence of phonology on language switching. Unlike previous studies that investigated this influence by comparing words that are phonologically similar vs. dissimilar in two languages, the current language switching study focused on the role of phonological characteristics across words. Specifically, words with the first two phonemes being identical to those of the word in the previous trial were contrasted against words without such phonological overlap. The results revealed that the switch cost asymmetry was influenced by phonological overlap. Further investigation revealed that this influence was mainly due to persisting after-effects of phonological overlap, which caused a reversal of the asymmetrical switch cost pattern in the following trial. These results clearly indicate that manipulations on the level of phonology can have an effect on language switching. Therefore, we propose that, in contrast with the claims of most models, phonological characteristics of words play an important role in language control.
Tidewater glaciers in Greenland experienced widespread retreat during the last century. Information on their behaviour prior to this is often poorly constrained due to lack of observations, while determining the drivers prior to instrumental records is also problematic. Here we present a record of the dynamics of Kangiata Nunaata Sermia (KNS), southwest Greenland, from its Little Ice Age maximum (LIAmax) to 1859 – the period before continuous air temperature observations began at Nuuk in 1866. Using glacial geomorphology, historical accounts, photographs and GIS analyses, we provide evidence KNS was at its LIAmax by 1761, had retreated by ~5 km by 1808 and a further 7 km by 1859. This predates retreat at Jakobshavn Isbræ by 43–113 years, demonstrating the asynchroneity of tidewater glacier terminus response following the LIA. We use a one-dimensional flowband model to determine the relative sensitivity of KNS to atmospheric and oceanic climate forcing. Results demonstrate that terminus forcing rather than surface mass balance drove the retreat. Modelled glacier sensitivity to submarine melt rates is also insufficient to explain the retreat observed. However, moderate increases in crevasse water depth, driving an increase in calving, are capable of causing terminus retreat of the observed magnitude and timing.
In 2011 the IRSN conducted several assessments of atmospheric
radioactive releases due to the Fukushima Daiichi NPP accident (March
11, 2011) and of their impact on Japan’s terrestrial environment.
They were based on the IRSN’s emergency management tools and on
the abundant information and technical data gradually published
in Japan. According to these assessments, the main release phase
lasted from March 12 to 25, 2011 and impacted Japanese land in two
events, the first on 15 and 16 March, in which the main radioactive
deposits were formed, and the second from March 20 to 23, which
was less significant. The highest amounts of radioactive deposits were
found in an area extending upwards of several tens of kilometers
northwest of the plant. Lower amounts were discontinuously scattered
in an area extending up to over 250 km away. Initially composed
mainly of short-lived radionuclides, the deposits’ activity sharply
decreased in the subsequent weeks. Since the summer of 2011, cesium-134
and cesium-137 have become the residual deposits’ main components.
According to IRSN estimates, in the absence of protection, the doses
due to exposure to the radioactive plume during the atmospheric
release phase may have been potentially higher for people who remained
in coastal areas up to several tens of kilometers north and south
of the damaged plant. Thereafter, people living up to 50 km northwest
of the plant, outside the 20-km emergency evacuation zone, were potentially
most vulnerable to residual radioactive deposits over time.
The growing number of spastic ataxia of Charlevoix-Saguenay (SACS) gene mutations reported worldwide has broadened the clinical phenotype of autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). The identification of Quebec ARSACS cases without two known SACS mutation led to the development of a multi-modal genomic strategy to uncover mutations in this large gene and explore phenotype variability.
Search for SACS mutations by combining various methods on 20 cases with a classical French-Canadian ARSACS phenotype without two mutations and a group of 104 sporadic or recessive spastic ataxia cases of unknown cause. Western blot on lymphoblast protein from cases with different genotypes was probed to establish if they still expressed sacsin.
A total of 12 mutations, including 7 novels, were uncovered in Quebec ARSACS cases. The screening of 104 spastic ataxia cases of unknown cause for 98 SACS mutations did not uncover carriers of two mutations. Compounds heterozygotes for one missense SACS mutation were found to minimally express sacsin.
The large number of SACS mutations present even in Quebec suggests that the size of the gene alone may explain the great genotypic diversity. This study does not support an expanding ARSACS phenotype in the French-Canadian population. Most mutations lead to loss of function, though phenotypic variability in other populations may reflect partial loss of function with preservation of some sacsin expression. Our results also highlight the challenge of SACS mutation screening and the necessity to develop new generation sequencing methods to ensure low cost complete gene sequencing.