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 firstname.lastname@example.org
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.
Human donor milk (DM) is Holder pasteurised (62·5°C, 30 min) to ensure its microbiological safety for infant consumption. In low-resource settings, flash heating is used to pasteurise milk. Although there is considerable interest in non-thermal alternatives (high hydrostatic pressure processing (HHP) and UVC irradiation) for pasteurisation, their effect on the fatty acid composition is not well understood. Of particular interest is the effect of pasteurisation on the generation of oxylipins. DM from eight mothers containing bacteria >5 × 107 colony-forming units/l was used. In a paired design, each pool of milk underwent four pasteurisation techniques: Holder; flash heating; UVC (250 nm, 25 min) and HHP (500 MPa, 8 min). Fatty acids were quantified by GC-flame ionisation detection and oxylipins derived from arachidonic acid; 18-carbon PUFA (α-linolenic acid, linoleic acid and γ-linolenic acid) and EPA/DHA were measured by liquid chromatography-tandem MS in aliquots of raw and processed milk. There were no significant changes to the composition of fatty acids following all pasteurisation techniques compared with raw milk. The n-6:n-3 ratio remained constant ranging from 6·4 to 6·6. Several arachidonic acid-derived oxylipins were highest post-UVC and elevated post-HHP compared with raw milk. Several oxylipins derived from 18-carbon PUFA (linoleic and α-linolenic acids) were elevated in UVC-treated milk. EPA/DHA-derived oxylipins were on average, unaffected by pasteurisation. Although some PUFA-derived oxylipins were increased following UVC and HHP, no method affected the fatty acid composition of human DM. Further research is needed to determine if varying levels of oxylipins in human DM as a result of processing can potentially mediate cellular signalling; proliferation and apoptosis, especially important for preterm infant development.
The way an individual handles the experience of psychosis, the so-called ‘recovery style’, has been shown to substantially affect long-term outcomes. The Recovery Style Questionnaire (RSQ) measures this psychological dimension. The aim of this study was to provide a validation of the German version of the RSQ and to raise awareness for recovery-oriented approaches.
The RSQ was translated into German according to the guidelines of the WHO and patients were administered this questionnaire and measures of internalised stigma, psychotic symptoms, illness concept, empowerment, self-esteem and quality of life. Descriptive statistics were demonstrated to characterise the sample. Reliability was assessed in different forms: internal consistency, test–retest reliability and split-half reliability. Items were evaluated with descriptive data and item-total correlations. Convergent and discriminant validity were shown, and a confirmatory factor analysis was performed. In order to ameliorate the model, a post hoc model modification was done.
The sample consisted of 138 patients diagnosed with schizophrenia spectrum disorders (mean age: 35.7 years; 53.6% men; mean duration of illness: 20.6 years) with a mean RSQ overall percentage of 66.12 (s.d. ± 17.43%), mainly representing the categories ‘mixed picture’ and ‘tends towards integration’. The reliability of the RSQ was acceptable with a Cronbach's α of 0.741 and a test–retest coefficient of 0.502. Item-total correlations were not acceptable for 27 of 39 items. Moderate evidence for convergent validity of the RSQ was found. Confirmatory factor analysis revealed that the 13-factor model with 39 items originally proposed was partially poorly replicated in the present sample (χ2 ratio to degrees of freedom (χ2/df) of 1.732, Comparative Fit Index (CFI) of 0.585, Normed Fit Index (NFI) of 0.414, Tucker–Lewis Index (TLI) of 0.508, root mean square error of approximation (RMSEA) of 0.095). The RSQ was modified based on item-total correlations and path coefficients of the single items. The confirmatory factor analysis of the resulting one-factor model with 11 items showed adequate fit to the data (χ2/df of 1.562, CFI of 0.936, NFI of 0.847, TLI of 0.910, RMSEA of 0.083) and demonstrated good model fit.
Despite partially insufficient psychometric data of the original RSQ, the concept of recovery style is beneficial to psychiatric research and clinical practice. The underlying idea is valuable, and the questionnaire needs further development. Therefore, a short version of the RSQ is proposed.
The imposition of male sexual characteristics onto the female (imposex) is present in wild populations of the non-native veined rapa whelk (Rapana venosa) in Chesapeake Bay, USA but does not appear to compromise reproductive function. Cultured whelks were used to test two hypotheses: (1) Observed imposex metrics will be similar to tributyltin (TBT) water concentrations at each of three sites; (2) Male and imposex/female whelks from the same site will have similar TBT body burdens. Cultured 2-year-old whelks were transplanted to three field sites in the York River, USA at the onset of their second reproductive season. Transplant site mean TBT water concentrations ranged from 1.4 ± 0.77 to 64.2 ± 57.8 ng l−1. Imposex incidence was 100% after 28 weeks with an observed M:F:IF ratio of 81:0:92 across all sites. Imposex stages (median vas deferens scale index = 4) and reproductive output were similar across sites. The imposex severity (IS = penis length/shell length) increased with increasing TBT concentrations. The relative penis length (RPLI) and relative penis size (RPSI) indices were positively related to site-specific TBT levels. Male whelks accumulated significantly higher TBT concentrations than female whelks at the site with the highest TBT concentration. Mean TBT concentrations in whelk egg capsules were significantly higher than concentrations in male or female whelk tissue. Egg capsule deposition provides a depuration mechanism for female whelks to reduce body burden of lipophilic TBT. Sex, season and reproductive status should be considered when using gastropod bioaccumulation to monitor TBT effects.
The Be massive X-ray binary LSI+61°303 is a 26.5 days periodic radiosource (Taylor & Gregory, 1984), exhibiting radio outbursts maxima between phases 0.6–0.8. Evidence of a photometric period of similar value has also been reported (Paredes & Figueras, 1986; Mendelson & Mazeh, 1989). The previous spectroscopic radial velocity observations of Hutchings & Crampton (1981) are in agreement with the radio period, and give support to the presence of a companion. We present new optical and infrared photometric observations and high resolution Hα spectra of LSI+61°303.
III Zw 35 is a pair of galaxies characterised by intense OH maser emission, and powerful far-infrared and radio continuum. We have made a detailed study of the galaxy pair based on optical, infrared and radio observations. The brighter northern component is identified as a LINER or Seyfert galaxy and contains an active nuclear region from which radio continuum, OH maser and thermal dust emission are detected. We propose that the northern component has a compact active nucleus deeply embedded in an obscured region of diameter ~ 210 pc within which enhanced star-formation occurs. The lower luminosity, southern component is of low mass and is undergoing starburst activity over an extended region of diameter ~ 5.5 kpc. The origin of the starburst and non-thermal activity appears to be an interaction between the two components.
Objectives: The extended face network contains clusters of neurons that perform distinct functions on facial stimuli. Regions in the posterior ventral visual stream appear to perform basic perceptual functions on faces, while more anterior regions, such as the ventral anterior temporal lobe and amygdala, function to link mnemonic and affective information to faces. Anterior and posterior regions are interconnected by a long-range white matter tracts; however, it is not known if variation in connectivity of these pathways explains cognitive performance. Methods: Here, we used diffusion imaging and deterministic tractography in a cohort of 28 neurologically normal adults ages 18–28 to examine microstructural properties of visual fiber pathways and their relationship to certain mnemonic and affective functions involved in face processing. We investigated how inter-individual variability in two tracts, the inferior longitudinal fasciculus (ILF) and the inferior fronto-occipital fasciculus (IFOF), related to performance on tests of facial emotion recognition and face memory. Results: Results revealed that microstructure of both tracts predicted variability in behavioral performance indexed by both tasks, suggesting that the ILF and IFOF play a role in facilitating our ability to discriminate emotional expressions in faces, as well as to remember unique faces. Variation in a control tract, the uncinate fasciculus, did not predict performance on these tasks. Conclusions: These results corroborate and extend the findings of previous neuropsychology studies investigating the effects of damage to the ILF and IFOF, and demonstrate that differences in face processing abilities are related to white matter microstructure, even in healthy individuals. (JINS, 2016, 22, 180–190)
Effective trauma resuscitation requires the coordinated efforts of an interdisciplinary team. Mental practice (MP) is defined as the mental rehearsal of activity in the absence of gross muscular movements and has been demonstrated to enhance acquiring technical and procedural skills. The role of MP to promote nontechnical, team-based skills for trauma has yet to be investigated.
We randomized anaesthesiology, emergency medicine, and surgery residents to two-member teams randomly assigned to either an MP or control group. The MP group engaged in 20 minutes of MP, and the control group received 20 minutes of Advanced Trauma Life Support (ATLS) training. All teams then participated in a high-fidelity simulated adult trauma resuscitation and received debriefing on communication, leadership, and teamwork. Two blinded raters independently scored video recordings of the simulated resuscitations using the Mayo High Performance Teamwork Scale (MHPTS), a validated team-based behavioural rating scale. The Mann-Whitney U-test was used to assess for between-group differences.
Seventy-eight residents provided informed written consent and were recruited. The MP group outperformed the control group with significant effect on teamwork behaviour as assessed using the MHPTS: r=0.67, p<0.01.
MP leads to improvement in team-based skills compared to traditional simulation-based trauma instruction. We feel that MP may be a useful and inexpensive tool for improving nontechnical skills instruction effectiveness for team-based trauma care.
GaN based homo- and heterotype LED's have been fabricated and characterized which emit in the blue and ultra-violet part of the spectral range. Complete epitaxial LED layer sequences with different recombination zones have been grown using MOVPE as well as MBE. Subsequent to the material growth, chemically-assisted ion-beam etching and contact metallization are utilized to achieve full LED devices. MBE-grown homotype LED's reveal a peak in the output light spectrum at a wavelength of 372 nm with a linewidth being as narrow as 12 nm. GaN/InGaN LED's grown by MOVPE show visible single peak emission with linewidths of 23 nm. The optical output power as measured in a calibrated Ulbricht sphere is in the 1 μW regime.
The acheulian site at Boxgrove contains one of the most extensive areas of in situ fauna and flintwork yet discovered in Britain. This material is found in a complex sequence of sediments which represent depositional conditions from a 42 m sea level rise to the onset of a full periglacial climate. Excavation of the archaeological horizon has been accompanied by a programme of multidisciplinary research examining site formation processes, palaeolandscape and palaeoecological development, using sedimentological and environmental reconstruction techniques. Dating of the site is tentative as no absolute dates are available at present. However, comparative analysis with other British sites would suggest a position for the Boxgrove sequence within the Middle Pleistocene. The archaeological horizon is interpreted as being deposited towards the latter part of an interglacial or an interstadial period.
Ultrasonic assessment of optic nerve sheath diameter (ONSD) as a non-invasive measure of intracranial pressure (ICP) has been evaluated in the literature as a potential valid technique for rapid ICP estimation in the absence of invasive intracranial monitoring. The technique can be challenging to perform and little literature exists surrounding intra-operator variability.
In this study we describe the creation of a novel model of ONSD to be utilized in ultrasound training of this technique. We demonstrate the realistic ultrasonographic images created utilizing this novel model.
We designed ocular models composed of gelatin spheres and variable three dimensional printed cylinders, which simulate the globe of the eye and variable ONSD's respectively. These models were suspended in a gelatin background and ultrasound of the ONSD was conducted using standard techniques described in the literature.
This model produces clear and accurate representation of ONSD that closely mimics in vivo images. It is affordable and easy to produce in large quantities, portending its use in an educational environment.
Utilizing the standard linear array ultrasound probe for ONSD measurements in our model provided realistic images comparable to in vivo. This provides an affordable and exciting means to test intra- and inter- operator variability in a standardized environment. Knowing this, we can further apply this novel model of ONSD to ultrasound teaching and training courses with confidence in its ability and the technique's ability to produce consistent results.
The present work shows results on elemental distribution analyses in Cu(In,Ga)Se2 thin films for solar cells performed by use of wavelength-dispersive and energy-dispersive X-ray spectrometry (EDX) in a scanning electron microscope, EDX in a transmission electron microscope, X-ray photoelectron, angle-dependent soft X-ray emission, secondary ion-mass (SIMS), time-of-flight SIMS, sputtered neutral mass, glow-discharge optical emission and glow-discharge mass, Auger electron, and Rutherford backscattering spectrometry, by use of scanning Auger electron microscopy, Raman depth profiling, and Raman mapping, as well as by use of elastic recoil detection analysis, grazing-incidence X-ray and electron backscatter diffraction, and grazing-incidence X-ray fluorescence analysis. The Cu(In,Ga)Se2 thin films used for the present comparison were produced during the same identical deposition run and exhibit thicknesses of about 2 μm. The analysis techniques were compared with respect to their spatial and depth resolutions, measuring speeds, availabilities, and detection limits.
Highly oriented proteins with characteristic nanometer dimensions are used as a template for the synthesis and support of metallic nanoparticles. Following a bottom-up approach, noble metal particles in the nanometer size range were obtained by the reduction of the corresponding metal salts in the presence of the protein assemblies. The catalytic activity of the protein-supported particles was determined by hydrogenation reactions.
Carbon Nanotubes (CNTs) offer extraordinary properties for applications in microelectronics. We assess the methods used to grow CNTs for integration into microelectronics, in particular, metallic carbon nanotubes for vias and interconnects as well as semiconducting CNTs for fieldeffect devices are discussed. State-of-the-art CNTFETs are compared to Si-MOSFETs. A vertical CNTFET (VCNTFET) device concept is presented which offers better growth control, adding a new quality to microelectronics and making real 3-dimensional electronics possible.
Part 1: Non-managed care techniques to improve clinical practice
In recent years managed care became a promise of cost control and reduction of unnecessary services utilization, especially in countries with very limited resources. Most LMICs included it early in their reform packages (Tollman et al., 1990). In spite of scarce empirical evidence on the implementation of managed care techniques in this setting (Luck & Peabody, 2002) and intense debates surrounding their introduction in countries such as the USA (Christianson et al., 2005; Simonet, 2005), these techniques were increasingly exported to LMICs.
In this chapter we briefly analyze the results of the introduction of managed care techniques in different environments, explore issues related to the resulting loss of autonomy in clinical practice and offer alternative techniques to improve quality of health care.
What is managed care and what are its results?
The literature offers different approaches and definitions of managed care, probably because it does not convey one single, common concept, but a set of principles and interwoven practices (born in the 1980s in the USA to control costs).
Managed care techniques aim at providing incentives for productivity and efficiency while improving quality of services. They should be distinguished from the organizations which implement them. In this chapter we will attempt to focus on the former and address, in the first instance, clinical mechanisms designed to improve clinical decision making.
Four percent gelatine is an alkaline compound due to NH2 groups, whereas 6% hydroxyethyl starch 130/0.4 (HES130) has acidic features. We investigated whether these solutions lead to differences in acid–base balance in pigs during acidaemia and correction of pH.
Anaesthetized pigs were randomized to HES130 or gelatine infusion (n = 5 per group). Animals received acid infusion (0.4 M solution of lactic acid and HCl diluted in normal saline) and low tidal volume ventilation (6–7 mL kg−1, PaCO2 of 80–85 mmHg, pH 7.19–7.24). Measurements were made before and after induction of acidaemia, before and after correction of pH with haemofiltration (continuous venovenous haemofiltration) and tris-hydroxymethylaminomethane infusion. We measured parameters describing acid–base balance according to Stewart’s approach, ketone body formation, oxygen delivery, haemodynamics, diuresis and urinary pH.
Acid–base balance did not differ significantly between the groups. In HES130-treated pigs, the haemodilution-based drop of haemoglobin (1.4 ± 1.0 g dL−1, median ± SD) was paralleled by an increase in the cardiac output (0.5 ± 0.4 L min−1). Lacking increases in cardiac output, gelatine-treated pigs demonstrated a reduction in oxygen delivery (149.4 ± 106.0 mL min−1). Tris-hydroxymethylaminomethane volumes required for pH titration to desired values were significantly higher in the gelatine group (0.7 ± 0.1 mL kg−1 h−1 vs. HES130: 0.5 ± 0.2 mL kg−1 h−1).
The buffer capacity of gelatine did not lead to favourable differences in acid–base balance in comparison to HES130.