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In 2019, a 42-year-old African man who works as an Ebola virus disease (EVD) researcher traveled from the Democratic Republic of Congo (DRC), near an ongoing EVD epidemic, to Philadelphia and presented to the Hospital of the University of Pennsylvania Emergency Department with altered mental status, vomiting, diarrhea, and fever. He was classified as a “wet” person under investigation for EVD, and his arrival activated our hospital emergency management command center and bioresponse teams. He was found to be in septic shock with multisystem organ dysfunction, including circulatory dysfunction, encephalopathy, metabolic lactic acidosis, acute kidney injury, acute liver injury, and diffuse intravascular coagulation. Critical care was delivered within high-risk pathogen isolation in the ED and in our Special Treatment Unit until a diagnosis of severe cerebral malaria was confirmed and EVD was definitively excluded.
This report discusses our experience activating a longitudinal preparedness program designed for rare, resource-intensive events at hospitals physically remote from any active epidemic but serving a high-volume international air travel port-of-entry.
We describe an ultra-wide-bandwidth, low-frequency receiver recently installed on the Parkes radio telescope. The receiver system provides continuous frequency coverage from 704 to 4032 MHz. For much of the band (
), the system temperature is approximately 22 K and the receiver system remains in a linear regime even in the presence of strong mobile phone transmissions. We discuss the scientific and technical aspects of the new receiver, including its astronomical objectives, as well as the feed, receiver, digitiser, and signal processor design. We describe the pipeline routines that form the archive-ready data products and how those data files can be accessed from the archives. The system performance is quantified, including the system noise and linearity, beam shape, antenna efficiency, polarisation calibration, and timing stability.
This article examines the ideological and political transformations that allowed dialogue between Catholics and socialists to bear fruit in the Federal Republic of Germany in the immediate post-war era. It focuses on the role played by Ernst-Wolfgang Böckenförde, the prominent Catholic intellectual, constitutional theorist, historian and future Constitutional Court justice.
Studies suggest that alcohol consumption and alcohol use disorders have distinct genetic backgrounds.
We examined whether polygenic risk scores (PRS) for consumption and problem subscales of the Alcohol Use Disorders Identification Test (AUDIT-C, AUDIT-P) in the UK Biobank (UKB; N = 121 630) correlate with alcohol outcomes in four independent samples: an ascertained cohort, the Collaborative Study on the Genetics of Alcoholism (COGA; N = 6850), and population-based cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC; N = 5911), Generation Scotland (GS; N = 17 461), and an independent subset of UKB (N = 245 947). Regression models and survival analyses tested whether the PRS were associated with the alcohol-related outcomes.
In COGA, AUDIT-P PRS was associated with alcohol dependence, AUD symptom count, maximum drinks (R2 = 0.47–0.68%, p = 2.0 × 10−8–1.0 × 10−10), and increased likelihood of onset of alcohol dependence (hazard ratio = 1.15, p = 4.7 × 10−8); AUDIT-C PRS was not an independent predictor of any phenotype. In ALSPAC, the AUDIT-C PRS was associated with alcohol dependence (R2 = 0.96%, p = 4.8 × 10−6). In GS, AUDIT-C PRS was a better predictor of weekly alcohol use (R2 = 0.27%, p = 5.5 × 10−11), while AUDIT-P PRS was more associated with problem drinking (R2 = 0.40%, p = 9.0 × 10−7). Lastly, AUDIT-P PRS was associated with ICD-based alcohol-related disorders in the UKB subset (R2 = 0.18%, p < 2.0 × 10−16).
AUDIT-P PRS was associated with a range of alcohol-related phenotypes across population-based and ascertained cohorts, while AUDIT-C PRS showed less utility in the ascertained cohort. We show that AUDIT-P is genetically correlated with both use and misuse and demonstrate the influence of ascertainment schemes on PRS analyses.
Consumers in the United States fall short of meeting the recommended guideline for dietary fiber intake. Using a quarterly panel of households from Nielsen for the years 2004 through 2014, we employ a Heckman two-step approach to estimate nine panel regressions concerning per person fiber intakes derived from various food categories to uncover the importance of prices as well as socioeconomic and demographic factors. Prices play a prominent role in the per person intake of dietary fiber derived from the respective food products considered. Households below poverty thresholds had lower intakes of fiber relative to households above poverty thresholds. Ethnicity, race, age of the household head, region, and the presence of children also had significant effects on dietary fiber derived from the respective food categories. A proposed 20 percent subsidy applied to fruits and vegetables would increase per person intake of fiber by 9.4 percent. Therefore, if one were to consider meeting the dietary fiber requirement only through the provision of a subsidy, a large subsidy applied to fruits and vegetables would be required. Therefore, given the complex nature of the various factors affecting the intake of dietary fiber, the feasibility of using subsidies alone to increase the intake of dietary fiber is called into question.
An ever-increasing number of laboratory facilities are enabling in situ spectral reflectance measurements of materials under conditions relevant to all the bodies in the Solar System, from Mercury to Pluto and beyond. Results derived from these facilities demonstrate that exposure of different materials to various planetary surface conditions can provide insights into the endogenic and exogenic processes that operate to modify their surface spectra, and their relative importance. Temperature, surface atmospheric pressure, atmospheric composition, radiation environment, and exposure to the space environment have all been shown to measurably affect reflectance and emittance spectra of a wide range of materials. Planetary surfaces are dynamic environments, and as our ability to reproduce a wider range of planetary surface conditions improves, so will our ability to better determine the surface composition of these bodies, and by extension, their geologic history.
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
Objectives: Down syndrome (DS) is a population with known hippocampal impairment, with studies showing that individuals with DS display difficulties in spatial navigation and remembering arbitrary bindings. Recent research has also demonstrated the importance of the hippocampus for novel word-learning. Based on these data, we aimed to determine whether individuals with DS show deficits in learning new labels and if they may benefit from encoding conditions thought to be less reliant on hippocampal function (i.e., through fast mapping). Methods: In the current study, we examined immediate, 5-min, and 1-week delayed word-learning across two learning conditions (e.g., explicit encoding vs. fast mapping). These conditions were examined across groups (twenty-six 3- to 5-year-old typically developing children and twenty-six 11- to 28-year-old individuals with DS with comparable verbal and nonverbal scores on the Kaufman Brief Intelligence Test – second edition) and in reference to sleep quality. Results: Both individuals with and without DS showed retention after a 1-week delay, and the current study found no benefit of the fast mapping condition in either group contrary to our expectations. Eye tracking data showed that preferential eye movements to target words were not present immediately but emerged after 1-week in both groups. Furthermore, sleep measures collected via actigraphy did not relate to retention in either group. Conclusions: This study presents novel data on long-term knowledge retention in reference to sleep patterns in DS and adds to a body of knowledge helping us to understand the processes of word-learning in typical and atypically developing populations. (JINS, 2018, 24, 955–965)
The unsteady ascent of a buoyant, turbulent line plume through a quiescent, uniform environment is modelled in terms of the width-averaged vertical velocity and density deficit. It is demonstrated that for a well-posed, linearly stable model, account must be made for the horizontal variation of the velocity and the density deficit; in particular the variance of the velocity field and the covariance of the density deficit and velocity fields, represented through shape factors, must exceed threshold values, and that models based upon ‘top-hat’ distributions in which the dependent fields are piecewise constant are ill-posed. Numerical solutions of the nonlinear governing equations are computed to reveal that the transient response of the system to an instantaneous change in buoyancy flux at the source may be captured through new similarity solutions, the form of which depend upon both the ratio of the old to new buoyancy fluxes and the shape factors.
Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed.
To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses.
Item selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales.
Interreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia.
The ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia.
In these four volumes Wolfram Kinzig has put together the largest compilation to date of texts which profess to set out the principal tenets of the Church between the second and the eighth centuries of the Christian era. In dimension it easily surpasses its German precursors of the eighteenth and nineteenth centuries, while in content it can aim to be more eclectic than the compendium which Philip Schaff addressed to the clergy and fellow-believers in 1877. Its only rival in the twenty-first century is the joint labour of Jaroslav Pelikan and Valerie Hotchkiss, broader in chronological range but therefore less exhaustive in its representation of this formative epoch. The first volume affords all necessary materials for the telling and untelling of the narrative which customarily ends with the promulgation of an amplified version of the Nicene Creed at Constantinople in 381; the second is an argosy of western specimens, a high proportion being prototypes or variants of the so-called Apostles Creed; the third is a miscellany of both personal and synodical confessions, some conventional, some idiosyncratic, many obscure in provenance and purpose; the contents of the fourth are drawn primarily from the Carolingian era, though the sources consulted in the first half are as various as the Pontifical of Donaueschingen (vol. iv. 99), the Irish Book of Dimma (iv. 119), the Dicta Leonis Episcopi (iv. 158–61) and the Sacramentary of Autun (iv. 283). The result is a monument of erudition, an invaluable resource for all future scholarship, and pleasurable reading for those who have hitherto been unable to approach the texts for want of an English rendering. The following remarks are therefore offered to the editor of these volumes as a stimulus to discussion, not to throw any aspersion on his judgement or on his many-times-proven competence as historian and critic.
This study uses stable carbon δ13C and oxygen δ18O isotope compositions data to assess the extent to which diet breadths of northwestern Guyana changed during the Holocene. We analyzed human bone and enamel remains from seven shell mound sites dating between 7500 and 2600 BP. Our analyses demonstrate some constancy in C3 plant availability during the past several thousand years, though we note increasing reliance on such plants beginning in the Early Holocene. We also document warming intervals during the Early Holocene (Early Archaic) that appear to correlate with dry periods known elsewhere in the central Amazon during this period.
Were Pope Pius XII and the Catholic Church in Germany unduly singled out after 1945 for their conduct during the National Socialist era? Mark Edward Ruff explores the bitter controversies that broke out in the Federal Republic of Germany from 1945 to 1980 over the Catholic Church's relationship to the Nazis. He explores why these cultural wars consumed such energy, dominated headlines, triggered lawsuits and required the intervention of foreign ministries. He argues that the controversies over the church's relationship to National Socialism were frequently surrogates for conflicts over how the church was to position itself in modern society - in politics, international relations and the media. More often than not, these exchanges centered on problems perceived as arising from the postwar political ascendancy of Roman Catholics and the integration of Catholic citizens into the societal mainstream.