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In this cohort of Escherichia coli and Klebsiella spp hospital-onset bacteremia, isolated fluoroquinolone resistance had a larger relative impact on mortality than other phenotypic resistance patterns. This finding may support stewardship efforts targeting unnecessary fluoroquinolone use and increased attention from infection prevention and control departments.
Following publication, errors were discovered in the y-axis labels of the electron and hole concentration plots in the following figure panels: figure 4c, figure 4d, figure 5c, figure 5d, figure 6c, figure 6d, figure 8c and figure 8d. The error does not affect the description, analysis or conclusions. The correct representation of the figure panels are shown here.
Background: EMBRACE (NCT02462759) Part 1 is a randomized, double-blind, sham-procedure controlled study assessing safety/tolerability of intrathecal nusinersen (12-mg equivalent dose) in symptomatic infants/children with SMA who were not eligible to participate in ENDEAR or CHERISH. Methods: Eligible participants had onset of SMA symptoms at ≤6 months with 3 SMN2 copies; onset at ≤6 months, age >7 months and 2 copies; or onset at >6 months, age ≤18 months, and 2/3 copies. Safety/tolerability was the primary endpoint. Exploratory endpoints included Hammersmith Infant Neurological Examination Section 2 (HINE-2) motor milestone attainment, change in ventilator use, and growth. Results: EMBRACE Part 1 was terminated early based on positive results from ENDEAR. Safety/tolerability was similar to previous trials. More nusinersen-treated (11/14;79%) vs. sham–treated individuals (2/7;29%) were HINE-2 motor milestone responders. Between Day 183 and 302, mean (SD) hours of ventilator use changed by +1.236 (3.712) hours in nusinersen-treated (n=12) and +2.123 (3.023) hours in sham–treated individuals (n=7). Similar increases in weight and body length were observed in nusinersen-treated and sham–treated individuals by Day 183. Conclusions: In EMBRACE Part 1, nusinersen demonstrated a favorable benefit-risk profile. These results add to the aggregated efficacy, safety/tolerability data of nusinersen in SMA.
Increasing evidence suggests that the presence of mobile ions in perovskite solar cells (PSCs) can cause a current–voltage curve hysteresis. Steady state and transient current–voltage characteristics of a planar metal halide CH3NH3PbI3 PSC are analysed with a drift-diffusion model that accounts for both charge transport and ion vacancy motion. The high ion vacancy density within the perovskite layer gives rise to narrow Debye layers (typical width ~2 nm), adjacent to the interfaces with the transport layers, over which large drops in the electric potential occur and in which significant charge is stored. Large disparities between (I) the width of the Debye layers and that of the perovskite layer (~600 nm) and (II) the ion vacancy density and the charge carrier densities motivate an asymptotic approach to solving the model, while the stiffness of the equations renders standard solution methods unreliable. We derive a simplified surface polarisation model in which the slow ion dynamics are replaced by interfacial (non-linear) capacitances at the perovskite interfaces. Favourable comparison is made between the results of the asymptotic approach and numerical solutions for a realistic cell over a wide range of operating conditions of practical interest.
It is the practise for some farmers to supplement new season lambs with concentrates, often as a creep feed, in order to get them to market early before the price declines. This concentrate is usually based on cereals and would be high in n-6 fatty acids, diluting the beneficial effect of grass grazing which promotes the n-3 polyunsaturated fatty acid (PUFA) content in the meat (Fisher et al., 2000). The purpose of this trial was to assess the addition of linseed to the concentrate, fed in a creep-feed system, which would maintain or enhance the n-3 fatty acid composition of the meat of animals fed concentrates at grass during the finishing period (Cooper et al., 2004).
The aim of future beef production is healthier, tastier products which consumers will find attractive. Combinations of breed and feeding system are required to fulfil these aims. In this project we compared the Holstein- Friesian (HF) breed, an allegedly inferior beef producer, with Welsh Black (WB), a traditional beef breed. Of particular interest was the role of polyunsaturated fatty acids (PUFA) in flavour development.
Thirty six steers, 18 HF and 18 WB, were reared on grass silage plus one of three concentrates. The concentrates contained different fat sources at 0.03 of intake: 1. megalac (control, C16:0); 2. formaldehyde-protected whole linseed (Lin, C18:3 n-3); and 3. an equal mix on a fat basis of protected linseed and fish oil (Lin/fish, C20:5 and C22:6 n-3). The animals were slaughtered after 90 days consumption of the diets. Fortyeight hours after slaughter, three forequarter muscles (M. supraspinatus, M. infraspinatus and M. triceps brachii caput longum) were trimmed of fat, minced and displayed in modified atmosphere packs (0.8 02:0.2 CO2, 4°C in 1000 Lux) for 3 or 10 days.
Under controlled experimental conditions, ruminally protected lipid supplements (PLS) rich in 18:2n-6 and 18:3n-3 have been successful in creating large shifts in the fatty acid composition of beef muscle (Scollan et al., 2003). However, there is a need to test methodology under commercial conditions and with a wider range of breed types. This study was conducted at a Yorkshire Farm and used Charolais Cross and the Stabiliser breed, a mix of 5 breeds designed to combine efficient production and good carcass quality.
Recommendations to improve the UK diet suggest an increase in the ratio of polyunsaturated to saturated fatty acids (P:S ratio) and a higher consumption of n-3 polyunsaturated fatty acids (PUFA). Ruminant meats have a poor P:S ratio, approximately 0.1 compared to the recommendation of 0.4-1.0 for the whole diet. However, the ratio of C18:2 n-6/C18:3 n-3 (the n-6:n-3) is well within the recommended value of <4.0 at approximately 2 and ruminant muscle also supplies longer-chain n-3 PUFA. By feeding lipid in a formaldehyde cross-linked protein matrix, rumen biohydrogenation can be avoided and the tissue PUFA level increased but with potential effects on oxidative shelf-life, colour and flavour of the meat. This trial investigated the fatty acid composition and quality of meat produced by feeding a protected lipid supplement (PLS).
Skatole is formed as a result of bacterial degradation of tryptophan in the rumen of cattle and sheep, and the hindgut of pigs. It accumulates in fat where it is an important component of boar taint in pigs (Claus et al, 1994), and with branched chain fatty acids, has been implicated as a contributor to the strong flavour characteristic of sheepmeat (Young et al, 1997). This study examines the role of breed, diet and age on skatole deposition in the fat and perception of beef flavour.
Research has shown both production and health benefits for the use of chicory (Cichorium intybus) within ruminant diets. Despite this, little was known about the effects of this forage, containing differing fatty acid profiles and secondary plant compounds compared with ryegrass, on beef stability, fatty acid composition or sensory properties. An experiment was conducted to investigate whether the inclusion of chicory in the diet of grazing beef steers would alter these three properties in the M. Longissimus muscle when compared with beef steers grazing perennial ryegrass (Lolium perenne). Triplicate 2 ha plots were established with a chicory (cv. Puna II)/perennial ryegrass mix or a perennial ryegrass control. A core group of 36 Belgian Blue – cross steers were used within a 2-year beef finishing experiment (n=6/replicate plot). In the 2nd grazing year, steers were slaughtered as they reached a target fat class of 3. Muscle pH was checked 2 and 48 h post-slaughter. A section of the hindloin joint containing the M. Longissimus lumborum muscle was removed and a 20 mm-thick steak was cut and muscle samples were taken for analysis of vitamin E and fatty acid analysis. The remaining section of the loin was vacuum packed in modified atmosphere packs and subjected to simulated retail display. A section of the conditioned loin was used for sensory analysis. Data on pH, vitamin E concentration and colour stability in a simulated retail display showed there were no effects of including chicory in the diet of grazing beef steers on meat stability. There were also no differences found in the fatty acid composition or the overall eating quality of the steaks from the two treatments. In conclusion, there were no substantive effects of including chicory in the swards of grazing beef cattle on meat stability, fatty acid composition or sensory properties of the M. Longissimus muscle when compared with beef steers grazing ryegrass-only swards.
There are an estimated 1.5 million internally displaced persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine.
A cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety. Descriptive and multivariate regression analyses were used.
PTSD prevalence was 32%, depression prevalence was 22%, and anxiety prevalence was 17%. Among those that likely required care (screened positive with one of the three disorders, and also self-reporting a problem) there was a large treatment gap, with 74% of respondents who likely required MHPSS care over the past 12 months not receiving it. For the 26% (N = 180) that had sought care, the most common sources of services/support were pharmacies, family or district doctor/paramedic (feldsher), neurologist at a polyclinic, internist/neurologist at a general hospital, psychologists visiting communities, and non-governmental organisations/volunteer mental health/psychosocial centres. Of the 180 respondents who did seek care, 163 could recall whether they had to pay for their care. Of these 163 respondents, 72 (44%) recalled paying for the care they received despite government care officially being free in Ukraine. The average costs they paid for care was US$107 over the previous 12 months. All 180 respondents reported having to pay for medicines and the average costs for medicines was US$109 over the previous 12 months. Among the 74% had not sought care despite likely needing it; the principal reasons for not seeking care were: thought that they would get better by using their own medications, could not afford to pay for health services or medications, no awareness of where to receive help, poor understanding by health care providers, poor quality of services, and stigma/embarrassment. The findings from multivariate regression analysis show the significant influence of a poor household economic situation on not accessing care.
The study highlights a high burden of mental disorders and large MHPSS treatment gap among IDPs in Ukraine. The findings support the need for a scaled-up, comprehensive and trauma-informed response to provision of MHPSS care of IDPs in Ukraine alongside broader health system strengthening.
Recent studies have improved our understanding of nearshore marine ecosystems surrounding Ascension Island (central Atlantic Ocean), but little is known about Ascension's benthic environment beyond its shallow coastal waters. Here, we report the first detailed physical and biological examination of the seabed surrounding Ascension Island at 100–1000 m depth. Multibeam swath data were used to map fine scale bathymetry and derive seabed slope and rugosity indices for the entire area. Water temperature and salinity profiles were obtained from five Conductivity, Temperature, Depth (CTD) deployments, revealing a spatially consistent thermocline at 80 m depth. A camera lander (Shelf Underwater Camera System; SUCS) provided nearly 400 images from 21 sites (100 m transects) at depths of 110–1020 m, showing high variability in the structure of benthic habitats and biological communities. These surveys revealed a total of 95 faunal morphotypes (mean richness >14 per site), complemented by 213 voucher specimens constituting 60 morphotypes collected from seven targeted Agassiz trawl (AGT) deployments. While total faunal density (maximum >300 m−2 at 480 m depth) increased with rugosity, characteristic shifts in multivariate assemblage structure were driven by depth and substratum type. Shallow assemblages (~100 m) were dominated by black coral (Antipatharia sp.) on rocky substrata, cup corals (Caryophyllia sp.) and sea urchins (Cidaris sp.) were abundant on fine sediment at intermediate depths (250–500 m), and shrimps (Nematocarcinus spp.) were common at greater depths (>500 m). Other ubiquitous taxa included serpulid and sabellid polychaetes and brittle stars (Ophiocantha sp.). Cold-water corals (Lophelia cf. pertusa), indicative of Vulnerable Marine Ecosystems (VMEs) and representing substantial benthic carbon accumulation, occurred in particularly dense aggregations at <350 m but were encountered as deep as 1020 m. In addition to enhancing marine biodiversity records at this locality, this study provides critical baseline data to support the future management of Ascension's marine environment.
Following international recommendations (UNESCO / IASH 1969), the decision was made to determine the surface profile of a number of glaciers in Palmer Land and Alexander Island. By comparison with the ice sheet elsewhere on the continent, the chosen glaciers were small and hence more sensitive to the effect of climate over the last few decades. Six profiles were established between 1972 and 1976 and they were re-levelled in the 1985-86 summer. The profiles are between 0.5 and 4.5 km long and are terminated, at one end at least, by a bench mark established on rock. The profiles were re-measured close to the calendar date of the original survey so that recent trends would not be masked by the annual cycle of accumulation, densification and ablation. Five of the six profiles show that the ice sheet has thickened in the last 10-15 years, albeit at a slow rate. Changes in four profiles on Alexander Island within 300 m of sea-level range from a thickening of 66 mm a−1 to a thinning of 83 mm a−1; on average the sites show a thickening of just 6 mm a year. This is similar to the thickening rate of 5 mm a−1 which was found for a cold site on the spine of the Antarctic Peninsula at 1600 m above sea-level. The greatest change was found at an intermediate elevation (500 m). In a snow-field between two parallel mountain groups in the Batterbee Mountains of Palmer Land, thickening averaged 165 mm a−1. To put these values into perspective, in the absence of glacier flow and summer melting, the glaciers would thicken by up to about 500 mm each year as a result of the accumulation of snow.
Except in the Batterbee Mountains, we find that glacier flow is in close balance with present climate, despite the general warming trend that has occurred in the Antarctic Peninsula region over the past 30 years.
Eta Carinae is one of the most massive observable binaries. Yet determination of its orbital and physical parameters is hampered by obscuring winds. However the effects of the strong, colliding winds changes with phase due to the high orbital eccentricity. We wanted to improve measures of the orbital parameters and to determine the mechanisms that produce the relatively brief, phase-locked minimum as detected throughout the electromagnetic spectrum. We conducted intense monitoring of the He ii λ4686 line in η Carinae for 10 months in the year 2014, gathering ~300 high S/N spectra with ground- and space-based telescopes. We also used published spectra at the FOS4 SE polar region of the Homunculus, which views the minimum from a different direction. We used a model in which the He ii λ4686 emission is produced by two mechanisms: a) one linked to the intensity of the wind-wind collision which occurs along the whole orbit and is proportional to the inverse square of the separation between the companion stars; and b) the other produced by the ‘bore hole’ effect which occurs at phases across the periastron passage. The opacity (computed from 3D SPH simulations) as convolved with the emission reproduces the behavior of equivalent widths both for direct and reflected light. Our main results are: a) a demonstration that the He ii λ4686 light curve is exquisitely repeatable from cycle to cycle, contrary to previous claims for large changes; b) an accurate determination of the longitude of periastron, indicating that the secondary star is ‘behind’ the primary at periastron, a dispute extended over the past decade; c) a determination of the time of periastron passage, at ~4 days after the onset of the deep light curve minimum; and d) show that the minimum is simultaneous for observers at different lines of sight, indicating that it is not caused by an eclipse of the secondary star, but rather by the immersion of the wind-wind collision interior to the inner wind of the primary.
We propose a novel stereo visual IMU-assisted (Inertial Measurement Unit) technique that extends to large inter-frame motion the use of KLT tracker (Kanade–Lucas–Tomasi). The constrained and coherent inter-frame motion acquired from the IMU is applied to detected features through homogenous transform using 3D geometry and stereoscopy properties. This predicts efficiently the projection of the optical flow in subsequent images. Accurate adaptive tracking windows limit tracking areas resulting in a minimum of lost features and also prevent tracking of dynamic objects. This new feature tracking approach is adopted as part of a fast and robust visual odometry algorithm based on double dogleg trust region method. Comparisons with gyro-aided KLT and variants approaches show that our technique is able to maintain minimum loss of features and low computational cost even on image sequences presenting important scale change. Visual odometry solution based on this IMU-assisted KLT gives more accurate result than INS/GPS solution for trajectory generation in certain context.