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Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and two cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504 398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV and 6.7% were coinfected with HCV. Of the 269 884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1 093 050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.
Dietary carbohydrates constitute a major fraction of the diets for pigs. The carbohydrate fraction consists of mono-, di- and oligosaccharides and two broad classes of polysaccharides – starch and non-starch polysaccharides (NSP). The carbohydrate fraction has a diverse composition in terms of constituent sugars (pentoses, hexoses, deoxysugars, etc.), glycosidic linkages (alfa or beta), size (degree of polymerisation from one to several thousand), and physical form (soluble in water, insoluble, cation and adsorbing properties). It is now evidential clear that the composition of the carbohydrate fraction influences the digestion and absorption processes of carbohydrates and other nutrients in the various parts of the gastrointestinal tract, it has a profound influence on the secretory response of the gut to feed intake, the volume flow, the mucosal architecture, the composition of the gut flora and the development of the gastrointestinal tract.
Employing a comparative experimental design drawing on over 18,000 interviews across eleven countries on four continents, this article revisits the discussion about the economic and cultural drivers of attitudes towards immigrants in advanced democracies. Experiments manipulate the occupational status, skin tone and national origin of immigrants in short vignettes. The results are most consistent with a Sociotropic Economic Threat thesis: In all countries, higher-skilled immigrants are preferred to their lower-skilled counterparts at all levels of native socio-economic status (SES). There is little support for the Labor Market Competition hypothesis, since respondents are not more opposed to immigrants in their own SES stratum. While skin tone itself has little effect in any country, immigrants from Muslim-majority countries do elicit significantly lower levels of support, and racial animus remains a powerful force.
For the deep ice-core drilling community, the 2005/06 Antarctic season was an exciting and fruitful one. In three different Antarctic locations, Dome Fuji, EPICA DML and Vostok, deep drillings approached bedrock (the ice–water interface in the case of Vostok), emulating what had previously been achieved at NorthGRIP, Greenland, (summer 2003 and 2004) and at EPICA Dome C2, Antarctica (season 2004/05). For the first time in ice-core drilling history, three different types of drill (KEMS, JARE and EPICA) simultaneously reached the depth of ‘warm ice’ under high pressure. After excellent progress at each site, the drilling rate dropped and the drilling teams had to deal with refrozen ice on cutters and drill heads. Drills have different limits and perform differently. In this comparative study, we examine depth, pressure, temperature, pump flow and cutting speed. Finally, we compare a few parameters of ten different deep drills.
In 1983 three directional surveys were made in the bore hole from which a deep ice core was obtained in the summers of 1979–81. The inclination and azimuth of the bore hole were measured on three surveys, temperature was included on two surveys, fluid pressure and hole diameter on one of the surveys. Fluid-pressure measurements show that the ice-overburden pressure was undercompensated in the upper few hundred meters and overcompensated at the bottom of the hole. Diameter measurements show closure in the upper portion and expansion near the bottom beginning at the transition from the Holocene to Wisconsin ice at 1784 m. The hole expansion and increase in inclination correlate with dust and silt content in the Wisconsin ice. Changes in azimuth are due to flow of the ice and are consistent with the direction of flow at the surface. Temperature measurements show that the hole is at or near equilibrium. The gradient of 0.012 K/m below 1400 m is less than the 0.018 K/m at Camp Century. There is a slight reduction in gradient near the bottom from internal friction in the silty ice.
The 2037 m deep bore hole at Dye 3 in south Greenland was surveyed in 1981, 1983, 1985, and 1986. The directional surveys show the ice flow is planar with a surface velocity of 12.2m/year at an azimuth of 060°, which agrees with surface velocity measured by navigation satellites. Measurements of hole diameter and inclination are highly correlated with dust content in the ice. The temperature measurements show strong convection in the hole fluid with a cell height of about 20 m and an amplitude of 0.1 K. The calculated mean in-situ ice density is 921.3 ± 1.5kg/m3. Due to ice deformation, the lowest 4 m of the hole were not accessible in 1985 and the lowest 180 m were not accessible in 1986.
Introduction: In order to achieve the best possible outcomes for patients requiring resuscitation (PRRs) in the emergency department (ED), health care providers (HCPs) must provide an efficient, multi-disciplinary and coordinated response. A quality improvement (QI) project was undertaken to improve HCP response to PRRs at two tertiary care hospital EDs in Toronto. Methods: We conducted a before-and-after mixed-method survey to evaluate the perception of the adequacy of HCP response and clarity of HCP role when responding to PRRs. The results were compared using the Chi-square test. Qualitative responses to the first survey were also used to inform the development of the QI project. Through interviews of key stakeholders and with continuous input from front-line ED HCPs, a multi-disciplinary team modified the ED resuscitation protocol. This included standardized pre-hospital communication form with paramedics, ED-wide overhead announcement of ‘Code Resus’, dedicated HCPs assigned to respond to PRRs, and specific duties assigned to each responder. Change initiatives were reinforced through education and posters in the ED. Six months after implementation, a second survey was conducted to evaluate the sustained effects of the intervention. Results: Baseline measures indicated that 16 of 52 (30.8%) nurses surveyed believed their role was often or always apparent to themselves and others when they attended to a PRR (on a 5-point rating scale). This proportion increased to 35 of 55 (63.6%) nurses in the post-implementation survey (p < 0.001). Regarding adequacy of the number of HCPs responding to PRRs, 17 of 39 (43.6%) physicians and 23 of 53 (43.4%) nurses surveyed thought the appropriate number of HCPs responded to PRRs; the remainder thought that there were too few or too many HCPs. In the post-implementation survey, 34 of 41 (82.9%) physicians (p < 0.001) and 36 of 56 (64.3%) nurses (p = 0.029) surveyed felt that the appropriate number of HCPs attended to PRRs. Conclusion: Using a quality improvement approach, we identified and quantified perceived deficiencies in HCP response to PRRs in the ED. Through feedback-based modifications of the ED resuscitation protocol and by engaging HCP stakeholders, change initiatives were implemented to improve HCP response. As a result, this project achieved significant and sustained improvements in HCPs’ perceived response to PRRs.
We report the analysis of 154 hours of nearly continuous high-speed photometric data on the pulsating DB white dwarf (DBV) GD 358 obtained during the Whole Earth Telescope (WET) run of May 1990. The Fourier transform (FT) of the light curve is dominated by power in the range from 1200 – 1700μHz with more than 180 significant peaks in the total transform. We also see significant power at the sums and differences of the dominant frequencies, indicating the importance of nonlinear behavior. We can use this data to obtain an accurate total stellar mass, and surface He layer mass. The implied surface He layer mass, if correct, provides a significant and surprising challenge to stellar evolution theory, as well as the theory of chemical mixing.
Neuropsychiatric symptoms (NPS) occur in people with dementia throughout disease course and across etiologies. NPS are associated with significant morbidities and hastened disease processes. Nevertheless, people with dementia are not systematically assessed for NPS in clinical settings. We review existing NPS measures for clinical and/or research purposes, and identify measurement gaps.
We conducted a computerized search of peer-reviewed published studies of measures (January 1, 1980–December 1, 2013) using multiple search terms. Measures selected for review were in English, had adequate psychometric properties, and were developed for or used with people with dementia. Papers describing measures were evaluated by three coders along seven characteristics: behavioral domains, number of items, method of administration, response categories, targeted population, setting, and psychometric properties.
Overall, 2,233 papers were identified through search terms, and 36 papers from manual searches of references. From 2,269 papers, 85 measures were identified of which 45 (52.9%) had adequate psychometric properties and were developed or used with dementia populations. Of these, 16 (35.6%) were general measures that included a wide range of behaviors; 29 (64.4%) targeted specific behaviors (e.g. agitation). Measures differed widely as to behaviors assessed and measurement properties.
A robust set of diverse measures exists for assessing NPS in different settings. No measures identify risk factors for behaviors or enable an evaluation of the context in which behaviors occur. To improve clinical efforts, research is needed to evaluate concordance of behavioral ratings between formal and informal caregivers, and to develop and test measures that can identify known risks for behaviors and the circumstances under which behaviors occur.
The course of bipolar disorder progressively worsens in some patients. Although responses to pharmacotherapy appear to diminish with greater chronicity, less is known about whether patients' prior courses of illness are related to responses to psychotherapy.
Embedded in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) was a randomized controlled trial of psychotherapy for bipolar depression comparing the efficacy of intensive psychotherapy with collaborative care (a three-session psycho-educational intervention). We assessed whether the number of previous mood episodes, age of illness onset, and illness duration predicted or moderated the likelihood of recovery and time until recovery from a depressive episode in patients in the two treatments.
Independently of treatment condition, participants with one to nine prior depressive episodes were more likely to recover and had faster time to recovery than those with 20 or more prior depressive episodes. Participants with fewer than 20 prior manic episodes had faster time to recovery than those with 20 or more episodes. Longer illness duration predicted a longer time to recovery. Participants were more likely to recover in intensive psychotherapy than collaborative care if they had 10–20 prior episodes of depression [number needed to treat (NNT) = 2.0], but equally likely to respond to psychotherapy and collaborative care if they had one to nine (NNT = 32.0) or >20 (NNT = 9.0) depressive episodes.
Number of previous mood episodes and illness duration are associated with the likelihood and speed of recovery among bipolar patients receiving psychosocial treatments for depression.
LOFT (Large Observatory For X-ray Timing) is one of the four candidate missions currently
under assessment study for the M3 mission in ESAs Cosmic Vision program to be launched in
2024. LOFT will carry two instruments with prime sensitivity in the 2–30 keV range: a 10
m2 class large area detector (LAD) with a <1° collimated field of view
and a wide field monitor (WFM) instrument. The WFM is based on the coded mask principle,
and 5 camera units will provide coverage of more than 1/3 of the sky. The prime goal of
the WFM is to detect transient sources to be observed by the LAD. With its wide field of
view and good energy resolution of <500 eV, the WFM will be an excellent instrument
for detecting and studying GRBs and X-ray flashes. The WFM will be able to detect
~150 gamma ray bursts per year, and a burst alert system will enable the
distribution of ~100 GRB positions per year with a ~1 arcmin location
accuracy within 30 s of the burst.
It is well documented that global warming is unequivocal. Dairy production systems are considered as important sources of greenhouse gas emissions; however, little is known about the sensitivity and vulnerability of these production systems themselves to climate warming. This review brings different aspects of dairy cow production in Central Europe into focus, with a holistic approach to emphasize potential future consequences and challenges arising from climate change. With the current understanding of the effects of climate change, it is expected that yield of forage per hectare will be influenced positively, whereas quality will mainly depend on water availability and soil characteristics. Thus, the botanical composition of future grassland should include species that are able to withstand the changing conditions (e.g. lucerne and bird's foot trefoil). Changes in nutrient concentration of forage plants, elevated heat loads and altered feeding patterns of animals may influence rumen physiology. Several promising nutritional strategies are available to lower potential negative impacts of climate change on dairy cow nutrition and performance. Adjustment of feeding and drinking regimes, diet composition and additive supplementation can contribute to the maintenance of adequate dairy cow nutrition and performance. Provision of adequate shade and cooling will reduce the direct effects of heat stress. As estimated genetic parameters are promising, heat stress tolerance as a functional trait may be included into breeding programmes. Indirect effects of global warming on the health and welfare of animals seem to be more complicated and thus are less predictable. As the epidemiology of certain gastrointestinal nematodes and liver fluke is favourably influenced by increased temperature and humidity, relations between climate change and disease dynamics should be followed closely. Under current conditions, climate change associated economic impacts are estimated to be neutral if some form of adaptation is integrated. Therefore, it is essential to establish and adopt mitigation strategies covering available tools from management, nutrition, health and plant and animal breeding to cope with the future consequences of climate change on dairy farming.
We have studied an influence of pressure on the emission and absorption spectra measured from various types of InGaN structures such as epilayers, quantum wells and quantum dots. While the known pressure coefficients of GaN and InN bandgaps are in the range 40-25 meV/GPa, the experimental observation for the light emission shift with pressure for InGaN alloys is dramatically different. With the increasing In content and thus decreasing emission energy the observed pressure coefficients become very small eventually reaching zero or even slightly negative values! We have observed a much weaker trend for the decrease of the pressure coefficient for the absorption edges of InGaN. First principle calculations of InGaN band structure and its modification with a pressure are not able to explain the huge effect observed in the emission experiment but are in a good agreement with the results obtained in optical absorption measurements. We discuss here the possible mechanisms which can account for extremely low pressure coefficient of the light emission and the discrepancy between sensitivity light emission and absorption on applied pressure in InGaN alloys.
The relaxation processes of strained silicon films on silicon-rich relaxed SiGe alloys have been studied. Experimental structures were generated via Molecular Beam Epitaxial (MBE) growth techniques and contain a strained silicon capping layer of approximately 50 nm. The relaxed SiGe alloy compositions range from 0 to 30 atomic% germanium. Samples received two distinct types of silicon implants. A 12 keV Si+ implant at a dose of 1×1015 atoms/cm2 was used to generate an amorphous layer strictly confined within the strained Si cap. An alternate 60 keV Si+ implant at a dose of 1×1015 atoms/cm2 was employed to create a continuous amorphous layer extending from the sample surface to a position 50 nm into the bulk SiGe material. The strain relaxation and regrowth processes are quantified through High Resolution X-Ray Diffraction (HRXRD) rocking curves and Cross-sectional Transmission Electron Microscopy (XTEM). The role of injected silicon interstitials upon the strain relaxation processes at the Si/SiGe interface after annealing at 600°C is investigated.
Quantum Hall effect and Shubnikov-de Haas oscillations in a 2D hole gas at a p-GaAs/Al0.5Ga0 5As (001) interface show, that under in-plane (110) uniaxial compression a redistribution of carriers between the two spin-splitted subbands of the ground heavy hole state takes place. At the maximal compression of 2.5 kbar the carrier density of the most populated subband is decreased by 18%, while the total carrier density remains almost unchanged. A decrease of the spin-splitting under the uniaxial compression is proposed.
Nanophase powders of Si, C, and SiC with narrow size distributions are synthesized by dissociating reactants in a dc are plasma and quenching the hot gases in a subsonic nozzle expansion. The plasma is characterized by calorimetric energy balances and the powders by on-line aerosol measurcment techniques and conventional materials analysis. The measured nozzle quench rate is about 5 × 106 K/s. The generated particles have number mean diameters of about 10 nm or less, with Si forming relatively dense, coalesced particles, while SiC forms highly aggregated particles. Our data suggest that SiC particle formation is initiated by the nucleation of small silicon particles.
The radial pulsations of very luminous, low-mass models (L/M ˜ 104, solar units), which are possible representatives of the R CrB stars, have been examined. These pulsations are extremely nonadia–batic. We find that there are in some cases at least one extra (“strange”) mode which makes interpretation difficult. The blue instability edges are also peculiar, in that there is an abrupt excursion of the blue edge to the blue for L/M sufficiently large. The range of periods of the model encompasses observed periods of the Cepheid-like pulsations of actual R CrB stars.
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