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To evaluate the discriminative ability of hyperlactataemia for early morbidity and mortality in neonates with CHD following cardiac surgery.
Retrospective, observational study of neonates who underwent cardiac surgery on cardiopulmonary bypass at a tertiary care children’s hospital from June 2015 to June 2019. The primary predictor was lactate. The primary composite outcome was defined as ≥1 of the following: cardiac arrest or extracorporeal membrane oxygenation within 72 hours or 30-day mortality post-operatively. The secondary outcome was the presence of major residual lesions, according to the Technical Performance Score.
Of 432 neonates, 28 (6.5%) sustained the composite outcome. On univariate analysis, peak lactate within 48 hours, increase in lactate from ICU admission through 12 hours, and single ventricle physiology were significantly associated with the composite outcome. The peak lactate occurred at a median of 2.9 hours (interquartile range: 1, 35) before the event. Through multi-variable analysis, a multi-variable risk algorithm was created. Predicted probabilities demonstrated an increasing risk based on single ventricle status and delta lactate, ranging from 1.8% (95% CI: 0.9, 3.9) to 52.4% (95% CI: 32.4, 71.7). The model had good discriminative ability for the composite outcome on receiver operating characteristic analysis (area under the curve = 0.79; 95% CI: 0.75, 0.89). Moreover, a peak lactate of 7.3 mmol/l or greater was significantly associated with the presence of a major residual lesion (odds ratios: 5.16, 95% CI: 3.01, 8.87).
We present a simple, two-variable model, including delta lactate in the immediate post-operative period and single ventricle status, to prognosticate the risk of early morbidity and mortality in neonates undergoing cardiac surgery for potential intervention.
Recent models of psychopathology suggest the presence of a general factor capturing the shared variance among all symptoms along with specific psychopathology factors (e.g., internalizing and externalizing). However, few studies have examined predictors that may serve as transdiagnostic risk factors for general psychopathology from early development. In the current study we examine, for the first time, whether observed and parent-reported infant temperament dimensions prospectively predict general psychopathology as well as specific psychopathology dimensions (e.g., internalizing and externalizing) across childhood. In a longitudinal cohort (N = 291), temperament dimensions were assessed at 4 months of age. Psychopathology symptoms were assessed at 7, 9, and 12 years of age. A bifactor model was used to estimate general, internalizing, and externalizing psychopathology factors. Across behavioral observations and parent-reports, higher motor activity in infancy significantly predicted greater general psychopathology in mid to late childhood. Moreover, low positive affect was predictive of the internalizing-specific factor. Other temperament dimensions were not related with any of the psychopathology factors after accounting for the general psychopathology factor. The results of this study suggest that infant motor activity may act as an early indicator of transdiagnostic risk. Our findings inform the etiology of general psychopathology and have implications for the early identification for children at risk for psychopathology.
Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.
The ability to understand others’ actions and intentions is at the core of human social competence. Action understanding, what it means and how it develops, has received much attention in developmental research because it is viewed as one of the most fundamental abilities in early social-cognitive development. For example, there is a growing body of evidence linking early action understanding with later theory of mind (Brooks & Meltzoff, 2015; Charman et al., 2000; Wellman, Phillips, Dunphy-Lelii, & LaLonde, 2004), and to the development of communicative skills (e.g., Brooks & Meltzoff, 2008). Increasing evidence suggests that the mirror neuron system (MNS) is a key neural correlate of action understanding. In this chapter, we discuss the role the MNS is thought to play in the development of social cognitive skills in infancy. We also discuss the current challenges of measuring the MNS that are unique to work with infants, what such studies have found in both typical and atypical populations, and how this work can impact our understanding of development.
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.
Background: Endovascular thrombectomy (EVT) has shown efficacy in acute ischemic stroke (AIS) patients with infective endocarditis (IE). The possibility to undertake advanced histopathological clot analysis following EVT offers a new avenue to establish the etiological basis of the stroke – which is often labelled “cryptogenic.” In this paper, we present our findings from four consecutive patients with IE who underwent EVT following an AIS at our tertiary referral comprehensive stroke centre. Methods: Comprehensive histopathological analysis of clot retrieved after EVT, including morphology, was undertaken. Results: The consistent observation was the presence of dense paucicellular fibrinoid material mixed/interspersed with clusters of bacterial cocci. This clot morphology may be specific to septic embolus due to IE unlike incidental bacteraemia and could possibly explain the refractoriness of such clots to systemic thrombolysis. Conclusion: Detailed morphological and histopathological analysis of EVT-retrieved clots including Gram staining can assist in etiological classification of the clot. Understanding the composition of the clot may be of clinical value in early diagnostics and mapping treatment planning in IE.
The availability of lidar datasets has led to several advances in archaeology, notably in the process of site prospection. Some remote sensing practitioners have aimed to create automated feature extraction (AFE) techniques that increase the efficiency and efficacy of identification and analysis. While these advances have been successful, many archaeological professionals who might have an interest in lidar-derived products do not have the technical experience to modify or create AFE techniques for particular regions or environments. Additionally, some features are not appropriate for AFE. Instead, the most widely used technique is still likely to be visually based manual feature identification. Using authors of different experience levels, we seek to evaluate the use of manual techniques for feature identification and subsequent analysis by implementing a publicly available lidar-derived digital elevation model (DEM). We demonstrate that manual feature extraction (MFE) can be accurate when more than one researcher is involved in a sort of “checks and balances” process. We also show that the use of confidence ratings can be an important part of this process if those ratings have some systematic and clearly defined underpinning. Finally, we argue, using a case study from American Samoa, that manually identified features can be analytically important as part of larger landscape studies.
Because polarization encodes geometrical information about unresolved scattering regions, it provides a unique tool for analyzing the 3-D structures of supernovae (SNe) and their surroundings. SNe of all types exhibit time-dependent spectropolarimetric signatures produced primarily by electron scattering. These signatures reveal physical phenomena such as complex velocity structures, changing illumination patterns, and asymmetric morphologies within the ejecta and surrounding material. Interpreting changes in polarization over time yields unprecedentedly detailed information about supernovae, their progenitors, and their evolution.
Begun in 2012, the SNSPOL Project continues to amass the largest database of time-dependent spectropolarimetric data on SNe. I present an overview of the project and its recent results. In the future, combining such data with interpretive radiative transfer models will further constrain explosion mechanisms and processes that shape SN ejecta, uncover new relationships among SN types, and probe the properties of progenitor winds and circumstellar material.
η Carinae, the most extreme luminous blue variable in our Galaxy, underwent a Great Eruption in the 1800s and ejected significant mass into the well-known bipolar Homunculus. But η Car's outer ejecta, a spread of dense, nitrogen-rich knots outside the Homunculus, have led to suspicion that the Great Eruption was not this star's first major mass-loss event. We have measured proper motions for nearly 800 distinct features in the outer ejecta using 21 years of HST WFPC2 and ACS imaging. With motions measured across sixteen baselines, we find that the outer ejecta are expanding ballistically and belong to three age groups: one dating to the mid-1200s, another to the mid-1500s, and a third to the early 1800s, associated with but perhaps predating the peak of the Great Eruption. These three age groups are separated in space and radial velocity. There is no evidence for interaction between the dense ejecta that could be powering η Car's soft X-ray shell, which is instead likely driven by fast, rarefied ejecta from the Great Eruption striking the older dense ejecta. The thirteenth-century event was strikingly asymmetric, ejecting mass almost entirely to one side of the star. The sixteenth-century event displays bipolar symmetry, but along a different axis than the current Homunculus. These observations provide constraints on theoretical models of η Car's behavior, as viable models must explain the repetition, timescale, and asymmetry of these major mass-loss events. For more details, see Kiminki, Reiter, & Smith (2016, MNRAS, 463, 845).
During the Cretaceous and Paleogene, the Indian subcontinent was isolated as it migrated north from the east coast of Africa to collide with Asia. As it passed over the Reunion hotspot in the late Maastrichtian–early Danian, a series of lava flows extruded, known as the Deccan Traps. Also during this interval, there was a major mass-extinction event at the Cretaceous–Paleogene boundary, punctuated by a meteorite impact at Chicxulub, Mexico. What were the biological implications of these changes in paleogeography and the extensive volcanism in terms of biodiversity, evolution, and biogeography? By combining chronostratigraphic, paleosol, and paleobotanical data, an understanding of how the ecosystems and climates changed and the relative contributions of the Chicxulub impact, Deccan Traps volcanism, and paleogeographic isolation can be gained. Understanding relative ages of paleobotanical localities is crucial to determining floristic changes, and is challenging because different methods (e.g., magnetostratigraphy, radiometric dating, vertebrate and microfossil biostratigraphy) sometimes give conflicting answers, or have not been done for paleobotanical localities. Climatic data can be obtained quantitatively by studying paleosol geochemistry, as well as qualitatively by examining functional traits and nearest living relatives of fossil plants. An additional challenge is revising macrofossil data, which includes some confidently identified taxa and others with uncertain affinities. This is important for understanding ecosystem composition both spatially and temporally, as well as the biogeographic implications of an isolated India.
We present the observed “continuum” levels of polarization as a function of time for four well-observed Type II-Plateau supernovae (SNe II-P; Fig. 1), the class of SNe decisively determined to arise from red supergiant stars (Smartt 2009). All four objects show temporally increasing degrees of polarization through the end of the photospheric phase, with some exhibiting early-time polarization that challenge existing models (e.g., Dessart and Hillier 2011) to reproduce. A fundamental ejecta asymmetry is present in this photometrically diverse sample of type II SNe, and it probably takes different forms (e.g., 56Ni blobs/fingers, large scale deformation). We acknowledge support from NSF grants AST-1009571 and AST-1210311.
In this note we study properties of partially ample line bundles on simplicial projective toric varieties. We prove that the cone of q-ample line bundles is a union of rational polyhedral cones, and calculate these cones in examples. We prove a restriction theorem for big q-ample line bundles, and deduce that q-ampleness of the anticanonical bundle is not invariant under flips. Finally we prove a Kodaira-type vanishing theorem for q-ample line bundles.
While there is increasing recognition among archaeologists of the extent to which non-agricultural societies have managed their terrestrial ecosystems, the traditional management of marine ecosystems has largely been ignored. In this paper, we bring together Indigenous ecological knowledge, coastal geomorphological observations, and archaeological data to document how Northwest Coast First Nations cultivated clams to maintain and increase productivity. We focus on “clam gardens,” walled intertidal terraces constructed to increase bivalve habitat and productivity. Our survey and excavations of clam gardens in four locations in British Columbia provide insights into the ecological and social context, morphology, construction, and first reported ages of these features. These data demonstrate the extent of traditional maricultural systems among coastal First Nations and, coupled with previously collected information on terrestrial management, challenge us to broaden our definition of “forager” as applied to Northwest Coast peoples. This study also highlights the value of combining diverse kinds of knowledge, including archaeological data, to understand the social and ecological contexts of traditional management systems.
ZnO nanowire (NW) arrays were examined with Transmission Electron Microscopy (TEM) in cross-section after preparation by Focused Ion Beam (FIB) milling. This technique revealed that ZnO nanowires grown using a Au catalyzed vapor technique typically have Au particles at the NW tips, and also randomly dispersed across the base crystal growth that joins adjacent NWs. It is shown the adjacent NWs and the combined base growth is one crystal structure which can be used as a back electrical contact making fabrication of vertical array devices possible. However, the base growth displays detrimental features such as embedded Au particles and lattice defects which can affect the electrical output through depletion regions and scattering centers. In an effort to overcome these problems we investigate a growth method that is nucleated through a minor alteration of the a-plane sapphire surface roughness via a weak chemical etch. Observations of various stages of the growth show the growth nucleates as separate nanoislands that grow in c-plane alignment with Sapphire (1-210), and as growth continues these islands meet and form a polycrystalline film. Further growth initiates nanowire growth and the formation of a single crystal base layer and NW structure that can cover several square millimeter’s. This allows high quality arrays that are relatively free from defects to be formed without any metals contamination and ready for further device processing.