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Due to concerns over increasing fluoroquinolone (FQ) resistance among gram-negative organisms, our stewardship program implemented a preauthorization use policy. The goal of this study was to assess the relationship between hospital FQ use and antibiotic resistance.
Large academic medical center.
We performed a retrospective analysis of FQ susceptibility of hospital isolates for 5 common gram-negative bacteria: Acinetobacter spp., Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Primary endpoint was the change of FQ susceptibility. A Poisson regression model was used to calculate the rate of change between the preintervention period (1998–2005) and the postimplementation period (2006–2016).
Large rates of decline of FQ susceptibility began in 1998, particularly among P. aeruginosa, Acinetobacter spp., and E. cloacae. Our FQ restriction policy improved FQ use from 173 days of therapy (DOT) per 1,000 patient days to <60 DOT per 1,000 patient days. Fluoroquinolone susceptibility increased for Acinetobacter spp. (rate ratio [RR], 1.038; 95% confidence interval [CI], 1.005–1.072), E. cloacae (RR, 1.028; 95% CI, 1.013–1.044), and P. aeruginosa (RR, 1.013; 95% CI, 1.006–1.020). No significant change in susceptibility was detected for K. pneumoniae (RR, 1.002; 95% CI, 0.996–1.008), and the susceptibility for E. coli continued to decline, although the decline was not as steep (RR, 0.981; 95% CI, 0.975–0.987).
A stewardship-driven FQ restriction program stopped overall declining FQ susceptibility rates for all species except E. coli. For 3 species (ie, Acinetobacter spp, E. cloacae, and P. aeruginosa), susceptibility rates improved after implementation, and this improvement has been sustained over a 10-year period.
Semantic memory may be impaired in clinically recognized states of cognitive impairment. We investigated the relationship between semantic memory and depressive symptoms (DS) in patients with cognitive impairment.
323 cognitively healthy controls and 848 patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer's disease (AD) dementia were included. Semantic knowledge for famous faces, world capitals, and word vocabulary was investigated.
Compared to healthy controls, we found a statistically significant difference of semantic knowledge in the MCI groups and the AD group, respectively. Results of the SCD group were mixed. However, two of the three semantic memory measures (world capitals and word vocabulary) showed a significant association with DS.
We found a difference in semantic memory performance in MCI and AD as well as an association with DS. Results suggest that the difference in semantic memory is due to a storage loss rather than to a retrieval problem.
Health-related quality of life (HRQOL) is an important issue in the context of dementia care. The purpose of this study was to investigate the association between HRQOL and depressive symptoms in patients with subjective cognitive decline (SCD) and subtypes of mild cognitive impairment (MCI) and Alzheimer´s disease (AD).
In this cross-sectional, observational study, a control group and four experimental groups (SCD, non-amnestic MCI, amnesticMCI, AD) were compared. Neuropsychological measurers (NTBV) and psychological questionnaires were used for data collection.
The control group scored higher than patients with SCD, naMCI, aMCI, or AD for the Mental Health Component Score (MHCS) of the Short Form of the Health Survey (SF-36). The Physical Health Component Score (PHCS) of the SF-36 differed only between some groups. Furthermore, cognitive variables were more strongly associated with the physical aspects of HRQOL, whereas depressive symptoms were more strongly related with the mental aspects of HRQOL.
HRQOL and depressive symptoms are closely related in patients with cognitive impairments. Therefore, it is of great importance to assess patients with subjective impairment carefully in terms of depressive symptoms.
We have presented new observations of the ionized gas, molecular gas and cool dust in the Helix nebula (NGC 7293). The ionized gas is observed in the form of a Hα image, which is constructed using images from the Southern H-Alpha Sky Survey Atlas (SHASSA). The molecular emission was mapped using the H2v = 1 → 0 s(1) line at 2.122μm. The far-infrared (FIR) observations were obtained using ISOPHOT on the Infrared Space Observatory (ISO).
Deficits in facial emotion recognition (FER) have been shown to substantially impair several aspects in everyday life of affected individuals (e.g. social functioning). Presently, we aim at assessing differences in emotion recognition performance in three patient groups suffering from mild forms of cognitive impairment compared to healthy controls.
Performance on a concise emotion recognition test battery (VERT-K) of 68 patients with subjective cognitive decline (SCD), 44 non-amnestic (non-aMCI), and 25 amnestic patients (aMCI) with mild cognitive impairment (MCI) was compared with an age-equivalent sample of 138 healthy controls all of which were recruited within the framework of the Vienna Conversion to Dementia Study. Additionally, patients and controls underwent individual assessment using a comprehensive neuropsychological test battery examining attention, executive functioning, language, and memory (NTBV), the Beck Depression Inventory (BDI), and a measure of premorbid IQ (WST).
Type of diagnosis showed a significant effect on emotion recognition performance, indicating progressively deteriorating results as severity of diagnosis increased. Between-groups effect sizes were substantial, showing non-trivial effects in all comparisons (Cohen's ds from −0.30 to −0.83) except for SCD versus controls. Moreover, emotion recognition performance was higher in women and positively associated with premorbid IQ.
Our findings indicate substantial effects of progressive neurological damage on emotion recognition in patients. Importantly, emotion recognition deficits were observable in non-amnestic patients as well, thus conceivably suggesting associations between decreased recognition performance and global cognitive decline. Premorbid IQ appears to act as protective factor yielding lesser deficits in patients showing higher IQs.
Germany has been an officially bovine tuberculosis (bTB)-free (OTF) country since 1996. Gradually rising numbers of bTB herd incidents due to Mycobacterium bovis and M. caprae in North-Western and Southern Germany during the last few years prompted the competent authorities to conduct a nationwide bTB survey in 2013/2014. This led to the detection of a dairy herd in which as many as 55 cattle reacted positively to consecutive intra vitam testing. Test-positive animals lacked visible lesions indicative of bTB at necropsy. Extensive mycobacterial culturing as well as molecular testing of samples from 11 tissues for members of the M. tuberculosis complex (MTC) yielded negative results throughout. However, caseous lymphadenitis of Ln. mandibularis accessorius was observed during meat inspection of a fattening pig from the same farm at regular slaughter at that time. Respective tissue samples tested MTC positive by polymerase chain reaction, and M. tuberculosis T1 family were identified by spoligotyping. Four human reactors within the farmer's family were also found to be immunoreactive. As exposure of livestock to M. tuberculosis is not generally considered, its impact may result in regulatory and practical difficulties when using protocols designed to detect classical bTB, particularly in OTF countries.
We describe a laboratory plasma physics experiment at Los Alamos National Laboratory that uses two merging supersonic plasma jets formed and launched by pulsed-power-driven railguns. The jets can be formed using any atomic species or mixture available in a compressed-gas bottle and have the following nominal initial parameters at the railgun nozzle exit: ne ≈ ni ~ 1016 cm−3, Te ≈ Ti ≈ 1.4 eV, Vjet ≈ 30–100 km/s, mean charge
≈ 1, sonic Mach number Ms ≡ Vjet/Cs > 10, jet diameter = 5 cm, and jet length ≈20 cm. Experiments to date have focused on the study of merging-jet dynamics and the shocks that form as a result of the interaction, in both collisional and collisionless regimes with respect to the inter-jet classical ion mean free path, and with and without an applied magnetic field. However, many other studies are also possible, as discussed in this paper.
The goals of this study were to establish prevalence of subjective memory complaints (SMC) and depressive symptoms (DS) and their relation to cognitive functioning and cognitive status in an outpatient memory clinic cohort.
Two hundred forty-eight cognitively healthy controls and 581 consecutive patients with cognitive complaints who fulfilled the inclusion criteria were included in the study.
A statistically significant difference (p < 0.001) between control group and patient group regarding mean SMC was detected. 7.7% of controls reported a considerable degree of SMC, whereas 35.8% of patients reported considerable SMC. Additionally, a statistically significant difference (p < 0.001) between controls and patient group regarding Beck depression score was detected. 16.6% of controls showed a clinical relevant degree of DS, whereas 48.5% of patients showed DS. An analysis of variance revealed a statistically significant difference across all four groups (control group, SCI group, naMCI group, aMCI group) (p < 0.001). Whereas 8% of controls reported a considerable degree of SMC, 34% of the SCI group, 31% of the naMCI group, and 54% of the aMCI group reported considerable SMC. A two-factor analysis of variance with the factors cognitive status (controls, SCI group, naMCI group, aMCI group) and depressive status (depressed vs. not depressed) and SMC as dependent variable revealed that both factors were significant (p < 0.001), whereas the interaction was not (p = 0.820).
A large proportion of patients seeking help in a memory outpatient clinic report considerable SMC, with an increasing degree from cognitively healthy elderly to aMCI. Depressive status increases SMC consistently across groups with different cognitive status.
The current research examined the association between state disfavoured tax on soda (i.e. the difference between soda sales tax and the tax on food products generally) and a summary score representing the strength of state laws governing competitive beverages (beverages that compete with the beverages in the federally funded school lunch programme) in US schools.
The Classification of Laws Associated with School Students (CLASS) summary score reflected the strength of a state's laws restricting competitive beverages sold in school stores, vending machines, school fundraisers and à la carte cafeteria items. Bridging the Gap (BTG) is a nationally recognized research initiative that provided state-level soda tax data. The main study outcome was the states’ competitive beverage summary scores for elementary, middle and high school grade levels, as predicted by the states’ disfavoured soda tax. Univariate and multivariate analyses were conducted, adjusting for year and state.
Data from BTG and CLASS were used.
BTG and CLASS data from all fifty states and the District of Columbia from 2003 to 2010 were used.
A higher disfavoured soda sales tax was generally associated with an increased likelihood of having strong school beverage laws across grade levels, and especially when disfavoured soda sales tax was >5 %.
These data suggest a concordance between states’ soda taxes and laws governing beverages sold in schools. States with high disfavoured sales tax on soda had stronger competitive beverage laws, indicating that the state sales tax environment may be associated with laws governing beverage policy in schools.
Resonant coupling of an optical mode confined within a microcavity and an emitter is the basic prerequisite for the observation of Bose-Einstein condensation phenomena and the development of novel optical devices based on cavity polaritons.
We demonstrate highly spatially resolved 2” wafer characterization of the reflectivity and emission properties of a nitride based multi quantum well semi microcavity (i.e. structure without top Bragg reflector) to verify resonant regions. Photoluminescence and reflectivity spectra recorded at the same positions on the wafer exhibit a strong spatial dependence of the multi quantum well emission and the center wavelength of the stop band of the bottom Bragg reflector across the sample. Resonance, i.e., matching of the emission and the center wavelength of the stop band, is found in a region 8 mm off the center of the wafer.
The thickness profile across the AlInN/GaN Bragg reflector and multi quantum well layers was obtained by x-ray mappings over the full wafer. A perfect correlation between the local optical properties and the x-ray thickness distribution is found. Additional transmission electron microscopy investigations indicate a complete crack free structure and smooth interfaces between the layers within the Bragg reflector making the structure appropriate for strong coupling applications.
This paper presents proposals for the synthesis of several group III metal organics (In, Ga, Al compounds) and preliminary results on their use in the MOVPE (metal organic vapor phase epitaxy) of III-V semiconductors. The common feature of all these precursors is that they are saturated by interor intramolecular coordination. They are even non-pyrophoric and air resistant which is an interesting aspect with respect to safe handling. In addition, the compounds are liquid at room temperature with a low but sufficient vapor pressure for MOVPE without additional heating of the source.
Positron lifetime measurements give direct evidence on positron trapping in monovacancy defects in n-type, but not in p-type nor in semi-insulating LEC-grown GaAs. The defects are identified as As vacancies. Two Fermi level controlled transitions have been found in positron lifetime spectra at 0.03±0.01 eV and at 0.10±0.01 eV below the conduction band. We attribute them to the 2-/- and - / 0 ionisation levels of the As vacancy.
The use of ion-beam sputtered Al2O3 to passivate the mirrors of semiconductor injection lasers is described. Dense films, which offer considerable protection against corrosion, can be deposited without damage to the crystal surface. The overall quality of the passivation is demonstrated by long-term stress testing of the lasers.
The compatibility of candidate ceramic reinforcement materials with intermetallic matrices for high temperature composite systems has been evaluated. Powders of FeAl and NiAl were mixed with ceramic powders and consolidated by hot isostatic pressing and subsequent heat treatment. The microstructures of these composites and the nature of the ceramic/matrix interfaces were assessed using a wide variety of electron-beam techniques. The system FeAl/TiB2 was found to be particularly promising. The matrix appears to be bonded to the ceramic particles, which may be the result of diffusion of Fe into the ceramic. The particles stabilized in a previously unreported monoclinic crystal structure, rather than the equilibrium hexagonal form exhibited by the binary compound.
Ga0.5In0.5P has been investigated using optically detected cyclotron resonance and photoluminescence techniques. For the disordered alloy, the electron mass is determined to m*=0.092 m0, and for ordered material (band gap reduction ~ 50 meV) the value m*=0.088 m0 is found. The experimentally deduced values are compared with those obtained from a five-band kp calculation.
Lifetime measurement in Positron Annihilation Spectroscopy (PAS) is applied to the study of free-volume collagen characteristics as a function of concentration. The lifetimes of positrons were obtained by a conventional fast-fast coincidence system. All lifetime data are fitted in three components by using the computer program POSITRON FIT and resolved. For each concentration, lifetime distributions were analyzed in order to obtain the different components, thus we have observed three components of which a long component τ3. This long lived component can be associated with a pick-off annihilation of ortho-positronium (o-Ps) trapped in free volumes of amorphous region. This investigation shows the potential of the positron annihilation spectroscopy technique in the study of biopolymer microstructures.
Electroplating is a key technology in the LIGA process (German acronym for Lithographie (Lithography), Galvano (Electroplating) and Abformung (Moulding)). The electroplating process determines the physical, chemical, and mechanical properties of a device. In the macro environment, the process is empirically understood arid electroplating results are fairly well predictable. For use in the micro environment, in particular in microfabrication of LIGA components with high-aspect-ratios, effects like delamination from the substrate, inhomogeneous material distribution, pores in the material and large grain sizes have to be avoided. It is, therefore, important to investigate the structure and composition of such materials. Various electroplated Permalloy foils have been prepared, which are of interest because of their soft magnetic behaviour and use as materials for microsensors and microactuators. X-ray absorption fine structure (XAFS) and x-ray absorption near edge structure (XANES) have been recorded at the Nickel and Iron K-edges (8333 and 7112 eV respectively) for electroplated Permalloy.
Fourier transform infrared (FTIR) spectroscopy has gained significant attention among the forensic scientists because it shows high sensitivity and selectivity, and offers near-real-time detection. Application of the multivariate statistical techniques for the analysis of the spectra is necessary in order to enable feature extraction, proper evaluation and identification of obtained spectra. In this paper we show the development of a feasible procedure for the characterization of spectroscopic signatures of the explosive materials in the remnants after explosion. In our research especially designed and prepared sample catchers were used during the blasts of three various high explosives: C-4, TNT and PETN. Principal component analysis (PCA) was performed using broad spectral data range (600–4000 cm−1) for sample classification into separate classes. Most of the information contained in spectral data was compressed by PCA in few relevant principal components that explain most of the variance of spectral data. The results show that FTIR spectroscopy in combination with multivariate methods are well suited for identification and differentiation purposes even in very large data sets and could be employed by forensic laboratories for rapid screening analysis.