To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Wellness is often intimidating. Pursuing it requires significant commitment and carries emotional risk/vulnerability . While fear can be a strong motivator, it can also be the reason one may not try or follow-through with a plan. In most cases, fear prevents us from being able to accomplish what we wish to. In the case of wellness, we found that due to the commitment many were challenged by the fear of not being able to achieve the results and goals they had set for themselves. For example, if one was never taught, or had modeled, how to live a life full of joy, love, and wellness, they will fear a life different than what they were taught, whether by observation or directly. Occasionally it can be more difficult and painful to break a pattern than to live in it . The path to wellness will likely be unique for each and every one of us.
Digital health is rapidly expanding due to surging healthcare costs, deteriorating health outcomes, and the growing prevalence and accessibility of mHealth and wearable technology. Data from Biometric Monitoring Technologies (BioMeTs), including mobile Health and wearables, can be transformed into digital biomarkers that act as indicators of health outcomes and can be used to diagnose and monitor a number of chronic diseases and conditions1. There are many challenges facing digital biomarker development, including a lack of regulatory oversight, limited funding opportunities, general mistrust of sharing personal data, and a shortage of open source data and code. Further, the process of transforming data into digital biomarkers is computationally expensive, and standards and validation methods in digital biomarker research are lacking.
In order to provide a collaborative, standardized space for digital biomarker research and validation, we present the first comprehensive, open source software platform for end-to-end digital biomarker development: The Digital Biomarker Discovery Pipeline (DBDP).
Here we detail the general DBDP framework as well as three robust modules within the DBDP that have been developed for specific digital biomarker discovery use cases.
The clear need for such a platform will accelerate the DBDP’s adoption as the industry standard for digital biomarker development and will support its role as the epicenter of digital biomarker collaboration and exploration.
Alien species are a driver of biodiversity loss, with impacts of different aliens on native species varying considerably. Identifying the contributions of alien species to native species declines could help target management efforts. Globally, seabirds breeding on islands have proven to be highly susceptible to alien species. The breeding colonies of the pink-footed shearwater (Ardenna creatopus) are threatened by the negative impacts of alien mammals. We combined breeding monitoring data with a hierarchical model to separate the effects of different alien mammal assemblages on the burrow occupancy and hatching success of the pink-footed shearwater in the Juan Fernández Archipelago, Chile. We show that alien mammals affected the rates of burrow occupancy, but had little effect on hatching success. Rabbits produced the highest negative impacts on burrow occupancy, whereas the effects of other alien mammals were more uncertain. In addition, we found differences in burrow occupancy between islands regardless of their alien mammal assemblages. Managing rabbits will improve the reproductive performance of this shearwater, but research is needed to clarify the mechanisms by which alien mammals affect the shearwaters and to explain why burrow occupancy varies between islands.
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.
Hot carrier based methods constitute a valuable approach for efficient and silicon compatible sub-bandgap photodetection. Although, hot electron excitation and transfer have been studied extensively on traditional materials such as Au and Ti, reports on alternative materials such as titanium nitride (TiN) are rare. Here, we perform hot hole photodetection measurements on a p-Si/metal thin film junction using Ti, Au and TiN. This material is of interest as it constitutes a refractory alternative to Au which is an important property for plasmonic applications where high field intensities can occur. In contrast to Au, a TiN/Si junction does not suffer from metal diffusion into the Si, which eases the integration with current Si-fabrication techniques. This work shows that a backside illuminated p-Si/TiN system can be used for efficient hot hole extraction in the IR, allowing for a responsivity of 1 mA/W at an excitation wavelength of 1250 nm and at zero bias. Via a comparison between TiN and other commonly used materials such as Au, the origin of this comparably high photoresponse can be traced back to be directly linked to a thin TiO2-x interfacial layer allowing for a distinct hot-hole transfer mechanism. Moreover, the fabrication of TiN nanodisk arrays is demonstrated which bears great promise to further boost the device efficiency.
To evaluate how avian influenza virus (AIV) circulates among the avifauna of the Antarctic and sub-Antarctic islands, we surveyed 14 species of birds from Marion, Livingston and Gough islands. A competitive enzyme-linked immunosorbent assay was carried out on the sera of 147 birds. Quantitative reverse transcription polymerase chain reaction was used to detect the AIV genome from 113 oropharyngeal and 122 cloacal swabs from these birds. The overall seroprevalence to AIV infection was 4.8%, with the only positive results coming from brown skuas (Catharacta antarctica) (4 out of 18, 22%) and southern giant petrels (Macronectes giganteus) (3 out of 24, 13%). Avian influenza virus antibodies were detected in birds sampled from Marion and Gough islands, with a higher seroprevalence on Marion Island (P = 0.014) and a risk ratio of 11.29 (95% confidence interval: 1.40–91.28) compared to Gough Island. The AIV genome was not detected in any of the birds sampled. These results confirm that AIV strains are uncommon among Antarctic and sub-Antarctic predatory seabirds, but they may suggest that scavenging seabirds are the main avian reservoirs and spreaders of this virus in the Southern Ocean. Further studies are necessary to determine the precise role of these species in the epidemiology of AIV.
Blue petrels (Halobaena caerulea Gmelin) rapidly moult their flight feathers in Antarctic waters in February–April, immediately following the breeding season, yet the behaviour of moulting birds at sea has not been described. We observed large numbers of moulting blue petrels off West Antarctica from 67–71°S and 78–119°W in mid-February 2017. Most of these birds probably breed at the Diego Ramirez archipelago, southwest of Cape Horn, which is the closest colony to this area. Moulting petrels often sit on the water in dense flocks, just outside the marginal ice zone, at sea temperatures of -0.7 to 0.9°C. Wing moult is intense, with 7–8 inner primaries (62–75% of primary length and 55–69% of primary mass), their corresponding primary coverts and all greater secondary coverts being grown at the same time. Moulting petrels need a reliable food source during this energetically demanding period, so the waters off West Antarctica are probably crucial for the Diego Ramirez population, which makes up more than half of the world's blue petrels.
The diet of most adults is low in fish and, therefore, provides limited quantities of the long-chain, omega-3 fatty acids (LCn-3FAs), eicosapentaenoic and docosahexaenoic acids (EPA, DHA). Since these compounds serve important roles in the brain, we sought to determine if healthy adults with low-LCn-3FA consumption would exhibit improvements in neuropsychological performance and parallel changes in brain morphology following repletion through fish oil supplementation.
In a randomized, controlled trial, 271 mid-life adults (30–54 years of age, 118 men, 153 women) consuming ⩽300 mg/day of LCn-3FAs received 18 weeks of supplementation with fish oil capsules (1400 mg/day of EPA and DHA) or matching placebo. All participants completed a neuropsychological test battery examining four cognitive domains: psychomotor speed, executive function, learning/episodic memory, and fluid intelligence. A subset of 122 underwent neuroimaging before and after supplementation to measure whole-brain and subcortical tissue volumes.
Capsule adherence was over 95%, participant blinding was verified, and red blood cell EPA and DHA levels increased as expected. Supplementation did not affect performance in any of the four cognitive domains. Exploratory analyses revealed that, compared to placebo, fish oil supplementation improved executive function in participants with low-baseline DHA levels. No changes were observed in any indicator of brain morphology.
In healthy mid-life adults reporting low-dietary intake, supplementation with LCn-3FAs in moderate dose for moderate duration did not affect neuropsychological performance or brain morphology. Whether salutary effects occur in individuals with particularly low-DHA exposure requires further study.
We compared systematic and random survey techniques to estimate breeding population sizes of burrow-nesting petrel species on Marion Island. White-chinned (Procellaria aequinoctialis) and blue (Halobaena caerulea) petrel population sizes were estimated in systematic surveys (which attempt to count every colony) in 2009 and 2012, respectively. In 2015, we counted burrows of white-chinned, blue and great-winged (Pterodroma macroptera) petrels within 52 randomized strip transects (25 m wide, total 144 km). Burrow densities were extrapolated by Geographic Information System-derived habitat attributes (geology, vegetation, slope, elevation, aspect) to generate island-wide burrow estimates. Great-winged petrel burrows were found singly or in small groups at low densities (2 burrows ha−1); white-chinned petrel burrows were in loose clusters at moderate densities (3 burrows ha−1); and blue petrel burrows were in tight clusters at high densities (13 burrows ha−1). The random survey estimated 58% more white-chinned petrels but 42% fewer blue petrels than the systematic surveys. The results suggest that random transects are best suited for species that are widely distributed at low densities, but become increasingly poor for estimating population sizes of species with clustered distributions. Repeated fixed transects provide a robust way to monitor changes in colony density and area, but might fail to detect the formation/disappearance of new colonies.
Natural disasters often damage or destroy the protective public health service infrastructure (PHI) required to maintain the health and well-being of people with noncommunicable diseases (NCDs). This interruption increases the risk of an acute exacerbation or complication, potentially leading to a worse long-term prognosis or even death. Disaster-related exacerbations of NCDs will continue, if not increase, due to an increasing prevalence and sustained rise in the frequency and intensity of disasters, along with rapid unsustainable urbanization in flood plains and storm-prone coastal zones. Despite this, the focus of disaster and health systems preparedness and response remains on communicable diseases, even when the actual risk of disease outbreaks post-disaster is low, particularly in developed countries. There is now an urgent need to expand preparedness and response beyond communicable diseases to include people with NCDs.
The developing evidence-base describing the risk of disaster-related exacerbation of NCDs does not incorporate the perspectives, concerns, and challenges of people actually living with the conditions. To help address this gap, this research explored the key influences on patient ability to successfully manage their NCD after a natural disaster.
A survey of people with NCDs in Queensland, Australia collected data on demographics, disease, disaster experience, and primary concern post-disaster. Descriptive statistics and chi-square tests with a Bonferroni-adjustment were used to analyze data.
There were 118 responses to the survey. Key influences on the ability to self-manage post-disaster were access to medication, medical services, water, treatment and care, power, and food. Managing disease-specific symptoms associated with cardiovascular disease, diabetes, mental health, and respiratory diseases were primary concerns following a disaster. Stress and anxiety, loss of sleep, weakness or fatigue, and shortness of breath were common concerns for all patients with NCDs. Those dependent on care from others were most worried about shortness of breath and slow healing sores. Accessing medication and medical services were priorities for all patients post-disaster.
The key influences on successful self-management post-disaster for people with NCDs must be reflected in disaster plans and strategies. Achieving this will reduce exacerbations or complications of disease and decrease demand for emergency health care post-disaster.
Natural disasters often damage the public health infrastructure required to maintain the wellbeing of people with noncommunicable diseases. This increases the risk of an acute exacerbation or complications, potentially leading to a worse long-term prognosis or even death. Disaster-related exacerbations of noncommunicable diseases will continue, if not increase, due to an increasing disease prevalence, sustained rise in the frequency and intensity of disasters, and rapid unsustainable urbanization in disaster-prone areas. However, the traditional focus of public health and disaster systems remains on communicable diseases, despite a low risk. There is now an urgent need to expand the public health response to include noncommunicable diseases.
To explore the key influences on patient ability to successfully manage their noncommunicable disease after a natural disaster.
A survey of people with noncommunicable diseases in Queensland, Australia, collected data on demographics, disease/condition, disaster experience, and primary concern post-disaster. Descriptive statistics and chi-square tests with Bonferroni-adjustment were used to analyze data.
There were 118 responses to the survey. Key influences on the ability to self-manage post-disaster were access to medication, medical services, water, treatment and care, power, and food. Managing disease-specific symptoms associated with cardiovascular disease, diabetes, mental health, and respiratory diseases were primary concerns following a disaster. Stress and anxiety, loss of sleep, weakness or fatigue and shortness of breath were common concerns for all noncommunicable diseases. Those dependent on care from others were most worried about shortness of breath and slow healing sores. Accessing medication and medical services were priorities for all patients post-disaster.
The key influences on successful self-management post disaster for people with noncommunicable diseases must be reflected in disaster plans and strategies. Achieving this will reduce exacerbations or complications of disease and decrease demand for emergency health care post-disaster.
The provision of artificial nests can improve the conservation status of threatened bird species that are limited by nest-site availability. The shortage of natural cavity nesting sites is one factor limiting the population growth of the Southern Ground Hornbill Bucorvus leadbeateri. In an 1,800 km2 study area in north-eastern South Africa, 31 wooden nest-boxes were installed during 2002–2015. We investigated the relationships between nests, as well as environmental and social factors, with breeding. Generalised linear mixed models were fitted to the observational data and identified positive relationships between breeding attempts and each of home range size and the previous year’s rainfall; as well as positive relationships between breeding success (amongst the groups that attempt breeding) and each of earlier breeding, nest height and thickness of the nest cavity wall. The provision of nest-boxes increased the number of breeding groups and although breeding success also increased initially, it later declined as the density of breeding groups increased above 20 groups. Although nest-boxes alone did not increase overall breeding success, they are an effective conservation tool to enhance the population of Southern Ground Hornbills if spaced optimally, to enhance reproductive output in areas where suitable nest-sites are scarce or lacking.
Astrophysics Telescope for Large Area Spectroscopy Probe is a concept for a National Aeronautics and Space Administration probe-class space mission that will achieve ground-breaking science in the fields of galaxy evolution, cosmology, Milky Way, and the Solar System. It is the follow-up space mission to Wide Field Infrared Survey Telescope (WFIRST), boosting its scientific return by obtaining deep 1–4 μm slit spectroscopy for ∼70% of all galaxies imaged by the ∼2 000 deg2 WFIRST High Latitude Survey at z > 0.5. Astrophysics Telescope for Large Area Spectroscopy will measure accurate and precise redshifts for ∼200 M galaxies out to z < 7, and deliver spectra that enable a wide range of diagnostic studies of the physical properties of galaxies over most of cosmic history. Astrophysics Telescope for Large Area Spectroscopy Probe and WFIRST together will produce a 3D map of the Universe over 2 000 deg2, the definitive data sets for studying galaxy evolution, probing dark matter, dark energy and modifications of General Relativity, and quantifying the 3D structure and stellar content of the Milky Way. Astrophysics Telescope for Large Area Spectroscopy Probe science spans four broad categories: (1) Revolutionising galaxy evolution studies by tracing the relation between galaxies and dark matter from galaxy groups to cosmic voids and filaments, from the epoch of reionisation through the peak era of galaxy assembly; (2) Opening a new window into the dark Universe by weighing the dark matter filaments using 3D weak lensing with spectroscopic redshifts, and obtaining definitive measurements of dark energy and modification of General Relativity using galaxy clustering; (3) Probing the Milky Way’s dust-enshrouded regions, reaching the far side of our Galaxy; and (4) Exploring the formation history of the outer Solar System by characterising Kuiper Belt Objects. Astrophysics Telescope for Large Area Spectroscopy Probe is a 1.5 m telescope with a field of view of 0.4 deg2, and uses digital micro-mirror devices as slit selectors. It has a spectroscopic resolution of R = 1 000, and a wavelength range of 1–4 μm. The lack of slit spectroscopy from space over a wide field of view is the obvious gap in current and planned future space missions; Astrophysics Telescope for Large Area Spectroscopy fills this big gap with an unprecedented spectroscopic capability based on digital micro-mirror devices (with an estimated spectroscopic multiplex factor greater than 5 000). Astrophysics Telescope for Large Area Spectroscopy is designed to fit within the National Aeronautics and Space Administration probe-class space mission cost envelope; it has a single instrument, a telescope aperture that allows for a lighter launch vehicle, and mature technology (we have identified a path for digital micro-mirror devices to reach Technology Readiness Level 6 within 2 yr). Astrophysics Telescope for Large Area Spectroscopy Probe will lead to transformative science over the entire range of astrophysics: from galaxy evolution to the dark Universe, from Solar System objects to the dusty regions of the Milky Way.
This study explored the concept of ‘giving up’ from the perspective of care staff working in care homes, and their everyday communication and hidden knowledge concerning what they think about this taboo topic and the context it reflects. Moving to a care home is a major transition where cumulative losses can pose risks to mental health in later life. If not recognised, this vulnerability can lead to depression which extends to suicide ideation and behaviours in the form of self-harm and self-neglect. Care homes are a significant place of care until death, yet a discourse of silence means that self-harm and suicide is under-reported or not attended to with specialist expertise. The layperson's concept of an older person ‘giving up’ on life is hardly discussed in the literature. This co-produced qualitative study used an inductive approach to explore this phenomenon through focus groups with 33 care staff across four care homes in South-East England. Findings paint a complex picture, highlighting tensions in providing the right support and creating spaces to respond to such challenging situations. ‘Giving up’ requires skilled detailed assessment to respond to risks alongside improved training and support for paid carers, to achieve a more holistic strategy which capitalises on significant relationships within a wider context.
When language users predict upcoming speech, they generate pluralistic expectations, weighted by likelihood (Kuperberg & Jaeger, 2016). Many variables influence the prediction of highly likely sentential outcomes, but less is known regarding variables affecting the prediction of less-likely outcomes. Here we explore how English vocabulary size and self-identification as a native speaker (NS) of English modulate adult bi-/multilinguals’ preactivation of less-likely sentential outcomes in two visual-world experiments. Participants heard transitive sentences containing an agent, action, and theme (The pirate chases the ship) while viewing four referents varying in expectancy by relation to the agent and action. In Experiment 1 (N=70), spoken themes referred to highly expected items (e.g., ship). Results indicate lower skill (smaller vocabulary size) and less confident (not identifying as NS) bi-/multilinguals activate less-likely action-related referents more than their higher skill/confidence peers. In Experiment 2 (N=65), themes were one of two less-likely items (The pirate chases the bone/cat). Results approaching significance indicate an opposite but similar size effect: higher skill/confidence listeners activate less-likely action-related (e.g., bone) referents slightly more than lower skill/confidence listeners. Results across experiments suggest higher skill/confidence participants more flexibly modulate their linguistic predictions per the demands of the task, with similar but not identical patterns emerging when bi-/multilinguals are grouped by self-ascribed NS status versus vocabulary size.
King penguins (Aptenodytes patagonicus Miller) are major consumers in the Southern Ocean. The colony at Ile aux Cochons, Iles Crozet, in the southern Indian Ocean was known in the 1980s as the largest king penguin colony and the second largest penguin colony in the world. However, there have not been any recent estimates of this colony. Aerial photographs taken from a helicopter, and satellite images were used to report on changes in the colony and population sizes over the past 50 years. The colony has declined by 88% over the past 35 years, from c. 500 000 pairs to 60 000 pairs. The possible causes of this decline were explored but no plausible explanation for such an unprecedented decrease in penguin populations was found. The study highlights the use of satellite imagery as a non-invasive technique for population monitoring, and stresses the need for further research on the causes of this alarming trend in this colony.
Children with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.
Materials and methods
We sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation.
A total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease.
The overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.