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 firstname.lastname@example.org
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.
Background: Nosocomial infections cause 4%–56% mortality in newborns. Several epidemiological studies have shown that transmission of opportunistic pathogens from the sink to the patient, including Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and Serratia marcescens are associated with nosocomial infections in neonatal intensive care units (NICUs). In this project, we aimed to develop fast, accurate, and high-throughput multilocus sequence typing assays (HiMLST-Illumina) to detect opportunistic pathogens to assess their distribution in the sink environment of NICUs and their transfer to patients. Methods: Genome sequences of P. aeruginosa (n = 45), S. maltophilia (n = 23) and S. marcescens (n = 34) strains were retrieved from public genome databases to build their pangenomes, using the open-source PGAdb-builder server. The core genome was identified for each opportunistic pathogen and was searched for genes displaying the highest polymorphism. The minimal number of loci to include in a HiMLST-Illumina assay was determined by comparing topology of phylogenetic trees of concatenated loci based on genome similarity, computed as the average nucleotide identity (ANI) score. The primers used for HiMLST-Illumina schemes were designed in silico on a conserved domain and were tested on reference strains of each species. Results: Bioinformatics analyses showed that 3–4 loci (<300 base pairs per locus) distinguished strains with the same performances than ANI scores. The assays were tested using opportunistic pathogen isolates and environmental DNA originating from NICU sinks. The HiMLST-Illumina analysis of environmental DNA revealed the presence of at least 1 of the 3 studied opportunistic pathogens in 50% of sampled drains (n = 20). In a previous sampling, P. aeruginosa was isolated on selective culture media before and 48 hours after disinfection of a sink drain with chlorine. S. marcescens was also isolated from another sink 2 weeks after disinfection. Identification of the isolates was confirmed by HiMLST-Illumina analyses and will be typed to compare with clinical isolates. Conclusions: Initial in silico tests predict a high discriminating power of the HiMLST-Illumina method, suggesting that it would be possible to quickly identify strains of interest in a large number of samples. The power of this method is also in the possibility for molecular typing without a need for cultivation. Preliminary results suggest that sinks are readily colonized by opportunistic pathogens. This HiMLST-Illumina scheme will be applied in a 2-year intensive survey of NICUs in 3 hospitals in Montreal to evaluate the performance of new sink designs in limiting bioaerosol production and transmission of opportunistic pathogens to patients.
In this note, we study the hyperbolic stochastic damped sine-Gordon equation (SdSG), with a parameter β2 > 0, and its associated Gibbs dynamics on the two-dimensional torus. After introducing a suitable renormalization, we first construct the Gibbs measure in the range 0 < β2 < 4π via the variational approach due to Barashkov-Gubinelli (2018). We then prove almost sure global well-posedness and invariance of the Gibbs measure under the hyperbolic SdSG dynamics in the range 0 < β2 < 2π. Our construction of the Gibbs measure also yields almost sure global well-posedness and invariance of the Gibbs measure for the parabolic sine-Gordon model in the range 0 < β2 < 4π.
The equilibrium properties of allocation algorithms for networks with a large number of nodes with finite capacity are investigated. Every node receives a flow of requests. When a request arrives at a saturated node, i.e. a node whose capacity is fully utilized, an allocation algorithm may attempt to reallocate the request to a non-saturated node. For the algorithms considered, the reallocation comes at a price: either extra capacity is required in the system, or the processing time of a reallocated request is increased. The paper analyzes the properties of the equilibrium points of the associated asymptotic dynamical system when the number of nodes gets large. At this occasion the classical model of Gibbens, Hunt, and Kelly (1990) in this domain is revisited. The absence of known Lyapunov functions for the corresponding dynamical system significantly complicates the analysis. Several techniques are used. Analytic and scaling methods are used to identify the equilibrium points. We identify the subset of parameters for which the limiting stochastic model of these networks has multiple equilibrium points. Probabilistic approaches are used to prove the stability of some of them. A criterion of exponential stability with the spectral gap of the associated linear operator of equilibrium points is also obtained.
Behavioral and psychological symptoms of dementia (BPSD), constitute a major clinical component of Alzheimer’s disease (AD). There is a growing interest in BPSD as they are responsible for a large share of the suffering of patients and caregivers, and they strongly determine the patient’s lifestyle and management. Better detection and understanding of these symptoms is essential to provide appropriate management. This article is a consensus produced by the behavioral group of the European Alzheimer’s Disease Consortium (EADC). The aim of this article is to present clinical description and biological correlates of the major behavioral and psychological symptomatology in AD. BPSD is not a unitary concept. Instead, it should be divided into several symptoms or more likely: groups of symptoms, each possibly reflecting a different prevalence, course over time, biological correlate and psychosocial determinants. There is some clinical evidence for clusters within groups of BPSD. Biological studies indicate that patients with AD and BPSD are associated with variations in the pathological features (atrophy, brain perfusion/metabolism, histopathology) when compared to people with AD without BPSD. An individually tailored approach taking all these aspects into account is warranted as it may offer more, and better, pharmacological and non-pharmacological treatment opportunities.
Asking psychiatric in-patients about their drug consumption is unlikely to yield reliable results, particularly where alcohol and illicit drug use is involved. The main aim of this study was to compare spontaneous self-reports of drug use in hospitalized psychiatric patients to biological measures of same. A secondary aim was to determine which personal factors were associated with the use of tobacco, alcohol, and illicit drugs as indicated by these biological measures.
The consumption of substances was investigated using biological measures (urine cotinine, cannabis, opiates, cocaine, amphetamines and barbiturates; blood carbohydrate-deficient transferrin [CDT] and gamma-glutamyl transferase [GGT]) in 486 consecutively admitted psychiatric patients, one day following their hospitalization. Patients’ self-reports of alcohol, tobacco and illicit drugs consumption were recorded. Socio-professional and familial data were also recorded.
The results show a low correlation between biological measures and self-reported consumption of alcohol and illicit drugs. Fifty-two percent of the patients under-reported their consumption of illicit drugs (kappa = .47). Patients with schizophrenia and personality disorders were more likely to disclose their illicit drug consumption relative to patients suffering from mood disorders and alcohol dependence. Fifty-six percent of patients underreported alcohol use, as evaluated by CDT (kappa = .2), and 37% underreported when using the CDT + GGT measure as an indicator. Smoking appeared to be reported adequately. In the study we observed a strong negative correlation between cannabis use and age, a strong correlation between tobacco and cannabis use, and correlations between tobacco, cannabis and alcohol consumption.
This study is the first to compare self-reports and biological measures of alcohol, tobacco and illicit drug uses in a large sample of inpatients suffering from various categories of psychiatric illnesses, allowing for cross-diagnosis comparisons.
Researchers tried to explain the overlap between anxiety and depression by suggesting that some items of self-administered questionnaires were badly selected and that both constructs should rather be considered as multidimensional. Thus, we hypothesise that the Spielberger trait anxiety inventory (TAI) includes items related to depression.
A non-clinical sample of 193 subjects filled out the TAI and the Hospitalised Anxiety–Depression Scale. Factors were postulated on the basis of item content and submitted to confirmatory factor analysis (CFA).
We found five factors: a 10-item anxiety factor containing three factors, a four-item unsuccessfulness factor correlated with the HADS anhedonia factor, and a six-item happiness factor.
The TAI scale encompasses measures of anxiety, depression and well-being. Consequently, the overlap with other measures of depression may result from item selection. This work awaits replication in independent normal and pathological samples.
The bipolar dimension of morningness–eveningness refers to the preferred times of day for achieving various activities (i.e. the phase of the circadian clock). It is validated from a biological point of view, associated with at least one gene and heritable through an epistatic mechanism. It has been used as a proxy to study the relationships between the circadian system, personality and psychopathology: there is a correlation between the evening orientation and depression, extraversion and, probably, impulsivity. Furthermore, there is a possible relationship with temperament in children as theorized by Thomas and Chess. In this paper, we expanded on the hypothesis that impulsive subjects are low in morningness by performing a factor analysis of the Composite Scale of Morningness, Cloninger’s temperament and character inventory, and Spielberger’s trait anxiety inventory in a sample of 129 males. The results can probably be extended to women. Morningness is negatively correlated with novelty seeking (which includes an impulsivity facet), positively correlated with persistence, and independent of character dimensions and trait anxiety. Future research may focus in the involvement of the circadian system in these personality dimensions and facets, and the benefits of adding chronotherapic manipulations in the treatment of the personality disorders.
This study investigated metabolic, endocrine, appetite and mood responses to a maximal eating occasion in fourteen men (mean: age 28 (sd 5) years, body mass 77·2 (sd 6·6) kg and BMI 24·2 (sd 2·2) kg/m2) who completed two trials in a randomised crossover design. On each occasion, participants ate a homogenous mixed-macronutrient meal (pizza). On one occasion, they ate until ‘comfortably full’ (ad libitum) and on the other, until they ‘could not eat another bite’ (maximal). Mean energy intake was double in the maximal (13 024 (95 % CI 10 964, 15 084) kJ; 3113 (95 % CI 2620, 3605) kcal) compared with the ad libitum trial (6627 (95 % CI 5708, 7547) kJ; 1584 (95 % CI 1364, 1804) kcal). Serum insulin incremental AUC (iAUC) increased approximately 1·5-fold in the maximal compared with ad libitum trial (mean: ad libitum 43·8 (95 % CI 28·3, 59·3) nmol/l × 240 min and maximal 67·7 (95 % CI 47·0, 88·5) nmol/l × 240 min, P < 0·01), but glucose iAUC did not differ between trials (ad libitum 94·3 (95 % CI 30·3, 158·2) mmol/l × 240 min and maximal 126·5 (95 % CI 76·9, 176·0) mmol/l × 240 min, P = 0·19). TAG iAUC was approximately 1·5-fold greater in the maximal v. ad libitum trial (ad libitum 98·6 (95 % CI 69·9, 127·2) mmol/l × 240 min and maximal 146·4 (95 % CI 88·6, 204·1) mmol/l × 240 min, P < 0·01). Total glucagon-like peptide-1, glucose-dependent insulinotropic peptide and peptide tyrosine–tyrosine iAUC were greater in the maximal compared with ad libitum trial (P < 0·05). Total ghrelin concentrations decreased to a similar extent, but AUC was slightly lower in the maximal v. ad libitum trial (P = 0·02). There were marked differences on appetite and mood between trials, most notably maximal eating caused a prolonged increase in lethargy. Healthy men have the capacity to eat twice the energy content required to achieve comfortable fullness at a single meal. Postprandial glycaemia is well regulated following initial overeating, with elevated postprandial insulinaemia probably contributing.
The White-winged Snowfinch Montifringilla nivalis nivalis is assumed to be highly threatened by climate change, but this high elevation species has been little studied and the current breeding distribution is accurately known only for a minor portion of its range. Here, we provide a detailed and spatially explicit identification of the potentially suitable breeding areas for the Snowfinch. We modelled suitable areas in Europe and compared them with the currently known distribution. We built a distribution model using 14,574 records obtained during the breeding period that integrated climatic, topographic and land-cover variables, working at a 2-km spatial resolution with MaxEnt. The model performed well and was very robust; average annual temperature was the most important occurrence predictor (optimum between c.-3°C and 0°; unsuitable conditions below -10° and above 5°). The current European breeding range estimated by BirdLife International was almost three times greater than that classified as potentially suitable by our model. Discrepancies between our model and the distribution estimated by BirdLife International were particularly evident in eastern Europe, where the species is poorly monitored. Southern populations are likely more isolated and at major risk because of global warming. These differences have important implications for the supposed national responsibility for conservation of the species and highlight the need for new investigations on the species in the eastern part of its European range.
Though compact polarimetric approaches have been developed and applied in space and geo researching systems they have not been taken into consideration in automotive applications, yet. A sensor system has been designed to conduct polarimetric measurements in the 77 GHz frequency band, which is permitted for automotive usage. This system is able to transceive linearly as well as circularly polarized electromagnetic continuous waves. Depending on the case of application, the frequency output can be set statically or modulated over time within adjustable parameters. Hence, a variety of compact polarimetric modes can be performed and compared with full polarimetric approaches. Two compact polarimetric modes, dual-circular polarimetric mode, and circular-transmit-linear-receive, will be introduced and applied in this contribution. Their operability in this frequency range will be investigated after the microstrip antennas as well as the beam focusing dielectrical lense are characterized. Finally, results of a realistical measurement set-up will confirm the practicability of compact polarimetric approaches for double bounce recognition.
Finding the boundaries of linguistic variants and studying transitions between variants are key interests in classical linguistic geography. However, the definition of boundaries in areal linguistics is vague, and a quantitative characterization of transitions at the interface between dialectal variants is missing. We conceptualize these transitions as gradients, aiming to quantitatively account for the transition patterns which are traditionally only implicitly inferred from visualizations. Fitting of logistic functions in different spatial scopes (profiles as well as surfaces) is proposed as an approach to model the transition at the interface between the dominant usage areas of dialectal variants. Logistic functions can accommodate the breadth of boundary concepts, ranging from sharp isoglosses to transitions with different gradualities. The parameters of the fitted logistic models as well as supplementary measures then allow for the quantitative characterization and comparison of transitions across variables. To demonstrate the proposed methodology, we use Swiss German syntactic data on dialectal variables with a single transition zone.
In the actual context of terrorism targeting children and families, it seems essential to describe different experiences of pediatric psychological emergency devices after such unexpected mass trauma. Here we testify our experience of the psychological emergency care setup dedicated to children and families during the first 48 hours after the terrorist attack of Nice, France, on July 14, 2016. Activated within the hour following the attack, the device included two child psychiatry teams turning over each day, receiving at least 163 individuals (99 children and 64 adults) within the first 2 days. (Disaster Med Public Health Preparedness. 2019;13:144–146)
Using data from a Swiss German dialect syntax survey, this study aims to explore, in a spatially differentiated manner, the correlation between dialectal variation and geographic distances. A linguistic distance was expressed by a measure aggregated from 60 survey questions. To operationalize the possibility of language contact, Euclidean distance, as well as travel times in 2000, 1950 and 1850 between survey sites were used. Going beyond previous work by others, we also explore the covariation of geographic and linguistic distances at the local level, focusing on spatial subsets and individual survey sites, thus being able to paint a more differentiated picture. With the diverse physical landscape of Switzerland making an impact on potential language contact, we find that travel times are a better predictor than Euclidean distance for the syntactic variation in Swiss German dialects. However, on the local scale the difference is not always significant, depending on prevalent topography.
We consider a server with large capacity delivering video files encoded in various resolutions. We assume that the system is under saturation in the sense that the total demand exceeds the server capacity C. In such a case, requests may be rejected. For the policies considered in this paper, instead of rejecting a video request, it is downgraded. When the occupancy of the server is above some value C0 < C, the server delivers the video at a minimal bit rate. The quantity C0 is the bit rate adaptation threshold. For these policies, request blocking is thus replaced with bit rate adaptation. Under the assumptions of Poisson request arrivals and exponential service times, we show that, by rescaling the system, a process associated with the occupancy of the server converges to some limiting process whose invariant distribution is computed explicitly. This allows us to derive an asymptotic expression of the key performance measure of such a policy, namely the equilibrium probability that a request is transmitted at requested bitrate. Numerical applications of these results are presented.
Oral glucose tolerance and insulin sensitivity are common measures, but are determined using various blood sampling methods, employed under many different experimental conditions. This study established whether measures of oral glucose tolerance and oral glucose-derived insulin sensitivity (insulin sensitivity indices; ISI) differ when calculated from venous v. arterialised blood. Critically, we also established whether any differences between sampling methods are consistent across distinct metabolic conditions (after rest v. after exercise). A total of ten healthy men completed two trials in a randomised order, each consisting of a 120-min oral glucose tolerance test (OGTT), either at rest or post-exercise. Blood was sampled simultaneously from a heated hand (arterialised) and an antecubital vein of the contralateral arm (venous). Under both conditions, glucose time-averaged AUC was greater from arterialised compared with venous plasma but importantly, this difference was larger after rest relative to after exercise (0·99 (sd 0·46) v. 0·56 (sd 0·24) mmol/l, respectively; P<0·01). OGTT-derived ISIMatsuda and ISICederholm were lower when calculated from arterialised relative to venous plasma and the arterialised–venous difference was greater after rest v. after exercise (ISIMatsuda: 1·97 (sd 0·81) v. 1·35 (sd 0·57) arbitrary units (au), respectively; ISICederholm : 14·76 (sd 7·83) v. 8·70 (sd 3·95) au, respectively; both P<0·01). Venous blood provides lower postprandial glucose concentrations and higher estimates of insulin sensitivity, compared with arterialised blood. Most importantly, these differences between blood sampling methods are not consistent after rest v. post-exercise, preventing standardised venous-to-arterialised corrections from being readily applied.
Stratified shear flows occur in many geophysical contexts, from oceanic overflows and river estuaries to wind-driven thermocline layers. We explore a turbulent wall-bounded shear flow of lighter miscible fluid into a quiescent fluid of higher density with a range of Richardson numbers
$0.05\lesssim Ri\lesssim 1$
. In order to find a stability parameter that allows close comparison with linear theory and with idealized experiments and numerics, we investigate different definitions of
. We find that a gradient Richardson number defined on fluid interface sections where there is no overturning at or adjacent to the maximum density gradient position provides an excellent stability parameter, which captures the Miles–Howard linear stability criterion. For small
the flow exhibits robust Kelvin–Helmholtz instability, whereas for larger
interfacial overturning is more intermittent with less frequent Kelvin–Helmholtz events and emerging Holmboe wave instability consistent with a thicker velocity layer compared with the density layer. We compute the perturbed fraction of interface as a quantitative measure of the flow intermittency, which is approximately 1 for the smallest
but decreases rapidly as
increases, consistent with linear theory. For the perturbed regions, we use the Thorpe scale to characterize the overturning properties of these flows. The probability distribution of the non-zero Thorpe length yields a universal exponential form, suggesting that much of the overturning results from increasingly intermittent Kelvin–Helmholtz instability events. The distribution of turbulent kinetic energy, conditioned on the intermittency fraction, has a similar form, suggesting an explanation for the universal scaling collapse of the Thorpe length distribution.