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The stable isotope ratios of carbon (δ13C) and nitrogen (δ15N) and total mercury concentrations (THg) of the three marine catfish species Aspistor luniscutis, Bagre bagre and Genidens genidens were evaluated to understand their trophic relationship in northern Rio de Janeiro state, south-eastern Brazil. The δ13C was similar among the three marine catfishes, whereas δ15N was similar in A. luniscutis and B. bagre and lower in G. genidens. THg was higher in G. genidens and lower in B. bagre. The greater assimilation of Sciaenidae fishes and squids by A. luniscutis and B. bagre resulted in smaller isotopic niche areas and trophic diversity but higher isotopic niche overlap, trophic redundancy and evenness. For G. genidens, the similar assimilation of all prey items resulted in the broadest isotopic niche among the marine catfishes. The higher mercury content in G. genidens is consistent with an increased important contribution of prey with a higher Hg burden. The bioaccumulation process was indicated by significant correlations of δ15N and THg with total length and total mass. Additionally, a significant correlation between THg and δ15N reflected the biomagnification process through the food web.
Creating and assessing relatively broad conservation education curricula is important when trying to reach a variety of students. We used a curriculum centred around a storybook in 12 schools in four separate areas of Indonesia, reaching 529 students. We visited each school twice, and taught the ecology and importance of the target taxa, Indonesia’s seven threatened slow loris species (Nycticebus spp.). Through cultural consensus analyses and structural equation modelling, we found that students from all regions showed improvements in knowledge, and that the distance from the forest to where children lived, teachers’ use of given education materials, and students’ use of the storybook all affected student performance in drawing and essay accuracy. Here we make suggestions for creating and evaluating multi-site environmental education programmes. We recommend creating curricula that are not inclusive of any particular community; providing teachers with materials to supplement a conservation intervention; giving each child their own copy of any visual materials used in the lessons; following up with students and teachers about the use of such materials; and interviewing teachers and students regarding their experience with and attitudes towards the study subject. Furthermore we suggest practitioners share their materials and have confidence in adapting them for other species and locations.
Cipo Canastero Asthenes luizae is a relict ovenbird restricted to rocky outcrops at high elevations within the campo rupestre vegetation of the Espinhaço Range in the state of Minas Gerais, south-eastern Brazil. This poorly known species is considered ‘Near Threatened’, but recent studies have suggested that it should be listed under a higher category of threat. To contribute to the knowledge of this species and its conservation assessment and related planning, we compiled all literature records of the species distribution (n = 16 locations), collected new data on its occurrence (n = 72 locations), and calculated its geographic range using four different approaches. First, we defined the sky islands where the species occurs (nine units) using the lowest elevation value recorded (1,100 m asl) as a cut-off. Second, we performed species distribution modelling (SDM) across the sky islands and identified an area of 2,225.21 km2. Third, we measured the species’ extent of occurrence (EOO = 24,555.85 km2) and used SDM to estimate its upper limit (EOOup = 30,697.58 km2). Fourth, we measured the area of occupancy (AOO = 228 km2) and used SDM to estimate its upper limit (AOOup = 1,827.39 km2). We analysed the Cipo Canastero sky islands in terms of landscape metrics including size, isolation, protected area coverage, shape index, core area index, and proportion covered by SDM. We observed a very fragmented distribution, especially in the North sector of the species distribution, composed of small and isolated populations (separated by up to 112 km); the South sector is the core of its distribution and is composed of larger, more connected patches with differences in shape complexity that are not strongly influenced by an edge effect. The range sizes calculated, along with other reported information regarding population and habitat trends, justifies the inclusion of the species in at least the ‘Vulnerable’ category.
Phragmolites lissoni new species is described from 11 specimens found in the Sandbian Calapuja Formation near Calapuja in Peru. The deposits are part of the Central Andean Basin. This is the hitherto only systematically described Ordovician gastropod from Peru. The species is from a brachiopod-dominated siliciclastic sequence and is associated with bryozoans. Most specimens are preserved as external molds, but latex casts yield excellent details of shell ornamentation and are used as a basis for evaluating this feature in the genus. The characteristic ornamentation of Phragmolites should be called corrugated lamellae, and the individual elements on these should be referred to as flutes. A descriptive terminology for these is suggested. The development and shape of the corrugated lamellae and flutes could be biomechanical process. A second component in lamellar formation is the alternation between regular incremental growth and formation of a lamella. Phragmolites is mainly found in shallow-water carbonate facies from tropical latitudes in the Sandbian and a mid-latitude presence in Peru is unexpected. Brachiopods from the same section in Calapuja show affinities with faunas of the Mediterranean margin of Gondwana but also weak links with Avalonia. Phragmolites is found abundantly in deeper-water facies in Laurentia, and a broad tolerance to facies and temperature and possible planktotrophy might have allowed a wide geographical dispersal of the genus. The scant record of Ordovician gastropods in the Central Andean Basin precludes comparison with the disparate record of the Ordovician gastropod taxa from the Precordillera, which do not include Phragmolites.
Surgical site infections (SSIs) are common surgical complications that lead to increased costs. Depending on payer type, however, they do not necessarily translate into deficits for every hospital.
We investigated how surgical site infections (SSIs) influence the contribution margin in 2 reimbursement systems based on diagnosis-related groups (DRGs).
This preplanned observational health cost analysis was nested within a Swiss multicenter randomized controlled trial on the timing of preoperative antibiotic prophylaxis in general surgery between February 2013 and August 2015. A simulation of cost and income in the National Health Service (NHS) England reimbursement system was conducted.
Of 5,175 patients initially enrolled, 4,556 had complete cost and income data as well as SSI status available for analysis. SSI occurred in 228 of 4,556 of patients (5%). Patients with SSIs were older, more often male, had higher BMIs, compulsory insurance, longer operations, and more frequent ICU admissions. SSIs led to higher hospital cost and income. The median contribution margin was negative in cases of SSI. In SSI cases, median contribution margin was Swiss francs (CHF) −2045 (IQR, −12,800 to 4,848) versus CHF 895 (IQR, −2,190 to 4,158) in non-SSI cases. Higher ASA class and private insurance were associated with higher contribution margins in SSI cases, and ICU admission led to greater deficits. Private insurance had a strong increasing effect on contribution margin at the 10th, 50th (median), and 90th percentiles of its distribution, leading to overall positive contribution margins for SSIs in Switzerland. The NHS England simulation with 3,893 patients revealed similar but less pronounced effects of SSI on contribution margin.
Depending on payer type, reimbursement systems with DRGs offer only minor financial incentives to the prevention of SSI.
Asthma-obesity is a multifactorial disease with specific asthma phenotypes that aggravate due to overweight and an unbalanced diet. Furthermore, obese asthmatic patients are corticotherapy-resistant. Therefore, the aims of the present study were to evaluate the effects of an interdisciplinary intervention on food consumption, body composition, lung function and adipokines in asthmatic and non-asthmatic obese adolescents and to investigate the influence of nutrients on lung function. Obese non-asthmatic (n 42) and obese asthmatic (n 21) adolescents of both sexes were enrolled in the present study. Food intake, adipokine levels, body composition, asthma symptoms and lung function were assessed across the study. After the intervention of 1 year, there was a reduction (P ≤ 0·01) in BMI, body fat percentage, visceral and subcutaneous fat and an increase (P ≤ 0·01) in lean mass and all lung function variables in both groups, except the relation between forced expiratory volume in 1 s and forced vital capacity (FEV1:FVC) in non-asthmatic patients. Moreover, both groups decreased lipid and cholesterol consumption (P ≤ 0·01). The highest energy consumption (β = −0·021) was associated with lower values of FVC. Similarly, carbohydrate consumption (β = −0·06) and cholesterol were negative predictors (β = −0·05) in FEV1:FVC. However, the consumption of Ca (β = 0·01), fibres (β = 1·34) and vitamin A (β = 0·01) were positive predictors of FEV1:FVC. Asthma-obesity interdisciplinary treatment promoted an improvement on food consumption and lung function in adolescents and demonstrated that the consumption of nutrients influenced an increase in lung function.
Xenarthra is an endemic South American lineage of mammals, probably the sister clade of the other placental mammals. The oldest records of Xenarthra are from the latest Paleocene, although its current diversity is much lower than that recorded in some intervals of the Cenozoic Era. A new Neogene Xenarthra (Pilosa and Cingulata) assemblage from two localities of the Argentine Eastern Puna (Calahoyo and Casira) is described. The newly recorded taxa—Cingulata, Dasypodidae, Eutatini: Stenotatus sp. indet. and Eutatini indet., Euphractini: Macrochorobates scalabrinii (Moreno and Mercerat, 1891), and Tardigrada, Mylodontinae: cf. Simomylodon sp. indet. and Simomylodon cf. S. uccasamamensis Saint-André et al., 2010—and those already published from Calahoyo—Cingulata: Macrochorobates chapadmalensis (Ameghino, 1908), Eosclerocalyptus sp. indet., and Tardigrada, Megatheriidae: Pyramiodontherium bergi (Moreno and Mercerat, 1891)—suggest a middle–late Miocene age for the fossil-bearing levels. In Calahoyo, the presence of Stenotatus sp. indet., in addition to some rodents currently under study in the lower levels, suggest a closer similarity with the palaeofauna of Cerdas (southern Bolivia), probably involving the last part of the Miocene Climatic Optimum. The Xenarthra recorded in the middle and upper levels of Calahoyo and Casira suggest a late Miocene–Pliocene age. A comparative analysis between Calahoyo and Casira highlights the absence of Cingulata in the latter and a high diversity in the former. This situation probably indicates different paleoenvironmental conditions. Finally, we present the first certain record of the genus Simomylodon Saint-André et al., 2010 in Argentina, which includes the oldest record of dermal ossicles for sloths in South America.
Femoral vein access is the first choice for percutaneous atrial septal defect closure, and when it cannot be used due to anatomic reasons, the alternative sites should be considered, frequently increasing the complexity of the procedure. Here we report the case of a 3-year-old boy, with situs inversus and dextrocardia, electively referred for percutaneous closure of an ostium secundum atrial septal defect. During the procedure, agenesis of the infra-hepatic segment of the inferior caval vein was diagnosed, and no double inferior caval vein or right superior caval vein were identified by ultrasound or angiography. Therefore, we opted to perform the procedure through the left internal jugular vein, with fluoroscopy and transesophageal echocardiographic guidance. Catheters were navigated through a hydrophilic guidewire, and a Stiff guidewire was positioned in the left ventricle for better support. An Amplatzer septa occluder 19 was successfully deployed without major difficulties and the patient was discharged after 24 hours in good clinical condition. Percutaneous atrial septal defect closure through alternative access sites, especially in the presence of situs inversus, may pose significant challenges to the interventional team. In this case, the left internal jugular vein has shown to be a feasible option, allowing the navigation and manipulation of devices without complications. Provided the expertise of the interventional team, and awareness of the risks involved, alternative access sites can be successfully used for paediatric structural interventions.
Floriculture value exceeds $5.8 billion in the United States. Environmental challenges, market trends, and diseases complicate breeding priorities. To inform breeders’ and geneticists’ research efforts, we set out to gather consumers’ preferences in the form of willingness to pay (WTP) for different rose attributes in a discrete choice experiment. The responses are modeled in WTP space, using polynomials to account for heterogeneity. Consumer preferences indicate that heat and disease tolerance were the most important aspects for subjects in the sample, followed by drought resistance. To the best of our knowledge, this is the first study to identify breeding priorities in rosaceous plants from a consumer perspective.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
The electricity sector is in the midst of a structural change driven by new technologies. In Brazil, the electricity sector regulation has mechanisms to foster innovation, including investments in R&D. Recently, the regulatory agency and the industry have been calling for approaches to increase the rate at which R&D departments generate solutions that end up being adopted. As a result, novel approaches to R&D project management have entered the agenda. In this context, the objective of this paper is to characterise Agile Product Development and its application in a highly regulated sector. The paper presents a systematic literature review with the debates about Agile and new product development. Then, a case study exploring an early adoption of the Agile approach in R&D project management in the Brazilian electricity sector is presented. Results include the identification of the Agile features most frequently mentioned in the literature. Moreover, the case study explores the Agile features that were more easily absorbed in early adoption, such as iterative patterns, and discusses implementation challenges in team structure, feedback loops, and communication.
Following a mid twelfth-century BC demographic crisis, Frattesina, in northern Italy, arose as a prominent hub linking continental Europe and the Mediterranean, as evidenced by the remarkable variety of exotic materials and commodities discovered at the site. Debate persists, however, about the extent to which migrants influenced the foundation and development of Frattesina. The authors present the results of strontium isotope analyses, which suggest significant migration to the site, particularly of elites, mostly from within a 50km radius. Among these non-indigenous people, the authors identify a ‘warrior-chief’, whom they interpret as representing a new, more hierarchical society.
Several elicitors, stimulating induced resistance mechanisms, have potential in preventing or mitigating pathogen infections. Some of these compounds, triggering the production of jasmonic acid (JA), a precursor of herbivore-induced plant volatiles, could also play a central role in indirect resistance to pest species, by improving beneficial arthropod performance, and necrotrophic pathogens. In the current work, Trichoderma gamsii/T. asperellum and silica gel treatments – alone and in combination – were studied to evaluate the plant defence mechanism on grapevines (Vitis vinifera L.) by laboratory and field trials. JA production level was measured before and after Plasmopara viticola infection on potted vines. JA production induced by silica gel was higher than that caused by Trichoderma before infection. In Trichoderma-treated plants, JA production increased after P. viticola inoculation. In vineyard field trials, Mymaridae (Hymenoptera: Chalcidoidea) showed higher captures in transparent sticky traps on silica gel-treated plants, in comparison with control. On the other hand, no significant attraction was detected for Ichneumonoidea and other Chalcidoidea in silica gel and T. gamsii/T. asperellum-treated plants. The potential effects of elicitors are discussed, in the frame of attract and reward strategy.
Optimizing interfaces between photosynthetic natural photoconverters, like photosynthetic bacterial Reaction Centers (RCs) and electrode surfaces represents a challenge in the progress of bio-optoelectronic devices. The features of the surfaces may result detrimental for the tertiary and quaternary structures of the RC, even resulting in the denaturation of the enzyme. Functional surfaces possessing both confinement capability and conductive features able to preserve the conformation of the biomolecule and its bioelectronic behaviours are highly needed. In this work, the RC is adsorbed on diatomaceous silica and plasma treated hydrophobic silicon based materials. Both the materials are demonstrated to be able to preserve and enhance the RC photoconverting activity. In particular, we evaluate the functioning of isolated bacterial RC interacting with flat pSi electrode through two nanotextured interfaces designed to address the RC: a thin conductive silicon film nanotextured in pillars via plasma treatment, and a cast film of nanostructured dielectric biosilica obtained from diatomaceous earth. The characterization of these interfaces, together with the RC photocurrent production measurements, pave the way to new generation RC based bio-devices for photocurrent investigation.
We present a scintillator-based detector able to measure the proton energy and the spatial distribution with a relatively simple design. It has been designed and built at the Spanish Center for Pulsed Lasers (CLPU) in Salamanca and tested in the proton accelerator at the Centro de Micro-Análisis de Materiales (CMAM) in Madrid. The detector is capable of being set in the high repetition rate (HRR) mode and reproduces the performance of the radiochromic film detector. It represents a new class of online detectors for laser–plasma physics experiments in the newly emerging high power laser laboratories working at HRR.
The deformation of elementary fluid volumes by velocity gradients is a key process for scalar mixing, chemical reactions and biological processes in flows. Whilst fluid deformation in unsteady, turbulent flow has gained much attention over the past half-century, deformation in steady random flows with complex structure – such as flow through heterogeneous porous media – has received significantly less attention. In contrast to turbulent flow, the steady nature of these flows constrains fluid deformation to be anisotropic with respect to the fluid velocity, with significant implications for e.g. longitudinal and transverse mixing and dispersion. In this study we derive an ab initio coupled continuous-time random walk (CTRW) model of fluid deformation in random steady three-dimensional flow that is based upon a streamline coordinate transform which renders the velocity gradient and fluid deformation tensors upper triangular. We apply this coupled CTRW model to several model flows and find that these exhibit a remarkably simple deformation structure in the streamline coordinate frame, facilitating solution of the stochastic deformation tensor components. These results show that the evolution of longitudinal and transverse fluid deformation for chaotic flows is governed by both the Lyapunov exponent and power-law exponent of the velocity probability distribution function at small velocities, whereas algebraic deformation in non-chaotic flows arises from the intermittency of shear events following similar dynamics as that for steady two-dimensional flow.
The objective was to compare the performance of the updated Charlson comorbidity index (uCCI) and classical CCI (cCCI) in predicting 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB). All cases of SAB in patients aged ⩾14 years identified at the Microbiology Unit were included prospectively and followed. Comorbidity was evaluated using the cCCI and uCCI. Relevant variables associated with SAB-related mortality, along with cCCI or uCCI scores, were entered into multivariate logistic regression models. Global model fit, model calibration and predictive validity of each model were evaluated and compared. In total, 257 episodes of SAB in 239 patients were included (mean age 74 years; 65% were male). The mean cCCI and uCCI scores were 3.6 (standard deviation, 2.4) and 2.9 (2.3), respectively; 161 (63%) cases had cCCI score ⩾3 and 89 (35%) cases had uCCI score ⩾4. Sixty-five (25%) patients died within 30 days. The cCCI score was not related to mortality in any model, but uCCI score ⩾4 was an independent factor of 30-day mortality (odds ratio, 1.98; 95% confidence interval, 1.05–3.74). The uCCI is a more up-to-date, refined and parsimonious prognostic mortality score than the cCCI; it may thus serve better than the latter in the identification of patients with SAB with worse prognoses.
Ultraluminous X-ray sources (ULXs) are end points of stellar evolution. They are mostly interpreted as binary systems with a massive donor. They are also the most probable progenitors for BH-BH, and even more, for BH-NS coalescence. Parameters of ULXs are not know and need to be better determined, in particular the link with the metallicity of the environment which has been invoked frequently but not proven strongly. We have tackled this problem by using a MUSE DEEP mosaic of the Cartwheel galaxy and applying a Monte Carlo code that jointly fits spectroscopy and photometry. We measure the metallicity of the emitting gas in the ring and at the positions of X-ray sources by constructing spatially resolved emission line ratio maps and BPT diagnostic maps. The Carthweel is the archetypal ring galaxy and the location and formation time of new stellar populations is easier to reconstruct than in more normal galaxies. It has the largest population of ULXs ever observed in a single galaxy (16 sources have been classified as ULXs in Chandra and XMM-Newton data). The Cartwheel galaxy is therefore the ideal laboratory to study the relation between Star Formation (SF Rates and SF History) and number of ULXs and also their final fate. We find that the age of the stellar population in the outer ring is consistent with being produced in the impact (≤300Myr) and that the metallicity is mostly sub-solar, even if solutions can be found with a solar metallicity that account for most observed properties. The findings for the Cartwheel will be a testbed for further modelisation of binary formation and evolution paths.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.