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To analyse publication and citations trends of case reports within otolaryngology – head and neck surgery literature, with specific attention to the most-cited reports.
Web of Science was searched for article type ‘case reports’ published in the leading otolaryngology – head and neck surgery journals since 1945. Variables including publication dates, citation dates and numbers, author, author number, and others were recorded and analysed for trends. The reports with the most citations (classics) were further studied.
Of nearly 67 000 published articles in leading otolaryngology – head and neck surgery journals, the overall number of case reports as a percentage of the total has substantially decreased over time. A total of 110 case report classics were identified for which citations have increased.
Although the case report may not be worthy of its tarnished record, declining trends in publication suggest a limited future for this valuable research and educational resource.
Essential fatty acids (EFA) are PUFA that are metabolised to long-chain PUFA and are important for brain development and cognitive function. The objective of this study was to determine the association between whole-blood EFA and cognitive function in Tanzanian children. A total of 325 2–6-year-old children attempted the dimensional change card sort (DCCS) tasks to assess executive function. Blood samples were collected for fatty acid (FA) analysis by GC. Associations between executive function and FA levels were assessed by regression. Among the 130 4–6-year-old children who attempted the DCCS tasks, whole-blood levels of linoleic acid were positively associated with executive function, whereas whole-blood levels of α-linolenic acid and nervonic acid were inversely associated with executive function. A full model including all twenty-five FA explained 38 % of the variation in executive function, whereas a reduced model including only the EFA (α-linolenic acid and linoleic acid), DHA and EPA explained 25 % of the variation in executive function. Children who had sufficient whole-blood levels of EFA were 3·8 times more likely to successfully complete all DCCS tasks compared with children with insufficient EFA. These results suggest that whole-blood FA levels are associated with cognitive abilities. Intervention trials that include assessment of whole-blood FA levels are required to determine the relationships between intake, blood levels and executive function in Tanzanian children.
Most of the recent advances in X-ray astronomy have resulted from satellite observations in the low energy (< 20 keV) range. The Einstein X-ray Observatory in particular has been responsible for a dramatic increase in our knowledge of the X-ray sky, in that all major classes of astronomical objects have been detected.
It is now firmly established that a small anisotropy of the galactic cosmic rays exists, observable from Earth as a variation of intensity in sidereal time. The problem now is to determine more clearly the characteristics of the anisotropy and, in particular, its detailed spatial structure and how it depends upon the energy and composition of the cosmic rays. This is a very difficult task and, in the final analysis, may not be fully achievable from Earth-based observations. The purpose of the present paper is to describe briefly an installation now operating in Tasmania to provide further information on the spatial structure of the anisotropy.
The binary X-ray source GX 1 + 4 was observed during a balloon flight in 1986, November. The source was in a relatively high intensity state. Time analysis of the data shows that the pulsation period was 111.8 ± 1.0 s indicating that one or more episodes of spin-down occurred between 1980 and 1986. Folded pulse profiles are very broad with an indication of a notch at the peak. Evidence has been found for a correlation between hard X-ray intensity and phase of the proposed 304 day orbital period. The time averaged intensity since 1980 is an order of magnitude lower than during the 1970’s. A survey of the post 1980 data shows that several reversals of the period derivative have occurred. Spin-up at the rates typical of the 1970’s has been followed by a dramatic spin-down episode with dP/dt>2.4 × 10−7 s/s.
Epidemiological data are often fragmented, partial, and/or ambiguous and unable to yield the desired level of understanding of infectious disease dynamics to adequately inform control measures. Here, we show how the information contained in widely available serology data can be enhanced by integration with less common type-specific data, to improve the understanding of the transmission dynamics of complex multi-species pathogens and host communities. Using brucellosis in northern Tanzania as a case study, we developed a latent process model based on serology data obtained from the field, to reconstruct Brucella transmission dynamics. We were able to identify sheep and goats as a more likely source of human and animal infection than cattle; however, the highly cross-reactive nature of Brucella spp. meant that it was not possible to determine which Brucella species (B. abortus or B. melitensis) is responsible for human infection. We extended our model to integrate simulated serology and typing data, and show that although serology alone can identify the host source of human infection under certain restrictive conditions, the integration of even small amounts (5%) of typing data can improve understanding of complex epidemiological dynamics. We show that data integration will often be essential when more than one pathogen is present and when the distinction between exposed and infectious individuals is not clear from serology data. With increasing epidemiological complexity, serology data become less informative. However, we show how this weakness can be mitigated by integrating such data with typing data, thereby enhancing the inference from these data and improving understanding of the underlying dynamics.
Mineralized soil nitrogen (N) is an important source of N for grassland production. Some soils can supply large quantities of plant-available N through mineralization of soil organic matter. Grass grown on such soils require less fertilizer N applications per unit yield. A reliable, accurate and user-friendly method to account for soil N supply potential across a large diversity of soils and growing conditions is needed to improve N management and N recommendations over time. In the current study, the effectiveness of chemical N tests and soil properties to predict soil N supply for grass uptake across 30 Irish soil types varying in N supply potential was investigated under controlled environmental conditions. The Illinois soil N test (ISNT) combined with soil C : N ratio provided a good estimate of soil N supply in soils with low residual mineral N. Total oxidized N (TON) had the largest impact on grass dry matter (DM) yield and N uptake across the 30 soil types, declining in its influence in later growth periods. This reflected the high initial mineral N levels in these soils, which declined over time. In the current study, a model with ISNT-N, C : N and TON (log TON) best explained variability in grass DM yield and N uptake. All three rapid chemical soil tests could be performed routinely on field samples to provide an estimate of soil N supply prior to making N fertilizer application decisions. It can be concluded that these soil tests, through their assessment of soil N supply potential, can be effective tools for N management on grassland; however, field studies are needed to evaluate this under more diverse growing conditions.
Engineered remediation technologies such as denitrifying bioreactors target single contaminants along a nutrient transfer continuum. However, mixed contaminant discharges to a water body are more common from agricultural systems. Indeed, evidence presented herein indicates that pollution swapping within denitrifying bioreactor systems adds to such deleterious discharges. The present paper proposes a more holistic approach to contaminant remediation on farms, moving from the use of ‘denitrifying bioreactors’ to the concept of a ‘permeable reactive interceptor’ (PRI). Besides management changes, a PRI should contain additional remediation cells for specific contaminants in the form of solutes, particles or gases. Balance equations and case studies representing different geographic areas are presented and used to create weighting factors. Results showed that national legislation with respect to water and gaseous emissions will inform the eventual PRI design. As it will be expensive to monitor a system continuously in a holistic manner, it is suggested that developments in the field of molecular microbial ecology are essential to provide further insight in terms of element dynamics and the environmental controls on biotransformation and retention processes within PRIs. In turn, microbial and molecular fingerprinting could be used as an in-situ cost-effective tool to assess nutrient and gas balances during the operational phases of a PRI.
Nitrification inhibitors are used in agriculture for the purpose of decreasing nitrogen (N) losses, by limiting the microbially mediated oxidation of ammonium (NH4+) to nitrate (NO3−). Successful inhibition of nitrification has been shown in numerous studies, but the extent to which inhibitors affect other N transformations in soil is largely unknown. In the present study, cattle slurry was applied to microcosms of three different grassland soils, with or without the nitrification inhibitor dicyandiamide (DCD). A solution containing NH4+ and NO3−, labelled with 15N either on the NH4+ or the NO3− part, was mixed with the slurry before application. Gross N transformation rates were estimated using a 15N tracing model. In all three soils, DCD significantly inhibited gross autotrophic nitrification, by 79–90%. Gross mineralization of recalcitrant organic N increased significantly with DCD addition in two soils, whereas gross heterotrophic nitrification from the same pool decreased with DCD addition in two soils. Fungal to bacterial ratios were not significantly affected by DCD addition. Total gross mineralization and immobilization increased significantly across the three soils when DCD was used, which suggests that DCD can cause non-target effects on soil N mineralization–immobilization turnover.
A considerable expansion of biogas production in Germany, paralleled by a strong increase in maize acreage, has caused growing concern that greenhouse gas (GHG) emissions during crop substrate production might counteract the GHG emission saving potential. Based on a 2-year field trial, a GHG balance was conducted to evaluate the mitigation potential of regionally adapted cropping systems (continuous maize, maize-wheat-Italian ryegrass, perennial ryegrass ley), depending on nitrogen (N) level and N type. Considering the whole production chain, all cropping systems investigated contributed to the mitigation of GHG emissions (6·7–13·3 t CO2 eq/ha), with continuous maize revealing a carbon dioxide (CO2) saving potential of 55–61% compared with a fossil energy mix reference system. The current sustainability thresholds in terms of CO2 savings set by the EU Renewable Energy Directive could be met by all cropping systems (48–76%). Emissions from crop production had the largest impact on the mitigation effect (⩾50%) unless the biogas residue storage was not covered. The comparison of N fertilizer types showed less pronounced differences in GHG mitigation potential, whereas considerable site effects were observed.
Oral administration of the nitrification inhibitor dicyandiamide (DCD) to ruminants for excretion in urine represents a targeted mitigation strategy to reduce nitrogen (N) losses from grazed pasture. A farmlet grazing study was undertaken to examine the environmental benefits of administering DCD in trough water to non-lactating Friesian dairy cows that consecutively grazed 12 replicated plots (each 627 m2 with a grazing intensity of up to 319 cows/ha/day) during two grazing rotations in the winter of 2007 in the Waikato region, New Zealand. Nitrate-N (NO3−-N) leaching losses were measured using ceramic cup samplers (600 mm soil depth) and gaseous emissions of nitrous oxide (N2O) were quantified using a static chamber technique in the DCD and control treatments. Administration of DCD in trough water had no effect on daily water intake by dairy cows, which averaged 15 and 18 l/cow/day for the June and August grazing rotations, respectively. This resulted in a mean daily DCD intake of 46 and 110 g/cow/day, respectively. The DCD farmlet had significantly lower NO3−-N concentrations in leachate at the last three samplings, which reduced total NO3−-N leaching losses by 40% (from 32·0 to 19·2 kg N/ha). The DCD treatment reduced N2O emission rates compared to the control treatment following the August grazing, resulting in a 45% reduction in total N2O emissions relative to the control treatment (from 0·49 to 0·27 kg N2O-N/ha). This preliminary study highlights the potential for administering ruminants with DCD as an effective mitigation option for reducing N losses from agricultural systems.
Studies of the relationship between childhood maltreatment and alcohol dependence have not controlled comprehensively for potential confounding by co-occurring maltreatments and other childhood trauma, or determined whether parental history of alcohol disorders operates synergistically with gender and maltreatment to produce alcohol dependence. We addressed these issues using national data.
Face-to-face surveys of 27 712 adult participants in a national survey.
Childhood physical, emotional and sexual abuse, and physical neglect were associated with alcohol dependence (p<0.001), controlling for demographics, co-occurring maltreatments and other childhood trauma. Attributable proportions (APs) due to interaction between each maltreatment and parental history revealed significant synergistic relationships for physical abuse in the entire sample, and for sexual abuse and emotional neglect in women (APs, 0.21, 0.31, 0.26 respectively), indicating that the odds of alcohol dependence given both parental history and these maltreatments were significantly higher than the additive effect of each alone (p<0.05).
Childhood maltreatments independently increased the risk of alcohol dependence. Importantly, results suggest a synergistic role of parental alcoholism: the effect of physical abuse on alcohol dependence may depend on parental history, while the effects of sexual abuse and emotional neglect may depend on parental history among women. Findings underscore the importance of early identification and prevention, particularly among those with a family history, and could guide genetic research and intervention development, e.g. programs to reduce the burden of childhood maltreatment may benefit from addressing the negative long-term effects of maltreatments, including potential alcohol problems, across a broad range of childhood environments.
To evaluate the outcomes of patients with giant pituitary tumours (GPTs) who underwent a purely binasal endoscopic transsphenoidal surgery (BETS) and compare their outcomes with those achieved through craniotomy and microscopic transsphenoidal surgery (MTS).
Seventy-two consecutive patients with GPTs (greater than 10 cm3 in volume) who were treated surgically with BETS, craniotomy, or MTS from October 1994 to July 2009 were reviewed for clinical outcomes, degree of tumor resection, recurrence rates, and surgical complications.
The BETS group had significantly better mean reduction of tumor volume (91%) than the craniotomy (63%, p = 0.001), and the MTS (63%, p = 0.010) groups. Gross total resection rates were also higher for BETS patients than for craniotomy patients (p = 0.010). Improvements in vision and headaches were noted in 96% and 100% of patients in the BETS group, respectively; these rates were similar to those in the craniotomy and MTS groups. Of the four patients with hormone-secreting tumours in the BETS group, three remained in remission. The median length-of-stay (four days) for the BETS group was shorter (p = 0.010), and surgical complications were less frequent (p = 0.037) and less severe compared to the craniotomy group. There were no differences in the recurrence rates: 79% percent of patients in the BETS group, 69% in the craniotomy group, and 79% in the MTS group were recurrence free at last follow-up (p = 0.829).
Treatment of GPT with BETS offers excellent oncologic and clinical outcomes and can frequently obviate the need for craniotomy in these patients.
Non-medical use of prescription opioids represents a national public health concern of growing importance. Mood and anxiety disorders are highly associated with non-medical prescription opioid use. The authors examined longitudinal associations between non-medical prescription opioid use and opioid disorder due to non-medical opioid use and mood/anxiety disorders in a national sample, examining evidence for precipitation, self-medication and general shared vulnerability as pathways between disorders.
Data were drawn from face-to-face surveys of 34 653 adult participants in waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression models explored the temporal sequence and evidence for the hypothesized pathways.
Baseline lifetime non-medical prescription opioid use was associated with incidence of any mood disorder, major depressive disorder (MDD), bipolar disorder, any anxiety disorder and generalized anxiety disorder (GAD in wave 2, adjusted for baseline demographics, other substance use, and co-morbid mood/anxiety disorders). Lifetime opioid disorder was not associated with any incident mood/anxiety disorders. All baseline lifetime mood disorders and GAD were associated with incident non-medical prescription opioid use at follow-up, adjusted for demographics, co-morbid mood/anxiety disorders, and other substance use. Baseline lifetime mood disorders, MDD, dysthymia and panic disorder were associated with incident opioid disorder due to non-medical prescription opioid use at follow-up, adjusted for the same covariates.
These results suggest that precipitation, self-medication as well as shared vulnerability are all viable pathways between non-medical prescription opioid use and opioid disorder due to non-medical opioid use and mood/anxiety disorders.
Using data from a cohort study conducted by the Veterinary Laboratories Agency (VLA), evidence of spatial clustering at distances up to 30 km was found for S. Agama and S. Dublin (P values of 0·001) and borderline evidence was found for spatial clustering of S. Typhimurium (P=0·077). The evolution of infection status of study farms over time was modelled using a Markov Chain model with transition probabilities describing changes in status at each of four visits, allowing for the effect of sampling visit. The degree of geographical clustering of infection, having allowed for temporal effects, was assessed by comparing the residual deviance from a model including a measure of recent neighbourhood infection levels with one excluding this variable. The number of cases arising within a defined distance and time period of an index case was higher than expected. This provides evidence for spatial and spatio-temporal clustering, which suggests either a contagious process (e.g. through direct or indirect farm-to-farm transmission) or geographically localized environmental and/or farm factors which increase the risk of infection. The results emphasize the different epidemiology of the three Salmonella serovars investigated.
Peach-potato aphids, Myzus persicae (Sulzer), collected in Scotland in the years 1995 and 2002–2004 were characterized using four microsatellite loci and three insecticide resistance mechanisms. From 868 samples, 14 multilocus genotypes were defined (designated clones A–N). Five of these (denoted A, B, H, M and N) carried modified acetylcholinesterase (MACE) resistance, the most recent resistance mechanism to have evolved in M. persicae. The current paper shows that the continued presence of MACE aphids is due to turnover, as clones A and B were replaced in field samples by clones H, M and N in later seasons. Thus, insecticide-resistant populations in Scotland can be attributed to multiple waves of rapid clone colonisations and not to the continued presence of stable resistant clones or mutation or sexual recombination in local populations. The MACE clones carried varying levels of the other insecticide resistance mechanisms, kdr and esterase. The presence of these mechanisms could alter the clones success in the field depending on insecticide spraying (positive selection) and resistance fitness costs (negative selection).
It is more than 25 years since the first case of AIDS was reported in the United Kingdom. In December 1981 a gay man was referred to a London hospital with opportunistic infections indicative of immunosuppression. National surveillance began the following year, in September 1982, with the notification of deaths and clinical reports of AIDS and Kaposi's sarcoma plus laboratory reports of opportunistic infections. Since then epidemiological surveillance systems have evolved, adapting to, and taking advantage of advances in treatments and laboratory techniques. The introduction of the HIV antibody test in 1984 led to the reporting of HIV-positive tests by laboratories and the establishment of an unlinked anonymous survey in 1990 measuring undiagnosed HIV infection among gay men attending sexual health clinics. The widespread use of highly active antiretroviral therapies (HAART) since 1996 has averted many deaths among HIV-positive gay men and has also resulted in a large reduction in AIDS cases. This led to a need for an enumeration of gay men with HIV accessing NHS treatment and care services (1995 onwards), more clinical information on HIV diagnoses for epidemiological surveillance (2000 onwards) and the routine monitoring of drug resistance (2001 onwards). Twenty-five years after the first case of AIDS was reported, gay and bisexual men remain the group at greatest risk of acquiring HIV in the United Kingdom. Latest estimates suggest that in 2004, 26 500 gay and bisexual men were living with HIV in the United Kingdom, a quarter of whom were undiagnosed. In this review, we examine how national surveillance systems have evolved over the past 25 years in response to the changing epidemiology of HIV/AIDS among gay and bisexual men in the United Kingdom as well as advances in laboratory techniques and medical treatments. We also reflect on how they will need to continue evolving to effectively inform health policy in the future.
The hypoglossal nerve is an underrated nerve usually consigned to a few words in anatomical text books, under the last four cranial nerves. However, paralysis of this nerve may be the first indication of a serious underlying disorder. Excluding previous surgery, radiotherapy and trauma, 50 per cent of cases of isolated hypoglossal nerve palsy are idiopathic. A further 20 per cent are malignant, 20 per cent are vascular and 10 per cent are due to miscellaneous causes. Presentation of an isolated hypoglossal nerve palsy is therefore an ominous sign. There is confusion over both cause and investigation, and management protocols for isolated hypoglossal nerve palsy are ill-defined. We present a case of isolated hypoglossal palsy which was due to a metastatic skull base deposit. This case illustrates the fact that magnetic resonance imaging is the investigation of choice in assessing the entire course of the hypoglossal nerve.