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.
Coeliac disease (CD) is an autoimmune gastrointestinal disorder whereby the ingestion of gluten, a storage protein found in wheat, barley and rye, causes damage to intestinal mucosa with resultant malabsorption, increased risk of anaemia and osteoporosis. Worldwide estimates suggest 1% of the population have CD. With no cure, the only treatment is a gluten-free diet (GFD). Adhering to a GFD can be very challenging; it requires knowledge, motivation and modified behaviours. Assessing adherence to a GFD is methodologically challenging. This review aims to provide an overview of the literature reporting adherence to a GFD in people with CD and the methodological challenges encountered. From six studies it has been reported that rates of adherence to a GFD range between 45 and 90% in patients of different ethnicities with CD. GF dietary adherence can be influenced by age at diagnosis, coexisting depression, symptoms on ingestion of gluten, nutrition counselling, knowledge of GF foods, understanding of food labels, cost and availability of GF foods, receiving GF foods on prescription and membership of a coeliac society. To date only five intervention studies in adults with CD have been undertaken to improve GF dietary adherence. These have included dietary and psychological counselling, and the use of online training programmes, apps, text messages and telephonic clinics. Future interventions should include people of all ethnicities, consider patient convenience and the cost-effectiveness for the healthcare environment.
A model of a High Voltage CMOS (HV-CMOS) Monolithic Active Pixel Sensor (MAPS) has been modelled using Technology Computer Aided Design (TCAD). The model has incorporated both the active region and the on-pixel readout circuits which were comprised of a source follower amplifier and an integrated charge amplifier. The simulation has examined the electrical characteristics and response output of a HV-CMOS MAPS sensor using typical dimensions, levels of doping in the structural layers and bias conditions for this sensor. The performance of two alternate designs of amplifier have been examined as a function of the operating parameters. The response of the sensor to the incidence of Minimum Ionizing Particles (MIPs) at different energies has been included in the model.
Escherichia coli O157 are zoonotic bacteria for which cattle are an important reservoir. Prevalence estimates for E. coli O157 in British cattle for human consumption are over 10 years old. A new baseline is needed to inform current human health risk. The British E. coli O157 in Cattle Study (BECS) ran between September 2014 and November 2015 on 270 farms across Scotland and England & Wales. This is the first study to be conducted contemporaneously across Great Britain, thus enabling comparison between Scotland and England & Wales. Herd-level prevalence estimates for E. coli O157 did not differ significantly for Scotland (0·236, 95% CI 0·166–0·325) and England & Wales (0·213, 95% CI 0·156–0·283) (P = 0·65). The majority of isolates were verocytotoxin positive. A higher proportion of samples from Scotland were in the super-shedder category, though there was no difference between the surveys in the likelihood of a positive farm having at least one super-shedder sample. E. coli O157 continues to be common in British beef cattle, reaffirming public health policy that contact with cattle and their environments is a potential infection source.
Population-based registries report 95% 5-year survival for children undergoing surgery for CHD. This study investigated paediatric cardiac surgical outcomes in the Australian indigenous population.
All children who underwent cardiac surgery between May, 2008 and August, 2014 were studied. Demographic information including socio-economic status, diagnoses and co-morbidities, and treatment and outcome data were collected at time of surgery and at last follow-up.
A total of 1528 children with a mean age 3.4±4.6 years were studied. Among them, 123 (8.1%) children were identified as indigenous, and 52.7% (62) of indigenous patients were in the lowest third of the socio-economic index compared with 28.2% (456) of non-indigenous patients (p⩽0.001). The indigenous sample had a significantly higher Comprehensive Aristotle Complexity score (indigenous 9.4±4.2 versus non-indigenous 8.7±3.9, p=0.04). The probability of having long-term follow-up did not differ between groups (indigenous 93.8% versus non-indigenous 95.6%, p=0.17). No difference was noted in 30-day mortality (indigenous 3.2% versus non-indigenous 1.4%, p=0.13). The 6-year survival for the entire cohort was 95.9%. The Cox survival analysis demonstrated higher 6-year mortality in the indigenous group – indigenous 8.1% versus non-indigenous 5.0%; hazard ratio (HR)=2.1; 95% confidence intervals (CI): 1.1, 4.2; p=0.03. Freedom from surgical re-intervention was 79%, and was not significantly associated with the indigenous status (HR=1.4; 95% CI: 0.9, 1.9; p=0.11). When long-term survival was adjusted for the Comprehensive Aristotle Complexity score, no difference in outcomes between the populations was demonstrated (HR=1.6; 95% CI: 0.8, 3.2; p=0.19).
The indigenous population experienced higher late mortality. This apparent relationship is explained by increased patient complexity, which may reflect negative social and environmental factors.
Treerow vegetation abundance and biodiversity were measured in response to six orchard floor management strategies in organic peach in northern Utah for three growing seasons. A total of 32 weed species were observed in the treerow; the most common were field bindweed, dandelion, perennial grasses (e.g., red fescue and ryegrass), clovers, and prickly lettuce. Weed biomass was two to five times greater in unmanaged (living mulch) than in manipulated treatments. Tillage greatly reduced weeds for approximately one month; however, vegetation rebounded midseason. Tillage selected for species adapted to disturbance, such as common purslane and field bindweed. Straw mulch provided equivalent weed suppression to tillage in the early season. Straw required annual reapplication with material costs, labor, and weed-seed contamination (e.g., volunteer grains and quackgrass) as disadvantages. Plastic fabric mulch reduced weeds the most, but had high initial costs and required seasonal maintenance. Weed biomass declined within seasons and across the three years of the study, likely due to tree canopy shading. Neither birdsfoot trefoil nor a perennial grass mixture planted in the alleyways influenced treerow weeds. Our results demonstrate several viable alternatives to tillage for weed management in treerows of organic peach orchards in the Intermountain West.
In many regions of the world, the cultivation of landraces is still common, in particular in centres of crop diversity. Significant effort has been put into ex situ conservation of landraces but limited data exist on the changes in genetic diversity that occur over time in farmers’ fields. We assessed temporal changes in barley landrace diversity in Jordan using seed samples collected in 1981 and 2012 from the same locations. We did not observe significant changes in the amount of genetic diversity, but samples collected in 2012 were more homogenous and less locally distinct. In two sites, we observed replacement of the old material. We observed a change in phenotype, and phenotypes were found to be more homogeneous among sites in 2012. Climate changed significantly over the study period, becoming hotter and dryer, but we did not identify any correlation between the changes in climate and genetic and phenotypic variations. While the amount of genetic diversity in terms of allelic richness and number of multi-locus genotypes has been maintained, local distinctiveness among landrace barley populations in Jordan was reduced.
Mental health problems are inseparable from the environment. With virtual reality (VR), computer-generated interactive environments, individuals can repeatedly experience their problematic situations and be taught, via evidence-based psychological treatments, how to overcome difficulties. VR is moving out of specialist laboratories. Our central aim was to describe the potential of VR in mental health, including a consideration of the first 20 years of applications. A systematic review of empirical studies was conducted. In all, 285 studies were identified, with 86 concerning assessment, 45 theory development, and 154 treatment. The main disorders researched were anxiety (n = 192), schizophrenia (n = 44), substance-related disorders (n = 22) and eating disorders (n = 18). There are pioneering early studies, but the methodological quality of studies was generally low. The gaps in meaningful applications to mental health are extensive. The most established finding is that VR exposure-based treatments can reduce anxiety disorders, but there are numerous research and treatment avenues of promise. VR was found to be a much-misused term, often applied to non-interactive and non-immersive technologies. We conclude that VR has the potential to transform the assessment, understanding and treatment of mental health problems. The treatment possibilities will only be realized if – with the user experience at the heart of design – the best immersive VR technology is combined with targeted translational interventions. The capability of VR to simulate reality could greatly increase access to psychological therapies, while treatment outcomes could be enhanced by the technology's ability to create new realities. VR may merit the level of attention given to neuroimaging.
The electrical characteristics of Au/Ni/Ti/ n-SiC contacts have been examined as a function of implant dose (1013-1014 ions/cm2) at 5 KeV and temperature of annealing (750-1000 °C). Measurements of specific contact resistance, ρc, were approximately constant at lower implant doses until increasing at 1 x 1015 ions/cm2 for both C and P ions. Annealing at a temperature of 1000 °C has reduced the value of ρc by an order of magnitude to ∼1 x 10-6 Ω.cm2 at implant doses of 1013-1014 ions/cm2. Auger Electron Spectroscopy (AES) has shown that annealing at 1000 °C resulted in a strong indiffusion of the metallization layers at the interface.
We compare the results of using a Random Forest Classifier with the results of using Nonparametric Discriminant Analysis to classify whether a filament channel (in the case of a filament eruption) or an active region (in the case of a flare) is about to produce an event. A large number of descriptors are considered in each case, but it is found that only a small number are needed in order to get most of the improvement in performance over always predicting the majority class. There is little difference in performance between the two classifiers, and neither results in substantial improvements over simply predicting the majority class.
Finite element modelling has been used to optimise the current/ voltage (I/V) characteristics of metal/ n-SiC and metal/ n-Si diodes incorporating a thin interfacial layer. The electrical properties of the diodes have been examined in relation to the polytype of SiC (3H, 4H or 6C), the doping level, NA, (1015 - 1018cm3) of the substrate, the defect state density, Dit and the work function of the Schottky metal, Φm. The modelling by Technology Computer-Aided Design (TCAD) has shown that the presence of an interfacial insulating layer with a thickness of 1.0 nm has reduced the reverse leakage current of the diode by a factor of ∼102 in Si and 1013 (from 10-19 A to 10-6 A) for SiC with only a minor reduction (∼ 0.8 times) in the forward current in SiC. The properties of the diodes have been modelled at room temperature without thermal annealing.
A nationwide initiative was implemented in February 2014 to decrease Clostridium difficile infections (CDI) in Veterans Affairs (VA) long-term care facilities. We report a baseline of national CDI data collected during the 2 years before the Initiative.
Personnel at each of 122 reporting sites entered monthly retrospective CDI case data from February 2012 through January 2014 into a national database using case definitions similar to those used in the National Healthcare Safety Network Multidrug-Resistant Organism/CDI module. The data were evaluated using Poisson regression models to examine infection occurrences over time while accounting for admission prevalence and type of diagnostic test.
During the 24-month analysis period, there were 100,800 admissions, 6,976,121 resident days, and 1,558 CDI cases. The pooled CDI admission prevalence rate (including recurrent cases) was 0.38 per 100 admissions, and the pooled nonduplicate/nonrecurrent community-onset rate was 0.17 per 100 admissions. The pooled long-term care facility–onset rate and the clinically confirmed (ie, diarrhea or evidence of pseudomembranous colitis) long-term care facility–onset rate were 1.98 and 1.78 per 10,000 resident days, respectively. Accounting for diagnostic test type, the long-term care facility–onset rate declined significantly (P=.05), but the clinically confirmed long-term care facility–onset rate did not.
VA long-term care facility CDI rates were comparable to those in recent reports from other long-term care facilities. The significant decline in the long-term care facility-onset rate but not in the clinically confirmed long-term care facility–onset rate may have been due to less testing of asymptomatic patients. Efforts to decrease CDI rates in long-term care facilities are necessary as part of a coordinated approach to decrease healthcare-associated infections.
Infect. Control Hosp. Epidemiol. 2016;37(3):295–300
The effect of low energy implantation of P or C ions in 3C-SiC on the properties of Ti/Ni/Au contacts has been examined for doses in the range 1013-1015 ions/cm2. Measurements of specific contact resistance, ρc, were performed using the two-contact circular test structure. The magnitude of ρc for the Ti/Ni/Au contacts on unimplanted SiC was 1.29 x 10−6 Ω.cm2. The value of ρc increased significantly at an implant dose of 1 x 1015 ions/cm2. The dependence of ρc on ion dose has been measured using both C and P implant species.
Carbon films deposited by filtered cathodic vacuum arc have been used to form high quality Schottky diodes on p-Si. Energetic deposition with an applied substrate bias of -1 kV and with a substrate temperature of 100 °C has produced carbon diodes with rectification ratios of ∼ 3 × 106, saturation currents of ∼0.02 nA and ideality factors close to unity (n = 1.05). Simulations were used to estimate the effective work function and the thickness of an interfacial mixed (C/SiO2) layer from the current/voltage characteristics of the diodes.
The second epoch Molonglo Galactic Plane Survey covers the area 245° ⩽ l ⩽ 365° and |b| ⩽ 10° at a frequency of 843 MHz and an angular resolution of 45 arcsec × 45 arcsec cosec(δ). The sensitivity varies between 1–2 mJy beam− 1 depending on the presence of strong extended sources. This survey is currently the highest resolution and most sensitive large-scale continuum survey of the southern Galactic plane. In this paper, we present the images of the complete survey, including postage stamps of some new supernova remnant (SNR) candidates and a discussion of the highly structured features detected in the interstellar medium. The intersection of these two types of features is discussed in the context of the ‘missing’ SNR population in the Galaxy.
Since mid-2007 we have carried out a dedicated long-term monitoring programme at 15 GHz using the Owens Valley Radio Observatory 40 meter telescope (OVRO 40m). One of the main goals of this programme is to study the relation between the radio and gamma-ray emission in blazars and to use it as a tool to locate the site of high energy emission. Using this large sample of objects we are able to characterize the radio variability, and study the significance of correlations between the radio and gamma-ray bands. We find that the radio variability of many sources can be described using a simple power law power spectral density, and that when taking into account the red-noise characteristics of the light curves, cases with significant correlation are rare. We note that while significant correlations are found in few individual objects, radio variations are most often delayed with respect to the gamma-ray variations. This suggests that the gamma-ray emission originates upstream of the radio emission. Because strong flares in most known gamma-ray-loud blazars are infrequent, longer light curves are required to settle the issue of the strength of radio-gamma cross-correlations and establish confidently possible delays between the two. For this reason continuous multiwavelength monitoring over a longer time period is essential for statistical tests of jet emission models.