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Self-reported activity restriction is an established correlate of depression in dementia caregivers (dCGs). It is plausible that the daily distribution of objectively measured activity is also altered in dCGs with depression symptoms; if so, such activity characteristics could provide a passively measurable marker of depression or specific times to target preventive interventions. We therefore investigated how levels of activity throughout the day differed in dCGs with and without depression symptoms, then tested whether any such differences predicted changes in symptoms 6 months later.
Design, setting, participants, and measurements:
We examined 56 dCGs (mean age = 71, standard deviation (SD) = 6.7; 68% female) and used clustering to identify subgroups which had distinct depression symptom levels, leveraging baseline Center for Epidemiologic Studies of Depression Scale–Revised Edition and Patient Health Questionnaire-9 (PHQ-9) measures, as well as a PHQ-9 score from 6 months later. Using wrist activity (mean recording length = 12.9 days, minimum = 6 days), we calculated average hourly activity levels and then assessed when activity levels relate to depression symptoms and changes in symptoms 6 months later.
Clustering identified subgroups characterized by: (1) no/minimal symptoms (36%) and (2) depression symptoms (64%). After multiple comparison correction, the group of dCGs with depression symptoms was less active from 8 to 10 AM (Cohen’s d ≤ −0.9). These morning activity levels predicted the degree of symptom change on the PHQ-9 6 months later (per SD unit β = −0.8, 95% confidence interval: −1.6, −0.1, p = 0.03) independent of self-reported activity restriction and other key factors.
These novel findings suggest that morning activity may protect dCGs from depression symptoms. Future studies should test whether helping dCGs get active in the morning influences the other features of depression in this population (i.e. insomnia, intrusive thoughts, and perceived activity restriction).
The electrical reliability of multilayer high density interconnection printed circuit boards (HDI-PCBs) is mainly affected by the thermo-mechanical stability of stacked micro via interconnections. Here, a critical failure mode is the stress related crack between the electrolytically filled via and the target pad, commonly known as target pad separation. The junction includes two Cu-Cu-interfaces, one between the target Cu pad and the thin electroless Cu layer and the second between electroless Cu and electrolytic Cu. In this paper we will show that state-of-the-art electroless Cu plating processes are able to provide solid, completely recrystallized and highly reliable stacked via junctions. Defect free interfaces were achieved by using ionic Pd-activators and electroless Cu baths with a cyanide based stabilizer system. Cyanide free electroless Cu baths tend more to the formation of nanometer sized defects, discovered via Transmission Electron Microscopy (TEM). In this case a precise adjustment of single stabilizer components is mandatory to achieve defect free layers. The defects are hollow and were identified as “nano voids”. A critical density of these nano voids weakens the interface, predefines the crack path and reduces the overall reliability of the junction. A precise localization of the nano voids within the junction was enabled by detecting the Ni-containing electroless Cu layer via TEM-Ni mapping. Slower volume exchange of the electroless Cu solution within the blind micro via (BMV) substantially increases the nano void density. The ability of nano voids to migrate and coalesce at elevated temperatures was investigated as well.
This paper investigates how high school students in an introductory computer science (CS) course approach computing in the logic programming (LP) paradigm. This qualitative study shows how novice students operate within the LP paradigm while engaging in foundational computing concepts and skills: students are engaged in a cyclical process of abstraction, reasoning, and creating representations of their ideas in code while also being informed by the (procedural) requirements and the revision/debugging process. As these computing concepts and skills are also expected in traditional approaches to introductory K-12 CS courses, this paper asserts that LP is a viable paradigm choice for high school novices.
We present Web-STAR, an online platform for story understanding built on top of the STAR reasoning engine for STory comprehension through ARgumentation. The platform includes a web-based integrated development environment, integration with the STAR system, and a web service infrastructure to support integration with other systems that rely on story understanding functionality to complete their tasks. The platform also delivers a number of “social” features, including a community repository for public story sharing with a built-in commenting system, and tools for collaborative story editing that can be used for team development projects and for educational purposes.
A range of endophenotypes characterise psychosis, however there has been limited work understanding if and how they are inter-related.
This multi-centre study includes 8754 participants: 2212 people with a psychotic disorder, 1487 unaffected relatives of probands, and 5055 healthy controls. We investigated cognition [digit span (N = 3127), block design (N = 5491), and the Rey Auditory Verbal Learning Test (N = 3543)], electrophysiology [P300 amplitude and latency (N = 1102)], and neuroanatomy [lateral ventricular volume (N = 1721)]. We used linear regression to assess the interrelationships between endophenotypes.
The P300 amplitude and latency were not associated (regression coef. −0.06, 95% CI −0.12 to 0.01, p = 0.060), and P300 amplitude was positively associated with block design (coef. 0.19, 95% CI 0.10–0.28, p < 0.001). There was no evidence of associations between lateral ventricular volume and the other measures (all p > 0.38). All the cognitive endophenotypes were associated with each other in the expected directions (all p < 0.001). Lastly, the relationships between pairs of endophenotypes were consistent in all three participant groups, differing for some of the cognitive pairings only in the strengths of the relationships.
The P300 amplitude and latency are independent endophenotypes; the former indexing spatial visualisation and working memory, and the latter is hypothesised to index basic processing speed. Individuals with psychotic illnesses, their unaffected relatives, and healthy controls all show similar patterns of associations between endophenotypes, endorsing the theory of a continuum of psychosis liability across the population.
Major depression and anxiety disorders are known to negatively influence cognitive performance. Moreover, there is evidence for greater cognitive decline in older adults with generalized anxiety disorder. Except for clinical studies, complex executive planning functions and subclinical levels of anxiety have not been examined in a population-based sample with a broad age range.
Planning performance was assessed using the Tower of London task in a population-based sample of 4240 participants aged 40–80 years from the Gutenberg Health Study (GHS) and related to self-reported anxiety and depression by means of multiple linear regression analysis.
Higher anxiety ratings were associated with lower planning performance (β = −0.20; p < 0.0001) independent of age (β = 0.03; p = 0.47). When directly comparing the predictive value of depression and anxiety on cognition, only anxiety attained significance (β = −0.19; p = 0.0047), whereas depression did not (β = −0.01; p = 0.71).
Subclinical levels of anxiety but not of depression showed negative associations with cognitive functioning independent of age. Our results demonstrate that associations observed in clinical groups might differ from those in population-based samples, also with regard to the trajectory across the life span. Further studies are needed to uncover causal interrelations of anxiety and cognition, which have been proposed in the literature, in order to develop interventions aimed at reducing this negative affective state and to improve executive functioning.
Background: Palliative care is a cornerstone of the management of progressive neurological illness, but there lacks a standardized evidence-based curriculum to teach the unique aspects of neurology-based palliative care to current learners. Methods: A needs assessment involving focus groups with patients, physicians, interdisciplinary members, and trainees was conducted to identify gaps in the current curriculum. The Kolb Learning Style Inventory identified learning strategies among neurology residents. A Palliative Medicine Comfort and Confidence Survey and knowledge pre-test was distributed to determine current learner needs. The curriculum was delivered during academic time, and feedback was obtained for further content revision. Results: Qualitative analysis was used to develop the curriculum with the key principles of symptom management, end-of life communication, psychosocial components of care, and community coordination. Learning styles varied, but preference for active experimentation and concrete experience was noted. Learners identified as comfortable with withdrawal of medical interventions, but requiring support on home palliative care referral, and management of terminal delirium and dyspnea. Further teaching was requested for end of life ethics and communication skills. Conclusions: By integrating current best evidence-based practice in palliative neurology with learner feedback, this project aims to create a comprehensive palliative care curriculum for neurology learners.
Site-specific management provides the ability to align the production intensity to demand and thus adjust the expenses to the necessary level. So it is possible to increase the proportion of marketable commodity in the normal sort–size of 40 mm to 60 mm. Planting distances adapted to the soil properties seem to achieve this objective. It is possible to further optimize the proportion of marketable commodity especially in the potato regions where irrigation and fertilization already contribute to a consistently high yield. Different planting distances on the soil sites by EM38 were tested in field trials. Planting distances of 31.50 cm in the row on the light (sandy) soil, 24.50 cm on middle and 27.50 cm on the heavy soil sites seems the best for these three years. There is a yield impact in total, as well as in the proportion of marketable commodity. Depending on the planting strategy, increases in income up to €153 per hectare can be obtained.
We present results from a multiwavelength study of the blazar PKS 1954–388 at radio, UV, X-ray, and gamma-ray energies. A RadioAstron observation at 1.66 GHz in June 2012 resulted in the detection of interferometric fringes on baselines of 6.2 Earth-diameters. This suggests a source frame brightness temperature of greater than 2 × 1012 K, well in excess of both equipartition and inverse Compton limits and implying the existence of Doppler boosting in the core. An 8.4-GHz TANAMI VLBI image, made less than a month after the RadioAstron observations, is consistent with a previously reported superluminal motion for a jet component. Flux density monitoring with the Australia Telescope Compact Array confirms previous evidence for long-term variability that increases with observing frequency. A search for more rapid variability revealed no evidence for significant day-scale flux density variation. The ATCA light-curve reveals a strong radio flare beginning in late 2013, which peaks higher, and earlier, at higher frequencies. Comparison with the Fermi gamma-ray light-curve indicates this followed ~ 9 months after the start of a prolonged gamma-ray high-state—a radio lag comparable to that seen in other blazars. The multiwavelength data are combined to derive a Spectral Energy Distribution, which is fitted by a one-zone synchrotron-self-Compton (SSC) model with the addition of external Compton (EC) emission.
An automated respirometer system was used to measure VO2, protein catabolism as ammonia quotient and the energy budget to evaluate whether the crude protein content of a standard protein (SP) diet (42·5 %) or a high-protein (HP) diet (49·5 %) influences metabolism in rainbow trout under challenging intermittent, low dissolved oxygen concentrations. In total, three temperature phases (12, 16, 20°C) were tested sequentially, each of which were split into two oxygen periods with 5 d of unmanipulated oxygen levels (50–70 %), followed by a 5d manipulated oxygen period (16.00–08.00 hours) with low oxygen (40–50 %) levels. For both diets, catabolic protein usage was lowest at 16°C and was not altered under challenging oxygen conditions. Low night-time oxygen elevated mean daily VO2 by 3–14 % compared with the unmanipulated oxygen period for both diets at all temperatures. The relative change in VO2 and retained energy during the intermittent low oxygen period was smaller for the HP diet compared with the SP diet. However, in absolute terms, the SP diet was superior to the HP diet as the former demonstrated 30–40 % lower protein fuel use rates, higher retained energy (1–4 % digestible energy) and slightly lowered VO2 (0–8 %) over the range of conditions tested. The decrease in retained energy under low oxygen conditions suggests that there is scope to improve the performance of SP diets under challenging conditions; however, this study suggests that simply increasing the dietary protein content is not a remedy, and other strategies need to be explored.
A number of laser facilities coming online all over the world promise the capability of high-power laser experiments with shot repetition rates between 1 and 10 Hz. Target availability and technical issues related to the interaction environment could become a bottleneck for the exploitation of such facilities. In this paper, we report on target needs for three different classes of experiments: dynamic compression physics, electron transport and isochoric heating, and laser-driven particle and radiation sources. We also review some of the most challenging issues in target fabrication and high repetition rate operation. Finally, we discuss current target supply strategies and future perspectives to establish a sustainable target provision infrastructure for advanced laser facilities.
Internet-based cognitive–behavioural treatment (ICBT) for anxiety disorders has shown some promise, but no study has yet examined unguided ICBT in primary care. This randomized controlled trial (RCT) investigated whether a transdiagnostic, unguided ICBT programme for anxiety disorders is effective in primary care settings, after a face-to-face consultation with a physician (MD). We hypothesized that care as usual (CAU) plus unguided ICBT would be superior to CAU in reducing anxiety and related symptoms among patients with social anxiety disorder (SAD), panic disorder with or without agoraphobia (PDA) and/or generalized anxiety disorder (GAD).
Adults (n = 139) with at least one of these anxiety disorders, as reported by their MD and confirmed by a structured diagnostic interview, were randomized. Unguided ICBT was provided by a novel transdiagnostic ICBT programme (‘velibra’). Primary outcomes were generic measures, such as anxiety and depression symptom severity, and diagnostic status at post-treatment (9 weeks). Secondary outcomes included anxiety disorder-specific measures, quality of life, treatment adherence, satisfaction, and general psychiatric symptomatology at follow-up (6 months after randomization).
CAU plus unguided ICBT was more effective than CAU at post-treatment, with small to medium between-group effect sizes on primary (Cohen's d = 0.41–0.47) and secondary (Cohen's d = 0.16–0.61) outcomes. Treatment gains were maintained at follow-up. In the treatment group, 28.2% of those with a SAD diagnosis, 38.3% with a PDA diagnosis, and 44.8% with a GAD diagnosis at pretreatment no longer fulfilled diagnostic criteria at post-treatment.
The unguided ICBT intervention examined is effective for anxiety disorders when delivered in primary care.
Prenatal and early-life environmental exposures play a key role in the development of atopy and allergic disease. The Family Atherosclerosis Monitoring In earLY life Study is a general, population-based Canadian birth cohort that prospectively evaluated prenatal and early-life traits and their association with atopy and/or allergic disease. The study population included 901 babies, 857 mothers and 530 fathers. Prenatal and postnatal risk factors were evaluated through questionnaires collected during the antenatal period and at 1 year. The end points of atopy and allergic diseases in infants were evaluated through questionnaires and skin prick testing. Key outcomes included atopy (24.5%), food allergy (17.5%), cow’s milk allergy (4.8%), wheezing (18.6%) and eczema (16%). The association between infant antibiotic exposure [odds ratio (OR): 2.04, 95% confidence interval (CI): 1.45–2.88] and increased atopy was noted in the multivariate analysis, whereas prenatal maternal exposure to dogs (OR: 0.60, 95% CI: 0.42–0.84) and acetaminophen (OR: 0.68, 95% CI: 0.51–0.92) was associated with decreased atopy. This population-based birth cohort in Canada demonstrated high rates of atopy, food allergy, wheezing and eczema. Several previously reported and some novel prenatal and postnatal exposures were associated with atopy and allergic diseases at 1 year of age.
The stellar radial velocity dispersion profiles of elliptical galaxies can be well described by a power-law σ(r)∝r−β. We analyze a set of elliptical galaxies formed by major mergers of isolated disk galaxies with mass ratios of 1:1 and 3:1 for several orbital configurations (Johansson et al. 2009). The galaxies in our sample show a deviation from the power-law at 1 − 3Reff, which we term the σ-bump (Schauer et al. 2014). This feature is most prominent in remnants of 1:1 mergers and weakens for remnants of mergers with smaller mass ratios, indicating that the σ-bump is a signature of an equal mass merger. The σ-bump does not vanish with time but stays constant once it has formed, in contrast to shells. It can be seen under all projections, making it an observable feature in the outskirts of elliptical galaxies. We indeed identify three possible σ-bump candidates in the sample of 12 SLUGGS-survey ellipticals studied by Pota et al. (2013), who use globular clusters as tracers for the outer stellar halos (see Schauer et al. 2014, for more details). For further comparisons, we here provide for the first time a two dimensional map of the velocity dispersion of one simulated σ-bump galaxy, to identify the σ-bump in observations of kinematic maps out to several Reff. The σ-bump appears as a global ring-like feature if seen face-on and as an extended box-like feature in its edge-on projection.
To identify themes associated with patient perceptions of antibiotic use and the role of patients in inpatient antimicrobial stewardship.
We conducted semi-structured interviews with 30 hospitalized patients using the Health Belief Model as the framework for questions and analysis.
An academic tertiary care hospital in Madison, Wisconsin.
A total of 30 general medicine inpatients receiving at least 1 anti-infective medication were interviewed.
Participants recognized antibiotic resistance as a serious public health threat but expressed low perceived susceptibility to being personally affected by antibiotic resistance. Views of susceptibility were influenced by a high degree of trust in physicians and misperceptions regarding the mechanisms underlying resistance. Participants expressed high self-efficacy and a desire to be involved in their health care. Perceived roles for patients in preventing the inappropriate use of antibiotics ranged from asking questions and speaking up about concerns to active involvement in decision making regarding antibiotic treatments. Few participants reported being offered the opportunity to engage in such shared decision making while hospitalized.
Our findings suggest an important role for patients in improving antibiotic use in hospitals. However, patient engagement has not been recognized as a critical component of antimicrobial stewardship programs. Our study suggests that the likelihood of patient engagement in stewardship practices is currently limited by low perceived susceptibility and lack of cues to act. Further investigation into how patients may be engaged as good stewards of antibiotics may reveal new ways to improve antibiotic prescribing practices in the inpatient setting.
The Herschel Space Observatory was the fourth cornerstone mission in the European Space Agency (ESA) science programme with excellent broad band imaging capabilities in the sub-mm and far-infrared part of the spectrum. Although the spacecraft finished its observations in 2013, it left a large legacy dataset that is far from having been fully scrutinised and still has a large potential for new scientific discoveries. This is specifically true for the photometric observations of the PACS and SPIRE instruments. Some source catalogues have already been produced by individual observing programs, but there are many observations that risk to remain unexplored. To maximise the science return of the SPIRE and PACS data sets, we are in the process of building the Herschel Point Source Catalogue (HPSC) from all primary and parallel mode observations. Our homogeneous source extraction enables a systematic and unbiased comparison of sensitivity across the different Herschel fields that single programs will generally not be able to provide. The catalogue will be made available online through archives like the Herschel Science Archive (HSA), the Infrared Science Archive (IRSA), and the Strasbourg Astronomical Data Center (CDS).