To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Chronic suppurative otitis media is a massive public health problem in numerous low- and middle-income countries. Unfortunately, few low- and middle-income countries can offer surgical therapy.
A six-month long programme in Cambodia focused on training local surgeons in type I tympanoplasty was instigated. Qualitative educational and quantitative surgical outcomes were evaluated in the 12 months following programme completion. A four-month long training programme in mastoidectomy and homograft ossiculoplasty was subsequently implemented, and the preliminary surgical and educational outcomes were reported.
A total of 124 patients underwent tympanoplasty by the locally trained surgeons. Tympanic membrane closure at six weeks post-operation was 88.5 per cent. Pure tone audiometry at three months showed that 80.9 per cent of patients had improved hearing, with a mean gain of 17.1 dB. The trained surgeons reported high confidence in performing tympanoplasty. Early outcomes suggest the local surgeons can perform mastoidectomy and ossiculoplasty as safely as overseas-trained surgeons, with reported surgeon confidence reflecting these positive outcomes.
The training programme has demonstrated success, as measured by surgeon confidence and operative outcomes. This approach can be emulated in other settings to help combat the global burden of chronic suppurative otitis media.
Schizophrenia is a highly heritable disorder, linked to several structural abnormalities of the brain. More specifically, previous findings have suggested that increased gyrification in frontal and temporal regions are implicated in the pathogenesis of schizophrenia.
The current study included participants at high familial risk of schizophrenia who remained well (n = 31), who developed sub-diagnostic symptoms (n = 28) and who developed schizophrenia (n = 9) as well as healthy controls (HC) (n = 16). We first tested whether individuals at high familial risk of schizophrenia carried an increased burden of trait-associated alleles using polygenic risk score analysis. We then assessed the extent to which polygenic risk was associated with gyral folding in the frontal and temporal lobes.
We found that individuals at high familial risk of schizophrenia who developed schizophrenia carried a significantly greater burden of risk-conferring variants for the disorder compared to those at high risk (HR) who developed sub-diagnostic symptoms or remained well and HC. Furthermore, within the HR cohort, there was a significant and positive association between schizophrenia polygenic risk score and bilateral frontal gyrification.
These results suggest that polygenic risk for schizophrenia impacts upon early neurodevelopment to confer greater gyral folding in adulthood and an increased risk of developing the disorder.
A deep-ice temperature measurement program has been conducted on Trapridge Glacier, Yukon Territory. Large regions of temperate ice are predicted at the base of the otherwise cold glacier, The glacier snout, frozen to bedrock, appears to act as an ice dam allowing the build up of an ice reservoir in the upper regions. Thermal regulation of the surges of Trapridge Glacier is suggested and the relevance of basal temperatures in large surging glaciers is discussed.
Ice temperature measurements have been made in Steele Glacier to a depth of 114 m. All measured temperatures were below 0° C, the coldest being –6.5° C at a depth of 114 m. The temperature profile indicates an anomalously warm layer of ice between 30 m and 50 m, which is probably due to the freezing of water in crevasses opened during the 1965–66 surge. A two-dimensional model of a cold glacier with partially water-filled crevasses predicts temperature profiles very similar to that observed.
As part of a program to study surge-type glaciers, a radar-depth survey, using a frequency of 620 MHz, has been made of Trapridge Glacier, Yukon Territory. Soundings were taken at 26 locations on the glacier surface and a maximum ice thickness of 143 m was measured. A rapid change in surface slope in the lower ablation region marks the boundary between active and stagnant ice and is suggestive of an “ice dam” or the water “collection zone” postulated by Robin and Weertman for surging glaciers.
Jakobshavns Isbræ is a large, fast-moving ice stream/outlet glacier in West Greenland which ends at a floating, calving front. It drains about 6.5% of the area of the Greenland ice sheet. Studies of its surface morphology are described in this paper. The surface is relatively steep (0.01–0.03) and the thickness is large (up to 2600 m along the center line (Clarke and Echelmeyer, 1989)), indicating very high driving stresses (200–300 kPa). The ice stream is about 6 km wide and 85–90 km long, all of which is in an area of surface melting. The base of the ice stream, and of much of the drainage area, is below sea level. Marginal crevasse zones have a width on the order of the width of the ice stream itself. Unique surficial features are ice blisters and lakes; the latter have a sequence of ogive-like features on their floating ice cover which can be used to determine velocity. There is a pinning point near the terminus which may act as a stabilizing influence, possibly playing a role in halting, at least temporarily, a recent retreat of the terminus. Ice-thickness estimates at the terminus lead to a flux which is less than previously assumed by others (e.g. Bindschadler, 1984; Pelto and others, 1989) when estimating Jakobshavns Isbræ’s drainage basin to be nearly in balance.
The driving stresses on Jakobshavns Isbræ are an order of magnitude higher than those of the ice streams of West Antarctica. Its crevasse patterns are much less localized. Its relatively unconfined terminus is more comparable to that of relatively unbuttressed ice streams such as Pine Island and Thwaites Glaciers than it is to other West Antarctic ice streams which terminate in large, confined ice shelves.
The fragmented ecosystems along the Niagara Escarpment World Biosphere Reserve provide important habitats for biota including lichens. Nonetheless, the Reserve is disturbed by dense human populations and associated air pollution. Here we investigated patterns of lichen diversity within urban and rural sites at three different locations (Niagara, Hamilton, and Owen Sound) along the Niagara Escarpment in Ontario, Canada. Our results indicate that both lichen species richness and community composition are negatively correlated with increasing human population density and air pollution. However, our quantitative analysis of community composition using canonical correspondence analysis (CCA) indicates that human population density and air pollution is more independent than might be assumed. The CCA analysis suggests that the strongest environmental gradient (CCA1) associated with lichen community composition includes regional pollution load and climatic variables; the second gradient (CCA2) is associated with local pollution load and human population density factors. These results increase the knowledge of lichen biodiversity for the Niagara Escarpment and urban and rural fragmented ecosystems as well as along gradients of human population density and air pollution; they suggest a differential influence of regional and local pollution loads and population density factors. This study provides baseline knowledge for further research and conservation initiatives along the Niagara Escarpment World Biosphere Reserve.
Serum thyroglobulin is used as a surrogate marker for well-differentiated thyroid carcinoma recurrence. This study investigates whether thyroglobulin measured at the time of ablative radioactive iodine therapy predicts disease-free survival.
A retrospective review was conducted of patients with well-differentiated thyroid carcinoma presenting from 1989 to 2010 at the Royal Prince Alfred Hospital, New South Wales, Australia. Disease-free survival of patients with a significantly elevated stimulated thyroglobulin level (27.5 µg/l or higher) at the time of ablative radioactive iodine therapy was compared to that of patients without a significantly elevated thyroglobulin level using univariate analysis.
Patients with a thyroglobulin level of 27.5 µg/l or higher had an increased relative risk of disease recurrence of 4.50 (95 per cent confidence interval = 1.35–15.04). If lateral neck dissection was required at the time of surgery, patients also had an increased relative risk of macroscopic disease recurrence of 4.94 (95 per cent confidence interval = 1.47–16.55).
An elevated thyroglobulin level of 27.5 µg/l or higher at the time of ablative radioactive iodine therapy is a prognostic indicator for macroscopic disease recurrence in well-differentiated thyroid carcinoma.
The rate at which the poaching of rhinoceroses has escalated since 2010 poses a threat to the long-term persistence of extant rhinoceros populations. The policy response has primarily called for increased investment in military-style enforcement strategies largely based upon simple economic models of rational crime. However, effective solutions will probably require a context-specific, stakeholder-driven mix of top-down and bottom-up mechanisms grounded in theory that represents human behaviour more realistically. Using a problem-oriented approach we illustrate in theory and practice how community-based strategies that explicitly incorporate local values and institutions are a foundation for combating rhinoceros poaching effectively in specific contexts. A case study from Namibia demonstrates how coupling a locally devised rhinoceros monitoring regime with joint-venture tourism partnerships as a legitimate land use can reconcile individual values represented within a diverse stakeholder group and manifests as both formal and informal community enforcement. We suggest a social learning approach as a means by which international, national and regional governance can recognize and promote solutions that may help empower local communities to implement rhinoceros management strategies that align individual values with the long-term health of rhinoceros populations.
Little is known about cause-specific long-term mortality beyond 30 days in pneumonia. We aimed to compare the mortality of patients with hospitalized pneumonia compared to age- and sex-matched controls beyond 30 days. Participants were drawn from the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study. Hospitalized pneumonia cases were identified from record linkage (ICD-10: J12-J18). For this study we excluded people with hospitalized pneumonia who died within 30 days. Each case identified was matched to four controls and followed up until the end June 2012 (total 15 074 person-years, mean 6·1 years, range 0·08–15·2 years). Cox regression models were constructed to examine the all-cause, respiratory and cardiovascular mortality using date of pneumonia onset as baseline with binary pneumonia status as exposure. A total of 2465 men and women (503 cases, 1962 controls) [mean age (s.d.) 64·5 (8·3) years] were included in the study. Between a 30-day to 1-year period, hazard ratios (HRs) of all-cause and cardiovascular mortality were 7·3 [95% confidence interval (CI) 5·4–9·9] and 5·9 (95% CI 3·5–9·7), respectively (with very few respiratory deaths within the same period) in cases compared to controls after adjusting for age, sex, asthma, smoking status, pack years, systolic and diastolic blood pressure, diabetes, physical activity, waist-to-hip ratio, prevalent cardiovascular and respiratory diseases. All outcomes assessed also showed increased risk of death in cases compared to controls after 1 year; respiratory cause of death being the most significant during that period (HR 16·4, 95% CI 8·9–30·1). Hospitalized pneumonia was associated with increased all-cause and specific-cause mortality beyond 30 days.
Intestinal health is important for maximising the health, welfare, and performance of poultry. In addition, intestinal health issues in poultry can have devastating financial impacts for producers, and food safety concerns for consumers. Until recently, intestinal health issues were seen as a handful of known infectious agents leading to a set of severe and identifiable named diseases. There is however an emerging area which depicts intestinal health as a more complex and multifaceted system than previously known. Recent progress in technology suitable for microbial community analysis has evolved our understanding of the chicken intestinal microbiome. It is now understood that shifts in the composition of microbial communities can occur. These shifts can result in a series of implications, including: disease, welfare, environmental, and food safety concerns. Minor shifts in intestinal microbial balance can result in a wide continuum of disease presentations ranging from severe to mild clinical, subclinical or asymptotic. Differential diagnosis of poultry intestinal health issues may be challenging and is important for applying appropriate treatment options. This review discusses new and emerging topics in broiler chicken intestinal health, with a focus on microbial composition, newly discovered microbial shifts in classical poultry diseases, range in severity of enteric diseases, newly identified organisms in normal intestinal flora, implications of shifts in intestinal microbial communities and diagnosis of emerging intestinal health issues in poultry.
The Murchison Widefield Array is a Square Kilometre Array Precursor. The telescope is located at the Murchison Radio–astronomy Observatory in Western Australia. The MWA consists of 4 096 dipoles arranged into 128 dual polarisation aperture arrays forming a connected element interferometer that cross-correlates signals from all 256 inputs. A hybrid approach to the correlation task is employed, with some processing stages being performed by bespoke hardware, based on Field Programmable Gate Arrays, and others by Graphics Processing Units housed in general purpose rack mounted servers. The correlation capability required is approximately 8 tera floating point operations per second. The MWA has commenced operations and the correlator is generating 8.3 TB day−1 of correlation products, that are subsequently transferred 700 km from the MRO to Perth (WA) in real-time for storage and offline processing. In this paper, we outline the correlator design, signal path, and processing elements and present the data format for the internal and external interfaces.
Antarctic and Southern Ocean science is vital to understanding natural variability, the processes that govern global change and the role of humans in the Earth and climate system. The potential for new knowledge to be gained from future Antarctic science is substantial. Therefore, the international Antarctic community came together to ‘scan the horizon’ to identify the highest priority scientific questions that researchers should aspire to answer in the next two decades and beyond. Wide consultation was a fundamental principle for the development of a collective, international view of the most important future directions in Antarctic science. From the many possibilities, the horizon scan identified 80 key scientific questions through structured debate, discussion, revision and voting. Questions were clustered into seven topics: i) Antarctic atmosphere and global connections, ii) Southern Ocean and sea ice in a warming world, iii) ice sheet and sea level, iv) the dynamic Earth, v) life on the precipice, vi) near-Earth space and beyond, and vii) human presence in Antarctica. Answering the questions identified by the horizon scan will require innovative experimental designs, novel applications of technology, invention of next-generation field and laboratory approaches, and expanded observing systems and networks. Unbiased, non-contaminating procedures will be required to retrieve the requisite air, biota, sediment, rock, ice and water samples. Sustained year-round access to Antarctica and the Southern Ocean will be essential to increase winter-time measurements. Improved models are needed that represent Antarctica and the Southern Ocean in the Earth System, and provide predictions at spatial and temporal resolutions useful for decision making. A co-ordinated portfolio of cross-disciplinary science, based on new models of international collaboration, will be essential as no scientist, programme or nation can realize these aspirations alone.
The current gold-standard therapeutic strategies for bone grafts in the patient population are to use either allograft or autograft bone. Although these approaches have a long track record of utilization, neither is without risk to the patient, and there remains a desire in the field to improve treatment options. While there have been treatments approved by the FDA for full length growth factors and calcium salt-laden collagen sponges, these are not available for the entire population of potential bone graft patients. One viable strategy to focus on these concerns is to design an implantable bone graft substitute that can address all the negative drawbacks of autograft bone, allograft bone, and full length proteins. The work provides a preliminary investigation of synthetic, nanofiber-permeated, composite polymer/ceramic scaffold for bone repair using thermally induced phase separation, PLLA microspheres, and hydroxyapatite. The scaffolds as described have fiber diameters that mimic natural collagen ECM networks in bone as determined by scanning electron microscopy and will serve as the basis for future studies in substrate-guided bone tissue regeneration.