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.
Tom Dishion, a pioneer in prevention science, was one of the first to recognize the importance of adapting interventions to the needs of individual families. Building towards this goal, we suggest that prevention trials be used to assess baseline target moderated mediation (BTMM), where preventive intervention effects are mediated through change in specific targets, and the resulting effect varies across baseline levels of the target. Four forms of BTMM found in recent trials are discussed including compensatory, rich-get-richer, crossover, and differential iatrogenic effects. A strategy for evaluating meaningful preventive effects is presented based on preventive thresholds for diagnostic conditions, midpoint targets and proximal risk or protective mechanisms. Methods are described for using the results from BTMM analyses of these thresholds to estimate indices of intervention risk reduction or increase as they vary over baseline target levels, and potential cut points are presented for identifying subgroups that would benefit from program adaptation because of weak or potentially iatrogenic program effects. Simulated data are used to illustrate curves for the four forms of BTMM effects and how implications for adaptation change when untreated control group outcomes also vary over baseline target levels.
The properties of the acoustic modes are sensitive to magnetic activity. The unprecedented long-term Kepler photometry, thus, allows stellar magnetic cycles to be studied through asteroseismology. We search for signatures of magnetic cycles in the seismic data of Kepler solar-type stars. We find evidence for periodic variations in the acoustic properties of about half of the 87 analysed stars. In these proceedings, we highlight the results obtained for two such stars, namely KIC 8006161 and KIC 5184732.
Significant efforts have been made to identify risk factors associated with suicide. However, the evidence suggests that risk categorisation may be of limited value, or worse, potentially harmful, confusing clinical thinking. We argue instead for a shift in focus towards real engagement with the individual patient, their specific problems and circumstances.
Obsessive-compulsive disorder (OCD) is a chronic, relapsing mental illness. Selective serotonin reuptake inhibitors block serotonin transporters (SERTs) and are the mainstay of treatment for OCD. SERT abnormalities are reported in drug-free patients with OCD, but it is not known what happens to SERT levels during treatment. This is important as alterations in SERT levels in patients under treatment could underlie poor response, or relapse during or after treatment. The aim of the present study was first to validate a novel approach to measuring SERT levels in people taking treatment and then to investigate SERT binding potential (BP) using [11C]DASB PET in patients with OCD currently treated with escitalopram in comparison with healthy controls.
Twelve patients and age- and sex-matched healthy controls were enrolled. The patients and healthy controls underwent serial PET scans after administration of escitalopram and blood samples for drug concentrations were collected simultaneously with the scans. Drug-free BPs were obtained by using an inhibitory Emax model we developed previously.
The inhibitory Emax model was able to accurately predict drug-free SERT BP in people taking drug treatment. The drug-free BP in patients with OCD currently treated with escitalopram was significantly different from those in healthy volunteers [Cohen's d = 0.03 (caudate), 1.16 (putamen), 1.46 (thalamus), −5.67 (dorsal raphe nucleus)].
This result extends previous findings showing SERT abnormalities in drug-free patients with OCD by indicating that altered SERT availability is seen in OCD despite treatment. This could account for poor response and the high risk of relapse in OCD.
We study the problem of efficiently constructing a curve
over a finite field
for which either the curve
itself or its Jacobian has a prescribed number
In the case of the Jacobian, we show that any ‘CM-construction’ to produce the required genus-
curves necessarily takes time exponential in the size of its input.
On the other hand, we provide an algorithm for producing a genus-
curve with a given number of points that, heuristically, takes polynomial time for most input values. We illustrate the practical applicability of this algorithm by constructing a genus-
curve having exactly
(prime) points, and two genus-
curves each having exactly
In an appendix we provide a complete parametrization, over an arbitrary base field
of characteristic neither two nor three, of the family of genus-
maps to elliptic curves, including formulas for the genus-
curves, the associated elliptic curves, and the degree-
The exposure of indigenous humans and native fauna in Australia and the Wallacea zoogeographical region of Indonesia to exotic Salmonella serovars commenced during the colonial period and has accelerated with urbanization and international travel. In this study, the distribution and prevalence of exotic Salmonella serovars are mapped to assess the extent to which introduced infections are invading native wildlife in areas of high natural biodiversity under threat from expanding human activity. The major exotic Salmonella serovars, Bovismorbificans, Derby, Javiana, Newport, Panama, Saintpaul and Typhimurium, isolated from wildlife on populated coastal islands in southern temperate areas of Western Australia, were mostly absent from reptiles and native mammals in less populated tropical areas of the state. They were also not recorded on the uninhabited Mitchell Plateau or islands of the Bonaparte Archipelago, adjacent to south-eastern Indonesia. Exotic serovars were, however, isolated in wildlife on 14/17 islands sampled in the Wallacea region of Indonesia and several islands off the west coast of Perth. Increases in international tourism, involving islands such as Bali, have resulted in the isolation of a high proportion of exotic serovar infections suggesting that densely populated island resorts in the Asian region are acting as staging posts for the interchange of Salmonella infections between tropical and temperate regions.
Spectra from 1 to 2·5 μm, at 230–430 spectral resolution, are presented of the fluorescent molecular hydrogen line emission from two locations in the reflection nebula NGC 2023. Over 100 H2 lines can be identified in the spectra, although blending and poor atmospheric transmission mean that reliable level column densities can only be obtained from 35 lines. This latter group includes lines from v = 1–8 and v = 10, spanning an energy range from 6000 to 45,000 K above the ground state. These data may be used to constrain models of photodissociation regions and of fluorescent excitation for molecular hydrogen.
Plasmon waveguide resonance (PWR) Raman spectroscopy provides chemical content information with interface or thin film selectivity. Near the plasmon waveguide interface, large increases in the interfacial optical energy density are generated at incident angles where plasmon waveguide resonances are excited. When a polymer of sufficient thickness is deposited on a gold film, the interface acts as a plasmon waveguide and large enhancements in the Raman signal can be achieved. This paper presents calculations to show how polymer thickness and excitation wavelength are predicted to influence PWR Raman spectroscopy measurements. The results show the optical energy density (OED) integrated over the entire polymer film using 785 nm excitation are 1.7× (400 nm film), 2.17× (500 nm film), 2.48× (600 nm film), 3.08× (700 nm film) and 3.62× (800 nm film) higher compared to a 300 nm film. Accounting for the integrated OED and frequency to the fourth power dependence of the Raman scatter, a 532 nm excitation wavelength is predicted to generate the largest PWR Raman signal at the polymer waveguide interface. This work develops a foundation for chemical measurements of numerous devices, such as solar energy capturing devices that utilize conducting metals coated with thin polymer films.
After enactment of the first “modern” state adoption statute by Massachusetts in 1851, and the subsequent abolishment of slavery and indentured servitude by the Thirteenth Amendment to the U.S. Constitution, adoption in the United States, for the next 120 plus years, evolved as both a state judicial process and a specialized child welfare service to promote the so-called best interests of children in need of permanent homes. During the last two decades, however, developments such as (1) increased involvement of the federal government in promoting adoption for children in state foster care, (2) the federally mandated elimination of race from all adoption or foster care placement decision making, and (3) the rapid growth of private adoptions of infants as a “business” should force us to ask whether U.S. adoption today is meeting its original child welfare intent, or is rather serving the interests of adults. President Clinton's heralded Adoption 2002 Initiative and the 1993 Hague Convention on Protection of Children and Co-Operation in Respect of Intercountry Adoption declared an intent to promote the best interests of children adopted within the country or from outside the country – but is this happening?
As we move into the second decade of the new millennium, all serious child advocates and responsible professionals working in the field of adoption should question the efficacy of the current federal prohibition against any consideration of race in adoption or foster care placement decision making.
Image capture systems that display and record endoscopic images are important for documentation and teaching. We have modified a universal serial bus microscope to couple with most clinical endoscopes used in our practice. This very economical device produces images suitable for teaching, and potentially for clinical use. The implications of this could be significant for teaching, patient education, documentation and the developing world.
Residents must become proficient in a variety of procedures. The practice of learning procedural skills on patients has come under ethical scrutiny, giving rise to the concept of simulation-based medical education. Resident training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the impact of a simulation-based procedural skills training course on residents' competence in the performance of critical resuscitation procedures.
We solicited self-assessments of the knowledge and clinical skills required to perform resuscitation procedures from a cross-sectional multidisciplinary sample of 28 resident study participants. Participants were then exposed to an intensive 8-hour simulation-based training program, and asked to repeat the self-assessment questionnaires on completion of the course, and again 3 months later. We assessed the validity of the self-assessment questionnaire by evaluating participants' skills acquisition through an Objective Structured Clinical Examination station.
We found statistically significant improvements in participants' ratings of both knowledge and clinical skills during the 3 self-assessment periods (p < 0.001). The participants' year of postgraduate training influenced their self-assessment of knowledge (F2,25 = 4.91, p < 0.01) and clinical skills (F2,25 = 10.89, p < 0.001). At the 3-month follow-up, junior-level residents showed consistent improvement from their baseline scores, but had regressed from their posttraining measures. Senior-level residents continued to show further increases in their assessments of both clinical skills and knowledge beyond the simulation-based training course.
Significant improvement in self-assessed theoretical knowledge and procedural skill competence for residents can be achieved through participation in a simulation-based resuscitation course. Gains in perceived competence appear to be stable over time, with senior learners gaining further confidence at the 3-month follow-up. Our findings support the benefits of simulation-based training for residents.
The number of plaque-forming units is underestimated if plaques overlap. A simple model was developed to account for this bias, and tested by an extensive experimental analysis. It is shown that models of this type are inadequate, but can be modified to give objective methods for setting limits to the acceptable counting range, and for correcting the overlap bias of observed counts which fall within this range.
Where overlapping of plaques is a significant source of error, these methods will improve the efficiency of plaque assays and will render the statistical analysis of counting data more reliable.
The overlapping of plaques compresses their distributions and reduces observed variances. For a given distribution the reduction of the variance is substantially larger than that of the mean. To derive the error of a plaque assay from the assumption that the variance equals the mean may therefore lead to serious over-estimation of the precision of the assay.
Procedures for estimating the true error of plaque assays are developed, and their use is illustrated on experimental material.
This report describes the occurrence of pneumonitis in a young male immediately after inhalation of aerosolized chemicals subsequent to motor vehicle airbag deployment. The clinical presentation was one of mild shortness of breath associated with bilateral alveolar infiltrates on chest radiology. Not previously described, this diagnosis should be considered in the differential of pulmonary infiltrates in motor vehicle crash patients.