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Bronchoscopic procedures are commonly performed for diagnosis of respiratory disorders and therapeutic airway treatment and management. A thorough understanding of procedural and technical fundamentals is critical for improving yield and safety, but they are not featured in procedural reviews for advanced endoscopists. In this book those critical cornerstones of performing bronchoscopy are discussed and explained in detail. Following the successful structure of the first edition, the fully updated content provides detailed reviews of procedural fundamentals including endobronchial ultrasound. Equipment components are described and maintenance is discussed. All chapters include advice on procedural quality improvement. Regulatory requirements, bronchoscopy procedure unit design and management principles are also addressed. This text will be beneficial to a wide range of practitioners including trainees and specialists in pulmonary and all critical care fields, surgeons, anaesthesiologists and respiratory therapists.
In unipolar depressed patients participating in trials on antidepressants, we investigated if illness characteristics at baseline could predict conversion to bipolar disorder.
A long-term register-based follow-up study of 290 unipolar depressed patients with a mean age of 50.8 years (SD = 11.9) participating in three randomized trials on antidepressants conducted in the period 1985–1994. The independent effects of explanatory variables were examined by applying Cox regression analyses.
The overall risk of conversion was 20.7%, with a mean follow-up time of 15.2 years per patient. The risk of conversion was associated with an increasing number of previous depressive episodes at baseline, [HR 1.18, 95% CI (1.10–1.26)]. No association with gender, age, age at first depressive episode, duration of baseline episode, subtype of depression or any of the investigated HAM-D subscales included was found.
The patients were followed-up through the Danish Psychiatric Central Research Register, which resulted in inherent limitations such as possible misclassification of outcome.
In a sample of middle-aged hospitalized unipolar depressed patients participating in trials on antidepressants, the risk of conversion was associated with the number of previous depressive episodes. Therefore, this study emphasizes that unipolar depressed patients experiencing a relatively high number of recurrences should be followed more closely, or at least be informed about the possible increased risk of conversion.
As physical activity may modify the effect of the apolipoprotein E (APOE) ε4 allele on the risk of dementia and Alzheimer's disease (AD) dementia, we tested for such a gene–environment interaction in a sample of general practice patients aged ⩾75 years.
Data were derived from follow-up waves I–IV of the longitudinal German study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). The Kaplan–Meier survival method was used to estimate dementia- and AD-free survival times. Multivariable Cox regression was used to assess individual associations of APOE ε4 and physical activity with risk for dementia and AD, controlling for covariates. We tested for gene–environment interaction by calculating three indices of additive interaction.
Among the randomly selected sample of 6619 patients, 3327 (50.3%) individuals participated in the study at baseline and 2810 (42.5%) at follow-up I. Of the 2492 patients without dementia included at follow-up I, 278 developed dementia (184 AD) over the subsequent follow-up interval of 4.5 years. The presence of the APOE ε4 allele significantly increased and higher physical activity significantly decreased risk for dementia and AD. The co-presence of APOE ε4 with low physical activity was associated with higher risk for dementia and AD and shorter dementia- and AD-free survival time than the presence of APOE ε4 or low physical activity alone. Indices of interaction indicated no significant interaction between low physical activity and the APOE ε4 allele for general dementia risk, but a possible additive interaction for AD risk.
Physical activity even in late life may be effective in reducing conversion to dementia and AD or in delaying the onset of clinical manifestations. APOE ε4 carriers may particularly benefit from increasing physical activity with regard to their risk for AD.
The WGARG was created in 2001 to oversee the rapid growth of the quantitative determination and understanding of the abundance patterns seen in red-giant stars. As the field progresses we are regularly reminded of how broad and multi-disciplinary is this area of research.
Gas-accepting ion sources for radiocarbon accelerator mass spectrometry (AMS) have permitted the direct analysis of CO2 gas, eliminating the need to graphitize samples. As a result, a variety of analytical instruments can be interfaced to an AMS system, processing time is decreased, and smaller samples can be analyzed (albeit with lower precision). We have coupled a gas chromatograph to a compact 14C AMS system fitted with a microwave ion source for real-time compound-specific 14C analysis. As an initial test of the system, we have analyzed a sample of fatty acid methyl esters and biodiesel. Peak shape and memory was better then existing systems fitted with a hybrid ion source while precision was comparable. 14C/12C ratios of individual components at natural abundance levels were consistent with those determined by conventional methods. Continuing refinements to the ion source are expected to improve the performance and scope of the instrument.
The classical time series decomposition method was used to compare the temporal pattern of rabies in Chile before and after the implementation of the control programme. In the years 1950–60, a period without control measures, rabies showed an increasing trend, a seasonal excess of cases in November and December and a cyclic behaviour with outbreaks occurring every 5 years. During 1961–1970 and 1971–86, a 26-year period that includes two different phases of the rabies programme which started in 1961, there was a general decline in the incidence of rabies. The seasonality disappeared when the disease reached a low frequency level and the cyclical component was not evident.
In the context of a general survey on the thermoelectric potential of cationic clathrates, formation, crystal chemistry and physical properties were investigated for novel inverse clathrates deriving from Sn19.3Cu4.7P22I8. Substitution of Cu by Zn and Sn by Ni was attempted to bring down electrical resistivity and lower thermal conductivity. Materials were synthesized by mechanical alloying using a ball mill and hot pressing. Structural investigations for all specimens confirm isotypism with the cubic primitive clathrate type I structure (lattice parameters a = ˜1.1 nm and space group type Pm-3n). Studies of transport properties evidence holes as the majority charge carriers. Thermal expansion data, measured in a capacitance dilatometer from 4 to 300 K on Sn19.3Cu1.7Zn3P19.92.1I8, compare well with literature data available for Sn24P19.62.4Br8 and for an anionic type I clathrate Ba8Zn8Ge38. From the rather complex crystal structure including split atom sites and lattice defects thermal conductivity in inverse clathrates is generally low. Following Zintl rules rather closely inverse clathrates tend to be semiconductors with attractive Seebeck coefficients. Thus for thermoelectric applications the main activity will have to focus on achieving low electrical resistivity in a compromise with still sufficiently high Seebeck coefficients.
The main activity of the WG on Abundances in Red Giants has been to propose a JD for the IAU GA in 2009. The increasing evidence for distinct populations within globular clusters is leading to the view that there is a continuum between globular clusters and the smallest of the galaxies. Our JD was designed to investigate this link. However, our JD was incorporated into IAU Symposium No. 266 Star Clusters: Basic Building Blocks throughout Time and Space for the IAU XXVII in Rio de Janeiro, 2009. We will be responsible for organising one session in the Symposium to cover the agenda put forward in our JD proposal.
Chronic elevations of endogenous cortisol levels have been shown to alter medial temporal cortical structures and to be accompanied by declarative memory impairments and depressive symptoms in human adults. These effects of elevated endogenous levels of cortisol have not been directly studied in adolescents. Because adolescents with Cushing syndrome show endogenous elevations in cortisol, they represent a unique natural model to study the effects of prolonged hypercortisolemia on brain function, and memory and affective processes during this developmental stage. Using functional magnetic resonance imaging (fMRI), we compared 12 adolescents with Cushing syndrome with 22 healthy control adolescents on amygdala and anterior hippocampus activation during an emotional faces encoding task. None of these adolescents manifested depressive symptoms. Encoding success was assessed using a memory recognition test performed after the scan. The fMRI analyses followed an event-related design and were conducted using the SPM99 platform. Compared to healthy adolescents, patients with Cushing syndrome showed greater left amygdala and right anterior hippocampus activation during successful face encoding. Memory performance for faces recognition did not differ between groups. This first study of cerebral function in adolescents with chronic endogeneous hypercortisolemia due to Cushing syndrome demonstrates the presence of functional alterations in amygdala and hippocampus, which are not associated with affective or memory impairments. Such findings need to be followed by work examining the role of age and related brain maturational stage on these effects, as well as the identification of possible protective factors conferring resilience to affective and cognitive consequences in this disease and/or during this stage of cerebral development.