To save 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 saving content to .
To save 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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved 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.
Cognitive impairment is consistently reported in bipolar disorder (BD), but few studies have characterised which memory component processes are affected. Further, it is unknown whether the component processes underlying memory impairment are moderated by sex. The present study examined diagnosis and sex differences in both verbal and visual memory/learning domains in patients with BD and psychiatrically healthy controls.
Verbal and visual memory/learning were measured using the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R). 114 patients with BD (n = 50 males, n = 64 females), were compared to 105 psychiatrically healthy controls (n = 42 males, n = 63 females).
Patients with BD had worse performance in verbal and visual immediate and total recall, verbal and visual delayed free recall, and verbal recognition discrimination scores, but there were no group differences in learning slopes and cumulative learning index scores. There were trends for BD females to outperform BD males in visual memory/learning free recall and cumulative learning, but these results did not survive multiple testing correction. These findings did not change in a secondary sensitivity analysis comparing only strictly euthymic BD patients to controls (n = 64).
The present study found trait-like verbal and visual memory/learning impairment in BD that was attributable to deficient encoding and/or consolidation processes rather than deficits in learning. We did not find marked sex differences in either visual or verbal memory/learning measures, although some trend level effects were apparent and deserve exploration in future studies.
To estimate population-based rates and to describe clinical characteristics of hospital-acquired (HA) influenza.
US Influenza Hospitalization Surveillance Network (FluSurv-NET) during 2011–2012 through 2018–2019 seasons.
Patients were identified through provider-initiated or facility-based testing. HA influenza was defined as a positive influenza test date and respiratory symptom onset >3 days after admission. Patients with positive test date >3 days after admission but missing respiratory symptom onset date were classified as possible HA influenza.
Among 94,158 influenza-associated hospitalizations, 353 (0.4%) had HA influenza. The overall adjusted rate of HA influenza was 0.4 per 100,000 persons. Among HA influenza cases, 50.7% were 65 years of age or older, and 52.0% of children and 95.7% of adults had underlying conditions; 44.9% overall had received influenza vaccine prior to hospitalization. Overall, 34.5% of HA cases received ICU care during hospitalization, 19.8% required mechanical ventilation, and 6.7% died. After including possible HA cases, prevalence among all influenza-associated hospitalizations increased to 1.3% and the adjusted rate increased to 1.5 per 100,000 persons.
Over 8 seasons, rates of HA influenza were low but were likely underestimated because testing was not systematic. A high proportion of patients with HA influenza were unvaccinated and had severe outcomes. Annual influenza vaccination and implementation of robust hospital infection control measures may help to prevent HA influenza and its impacts on patient outcomes and the healthcare system.
We present the data and initial results from the first pilot survey of the Evolutionary Map of the Universe (EMU), observed at 944 MHz with the Australian Square Kilometre Array Pathfinder (ASKAP) telescope. The survey covers
of an area covered by the Dark Energy Survey, reaching a depth of 25–30
rms at a spatial resolution of
11–18 arcsec, resulting in a catalogue of
220 000 sources, of which
180 000 are single-component sources. Here we present the catalogue of single-component sources, together with (where available) optical and infrared cross-identifications, classifications, and redshifts. This survey explores a new region of parameter space compared to previous surveys. Specifically, the EMU Pilot Survey has a high density of sources, and also a high sensitivity to low surface brightness emission. These properties result in the detection of types of sources that were rarely seen in or absent from previous surveys. We present some of these new results here.
Although Li-Young Lee frequently presents himself as a poet of the absolute, his work is often demonstrably driven by a substrate of anger. Examining Lee’s first collection, Rose, this chapter shows how diasporic anger both influences Lee’s formal practices and shapes his self-understanding. As I strive to suggest, the collection develops what might be called a poetics of failure, a way of making poetry out of the failure of poetry. This poetics enables Lee both to tap into and to contain diasporic anger, ultimately generating what I call diasporic irony – an exile’s version of the literary and philosophical tradition of romantic irony. In substantiating these claims, I hope not only to call attention to anger as a recurrent and generative feature of Asian American literary and cultural production, but also to contribute to the renewed attention to form in Asian American literary criticism. Often dismissed as merely content-based, Asian American poetry is in fact formally innovative, and its formal innovations have everything to do with the sociohistorical and political conditions of its emergence.
In April 2019, the U.S. Fish and Wildlife Service (USFWS) released its recovery plan for the jaguar Panthera onca after several decades of discussion, litigation and controversy about the status of the species in the USA. The USFWS estimated that potential habitat, south of the Interstate-10 highway in Arizona and New Mexico, had a carrying capacity of c. six jaguars, and so focused its recovery programme on areas south of the USA–Mexico border. Here we present a systematic review of the modelling and assessment efforts over the last 25 years, with a focus on areas north of Interstate-10 in Arizona and New Mexico, outside the recovery unit considered by the USFWS. Despite differences in data inputs, methods, and analytical extent, the nine previous studies found support for potential suitable jaguar habitat in the central mountain ranges of Arizona and New Mexico. Applying slightly modified versions of the USFWS model and recalculating an Arizona-focused model over both states provided additional confirmation. Extending the area of consideration also substantially raised the carrying capacity of habitats in Arizona and New Mexico, from six to 90 or 151 adult jaguars, using the modified USFWS models. This review demonstrates the crucial ways in which choosing the extent of analysis influences the conclusions of a conservation plan. More importantly, it opens a new opportunity for jaguar conservation in North America that could help address threats from habitat losses, climate change and border infrastructure.
Understanding the development of specific components of the neonatal immune system is critical to the understanding of the susceptibility of the neonate to specific pathogens . With the increasing survival of extremely premature infants, neonatologists and other physicians caring for these newborns need to be aware of the vulnerability of this population. Furthermore, it is important for neonatologists to be able to differentiate between immune immaturity and the manifestations of a true primary immunodeficiency that present during the neonatal period. Failure to properly identify primary or acquired immunodeficiency diseases can result in delayed diagnosis and treatment, adversely affecting outcomes. This chapter will briefly define the immune immaturity of the neonate and a diagnostic approach for primary immune deficiency diseases that may present in the neonatal period.
Spinal muscular atrophy (SMA) is characterized by the progressive loss of motor neurons causing muscle atrophy and weakness. Nusinersen, the first effective SMA therapy was approved by Health Canada in June 2017 and has been added to the provincial formulary of all but one Canadian province. Access to this effective therapy has triggered the inclusion of SMA in an increasing number of Newborn Screening (NBS) programs. However, the range of disease-modifying SMN2 gene copy numbers encountered in survival motor neuron 1 (SMN1)-null individuals means that neither screen-positive definition nor resulting treatment decisions can be determined by SMN1 genotype alone. We outline an approach to this challenge, one that specifically addresses the case of SMA newborns with four copies of SMN2.
To develop a standardized post-referral evaluation pathway for babies with a positive SMA NBS screen result.
An SMA NBS pilot trial in Ontario using first-tier MassARRAY and second-tier multi-ligand probe amplification (MLPA) was launched in January 2020. Prior to this, Ontario pediatric neuromuscular disease and NBS experts met to review the evidence regarding the diagnosis and treatment of children with SMA as it pertained to NBS. A post-referral evaluation algorithm was developed, outlining timelines for patient retrieval and management.
Ontario’s pilot NBS program has created a standardized path to facilitate early diagnosis of SMA and initiation of treatment. The goal is to provide timely access to those SMA infants in need of therapy to optimize motor function and prolong survival.
The co-occurrence of the 2020 Atlantic hurricane season and the ongoing coronavirus disease 2019 (COVID-19) pandemic creates complex dilemmas for protecting populations from these intersecting threats. Climate change is likely contributing to stronger, wetter, slower-moving, and more dangerous hurricanes. Climate-driven hazards underscore the imperative for timely warning, evacuation, and sheltering of storm-threatened populations – proven life-saving protective measures that gather evacuees together inside durable, enclosed spaces when a hurricane approaches. Meanwhile, the rapid acquisition of scientific knowledge regarding how COVID-19 spreads has guided mass anti-contagion strategies, including lockdowns, sheltering at home, physical distancing, donning personal protective equipment, conscientious handwashing, and hygiene practices. These life-saving strategies, credited with preventing millions of COVID-19 cases, separate and move people apart. Enforcement coupled with fear of contracting COVID-19 have motivated high levels of adherence to these stringent regulations. How will populations react when warned to shelter from an oncoming Atlantic hurricane while COVID-19 is actively circulating in the community? Emergency managers, health care providers, and public health preparedness professionals must create viable solutions to confront these potential scenarios: elevated rates of hurricane-related injury and mortality among persons who refuse to evacuate due to fear of COVID-19, and the resurgence of COVID-19 cases among hurricane evacuees who shelter together.
This chapter restores the play Hypsipyle to a central place in discussions of female agency in tragedy by demonstrating how the intricacies of its plot result from a series of interconnected decisions made by women. At critical junctures both before and within the timeframe of the play itself, it is the female characters Hypsipyle, Eurydice and Eriphyle whose actions determine the course of the plot and have far-reaching implications for each other. The analysis in this chapter shows how the play’s happy ending – which sees Hypsipyle finally re-united with her twin sons – is made possible only because of a long series of choices enacted by these three women. In particular, Eurydice’s decision to exercise forgiveness and spare Hypsipyle, whose neglect of her son Opheltes has led to his death, marks a powerful departure from the vengeful mothers that we find in other tragedies. Through these characters, Euripides articulates a view of women’s experience and subjectivity that is no less rich and engaging than the male world of the unfolding expedition against Thebes, which forms this play’s backdrop.
There is a growing consensus in the literature that governance architectures matter. However, we lack sufficient knowledge about their emergence, dynamics and impacts. This concluding chapter summarizes all insights in the book Architectures of Earth System Governance, and emphasizes how this book has made a scientific contribution by enhancing conceptual clarity, synthesizing a decade of intense research, and charting directions for future research. The book has made at least one point clear: the ‘architecture lens’ offers a bird’s-eye view on the global governance landscape that is highly valuable in explaining outcomes of world politics. The architectures matter in how institutions interact with others, how institutions are entangled with others in larger regime complexes and how institutions are affected by broader architectures that are more or less fragmented or polycentric. In this concluding chapter, we also illustrate how such key insights gained could inform a set of transformative policy proposals regarding the architecture of earth system governance.
We estimate the ecosystem service value of water supplied by the San Bernardino National Forest in Southern California under climate change projections through the 21st century. We couple water flow projections from a dynamic vegetation model with an economic demand model for residential water originating from the San Bernardino National Forest. Application of the method demonstrates how estimates of consumer welfare changes due to variation in water supply from public lands in Southern California can inform policy and land management decisions. Results suggest variations in welfare changes over time due to alterations in the projected water supply surpluses, shifting demand limited by water supply shortages or surpluses, and price increases. Results are sensitive to future climate projections—in some cases large decreases in welfare due to supply shortages—and to assumptions about the demand model.
The dynamic interplay between surface and subsurface flow in the presence of a permeable boundary was investigated using low and high frame-rate particle-image velocimetry measurements in a refractive-index-matching flow environment. Two idealized permeable wall models were considered. Both models contained five layers of cubically packed spheres, but one exhibited a smooth interface with the flow, while the other embodied a hemispherical surface topography. The relationship between the large-scale turbulent motions overlying the permeable walls and the small-scale turbulence just above, and within, the walls was explored using instantaneous and statistical analyses. Although previous studies have indirectly identified the potential existence of amplitude modulation in permeable-wall turbulence (a phenomenon identified in impermeable-wall turbulence whereby the outer large scales modulate the intensity of the near-wall, small-scale turbulence), the present effort provides direct evidence of its existence in flow over both permeable walls considered. The spatio-temporal signatures of amplitude modulation were also characterized using conditional averaging based on zero-crossing events. This analysis highlights the connection between large-scale regions of high/low streamwise momentum in the surface flow, downwelling/upwelling across the permeable interface and enhancement/suppression of small-scale turbulence, respectively, just above and within the permeable walls. The presence of bed roughness is found to intensify the strength and penetration of flow into the permeable bed modulated by large-scale structures in the surface flow, and linked to possible roughness-formed channelling effects and shedding of smaller-scale flow structures from the roughness elements.
In many materials development projects, scientists and research heads make decisions to guide the project direction. For example, scientists may decide which processing steps to use, what elements to include in their material selection, or from what suppliers to source their materials. Research heads may decide whether to invest development effort in reducing the environmental impact or production cost of a material. When making these decisions, it would be helpful to know how those decisions affect the achievable performance of the materials under consideration. Often, these decisions are complicated by trade-offs in performance between competing properties. This paper presents an approach for visualizing and evaluating design spaces, where a design space is defined as the set of possible materials under consideration given specified constraints. This design space visualization approach is applied to two case studies with environmental impact motivations: one in biodegradability for solvents, and the other in sustainable materials sourcing for Li-ion batteries. The results demonstrate how this visualization approach can enable data-driven, quantitative decisions for project direction.
Research participants want to receive results from studies in which they participate. However, health researchers rarely share the results of their studies beyond scientific publication. Little is known about the barriers researchers face in returning study results to participants.
Using a mixed-methods design, health researchers (N = 414) from more than 40 US universities were asked about barriers to providing results to participants. Respondents were recruited from universities with Clinical and Translational Science Award programs and Prevention Research Centers.
Respondents reported the percent of their research where they experienced each of the four barriers to disseminating results to participants: logistical/methodological, financial, systems, and regulatory. A fifth barrier, investigator capacity, emerged from data analysis. Training for research faculty and staff, promotion and tenure incentives, and funding agencies supporting dissemination of results to participants were solutions offered to overcoming barriers.
Study findings add to literature on research dissemination by documenting health researchers’ perceived barriers to sharing study results with participants. Implications for policy and practice suggest that additional resources and training could help reduce dissemination barriers and increase the return of results to participants.
Hypertensive disorders of pregnancy (HDP) may increase the risk of offspring depression in childhood. Low birth weight is also associated with increased risk of mental health problems, including depression. This study sought to investigate (a) whether there is an association between HDP and the risk of depression in childhood and (b) whether low birth weight mediates this association. The current study is based on the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective, population-based study that has followed a cohort of offspring since their mothers were pregnant (n = 6,739). Depression at the age of 7 years was diagnosed using parent reports via the Development and Well-Being Assessment (DAWBA). Log-binomial regression and mediation analyses were used. Children exposed to HDP were 2.3 times more likely to have a depression diagnosis compared with nonexposed children, adjusted Risk Ratio [RR], 2.31; 95% CI, [1.20, 4.47]. Low birth weight was a weak mediator of this association. Results were adjusted for confounding variables including antenatal depression and anxiety during pregnancy.This study suggests that fetal exposure to maternal hypertensive disorders of pregnancy increased the risk of childhood depression. The study adds to the evidence suggesting that the uterine environment is a critical determinant of neurodevelopmental and psychiatric outcomes.