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Cricothyrotomy and chest needle decompression (NDC) have a high failure and complication rate. This article sought to determine whether paramedics can correctly identify the anatomical landmarks for cricothyrotomy and chest NDC.
A prospective study using human models was performed. Paramedics were partnered and requested to identify the location for cricothyrotomy and chest NDC (both mid-clavicular and anterior axillary sites) on each other. A board-certified or board-eligible emergency medicine physician timed the process and confirmed location accuracy. All data were collected de-identified. Descriptive analysis was performed on continuous data; chi-square was used for categorical data.
A total of 69 participants were recruited, with one excluded for incomplete data. The paramedics had a range of six to 38 (median 14) years of experience. There were 28 medical training officers (MTOs) and 41 field paramedics. Cricothyroidotomy location was correctly identified in 56 of 68 participants with a time to identification range of 2.0 to 38.2 (median 8.6) seconds. Chest NDC (mid-clavicular) location was correctly identified in 54 of 68 participants with a time to identification range of 3.4 to 25.0 (median 9.5) seconds. Chest NDC (anterior axillary) location was correctly identified in 43 of 68 participants with a time to identification range of 1.9 to 37.9 (median 9.6) seconds. Chi-square (2-tail) showed no difference between MTO and field paramedic in cricothyroidotomy site (P = .62), mid-clavicular chest NDC site (P = .21), or anterior axillary chest NDC site (P = .11). There was no difference in time to identification for any procedure between MTO and field paramedic.
Both MTOs and field paramedics were quick in identifying correct placement of cricothyroidotomy and chest NDC location sites. While time to identification was clinically acceptable, there was also a significant proportion that did not identify the correct landmarks.
Altered levels of phenylalanine and its metabolites in blood and cerebrospinal fluid have previously been reported in schizophrenia. This study attempted to examine whether phenylalanine kinetics is altered in schizophrenia using the 13C-phenylalanine breath test (13C-PBT).
Subjects were 20 patients with schizophrenia and the same number of controls. 13C-phenylalanine was administered and then 13CO2 concentration in breath was monitored for 120 minutes. The Δ 13CO2 at each collecting time, the maximal Δ 13CO2 (Cmax), the time to reach Cmax (Tmax), the area under the curve of time course of Δ13CO2 (AUC), the cumulative recovery rate (CRR) at each collecting time of the 13C-PBT were calculated for each subject.
Body weight (BW) and diagnostic status were significant predictors for Cmax. BW, age and diagnostic status were significant predictors for AUC and CRR at 120 minutes (CRR0-120). A repeated measures ANCOVA controlling for age and BW revealed a different pattern of change in CRR over time between the patients and controls and that Δ13CO2 in schizophrenia were lower than that in healthy control at all sampling point during 120 min, with an overall significant differences between healthy control and schizophrenia. The ANCOVA controlling for age and BW, showed that Cmax, AUC and CRR0-120 were significantly lower in schizophrenics than in controls.
Our data indicate the different change of Δ13CO2 and CRR over time and the decreased Cmax, AUC and CRR0-120 of 13C-PBT in schizophrenia patients compared to healthy controls, suggesting the altered phenylalanine kinetics in schizophrenia.
Public health checkups are conducted on 3-year-old children in Japan. However, it is often difficult to detect or provide ongoing support to children with developmental disorders without MR. Therefore we have conducted health checkups on 5 year olds.
The objectives are to describe the results and follow-up of health checkups in 5-year-old children and examine the utility of such checkups.
The aims are to make clear the utility of health checkups in 5-year-old children for screening for developmental disorders.
The subjects were 303 children of 5-year-old that lived in Kanie-cho and participated in health checkups. in the checkups, a child psychiatrist examined the children, and made a provisional diagnosis of a developmental disorder.
Eighty-two children were provisionally diagnosed as having developmental disorders. the follow-up allowed final diagnosis of developmental disorders (suspect diagnosis included) to be made in 39 children (12.9%), and pinpointed 19 children with ADHD, 9 children with PDD, 9 children with mild MR, and 2 children with motor skills disorder.
All children with PDD had already been informed about the possible occurrence of developmental disorders at 3 years of age. However, most of ADHD, mild MR, and motor function disorder were diagnosed in these children during the checkups at the age of 5 years.
The health checkup in 5-year-old children is useful not only as a tool to detect developmental disorders that are difficult to diagnose at the age of 3 years but also as an approach in patients lost to follow-up.
Children with Learning Disorders (LD) are susceptible to decreased self-esteem and willingness because of their difficulty learning, which can lead to exacerbation of the learning difficulty in a vicious cycle. Appropriate learning supports may help not only in terms of learning, but also psychologically.
The purpose of this study was to investigate the psychological effect of learning supports for children with LD.
The aims are to make clear that psychological changes occur for children by the learning supports.
We conducted 10 learning support sessions for 12 children (age 8–11 years) diagnosed as LD. Afterward, we gave a questionnaire on motivation and self-efficacy in learning to the children and their parents, and a questionnaire on positive participation in class to the children's teachers.
The children's responses showed increased intrinsic motivation with high autonomy, and decreased extrinsic motivation with low autonomy and self-efficacy after supports. the parents’ responses indicated increased self-efficacy and decreased motivation overall after supports, while the teachers’ responses indicated increased positive class participation after supports.
Parents and teachers see that willingness for learning improve through learning supports, but the children themselves feel decreased efficacy. At the same time, the children came to have more autonomous intrinsic motivation for learning. Both of motivation and willigness increased through learning supports, but conversely the children came to notice their own weaknesses (true abilities), which is thought to have led to decreased self-efficacy. with continuing support improvement of true efficacy may be expected.
The Keio Twin Research Center (KoTReC) was established in 2009 at Keio University to combine two longitudinal cohort projects — the Keio Twin Study (KTS) for adolescence and adulthood and the Tokyo Twin Cohort Project (ToTCoP) for infancy and childhood. KoTReC also conducted a two-time panel study of self-control and psychopathology in twin adolescence in 2012 and 2013 and three independent anonymous cross-sectional twin surveys (ToTcross) before 2012 — the ToTCross, the Junior and Senior High School Survey and the High School Survey. This article introduces the recent research designs of KoTReC and its publications.
We report fourteen and twenty-eight protocluster candidates at z = 5.7 and 6.6 over 14 and 19 deg2 areas, respectively, selected from 2,230 Lyα emitters (LAEs) photometrically identified with Subaru/Hyper Suprime-Cam (HSC) deep images. Six out of the 42 protocluster candidates include at least 1 spectroscopically confirmed LAEs at redshifts up to z = 6.574. By the comparisons with the cosmological Lyα radiative transfer (RT) model reproducing LAEs with the reionization effects, we find that more than a half of these protocluster candidates might be progenitors of the present-day clusters with a mass of ≳ 1014M⊙. We also investigate the correlation between LAE overdensity and Lya rest-frame equivalent width (EW), because the cosmological Lyα RT model suggests that a slope of EW-overdensity relation is steepened towards the epoch of cosmic reionization (EoR), due to the existence of the ionized bubbles around galaxy overdensities easing the escape of Lyα emission from the partly neutral intergalactic medium. The available HSC data suggest that the slope of the EW-overdensity correlation does not evolve from the post-reionization epoch z = 5.7 to the EoR z = 6.6 beyond the moderately large statistical errors.
The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
A new generation of high power laser facilities will provide laser pulses with extremely high powers of 10 petawatt (PW) and even 100 PW, capable of reaching intensities of
in the laser focus. These ultra-high intensities are nevertheless lower than the Schwinger intensity
at which the theory of quantum electrodynamics (QED) predicts that a large part of the energy of the laser photons will be transformed to hard Gamma-ray photons and even to matter, via electron–positron pair production. To enable the investigation of this physics at the intensities achievable with the next generation of high power laser facilities, an approach involving the interaction of two colliding PW laser pulses is being adopted. Theoretical simulations predict strong QED effects with colliding laser pulses of
focused to intensities
We aimed to verify the effectiveness of real-time reverse transcription (rRT) polymerase chain reaction (PCR) for detecting cases of modified measles (M-Me) and for predicting super-spreader candidates through the experience of a measles outbreak dominated by M-Me in Yamagata, Japan, during March–April 2017. We applied rRT-PCR to specimens from 35 cases of M-Me, nine cases of typical measles (T-Me) and nine cases of prodromal stage of T-Me (P-Me). From rRT-PCR among the M-Me cases, peripheral blood mononuclear cells (PBMC) showed the highest positive rate (80.0%), followed by throat swab (48.6%), urine (33.3%) and serum (3.1%). The negative result of PBMC in M-Me cases was recovered by the result of a throat swab. In specimens of PBMC, throat swab and urine, M-Me group showed the significantly higher cycle of threshold (i.e., lower viral load) in the rRT-PCR than T-Me and P-Me groups, respectively. Furthermore, three super-spreaders in T-Me or P-Me showed an extremely low cycle of threshold in their throat swab specimens. rRT-PCR using PBMC and throat swab might be helpful for clinical management and measles control by certain detection of M-Me cases and by predicting super-spreading events resulting from measles cases with the high viral load.
The theme of this focus meeting is related to the detection, characterization and modeling of nano particles — cosmic dust of sizes of roughly 1 to 100 nm — in space environments like the interstellar medium, planetary debris disks, the heliosphere, the vicinity of the Sun and planetary atmospheres, and the space near Earth. Discussions focus on nano dust that forms from condensations and collisions and from planetary objects, as well as its interactions with space plasmas like the solar and stellar winds, atmospheres and magnetospheres. A particular goal is to bring together space scientists, astronomers, astrophysicists, and laboratory experimentalists and combine their knowledge to reach cross fertilization of different disciplines.
The extraction of templates such as ‘regard X as Y’ from a set of related phrases requires the identification of their internal structures. This paper presents an unsupervised approach for extracting templates on-the-fly from only tagged text by using a novel relaxed variant of the Sequence Binary Decision Diagram (SeqBDD). A SeqBDD can compress a set of sequences into a graphical structure equivalent to a minimal deterministic finite state automata, but more compact and better suited to the task of template extraction. The main contribution of this paper is a relaxed form of the SeqBDD construction algorithm that enables it to form general representations from a small amount of data. The process of compression of shared structures in the text during Relaxed SeqBDD construction, naturally induces the templates we wish to extract. Experiments show that the method is capable of high-quality extraction on tasks based on verb+preposition templates from corpora and phrasal templates from short messages from social media.
To assess the diagnostic role of mean platelet volume in tonsillitis with and without peritonsillar abscess.
Mean platelet volume and other laboratory data were retrospectively investigated.
Mean platelet volume was significantly lower in the tonsillitis group (7.8 per cent ± 0.7 per cent) than in the control group (8.7 per cent ± 0.6 per cent; p < 0.0001), and it was significantly lower in the abscess group (7.5 per cent ± 0.6 per cent) than in the no abscess group (8.0 per cent ± 0.7 per cent; p = 0.0277). White blood cell counts and C-reactive protein levels were not significantly different between patients with an abscess and those without. The mean platelet volume cut-off values for the diagnosis of tonsillitis and peritonsillar abscess were 7.95 fl and 7.75 fl, respectively.
Our results suggest that a decreased mean platelet volume is associated with the development and severity of tonsillitis. This finding provides useful diagnostic information for physicians treating patients with tonsillitis.
Oxoammonium cation of 2,2,6,6-tetramethylpiperidin-1-oxyl (TEMPO) was used as an oxidizing dopant of triaryl amines to efficiently and almost quantitatively generate radical cations of the amines or a hole carrier. The doped-triaryl amines yielded an amorphous and homogeneous layer without any residual oxidant or neutral TEMPO molecule through its sublimination or warming the layer. The TEMPO cation-doped spiro-OMeTAD [tetrakis(dimethoxyphenylamine)spirobifluorene] produced a high hole mobility of 2 × 10−4 cm2/Vs. The perovskite solar cell fabricated with the TEMPO cation-doped or residual dopant-free spiro-OMeTAD as the hole-transporting layer displayed a photo-conversion efficiency of 20.1% with durability.
Competition from weeds is one of the major biophysical constraints to rice (Oryza spp.) production in sub-Saharan Africa. Smallholder rice farmers require efficient, affordable and labour-saving weed management technologies. Mechanical weeders have shown to fit this profile. Several mechanical weeder types exist but little is known about locally specific differences in performance and farmer preference between these types. Three to six different weeder types were evaluated at 10 different sites across seven countries – i.e., Benin, Burkina Faso, Côte d'Ivoire, Ghana, Nigeria, Rwanda and Togo. A total of 310 farmers (173 male, 137 female) tested the weeders, scored them for their preference, and compared them with their own weed management practices. In a follow-up study, 186 farmers from Benin and Nigeria received the ring hoe, which was the most preferred in these two countries, to use it during the entire crop growing season. Farmers were surveyed on their experiences. The probability of the ring hoe having the highest score among the tested weeders was 71%. The probability of farmers’ preference of the ring hoe over their usual practices – i.e., herbicide, traditional hoe and hand weeding – was 52, 95 and 91%, respectively. The preference of this weeder was not related to gender, years of experience with rice cultivation, rice field size, weed infestation level, water status or soil texture. In the follow-up study, 80% of farmers who used the ring hoe indicated that weeding time was reduced by at least 31%. Of the farmers testing the ring hoe in the follow-up study, 35% used it also for other crops such as vegetables, maize, sorghum, cassava and millet. These results suggest that the ring hoe offers a gender-neutral solution for reducing labour for weeding in rice as well as other crops and that it is compatible with a wide range of environments. The implications of our findings and challenges for out-scaling of mechanical weeders are discussed.
We initiated a long-term and highly frequent monitoring project toward 442 methanol masers at 6.7 GHz (Dec >−30 deg) using the Hitachi 32-m radio telescope in December 2012. The observations have been carried out daily, monitoring a spectrum of each source with intervals of 9–10 days. In September 2015, the number of the target sources and intervals were redesigned into 143 and 4–5 days, respectively. This monitoring provides us complete information on how many sources show periodic flux variations in high-mass star-forming regions, which have been detected in 20 sources with periods of 29.5–668 days so far (e.g., Goedhart et al. 2004). We have already obtained new detections of periodic flux variations in 31 methanol sources with periods of 22–409 days. These periodic flux variations must be a unique tool to investigate high-mass protostars themselves and their circumstellar structure on a very tiny spatial scale of 0.1–1 au.
Major depressive disorder (MDD) is moderately heritable, however genome-wide association studies (GWAS) for MDD, as well as for related continuous outcomes, have not shown consistent results. Attempts to elucidate the genetic basis of MDD may be hindered by heterogeneity in diagnosis. The Center for Epidemiological Studies Depression (CES-D) scale provides a widely used tool for measuring depressive symptoms clustered in four different domains which can be combined together into a total score but also can be analysed as separate symptom domains.
We performed a meta-analysis of GWAS of the CES-D symptom clusters. We recruited 12 cohorts with the 20- or 10-item CES-D scale (32 528 persons).
One single nucleotide polymorphism (SNP), rs713224, located near the brain-expressed melatonin receptor (MTNR1A) gene, was associated with the somatic complaints domain of depression symptoms, with borderline genome-wide significance (pdiscovery = 3.82 × 10−8). The SNP was analysed in an additional five cohorts comprising the replication sample (6813 persons). However, the association was not consistent among the replication sample (pdiscovery+replication = 1.10 × 10−6) with evidence of heterogeneity.
Despite the effort to harmonize the phenotypes across cohorts and participants, our study is still underpowered to detect consistent association for depression, even by means of symptom classification. On the contrary, the SNP-based heritability and co-heritability estimation results suggest that a very minor part of the variation could be captured by GWAS, explaining the reason of sparse findings.
We previously reported an association between human parechovirus type 3 (HPeV3) and epidemic myalgia with myositis in adults during summers in which an HPeV3 outbreak occurred in children. However, this disease association has not yet been reported elsewhere. We have since continued our surveillance to accumulate data on this disease association and to confirm whether myalgia occurs in children as well as adults. Between June and August 2014, we collected 380 specimens from children with infectious diseases. We also collected clinical specimens from two adult and three paediatric patients suspected of myalgia. We then performed virus isolation and reverse-transcription–PCR using the collected specimens. We detected HPeV3 in 26 children with infectious diseases, which we regarded as indicating an outbreak. We also confirmed HPeV3 infection in all patients suspected of myalgia. In particular the symptoms in two boys, complaining of myalgia and fever, closely matched the criteria for adult myalgia. Based on our findings from 2008, 2011 and 2014, we again urge that clinical consideration be given to the relationship between myalgia and HPeV3 infections during HPeV3 outbreaks in children. Furthermore, our observations from 2014 suggest that epidemic myalgia and myositis occur not only in adults but also in children.