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The availability of large healthcare datasets offers the opportunity for researchers to navigate the traditional clinical and translational science research stages in a nonlinear manner. In particular, data scientists can harness the power of large healthcare datasets to bridge from preclinical discoveries (T0) directly to assessing population-level health impact (T4). A successful bridge from T0 to T4 does not bypass the other stages entirely; rather, effective team science makes a direct progression from T0 to T4 impactful by incorporating the perspectives of researchers from every stage of the clinical and translational science research spectrum. In this exemplar, we demonstrate how effective team science overcame challenges and, ultimately, ensured success when a diverse team of researchers worked together, using healthcare big data to test population-level substance use disorder (SUD) hypotheses generated from preclinical rodent studies. This project, called Advancing Substance use disorder Knowledge using Big Data (ASK Big Data), highlights the critical roles that data science expertise and effective team science play in quickly translating preclinical research into public health impact.
Registry-based trials have emerged as a potentially cost-saving study methodology. Early estimates of cost savings, however, conflated the benefits associated with registry utilisation and those associated with other aspects of pragmatic trial designs, which might not all be as broadly applicable. In this study, we sought to build a practical tool that investigators could use across disciplines to estimate the ranges of potential cost differences associated with implementing registry-based trials versus standard clinical trials.
We built simulation Markov models to compare unique costs associated with data acquisition, cleaning, and linkage under a registry-based trial design versus a standard clinical trial. We conducted one-way, two-way, and probabilistic sensitivity analyses, varying study characteristics over broad ranges, to determine thresholds at which investigators might optimally select each trial design.
Registry-based trials were more cost effective than standard clinical trials 98.6% of the time. Data-related cost savings ranged from $4300 to $600,000 with variation in study characteristics. Cost differences were most reactive to the number of patients in a study, the number of data elements per patient available in a registry, and the speed with which research coordinators could manually abstract data. Registry incorporation resulted in cost savings when as few as 3768 independent data elements were available and when manual data abstraction took as little as 3.4 seconds per data field.
Registries offer important resources for investigators. When available, their broad incorporation may help the scientific community reduce the costs of clinical investigation. We offer here a practical tool for investigators to assess potential costs savings.
In the mid eleventh century AD, Cahokia emerged as a substantial Mississippian urban centre. To the east, a shrine-complex known as the Emerald Acropolis, marking the beginning of a processional route to the city, also flourished. Excavations and geophysical survey of the monumental landscape around this site suggest that lunar cycles were important in the orientation of structures and settlement layout. They further indicate that water played a significant role in the ritual activities associated with the closure and abandonment of individual structures. The contemporary development of these sites suggests an intrinsic connection between them, and provides early evidence of the importance that the moon and water came to assume in Mississippian culture.
On 1922 August 20, a 20-strong scientific team, together with a naval party of 10, left Fremantle on one of the major scientific expeditions in Western Australian history. After picking up further personnel at Broome, the party proceeded to the isolated post and telegraph station of Wallal on the northern coast of Western Australia. Their task was to measure with great care the deflection of starlight by the Sun during the total solar eclipse of 1922 September 21. Specially designed photographic equipment of very high quality was used and meteorological conditions were excellent. As a result, measurements were obtained for well over a hundred stars.
Timely diagnosis of the nematode Angiostrongylus vasorum in dogs is important in view of severe and permanent lung and cardiovascular lesions that may occur. The performance of the classical Baermann coprological method was compared with ELISAs for the serological detection of circulating antigen and specific antibodies and with Polymerase chain reaction (PCR) performed on EDTA blood, feces and tracheal swabs of serial samples from experimentally inoculated dogs over 13 weeks post inoculation (wpi) (n = 16) and following anthelmintic treatment (n = 6). Patency was observed from 6·7 to 7·6 wpi in all dogs, Baermann results were then mostly positive (116/119, 97%) during the patent period, with wide variations in the numbers of first stage larvae numbers. Blood PCR was tested positive on 1–2 occasions in 11/16 dogs in the pre-patent period, while all tested positive by antibody-detection ELISA by 6 wpi. The proportion of dogs testing positive by fecal PCR and antigen-detection ELISA rose early in the patent period. Tracheal swabs were occasionally DNA-positive in 3/16 dogs starting from 10 wpi. Following treatment, larval excretion stopped within 3 weeks and blood PCR results became negative within 1 week (5/6 dogs), while 4/6 dogs were positive for parasite DNA in tracheal swabs. Parasite antigen and specific antibodies both persisted in the blood for 3–9 weeks after treatment, with average optical densities and the proportion of positive dogs falling gradually, while results using other tests were much more variable. Results indicate that the earliest and most consistent results are obtained by the ELISAs, which can also be used for monitoring dogs after anthelmintic treatment.
At Cahokia, in the beginning, the particular materiality of the place lent theatricality to everyday experience while, in the end, it ensured that the whole could be partitioned and forgotten. This chapter examines the disposition of such features and the materiality of the process and foundational circumstances of Cahokia. Besides the facts of immigration and tranquility at Old Cahokia, there are two more circumstances surrounding Cahokia's 'big bang' at C. 1050. First, the decades on either side of 1050 were warmer and wetter than usual, ideal for growing bumper crops. Second, the early-mid-eleventh century was a period of great celestial activity. The construction of a palisade wall shortly after 1150 CE was probably the harbinger of significant cultural change. Cahokia's earthen and wooden construction materials defined the field of memory work and constrained the futures of its descendants, which might have been quite different had only the Cahokians worked in stone rather than earth and wood.
We report static and time-resolved terahertz (THz) conductivity measurements of a highperformance thermoelectric material containing tellurium nanowires in a PEDOT:PSS matrix. Composites were made with and without sulfur passivation of the nanowires surfaces. The material with sulfur linkers (TeNW/PD-S) is less conductive but has a longer carrier lifetime than the formulation without (TeNW/PD). We find real conductivities at f = 1THz of σTeNW/PD = 160 S/cm and σTeNW/PD-S = 5.1 S/cm. These values are much larger than the corresponding DC conductivities, suggesting DC conductivity is limited by structural defects. The free-carrier lifetime in the nanowires is controlled by recombination and trapping at the nanowire surfaces. We find surface recombination velocities in bare tellurium nanowires (22m/s) and TeNW/PD-S (40m/s) that are comparable to evaporated tellurium thin films. The surface recombination velocity in TeNW/PD (509m/s) is much larger, indicating a higher interface trap density.
We assessed the ability of climatic, environmental, and anthropogenic variables to predict areas of high-risk for plant invasion and consider the relative importance and contribution of these predictor variables by considering two spatial scales in a region of rapidly changing climate. We created predictive distribution models, using Maxent, for three highly invasive plant species (Canada thistle, white sweetclover, and reed canarygrass) in Alaska at both a regional scale and a local scale. Regional scale models encompassed southern coastal Alaska and were developed from topographic and climatic data at a 2 km (1.2 mi) spatial resolution. Models were applied to future climate (2030). Local scale models were spatially nested within the regional area; these models incorporated physiographic and anthropogenic variables at a 30 m (98.4 ft) resolution. Regional and local models performed well (AUC values > 0.7), with the exception of one species at each spatial scale. Regional models predict an increase in area of suitable habitat for all species by 2030 with a general shift to higher elevation areas; however, the distribution of each species was driven by different climate and topographical variables. In contrast local models indicate that distance to right-of-ways and elevation are associated with habitat suitability for all three species at this spatial level. Combining results from regional models, capturing long-term distribution, and local models, capturing near-term establishment and distribution, offers a new and effective tool for highlighting at-risk areas and provides insight on how variables acting at different scales contribute to suitability predictions. The combinations also provides easy comparison, highlighting agreement between the two scales, where long-term distribution factors predict suitability while near-term do not and vice versa.
The current study examines the impact of a nutrition rating system on consumers’ food purchases in supermarkets.
Aggregate sales data for 102 categories of food (over 60 000 brands) on a weekly basis for 2005–2007 from a supermarket chain of over 150 stores are analysed. Change in weekly sales of nutritious and less nutritious foods, after the introduction of a nutrition rating system on store shelves, is calculated, controlling for seasonality and time trends in sales.
One hundred and sixty-eight supermarket stores in the north-east USA, from January 2005 to December 2007.
Consumers purchasing goods at the supermarket chain during the study period.
After the introduction of the nutrition ratings, overall weekly food sales declined by an average of 3637 units per category (95 % CI –5961, –1313; P<0·01). Sales of less nutritious foods fell by 8·31 % (95 % CI –13·50, –2·80 %; P=0·004), while sales of nutritious foods did not change significantly (P=0·21); as a result, the percentage of food purchases rated as nutritious rose by 1·39 % (95 % CI 0·58, 2·20 %; P<0·01). The decrease in sales of less nutritious foods was greatest in the categories of canned meat and fish, soda pop, bakery and canned vegetables.
The introduction of the nutrition ratings led shoppers to buy a more nutritious mix of products. Interestingly, it did so by reducing purchases of less nutritious foods rather than by increasing purchases of nutritious foods. In evaluating nutrition information systems, researchers should focus on the entire market basket, not just sales of nutritious foods.
We report on the preparation and characterization of crystalline bismuth oxide thin films via Biased Target Ion Beam Deposition method. A focused blue laser (405nm) is used to write an array of dots in the bismuth oxide thin film and demonstrate clear and circular recording marks in form of “bubbles” or “little volcanos” (FWHM ∼500nm). Results indicate excellent static recording characteristics, writing sensitivity and contrast. The recording mechanism is investigated and is believed to be related to laser-induced morphology change.
The economic feasibility of soybeans, grain sorghum, and corn in annual rotation with winter wheat using reduced tillage and no-tillage systems in the Central Great Plains was evaluated, with continuous wheat and grain sorghum also analyzed. Net returns were calculated using simulated yield and price distributions based on historical yields, two historical annual price series, and 2011 costs. Stochastic Efficiency with Respect to a Function was used to determine the preferred strategies under various risk preferences. The no-till wheat-soybean and reduced-till wheat-soybean systems are the first and second most preferred, regardless of the level of risk aversion.
The World Health Organization ‘Surgical Safety Checklist’ has been adopted by UK surgical units following National Patient Safety Agency guidance. Our aim was to assess compliance with our local version of this Checklist.
Otolaryngology trainee doctors prospectively assessed compliance with the local Checklist over a six-week period. A staff educational intervention was implemented and the audit was repeated 12 months later.
A total of 72 cases were assessed. The initial audit found that: 44 per cent of procedures were undocumented at ‘Sign in’; ‘Time out’ was inappropriately interrupted in 39 per cent of cases; the procedure started before Checklist completion in 33 per cent of cases; and the ‘Sign out’ was not read out in 94 per cent of cases and was not fully documented in 42 per cent of cases. Following education, re-audit indicated that overall compliance had improved from 63.7 per cent (±8.9 per cent standard error of the mean) to 90.4 per cent (±2.7 per cent standard error of the mean).
Our completed audit cycle demonstrated a significant improvement in Checklist compliance following educational intervention. We discuss barriers to compliance, as well as strategies for quality improvement, and we call for other surgeons to similarly publish their Checklist experience and assess its impact on surgical outcomes.
The Nicotrol® (Pfizer, USA) nicotine inhaler reduces craving by mimicking the behavioural component of cigarettes and delivering controlled doses of nicotine, which binds to the beta-2 subunit-containing nicotinic acetylcholine receptors (β2*-nAChRs). Previous studies examined β2*-nAChR occupancy after administration of regular and low-nicotine cigarettes. Here, we measured occupancy of β2*-nAChRs after administration of nicotine via inhaler, and the relationship between occupancy and changes in craving for tobacco smoking and withdrawal symptoms. Tobacco smokers participated in [123I]5-IA-85380 SPECT studies with either a nicotine inhaler (n=9) or tobacco cigarette (n=4) challenge. [123I]5-IA was administered as a bolus plus constant infusion. After equilibrium was achieved, three 30-min baseline scans were collected, and subjects either used the nicotine inhaler or a regular cigarette, and up to six additional scans were obtained. Receptor occupancy was determined based on the Lassen plot method. Craving for tobacco smoking and withdrawal symptoms were evaluated pre- and post-challenge. Use of the nicotine inhaler produced an average 55.9±6.4% occupancy of β2*-nAChRs 2–5 h post-challenge, whereas use of a cigarette produced significantly higher receptor occupancy (F=10.6, p=0.009) with an average 67.6±14.1% occupancy 1.5–5 h post-challenge. There was a significant decrease in withdrawal symptoms post-nicotine inhaler use (F=6.13, p=0.04). These results demonstrate significant differences in occupancy of β2*-nAChRs by nicotine after use of the inhaler vs. a cigarette and confirm the ability of the nicotine inhaler to relieve withdrawal symptoms.
Little is known of the prevalence and life-cycle of trypanosomes in mammals native to Australia. Native Australian trypanosomes have previously been identified in marsupials in the eastern states of Australia, with one recent report in brush-tailed bettongs (Bettongia penicillata), or woylie in Western Australia in 2008. This study reports a novel Trypanosoma sp. identified in blood smears, from 7 critically endangered Gilbert's potoroos (Potorous gilbertii) and 3 quokkas (Setonix brachyurus) in Western Australia. Trypanosomes were successfully cultured in vitro and showed morphological characteristics similar to members of the subgenus Herpetosoma. Phylogenetic analysis of 18S rRNA gene sequences identified 2 different novel genotypes A and B that are closely related to trypanosomes previously isolated from a common wombat (Vombatus ursinus) in Victoria, Australia. The new species is proposed to be named Trypanosoma copemani n. sp.