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Southern Ocean sea ice can exhibit widespread flooding and subsequent snow-ice formation, due to relatively thick snow covers compared to the total ice thickness. Considerable subkilometer scale variability in snow and ice thickness causes poorly constrained uncertainties in determining the amount of flooding that occurs. Using datasets of snow depth and ice thickness acquired in the Weddell Sea during austral winter 2013 (AWECS campaign) from three floes, we demonstrate large spatial variability of a factor 10 and 5 for snow and combined snow and ice thickness, respectively. The temporal evolution after the floe visit was recorded by automatic weather station and ice mass balance buoys. Using a physics-based, multi-layer snow/sea ice model in a one-dimensional and distributed mode to simulate the thermodynamic processes, we show that the distributed simulations, modeling flooding across the entire heterogeneous floe, produced vastly different amounts of flooding than one-dimensional single point simulations. Three times the flooding is produced in the one-dimensional simulation for the buoy location than distributed (floe-averaged) simulations. The latter is in close agreement with buoy observations. The results suggest that using point observations or one-dimensional simulations to extrapolate processes on the floe-scale can overestimate the amount of flooding and snow-ice formation.
The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia.
Twenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 ± 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects.
There was a 3-year later age at onset for females (P < .001) and lower rates of negative symptoms (P < .01) and higher depression/anxiety measures (P < .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages (P = .001). No significant effects were found concerning duration of illness.
Our results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples.
On May 11, the Dutch Government allowed 26 nursing homes to welcome 1 visitor per resident, after 2 months of lockdown. The study aimed to monitor in-depth the feasibility of the regulations and their impact on the well-being of residents, their visitors, and healthcare staff.
Mixed-methods study in 5 of the 26 facilities; the facilities were affiliated to an academic network of nursing homes.
Visitors and healthcare professionals.
Allowing visitors using local regulations based on national guidelines.
Digital questionnaire, analyzing documentation such as infection prevention control protocols, attending meetings of COVID-19 crisis teams, in-depth telephone or in-person interviews with visitors and healthcare professionals, and on-site observations.
National guidelines were translated with great variety into local care practice. Healthcare professionals agreed that reopening would increase the well-being of the residents and their loved ones. However, there were also great worries for increasing workload, increasing the risk of emotional exhaustion, and the risk of COVID-19 infections. Compliance with local regulations was generally satisfactory, but maintaining social distance and correctly wearing face masks appeared to be difficult. Care staff remained ambivalent for fear of infections. In general, allowing visitors was experienced as having a positive impact on the well-being of all stakeholders. Nevertheless, some residents with dementia showed negative effects.
The complete lockdown of Dutch nursing homes had a substantial impact on the well-being of the residents. The reopening was welcomed by all stakeholders, but provided a high organizational workload as well as feelings of ambivalence among care staff. In the second wave, a more tailored approach is being implemented. However, facilities are sometimes still struggling to find the right balance between infection control and well-being.
We performed a retrospective analysis of the changes in accuracy of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes for colectomy and hysterectomy surgical site infection surveillance. After the transition from ICD-CM ninth edition to tenth edition codes, there was no significant change in the accuracy of these codes for SSI surveillance.
The crystal structure of ceftriaxone sodium hemiheptahydrate has been solved and refined using synchrotron X-ray powder diffraction data and optimized using density functional techniques. Ceftriaxone sodium hemiheptahydrate crystallizes in the space group C2 (#5) with a = 30.56 492(16), b = 4.75 264(2), c = 18.54 978(16) Å, β = 90.3545(6), V = 2694.562(21) Å3, and Z = 4. Both Na exhibit trigonal bipyramidal coordination. Prominent in the structure are alternating Na/O and organic layers perpendicular to the c-axis. There are many O–H⋯O hydrogen bonds involving the water molecules and the ionized portions of the anion. There are a surprising number of C–H⋯S hydrogen bonds, as well as C–H⋯N and C–H⋯O hydrogen bonds. The powder pattern has been submitted to ICDD for inclusion in the Powder Diffraction File™.
Attention Deficit Hyperactivity Disorder (ADHD) is a serious risk factor for co-occurring psychiatric disorders and negative psychosocial consequences in adulthood. Given this background, there is great need for an effective treatment of adult ADHD patients.
Therefore, our research group has conducted a first controlled randomized multicenter study on the evaluation of disorder-tailored DBT-based group program in adult ADHD compared to a psychophar-macological treatment.
Between 2007 and 2010, in a four-arm-design 433 patients were randomized to a manualized dialectical behavioural therapy (DBT) based group program plus methylphenidate or placebo or clinical management plus methylphenidate or placebo with weekly sessions in the first twelve weeks and monthly sessions thereafter. Therapists are graduated psychologists or physicians. Treatment integrity is established by independent supervision. Primary endpoint (ADHD symptoms measured by the Conners Adult ADHD Rating Scale) is rated by interviewers blind to the treatment allocation (Current Controlled Trials ISRCTN54096201). The trial is funded by the German Federal Ministry of Research and Education (01GV0606) and is part of the German network for the treatment of ADHD in children and adults (ADHD-NET). In the lecture the first data of our interim analysis are presented (baseline data, results of treatment compliance and adherence).
The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model.
Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed.
The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage.
The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.
The German version of the Conners Adult ADHD Rating Scales (CAARS) has proven to show very high model fit in confirmative factor analyses with the established factors inattention/memory problems, hyperactivity/restlessness, impulsivity/emotional lability, and problems with self-concept in both large healthy control and ADHD patient samples. This study now presents data on the psychometric properties of the German CAARS-self-report (CAARS-S) and observer-report (CAARS-O) questionnaires.
CAARS-S/O and questions on sociodemographic variables were filled out by 466 patients with ADHD, 847 healthy control subjects that already participated in two prior studies, and a total of 896 observer data sets were available. Cronbach's-alpha was calculated to obtain internal reliability coefficients. Pearson correlations were performed to assess test-retest reliability, and concurrent, criterion, and discriminant validity. Receiver Operating Characteristics (ROC-analyses) were used to establish sensitivity and specificity for all subscales.
Coefficient alphas ranged from .74 to .95, and test-retest reliability from .85 to .92 for the CAARS-S, and from .65 to .85 for the CAARS-O. All CAARS subscales, except problems with self-concept correlated significantly with the Barrett Impulsiveness Scale (BIS), but not with the Wender Utah Rating Scale (WURS). Criterion validity was established with ADHD subtype and diagnosis based on DSM-IV criteria. Sensitivity and specificity were high for all four subscales.
The reported results confirm our previous study and show that the German CAARS-S/O do indeed represent a reliable and cross-culturally valid measure of current ADHD symptoms in adults.
Patients with chronic depression (CD) by definition respond less well to standard forms of psychotherapy and are more likely to be high utilizers of psychiatric resources. Therefore, the aim of this guidance paper is to provide a comprehensive overview of current psychotherapy for CD. The evidence of efficacy is critically reviewed and recommendations for clinical applications and research are given.
We performed a systematic literature search to identify studies on psychotherapy in CD, evaluated the retrieved documents and developed evidence tables and recommendations through a consensus process among experts and stakeholders.
We developed 5 recommendations which may help providers to select psychotherapeutic treatment options for this patient group. The EPA considers both psychotherapy and pharmacotherapy to be effective in CD and recommends both approaches. The best effect is achieved by combined treatment with psychotherapy and pharmacotherapy, which should therefore be the treatment of choice. The EPA recommends psychotherapy with an interpersonal focus (e.g. the Cognitive Behavioural Analysis System of Psychotherapy [CBASP]) for the treatment of CD and a personalized approach based on the patient's preferences.
The DSM-5 nomenclature of persistent depressive disorder (PDD), which includes CD subtypes, has been an important step towards a more differentiated treatment and understanding of these complex affective disorders. Apart from dysthymia, ICD-10 still does not provide a separate entity for a chronic course of depression. The differences between patients with acute episodic depression and those with CD need to be considered in the planning of treatment. Specific psychotherapeutic treatment options are recommended for patients with CD.
Patients with chronic forms of depression should be offered tailored psychotherapeutic treatments that address their specific needs and deficits. Combination treatment with psychotherapy and pharmacotherapy is the first-line treatment recommended for CD. More research is needed to develop more effective treatments for CD, especially in the longer term, and to identify which patients benefit from which treatment algorithm.
Since the year 2000, Greenland ice sheet mass loss has been dominated by a decrease in surface mass balance rather than an increase in solid ice discharge. Southeast Greenland is an important region to understand how high accumulation rates can offset increasing Greenland ice sheet meltwater runoff. To that end, we derive a new 9-year long dataset (2009–17) of accumulation rates in Southeast Greenland using NASA Operation IceBridge snow radar. Our accumulation dataset derived from internal layers focuses on high elevations (1500–3000 m) because at lower elevations meltwater percolation obscured internal layer structure. The uncertainty of the radar-derived accumulation rates is 11% [using Firn Densification Model (FDM) density profiles] and the average accumulation rate ranges from 0.5 to 1.2 m w.e. With our observations spanning almost a decade, we find large inter-annual variability, but no significant trend. Accumulation rates are compared with output from two regional climate models (RCMs), MAR and RACMO2. This comparison shows that the models are underestimating accumulation in Southeast Greenland and the models misrepresent spatial heterogeneity due to an orographically forced bias in snowfall near the coast. Our dataset is useful to fill in temporal and spatial data gaps, and to evaluate RCMs where few in situ measurements are available.
The impact of cream processing on milk fat globule membrane (MFGM) was assessed in an industrial setting for the first time. Three creams and their derived MFGM fractions from different stages of the pasteurization procedure at a butter dairy were investigated and compared to a native control as well as a commercial MFGM fraction. The extent of cross-linking of serum proteins to MFGM proteins increased progressively with each consecutive pasteurization step. Unresolved high molecular weight aggregates were found to consist of both indigenous MFGM proteins and β-lactoglobulin as well as αs1- and β-casein. With regards to fat globule stability and in terms of resistance towards coalescence and flocculation after cream washing, single-pasteurized cream exhibited reduced sensitivity to cream washing compared to non- and double-pasteurized creams. Inactivation of the agglutination mechanism and the increased presence of non-MFGM proteins may determine this balance between stable and non-stable fat globules.
Sweetpotato (Ipomoea batatas, Convolvulaceae) is an important food crop in Sub-Saharan Africa (SSA). Lack of access to quality sweetpotato planting material after sweetpotato limits utilization of market oriented improved clones and new varieties. Obtaining clean planting material in the right quantity and quality is a challenge in the SSA region. Farmers often obtain planting materials from their own sources with multiple rooting, drawn from a previous crop or neighbors and face the risk of it being infected with sweetpotato viruses. The objective of this study was to examine the economic and physical yield performance of sandponics multiplication method by comparing with conventional soil method using optimal N-nutrient inputs. The performance of five sweetpotato cultivars (Irene, Delvia, Tanzania, Gweri, and Kabode) in the modified prototype sweetpotato nutrient media was evaluated. Vine production utilizing modified sandponics nutrient media with trellised plants was compared to the conventionally used soil media. Analysis of variance indicated that the main effects of cultivar and substrate were highly significant (p < 0.0001) for nodes produced, vine multiplication rate (VMR), number of cuttings produced, and vine length. In addition, cultivar by substrate interaction was highly significant at 0.01 probability level for nodes produced, VMR, and vine length. Vine multiplication rate was 33% higher in the sandponics system compared to the conventional soil method of multiplying sweetpotato vines. Among the cultivars studied, Irene was the most favorable cultivar with a VMR of 65.2 in sand and 45.5 in soil. The cost-effectiveness analysis indicates that the cost per cutting (i.e., 3–4 nodes) produced from sandponics method was 4.6 KSH (US$ 0.046) as compared to 3.1 KSH (US$ 0.031) per cutting produced from conventional method. Sandponics system is competitive due to its capability of increased VMRs. However, the optimal number of ratooning needs to be investigated to understand the economies of scale in future research.
Here we provide an update of the 2013 report on the Nigerian Twin and Sibling Registry (NTSR). The major aim of the NTSR is to understand genetic and environmental influences and their interplay in psychological and mental health development in Nigerian children and adolescents. Africans have the highest twin birth rates among all human populations, and Nigeria is the most populous country in Africa. Due to its combination of large population and high twin birth rates, Nigeria has one of the largest twin populations in the world. In this article, we provide current updates on the NTSR samples recruited, recruitment procedures, zygosity assessment and findings emerging from the NTSR.
The Netherlands Twin Register (NTR) is a national register in which twins, multiples and their parents, siblings, spouses and other family members participate. Here we describe the NTR resources that were created from more than 30 years of data collections; the development and maintenance of the newly developed database systems, and the possibilities these resources create for future research. Since the early 1980s, the NTR has enrolled around 120,000 twins and a roughly equal number of their relatives. The majority of twin families have participated in survey studies, and subsamples took part in biomaterial collection (e.g., DNA) and dedicated projects, for example, for neuropsychological, biomarker and behavioral traits. The recruitment into the NTR is all inclusive without any restrictions on enrollment. These resources — the longitudinal phenotyping, the extended pedigree structures and the multigeneration genotyping — allow for future twin-family research that will contribute to gene discovery, causality modeling, and studies of genetic and cultural inheritance.
The field of otology is increasingly at the forefront of innovation in science and medicine. The inner ear, one of the most challenging systems to study, has been rendered much more open to inquiry by recent developments in research methodology. Promising advances of potential clinical impact have occurred in recent years in biological fields such as auditory genetics, ototoxic chemoprevention and organ of Corti regeneration. The interface of the ear with digital technology to remediate hearing loss, or as a consumer device within an intelligent ecosystem of connected devices, is receiving enormous creative energy. Automation and artificial intelligence can enhance otological medical and surgical practice. Otology is poised to enter a new renaissance period, in which many previously untreatable ear diseases will yield to newly introduced therapies.
This paper speculates on the direction otology will take in the coming decades.
Making predictions about the future of otology is a risky endeavour. If the predictions are found wanting, it will likely be because of unforeseen revolutionary methods.
More than 130 late Pleistocene trackway sites from the coastal eolianites and beach deposits of the Cape south coast, South Africa, have previously mostly yielded tracks of large mammals and birds. However, two sites east of Still Bay, and a third near Garden Route National Park, yield distinctive trackways of hatchling sea turtles, made during the short posthatching (postemergence) interval when the trackmakers headed for the sea. One assemblage of approximately parallel trackways indicates smaller loggerhead turtle hatchlings, with alternating gaits, and contrasts with a wider trackway indicating a leatherback turtle hatchling. These are the world's first reports of fossil traces that document this brief “run-for the-sea” phenomenon. They help delineate late Pleistocene sea turtle breeding ranges and indicate climatic conditions along the Cape south coast. Ichnotaxonomically defined swim tracks of large adult sea turtles are known from a few Mesozoic sites. Likewise, walking and swim traces of terrestrial freshwater turtles are also known from the Mesozoic and Cenozoic. However, as no ichnotaxonomy exists for these diagnostic hatchling trails, we assign the trackways of the inferred loggerheads to the new ichnotaxon Australochelichnus agulhasii ichnogen. et ichnosp. nov., and the inferred leatherback trackway to Marinerichnus latus ichnogen. et ichnosp. nov.
Twin registries often take part in large collaborative projects and are major contributors to genome-wide association (GWA) meta-analysis studies. In this article, we describe genotyping of twin-family populations from Australia, the Midwestern USA (Avera Twin Register), the Netherlands (Netherlands Twin Register), as well as a sample of mothers of twins from Nigeria to assess the extent, if any, of genetic differences between them. Genotyping in all cohorts was done using a custom-designed Illumina Global Screening Array (GSA), optimized to improve imputation quality for population-specific GWA studies. We investigated the degree of genetic similarity between the populations using several measures of population variation with genotype data generated from the GSA. Visualization of principal component analysis (PCA) revealed that the Australian, Dutch and Midwestern American populations exhibit negligible interpopulation stratification when compared to each other, to a reference European population and to globally distant populations. Estimations of fixation indices (FST values) between the Australian, Midwestern American and Netherlands populations suggest minimal genetic differentiation compared to the estimates between each population and a genetically distinct cohort (i.e., samples from Nigeria genotyped on GSA). Thus, results from this study demonstrate that genotype data from the Australian, Dutch and Midwestern American twin-family populations can be reasonably combined for joint-genetic analysis.
Health insurance status may affect the risk for surgical site infection (SSI). A large prospective cohort study in a Swiss tertiary-care hospital did not find evidence of a difference in SSI risk in individuals with basic versus semiprivate or private insurance in a setting with universal health insurance coverage.
The current emphasis of schistosomiasis control is placed on preventive chemotherapy using praziquantel. However, reinfection may occur rapidly in the absence of complementary interventions. Recent studies from Senegal suggest that predatory prawns might feed on intermediate host snails and thus impact on schistosomiasis transmission. We designed a study with four repeated cross-sectional surveys pertaining to prawns and snails, coupled with a single cross-sectional parasitological survey among humans. We assessed for potential associations between the presence/density of prawns and snails and correlation with Schistosoma infection in a composite sample of school-aged children and adults. The study was carried out between October 2015 and December 2016 in 24 villages located near the Agnéby and Mé coastal river systems in south-eastern Côte d'Ivoire. At each site, snails and prawns were collected, and in each village, 150 individuals were subjected to stool and urine examination for the diagnosis of Schistosoma mansoni and S. haematobium. We found peaks of relative abundance of intermediate host snails in the villages of the Agnéby River system, while predatory prawns were predominantly recorded in the Mé River system. A negative association was observed between intermediate host snail densities and riverine prawns; however, no pattern was found between this trend in the predator–prey relationship and the prevalence of human schistosomiasis.