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Determination of whether vascular catheter disinfecting antiseptic-containing caps alone are effective at decreasing microbial colonization of connectors compared to antiseptic-containing caps plus a 5-second alcohol manual disinfection.
Setting:
The study was conducted in a 718-bed, tertiary-care, academic hospital.
Patients:
A convenience sample of adult patients across intensive care units and acute care wards with peripheral and central venous catheters covered with antiseptic-containing caps.
Methods:
Quality improvement study completed over 5 days. The standard-of-care group consisted of catheter connectors with antiseptic-containing caps cleaned with a 5-second alcohol wipe scrub prior to culture. The comparison group consisted of catheter connectors with antiseptic-containing caps without a 5-second alcohol wipe scrub prior to culture. The connectors were pressed directly onto blood agar plates and incubated. Plates were assessed for growth after 48-72 hours.
Results:
In total, 356 catheter connectors were cultured: 165 in the standard-of-care group, 165 in the comparison group, and 26 catheters connectors without an antiseptic-containing cap, which were designated as controls. Overall, 18 catheter connectors (5.06%) yielded microbial growth. Of the 18 connectors with microbial growth, 2 (1.21%) were from the comparison group, 1 (0.61%) was from the standard-of-care group, and 15 were controls without an antiseptic-containing cap.
Conclusions:
Bacterial colonization rates were similar between the catheter connectors cultured with antiseptic-containing caps alone and catheter connectors with antiseptic-containing caps cultured after a 5-second scrub with alcohol. This finding suggests that the use of antiseptic-containing caps precludes the need for additional disinfection.
This article studies how anti-Christian, ‘traditionally African’ organizations, locally known as Églises des Noirs, navigate religious competition in the Congolese capital through sonic and linguistic strategies. It focuses on the understudied Mpadist community, a ‘dissident’ branch of the better known Kimbanguist church. Mpadists mobilize diverging appreciations and meanings of sound and language to set themselves apart from the dominant Lingalaphone Pentecostal loudness of the city. In doing so, they pursue a delicate balance between Kongo traditionalism, the source of their spiritual legitimacy, rooted in colonial prophetic movements, and tactics of ‘modern’ community making in order to remain competitive within Kinshasa’s prolific religious setting. The article argues that ideologies of sound and language should be analysed within the same nexus, for they operate and are operationalized in similar ways. It therefore proposes to expand the sociolinguistic notion of indexicality to incorporate elements of the volume and modalities of sound making. The article also shows that sonic and linguistic ideologies are bound by context. In Kinshasa’s ‘low-fi’ soundscape, the indexical values of the languages Kikongo and Lingala, and of unamplified and amplified sound production, share similar features, yet they are evaluated differently in rural ‘hi-fi’ sonic environments.
The interpretation and understanding of the relationship between Middle to Late Holocene climate change in monsoon margins of northwest China with the westerlies and Asian monsoon (AM) remain controversial. Here we present a new multi-proxy sedimentary dataset from the Heihe River basin in the middle part of the Hexi Corridor on the northern margin of the Qinghai-Tibet Plateau (QTP), which is a sensitive zone for the interaction between the westerlies and AM. Fluctuations in grain size, δ13Corg, δ18O, magnetic susceptibility, total organic carbon, total nitrogen, and C/N ratio document regional lake and climate evolution since 5334 cal yr BP. Results show that climate conditions on the millennial timescale are humid in the late Middle Holocene (MH) and dry to wet in the Late Holocene (LH). Combined with the multi-model ensemble simulation from PMIP3-CMIP5, high lake levels and wetter climate in the late MH are closely linked to the strengthening Asian summer monsoon. Simultaneously, the slight wetting trend since the late LH may be the superimposing effect of enhanced westerlies and the weakening Asian winter monsoon. These findings can provide insights into the interpretation of the interaction between the westerlies and AM during the Holocene in East Asia.
We study numerically the characteristics of fluid–fluid displacement in simple mixed-wet porous micromodels using a dynamic pore network model. The porous micromodel consists of distinct water-wet and oil-wet regions, whose fractions are varied systematically to yield a variety of displacement patterns over a wide range of capillary numbers. We find that the impact of mixed-wettability is most prominent at low capillary numbers, and it depends on the complex interplay between wettability fraction and the intrinsic contact angle of the water-wet regions. For example, the fractal dimension of the displacement pattern is a monotonically increasing function of wettability fraction in flow cells with strongly water-wet clusters, but it becomes non-monotonic with respect to wettability fraction in flow cells with weakly water-wet clusters. Additionally, mixed-wettability also manifests itself in the injection pressure signature, which exhibits fluctuations especially at low wettability fraction. Specifically, preferential filling of water-wet regions leads to reduced effective permeability and higher injection pressure, even at vanishingly small capillary numbers. Finally, we demonstrate that scaling analyses based on a weighted average description of the overall wetting state of the mixed-wet system can effectively capture the variations in observed displacement pattern morphology.
How we are influenced by our environment is a fundamental question in developmental science. Theories and empirical research have claimed that some individuals are susceptible to environmental influences and others are much less susceptible. The present study addressed four questions: (1) Is environmental susceptibility a continuous or categorical construct? (2) Is environmental susceptibility unidimensional (i.e., domain general) or multidimensional (i.e., domain specific)? (3) Are there genetic contributions to individual differences in environmental susceptibility? (4) What are the temperamental characteristics of different environmental susceptibility patterns? We used child- and mother-report data from a sample of 11-year-old twins (N = 1,507) and applied a novel data-driven approach to assess an environmental susceptibility space, based on simultaneous associations between multiple environmental exposures (18 measures relating to parenting, parent, peer, and twin relationships) and developmental outcomes (10 measures relating to empathy, prosocial behavior, aggression, and self-esteem). The results suggest that the environmental susceptibility space we assessed is better conceptualized as continuous and multidimensional. Different children showed susceptibility to different contexts and variation in domain-general versus domain-specific patterns. A comparison of distances between monozygotic and dizygotic twins within the space demonstrated genetic contributions. Finally, susceptibility patterns could not be differentiated based on a specific temperament trait, but rather related to temperament profiles.
Let $\Sigma $ be a closed surface other than the sphere, the torus, the projective plane or the Klein bottle. We construct a continuum of probability measure preserving ergodic minimal profinite actions for the fundamental group of $\Sigma $ that are topologically free but not essentially free, a property that we call allostery. Moreover, the invariant random subgroups we obtain are pairwise distincts.
Using random H-1B visa lotteries as a natural experiment, we find that firms respond to shortages of high-skilled workers by acquiring firms that employ such workers. The effect is stronger among firms with high human capital and more senior workforces, firms facing tight labor markets and legal barriers to poaching workers, and firms lacking foreign affiliates. The acquired workers are highly educated, sharing skills and occupations similar to those of the acquirer’s existing workers. Our findings suggest skilled labor is an important driver of acquisitions and acquiring is an effective means of obtaining skilled labor.
Although studies show that the intake of ultra-processed products (UPP) has a negative impact on health, diet quality and dietary vitamin D, its influence on serum concentrations of this vitamin remains unknown; therefore, it is essential to verify the association between the UPP consumption and vitamin D deficiency. This is a cross-sectional, household, population-based study, carried out with 229 individuals aged 20 years or older, residents of the city of Teresina, Piauí, Brazil. Socio-demographic, lifestyle, food consumption and anthropometric data were collected. Food consumption was obtained using a 24-h food recall, and foods were grouped according to the NOVA classification. Plasma concentrations of calcidiol–25 (OH) D3 were determined by HPLC. Crude and adjusted binary logistic regression was applied to estimate the association between UPP consumption and vitamin D deficiency. Most individuals aged 20–39 years were vitamin D deficient (52·1 %). UPP contributed 19·9 % to the energetic intake of the participant’s diet. This contribution was higher for individuals with vitamin D deficiency (22·5 %, P = 0·04). In addition, a high intake of UPP was associated with twice the risk of vitamin D deficiency in comparison with low consumption of UPP (OR: 2·05; CI 1·06, 4·50; P: 0·04). Our results suggest that the consumption of UPP may have a negative impact on serum concentrations of vitamin D; more studies are needed.
We study experimentally the dynamics of a water droplet on a tilted and vertically oscillating rigid fibre. As we vary the frequency and amplitude of the oscillations the droplet transitions between different modes: harmonic pumping, subharmonic pumping, a combination of rocking and pumping modes, and a combination of pumping and swinging modes. We characterize these responses and report how they affect the sliding speed of the droplet along the fibre. The swinging mode is explained by a minimal model making an analogy between the droplet and a forced elastic pendulum.
Using a novel data set of over 3,500 public and private firms, we construct the network of executive and director connections prior to the 1929 financial market crash. We find that more connected firms have 17% higher 10-year survival rates. Consistent with a working capital channel, the results are strongest for small, private, cash-poor firms, and firms located in counties with high bank suspension rates. Moreover, connections to cash-rich firms that increase accounts receivable matter the most. Our results suggest that network connections can play a stabilizing role during a financial crisis by easing the flow of capital to constrained firms.
Rhynchophorus ferrugineus is a quarantine pest that mainly damages plants in tropical regions, which are essential economic resources. Cry3Aa has been used to control coleopteran pests and is known to be toxic to R. ferrugineus. The binding of the Cry toxin to specific receptors on the target insect plays a crucial role in the toxicological mechanism of Cry toxins. However, in the case of R. ferrugineus, the nature and identity of the receptor proteins involved remain unknown. In the present study, pull-down assays and mass spectrometry were used to identify two proteins of aminopeptidase N proteins (RfAPN2a and RfAPN2b) in the larval midguts of R. ferrugineus. Cry3Aa was able to bind to RfAPN2a (Kd = 108.5 nM) and RfAPN2b (Kd = 68.2 nM), as well as midgut brush border membrane vesicles (Kd = 482.5 nM). In silico analysis of both RfAPN proteins included the signal peptide and anchored sites for glycosyl phosphatidyl inositol. In addition, RfAPN2a and RfAPN2b were expressed in the human embryonic kidney 293T cell line, and cytotoxicity assays showed that the transgenic cells were not susceptible to activated Cry3Aa. Our results show that RfAPN2a and RfAPN2b are Cry3Aa-binding proteins involved in the Cry3Aa toxicity of R. ferrugineus. This study deepens our understanding of the action mechanism of Cry3Aa in R. ferrugineus larvae.
To determine the prevalence and timing of autism spectrum disorder diagnosis in a cohort of congenital heart disease (CHD) patients receiving neurodevelopmental follow-up and identify associated risk factors.
Method:
Retrospective single-centre observational study of 361 children undergoing surgery for CHD during the first 6 months of life. Data abstracted included age at autism spectrum disorder diagnosis, child and maternal demographics, and medical history.
Results:
Autism spectrum disorder was present in 9.1% of children with CHD, with a median age at diagnosis of 34 months and 87.9% male. Prematurity, history of post-operative extracorporeal membrane oxygenation, and seizures were higher among those with autism (p = 0.013, p = 0.023, p = 0.001, respectively). Infants with autism spectrum disorder were older at the time of surgery (54 days vs 13.5 days, p = 0.002), and infants with surgery at ≥ 30 days of age had an increased risk of autism spectrum disorder (OR 2.31; 95% CI =1.12, 4.77, p = 0.023). On multivariate logistic regression analysis, being male (OR 4.85, p = 0.005), surgery ≥ 30 days (OR 2.46, p = 0.025), extracorporeal membrane oxygenation (OR 4.91, p = 0.024), and seizures (OR 4.32, p = 0.003) remained associated with increased odds for autism spectrum disorder. Maternal age, race, ethnicity, and surgical complexity were not associated.
Conclusions:
Children with CHD in our cohort had more than three times the risk of autism spectrum disorder and were diagnosed at a much earlier age compared to the general population. Several factors (male, surgery at ≥ 30 days, post-operative extracorporeal membrane oxygenation, and seizures) were associated with increased odds of autism. These findings support the importance of offering neurodevelopmental follow-up after cardiac surgery in infancy.
What steps may clinicians looking after adult congenital heart patients take to improve the care they provide? An adult with complex congenital heart disease (CHD) who required a Fontan circulation has developed a discussion paper with the help of his attending clinicians. Drawing on his personal experience and that of others that he has represented, the paper highlights the problems in communication between such patients and their physician, followed by suggestions as to how to improve patient engagement, empowerment, and enablement. Attention to those suggestions may well benefit all in the care provided for this growing population.
In the first half of the 1960s China witnessed an unprecedented florescence of theatrical works on Third World decolonization, which aimed to disseminate the ideology of Maoist internationalism and cultivate transnational and interracial solidarity among the Chinese public. Existing scholarship on Maoist internationalist theatre tends to understand the phenomenon as the domestication of Third World decolonization for China’s political ends. This article, by focusing on the heterogeneous processes of production, adaptation, and reception, illuminates the practical and epistemological challenges of representing an internationalist subject, the imperfect performance of foreign culture and history, and the porous process of meaning-making for Chinese performers and audiences. Using previously untapped historical materials, such as performance programmes, personal recollections, and newspapers, this article explores the staging of the Congo Crisis (1960–1965)—a widely mediated international event in Maoist China and a central conflict in the global Cold War—in the spoken drama War Drums on the Equator (1965), its many local variations, and a dance drama adaptation, The Raging Congo River (1965). By mediating and enacting ‘embodied and affective knowledge’ about Congo, these theatrical works made the political motif of internationalist solidarity into sonorous and kinaesthetic artefacts that engendered plural meanings to Chinese performers and audiences. This article further reveals flawed perceptions, processes of corrections, and the epistemological limitations in the performance of the Congo Crisis in Maoist China.
In the United States, elections are often administered by directly elected local officials who run as members of a political party. Do these officials use their office to give their party an edge in elections? Using a newly collected dataset of nearly 5,900 clerk elections and a close-election regression discontinuity design, we compare counties that narrowly elect a Democratic election administrator to those that narrowly elect a Republican. We find that Democrats and Republicans serving similar counties oversee similar election results, turnout, and policies. We also find that reelection is not the primary moderating force on clerks. Instead, clerks may be more likely to agree on election policies across parties than the general public and selecting different election policies may only modestly affect outcomes. While we cannot rule out small effects that nevertheless tip close elections, our results imply that clerks are not typically and noticeably advantaging their preferred party.