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Shiga-toxin producing Escherichia coli (STEC) is a pathogen that can cause bloody diarrhoea and severe complications. Cases occur sporadically but outbreaks are also common. Understanding the incubation period distribution and factors influencing it will help in the investigation of exposures and consequent disease control. We extracted individual patient data for STEC cases associated with outbreaks with a known source of exposure in England and Wales. The incubation period was derived and cases were described according to patient and outbreak characteristics. We tested for heterogeneity in reported incubation period between outbreaks and described the pattern of heterogeneity. We employed a multi-level regression model to examine the relationship between patient characteristics such as age, gender and reported symptoms; and outbreak characteristics such as mode of transmission with the incubation period. A total of 205 cases from 41 outbreaks were included in the study, of which 64 cases (31%) were from a single outbreak. The median incubation period was 4 days. Cases reporting bloody diarrhoea reported shorter incubation periods compared with cases without bloody diarrhoea, and likewise, cases aged between 40 and 59 years reported shorter incubation period compared with other age groups. It is recommended that public health officials consider the characteristics of cases involved in an outbreak in order to inform the outbreak investigation and the period of exposure to be investigated.
Occasional cases of classical bovine spongiform encephalopathy (BSE) still continue to occur within the European Union (EU) for animals born after reinforced feed bans (BARBs), which should in theory have eliminated all risk of infection. The study aimed to determine (i) whether a common rate of decline of BSE infection was evident across EU member states, i.e. to determine whether control measures have been equally effective in all member states, (ii) whether there was any evidence of spontaneous occurrence of BSE in the data and (iii) the expected date for the last BSE case in UK. It was found that there was no significant difference in the rate of decline of BSE prevalence between member states, with a common rate of decline of 33·9% per annum (95% CI 30·9–37%) in successive annual birth cohorts. Trend analysis indicated an ultimate decline to 0 prevalence, suggesting that spontaneous occurrence does not explain the majority of cases. Projecting forward the trends from the back-calculation model indicated that there was approximately a 50% probability of further cases in the UK, and should the current rate of decline continue, there remains the possibility of further occasional cases up until 2026.
Introduced plants threaten biodiversity and ecosystem processes, including carbon (C) and nitrogen (N) cycles, but little is known about the threshold at which such effects occur. We examined the impact of the invasive shrub Amur honeysuckle on soil organic carbon (SOC) and N density at study sites that varied in invasion history. In plots with and without honeysuckle, we measured honeysuckle abundance and size (basal area) and extracted soil cores. SOC and N densities were highest at the site with the longest invasion history and highest invasion intensity (i.e., greatest abundance and basal area of honeysuckle). Basal area of honeysuckle positively affected SOC and N densities likely because of increased litter decomposition and altered microbial communities. Because honeysuckle increases forest net primary productivity (NPP) and SOC, it also may play a role in C sequestration. Our results demonstrate the need to consider the influence of invasion history and intensity when evaluating the potential impact of invasive species.
The archaeological record from the last millennium in southern California indicates that a period of significant cultural change was associated with a reported marine paleoenvironmental disruption ca. 1150-1250 A.D. A lengthy warm-water anomaly may have in part precipitated more complex sociopolitical and economic responses. We develop independent verification of the perturbation (originally deduced from sediment core data) using archaeological data. Respiratory pore number allometry in the black abalone shell is known to vary clinally in modern populations in response to temperature-induced variation in rate of growth. We use developmental trajectories of abalone from dated, stratified archaeological deposits to reconstruct prehistoric seawater temperatures.
Here, we report the feasibility and long-term efficacy of a granulomatous slack skin disease (GSSD) treatment with combined high-energy photon and proton beams.
Patient and methods
A GSSD patient with abdominal disease volume 25×15×2–4 cm deep was recommended for treatment at this institution. In addition to photons and electrons, high-energy protons delivered with advanced planning techniques and patient positioning were used. The patient was irradiated to a total dose of 40 Gy by using 20 Gy matched photon and electrons followed by 20 Gy equivalent protons delivered by using innovative range compensation and patient positioning.
Results
The test patient tolerated the treatment well and is now a 10-year survivor of the disease.
Conclusions
Treatment of GSSD with protons is feasible. The range and narrow penumbra properties of the proton beam provided an ideal capability to match fields accurately to cover large volumes while also sparing underlying normal tissues.
The Laboratoire des Sciences du Climat et de l'Environnement (LSCE) research program on prehistoric art conducts chronological studies of parietal representations with their associated archaeological context. This multidisciplinary approach provides chronological arguments about the creation period of parietal representations. This article presents chronological investigations carried out in several decorated caves in France (La Grande Grotte, Labastide, Lascaux, La Tête-du-Lion, Villars) and Spain (La Garma, Nerja, La Pileta, Urdiales). Several types of organic materials, collected from different areas of the caves close to the walls and in connection with parietal art, were dated to determine the periods of human presence in the cave, a presence that may have been related to artistic activities. These new radiocarbon results range from 33,000–29,000 (La Grande Grotte) to 16,000–14,000 cal BP (Urdiales).
To identify risk factors for polymicrobial bloodstream infections (BSIs) in pediatric bone marrow transplant (BMT) outpatients attending a newly constructed clinic affiliated with a children's hospital.
Methods.
All 30 outpatients treated at a new BMT clinic during September 10-21, 2007, were enrolled in a cohort study. The investigation included interviews, medical records review, observations, and bacterial culture and molecular typing of patient and environmental isolates. Data were analyzed using exact conditional logistic regression.
Results.
Thirteen patients experienced BSIs caused by 16 different, predominantly gram-negative organisms. Presence of a tunneled catheter (odds ratio [OR], 19.9 [95% confidence interval {CI}, 2.4-∞), catheter access (OR, 13.7 [95% CI, 1.8-∞]), and flushing of a catheter with predrawn saline (OR, 12.9 [95% CI, 1.0-766.0]) were independently associated with BSI. The odds of experiencing a BSI increased by a factor of 16.8 with each additional injection of predrawn saline (95% CI, 1.8-827.0). Although no environmental source of pathogens was identified, interviews revealed breaches in recommended infection prevention practice and medication handling. Saline flush solutions were predrawn, and multiple doses were obtained from single-dose preservative-free vials to avoid delays in patient care.
Conclusion.
We speculate that infection prevention challenges in the new clinic, combined with successive needle punctures of vials, facilitated extrinsic contamination and transmission of healthcare-associated pathogens. We recommend that preservative-free single-use vials not be punctured more than once. Use of single-use prefilled saline syringes might prevent multiuse of single-use saline vials. Storage of saline outside a medication supply system might be advisable. Before opening new clinic facilities, hospitals should consider conducting a mock patient flow exercise to identify infection control challenges.
So as to prepare future observations of terrestrial extrasolar planets liable to shelter life, we attempt to detect the life on the Earth seen as a dot. We use the Moon Earthshine, in which any place reflects the totality of the enlightened part of Earth facing the Moon. Observing from OHP and from ESO, we detected terrestrial chlorophyll in the near infrared, the so-called Vegetation Red Edge, and this detection is larger when forests are present than when an ocean is mainly visible from the Moon. Only if observations are made from a high latitude location, and at some moments in the year, Earthshine can be observed during a large part of the day. During these long observing windows, different “landscapes" are facing the Moon. So the Earthshine corresponding to various parts of our Earth could be studied. Preliminary testing observations have been made at Concordia since the first winterover campaign and the LUCAS experiment has been set up.
A microanalysis of task events in a common go/no-go task was completed to examine how task events impact individual reaction times. Predictors of long reaction times were analyzed to better understand increased intra-individual variability (IIV) among children with ADHD compared with normal controls. Sixty-five children with ADHD and 65 normal controls matched on gender, ethnicity, and age completed a go/no-go task. Children across both groups were slower before and after omission errors than all other trials. They were also slower on the trial before successfully inhibiting their response to no-go trials. Children with ADHD exhibited a pronounced slowing on trials prior to omission errors and trials prior to successful inhibitions compared with the normal control group. Pre-error slowing in children with ADHD may represent the beginning stages of attentional disengagement that subsequently results in the absence of responding (i.e., errors of omission or successful inhibition). While these event-related increases in reaction time explain some of the increased IIV observed in children with ADHD, the removal of these trials did not remove the pronounced between-group differences in IIV, suggesting that additional unmeasured processes are contributing to IIV in children with ADHD. (JINS, 2010, 16, 138–147.)
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has rapidly emerged in the USA as a cause of severe infections in previously healthy persons without traditional risk factors. We describe the epidemiology of severe CA-MRSA disease in the state of Georgia, USA and analyse the risk of death associated with three different clinical syndromes of CA-MRSA disease – pneumonia, invasive disease, and skin and soft-tissue infections (SSTIs). A total of 1670 cases of severe CA-MRSA disease were reported during 2005–2007. The case-fatality rate was 3·4%; sex and race of fatal and non-fatal cases did not differ significantly. While CA-MRSA pneumonia and invasive disease were less common than SSTIs, they were about 15 times more likely to result in death [risk ratio 16·69, 95% confidence interval (CI) 10·28–27·07 and 13·98, 95% CI 7·74–25·27, respectively]. When controlling for age and the presence of other clinical syndromes the odds of death in patients manifesting specific severe CA-MRSA syndromes was highest in those with pneumonia (odds ratio 11·34). Possible risk factors for severe CA-MRSA SSTI and pneumonia included the draining of lesions without medical assistance and an antecedent influenza-like illness.
In this paper, we explain our routine pretreatment of bone for radiocarbon dating by accelerator mass spectrometry (AMS), based on the specific reaction between amino acids and ninhydrin described by Nelson (1991). The values and uncertainties of the total system background are presented as a function of the carbon sample mass and the reliability of this method is discussed.
Animals enclosed in amber often provide a unique insight into their surface structure. Such fossils of reptiles are rare and usually not extremely ancient, the earliest being no more than 40 million years (my). A recently discovered 120 my lizard from the Lower Cretaceous of Lebanon provides direct evidence that several common external features of autarchoglossan lizards had evolved by this time. Ecomorphology indicates that the lizard concerned had considerable climbing ability on open surfaces and perhaps in vegetation, and probably lived in a mesic forested environment, something supported by associated plant and invertebrate remains.
We have purified an ∼60 kDa endoribonuclease from Xenopus liver polysomes with properties expected for a messenger RNase involved in the estrogen-regulated destabilization of serum protein mRNAs (Dompenciel et al., 1995, J Biol Chem 270:6108–6118). The present report describes the cloning of this protein and its identification as a novel member of the peroxidase gene family. This novel enzyme, named polysomal RNase 1, or PMR-1 has 57% sequence identity with myeloperoxidase, and like that protein, appears to be processed from a larger precursor. Unlike myeloperoxidase, however, PMR-1 lacks N-linked oligosaccharide, heme, and peroxidase activity. Western blot and immunoprecipitation experiments using epitope-specific antibodies to the derived protein sequence confirm the identity of the cloned cDNA to the protein originally isolated from polysomes. The 80 kDa pre-PMR-1 expressed in a recombinant baculovirus was not processed to the 60 kDa form in Sf9 cells and lacks RNase activity. However, the baculovirus-expressed mature 60-kDa form of the enzyme has RNase activity. The recombinant protein is an endonuclease that shows selectivity for albumin versus ferritin mRNA. While it does not cleave at consensus APyrUGA elements, recombinant PMR-1 generates the same minor cleavage products from albumin mRNA as PMR-1 purified from liver. Finally, we show estrogen induces only a small increase in the amount of PMR-1. This result is consistent with earlier data suggesting estrogen activates mRNA decay through a posttranslational pathway.
This paper gives an overview on different types of instabilities and structure formation in various fields of laser processing. Among the examples discussed in detail are non-coherent structures observed in laser-induced chemical vapor deposition (LCVD), in laser-induced surface modifications, and in laser ablation of polymers.
With the financial services industries in the member countries of the European Union coming under increasing attention resulting in relaxation of cross border controls, this paper addresses some pensions matters in this European context and how they may relate to the U.K. The main theme of the paper is the book reserve approach to pensions provision. Details of the German book reserve method are provided before developing possible ways in which this philosophy could be introduced into the U.K. These possibilities are assessed and consideration given to the effect they may have on the economy, commerce, the pension fund industry and, not least, the actuarial profession in the U.K.