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The irreversible behaviour of a highly confined non-Brownian suspension of spherical particles at low Reynolds number in a Newtonian fluid is studied experimentally and numerically. In the experiment, the suspension is confined in a thin rectangular channel that prevents complete particle overlap in the narrow dimension and is subjected to an oscillatory pressure-driven flow. In the small cross-sectional dimension, particles rapidly separate to the walls, whereas in the large dimension, features reminiscent of shear-induced migration in bulk suspensions are recovered. Furthermore, as a consequence of the channel geometry and the development and application of a single-camera particle tracking method, three-dimensional particle trajectories are obtained that allow us to directly associate relative particle proximity with the observed migration. Companion simulations of a steadily flowing suspension highly confined between parallel plates are conducted using the force coupling method, which also show rapid migration to the walls as well as other salient features observed in the experiment. While we consider relatively low volume fractions compared to most prior work in the area, we nevertheless observe significant and rapid migration, which we attribute to the high degree of confinement.
There is an extensive literature on the usage of Blissymbolics in augmentative and alternative communication that contradicts Morin's contention that it fails as an ideography. Morin's notion of “standardization” (target article, sect. X, para. X) is at odds with the highly developed understanding of this notion in linguistics. What Morin seems to have in mind corresponds to the notion of emergence in iterative and multiagent models of language learning.
Depression in dementia is common, disabling and causes significant distress to patients and carers. Despite widespread use of antidepressants for depression in dementia, there is no evidence of therapeutic efficacy, and their use is potentially harmful in this patient group. Depression in dementia has poor outcomes and effective treatments are urgently needed. Understanding why antidepressants are ineffective in depression in dementia could provide insight into their mechanism of action and aid identification of new therapeutic targets. In this review we discuss why depression in dementia may be a distinct entity, current theories of how antidepressants work and how these mechanisms of action may be affected by disease processes in dementia. We also consider why clinicians continue to prescribe antidepressants in dementia, and novel approaches to understand and identify effective treatments for patients living with depression and dementia.
To identify potential participants for clinical trials, electronic health records (EHRs) are searched at potential sites. As an alternative, we investigated using medical devices used for real-time diagnostic decisions for trial enrollment.
Methods:
To project cohorts for a trial in acute coronary syndromes (ACS), we used electrocardiograph-based algorithms that identify ACS or ST elevation myocardial infarction (STEMI) that prompt clinicians to offer patients trial enrollment. We searched six hospitals’ electrocardiograph systems for electrocardiograms (ECGs) meeting the planned trial’s enrollment criterion: ECGs with STEMI or > 75% probability of ACS by the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI). We revised the ACI-TIPI regression to require only data directly from the electrocardiograph, the e-ACI-TIPI using the same data used for the original ACI-TIPI (development set n = 3,453; test set n = 2,315). We also tested both on data from emergency department electrocardiographs from across the US (n = 8,556). We then used ACI-TIPI and e-ACI-TIPI to identify potential cohorts for the ACS trial and compared performance to cohorts from EHR data at the hospitals.
Results:
Receiver-operating characteristic (ROC) curve areas on the test set were excellent, 0.89 for ACI-TIPI and 0.84 for the e-ACI-TIPI, as was calibration. On the national electrocardiographic database, ROC areas were 0.78 and 0.69, respectively, and with very good calibration. When tested for detection of patients with > 75% ACS probability, both electrocardiograph-based methods identified eligible patients well, and better than did EHRs.
Conclusion:
Using data from medical devices such as electrocardiographs may provide accurate projections of available cohorts for clinical trials.
With manufacturers seeking investment opportunities in Africa, it is timely to explore the interaction of advanced manufacturing technology (AMT) and human resource management approaches there. Because research elsewhere suggests that the effects of the interaction differ across national boundaries, we investigated empowerment approaches and AMT utilisation in Nigeria and New Zealand. Using operational-level survey data from 153 manufacturing managers/CEOs in both countries, we explored the role of national culture on managerial attitudes towards employee empowerment during AMT adoption. Drawing on Hofstede’s cultural dimensions, our results suggest that the observed differences in AMT–empowerment interface are attributable to different national values. The results specifically indicated that during AMT adoption, New Zealand’s liberal culture encourages managers to empower employees more than does Nigeria’s authoritarian one. The results would particularly assist practitioners to recognise the traditional/conservative nature of African values when practicing HR in a country like Nigeria.
The goal of this effort was to reduce central venous catheter (CVC)-associated bloodstream infections (BSIs) in pediatric intensive care unit (ICU) patients by means of a multicenter evidence-based intervention.
Methods.
An observational study was conducted in 26 freestanding children's hospitals with pediatric or cardiac ICUs that joined a Child Health Corporation of America collaborative. CVC-associated BSI protocols were implemented using a collaborative process that included catheter insertion and maintenance bundles, daily review of CVC necessity, and daily goals. The primary goal was either a 50% reduction in the CVC-associated BSI rate or a rate of 1.5 CVC-associated BSIs per 1,000 CVC-days in each ICU at the end of a 9-month improvement period. A 12-month sustain period followed the initial improvement period, with the primary goal of maintaining the improvements achieved.
Results.
The collaborative median CVC-associated BSI rate decreased from 6.3 CVC-associated BSIs per 1,000 CVC-days at the start of the collaborative to 4.3 CVC-associated BSIs per 1,000 CVC-days at the end of the collaborative. Sixty-five percent of all participants documented a decrease in their CVC-associated BSI rate. Sixty-nine CVC-associated BSIs were prevented across all teams, with an estimated cost avoidance of $2.9 million. Hospitals were able to sustain their improvements during a 12-month sustain period and prevent another 198 infections.
Conclusions.
We conclude that our collaborative quality improvement project demonstrated that significant reduction in CVC-associated BSI rates and related costs can be realized by means of evidence-based prevention interventions, enhanced communication among caregivers, standardization of CVC insertion and maintenance processes, enhanced measurement, and empowerment of team members to enforce adherence to best practices.
Jackendoff's criticisms of the current state of theorization in cognitive neuroscience are defused by recent work on the computational complementarity of the hippocampus and neocortex. Such considerations lead to a grounding of Jackendoff's processing model in the complementary methods of pattern analysis effected by independent component analysis (ICA) and principle component analysis (PCA).
Fluorescent stains offer an effective means of visualising bacteria and fungi in soil or litter samples. Fluorescent brightener (FB) 28 (also known as Calcofluor White M2R) is commonly used to stain such microorganisms. However, during production of soil thin-sections we observed erratic crystallisation of this stain, particularly in soils colonised by Rhizoctonia solani. We report on the evaluation of alternative stains to FB 28 for their propensity to crystallize in interaction with fungi, staining efficiency, and suitability for application in soil thin-section production. All of the additional candidate stains namely Fluorescent Brightener Agent (FBA) 15/25, FBA 71 and SCRI Renaissance 2200 (SR 2200) were highly effective in staining agar-cultured hyphae, but differed in the degree to which they stained hyphae cultured in soil. All stains tested, except SR 2200, stained hyphae of R. solani insufficiently when growing on or through soil. These stains also showed extensive crystallisation in solutions that had been in contact with R. solani colonised soil. However, SR 2200 stained hyphae of R solani growing over soil as effectively as hyphae growing on agar and showed no evidence of crystallisation; the intensity of staining exceeded that of the ‘benchmark’ FB 28 for hyphae grown in two soil types. These excellent fluorescent properties of FBA 220 persisted in soil thin-sections, resulting in bright hyphae that could be readily visualised in situ in undisturbed soils.
The isomorphism between relational structures advocated by Palmer corresponds quite closely to Paul Churchland's theory of “state-space semantics,” so much so that one can be used to elucidate problematic areas in the other. The resulting hybrid shows eliminative materialism to be superior to functionalism as a theory of mental phenomena and seems to provide the best ontology for cognitive science.