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Background: While efgartigimod usage is expected to reduce immunoglobulin (IG) utilization, evidence in clinical practice is limited. Methods: In this retrospective cohort study, patients with gMG treated with efgartigimod for ≥1-year were identified from US medical/pharmacy claims data (April 2016-January 2024) and data from the My VYVGART Path patient support program (PSP). The number of IG courses during 1-year before and after efgartigimod initiation (index date) were evaluated. Patients with ≥6 annual IG courses were considered chronic IG users. Myasthenia Gravis Activities of Daily Living (MG-ADL) scores before and after index were obtained from the PSP where available. Descriptive statistics were used without adjustment for covariates. Results: 167 patients with ≥1 IG claim before index were included. Prior to efgartigimod initiation, the majority of patients (62%) received IG chronically. During the 1-year after index, the number of IG courses fell by 95% (pre: 1531, post: 75). 89% (n=149/167) of patients fully discontinued IG usage. Mean (SD) best-follow up MG-ADL scores were significantly reduced after index (8.0 [4.1] to 2.8 [2.1], P<0.05, n=73/167, 44%). Conclusions: Based on US claims, IG utilization was substantially reduced among patients who continued efgartigimod for ≥1-year, with patients demonstrating a favorable MG-ADL response.
Ice cliffs on debris-covered glaciers act as melt hotspots that considerably enhance glacier ablation. However, studies are typically limited in time and space; glacier-scale studies of this process of ice cliff melt are rare, and their varying seasonal energy balance remains largely unknown. In this study, we combined a process-based ice cliff backwasting model with high-resolution (1.0 m) photogrammetry-based terrain data to simulate the year-round melt of 479 ice cliffs on Trakarding Glacier, Nepal Himalaya. Ice cliff melt accounted for 26% of the mass loss of the glacier from October 2018 to October 2019, despite covering only 1.7% of the glacier surface. The annual melt rate of ice cliffs was 2.7 cm w.e. d−1, which is 8–9 times higher than the sub-debris melt rate. Ice cliff melt rates were significantly controlled by their aspects, with south-facing ice cliffs showing a melt rate 1.8 times higher than that of north facing ones. The results revealed that the aspect dependence of ice cliff melt rate was amplified in winter and decreased/disappeared toward the monsoon season. The seasonal changes in melt characteristics are considered to be related to variations in direct shortwave radiation onto the cliff surface, which are dependent on changes in solar altitude and monsoonal cloud cover.
A preliminary study to detect human worm carriers of Taenia solium in Papua (Irian Jaya), Indonesia was carried out using stool examinations for the detection of copro-antigens and adult proglottids after chemotherapy, and confirmation by mitochondrial DNA analysis using expelled proglottids and metacestodes developed in NOD/Shi-scid mice from eggs of expelled proglottids. Approximately 8.6% of the local population in Kama (5/58), 1 km from the local capital city centre, Wamena, were confirmed to harbour adult T. solium using these techniques.
Serology (ELISA and immunoblot) using native glycoproteins, affinity purified glycoproteins, and a recombinant antigen is known to be highly specific to Taenia solium cysticercosis in humans and pigs. These techniques were applied for dogs in the highly endemic area of cysticercosis in Papua (Irian Jaya), Indonesia. Analysis of dog sera by both ELISA and immunoblot revealed 7 of 64 dogs were highly positive. Examination of two sero-positive dogs revealed cysticerci of T. solium in the brain and heart of these dogs. Mitochondrial DNA analysis confirmed that they were the same as T. solium previously confirmed from pigs and biopsies from local people from Irian Jaya. It is suggested that the life cycle of T. solium may be completed not only between humans and pigs but also between humans and dogs.
The effect of environmental enrichment on the welfare of stabled horses was estimated on the basis of positive and negative behavioural indicators. Six stabled horses were exposed for seven days to each of two conditions in early spring: i) a window at the back of the loose box was opened, but no horses were within the view of the subject horses (OW) and ii) the window in the loose box was opened and two horses that had been in the same stable as the subject horses were turned out to the paddock next to the stable and were within view of the subject horses (OWH). The window in the loose box had been closed prior to the start of the study for protection against the cold during winter months (CW condition) but horses could see outside the loose box through the grille door. The behaviour of the subject horses was recorded by video camera from 1300 to 1530h, firstly, in the CW condition for the three days prior to treatment as the control condition, and then for the last three days of each week in the OW and OWH conditions. The behaviour was focal- and instantaneous-sampled at 30-s intervals. Significant differences between the effects of the loose box conditions on the mean percentage of time spent in standing behaviour, looking behaviour, and bedding investigation behaviour (which may be an indicator of frustration) were observed but no significant difference in the mean percentage of time spent in standing-sleep behaviour (which may be an indicator of behavioural satisfaction) was observed. When the window was opened, bedding investigation and standing behaviour decreased and, when the conspecifics were within view, bedding investigation behaviour decreased and looking behaviour increased. The results suggested that the OW and OWH treatments suppressed the frustration of stabled horses which did not perform any abnormal behaviour, but may not increase the behavioural satisfaction of stabled horses.
In June 2020, a large-scale food poisoning outbreak involving about 3000 elementary and junior high school students occurred in Yashio, Saitama, Japan. A school lunch was the only food stuff ingested by all of the patients. Escherichia coli serotype O7:H4 carrying the astA gene for enteroaggregative E. coli (EAggEC) heat-stable enterotoxin 1 (EAST1) was detected in faecal specimens from the patients, and sample inspection revealed its presence in a seaweed salad and red seaweed (Gigartina tenella) as one of the raw materials. Analysis of the antibiotic sensitivity of the isolates revealed resistance to ampicillin and cefotaxime. All isolates were confirmed to be of the same origin by pulsed-field gel electrophoresis after digestion with the restriction enzyme XbaI, and single nucleotide polymorphism analysis using whole genome sequencing. To our knowledge, this is the first report of a large-scale food poisoning caused by E. coli O7:H4, which lacks well-characterized virulence genes other than astA.
This study aimed to determine the requirements of standardized ileal digestible (SID) methionine (Met) + cysteine (Cys) of 15–30 kg barrows, maintaining or increasing the 1:1 ratio between SID Met and SID Cys. Seventy crossbred barrows averaging 15.2 ± 0.54 kg of live weight were allotted in a randomized block design 2 × 3 + 1 factorial scheme, with five replicates and two animals per pen. Treatments consisted of maintaining or increasing the 1:1 ratio between SID Met and SID Cys, three levels of SID Met + Cys (5.8, 6.4 and 7.0 g/kg) and a basal diet containing the lowest SID Met + Cys level (5.2 g/kg), formulated to provide a 1:1 ratio of SID Met (2.6 g/kg) and SID Cys (2.6 g/kg). Performance, blood parameters, longissimus dorsi muscle depth, backfat thickness and S–S linkages in the bristles were evaluated. The best average daily gain was estimated at 6.61 g/kg of SID Met + Cys, without maintaining the 1:1 ratio between sulphur amino acids (SAA). The daily intake of SID Met + Cys increased due to dietary SID Met + Cys levels, maintaining or increasing the same ratio between SAA. Plasma glucose increased and total cholesterol decreased according to SID Met + Cys levels, without maintaining the same ratio between the SAA. The requirement of SID Met + Cys for 15–30 kg barrows was 6.61 g/kg (7.88 g/day) for an optimum average daily gain, with no need to maintain the same ratio between the SAA.
Mental disorders can have a major impact on brain development. Peripheral blood concentrations of brain-derived neurotrophic factor (BDNF) are lower in adult psychiatric disorders. Serum BDNF concentrations and BDNF genotype have been associated with cortical maturation in children and adolescents. In 2 large independent samples, this study tests associations between serum BDNF concentrations, brain structure, and psychopathology, and the effects of BDNF genotype on BDNF serum concentrations in late childhood and early adolescence.
Methods
Children and adolescents (7-14 years old) from 2 cities (n = 267 in Porto Alegre; n = 273 in São Paulo) were evaluated as part of the Brazilian high-risk cohort (HRC) study. Serum BDNF concentrations were quantified by sandwich ELISA. Genotyping was conducted from blood or saliva samples using the SNParray Infinium HumanCore Array BeadChip. Subcortical volumes and cortical thickness were quantified using FreeSurfer. The Development and Well-Being Behavior Assessment was used to identify the presence of a psychiatric disorder.
Results
Serum BDNF concentrations were not associated with subcortical volumes or with cortical thickness. Serum BDNF concentration did not differ between participants with and without mental disorders, or between Val homozygotes and Met carriers.
Conclusions
No evidence was found to support serum BDNF concentrations as a useful marker of developmental differences in brain and behavior in early life. Negative findings were replicated in 2 of the largest independent samples investigated to date.
The Japanese Murrelet Synthliboramphus wumizusume is a rare, globally ‘Vulnerable’ seabird, endemic to Japan and South Korea. However, little is known of its at-sea distribution, habitat or threats. We conducted several years of at-sea surveys around Japan to model Japanese Murrelet density in relation to habitat parameters, and make spatial predictions to assess the adequacy of the current Japanese marine Important Bird and Biodiversity Area (IBA) network for the species. During a five-year period, 3,485 km of at-sea surveys recorded 3,161 Japanese Murrelets around four breeding locations. Maximum murrelet group size was 90 individuals with a mean group size of 2.9 ± 4.2 individuals. Models of Japanese Murrelet at-sea density around the two largest breeding locations predicted that almost all murrelets occur within 30 km of the breeding colony and most within 10 km. Murrelets were predicted closer to the colony in May than in April and closer to the colony at a neritic colony than at an offshore island colony. Additionally, murrelets breeding on an offshore island colony also commuted to mainland neritic habitat for foraging. The marine habitat used by Japanese Murrelets differed between each of the four surveyed colonies, however oceanographic variables offered little explanatory power in models. Models with colony, month and year generated four foraging radii (9–39 km wide) containing murrelet densities of > 0.5 birds/km2. Using these radii the Japanese marine IBA network was found to capture between 95% and 25% of Japanese Murrelet at-sea habitat while breeding and appears appropriately configured to protect near-colony murrelet distributions. Given the range of marine habitats that breeding murrelets inhabit, our simple models offer an applicable method for predicting to unsampled colonies and generating ecologically-informed seaward extension radii. However, data on colony populations and further at-sea surveys are necessary to refine models and improve predictions.
Measurements in the infrared wavelength domain allow direct assessment of the physical state and energy balance of cool matter in space, enabling the detailed study of the processes that govern the formation and evolution of stars and planetary systems in galaxies over cosmic time. Previous infrared missions revealed a great deal about the obscured Universe, but were hampered by limited sensitivity.
SPICA takes the next step in infrared observational capability by combining a large 2.5-meter diameter telescope, cooled to below 8 K, with instruments employing ultra-sensitive detectors. A combination of passive cooling and mechanical coolers will be used to cool both the telescope and the instruments. With mechanical coolers the mission lifetime is not limited by the supply of cryogen. With the combination of low telescope background and instruments with state-of-the-art detectors SPICA provides a huge advance on the capabilities of previous missions.
SPICA instruments offer spectral resolving power ranging from R ~50 through 11 000 in the 17–230 μm domain and R ~28.000 spectroscopy between 12 and 18 μm. SPICA will provide efficient 30–37 μm broad band mapping, and small field spectroscopic and polarimetric imaging at 100, 200 and 350 μm. SPICA will provide infrared spectroscopy with an unprecedented sensitivity of ~5 × 10−20 W m−2 (5σ/1 h)—over two orders of magnitude improvement over what earlier missions. This exceptional performance leap, will open entirely new domains in infrared astronomy; galaxy evolution and metal production over cosmic time, dust formation and evolution from very early epochs onwards, the formation history of planetary systems.
Section 4 of the FM14 focus on the outreach action and advocacy in the context of IAUs 2020-2030 Strategic Plan. This paper also contains supplementary materials that point to contributed talks and poster presentations that can be found online.
Polycondensation reactions between amino acids and phenols are one of the pathways for the formation of humic substances, and clay minerals are able to catalyse these reactions. To investigate the catalytic power of allophane, an allophane fraction (ALF) was separated from weathered pumice (WP) that contained imogolite as an impurity by taking advantage of differences in sedimentation velocity. The iron content in the separated ALF was increased by up to 3.0% compared to that in the starting WP (1.3%), and the ALF was further treated with sodium dithionate and citric acid (ALF-DC) to remove the iron. The catalytic powers of WP, ALF and ALF-DC were evaluated, based on the degree of darkening of reaction mixtures from polycondensation reactions between catechol and tryptophan, model compounds for precursors of humic substances. The catalytic power for ALF was significantly higher than the corresponding values for WP and ALF-DC. This can be attributed to the high iron content of the ALF, which serves as a Lewis acid that can enhance nucleophilic reactions which occur during the polycondensation reactions.
To enhance the catalytic activities of zeolites for the polycondensation reactions of humic precursors, Fe was loaded into a zeolite via an ion-exchange reaction and the resulting product was subjected to calcination at 773 K. Two types iron-loaded zeolites were prepared using one equivalent (Fe-Z-1) and 10-equivalents (Fe-Z-10) of Fe2+ to the cation-exchange capacity of a natural zeolite from Niki town (Hokkaido, Japan). X-ray diffraction (XRD) patterns and X-ray photoelectron spectroscopy (XPS) spectra showed that the Fe(II) that was originally loaded into the cation-exchange sites in the zeolite became oxidized to a Fe(III) ionic species during the preparation. The catalytic activities of each zeolite were evaluated, based on the degree of darkening for reaction mixtures containing catechol, glycine and glucose as model humic precursors. The catalytic activities of Fe-Z-1 and Fe-Z-10 were higher than that for an untreated zeolite, and increased with the amount of Fe in the zeolite.
The Zn-bearing beaverite of Sato et al. (2008) has been named ‘beaverite-(Zn)’ in accordance with the alunite supergroup nomenclature of Bayliss et al. (2010), and data for the mineral have been approved by the IMA-CNMNC. Beaverite-(Zn) occurs as a dark-brown secondary mineral in the hydrothermal Cu-Zn-Pb ore deposit of the Mikawa mine, Niigata Prefecture, Japan. Electron microprobe analysis gave an empirical formula of Pb0.95(Fe1.88Al0.10)(Zn0.83Cu0.03)(SO4)2[(OH)5.36O0.38] on the basis of S = 2. The Rietyeld analysis (Sato et al, 2008) indicated it to be trigonal, R3̄m, a = 7.3028(2), c = 17.0517(4) Å, V = 787.56(4) Å3.
Non-traumatic bone fractures in cancer patients are usually pathological fractures due to bone metastases. In head and neck cancer patients, clavicle stress fractures may occur as a result of atrophy of the trapezius muscle after neck dissection in which the accessory nerve becomes structurally or functionally damaged.
Case report:
A 71-year-old man underwent modified radical neck dissection with accessory nerve preservation and post-operative radiotherapy for submandibular lymph node metastases of tongue cancer. Four weeks after the radiotherapy, a clavicle fracture, with osteomyelitis and abscess formation in the pectoralis major muscle, occurred. Unlike in simple stress fracture, long-term antibiotic administration and drainage surgery were required to suppress the inflammation.
Conclusion:
As seen in the present patient, clavicle stress fractures may occur even after neck dissection in which the accessory nerve is preserved, and may be complicated by osteomyelitis and abscess formation owing to risk factors such as radiotherapy, tracheostomy and contiguous infection.
Ten ice-sheet models are used to study sensitivity of the Greenland and Antarctic ice sheets to prescribed changes of surface mass balance, sub-ice-shelf melting and basal sliding. Results exhibit a large range in projected contributions to sea-level change. In most cases, the ice volume above flotation lost is linearly dependent on the strength of the forcing. Combinations of forcings can be closely approximated by linearly summing the contributions from single forcing experiments, suggesting that nonlinear feedbacks are modest. Our models indicate that Greenland is more sensitive than Antarctica to likely atmospheric changes in temperature and precipitation, while Antarctica is more sensitive to increased ice-shelf basal melting. An experiment approximating the Intergovernmental Panel on Climate Change’s RCP8.5 scenario produces additional first-century contributions to sea level of 22.3 and 8.1 cm from Greenland and Antarctica, respectively, with a range among models of 62 and 14 cm, respectively. By 200 years, projections increase to 53.2 and 26.7 cm, respectively, with ranges of 79 and 43 cm. Linear interpolation of the sensitivity results closely approximates these projections, revealing the relative contributions of the individual forcings on the combined volume change and suggesting that total ice-sheet response to complicated forcings over 200 years can be linearized.
A good correlation was found between the ablation of snow and degree day index (cumulative values of positive daily mean air temperature) during the summer of 1978 on the Yukikabe snow patch in the Daisetsu mountains, central Hokkaido. The volume change of the snow patch in the ablation season of any year can hence be estimated from air temperature using this relationship. Each of the heat-balance terms controlling the ablation is evaluated separately by using empirical equations and assumed values for meteorological parameters at the snow patch. Triangular diagrams are constructed in order to illustrate the relative contributions of sensible heat, latent heat, and net radiation, the main three heat sources. A higher contribution from sensible and latent heat is found for the snow patches of Japan than for many glaciers and ice caps elsewhere. This may be due to higher mid-summer air temperatures than in other glaciated parts of the world.
The propagation of shock waves in unsaturated wet snow is investigated, both analytically and experimentally.
The experimental program was carried out in the laboratory with an electromagnetic stress-wave generator. During each test, impact velocity was measured at the base of the specimen by means of a contacting wire system. Also, pressure was measured at the opposite end with a piezo-resistive pressure transducer with a flat response from below 0.5 to above 100 kHz.
Densities of snow samples in the range from 200 to 500 kg m−3 were tested. Impact velocities at the base were varied from 20 to as high as 100 rns −1. Propagation distances (specimen lengths) were varied from 2 to 5 cm. Also, for each test, the free water moisture content in the test specimen was carefully measured so that the effect of this property could be evaluated. The test results are reported and the wave attenuation rates are characterized in terms of the parameters discussed above. In addition, these results are compared to test results for dry snow.
Finally, wave propagation theory is used to evaluate the material tangent modulus. The theory is also used to calculate particle velocity and density increases produced by the shock waves. The results are compared to those obtained earlier for dry snow.
Personal disaster and emergency support networks of rural older adults are described before and after participation in a disaster preparedness intervention, PrepWise.
Methods
At baseline, a total of 194 disaster support network members were identified by 27 older adults in a rural Midwest community. After the intervention, these participants identified 232 support network members. Multilevel logistic regression models were constructed to identify characteristics of the network members and social interactions associated with support providers at baseline as well as newly added support sources after the PrepWise intervention.
Results
Member and interaction characteristics associated with being identified as emergency support sources at baseline were as follows: family, lived in close proximity, weekly or more frequent contact, and being someone whom participants shared concerns with, trusted, and exchanged emotional support with. After receiving PrepWise, participants on average identified 3 new sources of emergency support within their networks. Support sources added at follow-up tended to be nonfamily members and those participants trusted.
Conclusions
Enhancements in personal emergency support networks occurred after the intervention. Understanding characteristics of the network members and social interactions may assist in identifying additional emergency support sources. Larger studies investigating the impacts of enhanced support networks on disaster-related behaviors and outcomes will be beneficial. (Disaster Med Public Health Preparedness. 2017;11:110–119)
There is accumulating evidence for the role of fronto-striatal and associated circuits in obsessive–compulsive disorder (OCD) but limited and conflicting data on alterations in cortical thickness.
Aims
To investigate alterations in cortical thickness and subcortical volume in OCD.
Method
In total, 412 patients with OCD and 368 healthy adults underwent magnetic resonance imaging scans. Between-group analysis of covariance of cortical thickness and subcortical volumes was performed and regression analyses undertaken.
Results
Significantly decreased cortical thickness was found in the OCD group compared with controls in the superior and inferior frontal, precentral, posterior cingulate, middle temporal, inferior parietal and precuneus gyri. There was also a group x age interaction in the parietal cortex, with increased thinning with age in the OCD group relative to controls.
Conclusions
Our findings are partially consistent with earlier work, suggesting that group differences in grey matter volume and cortical thickness could relate to the same underlying pathology of OCD. They partially support a frontostriatal model of OCD, but also suggest that limbic, temporal and parietal regions play a role in the pathophysiology of the disorder. The group x age interaction effects may be the result of altered neuroplasticity.