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Several studies have reported evidence of interference between respiratory viruses: respiratory viruses rarely reach their epidemic peak concurrently and there appears to be a negative association between infection with one respiratory virus and co-infection with another. We used results spanning 16 years (2002–2017) of a routine diagnostic multiplex panel that tests for nine respiratory viruses to further investigate these interactions in Victoria, Australia. Time series analyses were used to plot the proportion positive for each virus. The seasonality of all viruses included was compared with respiratory syncytial virus (RSV) and influenza A virus using cross-correlations. Logistic regression was used to explore the likelihood of co-infection with one virus given infection with another. Seasonal peaks were observed each year for influenza A and RSV and less frequently for influenza B, coronavirus and parainfluenza virus. RSV circulated an average of 6 weeks before influenza A. Co-infection with another respiratory virus was less common with picornavirus, RSV or influenza A infection. Our findings provide further evidence of a temporal relationship in the circulation of respiratory viruses. A greater understanding of the interaction between respiratory viruses may enable better prediction of the timing and magnitude of respiratory virus epidemics.
Family history is a long-standing and readily obtainable risk factor for schizophrenia (SCZ). Low-cost genotyping technologies have enabled large genetic studies of SCZ, and the results suggest the utility of genetic risk scores (GRS, direct assessments of inherited common variant risk). Few studies have evaluated family history and GRS simultaneously to ask whether one can explain away the other.
Methods
We studied 5959 SCZ cases and 8717 controls from four Nordic countries. All subjects had family history data from national registers and genome-wide genotypes that were processed through the quality control procedures used by the Psychiatric Genomics Consortium. Using external training data, GRS were estimated for SCZ, bipolar disorder (BIP), major depression, autism, educational attainment, and body mass index. Multivariable modeling was used to estimate effect sizes.
Results
Using harmonized genomic and national register data from Denmark, Estonia, Norway, and Sweden, we confirmed that family history of SCZ and GRS for SCZ and BIP were risk factors for SCZ. In a joint model, the effects of GRS for SCZ and BIP were essentially unchanged, and the effect of family history was attenuated but remained significant. The predictive capacity of a model including GRS and family history neared the minimum for clinical utility.
Conclusions
Combining national register data with measured genetic risk factors represents an important investigative approach for psychotic disorders. Our findings suggest the potential clinical utility of combining GRS and family history for early prediction and diagnostic improvements.
Using an augmented profit function framework designed to account for externalities related to chemical use in agriculture, this paper explains the chemical use choices of farmers in an urban fringe farming environment. It further estimates empirical logit models of reduced insecticide, fungicide, herbicide, and fertilizer usage. Results suggest that farmers who perceive their regulatory environment to be strict, who have experienced right-to-farm conflicts, and who have farms larger in size are more likely to reduce their chemical use over time, vis-à-vis other farmers. The results also suggest the importance of other farm structural and business climate factors in determining chemical use reduction choices.
Clinical guidelines advise against prescribing more than one antipsychotic with limited exceptions. Despite this, surveys continue to report high antipsychotic polypharmacy rates. The aim of the study was to investigate the effectiveness of a multi-faceted intervention in reducing prescribing of antipsychotic polypharmacy on general adult psychiatry wards, compared with guidelines alone.
Method
A pragmatic cluster randomized controlled trial recruited 19 adult psychiatric units (clusters) from the South West of England. Participants were all ward doctors and nurses. The multi-faceted intervention comprised: an educational/CBT workbook; an educational visit to consultants; and a reminder system on medication charts.
Results
The odds of being prescribed antipsychotic polypharmacy in those patients prescribed antipsychotic medication was significantly lower in the intervention than control group when adjusted for confounders (OR 0.43, 95% CI 0.21–0.90, p=0.028). There was considerable between-unit variation in polypharmacy rates and in the change in rates between baseline and follow-up (5 months after baseline).
Conclusion
The intervention reduced levels of polypharmacy prescribing compared to guidelines alone although the effect size was relatively modest. Further work is needed to elicit the factors that were active in changing prescribing behaviour.
Guillotine tonsillectomy was the widely practised technique of tonsillectomy in the late 19th century as it was considered a quick and reliable method of removing tonsils. It fell into disrepute in the early 20th century. This paper reviews the history of the origin of the tonsillotome and traces the various modifications over the last few centuries. The current practice of guillotine tonsillectomy is examined by means of a postal questionnaire surveyof all UK consultants.
Energetic particle methods have been used to synthesize two metastable layers with superior mechanical properties: amorphous Ni implanted with overlapping Ti and C, and amorphous diamond-like carbon (DLC) formed by vacuum-arc deposition or pulsed laser deposition. Elastic modulus, yield stress and hardness were reliably determined for both materials by fitting finiteelement simulations to the observed layer/substrate responses during nanoindentation. Both materials show exceptional properties, i.e., the yield stress of amorphous Ni(Ti,C) exceeds that of hardened steels and other metallic glasses, and the hardness of DLC (up to 88 GPa) approaches that of crystalline diamond (∼100 GPa). Tribological performance of the layers during unlubricated sliding contact appears favorable for treating Ni-based micro-electromechanical systems: stick-slip adhesion to Ni is eliminated, giving a low coefficient of friction (∼0.3–0.2) and greatly reduced wear. We discuss how energetic particle synthesis is critical to forming these phases and manipulating their properties for optimum performance.
The variability of CD-24 7599 (V=11.48 mag) was discovered by JCC during observing run XCOV7 of the Whole Earth Telescope (WET, Nather et al. 1990) network in February, 1992. The star was observed as an additional target and 117 hours of high-quality temporal spectroscopic observations were obtained.
Our analysis of these data revealed the presence of 7 independent pulsation modes between 27.0 and 38.1 cycles per day (313 – 441 μHz) with semiamplitudes of 2.1 – 10.2 milli-modulation amplitudes (mma). We showed that peaks at linear combination frequencies detected in the power spectra were not due to eigenmodes excited to visible amplitude by resonant mode coupling.