To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Zebra finches are often housed in monogamous pairs in small barren cages. In the present study it was investigated whether modest enrichment resulted in behavioural changes. Four plywood box cages of two different lengths were compared. A small and a large cage were used for the barren environment. Another small and large cage were used for the enriched environment, and included additional perches, twigs as well as sand and water baths. An ethogram consisting of 19 different behavioural patterns was used. The behaviour of the birds was studied using a combination of alternating (20s) one-zero and instantaneous sampling, one hour per day during a continuous four-week period.
Locomotor activity, vocalization and singing was significantly increased in the enriched cages and flying was more frequent in the large enriched cage than in any of the other cages. The study demonstrated the usefulness of behavioural analyses to determine to what extent simple enrichment allows the birds to exhibit a wider range of their natural behaviour.
The equation of state of Fo90 hydrous ringwoodite has been measured using X-ray powder diffraction to 45 GPa at the GSECARS beam line at the Advanced Photon Source synchrotron at Argonne National Laboratory. The sample was synthesized at 1400°C and 20 GPa in the 5000 ton multi anvil press at Bayerisches Geoinstitut in Bayreuth. The sample has the formula Mg1.70Fe0.192+ Fe0.023+H0.13- Si1.00O4 as determined by electron microprobe, Fourier transform infrared and Mössbauer spectroscopies, and contains ~0.79% H2O by weight. Compression of the sample had been been measured previously to 11 GPa by single crystal X-ray diffraction. A third-order Birch-Murnaghan equation of state fit to all of the data gives V0 = 530.49±0.07 Å3, K0 = 174.6±2.7 GPa and K' = 6.2±0.6. The effect of 1% H incorporation in the structure on the bulk modulus is large and roughly equivalent to an increase in the temperature of ∼600°C at low pressure. The large value of K' indicates significant stiffening of the sample with pressure so that the effect of hydration decreases with pressure.
Background: Central neuropathic pain syndromes are a result of central nervous system injury, most commonly related to stroke, spinal cord injury, or multiple sclerosis. These syndromes are much less common than peripheral etiologies, with less known regarding optimal treatment. The objective of this study was to determine the long-term clinical effectiveness of the management of central relative to peripheral neuropathic pain at tertiary pain centers. Methods: Patients diagnosed with central (n=79) and peripheral (n=710) neuropathic pain were identified from a prospective observational cohort from seven Canadian tertiary centers. Data regarding patient -characteristics, analgesic use, and patient-reported outcomes were collected at baseline and 12-month follow-up. The primary outcome was the composite of reduced average pain intensity and pain interference. Secondary outcomes included assessments of function, mood, and quality-of-life. Results: At 12-month follow-up, 13.5% (95%CI,5.6-25.8) of patients achieved ≥30% reduction in pain, whereas 38.5% (95%CI,25.3-53.0) achieved a ≥1 point reduction in pain interference; 9.6% (95%CI,3.2-21.0) of patients achieving both these measures. Patients with peripheral neuropathic pain were more likely to achieve this primary outcome at 12-months (25.3% of patients; 95%CI,21.4-29.5) (p=.012). Conclusions: Patients with central neuropathic pain were less likely to achieve a meaningful improvement in pain and function compared to patients with peripheral neuropathic pain at 12-month follow-up.
We describe a simple model for turbulence in a marginally unstable, forced, stratified shear flow. The model illustrates the essential physics of marginally unstable turbulence, in particular the tendency of the mean flow to fluctuate about the marginally unstable state. Fluctuations are modelled as an oscillatory interaction between the mean shear and the turbulence. The interaction is made quantitative using empirically established properties of stratified turbulence. The model also suggests a practical way to estimate both the mean kinetic energy of the turbulence and its viscous dissipation rate. Solutions compare favourably with observations of fluctuating ‘deep cycle’ turbulence in the equatorial oceans.
This study examines certain properties of human memory which impose limits on topic accessibility in discourse. While the discussion is centred on so-called “dative” and “cleft” sentences in English, the work is motivated by more general concerns which have been variously referred to as “topicworthiness” (Thompson 1988), “information flow” (Chafe 1987; Kuno, 1987), “topic continuity” (Givón 1983), “degree of presuppositionality” (Givón 1979), “pragmatic perspective” (Dik 1978), “packaging phenomena” (Chafe 1976), “staging” (Grimes 1975), “communicative dynamism” (Firbas 1967), “the theme system” (Halliday 1967), and “linear modification” (Bolinger 1952). The term adopted here is “information flow”.
One important aspect of the study of information flow is the attempt to determine the conditions under which speakers make selections from among alternative syntactic expressions of identical propositional meaning. While some of the motivation for such choices lies in sentence-internal factors such as the animacy or definiteness of NPs (e.g., Ransom 1979), I shall restrict the discussion here to the issue of contextual motivation as originally developed in Smyth (1977) and in Smyth et al (1979). A particular syntactic choice is said to be contextually motivated if the information flow features which govern it are external to the sentence, and the alternative structure is contextually inappropriate. Where contextual motivation is absent, I claim that either of the candidate syntactic forms is appropriate, although sentence-internal information flow factors may then exert a weaker influence on syntactic choice.
We have had experience with diaphragm pacing in 24 patients at the Toronto Western Hospital. Fourteen patients have undergone bilateral implants to treat chronic ventilatory insufficiency (CVI) caused by traumatic tetraplegia at the C1/2 level (eight patients), neurogenic apnea (five) and one case of neonatal apnea. Unilateral stimulators for nocturnal pacing have been implanted in five patients with central alveolar hypoventilation (sleep apnea) and five patients who suffered CVI resulting from various etiologies. Of the patients who were ventilatory dependent, 80% were successfully weaned and in the entire series, 58% of the patients are living. Diaphragm pacing was successful in 67%, partially successful in 8% and ineffective in 25%. The major complications were: death by pneumonia, failure of the radio receivers, and infection. Diaphragm pacing is the treatment of choice for patients who are ventilator dependent and tetraplegic from upper cervical trauma or in some cases of neurogenic apnea; it may be life saving for patients who suffer central alveolar hypoventilation.
Background: Painful diabetic neuropathy (PDN) is a frequent complication of diabetes mellitus. Current treatment recommendations are based on short-term trials, generally of duration ≤3 months. Limited data are available on the long-term outcomes of this chronic disease. This study aims to determine the long-term clinical effectiveness of the management of chronic PDN at tertiary pain centres. Methods: From a prospective observational cohort study of patients with chronic neuropathic non-cancer pain recruited from seven Canadian tertiary pain centres, 43 patients diagnosed with PDN were identified for analysis. Data were collected according to Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) guidelines including Brief Pain Inventory (BPI). Results: At 12-month follow-up, 37.2% of 43 patients achieved pain reduction of ≥30%, 51.2% achieved functional improvement with a reduction of ≥1 on the Pain Interference Scale (0-10, BPI), and 30.2% (95% CI: 17.2% to 46.1%) had achieved both these measures. Symptom management included at least 2 medication classes in 55.3%, and 3 medications classes (opioids, antidepressants, anticonvulsants) in 25.5%. Conclusions: A sizable minority of patients being managed for PDN in a tertiary care setting achieve meaningful improvement. Polypharmacy, including analgesic antidepressants, anticonvulsants and opioids, is often necessary to attain symptom management.
To investigate prognostic indicators in an aggressive Crooke's cell adenoma of the pituitary.
Methods:
The surgically removed tumor was studied by histology, immunohistochemistry and transmission electron microscopy.
Results:
An aggressive invasive sellar tumor removed by repeated surgeries from a 43-year-old woman with pituitary related Cushing's disease was classified as a Crooke's cell adenoma of the pituitary. The application of several cell proliferation markers confirmed the aggressive nature of the tumor.
Conclusions:
The investigation of the present case provides additional evidence that pituitary Crooke's cell adenomas may possess aggressive behavior.
General Practitioner consultation rates for influenza-like illness (ILI) are monitored through several geographically distinct schemes in the UK, providing early warning to government and health services of community circulation and intensity of activity each winter. Following on from the 2009 pandemic, there has been a harmonization initiative to allow comparison across the distinct existing surveillance schemes each season. The moving epidemic method (MEM), proposed by the European Centre for Disease Prevention and Control for standardizing reporting of ILI rates, was piloted in 2011/12 and 2012/13 along with the previously proposed UK method of empirical percentiles. The MEM resulted in thresholds that were lower than traditional thresholds but more appropriate as indicators of the start of influenza virus circulation. The intensity of the influenza season assessed with the MEM was similar to that reported through the percentile approach. The MEM pre-epidemic threshold has now been adopted for reporting by each country of the UK. Further work will continue to assess intensity of activity and apply standardized methods to other influenza-related data sources.
Disaster preparedness is an area of major concern for the medical community that has been reinforced by recent world events. The emergency healthcare system must respond to all types of disasters, whether the incidents occur in urban or rural settings. Although the barriers and challenges are different in the rural setting, common areas of preparedness must be explored.
Problem:
This study sought to answer several questions, including: (1) What are rural emergency medical services (EMS) organizations training for, compared to what they actually have seen during the last two years?; (2) What scale and types of events do they believe they are prepared to cope with?; and (3) What do they feel are priority areas for training and preparedness?
Methods:
Data were gathered through a multi-region survey of 1,801 EMS organizations in the US to describe EMS response experiences during specific incidents as well as the frequency with which these events occur. Respondents were asked a number of questions about local priorities.
Results:
A total of 768 completed surveys were returned (43%). Over the past few years, training for commonly occurring types of crises and emergencies has declined in favor of terrorism preparedness. Many rural EMS organizations reported that events with 10 or fewer victims would overload them. Low priority was placed on interacting with other non-EMS disaster response agencies, and high priority was placed on basic staff training and retention.
Conclusion:
Maintaining viable, rural, emergency response capabilities and developing a community-wide response to natural or man-made events is crucial to mitigate long-term effects of disasters on a local healthcare system. The assessment of preparedness activities accomplished in this study will help to identify common themes to better prioritize preparedness activities and maximize the response capabilities of an EMS organization.
An analysis was undertaken to measure age-specific vaccine effectiveness (VE) of 2010/11 trivalent seasonal influenza vaccine (TIV) and monovalent 2009 pandemic influenza vaccine (PIV) administered in 2009/2010. The test-negative case-control study design was employed based on patients consulting primary care. Overall TIV effectiveness, adjusted for age and month, against confirmed influenza A(H1N1)pdm 2009 infection was 56% (95% CI 42–66); age-specific adjusted VE was 87% (95% CI 45–97) in <5-year-olds and 84% (95% CI 27–97) in 5- to 14-year-olds. Adjusted VE for PIV was only 28% (95% CI −6 to 51) overall and 72% (95% CI 15–91) in <5-year-olds. For confirmed influenza B infection, TIV effectiveness was 57% (95% CI 42–68) and in 5- to 14-year-olds 75% (95% CI 32–91). TIV provided moderate protection against the main circulating strains in 2010/2011, with higher protection in children. PIV administered during the previous season provided residual protection after 1 year, particularly in the <5 years age group.
To evaluate associations between home environmental factors and BMI of young American-Indian children.
Design
Cross-sectional and prospective study.
Setting
School-based obesity prevention trial (Bright Start) on a Northern Plains Indian reservation in South Dakota. Mixed model multivariable analysis was used to examine associations between child BMI categories (normal, overweight and obese) and home food availability, children's dietary intake and physical activity. Analyses were adjusted for age, gender, socio-economic status, parent BMI and school; prospective analyses also adjusted for study condition and baseline predictor and outcome variables.
Subjects
Kindergarten children (n 424, 51 % male; mean age = 5·8 years, 30 % overweight/obese) and parents/caregivers (89 % female; 86 % overweight/obese) had their height and weight measured and parents/caregivers completed surveys on home environmental factors (baseline and 2 years later).
Results
Higher fast-food intake and parent-perceived barriers to physical activity were marginally associated with higher probabilities of a child being overweight and obese. Vegetable availability was marginally associated with lower probabilities of being overweight and obese. The associations between home environmental factors and child weight status at follow-up were not significant.
Conclusions
Findings indicate that selected aspects of the home environment are associated with weight status of American-Indian children. Obesity interventions with this population should consider helping parents to engage and model healthful behaviours and to increase availability of healthful foods at home.
The publications of the Hakluyt Society (founded in 1846) made available edited (and sometimes translated) early accounts of exploration. The first series, which ran from 1847 to 1899, consists of 100 books containing published or previously unpublished works by authors from Christopher Columbus to Sir Francis Drake, and covering voyages to the New World, to China and Japan, to Russia and to Africa and India. This volume, published in 1857, contains Girolamo Benzoni's History of the New World, originally published in Venice in 1565. The book is not only a history of the New World since Columbus' discovery but an account of what Benzoni himself saw, when 'being like many others anxious to see the world, and hearing of those countries of the Indians, recently found, called by everybody the New World, I determined to go there'. It includes severe criticism of the Spanish colonists' treatment of the indigenous inhabitants.
The UK was one of few European countries to document a substantial wave of pandemic (H1N1) 2009 influenza in summer 2009. The First Few Hundred (FF100) project ran from April–June 2009 gathering information on early laboratory-confirmed cases across the UK. In total, 392 confirmed cases were followed up. Children were predominantly affected (median age 15 years, IQR 10–27). Symptoms were mild and similar to seasonal influenza, with the exception of diarrhoea, which was reported by 27%. Eleven per cent of all cases had an underlying medical condition, similar to the general population. The majority (92%) were treated with antiviral drugs with 12% reporting adverse effects, mainly nausea and other gastrointestinal complaints. Duration of illness was significantly shorter when antivirals were given within 48 h of onset (median 5 vs. 9 days, P=0·01). No patients died, although 14 were hospitalized, of whom three required mechanical ventilation. The FF100 identified key clinical and epidemiological characteristics of infection with this novel virus in near real-time.
We consider shallow-water flow past a broad bottom ridge, localized in the flow direction, using the framework of the forced Su–Gardner (SG) system of equations, with a primary focus on the transcritical regime when the Froude number of the oncoming flow is close to unity. These equations are an asymptotic long-wave approximation of the full Euler system, obtained without a simultaneous expansion in the wave amplitude, and hence are expected to be superior to the usual weakly nonlinear Boussinesq-type models in reproducing the quantitative features of fully nonlinear shallow-water flows. A combination of the local transcritical hydraulic solution over the localized topography, which produces upstream and downstream hydraulic jumps, and unsteady undular bore solutions describing the resolution of these hydraulic jumps, is used to describe various flow regimes depending on the combination of the topography height and the Froude number. We take advantage of the recently developed modulation theory of SG undular bores to derive the main parameters of transcritical fully nonlinear shallow-water flow, such as the leading solitary wave amplitudes for the upstream and downstream undular bores, the speeds of the undular bores edges and the drag force. Our results confirm that most of the features of the previously developed description in the framework of the unidirectional forced Korteweg–de Vries (KdV) model hold up qualitatively for finite amplitude waves, while the quantitative description can be obtained in the framework of the bidirectional forced SG system. Our analytic solutions agree with numerical simulations of the forced SG equations within the range of applicability of these equations.
Evidence of past zoonotic infection was investigated serologically in randomly selected Northern Ireland farmers. The percentage of farmers with antibody was: Brucella abortus (0·7), Leptospira interrogans serovars (8·1), Borrelia burgdorferi (14·3), Toxoplasma gondii (73·5), Coxiella burnetii (28·0), Chlamydia psittaci (11·1) and Hantavirus (1·2).
The results show that Northern Ireland farmers have been exposed in the past to zoonotic infections. It is not known if these infections contributed to ill health in farmers but it is now time for the health of farm workers and their medical services to be reassessed.
An outbreak of Salmonella typhimurium DT 124 infection which affected 101 people in England in December 1987 and January 1988 was detected through surveillance of laboratory reports from medical microbiology laboratories of the NHS and PHLS. Within 1 week of noting the increase in reports, epidemiological and microbiological investigations identified a small German salami stick as the vehicle of infection and the product was withdrawn from sale. The epidemiological investigation highlighted the occurrence of a long incubation period, bloody diarrhoea. Prompt recognition and investigation of the outbreak prevented further cases of severe infection.
Following sequence analysis of a Leishmania donovani kinetoplast DNA (kDNA) minicircle, we have developed synthetic oligonucleotides for use in the polymerase chain reaction (PCR). With these primers, we have amplified L. donovani kDNA from splenic aspirates and blood samples taken from kala-azar patients. Treatment of the samples for PCR requires only limited DNA purification by lysis in SDS, digestion with proteinase K, phenol extraction and ethanol precipitation of the resulting nucleic acid. We have obtained amplified product routinely with DNA prepared from the equivalent of 2·5–25 µl of splenic aspirate or of 50–500 µl of blood from infected patients. In dilution experiments a visible product has been obtained on amplification of DNA from the equivalent of 2·5 × 10−7 µl of splenic material. We therefore propose the amplification of L. donovani kDNA by PCR as a rapid and highly sensitive method for the diagnosis of kala-azar.