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Observations of the 21 cm signal face significant challenges due to bright astrophysical foregrounds that are several orders of magnitude higher than the brightness of the hydrogen line, along with various systematics. Successful 21 cm experiments require accurate calibration and foreground mitigation. Errors introduced during the calibration process such as systematics can disrupt the intrinsic frequency smoothness of the foregrounds, leading to power leakage into the Epoch of Reionisation window. Therefore, it is essential to develop strategies to effectively address these challenges. In this work, we adopt a stringent approach to identify and address suspected systematics, including malfunctioning antennas, frequency channels corrupted by radio frequency interference, and other dominant effects. We implement a statistical framework that utilises various data products from the data processing pipeline to derive specific criteria and filters. These criteria and filters are applied at intermediate stages to mitigate systematic propagation from the early stages of data processing. Our analysis focuses on observations from the Murchison Widefield Array Phase I configuration. Out of the observations processed by the pipeline, our approach selects 18%, totalling 58 h, that exhibit fewer systematic effects. The successful selection of observations with reduced systematic dominance enhances our confidence in achieving 21 cm measurements.
Evidence for necrotising otitis externa (NOE) diagnosis and management is limited, and outcome reporting is heterogeneous. International best practice guidelines were used to develop consensus diagnostic criteria and a core outcome set (COS).
Methods
The study was pre-registered on the Core Outcome Measures in Effectiveness Trials (COMET) database. Systematic literature review identified candidate items. Patient-centred items were identified via a qualitative study. Items and their definitions were refined by multidisciplinary stakeholders in a two-round Delphi exercise and subsequent consensus meeting.
Results
The final COS incorporates 36 items within 12 themes: Signs and symptoms; Pain; Advanced Disease Indicators; Complications; Survival; Antibiotic regimes and side effects; Patient comorbidities; Non-antibiotic treatments; Patient compliance; Duration and cessation of treatment; Relapse and readmission; Multidisciplinary team management.
Consensus diagnostic criteria include 12 items within 6 themes: Signs and symptoms (oedema, otorrhoea, granulation); Pain (otalgia, nocturnal otalgia); Investigations (microbiology [does not have to be positive], histology [malignancy excluded], positive CT and MRI); Persistent symptoms despite local and/or systemic treatment for at least two weeks; At least one risk factor for impaired immune response; Indicators of advanced disease (not obligatory but mut be reported when present at diagnosis). Stakeholders were unanimous that there is no role for secondary, graded, or optional diagnostic items. The consensus meeting identified themes for future research.
Conclusion
The adoption of consensus-defined diagnostic criteria and COS facilitates standardised research reporting and robust data synthesis. Inclusion of patient and professional perspectives ensures best practice stakeholder engagement.
As COVID-19 was declared a health emergency in March 2020, there was immense demand for information about the novel pathogen. This paper examines the clinician-reported impact of Project ECHO COVID-19 Clinical Rounds on clinician learning. Primary sources of study data were Continuing Medical Education (CME) Surveys for each session from the dates of March 24, 2020 to July 30, 2020 and impact surveys conducted in November 2020, which sought to understand participants’ overall assessment of sessions. Quantitative analyses included descriptive statistics and Mann-Whitney testing. Qualitative data were analyzed through inductive thematic analysis. Clinicians rated their knowledge after each session as significantly higher than before that session. 75.8% of clinicians reported they would ‘definitely’ or ‘probably’ use content gleaned from each attended session and clinicians reported specific clinical and operational changes made as a direct result of sessions. 94.6% of respondents reported that COVID-19 Clinical Rounds helped them provide better care to patients. 89% of respondents indicated they ‘strongly agree’ that they would join ECHO calls again.COVID-19 Clinical Rounds offers a promising model for the establishment of dynamic peer-to-peer tele-mentoring communities for low or no-notice response where scientifically tested or clinically verified practice evidence is limited.
The search for novel anxiolytics and antidepressants has focused on compounds with the potential to reduce excessive hypothalamic-pituitary-adrenal (HPA) axis activity. L-glutamate, an excitatory neurotransmitter ubiquitously present within the central nervous system, conceivably plays an important role in activating the neural sites involved in stress modulation. Deactivation of the HPA axis by glutamatergic neurotransmission modulation may represent a novel therapeutic approach. Accordingly, the acute intravenous effects of the novel metabotropic (mGlu2/3) agonist LY354740 were tested on bonnet macaques (Macaca radiata) undergoing acute infusions of yohimbine, a noradrenergic stimulant. Dependent measures were the magnitude of the increase of plasma cortisol and plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) customarily elicited by yohimbine. Next, the effects of 6 weeks of chronic oral administration of LY354740 on baseline (postcapture) plasma cortisol and MHPG levels in comparison to the identical measure in untreated controls were assessed. Subjects chronically treated with LY354740 received yohimbine infusions which were compared to yohimbine infusions and saline infusions in non-LY354740-treated subjects. Preliminary evidence supports the view that acute LY354740 infusion resulted in a marked diminution of yohimbine-induced stress response, as manifest by a substantial attenuation of cortisol and MHPG response observed in comparison to the saline-treated yohimbine condition. Chronic oral administration of LY354740 led to postcapture baseline cortisol levels which were markedly reduced (∼50%) in comparison to untreated control subjects; however, there were no significant parallel differences in MHPG levels. Yohimbine infusions elicited an increase in cortisol and MHPG levels in both LY354740-treated and non-LY354740-treated subjects, in comparison to declines in cortisol values observed following vehicle infusions (group X time interaction; P<.0001). Chronic LY354740-treated subjects failed to achieve cortisol levels comparable in range to those of untreated subjects primarily because of their low baseline cortisol levels. In contrast, despite equivalent baselines, yohimbine-induced MHPG values were increased overall in the chronically treated group compared to the saline and yohimbine-alone groups. Thus, LY354740 markedly reduced the acute corticoid and noradrenergic response elicited by yohimbine infusion. Chronic administration of LY354740 appears to present a safe and effective mechanism to markedly down-modulate the HPA axis while retaining noradrenergic responsivity.
Since the development of the modern state system in Europe four centuries ago, there have been ten general wars involving a majority of the major powers and a high level of casualties. Another major war is difficult to conceive of, since it would presumably be the last such conflict, and yet it is not an impossibility. In this volume a distinguished group of political scientists and historians examine the origins of major wars and discuss the problems in preventing a nuclear war.
Nutrigenomics is the study of how constituents of the diet interact with genes, and their products, to alter phenotype and, conversely, how genes and their products metabolise these constituents into nutrients, antinutrients, and bioactive compounds. Results from molecular and genetic epidemiological studies indicate that dietary unbalance can alter gene–nutrient interactions in ways that increase the risk of developing chronic disease. The interplay of human genetic variation and environmental factors will make identifying causative genes and nutrients a formidable, but not intractable, challenge. We provide specific recommendations for how to best meet this challenge and discuss the need for new methodologies and the use of comprehensive analyses of nutrient–genotype interactions involving large and diverse populations. The objective of the present paper is to stimulate discourse and collaboration among nutrigenomic researchers and stakeholders, a process that will lead to an increase in global health and wellness by reducing health disparities in developed and developing countries.
We present a novel microfabrication process for realizing a new type of flexible sensory “smart skin”. In this work, we focus on demonstration of a skin containing a two dimensional array of tactile sensors using polyimide and metal strain gauges. A novel polymer microfabrication approach coupled with surface release methods is demonstrated. The process yields flexible sensory skins in a low cost, efficient manner. Experimental characterization of the devices is also presented. The demonstrated sensors use metal-film strain gauges in a multiplexed two-dimensional array of tactile pixels (taxels) embedded in a polyimide thin film membrane to detect force distribution on the flexible skin. The arrays have been used to image force distributions and could be used with slip-detection friction measurement for robotic gripping application.
Large grain polycrystalline Si films were grown by chemical vapor deposition (CVD) onto TiB2 substrates using the SiCl4–H2 reagent system. A statistically designed processing study was used to correlate the film growth rate, crystallographic orientation, and grain size with deposition temperature, the SiCl4 : H2 ratio, and the level of B doping. Each process variable influenced grain size with temperature having the dominant effect. Grains as large as 15 to 20 μm were achieved for a coating thickness of about 50 μm.
An internally consistent set of data was generated for the chemical vapor deposition (CVD) of SiC from methyltrichlorosilane (MTS) and H2 at atmospheric pressure. A moving fiber tow was used as the substrate. Coating rates between 0.3 and 3.7 µm/min and deposition efficiencies between 24 and 48% were obtained for MTS and H2 flow rates in the range 30 to 200 cm3/min and 300 to 2000 cm3/min, respectively. The data were analyzed and found to be best fit under a mass transfer regime. Based on this fit, a value of the constant in the Chilton–Colburn j factor expression for a moving fiber tow was estimated to be 2.74 × 10−6 with a standard deviation of 3.2 × 10−7. The efficiency of the reaction was found to decrease with increases in the total flow rate, indicating that the effect of the decreased residence time of reagents in the reactor was larger than the increase in the mass transfer coefficient. Finally, a comparison between the efficiencies for a stationary and a moving tow revealed that the moving tow had a higher efficiency, possibly due to a disruption of the boundary layer by the tow motion or due to the decrease in the canning of the moving tow.
This exploratory study compares the prevalence of personality disorders and traits in people over and under 55 years of age. The comorbidity between personality and other psychiatric disorders is also examined.
Method
Psychiatrists examined 810 subjects in a two-stage community survey. The semi-structured Standardized Psychiatric Examination was used to diagnose all DSM-III personality disorders and other psychiatric disorders.
Results
The older subjects were significantly less likely than the younger subjects to have any personality disorder (6.6% v. 10.5%; relative odds = 0.42, 95% confidence interval = 0.25–0.70, P<0.001). Antisocial and histrionic personality disorders were much less prevalent in the older than younger subjects (P < 0.05). The older subjects also had significantly fewer maladaptive personality traits (x2 = 88.9, d.f. = 3, P < 0.001). The patterns of comorbidity between personality disorders and other psychiatric disorders were different in the two age groups.
Conclusions
It is important to evaluate personality in patients of all ages. While some older patients no longer meet criteria for personality disorder, maladaptive traits may become evident during times of stress.
The fossil record of the later Proterozoic through the Early Cambrian is marked by extraordinary change. This change indicates a fundamental reorganization of the biosphere from the exclusively single-celled prokaryotic and protistan ecosystems that prevailed during much of the Proterozoic, to ecosystems characterized by complex multicellular plants and animals of the latest Proterozoic and Early Cambrian. The first recorded events in this transition took place about 900 Ma and the last about 550 Ma, a period of time exceeding that since the end of the Paleozoic. But the final and most dramatic phase, the “Cambrian Explosion,” occurred over a few tens of Ma at the onset of the Cambrian.
The glaring contrast between the Precambrian and the Phanerozoic has long been recognized as a major problem in the history of life. Darwin (1859) attempted to explain the sudden appearance of the Cambrian fauna by inadequacies of the rock record, and Walcott (1910) used a similar concept in his “Lipalian Interval” at the base of the Cambrian. Certainly the abrupt appearance in some local areas (for example, in the contact between Yudomian dolomites and Tommotian limestones in the Aldan-Lena region of Yakutia; Rozanov et al. 1969; Khomentovskij and Karlova 1986) may still be explained by incompleteness of the record.
We are acquiring a large-area sample of faint, high-latitude carbon star candidates for the study of halo dynamics by using an intermediate-band color system with CCDs in efficient survey modes. Except for one odd dwarf carbon (C) star, G77-61, it has long been assumed that these faint C stars are distant giants. However, we recently demonstrated that three more faint C stars are high proper motion objects, and therefore dwarfs. Now we are completing a proper motion survey of known faint high-latitude C stars to search for additional C dwarfs. The CCD and proper motion surveys together will place significant limits on the space density of C stars, be they dwarfs or giants.