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Expert knowledge of cardiac malformations is essential for paediatric cardiologists. Current cardiac morphology fellowship teaching format, content, and nomenclature are left up to the discretion of the individual fellowship programmes. We aimed to assess practices and barriers in morphology education, perceived effectiveness of current curricula, and preferences for a standardised fellow morphology curriculum.
A web-based survey was developed de novo and administered anonymously via e-mail to all paediatric cardiology fellowship programme directors and associate directors in the United States of America; leaders were asked to forward the survey to fellows.
A total of 35 directors from 32 programmes (51%) and 66 fellows responded. Curriculum formats varied: 28 (88%) programmes utilised pathological specimens, 25 (78%) invited outside faculty, and 16 (50%) utilised external conferences. Director nomenclature preferences were split – 6 (19%) Andersonian, 8 (25%) Van Praaghian, and 18 (56%) mixed. Barriers to morphology education included time and inconsistent nomenclature. One-third of directors reported that <90% of recent fellow graduates had adequate abilities to apply segmental anatomy, identify associated cardiac lesions, or communicate complex CHD. More structured teaching, protected time, and specimens were suggestions to improve curricula. Almost 75% would likely adopt/utilise an online morphology curriculum.
Cardiac morphology training varies in content and format among fellowships. Inconsistent nomenclature exists, and inadequate morphology knowledge is perceived to contribute to communication failures, both have potential patient safety implications. There is an educational need for a common, online cardiac morphology curriculum that could allow for fellow assessment of competency and contribute to more standardised communication in the field of paediatric cardiology.
Not only is depression associated with increased inflammation but inflammation is a risk factor for the genesis of depression. Many of the environmental risk factors for depression are transduced through inflammatory signaling. Anti-inflammatory agents show promise for the management of depression in preclinical, epidemiological, and early clinical studies. This opens the door to the potential for anti-inflammatory agents to treat and prevent depression. There are no evidence-based pharmacotherapies for depression prevention.
ASPREE-D, aspirin in the prevention of depression in the elderly, is a sub study of ASPREE, which explores the potential of aspirin to prevent a range of inflammation related disorders in the elderly. With a sample size of 19,114, and a duration of 5 years, this placebo controlled study will be one of the largest randomized controlled trials in psychiatry and will provide definitive evidence on the ability of aspirin to prevent depression.
This paper presents the rationale for the study and presents a summary of the study design.
ASPREE-D may not only define novel therapy but will provide mechanistic proof of concept of the role of inflammation in depression.
Advances in neuroscience in recent years have blurred the boundaries between psychiatry and neurology. They now have more in common than what divides them and this signals a return to their origins. Many have called for a merger of the two disciplines, which would offer a more holistic approach, whereas others vigorously reject such a move. Limiting neurology to the study of the nervous system and psychiatry to the social brain or affect and its disorders is no longer sustainable. The ongoing separation of the disciplines has had an impact on diagnosis and treatment, on professional isolation and on funding psychiatric research.
The problem of near-trapping of linear water waves in the time domain for rigid bodies or variations in bathymetry is considered. The singularity expansion method (SEM) is used to give an approximation of the solution as a projection onto a basis of modes. This requires a modification of the method so that the modes, which grow towards infinity, can be correctly normalized. A time-dependent solution, which allows for possible trapped modes, is introduced through the generalized eigenfunction method. The expression for the trapped mode and the expression for the near-trapped mode given by the SEM are shown to be closely connected. A numerical method that allows the SEM to be implemented is also presented. This method combines the boundary element method with an eigenfunction expansion, which allows the solution to be extended analytically to complex frequencies. The technique is illustrated by numerical simulations for geometries that support near-trapping.
The Lifetime Impairment Survey, conducted in Europe, assessed impairment and symptoms of attention-deficit/hyperactivity disorder (ADHD) in childhood, and experiences of ADHD diagnosis and treatment, as recalled by adults.
Adults with ADHD and without ADHD (control group) were invited to participate in an internet-based survey and report on their childhood experiences. History of ADHD diagnosis was self-reported. Groups were compared using impairment and symptom scales.
Overall, 588 adults with ADHD and 736 without ADHD participated. Mean (standard deviation [SD]) age at diagnosis of ADHD was 20.0 (12.6) years (median 18.0) following consultation with 3.8 (5.1) doctors (median 2) over 44.6 (69.3) months (median 17.0). A total of 64.1% (377/588) of adults with ADHD reported frustration or difficulties during the diagnostic process. The ADHD group had a higher mean (SD) score versus control for general (3.3 [1.2] vs 2.1 [1.2]; p < 0.001) and school impairment (2.8 [0.7] vs 2.3 [0.6]; p < 0.001) but not home impairment (2.1 [0.5] for both groups).
The survey demonstrated that ADHD had a negative impact on all aspects of childhood investigated, as recalled by adults.
These data provide insights into childhood impairments and identify areas for improvement in the management and treatment of ADHD.
The Gemini Planet Imager (GPI) is a high contrast coronagraph designed to directly image exoplanets and circumstellar disks. GPI includes a polarimetry mode designed to characterize dust grains and enhance the contrast of scattered, polarized light by a factor of 100. Reflections and birefringence of optics within the optical train induce a polarization signature that needs to be measured a priori and calibrated out during data reduction. Here we report on the results of an extensive laboratory characterization campaign of the polarimetry mode. The linear instrumental polarization has been measured in 4 GPI passbands and found to be between 3.5 ± 0.3 % at 1.0 micron and 1.1 ± 0.3 % at 2.0 microns. Modulation efficiency has been measured to be 94% at 1.0 micron increasing to 97% at 2.0 microns. Stability has been shown to better than 0.6% over timescales of ~ 3 months and over cool down cycles. The tests show that GPI passes all polarimetry design requirements and should be able to measure circumstellar disk linear polarization to 1% accuracy.
We present new imaging data and archival multiwavelength observations of the little-studied emission nebula K 1-6 and its central star. Narrow-band images inHα (+[N II]) and [O III] taken with the Faulkes Telescope North reveal a stratified, asymmetric, elliptical nebula surrounding a central star which has the colours of a late G or early K-type subgiant or giant. GALEX ultraviolet images reveal a very hot subdwarf or white dwarf coincident in position with this star. The cooler, optically dominant star is strongly variable with a period of 21.312± 0.008 days, and is possibly a high-amplitude member of the RS CVn class, although an FK Com classification is also possible. Archival ROSAT data provide good evidence that the cool star has an active corona. We conclude that K 1-6 is most likely an old bona fide planetary nebula at a distance of ∼1.0 kpc, interacting with the interstellar medium, and containing a binary or ternary central star. The observations and data analyses reported in this paper were conducted in conjunction with Year 11 high school students as part of an Australian Research Council Linkage Grant science education project, denoted Space To Grow, conducted jointly by professional astronomers, educational researchers, teachers, and high-school students.
Previous national nutrition surveys in Irish adults did not include blood samples; thus, representative serum 25-hydroxyvitamin D (25(OH)D) data are lacking. In the present study, we characterised serum 25(OH)D concentrations in Irish adults from the recent National Adult Nutrition Survey, and determined the impact of vitamin D supplement use and season on serum 25(OH)D concentrations. Of the total representative sample (n 1500, aged 18+ years), blood samples were available for 1132 adults. Serum 25(OH)D was measured via immunoassay. Vitamin D-containing supplement use was assessed by questionnaire and food diary. Concentrations of serum 25(OH)D were compared by season and in supplement users and non-users. Year-round prevalence rates for serum 25(OH)D concentration < 30, < 40, < 50 and < 75 nmol/l were 6·7, 21·9, 40·1 and 75·6 %, respectively (11·1, 31·1, 55·0 and 84·0 % in winter, respectively). Supplement users had significantly higher serum 25(OH)D concentrations compared to non-users. However, 7·5 % of users had winter serum 25(OH)D < 30 nmol/l. Only 1·3 % had serum 25(OH)D concentrations >125 nmol/l. These first nationally representative serum 25(OH)D data for Irish adults show that while only 6·7 % had serum 25(OH)D < 30 nmol/l (vitamin D deficiency) throughout the year, 40·1 % had levels considered by the Institute of Medicine as being inadequate for bone health. These prevalence estimates were much higher during winter time. While vitamin D supplement use has benefits in terms of vitamin D status, at present rates of usage (17·5 % of Irish adults), it will have only very limited impact at a population level. Food-based strategies, including fortified foods, need to be explored.
We present a calibration of the metallicity and physical parameters (temperature, luminosity, gravity, mass, radius) for RR Lyrae stars using the ugrizsdss photometric system. Our work is based on calculations of synthetic horizontal branches (HBs), fully taking into account evolutionary effects for a wide range in metallicities and HB morphologies. We provide analytical fits that are able to provide all quantities mentioned with very high (internal) precision, based solely on mean sdss magnitudes and colors.
AlxGa(1−x)As/GaAs quantum well lasers have been demonstrated via organometallic chemical vapor deposition (OMCVD) on relaxed graded GexSi(1−x) virtual substrates on Si. Despite unoptimized laser structures with high series resistance and large threshold current densities, surface threading dislocation densities as low as 2×106 cm−2 enabled cw room-temperature lasing at a wavelength of 858nm. The laser structures are oxide-stripe gain-guided devices with differential quantum efficiencies of 0.16 and threshold current densities of 1550A/cm2. Identical devices grown on commercial GaAs substrates showed differential quantum efficiencies of 0.14 and threshold current densities of 1700A/cm2. This comparative data agrees with our previous measurements of near-bulk minority carrier lifetimes in GaAs grown on Ge/GeSi/Si substrates. A number of GaAs/Ge/Si integration issues including thermal expansion mismatch and Ge autodoping behavior in GaAs were overcome.