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Orthostatic hypotension (OH) is common in Parkinson disease and contributes to injury, fatigue and reduced quality of life. More efficient approaches to identify higher-risk patients are needed.
Methods:
A cross-sectional, single-center study of consecutive people with Parkinson disease was conducted over three months. Linear models adjusted for age, sex and disease duration assessed associations of OH to patient-reported outcomes (autonomic symptoms, quality of life), medications and other clinical features. Receiver operating characteristic curves evaluated patient-reported outcomes as predictors of clinic-measured orthostatic hypotension.
Results:
Fifty-seven participants (mean age 69; 60% male) completed assessments. OH was present in 29 (50.9%), but only 3 were symptomatic. The Orthostatic Hypotension Questionnaire showed strong discrimination for OH (sensitivity 81%; specificity 73%). Supine-to-3-minute standing systolic blood pressure dropped most when measured within 1 hour of dopaminergic medication (−17.4 mmHg; 95% CI −30.4 to −4.4) or 1–2 hours (−17.2 mm Hg;−26.8 to −7.6) compared with 2–3 hours (+1.6 mm Hg; −10.0 to + 13.2) or more (−2.9 mmHg; −14.9 to + 9.1). Older age was associated with a greater diastolic blood pressure drop. Delayed OH was associated with worse patient-reported mobility.
Conclusion:
Orthostatic hypotension was common and usually asymptomatic in this sample. Patient-reported outcomes showed good sensitivity for identifying those likely to have OH. Time since dopaminergic medication impacted the blood pressure drop, and the delayed onset of hypotension was associated with worse mobility-related quality of life. Brief questionnaires may help risk-stratify patients for assessment, counseling and treatment of orthostatic hypotension.
Residual chlorhexidine gluconate (CHG) skin concentrations are thought to improve disease prevention. In the Changing Lives by Eradicating Antibiotic Resistance (CLEAR) trial, posthospitalization decolonization of MRSA carriers reduced MRSA infection and all-cause infection, but higher residual CHG concentrations did not improve outcomes. CHG concentration may indicate bathing quality, but high residual concentrations may not be necessary for benefit.
The exclusionary nature of academic philosophy has been well-documented. Not only do disabled and otherwise marginalized philosophers find it difficult to enter the field, but the combination of the current neoliberal structures of the university and the hegemonic nature of disciplinary norms are pushing out those of us who have made it past the threshold. However, philosophy of disability, using disability as method, allows us to trouble concepts such as competence and epistemic authority in ways that challenge how we pursue research and to whom our scholarship is accountable. In this paper, I argue for the necessity to practice diverse types of scholarship to resist these disempowering structures; specifically, I propose podcasting as a type of recreational scholarship, that is, a scholarly praxis that nourishes instead of depleting by embracing playfulness as a methodology. Cripping academic work through the medium of podcasting allows us to understand the liberatory possibilities of crip authorship for the discipline of philosophy and beyond. Through the lens of Maria Lugones’s concept of playfulness and of C. Thi Nguyen’s framework of striving play, I show how podcasting can be a recreational scholarship praxis.
This article explores an initiative aimed at fostering a culture of electronic music and sound arts in Peru, focusing on the Open Science project, Circuito Abierto (2022–2024). It explores how Circuito Abierto, an annual artistic residency rooted in Open Science culture and organised by the Laboratorio de Música Electroacústica y Arte Sonoro at the Universidad Nacional de Música (UNM, formerly the Conservatorio Nacional de Música), challenged traditional and conservative educational structures within Peru’s academic landscape. The project promoted an open, collaborative approach to music creation, aimed at bridging the gap between academic and popular music scenes in the education of electronic music. Circuito Abierto may serve as a case study for addressing broader historical challenges in Peruvian music education, particularly with regard to music technology and experimental electronic sound art practices.
Individuals with schizophrenia experience high rates of metabolic syndrome and premature mortality, largely driven by antipsychotic-induced weight gain and sedentary behaviour. Aerobic exercise and dietary interventions can positively impact quality of life and physical health indices. This study examines perspectives on engagement in aerobic exercise and diet in a cohort of participants treated with clozapine.
Methods:
Semi-structured interviews were conducted with 43 individuals attending a clozapine clinic at University hospital Galway. Participants’ perspectives regarding engagement in aerobic exercise and dietary modification were attained with chi-squared and regression analyses utilised to determine associations with functioning, symptomatology, and demographic data. Thematic analyses were utilised to assess qualitative data.
Results:
Twenty-nine individuals (67.4%) expressed a preference for engaging in additional exercise with brisk walking most favoured (n = 25, 58.1%) with patients stating a preference for home based or individualised interventions (i.e. walking) except for dancing. Participants who engaged in <2.5hours exercise per week were more willing to engage in a structured exercise programme (χ2 = 6.38, p = 0.04). Themes pertaining to engagement in exercise included importance of self-motivation (n = 8), benefits for health (n = 5), and environmental barriers to participation (n = 6) with themes pertaining to dietary change included willingness to change diet for health benefits (n = 21), and amotivation for change (n = 2).
Conclusion:
Embedding tailored, exercise, and dietary programmes provided as part of patient’s routine mental health care would be welcomed by patients. Future studies evaluating potential benefits of exercise and diet interventions across functioning, physical and mental health parameters are suggested.
Conducting health systems assessments helps highlight weaknesses and strengths to be explored to improve care delivery. The Assessment of Chronic Illness Care (ACIC) considers the perspective of professionals who work in the care-providing institution. Its structure comprises seven dimensions that provide specific data about the care offered. Objectives: (1) evaluate the institutional capacity for Type 2 Diabetes Mellitus (T2DM) management in the interior of the State of Amazonas from the perspective of health professionals; (2) verify the association between socio-educational, work and geographic location variables with the dimensions of the ACIC.
Methods:
A cross-sectional study carried out between October 2020 and December 2022 in 36 Primary Health Units (PHUs) of the seven cities of the Amazonas, totaling 230 participants. Excel 2019 and R (4.2.1) were used for data analysis. The association between independent variables and ACIC dimensions was analyzed using multiple logistic regression analysis.
Result:
The PHUs in the rural Amazonas have the basic capacity to care for patients with T2DM. Analysis of each dimension of the ACIC demonstrated that geographic location was the most relevant factor, showing an association with all instrument dimensions.
Conclusions:
Socioeducational variables showed an association with the dimensions of Decision Support, Design of the Service Delivery System, Clinical Information System, and Integration of components of the Care Model for Chronic Conditions. Work-related variables, on the other hand, were associated with the dimensions of Organization of Health Care, Community Resources, Support for Self-Management and Integration of the components of the Chronic Conditions Care Model.
Due to the negative impacts of climate change, soil degradation and losses of soil organic carbon (SOC) in arable agricultural ecosystems are gradually increasing worldwide. Therefore, implementing agricultural management practices that increase organic carbon (OC) sequestration in soils with intensive agricultural production is essential for maintaining soil quality (SQ) and enhancing sustainable crop production. Understanding the effects of management practices on SOC stability requires understanding the resulting changes in the SOC fractions (labile or recalcitrant), the OC contents associated with aggregates, and the soil organic carbon stocks (SOCStocks). In the present study, soil samples were collected from three different depths in the Çarşamba Alluvial Delta Plain, located in Turkey’s semi-humid climate zone, to investigate the long-term effects (>5 years) of six different land use types (LUTs). Our results regarding average values revealed that the labile soil organic carbon (SOCLC) and recalcitrant soil organic carbon (SOCRC) fractions, OC contents associated with aggregates, and SOCStocks changed significantly (p<0.01) in response to the effects of different LUTs. Compared to pasture land use, the contents of SOCLC and SOCRC were statistically decreased from 5.98 g/kg to 3.16 g/kg and from 6.37 g/kg to 3.43 g/kg (p<0.01), respectively, in soils under soybean land use. Also, it was found that both SOC fractions reduced statistically (p<0.01) with increasing soil depth. This study, which evaluated the long-term effects of different LUTs on SOC, revealed that SOCLC and SOCRC fractions can be successful indicators in assessing the effects of different LUTs and soil depths.
In colonial settings, missionary construction projects often dramatically transformed local architectural styles and settlement patterns. The relatively young age of these activities means that colonial chronologies are often based on documentary evidence or artefact typologies rather than chronometric determinations. Here, the author explores the use of uranium-thorium dating for coral blocks from a series of missionary-style buildings with unknown construction dates in the Mangareva Islands, French Polynesia. Although some samples reveal years/decades of inbuilt age that may reflect methods of material acquisition, the dates provide new information on the construction activities of a population of Polynesian Catholic converts.
Multiple sclerosis (MS), known to affect many individuals, can often lead to symptoms such as fatigue, cognitive impairment and depression, thereby adversely affecting quality of life. Therefore, the aim of this planned single-centre, randomised controlled trial is to determine the effects of implementing the MIND diet or a standard diet program on quality of life, fatigue, cognition and brain fog symptoms in patients with relapsing-remitting MS (RRMS). The study will include sixty-two adult RRMS patients living in Muğla, Türkiye. Eligible patients who agree to participate will be randomly assigned, in a 1:1 ratio, to the MIND diet or standard diet group for a 12-week intervention. Participants will be monitored weekly for adherence to the interventions. Primary outcomes will include determining the effects of dietary interventions on Multiple Sclerosis Quality of Life-54, Questionnaire, Modified Fatigue Impact Scale, Brief International Cognitive Assessment for MS battery and Brain Fog Scale. Secondary outcomes will consist of blood parameters including body composition and complete blood count, biochemical parameters (fasting glucose, lipid profile, liver enzymes and albumin), C-reactive protein, thyroid hormones and folate, vitamin B12 and vitamin D levels. The results of this study may help determine the potential beneficial effects of the MIND diet on MS-related fatigue, reduced quality of life, cognitive dysfunction and brain fog, contribute to comparing these findings with existing evidence in the literature and provide up-to-date evidence. In addition, it may contribute to the development of a new nutritional therapy for MS.
Personalized nutrition has emerged as a revolutionary paradigm in nutritional science, shifting from traditional “one-size-fits-all” approaches to tailored dietary recommendations. We conducted a comprehensive bibliometric analysis through a systematic search strategy capturing various conceptualizations of personalized nutrition. The analysis identified 3,159 publications demonstrating three distinct phases: an inaugural phase with minimal activity, a developmental phase showing gradual growth, and a maturation phase exhibiting exponential growth. Five distinct research clusters emerged: clinical nutrition applications for special populations, nutrigenomics and personalized dietary recommendations, metabolic health and weight management, gut microbiome and functional nutrition, and precision nutrition with multi-omics integration. Temporal analysis revealed a clear evolution from genetic foundations toward microbiome research, metabolomics, and computational approaches. Citation analysis highlighted landmark studies that established individual variability in dietary responses, the gut microbiome’s role in personalization, and technology-enabled intervention systems as foundational to the field. The convergence of microbiome research, metabolomics, artificial intelligence (AI), and clinical applications creates promising directions for advancing personalized nutrition science. Future research must bridge the gap between mechanistic elucidation and clinical application, leveraging AI-driven predictive models and precision delivery systems to translate biological insights into effective public health strategies.
The secondary literature on Hannah Arendt and Eric Voegelin’s 1953 debate on totalitarianism is in general agreement that these two thinkers offer fundamentally irreconcilable accounts of the phenomenon. This article adds to the literature on this debate by employing a broader temporal frame of analysis. I argue that, when viewed over the longer arc of their development, these thinkers converge in how they approach some of the moral questions associated with totalitarianism. This is especially evident in their reactions to resurgent questions of “German guilt” that arose in the early 1960s. Arendt’s “reality as such” and Voegelin’s “first reality” converge on what I call “moral reality.” Both ultimately treated totalitarianism as, in part, a moral catastrophe insofar as it entailed a loss of this sense of moral participation.
The consumption of ultra-processed food (UPF) has been linked to bone metabolism in adults, but its impact on bone mineral density (BMD) in children and adolescents remains unclear.This study analyzed data from 4,809 children and adolescents aged 8 to 19 years, drawn from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. UPF intake was categorized according to the NOVA classification system, with the percentage of energy derived from UPF divided into quartiles (Q1-Q4). A weighted multiple linear regression model was used to examine the relationship between UPF intake and Lumbar spine BMD(LSBMD) and Subtotal BMD(SBMD). Stratified analyses were conducted to explore associations across various subgroups.The results indicated that UPF intake was positively associated with LSBMD. This association was significant in girls for both LSBMD and SBMD. Positive correlations with LSBMD also emerged in 12-15 years old and specific subgroups. Moreover, mediation analysis showed TC mediated 4.8% of the UPF—LSBMD link, and HDL-C mediated 0.9% of the UPF—SBMD one.These findings indicate that UPF intake is associated with increased BMD in children and adolescents. Future research should further investigate the complex effects of UPF on the health of this population.
The spread of Candida auris (C. auris), methicillin-resistant Staphylococcus aureus (MRSA) and various viruses in healthcare settings is of global concern. Far-UV-C222 reduces the concentration of microorganisms in laboratory settings and can be used directly in patient care rooms at doses safe for human eyes and skin. The effectiveness of UV-C222 inactivation of C. auris, MRSA and T1 bacteriophage (a viral surrogate) in a hospital setting was studied.
Methods:
A partially blinded, cross-over study was conducted of two conditions: intervention, active UV and control, no UV. C. auris, MRSA and T1 bacteriophage were inoculated and dried onto stainless steel disc carriers at two soil levels, (0.03% BSA and 5.0% CBS), and placed at 24 locations in two unoccupied, two-bed patient rooms. UV-C222 luminaires were placed behind the head of each bed and one in the bathroom for both study rooms. Simultaneous 24-h exposures for both rooms were in random order. Pathogens were processed for cultures.
Results:
UV-C222 doses exposing the discs ranged from a low of 5 mJ/cm2 to high 637 mJ/cm2. Under treatment conditions, MRSA showed a 1.0 log reduction in 0.03% soil, C. auris showed a 2.6 log reduction in 0.03% soil and a 1.0 log reduction in 5.0% soil and T1 bacteriophage showed a 0.6 log reduction in 0.03% soil.
Conclusions:
In patient rooms, continuous UV-C222 exposure showed decreased concentrations of C. auris (low and high soil), MRSA (low soil), and T1 (low soil). Studies are needed to determine benefits in occupied settings.
Public input can provide state agencies with critical information as they adopt health-shaping rules. However, generating meaningful public input is challenging. State administrative procedure acts set out how state agencies must make rules and establish notice and comment processes to seek input into rulemaking. Notice and comment, though, is not conducive to meaningful public input. To enhance public input into state rules, government entities should not limit their engagement to notice and comment and should deploy, and maybe even amend, rulemaking processes to facilitate public input. Meanwhile, advocates and community members should prioritize state rulemaking, in all its phases, as part of their advocacy efforts.
This article examines the semiotics of epistemic politics surrounding climate change denial on Tangier Island, Virginia, a shrinking inhabited island in the Chesapeake Bay, USA. Using long-term ethnographic field research, the paper analyzes how islanders’ professed disbelief in climate change functions not as ignorance but as political and poetic positioning. Denial is treated as a symbolic act, not reducible to misinformation or scientific illiteracy, but shaped by classed and embodied relations with state knowledge regimes, media discourses, and environmental governance. Drawing on Peirce’s pragmatism and Jakobson’s poetics, the article frames climate denial as both an imposed stereotype from without and an identification strategy from within, connected to multiply indexed relationships. To that end, the article advances a semiotic approach to climate politics that centers affect, professed belief (creed) and epistemic stratification.
The geologically oldest known crinoid pentacrinoid larva is reported from Verulam Formation (Katian) from the Lafarge Cannifton Agg Quarry in Cannifton, Ontario, Canada. The entire specimen (arms, aboral cup, and incomplete column) is ~4.2 mm high with the aboral cup only ~1.3 mm high. The specimen is comparable in size to the early pentacrinoid larva of the living crinoid Metacrinus rotundatus Carpenter, 1885. As known, the morphology of this pentacrinoid larva does not correspond in all details with any adult crinoid in the Cannifton area or from the nearby Brechin Lagerstätte fauna, suggesting that considerable morphological change occurred during ontogeny of this taxon.
We establish a fixed-point theorem for the face maps that consist in deleting the ith entry of an ordered set. Furthermore, we show that there exists random finite sets of integers that are almost invariant under such deletions. Consequences for various monoids of order-preserving transformations of $\mathbf{N}$ are discussed in an appendix.
Precision applications are gaining interest as a sustainable approach to managing turfgrass pests. For instance, controlling turfgrass weeds with precision application could effectively reduce herbicide volume without sacrificing weed control. Machine learning models have been a common method for precision application, but machine learning requires intensive labor and expertise to collect and label imagery. The objective of this study was to develop and test a new system utilizing the Dark Green Color Index (DGCI) for precision application of glyphosate to detect and spray winter weeds in dormant bermudagrass systems. For this study, a sprayer prototype was constructed that utilized machine vision and DGCI. The prototype consisted of three primary components: 1) a camera that streamed video frames, 2) a control system that stored computer code focused on the integration of DGCI, and 3) solenoid valves that activated upon detection of winter weeds in dormant bermudagrass. Four field trials with different weed species and weed densities were established to test the DGCI system amongst traditional application methods (i.e., broadcast application and manual spot application with a backpack sprayer). In the lowest weed-density scenario, the DGCI system accurately detected and sprayed 90% of the weed population, reducing herbicide volume by 62% compared to a broadcast application. Additionally, the DGCI system required less time for treatment than the spot application with a backpack sprayer. The results from these trials suggest that vegetative indices, such as DGCI, have potential in dormant bermudagrass systems to optimize herbicide volume.