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.
Subjective cognitive decline (SCD) may represent the earliest observable stage of Alzheimer’s disease (AD), yet identifying individuals at risk of progressing remains challenging. Cognitive dispersion, or intra-individual variability (IIV-D), may serve as a sensitive early marker. This study examined IIV-D across diagnostic groups, focusing on SCD and amnestic mild cognitive impairment (aMCI) progressors (SCD-p, aMCI-p; progressing to a more advanced disease stage) versus non-progressors (SCD-np, aMCI-np; not progressing to a more advanced stage). We expected greater IIV-D across groups (AD > aMCI > SCD > controls) and in progressors.
Methods:
A total of 308 participants aged 65–94 (67 healthy controls [HC], 126 SCD, 79 aMCI, 36 AD) from the Consortium for the Early Identification of Alzheimer’s Disease – Quebec (CIMA-Q) were included. SCD and aMCI participants were followed for up to eight years (34 SCD-p, 92 SCD-np; 29 aMCI-p, 50 aMCI-np). Analyses of covariance assessed baseline across- and verbal memory within-domain IIV-D, maximum discrepancy (MD), and domain-specific deviation.
Results:
IIV-D increased with disease severity (HC = SCD < aMCI < AD). Among SCD participants, progressors showed greater episodic memory deviation than non-progressors, primarily driven by poorer Logical Memory delayed recall. In aMCI, progressors showed higher IIV-D across all indices (across- and within-domain, IIV-D and MD), with domain-specific differences limited to episodic memory.
Conclusions:
These findings indicate that IIV-D measures distinguish aMCI progressors from non-progressors, although they do not appear to enhance predictive accuracy for progression to AD and may not yet be a reliable marker at the SCD stage.
It is a well-established fact that at a fixed angle of attack, with increasing Reynolds number, ${\textit{Re}}$, a laminar separation bubble (LSB) will shrink and eventually cease to exist, due to increase in the growth rate of hydrodynamic instability modes. However, during this wind tunnel test campaign, we observed that paradoxically the LSB increased in length from ${\textit{Re}}=2\times 10^5$ to ${\textit{Re}}=2.5\times 10^5$. Further diagnostics showed that this was due to a modification of the background forcing environment, often neglected in the literature. The perturbation generated from potential aero–vibroacoustic interaction unexpectedly boosted Tollmien–Schlichting modes and their faster amplification even upstream of the LSB drove the rapid secondary growth and breakdown at ${\textit{Re}}=2\times 10^5$. At ${\textit{Re}}=2.5\times 10^5$, when the lock-in with background forcing modes was not significant, a well-behaved LSB was observed with spatially amplifying Kelvin–Helmhotz modes. This finding raises important questions on the mechanisms entailing the dynamics and instability of LSBs proposed from not only experiments in similar facilities in the literature, but also in other scenarios where background perturbation due vibration, noise and confinement are non-negligible.
This study introduces the development and cross-cultural validation of the Compassion at Work Leadership Behavior Inventory (CAW-LBI), a novel hetero-evaluative tool aimed at assessing compassionate leadership behaviors according to the three-dimensional model proposed by Kanov et al. The present research consists of two studies. The first study involved two samples of Italian workers (N = 431) assessing the scale’s psychometric properties, including its factor structure through exploratory and confirmatory factor analyses, internal reliability, and convergent and discriminant validity. The results supported the hypothesized three-factor structure, with the best fit for a 9-item scale. The scale demonstrated excellent internal consistency, with high Cronbach’s alpha and McDonald’s omega values. AVE, CR, and the Fornell–Larcker criteria were satisfactory regarding convergent and discriminant validity. In addition, the scale showed significant and appropriate Pearson’s correlations with other related measures. The second study includes 225 Spanish workers, confirming the 9-item structure and supporting all the findings from the first study. Further analysis showed strong measurement invariance across samples, indicating that the CAW-LBI reliably captures compassionate leadership behaviors in different cultural contexts. These results suggest that the CAW-LBI is a robust tool for assessing compassionate leadership in various organizational and cultural contexts, offering a valuable contribution to leadership research.
Although spiritual pain in cancer patients has been extensively studied, little is known about the spiritual pain experienced by bereaved caregivers in Japan.
Objectives
This preliminary scale development aimed to clarify the structure of spiritual pain experienced by bereaved caregivers of cancer patients.
Methods
This preliminary scale development was conducted as a secondary analysis of the nationwide J-HOPE4 survey, a cross-sectional questionnaire study of bereaved family members of cancer patients. Thirty-five items related to spiritual pain were analyzed using exploratory factor analysis (EFA).
Results
Responses were obtained from 930 bereaved caregivers in general hospitals and palliative care units. Seven constructs were obtained through the EFA: Loneliness, Life’s heartlessness, A sense of unfinished business, Distress over patient deterioration, Remorse, Regret, and A sense of loss.
Conclusion
This preliminary scale development provides insights into the structure of spiritual pain experienced by bereaved caregivers of cancer patients. Further validation using independent samples is required.
Significance of results
Seven factors of spiritual pain were identified among bereaved caregivers of cancer patients, and understanding this multidimensional experience may inform supportive care.
Transcutaneous auricular vagus nerve stimulation (taVNS) is a noninvasive technique engaging vagal afferents that may enhance cognition, but results vary across domains and samples. Following PRISMA, seven databases (inception–October 2025) plus registries and gray literature were searched. Random-effects meta-analyses (REML; Hedges’ g) were complemented by Bayesian hierarchical models and sensitivity analyses. Fifty-three studies were included; 30 contributed quantitative data (>1,500 participants). taVNS was associated with improved cognitive performance overall (g = 0.41, 95% CI: 0.30–0.53; I2 = 51.4%). Effects were moderate for executive functions (g = 0.46, 95% CI: 0.27–0.65; I2 = 9.5%) and cognitive flexibility/learning (g = 0.53, 95% CI: 0.32–0.75; I2 = 52.9%), and small for working memory/attention (g = 0.19, 95% CI: 0.04–0.33; I2 = 14.9%). Social cognition/emotion regulation showed larger but imprecise effects (k = 3; g = 0.80, 95% CI: 0.07–1.52; I2 = 82.1%). Clinical samples benefited similarly (k = 7; g = 0.55, 95% CI: 0.31–0.79; I2 = 29.5%), with no difference from healthy cohorts (β = −0.001, p = .994). High-intensity protocols (>1.0 mA) yielded larger effects; mode, duration, and site were not moderators. Bayesian models supported effects (P [μ > 0] ≥ 0.93). taVNS is associated with statistically significant improvements in cognitive performance, strongest for executive control and adaptive learning. We propose a Vagal Neurocognitive Integration Model linking LC-NE arousal modulation to prefrontal control. Future diagnosis-specific, adequately powered trials with multimodal neuroimaging should refine mechanisms and dose–response.
‘Teaching about Transatlantic Slavery’ was a three-year professional development project for teachers centring on the Historic Collections of Balliol College, University of Oxford, and the Museum of the American Revolution (MOAR) in Philadelphia. The project grew out of Balliol’s 2021 exhibition, ‘Slavery in the Age of Revolution’, which was inspired by the work of Fellows Sudhir Hazareesingh, Black Spartacus: the epic life of Toussaint Louverture (2020) and Marisa J. Fuentes, Dispossessed Lives: enslaved women, violence and the archive (2016). This paper discusses how we approached the aims of the project, telling a fuller history by foregrounding the role of Black people in the struggle for abolition and increasing awareness of the lasting impact of transatlantic slavery on the way we live and think today. We will address how some of the challenges of working with the material in Balliol’s collections became project strengths when we learnt to navigate bias and acknowledge and elaborate on the gaps and erasures in the historical record. We also acknowledge the diverse range of people who contributed and their importance to the consequent depth and effectiveness of the project. ‘Teaching about Transatlantic Slavery’ reached forty teachers and educators from the USA and the UK and has had lasting impact. The programme allowed teachers to practise teaching with objects, artwork, and primary source documents, deepen their subject knowledge, and develop skills for engaging in sensitive and difficult conversations around complex topics.
The Community Mental Health Education and Detection (CMED) tool was designed and validated for community health workers (CHWs) in South Africa to promote mental health education, detection and linkage to care for adults at risk of mental health conditions. This study evaluated CMED scale-up using implementation research to understand reach and adoption.Routinely collected CHW data from three scale-up community areas were analysed over six months. Using the Reach and Adoption components of the RE-AIM framework, data included the (i) number of CMED administrations; (ii) proportion of identified presumptive cases; and (iii) proportion of referred cases who received care. These data identified high-and low-adopting CHW teams. Observations and repeated group discussions explored factors influencing adoption. CHWs completed 2,135 CMED administrations. Seventeen percent screened positive and were referred for further assessment at PHC facilities; 62% of those referred presented for assessment, diagnosis, and management. Adoption varied across teams. Barriers included poor data systems and inconsistent supply of mental health services. Supportive leadership and supervision were strong facilitators of adoption. Policy uptake signalled maintenance. Findings suggest the CHW-delivered CMED tool is viable and useful for narrowing the treatment gap by strengthening demand for and access to mental health services.
Cotton and soybean with tolerance to 2,4-D, glufosinate, and glyphosate offer useful options for managing herbicide-resistant weeds, especially Palmer amaranth, but effective late-season weed management depends on herbicide program design and timing. In 2019 and 2020, field experiments at two North Carolina locations compared herbicide programs built on preemergence (PRE) herbicides (fomesafen + acetochlor), followed by an early postemergence (EPOST, glufosinate) application and/or a late postemergence (LPOST, 2,4-D + glyphosate). Control was assessed 7–8 weeks after planting, and yields were standardized within environment to the maximum observed yield to allow direct comparison of herbicide programs across crops. Overall, programs that included a herbicide applied LPOST (PRE+LPOST, EPOST+LPOST, or PRE+EPOST+LPOST) controlled weeds completely and prevented yield losses. Herbicides applied PRE+EPOST frequently provided a slightly lower control than LPOST herbicide programs, and PRE herbicide alone consistently resulted in the lowest control. Lower early-season rainfall in 2019 coincided with reduced PRE herbicide performance and wider differences among herbicide programs, whereas earlier, greater rainfall in 2020 increased weed control consistent with improved PRE herbicide soil incorporation. Weed control in soybean was often greater than in cotton with PRE+EPOST in the drier year, consistent with faster canopy closure. Weed species responded similarly across programs, though PRE-only control of morningglories was generally 20–30 % lower than for Palmer amaranth and annual grasses. Relative yield reflected differences in weed control; plots without herbicides exhibited 70–90% losses, whereas herbicide programs with LPOST treatments achieved maximum yields. Results support pairing PRE residuals with sequential herbicides applied POST in herbicide programs, and highlight the value of herbicides applied LPOST to mitigate escapes of late-emerging weeds and avoid yield losses.
Analysis of fracture networks in horizontally bedded limestone and shale in the Eastern Shelf of the Permian Basin of west-central Texas was performed to investigate the lithologic and mineralogic controls on fracture networks. The results show that opening-mode fracturing is sensitive to mineralogy as a primary control and that opening-mode fracturing depends on total clay and calcite percentages. Systematically fractured beds in this study all have >80% calcite, <9% quartz and <7.5% total clay minerals, whereas beds with <80% calcite, >9% quartz and >6% clay minerals are unfractured. Depositional-texture-based lithologic classifications (grainstone, packstone, wackestone, mudstone) based on proportions of carbonate grains and carbonate mud, although extremely convenient and important for interpreting depositional environments of carbonate rocks, are not robust predictors of fracturing. The reason for this is the sensitivity of rock strength to mineralogy – in carbonate rocks, particularly the clay mineral versus calcite content. Our results show that a mineralogic threshold approach may be valuable for opening-mode fracture prediction in limestone and shale.
Our goal is to provide simple and practical algorithms in higher-order Fourier analysis which are based on spectral decompositions of operators. We propose a general framework for such algorithms and provide a detailed analysis of the quadratic case. Our results reveal new spectral aspects of the theory underlying higher-order Fourier analysis. Along these lines, we prove new inverse and regularity theorems for the Gowers norms based on higher-order character decompositions. Using these results, we prove a spectral inverse theorem and a spectral regularity theorem in quadratic Fourier analysis.
The physiological demands of pregnancy substantially alter iodine metabolism and thyroid function. This critical period heightens the requirement for iodine, making deficiency a significant risk factor for both maternal and fetal thyroid dysfunction. This study aimed to evaluate the iodine nutritional status of pregnant women in Hubei Province, explore the relationship between serum iodine concentration (SIC) and thyroid function, and determine the prevalence of thyroid disorders.
Design:
The eligible participants underwent a face-to-face interview and completed questionnaire surveys to collect baseline information and dietary intake data. Serum thyroid hormones, thyroid antibodies, SIC, and urine iodine concentration (UIC) were measured. The 95% reference intervals of SIC were established and ROC analysis was applied to compare the predictive ability of SIC and UIC for thyroid dysfunction.
Setting:
Hubei Province, China.
Participants:
1197 eligible pregnant women were included in this study.
Results:
This study revealed a thyroid dysfunction prevalence of 28.40%, with hypothyroxinemia being the most prevalent thyroid function abnormality, accounting for 79.7% of all thyroid dysfunction cases. Significant differences in hypothyroxinemia prevalence were noted across pregnancy trimesters (P < 0.001), with the highest prevalence in the first trimester and the lowest in the third. In the first trimester, SIC was negatively correlated with TSH (r = –0.195, P < 0.001) and positively correlated with FT3 (r = 0.294, P < 0.001). Additionally, SIC demonstrated a positive correlation with FT4 in each trimester (all P < 0.001). Finally, the SIC reference intervals for pregnant women in the first, second, and third trimesters were 50.08∼118.61 µg/L, 59.16∼127.44 µg/L, and 53.61∼118.67 µg/L, respectively.
Conclusions:
SIC can serve as a reliable indicator for evaluating individual iodine nutritional status and predicting thyroid dysfunction.
In this paper, we analyze the potential harms of everyday self-help discourse, particularly in contexts of systemic oppression. After analyzing the core principles of self-help, such as the power of positive thinking, eliminating negative thinking, gratitude, self-knowledge for self-improvement, and individual choice and responsibility, we argue that self-help discourse is likely to perpetuate different forms of harm in conditions of oppression. First, we argue that, when used in contexts of systemic oppression, self-help discourse contributes to victim-blaming. Secondly, we highlight that the harms of self-help discourse include epistemic and affective dimensions. On the epistemic front, self-help discourse carries epistemic risks, including testimonial smothering and hermeneutical injustice, by discouraging the expression of certain perspectives and lived experiences. On the affective front, self-help discourse reinforces oppression by adding emotional burdens to the oppressed, dismissing their emotional experiences, and imposing the emotional norms of the dominant group. Finally, we revisit the principles of self-help, and show how they contribute to the highlighted harms, particularly by reinforcing victim-blaming, and epistemic and affective forms of injustice.
In this study, experimental deep reinforcement learning (DRL) control of aerofoil flow separation is conducted at a chord-based Reynolds number of ${\textit{Re}}_c=1.5\times 10^5$. A dielectric barrier discharge plasma actuator mounted at the leading edge and a hotwire placed in the separated shear layer act as the flow disturber and the state monitor, respectively. The closed-loop control law is parameterised by a radial basis function network and executed in real time on a field-programmable gate array at 1 kHz. With the aid of a deep deterministic policy gradient algorithm, a satisfying closed-loop control strategy can be derived in less than one minute, and the resulting lift coefficient increment (21 %) is similar to that achieved by the best open-loop control. For stable and effective DRL control, the sensor should be placed at the position with strongest velocity fluctuation, and both time delay and cashing period should be accounted in the reward design. Incorporating historical sensor measurements are beneficial to DRL control, and the optimal history length is approximately equal to the ratio of the local Taylor microscale to the control period. The final control law sought by DRL dictates that strong plasma actuation should only be applied when the flow separation region contracts to a minimum. Statistically, control benefits can be ascribed to both the increase of average reward at each cluster and the elevation of occurrence probabilities of high-reward clusters. Physically, suppression of the aerofoil flow separation is attributed to the excitation of large-scale shear layer vortices, which promotes the momentum exchange between the free stream and the reverse flow.
We introduce and study Liouville number groups, namely additive subgroups of the real numbers in which every nonzero element is a Liouville number. Using continued-fraction methods and linear independence over the field of algebraic numbers, we establish the existence of large families of such groups with rich algebraic and topological structure. We prove that there exist $(2^{\mathfrak {c}}) $ pairwise distinct Liouville number groups generated by strong Liouville numbers and that, among these, there are $(2^{\mathfrak {c}})$ pairwise nonhomeomorphic groups. We further show that there exist continuum many countable Liouville number groups, each generated by countably many strong Liouville numbers and homeomorphic, as topological spaces, to the rational numbers. In addition, we prove that no subgroup of the real numbers is homeomorphic to the space of Liouville numbers, thereby highlighting a strong topological distinction between the space of Liouville numbers and Liouville number groups.