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The aim of this study is to identify risk factors for residual dizziness in benign paroxysmal positional vertigo patients after repositioning manoeuvres and explore the mediation role of lipid indicators.
Methodology
In all, 110 benign paroxysmal positional vertigo patients treated from January 2019 to February 2022 were studied. Data on demographics, diseases, behaviours, and lipids were collected. Multivariate logistic regression assessed risk factors, and mediation analyses explored effects via lipid indicators. Odds ratios and 95 per cent confidence intervals are reported.
Results
Differences between groups with and without residual dizziness included limb weakness, hypertension, nausea, arteriosclerosis, medication, dizziness handicap inventory scores, hospital anxiety and depression scale scores, and lipid distributions (p < 0.05). Significant risk factors were sleep disorders, medication, hypertension, triglycerides, and total cholesterol (p < 0.05). Total cholesterol mediated 9.1 per cent of the effect of sleep disorders on residual dizziness.
Conclusion
Managing lipid levels and sleep disorders is crucial in treating residual dizziness in benign paroxysmal positional vertigo patients after repositioning.
To minimize loss of life, mass casualty response requires swift identification, efficient triage categorization, and rapid hemorrhage control. Current training methods remain suboptimal. Our objective was to train first responders to triage a mass casualty incident using Virtual Reality (VR) simulation and obtain their impressions of the training’s quality and effectiveness.
Methods
We trained subjects in SALT Triage then had them respond to a terrorist bombing of a subway station using a fully immersive VR simulation. We gathered learner reactions to their VR experience and post-encounter debriefing with a custom electronic survey.
Results
Nearly 400 subjects experienced the VR encounter and completed evaluation surveys. Most participants (95%) recommended the experience for other first responders and rated the simulation (95%) and virtual patients (91%) as realistic. Ninety-four percent of participants rated the VR simulator as “excellent” or “good.” We observed no differences between those who owned a personal VR system and those who did not.
Conclusions
Our VR simulator (go.osu.edu/firstresponder) is an automated, customizable, fully immersive virtual reality system for training and assessing personnel in the proper response to a mass casualty incident. Participants perceived the encounter as effective for training, regardless of their prior experience with virtual reality.
Immigration is a fiery topic in U.S. society, as it generally brings to a boil native-born citizens’ disparate attitudes toward immigrants and immigration. While immigration has its fierce supporters and opponents alike, the topic provides fodder for politicians who use it to stoke the fear of an impending “immigrant invasion” among citizens. This is why scholars must regularly undertake empirical studies to assess community members’ views about immigrants and immigration in U.S. society. To add to the contemporary immigration debate, I analyze data from a random sample of 610 respondents who reside in the seven cities that make up the Hampton Roads region of Southeast Virginia (this region has approximately 1.5 million people). The results show that younger people, the more highly educated, and males were of the opinion that immigration is generally good for the Hampton Roads economy. Moreover, participants who did not believe that immigration increased crimes rates or that recent immigrants will take jobs away from Hampton Roads residents agreed that immigration is generally good for the Hampton Roads economy. Finally, respondents who were pleased with the quality of life in both their neighborhood and city believed that immigration has a positive impact on Hampton Roads’ economy. The implications of my findings for scholars, elected officials, community members, public policy, and future research are discussed.
We report on the successful implementation of a photonic-based beam steering approach for point-to-multipoint terahertz (THz) communications. The frequency-agile radiation properties of a THz leaky-wave antenna connected to a photodiode are utilized in the remote transmitter for generating multiple individually steerable THz beams. The approach benefits from the ultra-wide frequency tunability of optical heterodyne systems for frequency-agile THz beam steering. Moreover, the approach allows to exploit high performance and mature optical modulation techniques for generating THz beams with a high data capacity. In the THz receiver, a carrier frequency insensitive envelope THz detector based upon a single Schottky-barrier diode is used. In detail, THz communications in the 300 GHz band (WR3.4) with a maximum steering angle up to 90° is reported. Experimentally, for single steerable THz beam operation, a record high data rate of 35 Gbit/s at a wireless distance of 30 cm is achieved using two-level pulse amplitude modulation. Also, longer wireless distances up to 110 cm with 5 Gbit/s are demonstrated. Furthermore, point-to-multipoint THz communications is reported using two individually steerable THz beams carrying 10 Gbit/s and 5 Gbit/s over 70 cm and 50 cm, respectively.
Patients with stroke while hospitalized experience important delays in symptom recognition. This study aims to describe the overall management of an in-hospital stroke population and how it compares with an out-of-hospital community-onset stroke population.
Methods:
In this retrospective observational study, we included consecutive patients with in-hospital and out-of-hospital strokes (both ischemic and hemorrhagic) over a period of one year treated at a comprehensive stroke center. Demographic and clinical data were extracted, and patient groups were compared with regard to stroke treatment time metrics.
Results:
A total of 362 patients diagnosed with acute stroke were included, of whom 38 (10.5%) had in-hospital and 324 (89.5%) had out-of-hospital strokes. The median delay to stroke recognition (time between the last time seen well and first time seen symptomatic) was significantly longer in in-hospital compared to out-of-hospital strokes (77.5 [0–334.8] vs. 0 [0–138.5] min, p = 0.04). The median time interval from stroke code activation to the arrival of the stroke team at the bedside was significantly shorter in in-hospital versus out-of-hospital cases (10 [6–15] vs. 15 [8–24.8] min, p = 0.01). In-hospital strokes were less likely to receive thrombolysis (12.8% vs. 45.4%, p < 0.01) with significantly higher mortality (18.2% versus 2.6%, p < 0.01) and longer overall median hospital stay (3 [1–7] vs. 12 days [7–23], p < 0.01) compared to out-of-hospital strokes.
Conclusion:
This study showed significant delays in stroke symptom recognition and stroke code activation for in-hospital stroke patients despite comparable overall stroke time metrics. Development of in-hospital stroke protocols and systematic staff training on stroke symptom recognition should be implemented to improve care for hospitalized patients.
Over the past decades, bilingualism researchers have come to a consensus around a fairly strong view of nonselectivity in bilingual speakers, often citing Van Hell and Dijkstra (2002) as a critical piece of support for this position. Given the study’s continuing relevance to bilingualism and its strong test of the influence of a bilingual’s second language on their first language, we conducted an approximate replication of the lexical decision experiments in the original study (Experiments 2 and 3) using the same tasks and—to the extent possible—the same stimuli. Unlike the original study, our replication was conducted online with Dutch–English bilinguals (rather than in a lab with Dutch–English–French trilinguals). Despite these differences, results overall closely replicated the pattern of cognate facilitation effects observed in the original study. We discuss the replication of outcomes and possible interpretations of subtle differences in outcomes and make recommendations for future extensions of this line of research.
This study aimed to identify meal and snack patterns and assess their association with sleep timing in schoolchildren. This is a cross-sectional study carried out in 2018/2019 with 1333 schoolchildren aged 7–14 years from public and private schools in Florianópolis, Brazil. Previous-day dietary intake data for breakfast, mid-morning snack, lunch, mid-afternoon snack, dinner and evening snack were collected using a validated online questionnaire. Sleep timing was measured by the midpoint of sleep and classified as quartiles (very early, early, late and very late). Latent class analysis was performed to identify meal and snack patterns, and multinomial logistic regression was used to assess associations. Students with very late sleep timing were less likely to consume the ‘coffee with milk, bread and cheese’ breakfast pattern compared with very early group. Also, the former were more likely to consume the ‘mixed’ breakfast pattern (healthy and unhealthy foods) compared with very early students. The latter were more likely to eat the ‘Brazilian traditional, processed meat, egg and fish’ lunch pattern to the late students and less likely to consume the ‘pasta and cheese’ lunch pattern compared with the students with later sleep timing. Students with later sleep timing were more likely to eat ultra-processed food at mid-afternoon snacks compared with early group. The study findings suggest that morning preference appears to promote healthier breakfast, lunch and afternoon snack patterns, whereas later sleep timing may pose challenges in maintaining healthy patterns at these meals/snacks.
Stratified Middle and Upper Palaeolithic sites in Central Asia are rare. The recently discovered Soii Havzak rockshelter, in the Zeravshan Valley in northern Tajikistan, is a stratified site that contains several phases of Palaeolithic occupation rich in lithic, faunal and charcoal remains that help establish chronology of the region.
This study aimed to investigate gastrointestinal tolerability, treatment persistence and iron status markers in patients with iron deficiency anaemia (IDA) who received oral iron replacement therapy (IRT) with v. without concomitant Lactobacillus plantarum 299v (L. plantarum 299v) probiotic supplementation. A total of 295 patents with newly diagnosed IDA were randomly assigned to receive either IRT alone (n 157, IRT-only group) or IRT plus L. plantarum 299v (n 138, IRT-Pro group) in this prospective randomised non-placebo-controlled study (ClinicalTrials.gov Identifier: NCT06521879). Gastrointestinal intolerance symptoms (at baseline, within the first 30 d of IRT and at any time during 3-month IRT), serum Hb levels (at baseline and 3rd month of IRT) and iron status markers (at baseline and 3rd month of IRT) were recorded. IRT-Pro group, when compared with IRT-only group, experienced significantly lower rates of gastrointestinal intolerance over the course of IRT (13·0 % v. 46·5 %, P < 0·001) and treatment discontinuation within the first 30 d (3·6 % v. 15·9 %, P < 0·001). At 3rd month of therapy, IRT-Pro v. IRT-only group had significantly higher serum levels for iron (76·0 (51·0–96·0) v. 60·0(43·0–70·0) µg/dl, P < 0·001) and transferrin saturation (20·1 (12·5–28·5) v. 14·5 (10·5–19·0) %, P < 0·001) and higher change from baseline Hb (0·9 (0·3–1·3) v. 0·4 (–0·1–1·1) g/dl, P < 0·001) levels. Use of L. plantarum 299v probiotic supplementation during the first 30 d of IRT in IDA patients significantly reduces the gastrointestinal burden of IRT (particularly abdominal pain and bloating), the likelihood of intolerance development (by ∼3 times) and treatment discontinuation (by∼5 times), as accompanied by improved serum Hb levels and serum iron markers.
Metabolic dysfunction is an established phenomenon in people with severe mental illness (SMI), and it has a higher prevalence than in the general population. It is associated with increased morbidity and mortality, and effective recognition and management are essential to enable good psychiatric care. Despite widespread awareness of this disparity for several decades, health outcomes continue to worsen, highlighting the need for more effective preventive and treatment measures. This article outlines the risk factors that contribute to metabolic dysfunction in this population, including genetic, environmental and pharmacological factors, and considers underlying metabolic pathophysiological processes as part of SMI itself. To aid discussions with patients, recognition and interpretation of metabolic risk factors are outlined, together with mitigating strategies. Novel areas of uncertainty are discussed, including the use of a ketogenic diet. This article advocates use of the term ‘metabolic psychiatry’, to increase awareness of the significant overlap between psychiatric illness and metabolic dysfunction.
Augmented reality (AR) is a valuable tool in disaster preparedness training such as tabletop exercises that enhances the exercise by overlaying digital information and virtual objects.
Objective
This study intends to develop an application using AR to be used during the exercise.
Methods
The data is collected through interviews on the opinions and views of the experts from five main agencies in a disaster response; the National Disaster Management Agency, the Royal Malaysia Police, the Fire and Rescue Department of Malaysia, the Ministry of Health, and the Malaysia Civil Defence Department, discussing their duties during a flood scenario. The consensus achieved after series of interviews with the experts, including document reviews guided by National Security Council Directive 20.
Results
The AR approach is created through ‘marker-based’ which use an image recognition to build up an engaging ‘storyline’ of flood scenario. It includes the updates on the changing plot during the exercise using an ‘inject’ meant to progress the plot and provide fresh data to evaluate and react to.
Discussion
Integrating virtual objects and entities into the tabletop exercise is made possible by AR, where it revolutionises how disaster responders being trained using an approach that more engaging and effective.
Supersonic shear layers experience instabilities that generate significant adverse effects; in complex configurations, these instabilities have global impacts as they foster compounding complications with other independent flow features. We consider the flow near the exit of a dual-stream rectangular nozzle. The supersonic core and sonic bypass streams mix downstream of a splitter plate trailing edge (SPTE) just above an adjacent deck. We perform two-dimensional direct numerical simulations with laminar inflow conditions to parametrically explore the influence of active flow control, considering various actuation angles and locations. The goal is to alleviate the prominent tone associated with vortices shed at the SPTE; these vortices initiate an unsteady shock system that affects the entire flow field through a shock-induced separation and the downstream evolution of plume shear layers. Resolvent analysis is performed on the baseline flow. The identified optimal response guides the placement of steady-blowing actuators. Since the resolvent analysis fundamentally investigates the input–output dynamics of a system, it is also utilized to uncover actuation-induced changes in the forcing–response dynamics. Spectral analysis shows that the baseline flow fluctuating energy is concentrated in the shedding instability. Actuating at optimal angles based on location disperses this energy into various flow features; this affects the shedding itself, and the structure and unsteadiness of the shock system, and thus the response of the deck and nozzle wall boundary layers and the plume. The resolvent analysis indicates, and Navier–Stokes solutions confirm, that favourable control is obtained by either indirectly or directly mitigating the baseline instability.
In this brief discussion of McKaughan and Howard-Snyder’s “How Does Trust Relate to Faith?” I call into question the authors’ finding that faith is necessarily resilient while trust is not. To do this, I demonstrate how the constraints of McKaughan and Howard-Snyder’s inquiry screen out a particular kind of trust, two-place trust, which does manifest resilience. Turning then to two-place trust, I offer two positive reasons—proportionality and the value of relationships—to think that trust may be essentially resilient after all. If this is correct, it takes us a step closer to understanding how trust relates to faith.
In my examination of Sophocles’ Antigone, I use Beauvoir’s existential philosophy as a lens and hermeneutic model and apply her language and terms—immanence, transcendence, and ambiguity—to the original ancient text to understand the gendered metaphors of the play and to reveal an area of oversight in her superficial treatment of the tragedy. Taking this theoretical approach, I use “feminist” or “existentialist” Beauvoir (The ethics of ambiguity, The second sex) against herself, that is, her interpretation of the Antigone in “Moral idealism and political realism,” to show how existentialist freedom is achieved in the tragedy. In my reading, I cast Antigone as a figure of ambiguity, situated in an oppressive context, and I argue that she creates her own project and strives towards freedom, in the Beauvoirian sense. I also extend the subjectivity of ambiguity to Ismene and illustrate the course of her own existential freedom to portray the reversibility of the transcendence/immanence polarity in these two figures and, ultimately, to suggest that the sisters are intertwined. Inscribing my reading in a tradition of feminist interpretations surrounding the Antigone, I advance a new reading that finds in the play a feminist political theory of existentialism, inclusive of the sororal pair.
Internalizing and externalizing problems tend to co-occur beginning in early childhood. However, the dynamic interplay of symptom-level internalizing and externalizing problems that may drive their co-occurrence is poorly understood. Within the frameworks of the Network Approaches to Psychopathology and the Developmental Cascade Perspective, this study used a panel network approach to examine how symptoms of internalizing and externalizing problems are related in early childhood both concurrently and longitudinally and whether the pattern may differ in American (N = 1,202) and Chinese (N = 180) preschoolers. Internalizing and externalizing problems were rated by mothers in two waves. Results from cross-sectional networks showed that the bridge symptoms underlying the co-occurrence of internalizing and externalizing problems were largely consistent in American and Chinese preschoolers (e.g., withdrawal, aggressive behavior, anxiety and depressive moods). Results from cross-lagged panel networks further showed that the co-occurrence was manifested by unidirectional relations from internalizing to subsequent externalizing symptoms in both American and Chinese preschoolers. The findings contribute needed cross-cultural evidence to better understand the co-occurrence of internalizing and externalizing problems and highlight the temporal heterogeneity of the symptom networks of internalizing and externalizing problems in early childhood.