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To evaluate the clinical efficacy of tobramycin dexamethasone eye ointment combined with a catheter in endoscopic dacryocystorhinostomy.
Methods
Eighty chronic dacryocystitis patients were randomly divided into two groups: observation (n = 39) and control (n = 41). Both groups underwent endoscopic dacryocystorhinostomy. The observation group used tobramycin dexamethasone eye ointment and catheter support, while the control group used only the eye ointment.
Results
No statistical differences were found in gender, age, disease course or eye type. However, the anastomotic formation time and bleeding amount were significantly different between the two groups (p < 0.001). After six months of follow up, there were no significant complications differences (p > 0.05). The fluorescein disappearance test time in the observation group was significantly shorter (p < 0.001), and the clinical effective rate was significantly higher (97.4 per cent vs 78 per cent, p < 0.05) in the observation group.
Conclusion
Using tobramycin dexamethasone eye ointment combined with a catheter slightly prolongs the operation time and increases bleeding, but promotes anastomotic healing, accelerates tear drainage, improves the operation success rate and is economically efficient.
Decades of evidence have elucidated associations between early adversity and risk for negative outcomes. However, traditional conceptualizations of the biologic embedding of adversity ignore neuroscientific principles which emphasize developmental plasticity. Dimensional models suggest that separate dimensions of experiences shape behavioral development differentially. We hypothesized that deprivation would be associated with higher psychopathology and lower academic achievement through executive function and effortful control, while threat would do so through observed, and parent reported emotional reactivity.
Methods:
In this longitudinal study of 206 mother–child dyads, we test these theories across the first 7 years of life. Threat was measured by the presence of domestic violence, and deprivation by the lack of cognitive stimulation within the parent–child interaction. We used path analyses to test associations between deprivation and threat with psychopathology and school outcomes through cognition and emotional reactivity.
Results:
We show that children who experienced more deprivation showed poor academic achievement through difficulties with executive function, while children who experienced more threat had higher levels of psychopathology through increased emotional reactivity.
Conclusion:
These observations are consistent with work in adolescence and reflect how unique adverse experiences have differential effects on children’s behavior and subsequently long-term outcomes.
The expansion of soybean cultivation in South America has created substantial economic prosperity but has also raised a series of unsustainable land-use issues. Considering the telecoupling system (a system of socio-ecological interactions between distant places) between South America and its soybean trade partners, transnational governance could play an important role in addressing these issues. To achieve effective governance of this specific telecoupling system, this study applies a polycentric approach to improve the existing transnational governance and identify more suitable governance arrangements. This study first explores the telecoupling system and the existing transnational governance system of soybean land use in South America. It then compares the existing governance system with the polycentric approach to examine the gaps between them. Based on these analyses, suggestions for improving the governance system are provided, including increasing the involvement of major governance centres, improving public-private partnerships, and establishing a knowledge-sharing platform.
Neuropsychological assessment through VideoTeleConferencing (VTC) can help improve access to diagnostic and follow-up care in memory clinics. This study investigated the stability of performance on VTC assessment in relation to in-person assessment using a test-retest design and explored user experiences of VTC assessment.
Materials and Methods:
Thirty-one patients (62 ± 6.7 years, 45% female, 58% Subjective Cognitive Decline, 42% Mild Cognitive Impairment/dementia diagnosis) were included from the Amsterdam Dementia Cohort between August 2020 and February 2021. Patients underwent a face-to-face neuropsychological assessment followed by a VTC assessment using the same test protocol within 4 months. Reliability coefficients were calculated using intraclass correlation coefficients (ICC). For each test, the proportion of clinically relevant differences in performances between assessment modalities was calculated. User experiences of patients and neuropsychologists were assessed with questionnaires (User Satisfaction and Ease of use [USE] questionnaire and System Usability Scale [SUS]). Neuropsychologists also participated in a focus group.
Results:
ICC values were moderate to excellent (0.63-0.93) for all test measures in the total sample. On all tests, most patients did not show clinically relevant performance differences between modalities. Patients and neuropsychologists reported overall positive VTC system usability, although neuropsychologists indicated in the focus group that patients without cognitive impairment required less training for the system and were more independent.
Conclusion:
VTC assessment showed adequate to excellent test-retest reliability for a broad range of neuropsychological tests commonly used in practice. Assessment through VTC may be a user friendly method in the memory clinic, especially to monitor individuals at risk for future cognitive decline.
The aim of this study is to investigate hearing outcomes in patients who have undergone cerebrospinal fluid (CSF) leak repair via a middle cranial fossa (MCF) approach and to identify any variables that influence post-operative hearing outcomes.
Methods
This is a multi-centre study. A total of 65 patients who underwent an MCF approach CSF leak repair were included. Retrospective case review was conducted to collect patient demographic and clinical data including pre- and post-operative audiometry.
Results
A total of 65 patients were included: 9 patients (9.2per cent) had an encephalocele confirmed on magnetic resonance (MR) imaging, whilst the remaining patients had biochemically confirmed, beta-trace protein positive CSF leaks. Post-operatively, there was a statistically significant improvement in both bone conduction (Z = -3.71, p < 0.001) and air conduction thresholds (Z = -5.82, p < 0.001). None of the studied variables were found to be associated with the degree of hearing improvement.
Conclusion
The MCF approach for CSF leak repair yields favorable audiological outcomes.
Three new books by sociologists—The Policing Machine by Tony Cheng, The Minneapolis Reckoning by Michelle Phelps, and The Danger Imperative by Michael Sierra-Arévalo—offer us a view into the state of US policing leading up to and following the racial reckoning of 2020. I read these books together through the lens of boundary work, examining what they tell us about the various projects that seek to maintain, expand, or change police jurisdiction over the production of public safety. Collectively, these books suggest that the police work to preserve and extend their extant role and power. Meanwhile, boundary work through movement mobilization and political systems has aimed to contain policing through law and policy, shrink policing within municipal service systems, and replace policing through community-led models of safety. These projects point us toward important areas of inquiry in efforts to understand whether and how policing can change.
The present study characterized heterogeneity in the cognitive profiles of monolingual and bilingual Latino older adults enrolled in the HABS-HD.
Methods:
A total of 859 cognitively unimpaired older adults completed neuropsychological testing. Raw scores for cognitive tests were converted to z-scores adjusted for age, education, sex, and language of testing. A latent profile analysis (LPA) was conducted for monolingual and bilingual speaker groups. A series of 2–5 class solutions were examined, and the optimal model was selected based on fit indices, posterior probabilities, proportion of sample sizes, and pattern of scores. Identified classes were compared on sociodemographic, psychosocial, and health characteristics.
Results:
For the monolingual group (n = 365), a 3-class solution was optimal; this consisted of a Low Average Memory group with low average verbal memory performances on the SEVLT Total Learning and Delayed Recall trials, as well as an Average Cognition group and a High Average Cognition group. For the bilingual group (n = 494), a 3-class solution was observed to be optimal; this consisted of a Low Average Memory group, with low average verbal memory performances on the learning and delayed recall trials of Logical Memory; a Low Average Executive group, where performance on Trails A and B and Digit Substitution were the lowest; and a High Average Cognition group, where performance was generally in the high average range across most cognitive measures.
Conclusions:
Cognitive class solutions differed across monolingual and bilingual groups and illustrate the need to better understand cognitive variability in linguistically diverse samples of Latino older adults.
Effusion cooling is one of the significant cooling technologies in combustor liners in terms of cooling efficiency and weight reduction. However, effusion cooling technology is difficult to manufacture. In fact this technology requires laser-drilling of thousands of tiny holes with shallow angles on a sheet metal with a thickness generally varying between 0.5 to 1.5 mm. In addition, the use of thermal barrier coating is common in gas turbine engines and is one more challenge for the drilling process. In order to obtain more efficient gas turbine engines, the inlet temperature keeps increasing in the last decades, which induces the combustion chamber to operate in a hotter environment. Therefore, efficient cooling technology is needed, even if it is hard to manufacture. For laser drilling, several parameters have to be explored to obtain acceptable holes. This study includes the microstructure investigations of the holes produced with different laser parameters and the optimal laser parameters determined according to the microstructure of six different effusion cooling hole configurations. The results show that laser process differences affect the metal substrate microstructure and thermal barrier coating structure. Drilling method, peak power, number of pulses, gas type and pressure value have a significant effect on the hole geometry and its microstructure.
We investigate the effect of women's political representation in the state legislative assembly and public administration on natural disaster mortality in 20 Indian states from 1981 to 2019. The paper combines two critical dimensions: political and administrative representation of women and disaster risk reduction. Results suggest that women's political representation reduces total disaster mortality after controlling socioeconomic and political covariates; however, the effects are statistically insignificant for the current and lag periods. We find that a one standard deviation increase in women's representation in public administration lowers total disaster mortality by 20.6 percentage points, which is 9.8 per cent of the sample mean. We observe the impacts of female administrative representation on gender-specific human development outcomes through reduced male and female disaster mortality, and we explain some mechanisms. Thus, women's political and administrative representation is crucial for addressing disaster mortality as it has major public health consequences.
First bite syndrome refers to pain in the parotid region during the first bite when eating that improves with subsequent bites. There is a paucity of evidence in the literature to justify recommending optimal management therefore this study aimed to review the latest evidence for its management.
Methods
A literature search across four databases was conducted using a Population, Intervention, Comparison, Outcome-generated search strategy between 2012 and 2022. Screening was done by two reviewers according to pre-determined inclusion and exclusion criteria, demonstrated in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart.
Results
Eleven articles were included. Six articles used repeated botulinum toxin injection, which in all the studies resulted in complete symptoms resolution. Four articles found a watch-and-wait technique to be effective. There were conflicting results on the efficacy of medical treatments such as opioids or anticonvulsants.
Conclusion
Studies have shown that first bite syndrome symptoms eventually resolve with conservative management, but repeated botulinum toxin appeared efficacious for quicker symptom resolution. Further higher-quality studies should be conducted to identify the optimal management.
Between 1979 and 1982, 20,000 troops from the People's Liberation Army Engineering Corps travelled from military-industrial sites in the interior to Shenzhen, China's first Special Economic Zone (SEZ). They were the first batch of state-sponsored migrants to the SEZ and the pioneer builders of the city's urban infrastructure. This article uses the case of military workers in the SEZ to examine state–market relations during the early phase of China's post-socialist transition. On one hand, the Deng administration strategically repurposed a disciplined labour force from Mao's command economy to jump-start marketization. On the other hand, the Mao-era power structure of the Engineering Corps not only persisted but became even more entrenched in the SEZ at the forefront of China's reform. The higher one's military rank was before demobilization, the more easily one could monetize socialist-era political credentials, particularly by taking advantage of the rising value of land in Shenzhen's urbanization process. Academic credentials served as a moderate booster of status within the public sector and a more powerful ingredient leading to success for private entrepreneurs. The lower the military rank before demobilization, the less meaningful the agency to obtain material rewards commensurate with past contributions.
This is the second part of a two-part paper. We apply the methodology of the first paper (Souza, J. Fluid Mech., vol. 997, 2024, A1) to construct a data-driven finite-volume discretization of the Liouville/Fokker–Planck equation of a high-dimensional dynamical system, i.e. the compressible Euler equations with gravity and rotation evolved on a thin spherical shell. We show that the method recovers a subset of the statistical properties of the underlying system, steady-state distributions of observables and autocorrelations of particular observables, as well as revealing the global Koopman modes of the system. We employ two different strategies for the partitioning of a high-dimensional state space, and explore their consequences.
Hereditary haemorrhagic telangiectasia (HHT) is characterised by recurrent, severe epistaxis. While nasal closure is a relatively well-established treatment for HHT patients with intractable epistaxis, recent studies highlight the efficacy of bevacizumab in this subgroup. We aim to evaluate the effectiveness of nasal closure for patients with contraindications to bevacizumab.
Methods
A case series of five patients with HHT and severe refractory transfusion-dependent epistaxis who were treated with nasal closure.
Results
All patients had subjective improvement in epistaxis. Haemoglobin concentrations increased in all patients, with none requiring transfusion for epistaxis post-operatively. Four patients experienced complete cessation in epistaxis. Four returned positive Glasgow Benefit Inventory scores.
Conclusion
Nasal closure appears to be a safe and effective option for the management of epistaxis in patients with severe, refractory HHT-related epistaxis. Treatment improved quality of life, reduced severity of epistaxis and increased haemoglobin concentrations. Nasal closure should be considered for HHT patients with severe, refractory epistaxis, particularly in cases where bevacizumab is contraindicated.
The term ‘natural theology’ provokes a variety of reactions, spanning from whole-hearted endorsement to passionate rejection. Charged as it is with polemical and pejorative undertones, this debate begs for an intervention. If the scholarly community is to engage constructively with the concept and practice of natural theology – either by way of acceptance, rejection, or something in between – clarity in its definition and identification is imperative. The aim of this paper is to try to shed some light on three of the most common definitions of ‘natural theology’ in contemporary scholarship, to provide clarity about the ways in which they differ, and to propose some conceptual refinements in the hope that, if adopted, more fruitful discourse may take place in relation to this much-debated and interdisciplinary phrase.
Human rights due diligence (HRDD) is a buzzword in business and human rights (BHR) activities. However, multinational corporations (MNCs) often conduct it as a tick-box exercise without transparency. Using a relational contract theory, this article argues that when MNCs contract with local communities through community development agreements (CDAs) to perform HRDD, such contracts are internationalized relational contracts that attract a level of good faith. An established principle in international economic law, good faith serves as a standard for assessing conduct designed to discharge obligations in international contracts between states and MNCs (investor-state contracts). Similar to how investor-state arbitration tribunals use good faith jurisprudence in regulating the relationship between states and MNCs, this article proposes a BHR good faith jurisprudence to prescribe how HRDD obligations should be discharged. The article concludes that a good faith interpretational exercise in BHR would (1) reduce MNCs’ cosmetic compliance with HRDD principles; (2) increase transparency in the HRDD exercise; and (3) become a source of rights for local communities to enforce corporate accountability.
Philosophical arguments about government contracting either categorically oppose it on legitimacy grounds or see it as largely anodyne. I argue for a normatively distinct kind of contracting – the advance market commitment, or AMC – and show that it is justified by the same liberal values that justify the welfare state.