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.
Two sediment sections are investigated at Cape Arkhangelos, island of Rhodes, where Pleistocene marine sediments crop out in horsts and grabens of a Mesozoic basement. There, hemipelagic sediments characterized by upper bathyal communities are atypically mixed with much shallower faunal components because they were deposited close to rugged coastal landforms. Biostratigraphic analyses show that the sections were deposited between 1.8 and 0.9 Ma, and between 1.8 and 1.6 Ma, respectively. By combining the planktonic/benthic foraminiferal ratio with 31 bathymetric indicators chosen among extant species of benthic foraminifera, mollusks, and bryozoans, we show that relative sea-level fluctuations can be reconstructed in these atypical settings despite the proximity of steep slopes that favored transportation of allochthonous fauna. The shallow-water components (including gravels and calcareous algae) were transported downslope by the combined action of gravity, currents, and tectonic disturbance that promoted drowning (with a maximum flooding recorded at ca. 1.7 Ma) and then uplift of fault-bounded paleovalleys that formed during the Early Pleistocene. Abrupt facies changes and age differences between sections have been triggered by the irregular paleotopography of the Mesozoic basement, which fostered differential depositional settings, with outer to middle neritic deposits above the horsts and upper bathyal deposits in paleovalleys.
Since 2006, Rwanda has experienced a substantial rise in the facility-based delivery (FBD) rate, attributed to various health initiatives. This paper investigates the impact of multiple health reforms on maternal service utilization and neonatal mortality rates. Employing a difference-in-differences framework utilizing geographical variation in the baseline FBD rate, our estimates indicate a 10–17 percentage point increase in FBD and a 0.15–0.18 times increase in the number of antenatal care visits. While our analysis indicates some evidence of a reduction in neonatal mortality rates, the findings are inconclusive. Nevertheless, our results suggest that the effect of the reforms on neonatal mortality rates was weakly intensified for those residing near district hospitals providing care for complicated pregnancies.
We report a 14-month-old male with hypoplastic left heart syndrome, mitral stenosis, and aortic stenosis with native aortic root thrombus. He developed a wide complex ventricular tachycardia and ST-segment elevation myocardial infarction with troponin I levels peaking at 388 ng/mL. He was treated safely with systemic alteplase with a resolution of his regional wall motion abnormality 18 hours later.
Georgia represents an interesting case to study the agency of small states in reshaping their regional identity and external environment. Although much of the world has considered Georgia as politically part of the South Caucasus region, the country’s political elites themselves have long attempted to escape the geographic boundaries of the South Caucasus region and relocate their country into Eastern Europe. We argue that Georgian elites were partially successful in their quest for foreign political identity change. Although they did not manage to entirely change the international perception about Georgia’s geographic belonging, the country has politically moved closer to Eastern Europe and is considered to be part of “Associated Trio” together with Ukraine and Moldova—and recently became an EU candidate. From a theoretical perspective, we argue that Georgia’s quest for foreign policy identity recalibration fits the constructivist paradigm of international relations well. It can be argued that Georgia’s political elites were partially driven by ideational factors and were ignorant of the balance of power in their external environment, which cost the country the lost wars and compromised territorial sovereignty.
This observational study investigates migratory foreign bodies in the upper aerodigestive tract, emphasising clinical presentation, assessment and factors contributing to extraluminal migration.
Methods
Conducted across multiple medical centres in India, the study included 15 patients aged 11 to 70 years. Detailed observations, demographic information, clinical history, radiological findings and intra-operative outcomes were compiled.
Results
Fifteen patients presented with varied symptoms. Fish and chicken bones, along with metal wires, were common foreign bodies. Computed tomography scans played a crucial role in diagnosis, confirming extraluminal migration. Neck exploration successfully retrieved foreign bodies in most cases, with varied sites of impaction.
Conclusion
Migratory foreign bodies, although rare, pose significant challenges for otolaryngologists. Early recognition, thorough diagnosis and meticulous neck exploration, is crucial for effective management, preventing severe complications. This study adds valuable insights to the understanding of migratory foreign bodies, contributing to the existing literature in otolaryngology practice.
Hobby metal detecting in Norway has grown since 2014. In the Norwegian recording system, all finds are catalogued by professionals at five regional museums. The examination of the dataset thus created allows the authors to look at regional and national patterns and discuss the inherently messy and ‘human’ nature of a seemingly quantitative material. Their study suggests that both archaeologists and detectorists influence the quality of the evidence and how representative the data are. They argue that metal detecting patterns are primarily the result of modern activities, such as management practices and the endeavours of a few very prolific detectorists in certain areas. Understanding these biases and systematically recording the activities of the actors involved is crucial if we are to make full use of the metal-detected material.
The growth and characteristics of linear, oblique instabilities on a highly swept fin on a straight cone in Mach 6 flow are examined. Large streamwise pressure gradients cause doubly inflected cross-flow profiles and reversed flow near the wall, which necessitates using the harmonic linearized Navier–Stokes equations. The cross-flow instability is responsible for the most-amplified disturbances, however, not all disturbances show typical cross-flow characteristics. Distinct differences in perturbation structure are shown between small ($\sim$3–5 mm) and large ($\sim$10 mm) wavelength disturbances at the unit Reynolds number $Re' = 11 \times 10^6$ m$^{-1}$. As a result, amplification measurements based solely on wall quantities bias a most-amplified disturbance assessment towards larger wavelengths and lower frequencies than would otherwise be determined by an off-wall total-energy approach. A spatial-amplification energy-budget analysis demonstrates (i) that wall-normal Reynolds-flux terms dictate the local growth rate, despite other terms having a locally larger magnitude and (ii) that the Reynolds-stress terms are responsible for large-wavelength disturbances propagating closer to the wall compared with small-wavelength disturbances. Additionally, the effect of free-stream unit Reynolds number and small yaw angles on the perturbation amplification and energy budget is considered. At a higher Reynolds number ($Re' = 22 \times 10^6$ m$^{-1}$), the most-amplified wavelength shrinks. Perturbations do not behave self-similarly in the thinner boundary layer, and the shift in most-amplified wavelength is due to decreased dissipation relative to the lower-Reynolds-number case. Small yaw angles produce a streamwise shift in the boundary layer and disturbance amplification. The yaw results quantify a potential uncertainty source in experiments and flight.
Post the great financial crisis (GFC) of 2008–2009, there has been a surge in the macroeconomics literature on aggregate uncertainty. Although the recent literature has recognized the adverse real effects of global uncertainty shocks in emerging market economies (EMEs), the role of monetary policy in offsetting these adverse effects and their link with the exchange rates is not explored in the literature. We find that the currently followed interest rate rules (IRRs) under a flexible inflation-targeting regime are ineffective in stabilizing the domestic economy during periods of high global uncertainty in the EMEs. Using a small open economy new Keynesian DSGE model with Epstein–Zin preferences and second-moment demand shocks, we compare and propose alternate monetary policy rules that significantly reduce welfare losses. We find that the best monetary policy rule in terms of welfare depends on the nature of shock that is, first-moment or second-moment shock.
Vitamin D deficiency has previously been linked to higher rates of exacerbation and reduced lung function in asthmatics. Previous randomised controlled trials investigating the effect of vitamin D supplementation have mainly focused on children with asthma. Trials involving adults have typically used bolus dosing regimens, and the main outcomes have been patient-focused without investigating underlying inflammation. The present study aimed to conduct a 12-week placebo-controlled randomised controlled trials administering a daily 125 µg vitamin D3 supplement to adults with mild to moderate asthma. A total of 32 participants were randomised to receive either the 125 μg vitamin D3 supplement or an identical matching placebo. The primary outcome of the study was lung function measured by the ratio of FEV1:FVC (effect size 2·5) with secondary outcomes including asthma symptoms and inflammatory biomarkers. There was a small but statistically significant higher increase in the mean (±sd) ratio of FEV1:FVC from baseline to post-intervention in the vitamin D group (+0·05 ± 0·06) compared with the placebo group (+0·006 ± 0·04, P = 0·04). There was no effect of the intervention on asthma control test scores, or the inflammatory biomarkers measured. There was a moderate, significant association between baseline plasma 25(OH)D concentration and baseline plasma IL-10 (r = 0·527, P = 0·005) and TNF-α (r = −0·498. P = 0·008) concentrations. A daily vitamin D3 supplement led to slightly improved lung function in adult asthmatics and may be a useful adjunct to existing asthma control strategies, particularly for individuals with suboptimal vitamin D status.
This paper presents a dictionary-based study of French loanwords in contemporary English in order to investigate the location of primary stress in these loanwords. Four factors are found to be significant predictors of the position of primary stress: endings, word complexity, the segmental structure of the final syllable, and syllable count. Moreover, this study confirms previous observations on the tendency for American English to have more final stress in French loanwords than British English. Finally, the implications of our findings are discussed in light of a model that assumes that English phonology consists of distinct interacting subsystems.
We investigate the statement “all automorphisms of ${\mathcal {P}}(\lambda )/[\lambda ]^{<\lambda }$ are trivial.” We show that MA implies the statement for regular uncountable $\lambda <2^{\aleph _0}$, that the statement is false for measurable $\lambda $ if $2^\lambda =\lambda ^+$, and that for “densely trivial” it can be forced (together with $2^\lambda =\lambda ^{++}$) for inaccessible $\lambda $.
China has constructed a rigorous state apparatus to control its online social content. To date, research has largely focused on the central government's cyber control, but the less studied local cyberspace administrative forces are also important. Our fieldwork and interviews at a county-level cyberspace administration office (CAO) in east China reveal that the local CAO had been rendered a “toothless tiger” with insufficient technology, power and labour. However, it has made up for these deficiencies by utilizing systems such as outsourced surveillance, organized mass reporting and personnel secondment. We contend that these practices, which we label “extra-institutional governance” (EIG), emerge when bureaucracies with limited resources face external pressures. The findings shed light on how censorship machines operate in local governments in China and reveal the general dynamics of how bureaucratic organizations adapt to environmental pressures.
We investigate the effect of water quality on the educational outcomes of children aged 8–11 in 39 districts in five states in the Ganges Basin of India. Using data from the Centre for Pollution Control Board of India and the Indian Human Development Survey (IHDS) 2011–12, we study the effect of water quality in the Ganges Basin on the performance in three test scores. Our evidence suggests that faecal coliform levels in water sources above safety thresholds negatively affect reading and writing test scores. The effects of Nitrate-N and Nitrite-N in the water appear to be weaker compared to those of faecal coliform. The results establish that water pollution caused by excessive presence of faecal coliform is an important environmental factor in determining educational outcomes of children. High levels of faecal coliform in the water could be lowering cognitive abilities of the pollution-affected children through the channel of waterborne diseases.
To investigate healthcare workers’ perceptions of the integrated disease surveillance and response (IDSR) strategy.
Methods
A cross-sectional survey of healthcare workers (HCWs) was conducted from December 2021 to June 2022 to assess their perceptions of the IDSR system attributes.
Results
Of the 409 respondents, 12 (2.9%) reported no prior training on disease surveillance. The IDSR was deemed simple, acceptable, useful, and timely by most participants. There were sharp differences in perceptions of flexibility and simplicity between doctors and the other healthcare professionals. However, acceptability, timeliness, and usefulness were uniformly perceived. Healthcare workers with at least 11 years of experience perceived the usefulness of the IDSR system significantly higher than those with lesser years of experience. However, work experience did not have an impact on HCWs perceptions of the simplicity, timeliness, and flexibility of the IDSR system.
Conclusions
Most healthcare workers have positive perceptions of the IDSR approach. However, there are reservations about how well the system can adapt to changing conditions and demands (flexibility) and how well it simplifies the implementation processes. These findings demonstrate the necessity of adopting cutting-edge strategies for capacity building as well as ongoing professional development of healthcare professionals responsible for the implementation of the IDSR strategy.