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.
Stroke remains a major public health issue globally. Tele-rehabilitation, incorporating internet-based interventions and wearable devices, offers an accessible strategy for post-discharge rehabilitation. This study evaluates their effectiveness in stroke patients.
Methods:
A total of 160 subacute stroke patients hospitalized between November 2022 and September 2023 were enrolled and randomly allocated to four groups at discharge (n = 40 per group): a control group receiving conventional rehabilitation, an internet-based tele-rehabilitation (ITR) group, a wearable-device-assisted (WDA) group and a combined intervention (IWT) group, which received both ITR and WDA training. The primary outcome was assessed by the Modified Barthel Index (MBI) at discharge, 4 weeks and 12 weeks post-discharge, with the 12-week score prespecified as the primary endpoint. Secondary outcomes included Berg Balance Scale (BBS), simplified Fugl-Meyer Assessment (sFMA), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Mini-Mental State Examination (MMSE) and Zarit Burden Interview (ZBI), all assessed at discharge, 4 weeks and 12 weeks post-discharge.
Results:
At baseline, no significant differences were observed among groups (P > 0.05). Over 12 weeks, all intervention groups demonstrated significant improvements in MBI, BBS and sFMA compared to the control group (P < 0.05), with the IWT group achieving the greatest gains (P < 0.01). Anxiety, depression and caregiver burden significantly decreased across intervention groups, with the IWT group showing the most pronounced reductions (P < 0.01). Cognitive function also improved significantly, particularly in the IWT group (P < 0.01).
Conclusion:
ITR and WDA training enhances functional and psychological recovery in stroke patients, highlighting its potential clinical significance in managing stroke recovery.
In a normal pregnancy, glucocorticoids (GC), such as cortisol, play an essential role in early heart development. GC concentrations surge in late gestation to facilitate the maturation of fetal systems in preparation for birth. However, pregnancy complications related to stress, lifestyle factors, disease, and commonly used antenatal care treatments (GC therapy and artificial reproductive technology) can lead to prematurely increased GC concentrations that are detrimental to the heart before it is mature enough to benefit. These findings underpin the hypothesis that GC play a double-edged role that benefits normal heart development but is potentially harmful when dysregulated. However, the mechanisms by which both physiological and pathological elevations in GC concentrations influence the fetal cardiometabolic pathways that lead to detrimental long-term cardiovascular outcomes remain unclear. This review will, firstly, describe how cortisol regulates different aspects of cardiac development and, secondly, compare findings from different animal models that have provided mechanistic insight into how excess cortisol/GC during pregnancy impacts cardiac health across the life course.
There is substantial international variation in recommended vitamin C intake levels. In the USA, the recommendation is 90 mg/d for men and 75 mg/d for women, while in the UK, the current recommendation – established in 1991 – is only 40 mg/d for adults. This UK level was based on the 1953 Sheffield study, which found that 10 mg/d prevents scurvy, with 40 mg/d chosen as the recommended level for yielding somewhat higher plasma levels. In this commentary, we argue that the UK recommendation overlooked key evidence available at the time. Specifically, at least six controlled trials published before 1991 reported benefits from vitamin C supplementation in participants whose baseline vitamin C intake was already 40 mg/d or higher. One randomised controlled trial, published in 1993, found benefits from vitamin C supplementation even at a baseline intake of about 500 mg/d; however, this trial involved ultramarathon runners, and the findings should not be broadly generalised. Nonetheless, such results challenge the assumption that 40 mg/d is universally adequate to maintain full health. We also highlight that the UK recommendations were narrowly focused on preventing dermatological symptoms of scurvy, despite strong evidence – even at the time – that vitamin C deficiency can also cause cardiac dysfunction and greater morbidity due to respiratory infections. We conclude that the current UK vitamin C recommendation should be re-evaluated in light of controlled trial evidence and broader clinical outcomes.
The dating of the qameṣ shift (*/aː/ > [ɔː]) in the Tiberian tradition of Biblical Hebrew has long been a scholarly puzzle. In this article I present possible evidence for this shift in the Greek transcriptions of Origen’s Hexapla, datable to the first half of the third century ce in Palestine. While the evidence is limited both in attested tokens and in grammatical scope, it is suggested that lexical diffusion may account for the gradual spread of this shift, as recorded in different stages of the transmission of Biblical Hebrew.
This paper studies the effect of gender imbalance on assortative matching and household income inequality. Using data across prefectures in China, we show that a higher sex ratio in the marriage market is negatively associated with both assortative marriage and household income inequality. Motivated by empirical evidence, we develop a heterogeneous-agent model to study the mechanism behind the pattern. The quantitative results of the model match the empirical evidence: a higher sex ratio is associated with a lower degree of assortative matching, which leads to a decrease in household income inequality. When we allow men and women to choose their level of education endogenously before entering the marriage market, we find that a higher sex ratio leads to a higher level of education investment among both men and women, with men investing more significantly than women.
Results are presented of an experimental investigation into the levitation of spheres on thin layers of viscous fluid. In one set of experiments the layer is formed on a planar vertical wall and in a second investigation the sphere sits on a fluid layer on the inside of a rotating horizontal cylinder. The motion takes place at a set of fixed locations in the latter case whereas the sphere generally translates up or down the plane wall of the belt. Lubrication layers formed between the surfaces of the spheres and the walls induce slip. Two distinct states are identified, and excellent accord is found between experimental results and those from a recently developed theory for the single-track state which is only observed in the rotating horizontal cylinder. The two-track state exists in both sets of experiments, but theoretical progress with this remains an outstanding challenge.
Many archaeology graduate students pursue advanced degrees in the hope of undertaking an academic career. Job-listing websites often serve as the first port-of-call for students seeking academic positions. We examined tenure-track job advertisements over the past decade to gain insights into the academic job market for archaeologists. Using data from the community-edited Academic Jobs Wiki for Archaeology, we examined changes in the academic job market over time. We investigated the editing dynamics of the Wiki to understand its users and their biases. We then analyzed the text of 431 job ads posted from 2013 to 2023. Our analysis addresses the question of how archaeological topics, methods, and geographic regions specified in archaeological job ads have shifted over time. We also explored whether the labor burden for applicants has changed over time: do institutions request more information and documents from applicants at the initial stages of application, compared to a decade ago? Finally, we assessed the influence of sociopolitical factors on the changing focus of research topics in the field. We conclude with implications for archaeology students, graduates, and advisors seeking to understand the dynamics of the academic job market and the requirements of employers.
La reciente excavación arqueológica efectuada en el centro provincial inka de Tambo Viejo, en el valle de Acarí, Perú, resultó en el hallazgo de una pequeña construcción de forma rectangular y semisubterránea. En su interior encontramos hojas y semillas de coca en asociación con arena limpia. Esta evidencia sugiere que la pequeña construcción sirvió para el almacenamiento de las hojas de coca, las que habían sido cubiertas con arena limpia para garantizar su preservación. La arena tiene propiedades térmicas que crean condiciones relativamente frías y que son óptimas para la preservación de productos orgánicos.
Estimate bacterial pathogen contamination of healthcare workers’ (HCW) long-sleeved attire.
Design:
Prospective observational study.
Setting:
Tertiary care hospital.
Participants:
HCWs wearing long-sleeved attire providing direct inpatient care.
Intervention:
Sampling of both sleeves of HCWs wearing long-sleeved attire was performed using a swab and cultured for aerobic bacterial growth classified as potential pathogens or presumptive skin commensals. Potential predictors of sleeve contamination, including participant survey responses related to attire and infection prevention practices, were analyzed using univariate analyses. Whole genome sequencing compared isolates to a genomic surveillance database of patient clinical isolates.
Results:
Among 280 samples, 81.1% (n = 227) demonstrated any bacterial growth and 20.7% (n = 58) grew ≥1 potential pathogen. Speciated organisms included alpha-hemolytic streptococci (n = 28), Bacillus sp. (n = 20), and Pantoea/Mixta sp. (n = 8), gram-negative bacilli (n = 6), and Staphylococcus aureus (n = 2). Univariate analysis demonstrated that sleeves sampled on non-intensive care units (P = .038) were significantly associated with any bacterial growth, and attire type (P = .002) and sleeve material (P = .004) were associated with growth of ≥1 potential pathogen. Fleece attire and material were more likely to be contaminated than other attire and material types. Sequenced isolates from sleeve samples were not genetically related to any patient isolates.
Conclusions:
HCW long sleeve contamination occurs frequently, including with potential pathogens. Changing trends in attire type may have an impact on bacterial transmissibility. While this study could not infer transmission events associated with clinically diagnosed patient infections, the potential benefit of a “bare below the elbows” attire policy warrants further investigation.
We report the first detections of Otiorhynchus albidus Stierlin (Coleoptera: Curculionidae) in North America. The first specimens of O. albidus were found inside a home in Kelowna, British Columbia, Canada, in June 2022, and additional specimens from the same location were collected throughout 2023 and 2024. Otiorhynchus albidus is of European origin. It is known to attack tree fruits and ornamental plants. Otiorhynchus albidus sometimes co-occurred with O. raucus (Fabricius), an already established weevil species in British Columbia that is a pest of tree fruits, grapes, vegetables, and ornamental plants. To test different surveillance methods and understand the seasonal occurrence of O. albidus, surveys for adult weevils were conducted in 2023 and 2024 with pitfall traps (outside the home) and sticky traps (inside and outside the home) in 2023. Both O. albidus and O. raucus were recovered with pitfall and sticky traps and were found in both years. We provide a key and reference DNA barcodes (from the cytochrome c oxidase subunit 1 region) to distinguish O. albidus from similar species present in Canada. Otiorhynchus albidus has the potential to become a pest of tree fruits and ornamental plants in North America, as well as a nuisance pest for homeowners.
This study aimed to systematically review the evidence on functional outcomes following dorsal preservation rhinoplasty, with a focus on nasal obstruction.
Methods
A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. PubMed, Embase, Scopus and Cochrane databases were searched up to March 2025. Studies reporting nasal airway outcomes following dorsal preservation rhinoplasty using subjective or objective measures were included.
Results
Six studies comprising 662 patients were included. Patient-reported outcomes (Nasal Obstruction Symptom Evaluation, Standardized Cosmesis and Health Nasal Outcomes Survey and Visual Analogue Scale) consistently demonstrated significant post-operative improvement. Objective measures (acoustic rhinometry, rhinomanometry and cone-beam computed tomography) showed maintained or improved airway dimensions. dorsal preservation rhinoplasty was functionally equivalent to traditional structural techniques, with low complication (<5 per cent) and revision rates (<2 per cent).
Conclusion
Dorsal preservation rhinoplasty maintains or improves nasal airway function while preserving structural integrity and reducing the need for grafting. It is a safe and effective alternative to traditional dorsal reduction techniques.
This position statement provides guidelines for health professionals who are considering online or direct-to-consumer genetic testing for their patients. It presents the major issues around online and direct-to-consumer (DTC) testing including how it is accessed, motivations for accessing testing and how to return these results. Online or DTC recommendations include: (1) DTC testing should only be done by individuals/consumers who are well informed, aware of the risks, benefits and limitations of testing, and able to consent for their DNA to be collected, analyzed and potentially stored. Where possible, individuals/consumers should also be aware of the alternative option of undertaking testing through healthcare professionals in a clinical context, and the benefits of this. (2) Decisions about having a child tested should be based on peer-reviewed, published evidence. Genomics testing for children should be within a clinical context where parents are informed, have access to clinical support and professional genetic counseling about this decision, as well as support for the range of results received. (3) Parents considering direct-to-consumer testing on their newborn are counselled, or given information, to encourage them to have standard government funded newborn bloodspot screening testing on their newborn. (4) When choosing an online genomic test, preference should be given to tests undertaken in accredited laboratories offering tests accredited with the Therapeutic Goods Administration. (5) Results obtained through methods other than direct analysis from a laboratory accredited to perform genomic testing to inform human health and wellbeing should be interpreted with caution. The HGSA recommends that such results must be confirmed in an accredited diagnostic laboratory prior to relying on them to inform options for treatment, surveillance or risk reduction, or before undertaking cascade testing in family members. (6) When individuals are concerned about their health, they should consult an appropriate healthcare professional to decide whether an online genomic test is appropriate and discuss how useful test results could be to make health-related decisions.
The accuracy, robustness and affordability of localisation are fundamental to autonomous robotic inspection within aircraft maintenance, repair and overhaul (MRO) hangars. Hangars typically have high ceilings and are predominantly steel-framed structures with metal cladding. Because of this, they are regarded as GPS-denied environments, characterised by significant multipath effects and strict operational constraints, which together form a unique challenging setting. The lack of comparative techno-economic benchmarks for localisation technologies in such environments remains a critical gap. Addressing this, the paper presents the first techno-economic analysis that benchmarks motion capture (MoCap), ultra-wideband (UWB) and a ceiling-mounted camera (CMC) system across three operational scenarios: robot localisation, asset monitoring and surface defect detection within a single-bay hangar. A two-stage optimisation framework for camera selection and placement is introduced, which couples market-based camera-lens selection with an optimisation solver, producing camera layouts that minimise hardware while meeting accuracy and coverage targets. The consolidated blueprints provide quantification of the required equipment and its performance: 15 global-shutter GigE cameras are adequate for drone localisation, 9 cameras meet the requirements for on-bay monitoring and 49 high-resolution cameras facilitate defect mapping of the upper airframe surfaces for midsize defects. Across these scenarios, the study reports indicative performance and cost envelopes: a MoCap installation delivers submillimeter localisation at an estimated £190k per bay, UWB delivers centimetre-level tracking for around £49k and the proposed CMC system layouts achieve task-specific coverage with costs in the £9k–£77k range. The analysis equips MRO planners with an actionable method to balance accuracy, coverage and budget, demonstrating that an optimised CMC system can deliver robust and cost-effective sensing for next-generation smart hangars.
There is growing concern regarding the increasing prevalence of synthetic opioids and their association with mortality and a range of health and social harms. Recognition, assessment and management of synthetic opioid use is a key challenge for practitioners working in hospitals, prisons and community services. This article gives an overview of the range and characteristics of synthetic opioids, key risks, the prevalence of synthetic opioid-related deaths in England, and prevention and management approaches. It highlights five areas critical to addressing the synthetic opioid crisis: improved access to medication for synthetic opioid addiction; increased naloxone availability and referral to addictions services following opioid overdose; strengthening prevention efforts targeting risk factors such as illicit drug markets and emerging trends in drug use; optimising pain management to reduce the use of prescription opioids and minimise the risk of associated synthetic opioid addiction; raising awareness among healthcare providers, patients and the general public about the dangers of synthetic opioids, including their potency, addictive nature and potential for overdose.
This case report details the diagnosis and surgical management of a 7 cm aortic root aneurysm occurring in a 12-year-old with cutis laxa type B, an extremely rare connective tissue disorder. Our patient underwent a Bentall procedure as primary treatment for the aneurysm and had a successful interventional treatment of a postoperative pseudoaneurysm.
This symposium firmly covers the impacts of human rights law on penal, prison, (police) custodial, immigration, and psychiatric policies in diverse jurisdictions, including Russia, Australia, Japan, Israel, the United States, and Europe, that have been understudied and neglected in comparison with the United States and Europe. It also raises socio-legal debates about accountability, operational complexities, transparency, the ability to either limit or increase the state’s right to punish, the efficacy of oversight bodies, the limits of human rights “law” in this context, access to justice and legal aid for detainees and prisoners, and the persistence of violations in the face of reform. In particular, this symposium offers an opportunity to analyze the way in which the United Nations, the European Court of Human Rights, national courts, the monitoring bodies, and detainees are able to challenge penal and detention policies as well as to soften them through the lens of human rights. This symposium intends therefore to demonstrate an engagement with existing scholarship in human rights, penal, detention, immigration and prison policies, and punishment. It relies on theoretical and empirical socio-legal work that addresses these issues from a local, national, and global perspective. It also challenges traditional socio-legal boundaries by taking into account and integrating the intersection of policy and subdiscipline spheres that cover criminal and penal justice, immigration, psychiatric institutions, and human rights. In this way, this symposium combines the study of these socio-legal fields and all places of detention in very contrasting jurisdictions with a view to analyzing the nature of relations between human rights and detention.