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This brief commentary on Greenberg's article ‘When the illness speaks’ addresses the problem of agency in mental disorder. Complementing the perspective of the article, it advocates an approach that does not see the causal mechanism of disorder-related behaviour in terms of an exclusive disjunction between the effects of the individual patient's own agency or manifestations of the illness. When reduced agency becomes part of the person's self-conception, passivity no longer means behaviour that is alien to their ‘genuine self’. Relatedly, the requirement that the patient's self-conception be validated raises some questions regarding its therapeutic constraints.
Wall modelling in large-eddy simulation (LES) is of high importance to allow scale resolving simulations of industrial applications. Numerous models were developed and validated for incompressible flows, including a simple quasi-analytical model based on Reichardt's formula that approximates the law of the wall. In this paper, a scaling is proposed to generalize this wall model to highly compressible flows. First, the results of wall-resolved LES (wrLES) of adiabatic compressible turbulent channel flows at $Re_\tau = 1000$ and at centreline Mach numbers of $M_c= 0.76$ and $1.5$ are presented. Then, three potential scalings of the incompressible wall model are proposed, and their a priori performance is evaluated : (i) the Howarth–Stewartson scaling, (ii) an improved Van Driest scaling and (iii) a new scaling obtained from a blending of those two. The results of wall-modelled LES (wmLES) of compressible channel flows using these three models are compared with the reference wrLES data, showing the superior accuracy of the hybrid scaling. The consistency of the new wall model at low Mach numbers is also verified by comparing the results of a wmLES at $M_c= 0.25$ with those of reference incompressible DNS data at $Re_\tau = 1000$ and $5200$. Finally, the proposed wall model is also applied to a turbulent channel flow at $M_c=1.5$ and $Re_\tau =5200$.
Maintaining attention underlies many aspects of cognition and becomes compromised early in neurodegenerative diseases like Alzheimer’s disease (AD). The consistency of maintaining attention can be measured with reaction time (RT) variability. Previous work has focused on measuring such fluctuations during in-clinic testing, but recent developments in remote, smartphone-based cognitive assessments can allow one to test if these fluctuations in attention are evident in naturalistic settings and if they are sensitive to traditional clinical and cognitive markers of AD.
Method:
Three hundred and seventy older adults (aged 75.8 +/− 5.8 years) completed a week of remote daily testing on the Ambulatory Research in Cognition (ARC) smartphone platform and also completed clinical, genetic, and conventional in-clinic cognitive assessments. RT variability was assessed in a brief (20-40 seconds) processing speed task using two different measures of variability, the Coefficient of Variation (CoV) and the Root Mean Squared Successive Difference (RMSSD) of RTs on correct trials.
Results:
Symptomatic participants showed greater variability compared to cognitively normal participants. When restricted to cognitively normal participants, APOE ε4 carriers exhibited greater variability than noncarriers. Both CoV and RMSSD showed significant, and similar, correlations with several in-clinic cognitive composites. Finally, both RT variability measures significantly mediated the relationship between APOE ε4 status and several in-clinic cognition composites.
Conclusions:
Attentional fluctuations over 20–40 seconds assessed in daily life, are sensitive to clinical status and genetic risk for AD. RT variability appears to be an important predictor of cognitive deficits during the preclinical disease stage.
To identify early postoperative haemodynamic and laboratory parameters predicting outcomes following total cavopulmonary connection.
Methods:
Patients who underwent total cavopulmonary connection between 2012 and 2021 were evaluated. Serial values of mean pulmonary artery pressure, mean arterial pressure, peripheral oxygen saturation, and lactate levels were collected. The influence of these variables on morbidities was analyzed. Cut-off values were calculated using the receiver operating characteristic analysis.
Results:
A total of 249 patients were included. All patients had previous bidirectional cavopulmonary shunt. Median age and weight at total cavopulmonary connection were 2.2 (1.8–2.7) years and 11.7 (10.7–13.4) kg, respectively. All patients were extubated in the ICU at a median of 3 (2–5) hours after ICU admission. Postoperative pulmonary artery pressure, around 12 hours after extubation, was significantly associated with chest tube drainage (p = 0.048), chylothorax (p = 0.021), ascites (p = 0.016), and adverse events (p = 0.028). Receiver operating characteristic analysis revealed a cut-off value of 13–15 mmHg for chest tube drainage and chylothorax and 17 mmHg for ascites and adverse events. Mean arterial pressure 1 hour after extubation was associated with prolonged chest tube drainage (p = 0.015) and adverse events (p = 0.008). Peripheral oxygen saturation 6 hours after extubation (p = 0.003) was associated with chest tube duration and peripheral oxygen saturation 1 hour after extubation (p < 0.001) was associated with ascites. Lactate levels on 2nd postoperative day (p = 0.022) were associated with ascites and lactate levels on 1st postoperative day (p = 0.009) were associated with adverse events.
Conclusions:
Higher pulmonary artery pressure, lower mean arterial pressure, lower peripheral oxygen saturation, and higher lactate in early postoperative period, around 12 hours after extubation, predicted in-hospital and post-discharge adverse events following total cavopulmonary connection.
Despite emotional stress being recognised as a key trigger for Raynaud’s phenomenon episodes, research in the area is still in its infancy.
Aims:
This study investigated the role of psychological factors relating to symptom severity and quality of life, and differences between Raynaud’s types (primary and secondary) to further inform the development of intervention in this field.
Method:
A cross-sectional design was used. Two hundred and ten adults with Raynaud’s completed an online questionnaire measuring stress, anxiety, depression, anxiety sensitivity, beliefs about emotions, symptom severity and quality of life.
Results:
Primary and secondary Raynaud’s groups differed in anxiety (p < .004), symptom severity (p < .001) and quality of life (p < .001). Stepwise multiple regressions indicated anxiety and Raynaud’s type explained 23% variance in hand symptom severity (p < .001); anxiety, Raynaud’s type and anxiety sensitivity explained 29% variance in symptom severity (global impact, p < .001); depression, Raynaud’s type and anxiety sensitivity explained 32% variance in quality of life (p < .001).
Conclusions:
Results highlight the importance of psychological factors in Raynaud’s phenomenon, indicating possible targets for treatment. Interventions such as cognitive behavioural therapy, which target both physical and psychological wellbeing, bear some promise as an adjuvant therapy for this group.
There is no evidence, nor need, for a fast block to polyspermy in animal oocytes. The idea that oocytes have evolved a mechanism to allow the entry of one spermatozoon and repel all others has, however, gained consensus over the last century. The main culprit is the sea urchin, which has been used for over a century in in vitro studies of the fertilization process. Images of sea urchin oocytes with thousands of sperm attached to the surface are commonplace in textbooks and appeal to the nature of the reader implying an intriguing surface mechanism of sperm selection despite these oocytes being fixed for photography (Figure 1). The abundance of gametes in this marine invertebrate and the ease of experimentation have given us the possibility to elucidate many aspects of the mechanism of fertilization, but has also led to ongoing controversies in reproductive biology, one being polyspermy prevention. Kinetic experiments by Rothschild and colleagues in the 1950s led to the hypothesis of a fast partial block to polyspermy in sea urchin oocytes that reduced the probability of a second spermatozoon from entering the oocyte by 1/20th. In the 1970s, Jaffe and colleagues suggested, with circumstantial evidence, that this partial block was due to the sperm-induced depolarization of the oocyte plasma membrane. However, the fate of supernumerary spermatozoa is determined well before the plasma membrane of the oocyte depolarizes. Transmembrane voltage does not serve to regulate sperm entry. Scholastic texts have inadvertently promulgated this concept across the animal kingdom with no logical correlation or experimentation and, as of today, a molecular mechanism to regulate sperm entry in oocytes has not been identified.
Paraconularia planicostata (Dawson, 1868) is one of two species in this genus (Sinclair, 1940) of conulariid cnidarian currently known from Mississippian strata in the Maritimes Basin in Atlantic Canada (Babcock and Feldmann, 1986). A salient characteristic of the species is the presence of a low and narrow internal carina at or near the longitudinal midline of each of the four faces of the gently tapered periderm (Van Iten et al., 2020). Paraconularia planicostata occurs in marine carbonates in the Upper Mississippian lower Windsor and lower Codroy groups in Nova Scotia and western Newfoundland, respectively (e.g., Bell, 1929; Stacy, 1953; Dix and James, 1988; Boehner et al., 1989; Boehner and Prime, 1993; Lavoie and Sami, 1998; Jutras et al., 2006; Ryan and Giles, 2017; Van Iten et al., 2020). The species is exceptionally abundant, with richly fossiliferous biohermal limestones containing up to approximately 20 specimens per 1000 cm3 of host rock (Van Iten, unpublished observations)—a volumetric density matched by few other conulariid-bearing rock units.
A fundamental open problem in the mechanics of granular media is the determination of the stress in the static state. It is known that the static stress depends strongly on how the grain assembly is created and the nature of confining boundaries. Non-trivial spatial variations have been observed even in simple geometries, posing long-standing challenges to continuum modelling. In this paper, we create gravity-deposited grain packings computationally and devise a method to visualise the paths of load transmission, which we call force lines. We show that the force lines reflect the flow during deposition, thereby encoding preparation history. We then show that the force lines coincide with ensemble averaged biased random walks in the particle contact network; this identification yields a closure relation for the stress, which together with the static momentum balances fully determines the stress field. The model makes accurate predictions for the stress in piles and silos, even for unusual deposition methods, thereby showing promise for more general scenarios.
Despite the large body of ALMP evaluations focussing on isolated training programmes for unemployed jobseekers, our understanding of potential reasons for (in)effectiveness remains limited. Specific training programmes aim to remediate particular supply- or demand-side barriers to employment experienced by targeted jobseekers. Consequently, this study unpacks training into four different types: (I) general classroom training (GCT) to enhance motivation and job search skills, (II) occupation-specific classroom training (OCT) addressing gaps in human capital, (III) non-contractual workplace training (NCWT) combining human capital acquisition with workplace experience, and (IV) contractual workplace training (CWT) additionally including a temporary wage subsidy to reduce hiring costs for employers. Using large-scale longitudinal register data, dynamic propensity score matching, and hazard models indicate positive effects of OCT participation, and particularly NCWT programmes allowing human and social capital accumulation in a workplace setting, on the transition into (stable) regular employment. In contrast, the non-effects for GCT participants highlight the need for more follow-up programmes, and the fact that, after controlling for the selective recruitment by employers of unemployed jobseekers with relatively strong profiles, CWT programme participants show moderate, short-lived positive effects which might inspire policymakers to reconsider programme assignment in light of cream-skimming by employers.
This longitudinal study aimed to investigate the role of maternal cognitive functioning and psychopathology in parent-child relationship quality during residential treatment for mothers with Substance Use Disorder (SUD), in order to identify factors that may enhance or limit intervention effects.
We assessed cognitive functioning (Esame Neuropsicologico Breve-2 [ENB-2]) and psychopathology (Symptom Checklist-90 Revised [SCL-90-R]) in 60 mothers diagnosed with SUD (Mage = 30.13 yrs; SD = 6.79) at treatment admission. Parent-child relationship quality was measured during free-play interactions using the Emotional Availability Scales every three months from admission (Child Mage = 17.17m; SD = 23.60) to the 15th month of the residential treatment.
A main effect of maternal psychopathology and an interaction effect of time and cognitive functioning were found. More maternal psychopathology predicted lower mother-child relationship quality. Mothers with higher cognitive functioning presented a better treatment trajectory, with an increase in mother-child relationship quality, whereas mothers with lower cognitive functioning showed a decrease in relationship quality after initial improvement.
These findings suggest that maternal psychopathology and cognitive functioning may influence the treatment of parent-child relationships in the context of SUD, although causality is not yet established. Implications for assessment and intervention are discussed.
Left ventricular tumour is a rare condition in children. The causes include vegetations, thrombus, and fibroma. 2-year-old asymptomatic female presented with an innocent heart murmur at 6 months of age. Subsequent follow-ups at 18 months of age showed left ventricular mass. Surgical pathology revealed “nodular fasciitis.” This type of tumour has never been described in the heart before.
Men with diabetes frequently experience spermatogenic dysfunction, which is the most significant sign that diabetes has harmed their ability to reproduce. The effect of various doses of the hydro-alcoholic extract of Nerium oleander leaves on the pituitary–gonadal axis, sperm motility and number, antioxidant system, changes in testicular tissue structure, and spermatogenesis in healthy and diabetic rats has been examined in the current study. Eighty male rats that had been streptozotocin-induced diabetic and healthy were divided into eight groups: (1) control, (2) Nerium (50 mg/kg), (3) Nerium (100 mg/kg), (4) Nerium (200 mg/kg), (5) DM (6) DM+Nerium (50 mg/kg), (7) DM+Nerium (100 mg/kg) and (8) DM+Nerium (200 mg/kg) and were administered orally for 48 days consecutive. Following the studies, analysis of the testicular tissues’ antioxidant capacity as well as sperm parameters, Johnsen’s scoring and morphometric evaluation, histology, biochemical and stereology studies were performed.
The outcomes showed that Nerium 50 and 100 mg/kg considerably enhanced the testicular morphology, sperm parameters, and reproductive organs to varying degrees in diabetic rats. After Nerium 50 mg/kg administration, glutathione peroxidase (GPX) and catalase (CAT) levels in the testicular tissue were increased whereas malondialdehyde (MDA) levels were markedly decreased. Nerium may help protect against diabetic-induced spermatogenic dysfunction in male rats by enhancing the activities of antioxidant enzymes in lower dosages.
We develop methods for testing factor models when the weights in portfolios of factors and test assets can vary with lagged information. We derive and evaluate consistent standard errors and finite sample bias adjustments for unconditional maximum squared Sharpe ratios and their differences. Bias adjustment using a second-order approximation performs well. We derive optimal zero-beta rates for models with dynamically trading portfolios. Factor models’ Sharpe ratios are larger but standard test asset portfolios’ maximum Sharpe ratios are larger still when there is dynamic trading. As a result, most of the popular factor models are rejected.
Normative data for older adults may be tainted by inadvertent inclusion of undiagnosed individuals at the very early stage of a neurodegenerative process. To avoid this pitfall, we developed norms for a cohort of older adults without MCI/dementia at 3-year follow-up.
Methods:
A randomly selected sample of 1041 community-dwelling individuals (age ≥ 65) received a full neurological and neuropsychological examination on two occasions [mean interval = 3.1 (SD = 0.9) years].
Results:
Of these, 492 participants (Group 1; 65–87 years old) were without dementia on both evaluations (CDR=0 and MMSE ≥ 26); their baseline data were used for norms development. Group 2 (n = 202) met the aforementioned criteria only at baseline, but not at follow-up. Multiple linear regressions included demographic predictors for regression-based normative formulae and raw test scores as dependent variables for each test variable separately. Standardized scaled scores and stratified discrete norms were also calculated. Group 2 performed worse than Group 1 on most tests (p-values < .001–.021). Education was associated with all test scores, age with most, and sex effects were consistent with the literature.
Conclusions:
We provide a model for developing sound normative data for widely used neuropsychological tests among older adults, untainted by potential early, undiagnosed cognitive impairment, reporting regression-based, scaled, and discrete norms for use in clinical settings to identify cognitive decline in older adults. Additionally, our co-norming of a variety of tests may enable intra-individual comparisons for diagnostic purposes. The present work addresses the challenge of developing robust normative data for neuropsychological tests in older adults.
Associations have been found between five-factor model (FFM) personality traits and risk of developing specific predementia syndromes such as subjective cognitive decline (SCD) and mild cognitive impairment (MCI). The aims of this study were to: 1) Compare baseline FFM traits between participants who transitioned from healthy cognition or SCD to amnestic MCI (aMCI) versus non-amnestic MCI (naMCI); and 2) Determine the relationship between FFM traits and risk of transition between predementia cognitive states.
Methods:
Participants were 562 older adults from the Einstein Aging Study, 378 of which had at least one follow-up assessment. Baseline data collected included levels of FFM personality traits, anxiety and depressive symptoms, medical history, performance on a cognitive battery, and demographics. Follow-up cognitive diagnoses were also recorded.
Results:
Mann–Whitney U tests revealed no differences in baseline levels of FFM personality traits between participants who developed aMCI compared to those who developed naMCI. A four-state multistate Markov model revealed that higher levels of conscientiousness were protective against developing SCD while higher levels of neuroticism resulted in an increased risk of developing SCD. Further, higher levels of extraversion were protective against developing naMCI.
Conclusions:
FFM personality traits may be useful in improving predictions of who is at greatest risk for developing specific predementia syndromes. Information on these personality traits could enrich clinical trials by permitting trials to target individuals who are at greatest risk for developing specific forms of cognitive impairment. These results should be replicated in future studies with larger sample sizes and younger participants.
Brazil et al. [‘Maximal subgroups of infinite symmetric groups’, Proc. Lond. Math. Soc. (3)68(1) (1994), 77–111] provided a new family of maximal subgroups of the symmetric group $G(X)$ defined on an infinite set X. It is easy to see that, in this case, $G(X)$ contains subsemigroups that are not groups, but nothing is known about nongroup maximal subsemigroups of $G(X)$. We provide infinitely many examples of such semigroups.