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We study the effect of railroads, the single largest public investment in colonial India, on human capital. Using district-level data on literacy and two different identification strategies, we find railroads had positive effects on literacy, in particular on male and English literacy. We show that railroads increased literacy by raising secondary and elite primary schooling, rather than vernacular primary schooling. Our mediation analysis suggests that non-agricultural income, urbanization, and opportunities for skilled employment are important mechanisms, while agricultural income is not.
Are the preferences of women and men unequally represented in public policies? This simple yet fundamental question has remained largely unexplored in the fast-growing fields of women’s representation and inequality in the opinion-policy link. Our study analyzes gender biases in policy representation using an original dataset covering 43 countries and four decades, with citizens’ preferences regarding more than 4,000 country-year policies linked to information about actual policy change. Our analysis reveals clear and robust evidence that women’s policy preferences are underrepresented compared to those of men. While this skew is fairly modest in terms of congruence, women’s representation is driven mostly by the high correlation of preferences with men. When there is disagreement, policy is more likely to align with men’s preferences. Our analyses further suggest that women’s substantive underrepresentation is mitigated in contexts with high levels of female descriptive representation and labor market participation. In sum, our study shows that gender inequality extends to the important realm of policy representation, but there is also meaningful variation in unequal representation across contexts.
Direct numerical simulations up to Reλ = 1445 show that the scaling exponents for the enstrophy and the dissipation rate extrema are different and depend on the Reynolds number. A similar Reynolds number dependence of the scaling exponents is observed for the moments of the dissipation rate, but not for the moments of the enstrophy. Significant changes in the exponents occur at approximately Reλ ≈ 250, where Reλ is the Taylor based Reynolds number, which coincides with structural changes in the flow, in particular the development of large-scale shear layers. A model for the probability density functions (PDFs) of the enstrophy and dissipate rate is presented, which is an extension of our existing model (Proc. R. Soc. A, vol. 476, 2020, p. 20200591) and is based on the mentioned development of large-scale layer regions within the flow. This model is able to capture the observed Reynolds number dependencies of the scaling exponents, in contrast to the existing theories which yield constant exponents. Moreover, the model reconciles the scaling at finite Reynolds number with the theoretical limit, where the enstrophy and dissipation rate scale identically at infinite Reynolds number. It suggests that the large-scale shear layers are vital for understanding the scaling of the extrema. Furthermore, to reach the theoretical limit, the scaling exponents must remain Reynolds number dependent beyond the present Reλ range.
The moral problem of authority can be expressed as follows: how can authority, and the deference it entails, be compatible with freedom and rationality? The pluralist approach separates political obligation from authority. For pluralists, authority is both unjustifiable and unnecessary, and so legitimate political obligation, including the duty to obey the law, does not entail deference. I argue that it is possible to retain the pluralist commitment to plural grounds of legitimacy, while rebutting the pluralist objections to authority. As a result, whenever authority does have legitimacy, the moral question of authority will demand an answer.
Fibre-optic laryngoscopy is still widely used in daily clinical practice; however, high-definition laryngoscopy using narrow band imaging could be more reliable in characterising pharyngeal and laryngeal lesions.
Methods
Endoscopic videos were assessed in a tertiary referral hospital by 12 observers with different levels of clinical experience. Thirty pairs of high-definition laryngoscopy with narrow band imaging and fibre-optic laryngoscopy videos were judged twice, with an interval of two to four weeks, in a random order. Inter- and intra-observer reliability, sensitivity and specificity were calculated in terms of detecting a malignant lesion and a specific histological entity, for beginners, trained observers and experts.
Results
Using high-definition laryngoscopy with narrow band imaging, inter-observer reliability for detecting malignant lesions increased from moderate to substantial in trained observers and experts (high-definition laryngoscopy with narrow band imaging κ = 0.66 and κ = 0.77 vs fibre-optic laryngoscopy κ = 0.51 and κ = 0.56, for trained observers and experts respectively) and sensitivity increased by 16 per cent.
Conclusion
Inter-observer reliability increased with the level of clinical experience, especially when using high-definition laryngoscopy with narrow band imaging.
This study evaluated the importance of a correction for amino acids (AA) released into the hindgut on a measure of AA absorption kinetics and tested whether AA absorption kinetics are related to the extent of AA absorption using the growing pig as a model for humans. Thirty-six nine-week-old pigs (22·3 kg) received a diet containing whey protein as the sole protein source for 8 d. Pigs received their last meal containing the indigestible marker titanium dioxide before being euthanised at 1, 2, 3, 4, 6 and 12 h post-feeding. The entire content of each gastrointestinal tract (GIT) region was collected to determine AA released into the hindgut, and the kinetics and extent of AA absorption (uncorrected and corrected for AA entering the hindgut). Amounts of AA released into the hindgut increased over time (e.g. 33 and 180 mg of Glu for 4 and 6 h post-feeding). The corrected apparent amount of each AA absorbed from the GIT lumen after 4 h post-feeding was generally lower (P ≤ 0·05) than the uncorrected counterpart. Differences in both the kinetics and extent of AA absorption were observed across AA. For example, the time to reach half of the apparent AA absorption (T50) was 1·5 and 3·4 h for Met and Arg, respectively, whereas their extent of apparent absorption was 93 and 73 %. Negative correlations between parameters related to kinetics and the extent of apparent absorption were observed (e.g. for T50 r = −0·81; P < 0·001). The kinetics of AA absorption is related to the extent of AA absorption.
Our systematic review assessed the impact of botanical fermented food (BFF) consumption on glucose, lipid, anthropometric, inflammatory and gut microbiota parameters, in adults with metabolic syndrome (MetS), MetS components or type 2 diabetes mellitus (T2DM). Embase, MEDLINE, Cochrane CENTRAL and Google Scholar were searched with no language limits, from inception to 31 August 2022, for eligible randomised controlled trials (RCTs). Two independent reviewers screened 6873 abstracts and extracted relevant data. Risk of bias (ROB) was assessed using the Cochrane Collaboration’s ROB2 tool. The final review included twenty-six RCTs, with thirty-one reports published between 2001 and 2022. Significant (p < 0·05) within-group and between-group changes in cardiometabolic outcome means were reported in twenty-three and nineteen studies, respectively. Gut microbiota composition was assessed in four studies, with two finding significant between-group differences. No significant difference between groups of any measured outcomes was observed in five studies. There were fourteen studies at low ROB; ten were of some concern; and two were at high ROB. In 73% of included studies, BFF consumption by participants with obesity, MetS or T2DM led to significant between-group improvements in discrete cardiometabolic outcomes, including fasting blood glucose, lipid profile, blood pressure, waist circumference, body fat percentage and C-reactive protein. BFF consumption increased the abundance of beneficial gut bacteria, such as Bifidobacterium and LAB, whilst reducing potential pathogens such as Bacteroides. To determine the clinical significance of BFFs as therapeutic dietary adjuncts, their safety, tolerability and affordability must be balanced with the limited power and magnitude of these preliminary findings.
Globally, the prevalence of those living with obesity (≥30 kg/m2) is rising, with this trend expected to continue if firm and decisive policy interventions are not introduced. Across Europe, despite many consecutive policies aiming to reverse rising trends in weight status over recent decades, no country is currently on track to halt and reverse current trends in the coming years. This is evident in Ireland too, whereby the reporting of nationally representative weight status data show that targets have not been achieved since reporting began. The aim of this review is to critically appraise recent evidence relating to the key determinants of obesity including weight status, diet quality and physical activity with an emphasis on socioeconomic inequalities. And to consider these in the context of respective policy measures and propose future-focused recommendations. Furthermore, as with the complex nature of obesity, multifaceted approaches that shift the focus from the individual and place responsibility at a societal level will be reviewed.
In this paper, we are concerned with the non-existence of positive solutions of a Hartree–Poisson system:
\begin{equation*}\left\{\begin{aligned}&-\Delta u=\left(\frac{1}{|x|^{n-2}}\ast v^p\right)v^{p-1},\quad u \gt 0\ \text{in} \ \mathbb{R}^{n},\\&-\Delta v=\left(\frac{1}{|x|^{n-2}}\ast u^q\right)u^{q-1},\quad v \gt 0\ \text{in} \ \mathbb{R}^{n},\end{aligned}\right.\end{equation*}
where $n \geq3$ and $\min\{p,q\} \gt 1$. We prove that the system has no positive solution under a Serrin-type condition. In addition, the system has no positive radial classical solution in a Sobolev-type subcritical case. In addition, the system has no positive solution with some integrability in this Sobolev-type subcritical case. Finally, the relation between a Liouville theorem and the estimate of boundary blowing-up rates is given.
Luchino Visconti is widely recognised as a high-culture director. However, in his films of the period 1943–63 there was a firm engagement with consumer culture and modernity in terms of themes, characters and references. This article explores this often overlooked dimension in Visconti's films by analysing a number of key sequences and moments that relate directly to consumption, consumer culture, leisure, modernity, Americanisation and youth culture. The analysis shows how these representations related to the ongoing changes in Italian postwar society and to incoming Americanisation in particular. My research is informed by the work of Gary Cross, Victoria De Grazia and Emanuela Scarpellini on consumer culture and contextualises how Visconti's referencing of consumer culture and modernity was received by the PCI (Partito Comunista Italiano or Italian Communist Party).
The most influential English translation of Henry VIII's Assertio septem sacramentorum against Martin Luther, which is still widely available online and through e-publishing, was originally printed in London in 1687. Its translator, known only by the initials ‘T. W.’ that appear on the title page, is commonly identified in library catalogues as one Thomas Webster. Closer investigation reveals this identification to be based on a series of misunderstandings. It is suggested that this Thomas Webster never existed, and that the more likely translator was the Yorkshire-born controversialist, Thomas Ward.
We explore the complexity of Sacks’ Splitting Theorem in terms of the mind change functions associated with the members of the splits. We prove that, for any c.e. set A, there are low computably enumerable sets $A_0\sqcup A_1=A$ splitting A with $A_0$ and $A_1$ both totally $\omega ^2$-c.a. in terms of the Downey–Greenberg hierarchy, and this result cannot be improved to totally $\omega $-c.a. as shown in [9]. We also show that if cone avoidance is added then there is no level below $\varepsilon _0$ which can be used to characterize the complexity of $A_1$ and $A_2$.
Pediatric patients transferred by Emergency Medical Services (EMS) from urgent care (UC) and office-based physician practices to the emergency department (ED) following activation of the 9-1-1 EMS system are an under-studied population with scarce literature regarding outcomes for these children. The objectives of this study were to describe this population, explore EMS level-of-care transport decisions, and examine ED outcomes.
Methods:
This was a retrospective review of patients zero to <15 years of age transported by EMS from UC and office-based physician practices to the ED of two pediatric receiving centers from January 2017 through December 2019. Variables included reason for transfer, level of transport, EMS interventions and medications, ED medications/labs/imaging ordered in the first hour, ED procedures, ED disposition, and demographics. Data were analyzed with descriptive statistics, X2 test, point biserial correlation, two-sample z test, Mann-Whitney U test, and 2-way ANOVA.
Results:
A total of 450 EMS transports were included in this study: 382 Advanced Life Support (ALS) runs and 68 Basic Life Support (BLS) runs. The median patient age was 2.66 years, 60.9% were male, and 60.7% had private insurance. Overall, 48.9% of patients were transported from an office-based physician practice and 25.1% were transported from UC. Almost one-half (48.7%) of ALS patients received an EMS intervention or medication, as did 4.41% of BLS patients. Respiratory distress was the most common reason for transport (46.9%). Supplemental oxygen was the most common EMS intervention and albuterol was the most administered EMS medication. There was no significant association between level of transport and ED disposition (P = .23). The in-patient admission rate for transported patients was significantly higher than the general ED admission rate (P <.001).
Conclusion:
This study demonstrates that pediatric patients transferred via EMS after activation of the 9-1-1 system from UC and medical offices are more acutely ill than the general pediatric ED population and are likely sicker than the general pediatric EMS population. Paramedics appear to be making appropriate level-of-care transport decisions.