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Non-fatal strangulation as a consequence of a sexual assault attack or domestic violence represents serious bodily harm. Otolaryngologists have an important role in documenting physical findings and managing airway symptoms. This study aimed to describe our otolaryngology department's experience managing patients referred from the sexual assault referral centre who suffered non-fatal strangulation.
Method
A retrospective analysis of patients suffering non-fatal strangulation referred to the Manchester University Hospitals NHS Foundation Trust Otolaryngology Department from Saint Mary's Sexual Assault Referral Centre in Manchester between 1 January 2017 and 31 December 2019 was carried out.
Results
A total of 86 patients were referred from Saint Mary's Sexual Assault Referral Centre. Of these patients, 56 were given telephone advice and the remaining 30 were seen by the on-call otolaryngology team. In addition, 20 out of 30 (66.6 per cent) patients underwent fibre-optic nasal endoscopy. Common presenting symptoms were neck pain (81.4 per cent), dyspnoea (80.2 per cent) and dizziness (72.1 per cent). Five patients had identifiable laryngeal injury on endoscopy.
Conclusion
Meticulous documentation is recommended when managing patients who suffer non-fatal strangulation because medical records may be used as evidence in criminal investigations.
Economists have reported results based on populations for every country in the world for the past two thousand years. The source, McEvedy and Jones’ Atlas of World Population History, includes many estimates that are little more than guesses and that do not reflect research since 1978. McEvedy and Jones often infer population sizes from their view of a particular economy, making their estimates poor proxies for economic growth. Their rounding means their measurement error is not “classical.” Some economists augment that error by disaggregating regions in unfounded ways. Econometric results that rest on McEvedy and Jones are unreliable.
“… we haven’t just pulled the figures out of the sky. Well, not often.”
The effects of apparatus-induced dispersion on nonuniform, density-dependent flow in a cylindrical soil column were investigated using a finite-element model. To validate the model, the results with an analytical solution and laboratory column test data were analysed. The model simulations confirmed that flow nonuniformities induced by the apparatus are dissipated within the column when the distance to the apparatus outlet exceeds $3R/2$, where R represents the radius of the cylindrical column. Furthermore, the simulations revealed that convergent flow in the vicinity of the outlet introduces additional hydrodynamic dispersion in the soil column apparatus. However, this effect is minimal in the region where the column height exceeds $3R/2$. Additionally, it is found that an increase in the solution density gradient during the solute breakthrough period led to a decrease in flow velocity, which stabilized the flow and ultimately reduced dispersive mixing. Overall, this study provides insights into the behaviour of apparatus-induced dispersion in nonuniform, density-dependent flow within a cylindrical soil column, shedding light on the dynamics and mitigation of flow nonuniformities and dispersive mixing phenomena.
Private ‘bottom-up’ enforcement has been central to the efforts of the European Union (EU) to promote effective compliance with its ambitious environmental laws. This approach is strengthened by the EU's implementation of the Aarhus Convention, which aims to democratize environmental enforcement by conferring citizens and environmental non-governmental organizations (ENGOs) with legal rights of access to environmental information, rights of public participation, and rights of access to justice (the so-called ‘Aarhus mechanisms’). This article empirically assesses the extent to which the Aarhus mechanisms empower ENGOs to take an active role in the private enforcement of the EU Habitats and Birds Directives. Based on 75 surveys and 30 interviews with ENGOs from three Member States (France, Ireland, the Netherlands), we apply regulatory intermediary theory to show how European ENGOs play a vital role in intermediating between (i) EU Member States and their citizens, (ii) the EU and individual citizens, and even (iii) the EU and its Member States. We bring new empirical insights into the role of law as an enabler of regulatory intermediaries, and its potential as a tool for orchestrating regulatory intermediaries.
Semantic tool knowledge underlies the ability to perform activities of daily living. Models of apraxia have emphasized the role of functional knowledge about the action performed with tools (e.g., a hammer and a mallet allow a “hammering” action), and contextual knowledge informing individuals about where to find tools in the social space (e.g., a hammer and a mallet can be found in a workshop). The goal of this study was to test whether contextual or functional knowledge, would be central in the organization of tool knowledge. It was assumed that contextual knowledge would be more salient than functional knowledge for healthy controls and that patients with dementia would show impaired contextual knowledge.
Methods:
We created an original, open-ended categorization task with ambiguity, in which the same familiar tools could be matched on either contextual or functional criteria.
Results:
In our findings, healthy controls prioritized a contextual, over a functional criterion. Patients with dementia had normal visual categorization skills (as demonstrated by an original picture categorization task), yet they made less contextual, but more functional associations than healthy controls.
Conclusion:
The findings support a dissociation between functional knowledge (“what for”) on the one hand, and contextual knowledge (“where”) on the other hand. While functional knowledge may be distributed across semantic and action-related factors, contextual knowledge may actually be the name of higher-order social norms applied to tool knowledge. These findings may encourage researchers to test both functional and contextual knowledge to diagnose semantic deficits and to use open-ended categorization tests.
In this paper, we give necessary conditions for an $N$-expansive homeomorphism of a compact metric space to be nonchaotic in the Li–Yorke sense. As application we give a partial answer to a conjecture in [2].
Aging plays a crucial role in the mechanisms of the impacts of genetic and environmental factors on blood pressure and serum lipids. However, to our knowledge, how the influence of genetic and environmental factors on the correlation between blood pressure and serum lipids changes with age remains to be determined. In this study, data from the Chinese National Twin Registry (CNTR) were used. Resting blood pressure, including systolic and diastolic blood pressure (SBP and DBP), and fasting serum lipids, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TGs) were measured in 2378 participants (1189 twin pairs). Univariate and bivariate structural equation models examined the genetic and environmental influences on blood pressure and serum lipids among three age groups. All phenotypes showed moderate to high heritability (0.37–0.59) and moderate unique environmental variance (0.30–0.44). The heritability of all phenotypes showed a decreasing trend with age. Among all phenotypes, SBP and DBP showed a significant monotonic decreasing trend. For phenotype-phenotype pairs, the phenotypic correlation (Rph) of each pair ranged from −0.04 to 0.23, and the additive genetic correlation (Ra) ranged from 0.00 to 0.36. For TC&SBP, TC&DBP, TG&SBP and TGs&DBP, both the Rph and Ra declined with age, and the Ra difference between the young group and the older adult group is statistically significant (p < .05). The unique environmental correlation (Re) of each pair did not follow any pattern with age and remained relatively stable with age. In summary, we observed that the heritability of blood pressure was affected by age. Moreover, blood pressure and serum lipids shared common genetic backgrounds, and age had an impact on the phenotypic correlation and genetic correlations.
This essay takes a close look at Maura Dykstra's monograph Uncertainty in the Empire of Routine (Harvard Asia Center, 2022). It analyzes the book's multitude of problems, such as its flawed conception, numerous factual blunders, failure to engage existing scholarship, problematic choice of primary sources, and dubious citation practices. Most significantly, this essay aims to provide ample evidence to demonstrate how the book systematically misrepresents the majority of its primary sources to support an untenable thesis. It argues that the book's central claims are ungrounded in evidence.
To investigate the effects of combination therapy with and without batroxobin, and the frequency of batroxobin use on the prognosis of profound sudden sensorineural hearing loss.
Methods
Hearing recovery in the batroxobin group (231 patients) and non-batroxobin group (56 patients) was compared. The correlation between the number of times batroxobin was used and hearing recovery was analysed.
Results
The decrease in hearing threshold and overall improvement rate in the batroxobin group with hearing loss exceeding 100 dB HL was significantly higher than that in the non-batroxobin group. There was no linear correlation between the number of times batroxobin was used and the overall improvement rate. Using batroxobin two to three times achieved a therapeutic effectiveness plateau.
Conclusion
Batroxobin can improve the efficacy of combination therapy for profound sudden sensorineural hearing loss exceeding 100 dB HL, and using batroxobin two to three times yields the maximum overall improvement rate.
This article draws on status characteristics theory to explore the mechanisms of individual-level boundary-spanning behavior on employee creative performance, as well as the mediating role of informal status and the moderating role of Zhongyong thinking. The results of a two-wave questionnaire survey of 202 employees show that boundary-spanning behavior has a significant positive relationship with employees’ creative performance, informal status mediates the link between boundary-spanning behavior and creative performance of this employee, Zhongyong thinking plays a moderating role between employees’ boundary-spanning behavior and their informal status, and Zhongyong thinking also moderates the mediating role of informal status between boundary-spanning behavior and employee creative performance. In this paper, a moderated mediation model is established to enhance the understanding of the effects and mechanisms of individual boundary-spanning behavior, as well as to provide some constructive insight into how boundary-spanning behavior can be effectively employed in management practice within the Chinese context.