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.
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.
Rationing and illegal food trade in Second World War Italy have received very little scholarly attention in comparison to the scale and impact they had on people's daily life. This article contributes to filling this gap, first by providing an overview of the dynamics that already in the early years of the war determined the development of an illegal system of food trade. It then considers the experience of the black market through two wartime diaries, one published and the other unpublished, written by women of opposite political views, both living in Rome and its outskirts. The analysis of the diaries considers women's attitudes towards the black market. The article argues that the Fascist propaganda of duty to the homeland, so intensively practised through domestic literature during the 1920s and 1930s, was again exploited in wartime in the discourse around the black market and hid the political responsibilities of the government.
This paper presents a kinematics modeling and hybrid motion planning framework for wheeled-legged rovers. It is a unified solution for wheeled-legged rovers to traverse multiple challenging terrains using hybrid locomotion. A kinematic model is first established to describe the rover’s motions. Then, a hybrid motion planning framework is proposed to determine the rover’s gait patterns and parameterize the legs’ and the body’s trajectories. Furthermore, an optimization algorithm based on B-spline is utilized to minimize the motors’ energy dissipation and generate smooth trajectories. The wheeled and legged hybridization allows the rover for faster locomotion while maintaining high stability. Besides, it also improves the rover’s ability to overcome obstacles. Prototype experiments are carried out in more complex environments to verify the rover’s flexibility and maneuverability to traverse irregular terrains. The proposed algorithm reduces the swing amplitude by 83.3% compared to purely legged locomotion.
Recurrent respiratory papillomatosis is a benign manifestation of human papillomavirus types 6 and 11 in the respiratory tract. Disease is recurrent, and factors predicting these recurrences and severity of disease are incompletely characterised. This retrospective cohort study examined the relationship of immunosuppression with recurrent respiratory papillomatosis morbidity.
Methods
A retrospective cohort of 97 adult patients with recurrent respiratory papillomatosis treated at a tertiary referral centre from 2005 to 2020 was conducted. Measures assessed included inter-surgical interval, Voice Handicap Index (‘VHI-10’) and anatomical Derkay scores.
Results
Bivariate analyses comparing average inter-surgical interval, Voice Handicap Index and Derkay scores in immunosuppressed and healthy patients were insignificant. When controlling for diabetes mellitus and comparing immunosuppressed to healthy patients, inter-surgical interval and Voice Handicap Index change were insignificant (p = 0.458 and p = 0.465, respectively).
Conclusion
Recurrent respiratory papillomatosis morbidity for immunosuppressed patients did not significantly differ from that of immunocompetent patients.
In the early twentieth century, economic and religious antagonism between Sinhalese and Moors in Ceylon escalated into widespread, deadly violence. In the immediate aftermath of the 1915 pogrom, which involved the targeting of Moors and their property, the Sinhalese nationalist Anagarika Dharmapala observed that ‘Muhammadans’ had accumulated wealth through ‘Shylockian methods’. Even prior to Dharmapala’s claim, Moors were repeatedly depicted as the ‘Jews of Ceylon’ by both influential Sinhalese actors and colonial state actors. As Ceylon did not have a local Jewish population, this article investigates the use of a rhetorical device that was familiar within the broader networks of empire to ‘other’ a non-Jewish mercantile minority. The article accordingly enquires into how and why antisemitic epithets came to be used in prejudicial speech against Moors. It also explores propaganda portraying Moors in terms of ‘hostile’ Jewish stereotypes and the way in which such stereotypes were deployed in Sinhalese interactions with Moors. By tracing the connections between antisemitism and anti-capitalism, this article aims to contribute to a broader discourse on the positions of Semitic groups in British imperial ideology.
What qualifies as a political event is a core question for social and historical research. This article argues that the use of temporal structures in narratives of political and social developments contributes significantly to the making and unmaking of events. We show how arguments that draw upon history play a particularly important role in transforming the everyday unfolding of politics into discernable events with a clear time bracket. Through this lens, we investigate the 2016 Brexit referendum as an event that has triggered extensive debates about both Europe’s experiences of the past and political expectations for its future. Conflicting assessments of history are crucial for understanding how and when Brexit became an event of European significance and why it then ceased to be so. This case also enables us to distinguish more clearly between the agent-centered focus on the event itself, and the analytical ex-post assessment as a critical juncture. Methodologically, the article demonstrates the value of a multi-perspective approach for qualitative analyses with a focus on Brexit narratives articulated across several EU countries and the United Kingdom.