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An example of a nonfinitely based involution monoid of order five has recently been discovered. We confirm that this example is, up to isomorphism, the unique smallest among all involution monoids.
Individuals who maintain group memberships in their community tend to experience improved well-being relative to those who participate in few or no groups. There are, however, few investigations targeting variability in the correlates of group membership across the lifespan. The present examination probed age-related variability in the association between group memberships and subjective connectedness as well as well-being. Participants included 3,940 (mean age = 45.61 years, standard deviation [SD] = 15.62) Canadian and American respondents who completed an online survey during August of 2020 (i.e., amidst the COVID-19 pandemic). Time-varying effects modelling was used to estimate coefficients for group membership at each age within the sample. Memberships in social groups positively predicted connectedness, and this association was strongest in middle-to-older age; a similar association was also evident when predicting well-being. Connectedness was also a positive predictor of well-being throughout most ages. These findings build on emerging research conveying how group memberships have significance for people currently in middle-to-older age.
This feasibility study of routine nutrition risk screening in community-dwelling older adults using a partnership between health care and community-based organizations (CBO) aimed to (1) evaluate the ability of community-based partnerships to provide screening for nutrition risk, and appropriately refer at-risk individuals for follow-up care and (2) determine the barriers to and facilitators of screening. Adults 65 years of age and older were screened by staff in two primary care and one CBO setting using the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN)-8 nutrition risk screening tool. Screeners, organization administrators, and registered dietitians responded to surveys regarding SCREEN-8 administration, referral processes, and partnership interactions. All found the SCREEN-8 initiative feasible, acceptable, and appropriate. Sustainability requires strengthening of community resources, referral processes, and telephone assessments. The partnership added value despite limitations in communications. We conclude that broader implementation of this program using community-based partnerships has the potential to aid in the prevention of malnutrition in older adults.
One of the most important developments in international law for the protection of displaced women and girls—the implied non-refoulement obligation in the Convention on the Elimination of Discrimination Against Women has received little scholarly or jurisprudential attention. This Article presents, for the first time, a doctrinal analysis of the full corpus of asylum complaints decided by the Committee on the Elimination of Discrimination Against Women (Committee). It analyzes the early development of a prohibition on return to real, personal, and foreseeable risks of serious forms of discrimination against women; highlights critical shortcomings in the Committee's asylum practice; identifies key areas for improvement; and reflects on the Committee's as-yet-unrealized potential to contribute to international law in this area.
To assess the relative risk of hospital-onset Clostridioides difficile (HO-CDI) during each month of the early coronavirus disease 2019 (COVID-19) pandemic and to compare it with historical expectation based on patient characteristics.
Design:
This study used a retrospective cohort design. We collected secondary data from the institution’s electronic health record (EHR).
Setting:
The Ohio State University Wexner Medical Center, Ohio, a large tertiary healthcare system in the Midwest.
Patients or participants:
All adult patients admitted to the inpatient setting between January 2018 and May 2021 were eligible for the study. Prisoners, children, individuals presenting with Clostridioides difficile on admission, and patients with <4 days of inpatient stay were excluded from the study.
Results:
After controlling for patient characteristics, the observed numbers of HO-CDI cases were not significantly different than expected. However, during 3 months of the pandemic period, the observed numbers of cases were significantly different from what would be expected based on patient characteristics. Of these 3 months, 2 months had more cases than expected and 1 month had fewer.
Conclusions:
Variations in HO-CDI incidence seemed to trend with COVID-19 incidence but were not fully explained by our case mix. Other factors contributing to the variability in HO-CDI incidence beyond listed patient characteristics need to be explored.
We report a case of hypoplastic left heart syndrome and with subsequent aortopathy and then found to have hereditary haemorrhagic telangiectasia/juvenile polyposis syndrome due to a germline SMAD4 pathologic variant. The patient’s staged palliation was complicated by the development of neoaortic aneurysms, arteriovenous malformations, and gastrointestinal bleeding thought to be secondary to Fontan circulation, but workup revealed a SMAD4 variant consistent with hereditary haemorrhagic telangiectasia/juvenile polyposis syndrome. This case underscores the importance of genetic modifiers in CHD, especially those with Fontan physiology.
The indications for and approaches to extracapsular dissection for parotid gland benign tumours are debated in the literature. This study retrospectively evaluates a single site's short- and long-term results with a standardised extracapsular dissection approach to benign parotid tumours.
Methods
A retrospective review of a single institution's records identified cases with extracapsular dissection as the primary surgery for non-recurrent benign parotid tumours. A total of 194 eligible patients were identified (124 women and 70 men, age 47.75 ± 15.62 years). Pre-, intra- and post-surgical data were reviewed for complications and recurrences.
Results
Histology reported pleomorphic adenoma in 165 patients, Warthin's tumour in 28 patients and both in one patient. Mean follow up was 36 ± 16 months (range, 12–84 months). The incidences of complications following extracapsular dissection were temporary (n = 13) and permanent (n = 0) facial nerve dysfunction, Frey's syndrome (n = 1)) and recurrences (n = 5). These rates align with prior literature.
Conclusion
This case series shows how a standardised approach to extracapsular dissection for benign parotid tumours yields favourable results, supporting a progressive change of strategy towards reduced invasiveness.
Obesity is associated with low vitamin D status, and the optimal supplement and dosage of cholecalciferol (vitamin D3) or calcidiol (25OHD) for individuals with obesity have been debated. We aimed to determine the effect of high-dose vitamin D3 supplementation on achieving adequate vitamin D levels among infertile men with normal weight v. obesity. Here, we present secondary end points from a single-centre, double-blinded, randomised clinical trial, comprising 307 infertile men randomised to active or placebo treatment for 150 days. Men in the active group initially received an oral bolus of 300 000 mg of vitamin D3, followed by daily supplementation with 1400 mg of vitamin D3 and 500 mg of calcium. Baseline BMI was listed as a predefined subgroup. At baseline, serum 25OHD was significantly higher in men with normal weight (BMI < 25 kg/m2) compared with men with overweight (BMI 25–30 kg/m2) and obesity (BMI > 30 kg/m2) (48 nmol/l v. 45 nmol/l and 39 nmol/l, respectively; P = 0·024). After the intervention, men with normal weight, overweight and obesity treated with vitamin D3 had a significantly higher serum 25OHD compared with corresponding placebo-treated men (BMI < 25 kg/m2: 92 nmol/l v. 53 nmol/l, BMI = 25–30 kg/m2: 87 nmol/l v. 49 nmol/l and BMI > 30 kg/m2: 85 nmol/l v. 48 nmol/l; P < 0·001 for all, respectively). In conclusion, we show that high-dose vitamin D3 supplementation to infertile men with obesity and low vitamin D status is sufficient to achieve adequate serum 25OHD levels.
Urban green spaces are primarily recognized for their ability to provide opportunities for recreational activities. However, these spaces also offer a broader range of ecosystem services and benefits, which are often overlooked by city inhabitants and the government. This paper utilizes choice experiments to estimate the benefits derived from ecosystem services provided by undeveloped natural areas and urban parks in San José, Costa Rica. We evaluate three ecosystem services provided by undeveloped natural areas, namely habitats for animals and plants, hydrological control, and recreation. Additionally, we estimate the benefits derived from the restoration and construction of three types of urban parks: neighborhood, metropolitan, and central district parks. The results demonstrate that individuals place significant value on the restoration of undeveloped natural areas and urban parks. The findings also indicate variations in the valuation of ecosystem services between undeveloped natural areas and different park types, as well as among households.
The aim of this communication was to introduce a novel combined image (magnetic resonance and computed tomography-guided and sialendoscopy-assisted transoral approach for the treatment of a parotid duct stenosis with megaduct.
Methods
A 46-year-old woman was referred to our department for recurrent infections of the right parotid gland following unsuccessful multiple transoral surgical approaches for a Stensen's duct stricture with megaduct. An image (magnetic resonance and computed tomography)-guided and sialendoscopy-assisted transoral sialodochoplasty was planned and performed.
Results
No complications occurred. The patient was discharged 2 days after surgery. No more swelling or infections occurred. The patient is currently symptom-free after a follow up of 11 months.
Conclusion
Although imaging navigation means more technical effort and costs, this novel approach can be considered a viable surgical opportunity for distal and mid-third parotid duct stenosis with concomitant megaduct, particularly in cases of persistent inflammation or iatrogenic scars due to previous surgery.
By providing fresh insights into the development of Egyptian corporate networks and business groups between the early 1920s and late 1940s, this article extends the geographical ambit of an expanding field of study. Data from contemporaneous sources were analyzed through social network analysis techniques, in the search for an improved understanding of both the nature of and motivations behind networking in Egypt. In conducting this exercise, this article assesses the success with which the state acted to stimulate local entrepreneurship in its search for greater economic independence. By linking the Egyptian case to a wider literature on corporate networks, the article reveals similarities with other cases of how developing economies responded to the challenges of that era.
In this paper, an adaptive backstepping controller of hypersonic flight vehicle (HFV) system is investigated in the presence of unknown actuator and sensor faults, unknown control direction and varying external disturbance, which expands traditional fault-tolerant control (FTC) approaches in HFV field. The control-oriented model is established with reasonable and comprehensive analysis of various fault types. Compared with the previous FTC research on HFV system, the time-varying and fixed fault types are simultaneously designed for actuator and sensors, and the control direction is unknown, which can more accurately simulate the real fault situations in the hypersonic flight environment. To avoid singularity problems caused by the unknown control direction, the Nussbaum gain function technique is adopted in the control algorithm, which is also capable of overcoming the influence of unknown time-varying fault parameters. The boundness and stability of system under the designed control scheme are theoretically verified. Finally, numerical simulation results demonstrate the effectiveness and superiority of the proposed control strategy.