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The presence of nodal disease at presentation of a head and neck mucosal-based squamous cell carcinoma has a significant impact upon outcomes.
Methods
This is a retrospective, ethics-approved study in which patients with squamous cell carcinoma of the larynx, oropharynx, hypopharynx and oral cavity were reviewed and compared with respect to nodal disease (N0 vs N1–N2 vs N3). Patient, disease and treatment parameters were evaluated with ultimate local control, regional control, cancer-specific survival and overall survival investigated.
Results
In the cohort of 1265 patients, 764 presented with nodal disease (N3 = 60). The majority of the N3 group had oropharynx squamous cell carcinoma (52%) and experienced worse ultimate local control (63%; p < 0.001), regional control (67%; p < 0.001) and both squamous cell carcinoma and overall survival (log rank p < 0.001).
Conclusion
Patients presenting with N3 nodal disease had poor regional control, a lower cancer-specific survival and a worse overall survival compared to patients with lesser to no nodal disease.
Through the colonial period in Sāmoa, Christian morality was embedded into Samoan culture. This transformed gender relations, introducing a new, well-disciplined figure of the Samoan woman. Because of this shift, we argue for the need to develop Samoan feminist thought, which is as much a development of new thinking as it is a return to and restoration of Samoan feminist thought already in existence within Indigenous Samoan cosmologies. We contextualize this thinking within a coalition of Pacific, Indigenous, Black, and women of color feminist thinkers. As feminist scholars have established, feminism doesn’t resonate or work with a simple copy and paste to culture and context. Rather, feminisms are contextual and subjective. It is thus imperative that those from within various contexts continue to broaden understandings and conceptualizations of feminism/s, which work toward demarcating spaces for feminist thought that illuminates multiple, diverse, and intersecting subjectivities and positionalities. As such, the task for us as Samoan women, people, and communities is to develop a feminist space that encompasses and fosters a by-us, for-us, with-us approach that challenges coloniality in Sāmoa and articulates feminist possibilities and futures.
In 2017, the European Union Emissions Trading System underwent a policy intervention that resulted in a surge in carbon prices. Using this setting as a quasi-natural experiment, we focus on employment, productivity, and emission outcomes among covered enterprises. Results show that emission-intensive private firms, particularly those with financial constraints, are more likely to downsize by divesting production assets, reducing both workforce and emissions. Smaller, cash-strapped listed firms are also prone to downsize by decreasing their operating leverage while maintaining emission output and asset levels. Positive productivity outcomes indicate that both private and listed firms become leaner postintervention.
Late-life affective disorders (LLADs) are common and are projected to increase by 2050. There have been several studies linking late-life depression to an increased risk of dementia, but it is unclear if bipolar affective disorder or anxiety disorders pose a similar risk.
Aims
We aimed to compare the risk of LLADs progressing to all-cause dementia, and the demographic and clinical variables mediating the risk.
Methods
We used the South London and Maudsley National Health Service Foundation Trust Clinical Records Interactive Search system to identify patients aged 60 years or older with a diagnosis of any affective disorder. Cox proportional hazard models were used to determine differences in dementia risk between late-life anxiety disorders versus late-life depression, and late-life bipolar disorder versus late-life depression. Demographic and clinical characteristics associated with the risk of dementia were investigated.
Results
Some 5695 patients were identified and included in the final analysis. Of these, 388 had a diagnosis of bipolar affective disorder, 1365 had a diagnosis of an anxiety disorder and 3942 had a diagnosis of a depressive disorder. Bipolar affective disorder was associated with a lower hazard of developing dementia compared to depression (adjusted model including demographics and baseline cognition, hazard ratio: 0.60; 95% CI: 0.41–0.87). Anxiety disorders had a similar hazard of developing dementia (adjusted hazard ratio: 1.05; 95% CI: 0.90–1.22). A prior history of a depressive disorder reduced the risk of late-life depression progressing to dementia – suggesting the new onset of a depressive disorder in later life is associated with higher risk – but a prior history of anxiety disorders or bipolar affective disorder did not alter risk.
Conclusions
LLADs have a differential risk of developing all-cause dementia, with demographic- and illness-related factors influencing the risk. Further prospective cohort studies are needed to explore the link between LLADs and dementia development, and mediators of the lower risk of dementia associated with late-life bipolar disorder compared to late-life depression.
To explore methods for accurate diagnosis and effective treatment of otomycosis.
Methods
Using randomised stratification, eligible patients were split into a patient-applied medication group and a physician-applied medication group in order to compare the efficacy and recurrence rates of two treatment approaches.
Results
The primary symptom of otomycosis was ear blockage (35.2 per cent), followed by pruritis (26.7 per cent) and otorrhea (13.6 per cent). Predominant fungi were Aspergillus terreus (50.5 per cent), Candida parapsilosis (15.5 per cent) and Aspergillus niger (12.5 per cent). The treatment efficacy was 44.7 per cent (34/76) for the patient-applied medication group and 98.6 per cent (71/72) for the physician-applied medication group, with the difference being statistically significant (χ2 = 52.061, p <0.01). The recurrence rate was 35.3 per cent (12/34) for the patient-applied group and 2.8 per cent (2/71) for the physician-applied medication group, also showing a statistically significant difference (p <0.01).
Conclusion
Triamcinolone acetonide econazole cream application by a physician every 2–3 days, three times, effectively cures otomycosis and lowers recurrence.
Using clean numerical simulation (CNS) in which artificial numerical noise is negligible over a finite, sufficiently long interval of time, we provide evidence, for the first time, that artificial numerical noise in direct numerical simulation (DNS) of turbulence is approximately equivalent to thermal fluctuation and/or stochastic environmental noise. This confers physical significance on the artificial numerical noise of DNS of the Navier–Stokes equations. As a result, DNS on a fine mesh should correspond to turbulence under small internal/external physical disturbance, whereas DNS on a sparse mesh corresponds to turbulent flow under large physical disturbance. The key point is that all of them have physical meanings and so are correct in terms of their deterministic physics, even if their statistics are quite different. This is illustrated herein. Our paper provides a positive viewpoint regarding the presence of artificial numerical noise in DNS.
The facilities where the livestock carry their production cycle must have as their main characteristic the control of the influence of variation of environmental factors on the animals, which can be controlled through the use of different ventilation systems. In this way, the objective of this research was to evaluate the influence of different conditioning systems in the swine farrowing house. Three treatments were tested in a farrowing house located in Parana, Brazil: refrigerated ventilation (T1), forced ventilation (T2) and natural ventilation (T3), on 12 females with 11 piglets each. The climatic parameters evaluated were temperature, velocity and relative humidity of the air. For the females were analysed the parameters: surface temperature (laser thermometer and thermal image), average weight and feed conversion at the end of lactation; and for the piglets: surface temperature (thermal image), average weight and weekly feed conversion. The data were interpreted statistically by analysis of variance and Tukey’s test with 5% probability of error, using the program SAS (2008). The use of the refrigerated ventilation system decreased the temperature of the air and the superficial temperature of the females, without affecting the comfort of the piglets. There was no difference in the productive indexes of the animals, thus other aspects of the production chain could be explored to reflect a higher financial gain.
During the COVID-19 pandemic, Chile enacted three exceptional laws allowing withdrawals from affiliates’ pension accounts. We analyze how these withdrawals affected pension savings and the projected retirement income of affiliates and their households, finding that lower-income households withdrew a higher percentage of their savings. Simulations of worker contributions until retirement show an average reduction of 21% in contributory pensions, but increased non-contributory pension benefits reduce the average total income loss to 8%. Under a no-reform scenario, these withdrawals and higher non-contributory pensions may imply fiscal costs around 15.8% of the pre-pandemic gross domestic product (GDP). The current pension reform should reduce it to 12.4% of pre-pandemic GDP.
Consider, for any integer $n\ge 3$, the set $\operatorname {\mathrm {Pos}}_n$ of all n-periodic tree patterns with positive topological entropy and the set $\operatorname {\mathrm {Irr}}_n\subset \operatorname {\mathrm {Pos}}_n$ of all n-periodic irreducible tree patterns. The aim of this paper is to determine the elements of minimum entropy in the families $\operatorname {\mathrm {Pos}}_n$, $\operatorname {\mathrm {Irr}}_n$ and $\operatorname {\mathrm {Pos}}_n\setminus \operatorname {\mathrm {Irr}}_n$. Let $\unicode{x3bb} _n$ be the unique real root of the polynomial $x^n-2x-1$ in $(1,+\infty )$. We explicitly construct an irreducible n-periodic tree pattern $\mathcal {Q}_n$ whose entropy is $\log (\unicode{x3bb} _n)$. We prove that this entropy is minimum in $\operatorname {\mathrm {Pos}}_n$. Since the pattern $\mathcal {Q}_n$ is irreducible, $\mathcal {Q}_n$ also minimizes the entropy in the family $\operatorname {\mathrm {Irr}}_n$. We also prove that the minimum positive entropy in the set $\operatorname {\mathrm {Pos}}_n\setminus \operatorname {\mathrm {Irr}}_n$ (which is non-empty only for composite integers $n\ge 6$) is $\log (\unicode{x3bb} _{n/p})/p$, where p is the least prime factor of n.
In this paper, a polarization-reconfigurable antenna fed by a coplanar waveguide (CPW) using a stepped structure is presented. The main parts of the proposed antenna consist of a CPW-fed monopole and four branches. After studying and analyzing the structure and mechanism of the antenna, it was found that different polarizations can be generated by adjusting the antenna’s structure. Based on the mechanism, four PIN diodes are utilized and inserted between the four branches and the monopole for the switching. By controlling the ON/OFF states of the four PIN diodes, the antenna can switch among left-hand circular polarization (LHCP), right-hand circular polarization (RHCP), and linear polarization (LP). The optimized antenna has been fabricated and measured. Measured results indicate that the antenna’s −10-dB impedance bandwidth for LP is 15.93%, covering the frequency range from 2.3 to 2.71 GHz. The overlap bandwidth of −10-dB impedance and 3-dB axial ratio for the LHCP mode is 18.96%, covering frequencies from 2.1 to 2.54 GHz. For the RHCP mode, the overlap bandwidth is 20.5%, covering frequencies from 2 to 2.52 GHz. At all the three polarization modes, the antenna is capable of covering the 2.4-GHz WLAN band (2400–2480 MHz) as well as the LTE TD 2300 band (2300–2400 MHz).
There has been a growing emphasis on researching foreign language boredom in second language acquisition in recent years. However, existing research has yet to reach a consensus regarding the effect of foreign language boredom on learners’ learning achievement. To address this gap, the present study employs multilevel meta-analysis to analyze 47 effect sizes from 33 empirical studies involving a total sample size of 27,838 participants. The findings reveal that foreign language boredom illustrates a small negative effect (r = -.24, p < .001) on language achievement. Furthermore, the moderation analysis reveals that the magnitude of the effect size varies crossing educational stages, achievement measurements, domain-specific language skills, foreign language boredom measurements, teaching modes, and learning contexts. This study provides robust evidence to support the detrimental role of foreign language boredom in language acquisition and identified substantive gaps in this research field, offering valuable directions for future research.
Changing sea-ice conditions have significant societal impacts and implications across Alaska and the Arctic. This research examined the relationship between sea ice and extreme weather events with socio-economic impacts in Nome, Alaska (1990–2020), a community that has experienced notable changes in sea ice and impacts from extreme weather events. The research is based on the analysis of sea-ice concentrations from passive microwave data, socio-economic impacts of extreme weather events from an archival analysis of newspaper coverage, and an examination of the relationship between sea-ice concentrations and impacts. We found that sea-ice concentrations at the time of the reported socio-economic impacts were all characterised by ice-free conditions. Additionally, extreme events linked to socio-economic impacts occurred when sea-ice concentrations were at or below their historical (1979–2000) median for the day. Key implications for the observed increased probability of ice-free conditions in the autumn include a greater likelihood that a given coastal storm from November to mid-December may contribute to socio-economic impacts, which may have been mitigated by sea ice in the past, as well as an increased potential for impacts to occur when they have previously not been experienced.
Using household survey data linked to supervisory data of Dutch pension funds, we provide evidence of the increase in household savings caused by shocks to the financial position of pension funds. Our identification strategy exploits cross-sectional and time variations in pension funds’ funding ratios, which result from asset allocations and price corrections outside the control of fund members. The findings reveal that fluctuations in funding ratios significantly impact household savings, with a displacement effect above 40 percent. Lower funding ratios are associated with higher voluntary savings, driven primarily by members of pension funds with lower historical returns. Unlike earlier studies, this paper covers a long time span including three major economic crises, providing novel insights into the interaction between pension fund stability and individual saving behaviour.
In the Caribbean Sea, orcas (Orcinus orca, also known as killer whales) are present throughout the year. The most recent review confirmed seven strandings of the species in the Caribbean Sea in the period May 1851 to January 2023, all of which were single strandings and only one of which occurred in Venezuela. In this publication we document the circumstances of the successful rescue, by local fishers and authorities, of seven orcas that stranded in August 2023 on the coast of the State of Sucre, north-eastern Venezuela. Worldwide, this is only the second mass stranding of the species within the tropics (23.5°N to 23.5°S). We also documented the presence of a probable whalesucker (Remora australis) on a juvenile orca. The present case represents the first mass stranding event of orcas in Venezuela and the Caribbean Sea and only the second in a tropical location worldwide.
This study aimed to examine health care workers’ (HCWs) perceptions of hospital disaster planning and preparedness within the context of building resilient health care systems. It also evaluated HCWs’ involvement in the planning process.
Methods
Thirteen HCWs from 2 Queensland hospitals participated in in-depth, semi-structured interviews. These interviews were audio-recorded with participant consent and transcribed verbatim. Transcripts, recordings, and participant details were coded for confidentiality. Thematic analysis was used to identify essential patterns in the data and make sense of them.
Results
HCWs’ perspectives on disaster planning underscored the importance of comprehensive planning, business continuity, proactive approaches emphasizing anticipation and risk mitigation, and implementation of established plans through training, resource management, and operational readiness. HCWs’ participation in planning ranged from high engagement through collaboration and continuous improvement to moderate or lower levels focusing on regulatory compliance and resource allocation.
Conclusions
This study highlights HCWs’ views regarding disaster planning and preparedness for building resilient health care systems. HCWs emphasised comprehensive planning and proactive preparedness, aligning with global priorities for disaster risk reduction. They stress the importance of education, training, operational readiness, and continuous improvement. This study underlines the vital role of HCWs’ participation in disaster planning and the need for comprehensive training initiatives.
Inflammation and oxidative stress contribute to the progression of chronic diseases, and the volume of research in this area is rapidly expanding. Various dietary indices have been developed to determine the overall inflammatory or oxidative stress potential of a diet; however, few have been validated in cardiometabolic disease populations. This review aimed to explore the association between dietary indices and biomarkers of inflammation and oxidative stress in adults with cardiometabolic conditions. Four databases were systematically searched for literature in any language (Embase, CINAHL, CENTRAL and MEDLINE) with 12,286 deduplicated records identified. Seventeen studies of adults with metabolic syndrome, cardiovascular disease, type 2 diabetes, non-alcoholic fatty liver disease or chronic kidney disease were included. Fourteen studies were observational studies, one study was a clinical trial, and one was a randomised controlled trial. Four dietary indices were reported on with most studies (n 11) reporting on the dietary inflammatory index. The most reported biomarker was C-reactive protein. The findings were narratively synthesised. Results were inconclusive due to the heterogeneity of dietary indices and their use, disease states and biomarkers reported. Only one study reporting on the dietary inflammatory index assessed all 45 parameters. Observational studies, particularly retrospective designs (n 7), are subject to recall and selection biases, potentially presenting overestimated results. Further research is required to determine the relationship between dietary indices and biomarkers of inflammation and oxidative stress in cardiometabolic disease populations. Future research should be prospective, utilise rigorous research methods, assess the full range of index parameters, and examine biomarkers the tool was developed for.
In this paper, we establish suitable characterisations for a pair of functions $(W(x),H(x))$ on a bounded, connected domain $\Omega \subset \mathbb{R}^n$ in order to have the following Hardy inequality:
where d(x) is a suitable quasi-norm (gauge), $|\xi|^2_A = \langle A(x)\xi, \xi \rangle$ for $\xi \in \mathbb{R}^n$ and A(x) is an n × n symmetric, uniformly positive definite matrix defined on a bounded domain $\Omega \subset \mathbb{R}^n$. We also give its Lp analogue. As a consequence, we present examples for a standard Laplacian on $\mathbb{R}^n$, Baouendi–Grushin operator, and sub-Laplacians on the Heisenberg group, the Engel group and the Cartan group. Those kind of characterisations for a pair of functions $(W(x),H(x))$ are obtained also for the Rellich inequality. These results answer the open problems of Ghoussoub-Moradifam [16].