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There is currently no established normative data for cardiopulmonary exercise parameters in the semi-supine position. There is conflicting data regarding the impact of a semi-supine body position on the semi-supine recumbent ergometer on cardiopulmonary exercise parameters. The goal of the current study was to match semi-supine recumbent ergometer tests completed in children/adolescents with those completed on the cycle ergometer and treadmill to identify differences in cardiopulmonary exercise parameters between devices.
Methods:
Maximal semi-supine recumbent ergometer tests were matched by demographics (age, race/ethnicity, sex, height, weight, and body mass index) to tests completed on the cycle ergometer and treadmill. Groups were compared with two-sample T-tests for numeric variables and Fisher’s exact tests for categorical variables.
Results:
There was no difference in demographics between groups. Peak cardiopulmonary exercise parameters (watts, oxygen consumption, heart rate, blood pressure, oxygen saturation, minute ventilation, respiratory exchange ratio, respiratory rate, and anaerobic threshold) were unchanged between semi-supine recumbent ergometer and cycle ergometer, but the ventilatory equivalent of carbon dioxide was higher on the cycle ergometer versus semi-supine recumbent ergometer. Anaerobic threshold, peak oxygen consumption, and peak minute ventilation were lower on the semi-supine recumbent ergometer than on the treadmill.
Conclusions:
The uniformity in nearly all cardiopulmonary exercise parameters between the semi-supine recumbent ergometer and cycle ergometer suggests that normative data for the cycle ergometer are a reasonable surrogate for normative data on the semi-supine recumbent ergometer until semi-supine recumbent ergometer-specific normative data are developed.
In this paper, we study the quantitative recurrence properties in the case of $\mathbb {Z}$-extension of Axiom A flows on a Riemannian manifold. We study the asymptotic behavior of the first return time to a small neighborhood of the starting point. We establish results of almost everywhere convergence, and of convergence in distribution with respect to any probability measure absolutely continuous with respect to the infinite invariant measure. In particular, our results apply to geodesic flows on the $\mathbb {Z}$-cover of compact smooth surfaces of negative curvature.
This article explores the early development of Japan’s recording industry, focusing on locally driven “minor transnational engagements” between emerging Japanese record companies and foreign recording experts. The initial phase of Japan’s recording history mirrored the pattern in most countries from the early 1900s, with major record companies organizing international recording expeditions equipped with new acoustic disc recording technology. However, it was homegrown firms in the 1910s, especially the Nipponophone Company (Nihon Chikuonki Shōkai 日本蓄音器商會), that positioned themselves as the main producers of Japanese titles and gramophones. In the second half of the 1920s, the industry evolved further with the introduction of electrical recording technology, and Japanese record companies embraced it by partnering with international labels to establish multinational ventures. With a focus on the acoustic recording era of the 1910s and early 1920s, this article investigates Nipponophone’s recruitment of foreign recording experts, who not only shared their technical knowledge but also served as strategic conduits for expanding the company’s presence across regional and international markets. Nipponophone and other domestic record companies grew through expert collaborations and secondhand emulation. Their efforts, rather than global campaigns led by the multinational major labels, played a decisive role in shaping Japan’s early recording industry.
During the Imjin War (1592–1598), a new type of warfare centered on the harquebus was introduced into Korea. This led to the formation of a new infantry-based military composed largely of harquebusiers. Existing scholarship on the military change of Korea in this period has primarily focused on the emergence of the standing army. However, most of the troops were militiamen, similar to those of the prewar military. This article examines the broader contours of Korea’s military organization during this transformative period, with particular attention to the composition and roles of the forces. To be sure, a new standing army unit was organized, but its proportion was small both in absolute numbers and in participation in actual warfare. Instead, the militia continued to constitute the core of the Korean military and carried out the majority of wartime operations. The Korean court did not intend to raise a standing army as the new center of military power. This was due to its strong ideological commitment to the militia system and the actual military environment that Korea was facing. The Korean case presents a distinctive example of how the introduction of harquebus could coexist with the persistence of militia-based military structures.
Triplet pregnancies are linked to a higher risk of maternal and fetal complications compared to twins and singletons. Chorionicity has been suggested as a key factor influencing perinatal and maternal outcomes in triplet pregnancies; however, more evidence is needed to clarify its role. This study aimed to assess the impact of chorionicity on adverse maternal, fetal, and neonatal outcomes in triplet pregnancies. This retrospective observational study was conducted on triplet pregnancies delivered between 2010 and 2025 at Florence University Hospital, a tertiary referral maternity center. A total of 77 triplet pregnancies were included, 51 trichorionic and 26 nontrichorionic, resulting in the delivery of 214 newborns. Maternal characteristics and obstetric, fetal, and neonatal complications were compared based on chorionicity. Multivariate logistic regression analyses identified complications most strongly associated with chorionicity, after adjusting for maternal age, mode of conception, and gestational age at delivery. Women with nontrichorionic triplet pregnancies had higher risks of delivering earlier and postpartum hemorrhage. Their newborns had significantly lower birth weights, a greater need for neonatal intensive care admission and respiratory support, and higher rates of hypoglycemia and sepsis. The multivariate logistic regression confirmed nontrichorionicity as an independent factor associated with earlier delivery and postpartum hemorrhage. Chorionicity plays an essential role in determining the prognosis of triplet pregnancies. Nontrichorionic pregnancies are strongly linked to earlier delivery, lower birth weights, and increased neonatal complications. These findings are useful for counseling patients, helping them understand specific risks based on chorionicity, although intensive prenatal care remains critical for all triplet pregnancies.
A critical step toward determining eligibility for experimental and clinical treatment with anti-amyloid therapies in Alzheimer’s disease (AD) is to select appropriate subjects having a high likelihood of being Aβ+. We propose a clinical biomarker composite score, named Clinical β-Amyloid Positivity Prediction Score Plus (CAPS Plus), for Aβ+ prediction in people presenting with clinical Alzheimer’s syndrome including both prodromal and mild AD.
Methods:
The original CAPS incorporated scores from the neuropsychiatry inventory questionnaire, mini-mental state examination score loss per year and Fazekas score. Plasma p-tau-217, a novel addition to CAPS, was measured using the Simoa HD-X with the AlzPATH p-tau217 Advantage Plus assay. To incorporate p-tau-217 into CAPS Plus, an intra-cohort cut-off (>0.698 pg/ml) for p-tau217 was generated using logistic regression and Yoden’s index. CAPS Plus had a maximum score of 5, with those ≥4 indicating a high probability of being Aβ+. The accuracy of CAPS Plus was computed through logistic regression and area under the receiver operating characteristic curve (AUROC) analysis.
Results:
Of n = 44 patients, n = 25 (57%) were Aβ+. Plasma p-tau-217 was significantly higher in the Aβ+ subgroup (1.36 vs 0.46 pg/mL, p < 0.0001). The AUROC was 0.89 for a CAPS Plus score of 4 or more, suggesting excellent discrimination and improving the accuracy of the original CAPS (0.86). CAPS Plus has a notably better specificity (89%) than the original CAPS (80%) and p-tau-217 alone (74%).
Conclusion:
CAPS Plus is potentially a useful screening tool for enrollment in anti-Aβ therapy and clinical trials for AD, specifically addressing people with prodromal and mild AD.
This article examines the lexicon for “gift” in the Gāndhārī epigraphical corpus, focusing on three key word-forms: G. dana-, danamuha- and deyadhaṃma-. These terms, which denote the meaning of “gift”, appear 36, 111 and 14 times respectively (both as single words and as compound constituents) in Gāndhārī inscriptions currently recorded in the CKI. Despite their frequent appearance, existing scholarship has primarily restricted itself to identifying their synonymous functions or analysing their grammatical construction in the case of the two compounds. No comprehensive study has yet catalogued all occurrences of these word-forms, traced their semantic development or examined the reasons behind their changing usage over time. This article addresses this gap by providing a complete inventory of the occurrences of these word-forms in the Gāndhārī epigraphical corpus and examining their use in non-Gāndhārī sources. It also presents a semantic analysis, exploring their synchronic and diachronic relationships within Gāndhārī inscriptions.
Contemporary historians of philosophy almost universally embrace the idea that the young Plato had a close, personal relationship with the historical Socrates. Many refuse to countenance a similar status for Plato’s contemporary, Xenophon. This note takes as its focus a novel argument intended to support the claim that Xenophon was never on intimate terms with Socrates or even privy to reliable information about him. The reply offered here has implications far beyond this apparently narrow focus, however, and points to pervasive biases in Socratic studies generally that remain in sore need of correction.
This study aims to elucidate the ethical dilemmas faced by pre-hospital emergency medical service personnel during disaster triage, with a specific focus on the Kahramanmaraş Earthquakes, and to document their experiences.
Materials and Methods
This phenomenological study employed semi-structured interviews with 29 pre-hospital emergency medical service workers who served during the first 72 hours of the Kahramanmaraş Earthquakes to gather qualitative data. Purposeful sampling was used for face-to-face interviews, and MAXQDA20 was utilized for content analysis.
Results
The main themes encompassed problems related to disaster management organization, environmental factors, and individual factors. Environmental factors, such as coordination deficiencies at the scene, jurisdictional confusion, security concerns, and seasonal conditions, as well as personal factors including education and experience, were pivotal in the occurrence of ethical dilemmas in disaster triage.
Conclusion
Pre-hospital emergency medical services personnel affected by the disaster faced more ethical dilemmas. The presence of many affected children had a profound emotional impact on participants, leading to more frequent ethical dilemmas, particularly in the application of black code protocols.
In this paper, I attempt to interpret Kant’s early reported thesis that the historical practice of senicide (i.e., killing the elderly) among certain Inuit communities constituted a ‘loving service’ and was ‘to some degree justified’ insofar as it was carried out to prevent one’s parents from facing a ‘more ignominious death’. On my interpretation, Kant’s verdict on Inuit senicide sheds new light on a core idea within his mature ethics – that persons are obligated to preserve themselves for as long as they remain a subject of duty. As I argue, Kant’s verdict implies that those subject to senicide were no longer bound by the duty of self-preservation insofar as they were no longer able to live as persons with inviolable moral dignity. If my argument holds, this invites further exploration of the relationship between Kant’s notion of dignity and the duty of self-preservation in the broader context of end-of-life decision-making.
Metacercariae of Diplostomum spp. are globally distributed pathogens that infect the eyes and brains of fish and lampreys, including populations in northern latitudes. This study investigated the species diversity and distribution of Diplostomum in juvenile Atlantic salmon Salmo salar and brown trout Salmo trutta from 11 rivers in northwestern Russia. Phylogenetic analyses revealed two diplostomid species: ‘D. mergi’ Lineage 3 and D. numericum. It is the first record of these species in the Russian part of the Arctic. These species, previously recorded in Western/Central Europe and Russian Karelia, likely spread via major migratory flyways of their avian definitive hosts. The species composition of Diplostomum metacercariae in riverine salmonids of the studied region was notably poorer than in lacustrine salmonids from other Arctic localities. The haplotype distributions of recorded Diplostomum species showed no spatial structuring, consistent with broad-scale dispersal processes.
Contention about representations of history and the purposes of History education has long surrounded Japanese History textbooks. From 2012, the ascent of powerful nationalist Prime Minister Abe Shinzō raised questions about possible political pressures on textbook content. This article analyzes recent market-leading junior high school and high school History textbooks to discover how pedagogical format and content related to controversial topics or national identity have changed since 2012. It finds that leading junior high school textbooks have largely maintained their representation of controversial topics, while developing investigative, analytic pedagogical approaches. Coverage of some aspects of ethnic and cultural diversity within Japan has increased. Following the implementation of a new curriculum from 2022, some high school textbooks for the new compulsory subject “Integrated History” facilitate a more analytic, “disciplinary” pedagogy than previously evident in compulsory high school History. Nonetheless, an “enhancing collective memory” approach to History pedagogy remains central throughout secondary education. These developments suggest that power over History education in Japan is distributed between a range of actors. The state, the market, and social pressures all influence the content of History textbooks in Japan.
This article traces the contours of the history of women’s education in England and Ireland in the period 1850-2000, mapping dominant themes and key inflection points. Positing a framework for reading degrees of change over time, we propose four interrelated lenses: access, curriculum, institutional presence, and networks. Drawing on key contributions to the field, we argue that women’s engagement with higher education has followed a complex and uneven trajectory, reflective of the shifting sands of attitudes and accommodations toward women across time, space, and discipline.
Confronting and eliminating the injustice of the slave trade and slavery were crucial to the mission of the Church Missionary Society and its mid-19th-century ‘Upper Niger’ missionary agents in Nigeria. The native CMS missionaries on the Niger, led by Samuel Adjai Crowther, held a dual identity as subjects of the British Government (via the British colony of Sierra Leone) and as native members in their host communities. They were freed slaves or children of freed slaves who returned from Sierra Leone to serve in the natal regions from which they or their parents had been deported as slaves. They were the ones who purveyed the Christian ‘laws of God’. The influence of the British government, manifest, for example, in British consular oversight and in the frequent visits of imperial gunboats, also constituted them into subjects with the responsibility to espouse British law, ‘the laws of England’, and especially abolition and anti-slavery, in their Niger mission stations. But they were politically dependent on the support and approval of their politically autonomous hosts, whose structure of justice, ‘the laws of the land’, still accommodated slavery. This essay explores how these native CMS missionaries navigated among these conflictual juridical and moral spheres of responsibility.
Our thesis is that the degree of permissible interaction between government and religion and its policy implications is most strikingly documented in the educational arena. To support our claim, we make three arguments: (1) by the early 1970s, New York, Pennsylvania, Rhode Island, and other states were experimenting with accommodationist policies in education that neither increased religious divisiveness nor denied religious freedom. These policy experiments contributed to the Supreme Court’s new understanding of religious accommodation under the First Amendment; (2) beginning in the late 1970s, a scholarly reappraisal of the establishment clause—based on a close reading of the debates over the First Amendment in Congress and the states—was demonstrating that reasonable governmental accommodations, particularly in education, would not violate the establishment clause; and (3) that periodizing the establishment clause’s history, by focusing on state-level innovations and scholarly reinterpretations, enhances the understanding of the policy developments of the First Amendment, particularly in the educational field.
In this paper, we perform a Floquet-based linear stability analysis of the centrifugal parametric resonance phenomenon in a Taylor–Couette system subjected to a time-quasiperiodic forcing where both the inner and outer cylinders are oscillating with the same amplitude and different angular velocities given respectively by $\varOmega _0 \cos (\omega _1t)$ and $\varOmega _0 \cos (\omega _2t)$. In this context, the frequencies $\omega _1$ and $\omega _2$ are incommensurate, where the ratio $\omega _2/\omega _1$ is irrational. Taking into account non-axisymmetric disturbances, a new set of partial differential equations is derived and solved using the spectral method along with the Runge–Kutta numerical scheme. The obtained results in this framework show that this forcing triggers new and numerous reversing and non-reversing Taylor vortex flows arising via either synchronous or period-doubling bifurcations. A rich and complex dynamics is found owing to strong mode competition between these modes that alters significantly the topology of the marginal stability curves. The latter exhibit a multitude of small and condensed parabolas, giving rise to several codimension-two bifurcation points, discontinuities and cusp points in the stability diagrams. Furthermore, a proper tuning of the frequency ratio leads to a significant control of both the instability threshold and the axisymmetric nature of the primary bifurcation. Moreover, using a local quasi-steady analysis when the cylinders are slowly oscillating, intermittent instabilities are detected, characterised by spike-like behaviour in the stability diagrams with several successive growths, dampings and periods of quietness. In this limit case, the inner cylinder drive becomes the responsible forcing of the Taylor vortices’ formation where the calculated critical instability parameters correspond to those of the inner oscillating cylinder case with fixed outer cylinder. The potentially unstable regions between the cylinders are determined on the basis of the Rayleigh discriminant, where an excellent agreement with the linear stability analysis results is pointed out.