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The economic burden of migraine is substantial; determining the cost that migraine imposes on the Canadian healthcare system is needed.
Methods:
Administrative data were used to identify adults living with migraine, including chronic migraine (CM) and episodic migraine (EM), and matched controls in Alberta, Canada. One- and two-part generalized linear models with gamma distribution were used to estimate direct healthcare costs (hospitalization, emergency department, ambulatory care, physician visit, prescription medication; reported in 2022 Canadian dollars) of migraine during a 1-year observation period (2017/2018).
Results:
The fully adjusted total mean healthcare cost of migraine (n = 100,502) was 1.5 times (cost ratio: 1.53 [95% CI: 1.50, 1.55]) higher versus matched controls (n = 301,506), with a predicted annual incremental cost of $2,806 (95% CI: $2,664, $2,948) per person. The predicted annual incremental cost of CM and EM was $5,059 (95% CI: $4,836, $5,283) and $669 (95% CI: $512, $827) per person, respectively, compared with matched controls. All healthcare cost categories were greater for migraine (overall, CM and EM) compared with matched controls, with prescription medication the primary cost driver (incremental cost – overall: $1,381 [95% CI: $1,234, $1,529]; CM: $2,057 [95% CI: %1,891, $2,223]; EM: $414 [95% CI: $245, $583] per person per year).
Conclusion:
Persons living with migraine had greater direct healthcare costs than those without. With an estimated migraine prevalence of 8.3%–10.2%, this condition may account for an additional $1.05–1.29 billion in healthcare costs per year in Alberta. Strategies to prevent and effectively manage migraine and associated healthcare costs are needed.
The antenna characterization from planar near-field (NF) measurements is generally realized by using the classical NF to far-field transform technique of plane wave expansion (PWE). This approach imposes strong constraints on NF sampling. To overcome these limitations, an equivalent model of the antenna under test (AUT) is created based on a distribution of infinitesimal dipoles. A reduced-order model (ROM) of the problem is constructed to obtain a decomposition basis defining the radiated field. The powerful ability of the ROM in determining the number of points needed for accurate NF measurements is demonstrated. Also, efficient non-conventional sampling strategies are applied to the case of planar NF measurements and the influence of these distributions on the reduction of the number of samples is studied. The global analysis of our approach on simulated and measured NF data shows that only 20% of the total number of points are needed with respect to the classical PWE technique to achieve an accurate characterization.
The olive black scale, Saissetia oleae (Olivier), is a significant pest of olive crops worldwide. The developmental, reproductive, and population growth parameters of S. oleae were evaluated under five constant temperature conditions (18°C to 33°C). Developmental durations significantly decreased with increasing temperatures. Female lifespan decreased from 161.6 days at 18°C to 104.3 days at 33°C, while male lifespan decreased from 96.8 days at 18°C to 49.4 days at 33°C. The highest sex ratio (proportion of females) of 0.35 was observed at 30°C, with pre-adult survival rates of 63%, while survival rates dropped to 28% at 18°C. Parthenogenesis was not observed in females. The total pre-oviposition and post-oviposition periods decreased with increasing temperature, with the longest oviposition period at 33°C (49.6 days). Maximum fecundity was recorded at 33°C (379.0 eggs/female), followed by 30°C (298.6 eggs/female), and decreased sharply at 18°C (90.1 eggs/female). The intrinsic rate of increase (r) was highest at 30 and 33°C (0.038 d⁻1), while the net reproductive rate (R0) peaked at 30°C (104.5 offspring/female). The predicted fecundity of the next generation showed significant potential growth at 27 and 30°C, with the population increasing 65.3 times at 30°C and 39.4 times at 27°C. The developmental threshold for S. oleae was highest for first-instar nymphs (7.58°C), while second-instar nymphs had lower thresholds (1.09–1.65°C), with total pre-adult development requiring 1250 degree-days for both males and females. These findings underscore the significant impact of temperature on the development and reproduction of S. oleae, with implications for pest management in olive orchards.
Several new foraminiferal taxa are described from the Changhsingian carbonates of southern Turkey, and their evolutionary relationships are discussed within the middle to late Permian time frame. Comprising Retroseptellina, Septoglobivalvulina, and Paraglobivalvulinoides, Retroseptellininae n. subfam. originated in the Wordian with thin and dense microgranular walls and became diverse and abundant in Changhsingian strata. Paraglobivalvulina? intermedia n. sp. appeared in the late Capitanian, survived into the Changhsingian, and gave way to completely involute tests of Paraglobivalvulininae. From the class Miliolata, Midiellidae n. fam., consisting of Midiella and Pseudomidiella, is characterized by sigmoidal coiling, and Pseudomidiella sahini n. sp. is probably the youngest known Changhsingian descendant. Glomomidiellopsis? okayi n. sp., which is interpreted as an evolutionary link between Capitanian Hemigordiopsis and Lopingian Glomomidiellopsis, survived into the Changhsingian. In the class Nodosariata, from the fully coiled Robuloides lineage of Robuloididae, Robuloides lata n. sp. and Plectorobuloides taurica n. gen. n. sp. most likely originated from R. lens in the Changhsingian. The R. acutus lineage, characterized by the reduction of laterally thickened hyaline wall and the appearance of evolute coiling, yielded Robuloides? rettorii n. sp. and Pseudorobuloides reicheli n. gen. n. sp. Calvezina anatolica n. sp. and Eomarginulinella galinae n. sp. are interpreted to have evolved from weakly coiled lineages in Robuloididae, whereas Pseudocryptomorphina amplimuralis n. gen. n. sp. is a poorly understood taxon and requires further study. Robustopachyphloia farinacciae n. sp. is interpreted as a descendant of some species within the genus Pachyphloia. The presence of canal-like pores in the wall of some Pachyphloia specimens is suggestive of a new morphological structure in the evolutionary history of the Changhsingian foraminifera.
Pulmonary arteriovenous malformations are abnormal vascular connections between pulmonary arteries and veins, often causing right-to-left shunting. In this report, a 4-year-old boy with low oxygen saturation was diagnosed with a large, complex pulmonary arteriovenous malformation involving four feeding arteries. Percutaneous transcatheter closure was performed using four devices to occlude the major feeding arteries, resulting in increased arterial oxygen saturation from 72 to 98%. This report depicts the successful use of multiple devices for percutaneous closure of a complex pulmonary arteriovenous malformation in a child and highlights the minimally invasive and effective nature of this approach.
This paper presents a multibeam dielectric rod antenna for mm-wave wireless power transfer (WPT) applications. The proposed solution utilizes its unique multibeam setup which allows the generation of adjustable beams simultaneously, without the need for an additional beamforming network. To enhance the compactness of the system, each Rexolite rod is fed through an annular slot etched on a Rogers RO4003. The generated beams are steered toward the desired directions by adjustment in the configuration of these rods. The final configuration consists of five rods that were fabricated and measured. In this configuration, a beam coverage between $-30^{\circ}$ and 30∘ can be obtained, while in the frequency of interest, a gain value above $12\,\mathrm{dBi}$ is achieved. With its adjustable configuration, the proposed solution can be adapted to different operating scenarios. Moreover, the low cost and flexibility of the solution make it a promising candidate for Radio Frequency Wireless Power Transfer (RF-WPT) Internet of things applications.
The outcomes of radiosurgery for trigeminal neuralgia (TN) in patients with multiple sclerosis (MS) are not as extensively assessed as those for idiopathic or classical TN cases.
Objective:
Evaluate the safety and efficacy of radiosurgery for TN in MS patients and identify potential predictors of successful outcomes.
Methods:
A retrospective single-institution cohort study with patients treated between 2009 and 2022 was performed. Fifty patients were included, and a total of 68 radiosurgical interventions were delivered. Outcomes included the maintenance of pain relief assessed using Kaplan–Meier curves and treatment-related complications. Cox regression analyses were used to identify potential predictors of better pain relief.
Results:
Following the first radiosurgical treatments, the initial pain relief rate was 86% after a median latency period of 14 days. Adequate pain relief rates at 6, 12, 36 and 60 months were 86%, 52%, 35% and 24%, respectively. Adequate pain relief was sustained for an actuarial median of 12.7 months. After initial relief, pain recurrence occurred in 68% of patients. No statistical difference was seen in the duration of pain relief after initial or repeat radiosurgery (p = 0.368). The most frequent complication was facial hypesthesia (Barrow Neurological Institute facial hypesthesia scale grade II: 10%; III: 6%; IV: 0%). Ipsilateral vascular compression was predictive of better efficacy (p = 0.024).
Conclusion:
Radiosurgery for TN in patients with MS appears to be safe and to provide effective pain relief. Notably, radiological identification of vascular compression may predict more sustained pain relief.
This work presents the design of a wide-band frequency-selective surface (FSS) with its analysis for the performance enhancement of a microstrip antenna. To demonstrate the concept, a dual-band microstrip antenna is also designed and combined with the proposed FSS to investigate its advantages and performance enhancement capabilities. The proposed FSS is designed for a frequency range of 3.5–6.5 GHz, whereas the designed antenna operates in dual frequency bands of 3.5 and 5 GHz. The combined effect of the antenna and FSS is investigated at 5 GHz for improving the gain of the antenna from 2.8 to 3.2 dBi. The outcome of the measured performance validates that the proposed surface has potential capability for enhancing the gain of an antenna for 5G, WLAN, and Wi-Fi communication.
This article revises interpretations of the post-Reformation English Chapel Royal as a place for the performance of ‘conservative’ or ‘traditional’ forms of the Book of Common Prayer and establishes its importance as a space for negotiating Protestant royal worship. By detailed analysis of the sound and appearance of royal chapels under Elizabeth i and James vi & i the Chapel Royal is emphasised not for its anticipation of a Laudian ascendancy, but its sensitivity to the ceremonial boundaries of the reformed Church of England, and ability to negotiate a form of Protestant majesty in royal worship.
Attitude towards assisted dying was assessed among 3,230 people who took part in the Church 2024 survey. Asked to respond to the statement ‘I am in favour of allowing assisted dying’, 51% disagreed, 28% agreed and 21% were uncertain, suggesting a sizable minority were either in favour of changing the law or undecided. Those against changing the law tended to agree that it is wrong for someone to take their own life, that only God can give and take life and that the risks of abusing any process are too great. Opinion varied across various groups, with women more in favour than men, the old more in favour than the young, laity more in favour than clergy and Anglo-Catholics or Broad Church more in favour than Evangelicals. Personal and psychological disposition predicted some variations in attitude towards assisted dying, probably because they predisposed individuals to taking more general liberal or conservative stances. The patterns are similar to those seen in several different moral issues debated in the Church of England in the last three decades, suggesting assisted dying might follow a similar trajectory in years to come.
Multipath components (MPCs) are both the challenge and the resources to exploit in high-frequency wireless communication, especially in environments with complex reflections. On the one hand, late-arriving MPCs cause inter-symbol interferences in digital communication. On the other hand, techniques such as multiple-input multiple-output and rake receivers have been widely applied to utilize the information carried in the math-path components. To this end, identifying and clustering MPCs is the foundation for tackling the challenges and boosting the utilization of reliable and correct information. Past research focuses either on extracting the path information or on clustering the extracted components. In this paper, we propose a complete workflow that performs identification as well as clustering of MPCs. We extend our previous work in clustering algorithms to indoor propagation measurements of three different frequency bands, as well as multiple transmitter–receiver locations. We verify that the fast attenuation of terahertz-band signals results in clear separations of peaks in measurements, which in turn facilitates the identification and clustering solutions. The ease of application highlights the wide-applying potential of high-frequency communication.
Prior studies have shown that plant-based diets are associated with lower cardiovascular risk. However, these diets encompass a large diversity of foods with contrasted nutritional quality that may differentially impact health. We aimed to investigate the pooled cross-sectional association between metabolic syndrome (MetS), its components and healthy and unhealthy plant-based diet indices (hPDI and uPDI), using data from two French cohorts and one representative study from the French population. This study included 16 358 participants from the NutriNet-Santé study, 1769 participants from the Esteban study and 1565 participants from the STANISLAS study who underwent a clinical visit. The MetS was defined according to the International Diabetes Federation definition. The associations between these plant-based diet indices and MetS were estimated by multivariable Poisson and logistic regression models, stratified by gender. Meta-analysis enabled the computation of a pooled prevalence ratio. A higher contribution of healthy plant foods (higher hPDI) was associated with a lower probability of having MetS (PRmen: 0·85; 95 % CI: 0·75, 0·94, PRwomen: 0·72; 95 % CI: 0·67, 0·77), elevated waist circumferences and elevated blood pressure. In women, a higher hPDI was associated with a lower probability of having elevated triacylglyceride (TAG), low HDL-cholesterolaemia and hyperglycaemia; and a higher contribution of unhealthy plant foods was associated with a higher prevalence of MetS (PRwomen: 1·13; 95 % CI: 1·01, 1·26) and elevated TAG. A greater contribution of healthy plant floods was associated with protective effects on metabolic syndrome, especially in women. Gender differences should be further investigated in relation to the current sustainable nutrition transition.
Childhood maltreatment, a significant distal risk factor for individual development, is potentially linked to maladaptive cognitive emotion regulation strategies (MCERS) and increased internalizing problems (i.e., depression and anxiety). Prior research has widely identified that MCERS mediate the link between childhood maltreatment and internalizing problems. However, this result overlooks the potential bidirectional relationship between MCERS and internalizing problems. In this study, we aim to explore whether childhood maltreatment longitudinally linked to internalizing problems through the mediating role of MCERS, or, conversely, was related to subsequent MCERS through internalizing problems. Gender differences in the associations between these variables were also examined. Participants were 892 adolescents from a longitudinal design with two waves (487 females, 405 males; Mage = 15.36, SDage = 1.43). Our results indicated that childhood maltreatment was longitudinally related to MCERS and internalizing problems. T1 MCERS mediated the relationship between T1 child maltreatment and T2 internalizing problems, while T1 internalizing problems also played a mediating role between T1 child maltreatment and T2 MCERS. These findings were also equivalent across genders. Taken together, childhood maltreatment was longitudinally associated with internalizing problems through MCERS, and also related to subsequent MCERS through internalizing problems.
In this study, 170 neem (Azadirachta indica) germplasm accessions were characterized for morphological, yield and yield-related traits to assess their genetic variability and potential for genetic improvement. This comprehensive investigation revealed significant differences in mean performance across the accessions, providing a wide dataset that offers valuable insights into the genetic diversity of neem. Significant phenotypic variability was observed across all traits, including plant height (PHT), seed weight (SEW), kernel weight (KEW) and oil content percentage (OIP). The high variability in diameter at breast height (DBH) and oil content across the germplasm accessions panel highlights the potential for selecting superior genotypes for genetic improvement. Strong positive associations between DBH, seed weight, kernel weight and oil content were identified, indicating that these traits can be critical for selecting high-yielding genotypes. Euclidean distance-based clustering analysis grouped the accessions into four distinct clusters, with Cluster I comprising genotypes with high oil and kernel yields. Principal component analysis corroborated the clustering patterns and identified variables with strong associations, which could guide future breeding programmes. The superior accessions identified, such as VKAF-3, VKAF-9, VKAF-11, VKAF-13, VKAF-139, VKAF-85 and VKAF-20, exhibited promising traits for genetic improvement and sustainability in neem production. Further multi-location and multi-season evaluations are recommended to ensure the stability and adaptability of these promising germplasm accessions. This research underscores the importance of leveraging genetic diversity to enhance neem's economic potential and contribute to sustainable development.
In authoritarian regimes, governments regularly use overt and heavy-handed visual propaganda to effectively signal regime strength and deter protests. Can democratic leaders also use this so-called hard propaganda to project strength, or does this kind of authoritarian-style messaging potentially backfire because of societal norms for leaders’ behavior? Focusing on a rare instance in which outright visual hard propaganda was used in a democratic setting, we study how US citizens perceived its use by the Trump administration during the 2020 Black Lives Matter protests. In a preregistered online survey fielded from June 12 until June 16, 2020, we exposed participants from both sides of the political spectrum to randomized pairs of real-world propaganda images. This allowed us to explore how partisanship influenced perceptions of hard propaganda during the height of the protests. Our findings reveal that, compared to standard political messaging, hard propaganda can communicate greater strength to both government supporters and opponents in a democracy. Yet, in contrast to autocratic settings, it fostered opposition among Trump opponents. Trump supporters, however, did not find such propaganda any more or less appropriate than standard political communication, consistent with an increased acceptance of authoritarian practices within polarized democracies.
In 1525, Prussia became the first territory to enact the Reformation when its leaders issued a new church order based on the teachings of Martin Luther. As this article makes clear, these were not native Prussians instituting reforms but rather German clergymen, many of whom had travelled to Prussia because their marriages had provoked persecution in the Holy Roman Empire. To illuminate the intertwined phenomena of marriage, migration, and church reform in Prussia, this article compares the journeys of two German clergymen who travelled to Prussia and led the Reformation there: Paul Speratus, a Swabian preacher, and Albrecht of Brandenburg-Ansbach, the Grandmaster of the Teutonic Order. Although they came from different social strata and their journeys to Prussia were distinct, the leitmotif of marriage animates their embrace of the Reformation and their paths to Prussia.