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Politicians frequently face toxic behaviors. We argue that these behaviors impose a double burden on women, who may not only face higher exposure to toxicity, but experience attacks that they and others understand to be motivated by prejudice and designed to push them out of office. Using large-scale image-based conjoint experiments in the United States, Denmark, Belgium, and Chile, we demonstrate that both politicians themselves and citizens regard messages targeting women politicians as more toxic than otherwise equivalent messages targeting men. This perception intensifies when messages mention gender or come from perpetrators who are men. A second experiment to investigate the mechanisms shows that hostile behaviors toward women are more frequently understood as driven by prejudice and attempts to remove women from politics. These findings highlight the importance of understanding how perceptions of perpetrators’ motives affect the severity of political toxicity, and provide insights into the gendered effects of political hostility.
The mental health of paramedics is critical for disaster response in order to provide rapid and effective interventions. This study aimed to determine the prevalence of post-traumatic stress disorder (PTSD) and related individual and occupational factors in Turkish paramedics during the eleventh month of the COVID-19 pandemic.
Methods
The “Sociodemographic Information Form,” “Life Events Checklist,” and “Post-Traumatic Stress Disorder Checklist” were used to collect data from 440 randomly selected paramedics in this cross-sectional study.
Results
The prevalence of PTSD was 59.8% in the 11th month of the COVID-19 pandemic. Multiple regression analysis revealed that approximately 25% of the total PTSD score could be independently explained by paramedics’ general health situation and sociodemographic characteristics; 27% by crisis management skills, long working hours, a lack of equipment, and intensive work; and 40% by past traumatic experiences due to difficult life events during their professional practice, such as responding to gunshot wounds, becoming a victim of a gunshot attack, or sexual assault (P < 0.05).
Conclusions
Integrating a mental health monitoring system into the health and safety program, providing paramedics with supervision and psychological assistance, and engaging them in disaster preparedness planning would be beneficial.
This article examines the evolution of bioethics over the past four decades since the publication of John Harris’ seminal work, “The Value of Life” (1985). It argues that while the core principles articulated by Harris remain relevant, bioethics has undergone significant transformation across four key domains. First, the expanding frontiers of biotechnology have necessitated engagement with complex issues beyond individual clinical ethics. Second, there has been a widening of the circle of moral concern to encompass nonhuman animals, disability rights, and global health equity. Third, bioethics has become increasingly entangled with public policy and governance. Finally, the field has seen substantial academic proliferation and institutionalization. These developments have pushed bioethics to adapt its frameworks and methodologies while maintaining fidelity to foundational principles. This article concludes by considering the future challenges and opportunities for bioethics in an increasingly complex technological and social landscape.
This paper develops a novel full-state-constrained intelligent adaptive control (FIAC) scheme for a class of uncertain nonlinear systems under full state constraints, unmodeled dynamics and external disturbances. The key point of the proposed scheme is to appropriately suppress and compensate for unmodeled dynamics that are coupled with other states of the system under the conditions of various disturbances and full state constraints. Firstly, to guarantee that the time-varying asymmetric full state constraints are obeyed, a simple and valid nonlinear error transformation method has been proposed, which can simplify the constrained control problem of the system states into a bounded control problem of the transformed states. Secondly, considering the coupling relationship between the unmodeled dynamics and other states of the controlled system such as system states and control inputs, a decoupling approach for coupling uncertainties is introduced. Thereafter, owing to the employed dynamic signal and bias radial basis function neural network (BIAS-RBFNN) improved on traditional RBFNN, the adverse effects of unmodeled dynamics on the controlled system can be suppressed appropriately. Furthermore, the matched and mismatched disturbances are reasonably estimated and circumvented by a mathematical inequality and a disturbance observer, respectively. Finally, numerical simulations are provided to demonstrate the effectiveness of the proposed FIAC strategy.
Describing the evolution of a wind turbine's wake from a top-hat profile near the turbine to a Gaussian profile in the far wake is a central feature of many engineering wake models. Existing approaches, such as super-Gaussian wake models, rely on a set of tuning parameters that are typically obtained from fitting high-fidelity data. In the current study, we present a new engineering wake model that leverages the similarity between the shape of a turbine's wake normal to the streamwise direction and the diffusion of a passive scalar from a disk source. This new wake model provides an analytical expression for a streamwise scaling function that ensures the conservation of linear momentum in the wake region downstream of a turbine. The model also considers the different rates of wake expansion that are known to occur in the near- and far-wake regions. Validation is presented against high-fidelity numerical data and experimental measurements from the literature, confirming a consistent good agreement across a wide range of turbine operating conditions. A comparison is also drawn with several existing engineering wake models, indicating that the diffusion-based model consistently provides more accurate wake predictions. This new unified framework allows for extensions to more complex wake profiles by making adjustments to the diffusion equation. The derivation of the proposed model included the evaluation of analytical solutions to several mathematical integrals that can be useful for other physical applications.
AMS radiocarbon ages of organic matter from ice wedges and enclosing peat were determined for the polygonal peatland at the Lorino site on the eastern coast of the Chukchi Peninsula. The study’s goal was to fill a knowledge gap about the dynamics of polygonal peatlands with ice wedges and winter climate conditions during the Holocene in this easternmost region of the Russian Arctic. It has been found that peatland accumulated during the Younger Dryas and early Holocene, mostly between 14 and 9.9 cal ka BP, while ice wedges were dated from 7.7 to 6.6 cal ka BP. Since ice wedges have features of syngenetic growth, the discrepancy in the age of ice wedges and enclosing peatland may result from the significant presence of early and pre-Holocene peat. It is assumed that the older polygonal peatland deeply thawed during the Holocene optimum, and subsequently, when the permafrost aggraded, a new generation of ice wedges was formed. The AMS 14C age (18.1 cal ka BP) of the ice wedge exposed below the peat indicates the presence of a Late Pleistocene generation of ice wedges at the study site. Paleotemperature reconstructions based on the stable isotope composition of ice wedges show that the mean January air temperature during the Northgrippian stage of the Holocene varied from –27 to –23°C, and at the end of the Late Pleistocene, from –32 to –26°C.
As the most populous city in China, Shanghai’s human waste disposal underwent a dramatic transition between 1949 and 2010. While human waste continued to be sold to farmers as fertilizer, the authorities attempted to modernize the methods of manual removal, promoting nightsoil dump stations and vacuum trucks from the early 1970s. These new methods soon became widespread. However, urban human waste gradually lost its value as fertilizer from the late 1970s, chiefly because of the popularization of chemical fertilizers, at which point Shanghai was faced with serious human waste issues. Encountering this unforeseen shift, the municipality had to accept the reality that there were no longer rural markets for urban human waste, and that it would have to start treating human waste as refuse. In contrast to the Western model, Shanghai’s approach to modernizing human waste disposal was distinctive, having been influenced by factors beyond the city.
This article examines the intertwined history of local divination schools and divination instructors during the Yuan–Ming transition through a microhistory of the Zhu family—a diviner family who, as newcomers to Suzhou, carefully navigated the turbulent dynastic transition. Based on broader prosopographical research of Yuan and Ming divination school instructors, this study draws two main conclusions regarding social and institutional history during this crisis period. First, the Zhu family, representing lesser elites whose status depended on state institutions, survived the Yuan–Ming transition by building local networks, transforming their expertise, and manipulating narratives of their family history. Second, despite the Ming founder's order for the re-establishment of local divination schools, it was the diviner families, seeking to recover from the dynastic transition, who played a key role in restoring the local institution. This study extends our understanding of the scope of the fourteenth-century crisis, its diverse manifestations across social groups, and the manipulation of crisis narratives for various purposes. It also proposes a bottom-up approach to engage with the Yuan–Ming social and institutional continuity and rupture.
We evaluated the prevalence and risk factors for child maltreatment in multiples aged 3 years and compared them to singletons in Japanese population-based data. Records on child maltreatment and health check-ups at 3 years of age from 17,125 singletons, 488 twins and 18 triplets were collected from a Public Health Center between April 2007 and March 2011. The associations of child maltreatment with potential risk factors were analyzed using the logistic regression model. Out of all children, 76 (4.31 per 1000) children had documented maltreatment including 69 (4.03 per 1000) singletons and seven (14.31 per 1000) twins. All of the cases in twins were physical abuse (100%) and nearly half of the cases (43%) included emotional abuse. Among twins, 86% of the biological mothers were suspected. The alleged perpetrators of twins showed a significantly higher rate of maternal depression compared to those of singletons. After adjusting the results for a number of potential biological and social risk factors, twins or triplets had a higher risk for maltreatment than singletons (OR 3.39, 95% CI [1.17, 9.83]). Healthcare providers should be aware that a multiple birth can place considerable stress on a family leading to child maltreatment and should provide appropriate support and intervention for mothers with multiples.
Stemming from a canonical commentary of Theodore Balsamon (1130s–1195), this article examines an underexplored Byzantine Christian practice: the consecration of virgins. It focuses on an unusual religious establishment, a parthenon, founded in Thebes by its metropolitan John Kaloktenes (1166–c.1190), which accommodated lay virgins to pursue asceticism without demonstrating monastic commitments. It investigates the practice's origins, development and significance in Byzantine religious heritage, highlighting Kaloktenes's innovative revival of the practice. This study offers a unique case for exploring Byzantine monasticism and ecclesiastical leadership, while also demonstrating the potential for integrating Byzantium into the religious movements of the contemporary Latin West.
Deep brain stimulation (DBS) is an important treatment for Parkinson’s disease, tremor and dystonia in appropriately selected patients. The Canada Health Act emphasizes equity and “reasonable access to medically necessary hospital and physician services.” How to define “reasonable access” has not been well studied. We aimed to assess access to DBS implantation surgery and to determine the time required from initial assessment through to surgery and which step(s) delay the implantation.
Methods:
DBS implants from 2016 to 2023 at the University of Alberta were analyzed. The neurologists’ decision to proceed with DBS marks the start of the workup. The time required to see a neurosurgeon, psychiatrist, neuropsychologist and healthcare allies and to receive DBS surgery was assessed. The impact of COVID-19 was studied.
Results:
The total time from starting the workup to DBS surgery was 387.76 ± 125.19 days prior to COVID-19, and marked delay occurred during and post-COVID-19 (840.15 ± 165.41 days and 839.78 ± 300.66 days, respectively). Most workups were done within 6 months pre-COVID-19, although a big range existed due to variable factors. The longest delay to surgery was from consent to DBS implantation, owing to a lack of operative time. There has not been a recovery post-pandemic.
Conclusions:
Time to DBS implantation surgery from initial decision is lengthy and more than doubled over the course of the COVID-19 pandemic. The biggest delay was in the time from consent to implantation surgery, which has not improved despite the pandemic having ended.
In the mid-fourteenth century, the Jochid ulus went through a phase of extreme political turbulence. Following the death of the last Batuid khan Berdibek (r. 1357–1359), during the next two decades, circa 1360–1380, a high number of power contenders rose at both the central and the local levels of the ulus. This article aims to map and exemplify those attempts as part of the broader theoretical discussion concerning the scope and depth of the khanate's crisis. It does so by combining an overall, bird's-eye perspective on the political history of the ulus by zooming in on the regional history, as well as through the analysis of both written primary and numismatic sources. None of the multiple patterns of reaction to the dying-out of the Batuid lineage clearly contradicted the idea of the khanate's unity and the overarching ‘Chinggisid principle’. At this point in time, the ulus still followed the centrifugal logic of the Chinggisid rule. At the same time, the crisis of the Jochid ulus of the mid-fourteenth century indeed prepared the very ground for the power division between the still-existing branches of the Jochid family and the break-up of the Jochid power domain of the fifteenth century that followed the last unification attempt of the ulus under Toqtamïsh (r. 1380–1406).
This paper compares the views of Hegel and Schelling regarding the problem of individuation, i.e. the question of what makes an individual (a) numerically distinct from others and (b) the very individual it is. My focus is on how Hegel approaches this problem in his metaphysics and how that relates to Schelling’s views as articulated in his ‘negative philosophy’. While Hegelians like Robert Stern and Karen Ng are optimistic that Hegel can solve the problem of individuation, I argue that Schelling puts forward an objection that both challenges Hegel’s account and provides a rationale for taking seriously Schelling’s own insistence on a pre-logical dimension of being.
The Edmonton-based mobile stroke unit (MSU), which transports patients to the University of Alberta Hospital (UAH), enrolled patients in the Intravenous Tenecteplase Compared with Alteplase for Acute Ischemic Stroke (AcT) trial. We examined the feasibility of trial enrollment in MSU, its impact on acute stroke workflow metrics and functional outcomes at 90–120 days.
Methods:
In this post hoc analysis, patients were divided into three groups based on enrollment site: MSU (n = 43), UAH (n = 273) and non-UAH (n = 1261). All patients were enrolled with a deferred consent process. The primary outcome for this analysis was the feasibility of enrollment defined as the proportion of patients receiving intravenous thrombolysis (IVT) during the study period who were enrolled in the trial. Multiple linear and binary logistic regression was used to evaluate the adjusted effect of the study groups on acute stroke workflow metrics and functional outcomes at 90–120 days.
Results:
100% of eligible IVT-treated patients in the MSU during the study period were enrolled in the AcT trial. Covariate-adjusted linear regression showed shorter door-to-needle (17.2 [9.7–24.6] min) and CT-to-needle (10.7 [4.2–17.1] min) times in the MSU compared to UAH and non-UAH sites. There was no difference in the proportion of patients with an excellent functional outcome (mRS 0–1) at 90–120 days or symptomatic intracerebral hemorrhage (ICH) at 24 hours between groups.
Conclusions:
Enrollment in the AcT trial from the MSU was feasible. MSU-enrolled patients demonstrated faster door-to-needle and CT-to-needle times, resulting in earlier IVT administration and similar rates of symptomatic ICH.
This paper explores whether attitudes toward ethnic nationalism among Black and Asian Americans influence attitudes toward the Black Lives Matter Movement. Acceptance of a nationalist ideology typically makes an individual animus towards outgroups. Moreover, ethnic/Black nationalism is known to flare in times of perceived intense oppression. Given current racial tensions in the United States, we are interested in examining factors that may help facilitate alliance-building between Black and Asian Americans—two nonwhite groups that exist on different planks of the U.S. racial hierarchy. We begin by recounting historical and contemporary instances of Afro-Asian solidarity and conflict. This is followed by a review of past theoretical articulation and empirical research on nationalist ideology within each community. We develop a set of group-specific indicators of ethnic nationalism for Black and Asian Americans from the 2020 Collaborative Multiracial Post-Election Survey. Our results show clear evidence that being sympathetic to ethnic nationalism can unite rather than divide the two racialized communities in their attitudes toward present-day projects such as the Black Lives Matter Movement.
In North America, less than 30% of children with complex CHD receive recommended follow-up for neurodevelopmental and psychosocial care. While rates of follow-up care at surgical centres have been described, little is known about similar services outside of surgical centres.
Methods:
This cohort study used Maine Health Data Organization’s All Payer Claims Data from 2015 to 2019 to identify developmental and psychosocial-related encounters received by children 0–18 years of age with complex CHD. Encounters were classified as developmental, psychological, and neuropsychological testing, mental health assessment interventions, and health and behaviour assessments and interventions. We analysed the association of demographic and clinical characteristics of children and the receipt of any encounter.
Results:
Of 799 unique children with complex CHD (57% male, 56% Medicaid, and 64% rural), 185 (23%) had at least one developmental or psychosocial encounter. Only 13 children (1.6%) received such care at a surgical centre. Developmental testing took place at a mix of community clinics/private practices (39%), state-based programmes (31%), and hospital-affiliated clinics (28%) with most encounters billing Medicaid (86%). Health and behavioural assessments occurred exclusively at hospital-affiliated clinics, predominately with Medicaid claims (82%). Encounters for mental health interventions, however, occurred in mostly community clinics/private practices (80%) with the majority of encounters billing commercial insurance (64%).
Conclusion:
Children with complex CHD in Maine access developmental and psychosocial services in locations beyond surgical centres. To better support the neurodevelopmental outcomes of their patients, CHD centres should build partnerships with these external providers.