To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
A common way of acquiring multiword expressions is through language input, such as during reading and listening. However, this type of learning is slow. Identifying approaches that optimize learning from input, therefore, is an important language-learning endeavor. In the present study, 85 learners of English as a foreign language read short texts with 42 figurative English phrasal verbs, repeated three times. In a counterbalanced design, we manipulated access to definitions (before text, after text, no definition) and typographic enhancement (with bolding, without bolding). The learning was measured by immediate and delayed gap-fill and meaning generation posttests. All posttests showed that learning with definitions was better than without, and that access to definitions after reading was more beneficial than before reading. Typographic enhancement effectively promoted contextual learning of phrasal verbs and increased the learning advantage associated with presenting definitions after reading.
We document significant increases in the suspension of ongoing drug projects following the passage of the Food and Drug Administration Amendments Act of 2007 (FDAAA), which mandates that pharmaceutical companies publicly disclose detailed clinical study results. Our results suggest a causal interpretation through difference-in-differences analyses that exploit variations in pre-FDAAA information environments. We also show evidence that fewer new projects are initiated after the FDAAA. Drug developers’ learning from peer failures is the primary mechanism, further amplified by financial constraints. We also examine the consequences of enhanced information disclosure, including changes in firm investment efficiency, drug quality, and disease morbidity.
The evolutionary process of mixing induced by Rayleigh–Taylor (RT) and Richtmyer–Meshkov (RM) instabilities typically progresses through three stages: initial instability growth, subsequent mixing transition and ultimate turbulent mixing. Accurate prediction of this entire process is crucial for both scientific research and engineering applications. For engineering applications, Reynolds-averaged Navier–Stokes (RANS) simulation stands as the most viable method currently. However, it is noteworthy that existing RANS mixing models are primarily tailored for the fully developed turbulent mixing stage, rendering them ineffective in predicting the crucial mixing transition. To address that, the present study proposes a RANS mixing transition model. Specifically, we extend the idea of the intermittent factor, which has been widely employed to integrate with turbulence models for predicting boundary layer transition, to mixing problems. Based on a high-fidelity simulation of a RT case, the intermittent factor defined based on enstrophy is extracted and then applied to RANS calculations, showing that it is possible to accurately predict mixing transition by introducing the intermittent factor to the turbulence production from the baseline K-L turbulence mixing model. Furthermore, to facilitate practical predictions, a transport equation has been established to model the spatio-temporal evolution of the intermittent factor. Coupled with the K-L model, the intermittent factor provided by the transport equation is applied to modify the Reynolds stress in RANS calculations. Thereafter, the present transition model has been validated in a series of tests, demonstrating its accuracy and robustness in the capturing mixing process in different types and stages of interfacial mixing flows.
Biped wall-climbing robots (BWCRs) serve as viable alternatives to human workers for inspection and maintenance tasks within three-dimensional (3D) curtain wall environments. However, autonomous climbing in such environments presents significant challenges, particularly related to localization and navigation. This paper presents a pioneering navigation framework tailored for BWCRs to navigate through 3D curtain wall environments. The framework comprises three essential stages: Building Information Model (BIM)-based map extraction, 3D climbing path planning (based on our previous work), and path tracking. An algorithm is developed to extract a detailed 3D map from the BIM, including structural elements such as walls, frames, and ArUco markers. This generated map is input into a proposed path planner to compute a viable climbing motion. For path tracking during actual climbing, an ArUco marker-based global localization method is introduced to estimate the pose of the robot, enabling adjustments to the target foothold by comparing desired and actual poses. The conducted experiments validate the feasibility and efficacy of the proposed navigation framework and associated algorithms, aiming to enhance the autonomous climbing capability of BWCRs.
Language is the primary technology clinical ethicists use as they offer guidance about norms. Like any other piece of technology, to use the technology well requires attention, intention, skill, and knowledge. Word choice becomes a matter of professional practice. The Brief Report offers clinical ethicists several reasons for rejecting the phrase “aggressive care.” Instead, ethicists should consider replacing “aggressive care” with the adjacent concept of a “recovery-focused path.” The virtues of this neologism include: the opportunity to set aside the emotion of “aggression,” the phrase’s accuracy when capturing the intention of the patient or their representative, and an unappreciated rhetorical force—and transparent logic—that arises when the patient’s recovery is unlikely.
The objective of this study was to develop a self-report scale for the assessment of the competence of pre-hospital health professionals in responding to radiological incidents.
Methods
Based on the findings of a systematic review analyzing the literature, the instrument followed the processes of item generation, expert opinion, language control, pilot study, and field testing.
Results
In the exploratory factor analysis, 48 items were excluded on the grounds of insufficient common variance (>0.40) and factor loading relationship (>0.50). The remaining 18 items (11 negative and 7 positive items) exhibited a Cronbach’s alpha value of 0.913 and a range of 0.740 to 0.887 in the sub-factors. As the scores on the developed scale increased, there was a corresponding increase in the perceived adequacy of the interventions.
Conclusions
The objective, scope, constraints and stages of the scale’s design and development were elucidated in comprehensive detail, and its intelligibility to other societies was ensured. The scale was developed as a self-report scale that can evaluate the competence of prehospital health professionals in radiological incidents.
In the Islamic tradition, there’s a long standing controversy over the relationship between God’s attributes and His essence, giving rise to diverse theories with significant theological implications. In one respect, these views are broadly categorizable into three: A1, the doctrine of divine complexity (DDC), A2, the doctrine of divine simplicity (DDS), and B, the doctrine of divine anonymity (DDA). The entry focuses on DDS, specifically explaining the Avicennian version, and defends it against some objections from some recent DDC proponents.
To assess the post-earthquake trauma and hopelessness levels of nursing students due to the earthquakes that occurred on February 6, 2023.
Methods
This study was conducted between April and May 2023 in the Nursing Department in a province located in Southeastern Türkiye using the face-to-face interview technique. The study was completed with 276 students in line with the power analysis. The data were collected using a questionnaire, the Scale that Determines the Level of Post-Earthquake Trauma (SDLPET), and the Beck Hopelessness Scale (BHS).
Results
The mean SDLPET and BHS scores of the students were 55.45±13.58 and 9.38±4.53, respectively. Some 12.3% of the nursing students lost their friends due to the earthquake, 80.4% did not receive any earthquake training, 46% needed psychological support, 48.6% needed financial support, 49.6% needed social support, 37% had sleep problems, 72.8% experienced hopelessness, and the quality of life of 67.8% of the students was negatively affected due to the hopelessness they experienced.
Conclusions
It was found that the level of post-earthquake trauma and hopelessness of the students was moderate, and a positive and significant correlation was found between trauma and hopelessness scores.
The normative principle that every individual is equally entitled to continued life is a subject of debate in ethics, health economics and policy. We reconsider this principle in the context of setting priorities for healthcare interventions. When applied without restriction, the principle overlooks quality of life concerns entirely. However, we contend that it remains ethically relevant in certain situations, particularly when patients suffer from conditions unrelated to the therapeutic areas and treatments under consideration. Thus, we defend the principle while also emphasizing the need for its application within tight limits.
The relation between epistemic relativism and epistemic oppression is contentious but undertheorized. Both positions rest on one or the other version of the situated knowledge thesis, based on the idea that access to and justification of knowledge is dependent on a particular context or, to be precise, an epistemic system. Whether this notion is coextensive in both schools of thought is, however, unclear. In this article, I aim to examine the relation between epistemic relativism and epistemic oppression by analyzing the notion of “epistemic system.” Through this analysis, I shall argue that the epistemic relativism literature has neglected power imbalances within epistemic systems since it rests on idealizing epistemic systems to sets of epistemic principles. Understanding epistemic systems as necessarily social and political, I then confront the idea formulated in the epistemic oppression literature that some forms of oppression are “irreducibly epistemic.” I argue that epistemic principles can never fully determine their applications and thus essentially require the social. Thus, insisting on the “irreducibly epistemic” might not be a favorable option for epistemic oppression or epistemic relativism scholarship.
Treatment interruptions in disaster victims are concerning, owing to an increase in natural disasters and the growing elderly population with chronic conditions. This study examined the temporal trends in treatment interruptions among victims of 2 recent major heavy rain disasters in Japan: West Japan heavy rain in 2018 and Kumamoto heavy rain in 2020.
Methods
Data for this study were derived from the national standardized medical data collection system called the “Japan Surveillance in Post-Extreme Emergencies and Disasters.” Joinpoint regression analysis was performed to examine the daily trends in treatment interruptions reported soon after each disaster onset.
Results
A total of 144 and 87 treatment interruption cases were observed in the heavily affected areas of the West Japan heavy rain in 2018 and Kumamoto heavy rain in 2020, respectively. In both disasters, a high number of treatment interruption cases were observed on the first day after the disaster. Joinpoint regression analysis showed that trends in the percentage of treatment interruptions differed between the 2 disasters at different disaster scales.
Conclusions
The findings suggest the importance of a prompt response to treatment interruptions in the immediate aftermath of a disaster and consideration of the specific characteristics of the disaster when planning for disaster preparedness and response.
The study objective was to develop and validate a clinical decision support system (CDSS) to guide clinicians through the diagnostic evaluation of hospitalized individuals with suspected pulmonary tuberculosis (TB) in low-prevalence settings.
Methods:
The “TBorNotTB” CDSS was developed using a modified Delphi method. The CDSS assigns points based on epidemiologic risk factors, TB history, symptoms, chest imaging, and sputum/bronchoscopy results. Below a set point threshold, airborne isolation precautions are automatically discontinued; otherwise, additional evaluation, including infection control review, is recommended. The model was validated through retrospective application of the CDSS to all individuals hospitalized in the Mass General Brigham system from July 2016 to December 2022 with culture-confirmed pulmonary TB (cases) and equal numbers of age and date of testing-matched controls with three negative respiratory mycobacterial cultures.
Results:
104 individuals with TB (cases) and 104 controls were identified. Prior residence in a highly endemic country, positive interferon release assay, weight loss, absence of symptom resolution with treatment for alternative diagnoses, and findings concerning for TB on chest imaging were significant predictors of TB (all P < 0.05). CDSS contents and scoring were refined based on the case–control analysis. The final CDSS demonstrated 100% sensitivity and 27% specificity for TB with an AUC of 0.87.
Conclusions:
The TBorNotTB CDSS demonstrated modest specificity and high sensitivity to detect TB even when AFB smears were negative. This CDSS, embedded into the electronic medical record system, could help reduce risks of nosocomial TB transmission, patient-time in airborne isolation, and person-time spent reviewing individuals with suspected TB.
The current study examined the comprehension and production of classifiers, case marking, and morphological passive structures among 414 child Japanese heritage speakers (mean age = 10.01 years; range = 4.02 – 18.18). Focusing on individual differences, we extracted latent experiential factors via the Q-BEx questionnaire (De Cat, Kašćelan, Prévost, Serratrice, Tuller, Unsworth, & The Q.-Be Consortium, 2022), which were then used to predict knowledge and use of these grammatical structures. The findings reveal that: (i) experiential factors such as heritage language (HL) engagement at home and within the community modulate grammatical performance differentially from childhood through adolescence, and (ii) HL proficiency, immersion experiences, and literacy systematically predict HL grammatical outcomes. These results indicate that particular language background factors hold differential significance at distinct developmental stages and that higher proficiency, richer immersion experiences, and literacy engagement in the HL are crucial for the development of core grammatical structures.
Automatic license plate recognition (ALPR) systems are increasingly used to solve issues related to surveillance and security. However, these systems assume constrained recognition scenarios, thereby restricting their practical use. Therefore, we address in this article the challenge of recognizing vehicle license plates (LPs) from the video feeds of a mobile security robot by proposing an efficient two-stage ALPR system. Our ALPR system combines the on-the-shelf YOLOv7x model with a novel LP recognition model, called vision transformer-based LP recognizer (ViTLPR). ViTLPR is based on the self-attention mechanism to read character sequences on LPs. To ease the deployment of our ALPR system on mobile security robots and improve its inference speed, we also propose an optimization strategy. As an additional contribution, we provide an ALPR dataset, named PGTLP-v2, collected from surveillance robots patrolling several plants. The PGTLP-v2 dataset has multiple features to cover chiefly the in-the-wild scenario. To evaluate the effectiveness of our ALPR system, experiments are carried out on the PGTLP-v2 dataset and five benchmark ALPR datasets collected from different countries. Extensive experiments demonstrate that our proposed ALPR system outperforms state-of-the-art baselines.
Conventional survey tools such as weighting do not address non-ignorable nonresponse that occurs when nonresponse depends on the variable being measured. This paper describes non-ignorable nonresponse weighting and imputation models using randomized response instruments, which are variables that affect response but not the outcome of interest. This paper uses a doubly robust estimator that is valid if one, but not necessarily both, of the weighting and imputation models is correct. When applied to a national 2019 survey, these tools produce estimates that suggest there was nontrivial non-ignorable nonresponse related to turnout, and, for subgroups, Trump approval and policy questions. For example, the conventional MAR-based weighted estimates of Trump support in the Midwest were 10 percentage points lower than the MNAR-based estimates.
Augustinian accounts of ‘primal sin’ face a dilemma: either ‘Lucifer’s’ fall is arbitrary, or it results from God creating a flawed creature. Augustine and others hold that an omnipotent God faces unavoidable limits in creating creatures. In particular, creatures cannot enjoy God’s own first-person awareness of God’s goods, but must experience them second-personally. The resulting qualitative phenomenological difference between (1) the first-person awareness Lucifer had of the goods of his own being, and (2) his second-person awareness of the goods of God means that self-regarding goods would ‘light up’ for Lucifer very differently than other-regarding goods. This opens a psychologically resonant and metaphysically potent account of how the pre-Fall Lucifer could have faced a genuine value conflict – a conflict for which God is not culpable – in which Lucifer might come to love the goods presented first-personally (his own) over the goods presented second-personally (God’s).
Suicide is one of the leading causes of death among individuals aged 10–24. Research using intensive longitudinal methods to identify near-term predictors of suicidal thoughts and behaviors (STBs) has grown dramatically. Interpersonal factors may be particularly critical for suicide risk among young people, given the heightened salience of interpersonal experiences during adolescence and young adulthood. We conducted a narrative review on intensive longitudinal studies investigating how interpersonal factors contribute to STBs among adolescents and young adults. Thirty-two studies met the inclusion criteria and focused on theoretical and cross-theoretical interpersonal risk factors. Negative interpersonal states (e.g., perceived burdensomeness), hopelessness, and social support were consistently associated with proximal within-person changes in concurrent, but not prospective, suicidal thoughts. Further, work examining how these processes extend to suicidal behavior and among diverse samples remains scarce. Implications for contemporary interpersonal theories and intensive longitudinal studies of STBs among young people are discussed.
This study aimed to understand the current landscape of USA-based disaster medicine (DM) programs through the lens of alumni and program directors (PDs). The data obtained from this study will provide valuable information to future learners as they ponder careers in disaster medicine and allow PDs to refine curricular offerings.
Methods
Two separate surveys were sent to USA-based DM program directors and alumni. The surveys gathered information regarding current training characteristics, career trajectories, and the outlook of DM training.
Results
The study had a 57% response rate among PDs, and 42% response rate from alumni. Most programs are 1-year and accept 1-2 fellows per class. More than 60% of the programs offer additional advanced degrees. Half of the respondents accept international medical graduates (IMGs). Only 25% accept non-MD/DO/MBBs trained applicants. Most of the alumni hold academic and governmental positions post-training. Furthermore, many alumni report that fellowship training offered an advantage in the job market and allowed them to expand their clinical practice.
Conclusions
The field of disaster medicine is continuously evolving owing to the increased recognition of the important roles DM specialists play in healthcare. The fellowship training programs are experiencing a similar evolution with an increasing trend toward standardization. Furthermore, graduates from these programs see their training as a worthwhile investment in career opportunities.