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Natural disasters often require the rapid deployment of onsite medical team, such as World Health Organization (WHO) certified Emergency Medical Team (EMT) 2. This work analyzes the recent experience of the French EMT-2 Civil Security’s projectable surgical field hospital, with a specific attention to its deployment.
Methods
Retrospective review of mission reports, theatre logbooks with additional staff interviews were studied to analyze the deployment of a projectable surgical field hospital from beginning of catastrophe to first surgery.
Results
Since its EMT-2 qualification, the EMT-2 was deployed 3 times, in 2023 at Gölbasi (Adiyaman, Turkey), in 2023 at Derna (Cyrenaica, Libya) and in 2024 at Mamoudzou (Mayotte, France) showing its ability to fulfill its surgical mission in various situations. Nonetheless, the deployment of the surgical field hospital is frequently delayed due to geopolitical but mainly logistical constraints, thereby impeding the hospital’s early efficacy.
Conclusions
When on site, the EMT-2 facility can provide surgical care within less than 24 h. Nevertheless, reaching the deployment site is long which limits the early efficacy of the projectable surgical field hospital. This could be bypassed by the initial projection of a smaller surgical structure to which will be added the remaining of the EMT-2.
Hyperuricemia is a common metabolic disorder and has become a global health concern. This study investigated the association between DNA methylation (DNAm) and serum uric acid (SUA) by conducting an epigenomewide association study (EWAS) in Chinese monozygotic (MZ) twins. Genomewide DNAm of 50 MZ twin pairs was profiled using the Infinium MethylationEPIC v2.0 BeadChip (935K). Generalized estimating equations (GEE) were used to examine the association between DNAm and SUA. Causal relationships between DNAm and SUA were assessed using ICE FALCON approach. Associations between mRNA expression and SUA were further assessed. Finally, candidate genes identified through epigenomewide association study (EWAS), causal inference, and gene expression analyses were validated in a longitudinal twin study. We identified 70 CpGs, mapping to genes such as DOK6 and NGLY1, significantly associated with SUA (Bonferroni correction p < 5.8 × 10−8). Causal analyses revealed one CpG with a causal effect of DNAm on SUA, 22 CpGs with causal effects of SUA on DNAm, and 33 CpGs showing bidirectional causality. Eleven genes displayed expression levels associated with SUA. DOK6, NGLY1, PKM, and SLC44A1 were selected as candidate genes, all of which showed unidirectional causal effect of SUA on DNAm. In the longitudinal analysis, baseline SUA levels (2012–13) were associated with subsequent DNAm levels in DOK6 and NGLY1 genes (2023–24). In conclusion, we found that SUA levels may influence DNAm variations, particularly at CpG loci within the DOK6 and NGLY1 genes. These findings provide key clues for future investigations into the mechanisms linking SUA with its epigenetic regulatory pathways.
Nutrition has long been investigated with respect to its influence on human health. With the availability of various omics data, such as metagenomics and metabolomics, novel insights have been obtained into the influence of nutrition, particularly concerning the gut microbiome. The gut microbiome plays an important role in the breakdown of food-derived compounds and in producing essential bioactive metabolites required for human health. However, this wealth of information made the interactions between nutrition and human health increasingly intricate, and unravelling these links is complex. This review covers the concepts of genome-scale metabolic modelling as a tool to understand the links between nutrition, the gut microbiome and human metabolism and its applications. Genome-scale metabolic modelling treats metabolism as a mathematical problem which was used to develop models of human metabolism that incorporate physiology and organ-specific metabolism, known as whole-body metabolic models (WBMs). WBMs can incorporate physiological data, such as sex, weight, and body fat percentage, as well as nutrition in the form of its metabolite constituents. Finally, the gut microbiome can also be incorporated through a mathematical representation of the species present, based on stool metagenomics. WBMs have already been applied to understand gut microbiome–host co-metabolism in various non-communicable diseases. However, challenges remain, as metabolites measured in food items in public databases typically cover only common metabolites, and engagement with end-users such as nutritionists and policymakers is limited. Nevertheless, WBMs represent a promising step towards digital metabolic twins and thus personalised nutrition and medicine.
Patients with hypoplastic left heart syndrome who develop a restrictive atrial septum prenatally have higher rates of postnatal mortality compared to those without atrial restriction. It is not understood whether the gestational age at which restriction becomes apparent echocardiographically impacts clinical outcomes.
Methods:
A single-centre, retrospective cohort study was performed, including 196 patients with hypoplastic left heart syndrome from 2008 to 2022. A restrictive atrial septum was diagnosed based on fetal echocardiographic findings of an intact atrial septum, antegrade:retrograde pulmonary vein Doppler velocity time integral ratio <3, and/or the presence of a decompressing vein. Patients were grouped as follows: 1. Without Restriction, 2. Early Restriction (<30 weeks’ gestation), and 3. Late Restriction (≥30 weeks’ gestation), based on the gestational age at which diagnostic criteria for restriction were met. Comparative postnatal overall survival and transplant-free survival analyses were performed using the Kaplan–Meier method.
Results:
Overall mortality rates were higher in the Early group (62%, n = 13) compared to the Late group (29%, n = 7) and the group without atrial restriction (40%). Similarly, transplant rates were higher in the Early group (23%) compared to the Late group (14%) and those without restriction (14%). Overall survival and transplant-free survival were not statistically different among the groups.
Conclusions:
While not statistically significant in this cohort with a small number of patients with atrial restriction, our data suggest that patients with hypoplastic left heart syndrome who meet diagnostic criteria for atrial restriction later in gestation may have outcomes more similar to those without atrial restriction.
Older refugees often navigate complex health care needs while aging in resettlement contexts. For Syrian refugees in the Greater Toronto Area and surrounding regions, barriers within the Canadian health care system may shape how care is accessed, coordinated, and supplemented through transnational practices.
Objective
This study examines how older Syrian refugees aging in the Greater Toronto Area and surrounding regions navigate health care and construct hybrid health care pathways across local and transnational contexts.
Methods
A qualitative interpretive descriptive design was used. In-depth interviews were conducted with 20 Syrian refugees aged 55–63. Data were analyzed using reflexive thematic analysis to identify patterns in participants’ experiences of accessing, coordinating, and supplementing health care.
Findings
Participants described persistent linguistic barriers, long wait times, and limited access to culturally aligned services within the Canadian health care system. In response, they developed hybrid health care pathways that combined Canadian health care with transnational practices, including consultations with clinicians abroad, cross-border medication use, family support, traditional remedies, and digital technologies. Digital tools played a central role in bridging language and geographic gaps and supporting care coordination. While these hybrid pathways enhanced autonomy, continuity of care, and perceived control, they also introduced risks related to medication safety, fragmented care, informal decision-making, and digital inequities.
Discussion
The findings show that older Syrian refugees’ health care navigation extends beyond formal Canadian health services and is shaped by transnational relationships, cultural knowledge, digital access, and prior health system experiences. Hybrid health care pathways can support continuity and culturally meaningful care, but they also require careful attention to safety, communication, and equity. Health systems should develop culturally responsive and digitally inclusive models that recognize transnational care practices while supporting safer integration with local care.
Previous research shows that speakers use prosody to disambiguate between string-identical canonical information questions and noncanonical questions conveying surprise. In this study, we investigated whether the prosodic cues produced by speakers are enough for naïve listeners to distinguish between the two readings of two distinct question structures in French that can express either a request for information or an emotive reaction of surprise: ‘qu’est-ce que’ and ‘c’est quoi ce NP’ questions. This article provides experimental evidence that listeners can in fact disambiguate between the two interpretations based on prosodic cues alone, in particular the contour and the duration of the question word.
The genus Canoparmelia Elix & Hale contains c. 40 species, predominantly occurring in tropical and subtropical regions. The genus is characterized by having relatively narrow, subirregular lobes with rotund or subrotund eciliate margins, a pored epicortex, the presence of isolichenan in the cell walls, bifusiform conidia, and simple rhizines (Elix 1993; Crespo et al. 2010b). Phylogenetically, it belongs to the Parmotrema clade of parmelioid lichens (Crespo et al. 2010b). Since its original circumscription (Elix et al. 1986), species have been transferred to other genera, including Austroparmelina A. Crespo et al. (Crespo et al. 2010a), Crespoa (D. Hawksw.) Lendemer & B. P. Hodk. and Parmotrema A. Massal. (Crespo et al. 2010b; Hawksworth 2011; Lendemer & Hodkinson 2012; Kirika et al. 2016). In addition, some species of the genus Crespoa are morphologically similar to certain Canoparmelia species, which leaves uncertainty regarding the identification of the samples.
Despite a long and dynamic history of coexistence with humans, the prehistory and domestication of the common pigeon (Columba livia) are not well understood. Here, the authors re-examine a large assemblage of avian bones excavated from Late Bronze Age contexts at Hala Sultan Tekke on Cyprus, aiming to contextualise the presence of pigeons within the settlement and their relationship with contemporaneous humans. The results of zooarchaeological and stable isotope analyses, they argue, suggest that these birds may have been semi-domesticated and may have held a symbolic/ritualistic role that challenges their common perception as mere urban dwellers.
Synthetic control methods are widely used for causal inference in case studies and panel data settings, often applied to model counterfactuals for proportional outcomes. However, conventional synthetic control methods are designed for univariate outcomes, leading researchers to model counterfactuals for each proportion separately. We make the case for jointly estimating synthetic controls across multiple compositional outcomes. Using the same weights for each proportion establishes a constant control comparison, improving comparability while adhering to compositional constraints on treatment effects. We illustrate the benefits of the method through a simulation and two applications to recent empirical studies. This implementation integrates naturally with a wide range of synthetic control approaches, providing interpretable estimates for compositional panel data common in political science.
China impressed the world with its success in containing the COVID-19 pandemic in 2020 and 2021. Many researchers have attributed China’s success to its hybrid mode of urban neighborhood governance, which could effectively mobilize residents to implement strict surveillance and quarantine measures for the state. However, despite their growing attention to urban neighborhood governance, they tend to privilege the government’s role while neglecting residents’ agency, thereby perpetuating the myth of an omnipresent and omnipotent Chinese state and reducing residents to passive objects of governance. This article challenges earlier researchers’ assumptions by exploring a crisis scenario – the lockdown of Shanghai from March to June 2022 – in which the local government’s capacity to surveil and micro-manage individual residents and deliver public services was significantly hampered. Through semi-structured interviews with eighteen individuals who experienced the lockdown in Shanghai, it examines the self-preserving efforts made by Shanghai residents to address the most serious challenge confronting them – supply shortages. It demonstrates that spontaneous organization and autonomous action among Shanghai residents were crucial to their survival during the crisis.
Model organisms play a central role in biological research, yet the conceptual questions they raise continue to provoke debate among philosophers. This article examines one such question: What are the distinctive features that qualify model organisms as scientific models? Building on and extending previous work, we propose a refined conceptual framework for understanding model organisms in the context of contemporary scientific practice. Our framework highlights six key features that, collectively, uniquely characterize model organisms. We argue that model organisms should not be viewed merely as components within experimental systems but rather as autonomous experimental systems in their own right.