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This is the second part of a two-part paper. We apply the methodology of the first paper (Souza, J. Fluid Mech., vol. 997, 2024, A1) to construct a data-driven finite-volume discretization of the Liouville/Fokker–Planck equation of a high-dimensional dynamical system, i.e. the compressible Euler equations with gravity and rotation evolved on a thin spherical shell. We show that the method recovers a subset of the statistical properties of the underlying system, steady-state distributions of observables and autocorrelations of particular observables, as well as revealing the global Koopman modes of the system. We employ two different strategies for the partitioning of a high-dimensional state space, and explore their consequences.
Hereditary haemorrhagic telangiectasia (HHT) is characterised by recurrent, severe epistaxis. While nasal closure is a relatively well-established treatment for HHT patients with intractable epistaxis, recent studies highlight the efficacy of bevacizumab in this subgroup. We aim to evaluate the effectiveness of nasal closure for patients with contraindications to bevacizumab.
Methods
A case series of five patients with HHT and severe refractory transfusion-dependent epistaxis who were treated with nasal closure.
Results
All patients had subjective improvement in epistaxis. Haemoglobin concentrations increased in all patients, with none requiring transfusion for epistaxis post-operatively. Four patients experienced complete cessation in epistaxis. Four returned positive Glasgow Benefit Inventory scores.
Conclusion
Nasal closure appears to be a safe and effective option for the management of epistaxis in patients with severe, refractory HHT-related epistaxis. Treatment improved quality of life, reduced severity of epistaxis and increased haemoglobin concentrations. Nasal closure should be considered for HHT patients with severe, refractory epistaxis, particularly in cases where bevacizumab is contraindicated.
The term ‘natural theology’ provokes a variety of reactions, spanning from whole-hearted endorsement to passionate rejection. Charged as it is with polemical and pejorative undertones, this debate begs for an intervention. If the scholarly community is to engage constructively with the concept and practice of natural theology – either by way of acceptance, rejection, or something in between – clarity in its definition and identification is imperative. The aim of this paper is to try to shed some light on three of the most common definitions of ‘natural theology’ in contemporary scholarship, to provide clarity about the ways in which they differ, and to propose some conceptual refinements in the hope that, if adopted, more fruitful discourse may take place in relation to this much-debated and interdisciplinary phrase.
Human rights due diligence (HRDD) is a buzzword in business and human rights (BHR) activities. However, multinational corporations (MNCs) often conduct it as a tick-box exercise without transparency. Using a relational contract theory, this article argues that when MNCs contract with local communities through community development agreements (CDAs) to perform HRDD, such contracts are internationalized relational contracts that attract a level of good faith. An established principle in international economic law, good faith serves as a standard for assessing conduct designed to discharge obligations in international contracts between states and MNCs (investor-state contracts). Similar to how investor-state arbitration tribunals use good faith jurisprudence in regulating the relationship between states and MNCs, this article proposes a BHR good faith jurisprudence to prescribe how HRDD obligations should be discharged. The article concludes that a good faith interpretational exercise in BHR would (1) reduce MNCs’ cosmetic compliance with HRDD principles; (2) increase transparency in the HRDD exercise; and (3) become a source of rights for local communities to enforce corporate accountability.
Philosophical arguments about government contracting either categorically oppose it on legitimacy grounds or see it as largely anodyne. I argue for a normatively distinct kind of contracting – the advance market commitment, or AMC – and show that it is justified by the same liberal values that justify the welfare state.
To appraise clinical practice guidelines for anaplastic thyroid carcinoma treatment and management using the Appraisal of Guidelines for Research and Evaluation II tool.
Methods
A literature search was performed using MEDLINE/PubMed, Embase, Scopus, Cochrane, and Google Scholar. Four reviewers evaluated clinical practice guidelines utilising Appraisal of Guidelines for Research and Evaluation II, with domain scores requiring a threshold of greater than 60 per cent. Inter-reviewer agreement was evaluated using intraclass correlation coefficients.
Results
Twelve clinical practice guidelines were evaluated after application of inclusion and exclusion criteria. There were two “high-”, four “average-”, and six “low-” quality clinical practice guidelines. The domains with the highest scores were “clarity of presentation” (69.44 ± 16.75) and “scope and purpose” (68.87 ± 20.88), while “applicability” (7.12 ± 6.17) and “rigor of development” (50.26 ± 20.77) had the lowest scores. Intraclass correlation coefficients showed a high level of inter-reviewer agreement (0.689–0.924; good–excellent).
Conclusion
These results showcased wide variability in quality amongst guidelines for the treatment and management of anaplastic thyroid carcinoma. These findings necessitate greater standardisation among clinical practice guidelines and greater focus on the applicability of recommended practices.
To evaluate the impact of changes in the size and characteristics of the hospitalized patient population during the COVID-19 pandemic on the incidence of hospital-associated Clostridioides difficile infection (HA-CDI).
Design:
Interrupted time-series analysis.
Setting:
A 576-bed academic medical center in Portland, Oregon.
Methods:
We established March 23, 2020 as our pandemic onset and included 24 pre-pandemic and 24 pandemic-era 30-day intervals. We built an autoregressive segmented regression model to evaluate immediate and gradual changes in HA-CDI rate during the pandemic while controlling for changes in known CDI risk factors.
Results:
We observed 4.5 HA-CDI cases per 10,000 patient-days in the two years prior to the pandemic and 4.7 cases per 10,000 patient-days in the first two years of the pandemic. According to our adjusted segmented regression model, there were neither significant changes in HA-CDI rate at the onset of the pandemic (level-change coefficient = 0.70, P-value = 0.57) nor overtime during the pandemic (slope-change coefficient = 0.003, P-value = 0.97). We observed significant increases in frequency and intensity of antibiotic use, time at risk, comorbidities, and patient age before and after the pandemic onset. Frequency of C. difficile testing did not significantly change during the pandemic (P= 0.72).
Conclusions:
Despite large increases in several CDI risk factors, we did not observe the expected corresponding changes in HA-CDI rate during the first two years of the COVID-19 pandemic. We hypothesize that infection prevention measures responding to COVID-19 played a role in CDI prevention.
Arctic governance has entered a period of turmoil following the March 2022 Arctic Council pause in operations and, subsequently, the strained relations between the member states. As climate change dramatically alters the Arctic environment, opening the region to new economic possibilities and more global attention, the need for cooperation is greater than ever. This article examines the current geopolitical and environmental pressures that are undermining the Arctic Council’s legitimacy and operations at a critical juncture in Arctic governance. It contends that the Arctic Council must rethink how it engages with Arctic Council observers and the wider global community to ensure that pressing ecological, economic, and social issues are addressed judiciously to prevent potentially irreparable harm in the region. Specifically, the case is made that a shift to “inclusive regionalism” could secure the Arctic Council’s position as the pre-eminent forum to address Arctic issues and to re-establish the spirit of collaboration that reigned for a quarter century.
We recently showed that adherence to the Mediterranean diet increased the proportion of plasma n-3 PUFA, which was associated with an improved intestinal barrier integrity. In the present exploratory analysis, we assessed faecal fatty acids in the same cohort, aiming to investigate possible associations with intestinal barrier integrity. Women from the Lifestyle Intervention Study in Women with Hereditary Breast and Ovarian Cancer (LIBRE) randomised controlled trial, characterised by an impaired intestinal barrier integrity, followed either a Mediterranean diet (intervention group, n 33) or a standard diet (control group, n 35). At baseline (BL), month 3 (V1) and month 12 (V2), plasma lipopolysaccharide-binding protein, faecal zonulin and faecal fatty acids were measured. In the intervention group, faecal proportions of palmitoleic acid (16:1, n-7) and arachidonic acid (20:4, n-6) decreased, while the proportion of linoleic acid (18:2, n-6) and α linoleic acid (18:3, n-3) increased (BL-V1 and BL-V2, all P < 0·08). In the control group, faecal proportions of palmitic acid and arachidic acid increased, while the proportion of linoleic acid decreased (BL-V1, all P < 0·05). The decrease in the proportion of palmitoleic acid correlated with the decrease in plasma lipopolysaccharide-binding protein (ΔV1-BL r = 0·72, P < 0·001; ΔV2-BL r = 0·39, P < 0·05) and correlated inversely with adherence to the Mediterranean diet (Mediterranean diet score; ΔV1-BL r = –0·42, P = 0·03; ΔV2-BL r = -0·53, P = 0·005) in the intervention group. Our data show that adherence to the Mediterranean diet induces distinct changes in the faecal fatty acid composition. Furthermore, our data indicate that the faecal proportion of palmitoleic acid, but not faecal n-3 PUFA, is associated with intestinal barrier integrity in the intervention group.
This scoping review addresses gaps in the existing literature on dietary guidelines for pregnant and lactating women globally. The study delves into adherence levels, identifies influencing factors and examines outcomes associated with these guidelines. Analysing food-based dietary guidelines (FBDG) from around the world, the review reveals that half of the countries lack FBDG, with only 15% providing tailored advice for pregnant and lactating women. Utilising data extracted from forty-seven articles across MEDLINE and EMBASE, the study highlights a scarcity of adherence studies, particularly in low- or middle-income countries (LMIC), and emphasises the lack of research during lactation. Overall adherence to dietary guidelines is low, with disparities in fruit, vegetable, whole grain and fish consumption. Positive correlations with adherence include age, education, employment, social class and certain medical histories, while negative correlations involve smoking, alcohol consumption, metropolitan residence and elevated BMI. The study documented significant associations between adherence and reduced risks of gestational complications but calls for further exploration of intermediate nutritional outcomes such as micronutrient deficiencies and child growth. Emphasising the urgency for globally standardised guidelines, especially in LMIC, this review provides a foundational call for prioritised studies and strategies to enhance dietary practices for pregnant and lactating women worldwide.
Horizontal convection at large Rayleigh and Prandtl numbers is studied experimentally in a regime up to seven orders of magnitude larger in terms of Rayleigh numbers than previously achieved. To reach Rayleigh numbers up to $10^{17}$, the horizontal density gradient is generated using differential solutal convection by a differential input of salt and fresh water controlled by diffusion in a novel experiment in which the zero-net mass flux of water is ensured through permeable membranes. This set-up allows us to accurately measure the Nusselt number in solutal convection by carefully controlling the amount of salt water exchanged through the membranes. Combined measurements of density and velocity across more than five orders of magnitude in Rayleigh numbers show that the flow transitions from the Beardsley & Festa (J. Phys. Oceanogr., vol. 2, issue 4, 1972, pp. 444–455), Shishkina & Wagner (Phys. Rev. Lett., vol. 116, issue 2, 2016, 024302) regime to the Chiu-Webster et al. (J. Fluid Mech., vol. 611, 2008, pp. 395–426) regime and frames the present results within the scope of Shishkina et al. (Geophys. Res. Lett., vol. 43, issue 3, 2016, pp. 1219–1225), and the theory of Part 1 (Passaggia & Scotti, vol. 997, 2024, J. Fluid Mech., A5). In particular, we show that, even for large Prandtl numbers, the circulation eventually clusters underneath the forcing horizontal boundary, leaving a stratified core without motion. Finally, the previous regime diagrams (Hughes & Griffiths, Annu. Rev. Fluid Mech., vol. 40, 2008, pp. 185–208; Shishkina et al., Geophys. Res. Lett., vol. 43, issue 3, 2016, pp. 1219–1225) are extended by combining the present results at high Prandtl numbers, the results at low Prandtl numbers of Part 1, together with previous results from the literature. This work sets a new picture of the transition landscape of horizontal convection over six orders of magnitude in Prandtl number and sixteen orders of magnitude in Rayleigh number.
This study aimed to evaluate clinical characteristics, treatments and outcomes of paediatric temporal bone fractures at our institute.
Methods:
A retrospective study of paediatric skull fractures confirmed by imaging from January 2010 to December 2022. Data on demographics, clinical presentations, injury mechanisms and complications were analysed, and fractures were categorised into otic capsule sparing (OCS) and violating (OCV).
Results:
Of 369 skull fracture cases, 88 (24 per cent) involved temporal bones, predominantly caused by falls and vehicle accidents. Common symptoms were loss of consciousness, hematoma, and hemotympanum, with complications like facial nerve injury and cerebrospinal fluid leaks in 3.4 per cent of cases. OCV fractures led to more severe complications, including hearing loss. Audiology showed 65 per cent without hearing impairment, while others had various degrees of loss.
Conclusion:
Paediatric temporal bone fractures, particularly OCV types, pose significant challenges. Early detection and thorough management are vital, underscoring the need for consistent data collection and regular audiometric monitoring.
We examine a cyclic order on the directed edges of a tree whose vertices have cyclically ordered links. We use it to show that a graph of groups with left-cyclically ordered vertex groups and convex left-ordered edge groups is left-cyclically orderable.
The aim of this study is to identify the prognostic factors that may have an effect on the outcome of post-coronavirus disease 2019 acute invasive fungal sinusitis in order to help optimise diagnosis and management.
Methods
This retrospective study involved 60 patients with post-coronavirus disease 2019 acute invasive fungal sinusitis. We identified and studied several factors that may have an effect on the prognosis. These factors included patient-related factors, disease-related factors, and treatment-related factors.
Results
Comorbidities especially renal impairment, previous intensive care unit admission, skin involvement, and intracranial spread of infection are associated with significantly poorer outcomes. Early aggressive surgical debridement is an independent factor associated with better prognosis.
Conclusion
Identifying prognostic factors may have a role in prevention of invasive fungal sinusitis, predicting prognosis, and tailoring patient-specific treatment protocols.
Tufas are freshwater carbonate rocks that form in continental environments through a combination of physical, chemical, and biological processes. This study investigates the role of microorganisms in the precipitation of Quaternary tufa deposits in the Serra da Bodoquena Formation, in the Bonito region. Two sites along the Mimoso River, named Taíka and Mimosa, characterized by the pool–barrage–cascade depositional subenvironment, were selected for this study. Four distinct facies were identified: stromatolitic boundstones, phytoherm boundstones of algae, phytoherm boundstones of bryophytes, and phytoclastic rudstones. These facies were observed in diverse hydrological settings, including fast-flowing waters, such as waterfalls and cascades, as well as slow-flowing areas, such as pools and dams. The δ18O depletion indicated a meteoric origin for the fluid involved in carbonate precipitation. The low δ13C values were attributed to photosynthetic processes and the contribution of light carbon-enriched groundwater. The presence of Oocardium stratum and calcified organic mucilage from extracellular polymeric substance (EPS) corroborates the significant role of microorganisms in tufa formation, particularly in stromatolitic boundstones and phytoherm boundstones of algae. Rapid CO2 degassing significantly contributes to mineralization in fast-flowing waters. Micro-CT results offer detailed insights into the relationship between mechanical processes and biological influences in shaping porosity characteristics. The findings of this study significantly enhance our understanding of the role of microorganisms in tufa formation, highlighting the complex interplay between biotic and abiotic processes in the development of different tufa facies. Moreover, the insights gained from this study provide valuable implications for interpreting tufa deposits worldwide.
The behaviour of an axisymmetric bubble in a pure liquid forced by an acoustic pressure field is analysed. The bubble is assumed to have a sharp deformable interface, which is subject both to surface tension and to Rayleigh viscosity damping. Two modelling regimes are considered. The first is a linearized solution, based on the assumption of small axisymmetric deformations to an otherwise spherical bubble. The second involves a semi-numerical solution of the fully nonlinear problem, using a novel spectral method of high accuracy. For large-amplitude nonspherical bubble oscillations, the fully nonlinear solutions show that a complicated resonance structure is possible and that curvature singularities may occur at the interface, even in the presence of surface tension. Rayleigh viscosity at the interface prevents singularity formation, but eventually causes the bubble to become purely spherical unless shape-mode resonances occur. An extended analysis is also presented for purely spherical bubbles, which allows for a more detailed study of the effects of resonance and the Rayleigh viscosity at the bubble surface.
The attention-based view contends that executives possess limited attentional capabilities that must be carefully allocated across different strategic issues. Although many scholars contend that narrow strategic attention breadth leads to better performance, others argue that broad strategic attention breadth may be more beneficial due to better opportunity scanning. We posit that the relationship between strategic attention breadth and performance will be inverted U-shaped, where strategic attention breadth is positively related to firm performance up to an optimal point, after which firms will see declining benefits due to executive cognitive overload. Furthermore, we propose that executives’ assessment of strategic opportunities will be influenced by the firm’s corporate social responsibility perspective, as the firm’s environmental and ethical commitment may mitigate executive blind spots and enhance opportunity selection. We support our hypotheses with multiple measures of firm performance and a content analysis of annual reports corresponding to a 5-year longitudinal sample of 2,245 S&P 500 firms.
Learning orientation emphasizes the importance of learning from any experience. It is grounded on commitment to learn, shared vision, open‐mindedness, and knowledge sharing. Organizational knowledge management literature based on social complexity theory posits that learning orientation makes companies generate new knowledge through spontaneous multi-level iterations and self-organization. Challenges related to the current business environment requires companies to constantly adjust to remain competitive. Still, the mechanisms making learning-oriented companies more capable to develop innovative product have been scantly explored. Pertinent literature actually conjectures this relationship as spontaneous, directed, and unmediated. Moreover, Small and Medium Enterprises (SMEs)rarely represent the context of analysis of research on this topic. Frequently lacking resources to systematically pursue product innovation, SMEs rely on solutions deriving from the combination of internal knowledge and external sources; thus, these companies depend on learning orientation principles to remain innovative. In this vein, the research aims to understand how learning orientation allows product innovation in SMEs through the achievement of strategic flexibility. Structural equation modelling was used to analyse data from 300 British SMEs. The results demonstrate the mediating role of strategic flexibility in the relationships between learning orientation and product innovation. The importance of innovation culture also emerged.
One type of computational indeterminacy arises from partitioning a system’s physical state space into state types that correspond to the abstract state types underlying the computation concerned. The mechanistic individuative strategy posits that computation can be uniquely identified through either narrow physical properties exclusively or wide, proximal properties. The semantic strategy posits that computation should be uniquely identified through semantic properties. We develop, and defend, an alternative functional individuative strategy that appeals—when needed—to wide, distal functions. We claim that there is no actual computation outside of a functional context. Desiderata for the underlying notion of teleofunction are discussed.