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This study aims to investigate the key characteristics of a device to support patients with hearing impairments in utilising deep inspiration breath-hold (DIBH) radiation therapy (RT).
Method:
A qualitative approach was adopted. Semi-structured interviews were conducted both online and in person with 11 participants, including key stakeholders from a range of backgrounds: radiation oncologists, radiation therapists, medical physicists, RT service managers, industry vendors, and deaf service users. Data were analysed using thematic analysis, following the six-step approach outlined by Braun and Clarke.
Results:
Participants’ attitudes towards a device were explored across four key themes:
• Device characteristics
• Shape and size
• Interference with treatment
• Associated challenges
Thematic analysis identified several unifying themes, including the importance of co-designing a device incorporating both vibrational and visual elements. Overall, participants expressed a preference for a small and wireless device.
Conclusion:
This study identified potential characteristics for a device to support patients with hearing impairments in accessing DIBH during their radiation therapy treatment. A device incorporating both visual and vibrational elements may be optimal for addressing the diverse needs of patients in this cohort.
This article examines the late colonial performances of Adolphe Kisimba, a Congolese producer and performer who toured his show Mu Kongo – Mu Belgique to Belgium in early 1959. Developed under the auspices of the Belgian colonial state, this multimedia spectacular featured sketches, songs, a magic lantern light show, and a satirical “reverse ethnography” film of Belgian culture as narrated by Kisimba. This article traces Kisimba’s trajectory through state-sponsored shows such as Changwe Yetu, Spectacles Populaires, and the idiosyncratic Mu Kongo – Mu Belgique and argues that staged performance, and the international mobility that this art form inherently enables, served as a contested space in which Central Africans sought to redefine colonial hierarchies and through which they envisioned new professional horizons. The overlooked histories of Kisimba and late colonial African artists like him, this article suggests, offer new insights into African cultural negotiations and global outlooks before independence.
Patient transfers provide a critical mechanism for enhancing care capacity and distributing patient load across hospitals and communities. Yet, during disasters and surge events, decisions about where to send patients are often made by Medical Operations Coordination Centers and similar centralized regional coordination bodies, with limited visibility into how transfers are unfolding across the broader hospital system. This study proposes a spatial-network framework, informed by a typology of patient transfers, that represents interhospital transfers as patient flows across a geographic network of hospitals. The framework provides tools to identify and interpret transfer patterns that coordination bodies need to enhance situational awareness and make timely, informed decisions at the local, regional, and state levels. Using inpatient discharge data from a Florida health agency, this study further demonstrates the framework’s applicability during a disaster and shows how administrative health data can be transformed into spatial networks that support interhospital transfer coordination decision-making.
High-resolution large eddy simulations are conducted of locally forced, shear-free turbulence in the presence of an initially sharp density interface. The simulations are reminiscent of oscillating grid turbulence experiments used to isolate the effect of turbulent diffusion and entrainment from background shear. By simulating such a flow we avoid common challenges of the experiments such as secondary-flow contamination due to sidewall effects and the inevitable interaction of the stratifying agent and forcing region. To address the latter concern, we add a heating term (potential energy sink) to the governing equations in the forcing layer, thereby preventing a heat flux through the source region. This modification sets up a continuous stratification in the mixed layer that is often assumed to be negligible in experiments. Despite this difference, we are able to make meaningful comparisons in terms of the overall entrainment rate, which varies as a power law with a turbulent Richardson number. Two exponents, $-2$ and $-1$, are measured depending on the definition of the Richardson number and entrainment rate used. The definition leading to $-1$ is consistent with most experiments, and we argue it is the superior choice if one is able to measure the relevant quantities. We also verify the self-similar scaling of turbulence velocity and length scales in the homogeneous fluid and propose ‘inner’ and ‘outer’ scalings for the stratified cases based on a local Froude number. The detailed scaling results are useful for turbulence model validation.
Entomopathogenic nematodes (EPNs) from the genera Steinernema and Heterorhabditis are potent biocontrol agents. They kill insects through a unique symbiosis with pathogenic bacteria (Xenorhabdus or Photorhabdus), making them ideal for integrated pest management due to their broad host range and environmental safety. Despite high species diversity, genomic resources for these nematodes remain limited. The aim of this study was to characterise the nuclear and mitochondrial genomes of a newly described species, S. tarimense, and a putative novel Heterorhabditis species (strain XJ-55), both obtained from Xinjiang, China. A comprehensive genomic annotation and analysis were conducted to investigate the evolutionary origins of insect parasitism and the molecular adaptation mechanisms involved in host–parasite interactions. Through Illumina sequencing and de novo assembly, we obtained fragmented yet biologically informative genomes for both species. The assembly of S. tarimense reached a BUSCO completeness of 84.06% with an estimated genome size of 84.27 Mb, while that of Heterorhabditis sp. XJ-55 achieved 92.28% completeness with an estimated size of 75.11 Mb. Functional annotation revealed conserved metabolic profiles between the two species, with the Metabolism category being the most abundant. Mitochondrial genomes were successfully reconstructed using MitoZ and NOVOPlasty, resulting in a complete mitogenome of S. tarimense (13,836 bp) and a partial mitogenome of Heterorhabditis sp. XJ-55 (16,865 bp). Comparative mitogenomic analysis highlighted characteristic features such as pronounced A+T bias and distinct codon usage patterns, providing new evolutionary insights into these genera. These genomic resources establish a foundation for future comparative studies and functional investigations, with promising implications for enhancing the biological control efficacy of EPNs in sustainable agricultural systems.
An estimated 5% of cases of first-episode psychosis are due to rare and sometimes reversible causes that can be identified through diagnostic investigations that are currently less common in psychiatry, e.g. lumbar puncture, specialised brain imaging and genetic testing. The current clinical practice of the use of such technologies, however, raises several challenging ethical questions. Drawing on our multidisciplinary perspective spanning psychiatry, neurology, philosophy, neuroscience, sociology and medical ethics from three countries, we identify emerging ethical issues in the diagnosis of rare causes of psychosis. We group challenges thus: (a) diagnostic justice, (b) moral responsibility and (c) unintended consequences of diagnostic work-up. Justice challenges surrounded the role of (a) ‘luck’, (b) social capital and (c) prior psychiatric diagnoses in determining access to work-up. Moral responsibility challenges surround the extent to which (a) clinicians are expected to know the red flags and work-up for rare or ultra-rare causes; and (b) those running health systems should enable knowledgeable clinicians to provide the requisite work-up. Challenges related to unintended consequences include the risk of pursuing work-up of rare causes to reinforce (a) psychiatric exceptionalism and (b) paternalistic decision-making that doesn’t allow space for patient preferences. Finally, we reflect on unresolved issues and future directions.
This article examines the conditions under which policy learning occurs, distinguishing between instrumental learning (evidence-based, problem-solving oriented) and political learning (strategic, shaped by institutional position and incentives). Drawing on three cases presented by Claudio Radaelli – examining bureaucrats, politicians, and experts – the paper shows that much of what occurs in policy practice is best understood as political learning: actors acquire and deploy knowledge strategically, filtered through professional hierarchies, electoral pressures, and reputational concerns. While the literature has long recognised these dynamics, the paper argues that existing accounts of political learning understate its relational and contextual character. Political learning emerges through positioned interactions within institutional and epistemic communities, rather than from individual strategic calculation alone, and from alignment with shifting background political conditions that determine what knowledge becomes actionable. Recognising this relational dimension has implications for institutional design aimed at fostering democratic accountability and integrating expertise more effectively into policy making.
Tropheryma whipplei was identified by plasma microbial cell-free DNA sequencing within 4 days in severe culture-negative endocarditis after antibiotics had already been started. The result supported earlier diagnostic clarification and antimicrobial de-escalation before valve pathology was available, illustrating a practical diagnostic-stewardship role for noninvasive sequencing in high-acuity endocarditis.
This Article explores future fact-finding as a distinct subject of legal research. Usually, legal decision makers, such as judges, decide cases based on past or present facts. However, sometimes, legal norms oblige them to engage in future assessments. The Article argues that future fact-finding is fundamentally different from past or present fact-finding and should be treated as a separate legal phenomenon. It conceptualizes this practice in a legal context and sketches an initial theoretical framework for thinking about and engaging in future fact-finding. To do this, the Article draws on philosophical (epistemological) insights and applies a classical doctrinal method by examining positive law, case law, and doctrine.
State legislative turnover is one of the most commonly included measures in state and legislative politics. Yet, few states count legislative turnover or maintain records of internal shifts and those that do often have differences in how these records are maintained. To help resolve these differences we introduce SEAT, State Exits & Annual Turnover, a new dataset tracking legislative turnover in all 50 states spanning 30 years. In brief, we review the importance of turnover as a measure and offer insight into state legislative resources. In doing so, we illustrate the breadth of the data, demonstrate its usefulness, and offer a brief replication-extension. Focusing on annual turnover rates, we find numerous discrepancies with existing measures and state records. This release offers a more up to date understanding of turnover and its variation, as well as an inadvertent call for better records and measurements.
We introduce a slice-based quaternionic analog of wavelet sets in the right- quaternionic Hilbert space $L^{2}(\mathbb {R}^{d},\mathbb {H})$. Using a slice-quaternionic Fourier transform, we characterize boundedness and Parseval tightness of affine systems generated by $\widehat {\psi }=(2\pi )^{-d/2}\chi _{E}q$ via translation and dilation multiplicity conditions on E. These results extend the classical frame wavelet-set theory of Dai et al. (2003, J. Comput. Appl. Math. 155, 69–82) to the quaternionic setting under a natural slice-phase restriction. Several dyadic, directional, and multiwavelet examples illustrate the framework and provide the first systematic construction of quaternionic wavelet sets.
La Marmotta is one of the best-preserved Early Neolithic lakeshore settlements in the Mediterranean, yet its chronology has remained poorly defined. Previous interpretations relied mainly on decoration-based ceramic classifications and a limited radiocarbon dataset, hindering our understanding of the site’s occupational dynamics and its role in the wider European Neolithic. This study presents a revised chronological framework grounded in 35 radiocarbon determinations, including 22 new dates on short-lived botanical remains and selected wooden artifacts. The samples were carefully selected from well-documented contexts to minimise post-depositional disturbance and analyzed using Bayesian modeling. Radiocarbon results were interpreted in parallel with a detailed reassessment of ceramic artifacts and decorations. This integrated approach suggests that ceramic variability does not reflect a succession of different phases, but rather the cultural diversity of a single, dynamic community.
Climate change is threatening humanity’s existence. Youth have the potential and capability to contribute to tackling climate change. The current study aims to examine how school and family environmental education can enhance environmental knowledge, willingness to act, and pro-environmental behaviours among children and young people. The Bayesian Mindsponge Framework (BMF) analytics was utilised on a nationally representative dataset of 2069 Vietnamese primary, secondary, and high school students. The analysis suggests that school- and family-based environmental education is beneficial for improving students’ environmental knowledge and willingness to take environmental action. Notably, the effect of school education is more substantial for cultivating environmental knowledge, whereas family education has a stronger impact on raising students’ willingness to act. Students with better environmental knowledge are more likely to engage in pro-environmental behaviours only when they are willing to act. If students are unwilling, higher environmental knowledge is negatively associated with pro-environmental behaviour. Building on these findings, we advocate for coordinated educational efforts between schools and families to strengthen students’ environmental knowledge, pro-environmental intentions, and behaviours. Furthermore, we emphasise the need for Vietnam’s education system to gradually shift away from didactic, top-down methods toward more experiential, interdisciplinary, and student-centred approaches that support transformative environmental learning and nurture an eco-surplus culture.
This article explores the intersection of Indigenous cultural heritage and international intellectual property (IP) law. Drawing on personal narrative, community memory, and institutional experience, it traces how, despite colonial legacies embedded within global IP regimes, Indigenous Peoples have carved out space for agency and influence through diplomatic engagement in international forums such as the World Intellectual Property Organization (WIPO). The article narrates and examines the evolution of Indigenous participation within WIPO’s Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge, and Folklore (IGC), culminating in the landmark adoption of the 2024 WIPO Treaty on Intellectual Property, Genetic Resources, and Associated Traditional Knowledge. Through the lens of “Indigenous diplomacy,” it argues that Indigenous advocates have not only contested exclusion but also reshaped aspects of legal norms, contributing to a broader decolonial movement that seeks justice, recognition, and the right to control and benefit from their intellectual and cultural heritage.
Despite the burgeoning international literature on the history of sexual violence, the topic of incest has received limited attention from historians. This article examines hitherto restricted archival files on thirty-seven offenders who were convicted of incest in the independent Irish state under the Punishment of Incest Act 1908 and, in doing so, provides a rare glimpse into exploitative sexual practices within Irish families in the decades after independence. The findings show that incest perpetrators were effectively a male preserve and that incest was almost always an abusive relationship that persisted over an extended period of time. The article also reveals that victims were invariably younger than offenders, some incest offenses involved alcohol, violence, and threats, many cases resulted in pregnancy, motherless children appear to have been vulnerable, and most of these crimes were premeditated and non-consensual. The article concludes by capturing the limitations of the 1908 Act in neglecting to cover sexual acts other than vaginal intercourse and embrace a broader range of family relationships.
Through the examination of a criminal trial that took place in Vienna in January and February 1968, this article explores postwar Austria’s treatment of pornography. It argues that the 1950 law criminalizing pornography in Austria was a product of the Second Republic’s consensus-driven politics and emphasis on international obligations under a 1923 international treaty against obscenity. The spectacle of the presiding judge berating defendants on trial in 1968 sparked public outrage and calls for legal reform. The Austrian government strove to liberalize the country’s obscenity laws but soon abandoned these efforts. Through a comparison to Denmark and West Germany, the article suggests that the failure of legislative reform in Austria resulted from an emphasis on political consensus and on international law, as well as the terms of the debate over pornography after the 1968 trial, focused on restraining judicial power rather than artistic liberties and free speech.
On 28 May 2025, the Higher Court of Appeal in Hamm (Germany) delivered a pioneering judgment in the case Lliuya v. RWE. The Court confirmed that German private nuisance law was applicable in the transnational context, and that the greenhouse gas emissions of the energy company RWE contributed to climate change and its adverse impacts. Based on the evidence provided, the Court concluded that the normative threshold of ‘imminence’ of a future, first-time property impairment was not reached. This article assesses the Court’s reasoning and the challenges it faced in determining ‘imminence’, considering conflicting scientific evidence. Against the backdrop of a legal and scientific analysis, the article argues that the physical laws underpinning climate change, and the scientific assessments of the Intergovernmental Panel on Climate Change, form a baseline of ‘best available science’ for the legal assessment of climate risks. Case-specific evidence that deviates from this baseline requires careful consideration. Furthermore, the legal interpretation of causally relevant evidence must depend on whether the science provides a qualitative or a quantitative statement.
Chiral active fluids consist of self-spinning particles that rotate due to continuous energy injection at the microscopic scale (e.g. by activity or an external field). The hydrodynamics of such fluids is described by antisymmetric contributions in the viscosity tensor – called odd viscosity – which are allowed by symmetry due to the presence of a non-trivial spin angular momentum density. By generalising the Helmholtz minimum dissipation theorem to systems with odd viscosity, we show that incompressible three-dimensional odd fluids in the presence of sources that induce flow (e.g. surfaces that impose boundary conditions) admit a unique solution for their steady flow fields at low Reynolds number. Furthermore, we prove that such flows dissipate more energy than ordinary Stokes flow, provided that the flow field is affected by odd viscosity. As an example, we consider a model fluid described by one shear viscosity and one odd viscosity in the creeping flow regime. We explicitly compute the stress tensor for a fluid subjected to a point-force density. Finally, we compute exact results for the pressure and flow fields around a translating and rotating spherical particle from their singularity representations. From these solutions and our extended Helmholtz theorem, we explain why a translating sphere dissipates more energy when odd viscosity is present, whereas a rotating sphere does not.