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People with Raynaud’s phenomenon (RP) experience poorer mental health and quality of life than the general population, and there is limited evidence for treatment options in RP. The Common Sense Model of illness representations (CSM) is a well-established theoretical model, which has not yet been robustly investigated in RP, but may provide potential avenues for psychological interventions with the ability to explore perceptions and beliefs, such as cognitive behavioural therapy (CBT). The study aims were to investigate illness perceptions and examine the relationship between illness perceptions and symptom severity and quality of life in RP to explore a theoretical basis for potential treatment avenues. A cross-sectional online questionnaire design was employed and 169 adults with RP (primary or secondary) were analysed. Illness perceptions significantly differed between primary and secondary RP types on all but one domain (p < .05). Hierarchical multiple regressions indicated that illness perception subscales made a significant unique contribution to the models explaining 65% variance in symptom severity (R2 = .65, p < .001) and 30% variance in quality of life (R2 = .30, p < .001). This novel study provides preliminary evidence regarding the applicability of the CSM to RP in a clinically meaningful way. CBT, which can specifically target illness perceptions within a wider psychological formulation, may be helpful for individuals with RP who are experiencing psychological distress in relation to symptom severity. Further work is needed to develop outcome measures specific to RP and tailor interventions to manage distress and impaired quality of life.
Key learning aims
(1) The Common Sense Model is applicable and relevant to Raynaud’s phenomenon (RP) and there are important differences between illness perceptions in those with primary and secondary RP subtypes.
(2) Findings show that illness-specific cognitions make a significant contribution to the variance in symptom severity and quality of life in those with both subtypes of RP, which has notable implications for the assessment, formulation and treatment of psychological difficulties in RP.
(3) This offers a basis for further replication and development and adaptation of an intervention for this group, drawing on the evidence base for long-term conditions.
Influenza and other acute respiratory viral infections (ARVIs) are among the most common human diseases. In recent decades, the discovery of cytokines and their significance in the pathogenesis of diseases has led to extensive research on these compounds in various pathologies including ARVIs. The aim of the research was to study the cytokine profile in patients with ARVIs. The cases of 30 patients were investigated. Etiological diagnosis was performed by polymerase chain reaction. Different classes of cytokines in the serum were defined by the enzyme-linked immunosorbent assay (ELISA). The level of cytokines depended on the number of pathogens. The highest levels of pro-inflammatory interleukins and the lowest levels of anti-inflammatory IL-4 were observed in patients with a combination of five or more viruses compared to those with a monoinfection. Analysis of the data showed that in the acute phase, the levels of all studied pro-inflammatory cytokines – IL-2, IL-6, and TNF-α – increased by 8, 39, and 9 times, respectively, compared to those in healthy individuals. In the acute phase of ARVI, the levels of pro-inflammatory cytokines were significantly higher and depended on the severity of the disease. The imbalance of cytokines in the serum has been established in cases of ARVIs, depending on the severity of the disease.
In this paper, we prove a cocycle version of marked length spectrum rigidity. There are two consequences: the first one is marked length pattern rigidity for arithmetic hyperbolic locally symmetric manifolds, and the second one is a strengthened marked length spectrum rigidity for surfaces and closed locally symmetric manifolds.
Scholarship on early modern English Catholic music after the reformations tends to focus on the activities of male musicians and male institutions. Despite increased study of English convent culture by scholars of religious, social, and literary history, there remains little specialist examination of music at post-Reformation English convents in exile, and their role in wider musical networks in early modern Europe is markedly under-acknowledged. This article aims to highlight how complex miscellanies with links to English monastic institutions in exile can offer insight into the convents’ otherwise elusive musical world. Using a hitherto unanalysed miscellany – Douai Ms 785 – this article will show how codicological study of manuscripts, combined with study of concordances and unica, can illuminate the role of English convents in early modern musical networks. In doing so, it will demonstrate the need to understand miscellanies like Douai Ms 785 as witness to interacting, overlapping musical and religious ecosystems in early modern Europe.
This paper focuses on simulating turbulent flow over propagating waves by solving the full Navier–Stokes equations in a moving frame. A careful comparison of flow statistics with previous experimental and numerical results demonstrates, to some extent, the rationality of simplifying wind waves as turbulent flow over moving wave boundaries. The phase-averaging method is then applied to investigate the momentum and energy transfers between turbulent wind and waves propagating at slow, intermediate and fast speeds. The results suggest that the dominant mechanism for producing Reynolds shear stress (RSS) and turbulent kinetic energy (TKE) is related to the wave age. Slow waves produce RSS and TKE similar to a two-dimensional shear turbulence. However, a fast wave enhances the streamwise Reynolds normal stress, the windward side's negative RSS and the gradient of both streamwise and vertical velocities, leading to additional RSS and TKE productions that can be ignored under the slow wave regimes. A strengthening wave–turbulence exchange is also found for fast waves. The intermediate wave can be regarded as a transitional condition determining this change.
In December 2018, an outbreak of Salmonella Enteritidis infections was identified in Canada by whole-genome sequencing (WGS). An investigation was initiated to identify the source of the illnesses, which proved challenging and complex. Microbiological hypothesis generation methods included comparisons of Salmonella isolate sequence data to historical domestic outbreaks and international repositories. Epidemiological hypothesis generation methods included routine case interviews, open-ended centralized re-interviewing, thematic analysis of open-ended interview data, collection of purchase records, a grocery store site visit, analytic comparison to healthy control groups, and case–case analyses. Food safety hypothesis testing methods included food sample collection and analysis, and traceback investigations. Overall, 83 cases were identified across seven provinces, with onset dates from 6 November 2018 to 7 May 2019. Case ages ranged from 1 to 88 years; 60% (50/83) were female; 39% (22/56) were hospitalized; and three deaths were reported. Brand X profiteroles and eclairs imported from Thailand were identified as the source of the outbreak, and eggs from an unregistered facility were hypothesized as the likely cause of contamination. This study aims to describe the outbreak investigation and highlight the multiple hypothesis generation methods that were employed to identify the source.
We develop a new class of spatial voting models for binary preference data that can accommodate both monotonic and non-monotonic response functions, and are more flexible than alternative “unfolding” models previously introduced in the literature. We then use these models to estimate revealed preferences for legislators in the U.S. House of Representatives and justices on the U.S. Supreme Court. The results from these applications indicate that the new models provide superior complexity-adjusted performance to various alternatives and that the additional flexibility leads to preferences’ estimates that more closely match the perceived ideological positions of legislators and justices.
This study uses high-fidelity simulations (direct numerical simulation or large-eddy simulation) and experimental datasets to analyse the effect of non-equilibrium streamwise mean pressure gradients (adverse or favourable), including attached and separated flows, on the statistics of boundary-layer wall-pressure fluctuations. The datasets collected span a wide range of Reynolds numbers ($Re_\theta$ from 300 to 23 400) and pressure gradients (Clauser parameter from $-0.5$ to 200). The datasets are used to identify an optimal set of variables to scale the wall-pressure spectrum: edge velocity, boundary layer thickness and the peak magnitude of Reynolds shear stress. Using the present datasets, existing semi-empirical models of the wall-pressure spectrum are shown unable to capture effects of strong, non-equilibrium adverse pressure gradients, due to inappropriate scaling of the wall pressure using the wall shear stress, calibration with limited types of flows and dependency on model parameters based on the friction velocity, which reduces to zero at the detachment point. To address these shortcomings, a generalized wall-pressure spectral model is developed with parameters that characterize the extent of the logarithmic layer and the strength of the wake. Derived from the local mean streamwise velocity profile, these two parameters inherently carry the effect of the Reynolds number, as well as those of the non-equilibrium pressure gradient and its history. Comparison with existing models shows that the proposed model behaves well and is more accurate in strong-pressure-gradient flows and in separated-flow regions.
This paper examines the impact that the finally approved Artificial Intelligence Act (AIA) will have on European public authorities when developing, acquiring and using AI systems. It argues that, despite the initial disappointment that the Act may cause when approaching it from an administrative law perspective, and despite the fact that some of the solutions that have been finally chosen are questionable, it represents a remarkable step forward, duly addressing many of the problems raised in the literature in relation to the automation of administrative decisions and the use of AI systems by public authorities.
Does resident diplomacy influence international outcomes? Theoretically, I argue that resident diplomats tend to adopt uniquely cooperative stances toward their hosts. I test this expectation using a natural experiment involving British visa issuance. Starting in 2007, the UK transferred visa decision making from local diplomatic posts to centralized hubs, located either at third country diplomatic posts or domestically. I study this rollout to credibly estimate the causal effects of visa adjudication by local posts. I find that resident diplomats implement a much more lenient visa policy—transferring adjudication to an outside hub reduces issuance by about fifteen percent. There is a robust difference between the behavior of local and third-country posts, showing that this cooperative effect of diplomacy is relationship-specific.
The legally binding unilateral application of norms holds potential for abuse. Nonetheless, self-judgment is alive and kicking. Self-judgment language commonly features in treaties and states frequently invoke their authority to ‘self-judge’ sensitive issues, such as matters related to national security, before international judicial bodies. In many of these cases, the controversy whether a norm has a self-judgment quality or not has been decisive for the outcome of the dispute. Yet, the meaning and consequences of self-judgment remain contested.
This article develops self-judgment as the authoritative application of international legal norms by states. It posits that steps towards the judicialization of self-judgment by judicial bodies have given rise to state efforts to preserve unfettered discretion. Notably, states have responded to attempts by judicial bodies to gain authority over the application of self-judgment by drafting provisions more explicitly. This dynamic continues to make self-judgment a site of judicialization and pushback. The only way to understand the meaning, limitations and development of self-judgment is by studying this process. Doing so conceptually refines self-judgment and allows for more meaningful references to the notion in practice.
An investigation into an outbreak of Salmonella Newport infections in Canada was initiated in July 2020. Cases were identified across several provinces through whole-genome sequencing (WGS). Exposure data were gathered through case interviews. Traceback investigations were conducted using receipts, invoices, import documentation, and menus. A total of 515 cases were identified in seven provinces, related by 0–6 whole-genome multi-locus sequence typing (wgMLST) allele differences. The median age of cases was 40 (range 1–100), 54% were female, 19% were hospitalized, and three deaths were reported. Forty-eight location-specific case sub-clusters were identified in restaurants, grocery stores, and congregate living facilities. Of the 414 cases with exposure information available, 71% (295) had reported eating onions the week prior to becoming ill, and 80% of those cases who reported eating onions, reported red onion specifically. The traceback investigation identified red onions from Grower A in California, USA, as the likely source of the outbreak, and the first of many food recall warnings was issued on 30 July 2020. Salmonella was not detected in any tested food or environmental samples. This paper summarizes the collaborative efforts undertaken to investigate and control the largest Salmonella outbreak in Canada in over 20 years.
The public trust doctrine holds promise as a tool for combatting international climate inaction. A global public trust in the Earth’s atmosphere may be a feasible avenue for generating international cooperation in this issue. The public trust doctrine is a viable and underutilized mechanism of understanding our collaborative obligations with respect to natural resources. This Article looks to the historical origins and current presentations of public trusts to extract features which indicate its effectiveness and appeal for modern climate change applications. Additionally, it presents two circumstances under which a global public trust in the atmosphere could eventually develop.
This article analyses the law-making power of international sports federations, with a specific focus on their authority of shaping global norms on gender. It explores a variety of international sporting rules from feminist and queer perspectives. These include the ban of rainbow armbands at the 2022 FIFA (Men’s) World Cup, rules on the participation of transgender persons in rugby, gendered and racialized uniform regulations in sports, and the Semenya case concerning the sports participation of women with variations in sex characteristics The analysis asserts that despite being non-state actors, international sports federations are de facto international lawmakers that disseminate hegemonic gender norms reflecting cis-hetero-sexism and white body norms. However, analysing the Semenya case and the decision of the Chamber of the European Court of Human Rights in the case shows that the law-making power of international sports federations in shaping gender norms is not absolute but embedded in a transnational network of norms. The article concludes that subjecting international sports federations to a feminist, queer, and anti-racist legal analysis assists in understanding how hegemonic norms on gender circulate transnationally and enhances knowledge on how international law works in practice.
The cardiorespiratory effect in mental illnesses has recently received much attention. However, the cardiovascular and pulmonary effects of mood disorders have not been clearly demonstrated.
Aims
This study aims to compare individuals with mood disorders and healthy people in terms of exercise capacity, functionality, respiratory muscle strength, pulmonary function, dyspnoea and physical activity level.
Method
This cross-sectional study involved 30 patients with mood disorders and 35 age- and gender-matched healthy individuals. Exercise capacity (6-Minute Walk Test (6MWT), 3-Minute Step Test (3MST)), functionality (vertical jump test, functional reach test), respiratory parameters (respiratory muscle strength, pulmonary function test), dyspnoea (Modified Medical Research Council Dyspnoea Scale) and physical activity level (Short-Form International Physical Activity Questionnaire (IPAQ)) were evaluated.
Results
6MWT results (P < 0.001) and functional test scores (vertical jump test, P = 0.006; functional reach test, P < 0.001) were significantly lower, and heart rate recovery after 3MST (P < 0.001) was higher in mood disorder patients. Although patients' respiratory parameters were lower than healthy individuals, only measured and predicted respiratory muscle strength (P < 0.001), peak expiratory flow rate litres (P < 0.001), forced vital capacity predicted (P = 0.010) and forced expiratory volume in 1 s predicted (P = 0.002) values were statistically significantly different. Dyspnoea with activities was higher in patients (P < 0.001). Patients spent more time sitting (IPAQ, P < 0.001), but overall physical activity levels were similar between the two groups (P > 0.05).
Conclusions
Patients with mood disorders had decreased exercise capacity and pulmonary function, lower functionality scores and respiratory muscle strength, and increased dyspnoea. Exercise-based rehabilitation protocols are recommended for the management of risk factors affecting the mood disorder patients' cardiorespiratory status.
The trend of global cooling across the Cenozoic transformed the North American landscape from closed forest to more open grasslands, resulting in dietary adaptations in herbivores in response to shifting resources. In contrast, the material properties of the predator food source (muscle, skin, and bone) have remained constant over this transition, suggesting a corresponding lack of change in predator dietary adaptations. We investigated the North American mammalian predator fossil record using a tooth-shape metric and body mass, predicting that the former would exhibit stability. Instead, we found that mean molar morphology became more blade-like, with our tooth-shape metric sharply increasing in the late Eocene and remaining high from the Oligocene onward. Subsequent tests in extant carnivorans reveal taxa with more bladelike teeth are prevalent in more open environments. Our results reveal an unexpected functional shift among North American predators in response to large-scale environmental changes across the Cenozoic.
In recent decades, historians have acknowledged the role that women played in shaping and disseminating scientific knowledge during the Enlightenment. Current scholarship also suggests that fashion was a means through which haptic, economic, and practical knowledge was shared among women. This article focuses on one particular fashion accessory – the artificial flower – to explore its contribution to our understanding of women’s knowledge of botany in eighteenth-century France. An analysis of the receipts preserved in the credit records of France’s most famous fashion merchant, Marie-Jeanne (Rose) Bertin (1747–1813), demonstrates high levels of specificity in the flowers that women chose to adorn their outfits. Seventy-five different types of flowers are mentioned using their vernacular names, suggesting that knowledge about a wide variety of flowers was exchanged between fashion merchants and their clients during conversations about clothing. This article therefore casts the fashion merchant’s shop as a site of botanical knowledge generation and exchange.
Parents of children with skin conditions can experience stress from the additional responsibilities of care. However, there is a lack of psychological interventions for families affected by a dermatological diagnosis.
Aims:
To investigate (1) whether delivering the ‘Living in the Present’ mindfulness curriculum to parents of children with skin conditions reduced stress and increased both parental/child quality of life (QoL), and (2) determine intervention acceptability.
Method:
Ten parents of children with eczema, ectodermal dysplasia, ichthyosis, and alopecia took part in a mindfulness-based intervention. Using mixed methods, a single-group experimental case design (SCED) was conducted and supplemented by thematic analysis of exit interviews. Parents completed idiographic measures of parenting stress, standardised measures of QoL, stress, mindfulness, and took part in exit interviews. Children also completed QoL measures.
Results:
Tau-U analysis of idiographic measures revealed three parents showed some significant improvements in positive targets, and five parents showed some significant improvements in negative targets. Assessment of reliable change demonstrated that: one parent showed improvement in mindful parenting, three parents showed improvement in parenting stress, seven parents showed improvement in anxiety, three parents showed improvements in depression, six parents showed improvement in QoL, and four children showed improvement in QoL. However, two parents showed increased anxiety. Thematic analysis revealed positive changes to mood following mindfulness, although challenges were highlighted, including sustaining home practice.
Conclusion:
Findings suggest this specific form of mindfulness intervention could be effective for parents of children with skin conditions; however, further robust studies are needed.
Germany’s content moderation law—NetzDG— is often the target of criticism in English-language scholarship as antithetical to Western notions of free speech and the First Amendment. The purpose of this Article is to encourage those engaged in the analysis of transatlantic content moderation schemes to consider how Germany’s self-ideation influences policy decisions. By considering what international relations scholars term ontological security, Germany’s aggressive forays into the content moderation space are better understood as an externalization of Germany’s ideation of itself, which rests upon an absolutist domestic moral and constitutional hierarchy based on the primacy of human dignity. Ultimately, this Article implores American scholars and lawmakers to consider the impact of this subconscious ideation when engaging with Germany and the European Union in an increasingly multi-polar cyberspace.
We study the dynamics of dissipative billiard maps within planar convex domains. Such maps have a global attractor. We are interested in the topological and dynamical complexity of the attractor, in terms both of the geometry of the billiard table and of the strength of the dissipation. We focus on the study of an invariant subset of the attractor, the so-called Birkhoff attractor. On the one hand, we show that for a generic convex table with ‘pinched’ curvature, the Birkhoff attractor is a normally contracted manifold when the dissipation is strong. On the other hand, for a mild dissipation, we prove that, generically, the Birkhoff attractor is complicated, both from the topological and the dynamical points of view.