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This chapter explores how globalization constrains the policy autonomy of democratic governments and introduces a typology of four mechanisms that affect their ability to fulfill campaign promises: international legal obligations, market actors, citizens’ expectations, and economic uncertainty. These constraints are not evenly distributed: left-leaning parties are particularly vulnerable due to their typically expansionary agendas, whereas right-leaning parties are more aligned with market preferences. The chapter argues that globalization alters the cost–benefit calculus of promise making, and that parties often make promises knowing they may be difficult to keep, either due to informational uncertainty or strategic electoral incentives. These dynamics complicate the relationship between citizens and their governments, raising questions about the viability of promissory representation under global economic interdependence. This conceptual framework sets the stage for the empirical analysis in subsequent chapters.
Upper limb rehabilitation exoskeletons face fundamental challenges achieving coordinated multi-joint assistance within portable configurations. Current cable-driven systems demonstrate effective single-joint support but lack coordinated shoulder-elbow capabilities due to anchor-point sensing constraints that limit workspace during simultaneous movements. To address these limitations, this paper presents a novel coordinated 3-Degree of Freedom (DOF) shoulder-elbow exosuit (3.3 kg) employing motor-proximal sensing architecture. Strategic load cell repositioning from anchor points to actuation unit locations eliminates spatial constraints, while geometric compensation algorithms maintain measurement accuracy, enabling coordinated assistance (shoulder flexion/extension, abduction/adduction, elbow flexion/extension) with preserved 0–$90^\circ$ kinematic workspace. Systematic development integrating product design specifications, multi-criteria decision-making, and biomechanical component dimensioning provided traceable design synthesis. Preliminary proof-of-concept tests with healthy participants (n = 5) provide an initial assessment of the system performance, demonstrating adequate sensing accuracy within the primary Activities of Daily Living (ADL) workspace, measurable muscle activation reduction, and preserved natural kinematics with minimal range-of-motion (ROM) constraint. An extensive experimental validation is out of the scope of this work. Results establish technical feasibility for coordinated cable-driven assistance, identifying requirements for future clinical translation.
The “differentiability gap” presents a primary bottleneck in Earth system deep learning: Since models cannot be trained directly on non-differentiable scientific metrics and must rely on smooth proxies (e.g., MSE), they often fail to capture high-frequency details, yielding “blurry” outputs. We develop a framework that bridges this gap using two different methods to deal with non-differentiable functions: The first is to analytically approximate the original non-differentiable function into a differentiable equivalent one; the second is to learn differentiable surrogates for scientific functionals. We formulate the analytical approximation by relaxing discrete topological operations using temperature-controlled sigmoids and continuous logical operators. Conversely, our neural emulator uses Lipschitz-convolutional neural networks to stabilize gradient learning via: (1) spectral normalization to bound the Lipschitz constant and (2) hard architectural constraints enforcing geometric principles. We demonstrate this framework’s utility by developing the Minkowski image loss, a differentiable equivalent for the integral-geometric measures of surface precipitation fields (area, perimeter, and connected components). Validated on the EUMETNET OPERA dataset, our constrained neural surrogate achieves high emulation accuracy, completely eliminating the geometric violations observed in unconstrained baselines, which generate physically impossible precipitation fields in up to 7.8% of cases. However, applying these differentiable surrogates to a deterministic super-resolution task reveals a fundamental trade-off: While strict Lipschitz regularization ensures optimization stability, it inherently over-smooths gradient signals, restricting the recovery of highly localized convective textures. This work highlights the necessity of coupling such topological constraints with stochastic generative architectures to achieve full morphological realism.
In the homology cobordism group $\Theta_\mathbb{Z}^3$, it is not known if there are non-trivial linear dependences between Seifert fibered spheres. Based on involutive Heegaard Floer theory, Hendricks, Manolescu and Zemke introduced the local equivalence group $\mathfrak{I}$ along with the homomorphism $h\;:\;\Theta_\mathbb{Z}^3 \rightarrow \mathfrak{I}$. Using the work of Dai and Stoffregen, one can find non-trivial linear dependences between the images of Seifert fibered spheres under h. Therefore, it is interesting to ask if such dependences in $\mathfrak{I}$ originate from $\Theta_\mathbb{Z}^3$. In this paper, by employing the $r_s$-invariants from the filtered instanton Floer homology developed by Nozaki, Sato and Taniguchi, we provide certain conditions to guarantee that such relations are not realised even in the rational homology cobordism group. We also discuss the local equivalence class of the $\operatorname{Pin(2)}$-equivariant Seiberg–Witten Floer stable homotopy type.
The rapid expansion of omics technologies has created new opportunities to understand inter-individual variations in metabolic responses to diet. Such advances are particularly relevant for Asian populations, which exhibit distinct metabolic characteristics, including increased visceral adiposity, reduced β-cell reserves, and heightened susceptibility to type 2 diabetes at lower BMI levels, compared to Western populations. This review synthesizes the current evidence on metabolomic and genomic biomarkers associated with metabolic health in Asians and outlines the mechanistic pathways through which diet influences these biomarkers. Metabolomic signatures, such as lysophosphatidylcholines, micronutrient-derived metabolites, amino acid profiles, and oxidative stress indicators, have demonstrated strong potential for the early detection of metabolic dysfunction. In addition, carbohydrate-related markers of glycemic excursions, microbiome-derived metabolites, and diet-responsive fatty acid profiles may help capture the heterogeneity in postprandial regulation and diet responsiveness. Genetic variants enriched in Asian populations, including TMEM182- and NPC1L1-related polymorphisms, further modulate lipid metabolism, adipogenesis, and glycemic regulation. We also highlighted β-cell and nutrient-handling loci (e.g. KCNQ1, TCF7L2, SLC30A8, FUT2/6, BCMO1, and FADS1/2) as mechanistic anchors for biologically stratified dietary personalization. We discuss nutrient–metabolite interactions – particularly those involving dietary fibre and legumes – within culturally patterned Asian diets and highlight culturally consistent dietary strategies supported by multi-omics evidence. Finally, we propose a translational framework for implementing precision nutrition in Asia, emphasizing analytical standardization, clinician training, digital health integration, and equity considerations. Together, these insights underscore the potential of multi-omics approaches to inform individualized dietary recommendations and improve metabolic health across diverse Asian populations.
Central banking and monetary policy face particular challenges in heterogenous and multilevel currency areas. And yet, most literature on central banking, like most modern central banks themselves, assumes the validity of a unitary monetary authority implementing uniform monetary policy, even in compound polities. Here, I explore the dilemmas of central banking and monetary policy in politically decentralized currency areas by analyzing the origins of the Federal Reserve Act of 1913 and its provisions for a multilevel governance structure and decentralized monetary policy. The origins of the Federal Reserve remain puzzling because its decentralized structure is often dismissed as a failed experiment or a political compromise that nobody truly wanted. However, I find that its design was the product of a deliberate political effort to reimagine central banking in a federal society, and I trace the idea of a decentralized “central” bank to a distinct interpretation of the American political-constitutional tradition.
Belz and colleagues present GREAT, a seven-item clinical instrument for predicting electroconvulsive therapy response in unipolar depression, with promising discriminatory validity (AUC 0.841). We identify three methodological gaps – absent calibration, limited sample representativeness and unquantified incremental value – that must be addressed before GREAT can guide individual clinical decisions.
Dementia affects approximately 6–13% of adults aged 65 years and older, with Alzheimer’s disease accounting for most cases. Established symptomatic therapies, including acetylcholinesterase inhibitors and memantine, provide limited benefit and do not modify disease progression. Multiple monoclonal antibodies (mABs) targeting different amyloid-β species have been developed as potential disease-modifying therapies; because some agents have entered clinical use whereas others remain investigational, a continuously updated synthesis of their efficacy and safety is needed.
Aims
To evaluate the efficacy and safety of all anti-amyloid mABs for adults with Alzheimer’s disease, using a living systematic review and meta-analysis.
Method
We will conduct a living systematic review and meta-analysis in accordance with the Cochrane Handbook, Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 and the PRISMA extension for living systematic reviews. Randomised controlled trials comparing any approved or investigational anti-amyloid mAB with placebo, standard care or active comparators will be included. Searches of Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform will be updated every 6 months. Meta-analyses will be conducted separately for each antibody molecule using random-effects models. Critical outcomes include global clinical change and disease severity, cognitive abilities, functional ability and dependency, and safety (serious adverse events, treatment discontinuation and amyloid-related imaging abnormalities). Important outcomes include neuropsychiatric symptoms, quality of life and health system outcomes. Certainty of evidence will be assessed using the methodology Grading of Recommendations, Assessment, Development and Evaluation.
Results
This article describes a protocol; therefore, no review findings are available at this stage.
Conclusions
This living systematic review will provide an up-to-date synthesis of the benefits and harms of anti-amyloid monoclonal antibodies to inform clinical decision-making and health-system planning in Alzheimer’s disease.
Insects are increasingly used in environmental education (EE) due to their high diversity, ecological relevance, and presence in urban environments. This study evaluates the use of insects as a pedagogical tool by implementing formal and non-formal EE activities with secondary students living in areas with a high incidence of vector-borne diseases, on the coast of Oaxaca, Mexico. A total of 118 students participated in theoretical, fieldwork, and laboratory activities, as well as a public outreach event (“Entomo-Expo”). Pre- and post-workshop questionnaires were used to assess changes in knowledge, perceptions, and attitudes. At the end of the workshop, students identified 11 insect orders. They communicated their knowledge using scientific terminology, and negative reactions toward insects decreased, particularly in reports on killing behaviour, while responses associated with observation and the release of insects increased. Participants also recognised key ecological roles of insects, especially pollination. These results are associated with improvements in students’ conceptual understanding and more positive attitudes towards insects following participation in the programme. However, given the pre–post-design without a control group, these findings should be interpreted as changes over time rather than causal effects. To address the persistence of negative behaviours in older students, EE should employ both formal and non-formal teaching strategies to support a sense of responsibility and encourage a cognitive shift toward sustainable development.
International organizations (IOs) play a central role in contemporary international law-making: they institutionalize most of the processes through which international law is adopted today. From the perspective of the democratic legitimacy of international law, this raises the question of the conditions under which those IOs may be regarded as democratic representatives of their Member States' peoples. Curiously, given its important international and domestic stakes, however, the democratic representativeness of IOs, but also of States and other public and private institutions within those IOs does not seem to be much of a concern in practice. Even more curiously, and by contrast to other issues of democratic legitimacy it is necessarily related to, such as participation or deliberation inside IOs, representation has only rarely been addressed as such in scholarly debates. It is this gap in theory and practice that this volume purports to fill. It is the first one bringing global democracy theorists and international lawyers into dialogue on the topic and in English language. This title is also available as open access on Cambridge Core.
This Element argues that the 2008 financial crisis marked a turning point for populism in Europe by extending economic insecurity to the middle class. As insecurity spread, trust in institutions and markets declined, bringing a large new group of disillusioned voters into the political arena. The authors show that this expansion of middle-class anxiety accounts for a substantial share of the rise in populist voting. The political impact was strongest in countries with limited fiscal space, where governments lacked credible tools to cushion economic losses. As voters' demand for protection grew, both new and established parties adjusted their platforms, with populist and protectionist positions becoming more prominent. Using a novel empirical strategy based on differences in occupational exposure to financial constraints, the authors identify the causal effect of crisis-driven insecurity and explain why populism has persisted in European politics. This title is also available as Open Access on Cambridge Core.
How and why are key Indo-Pacific states adapting respective foreign and defence policies to secure submarine cable networks amid heightened Sino-US network-based competition? States are driven to control submarine cable networks as these infrastructures transmit information between continents and islands, traverse vulnerable maritime zones, and constrict data through limited chokepoints. China's Digital Silk Road has challenged Western submarine cable dominance, prompting a suite of countermeasures by Western states individually and in coalition. This Element posits a nodes-flows-production typology to illustrate how states are attempting to control connectivity nodes, secure transmission flows and dominate production. The analysis highlights how states are pursuing central network positions to mitigate vulnerability – but this structural competition risks enabling weaponisation. This microcosm of network-based competition reveals how the contest to control submarine cable infrastructure is defining contemporary great power rivalry and re-wiring the Indo-Pacific's arteries. This title is also available as Open Access on Cambridge Core.
Radiocarbon dating of disarticulated human remains from Brading Roman villa (Isle of Wight, UK) assigns them to a single event or multiple events within a short duration in the Late Roman period, c. 220/50–360/400. The evidence of the coins suggests the possibility of a brief abandonment of the villa following a potentially murderous event in the 340s or 350s, perhaps to be linked to reprisals taken by Constantius against supporters of Magnentius. This event may in turn coincide with a significant reorganisation of space in the west range of the villa.
The growing involvement of private health insurers within universal health systems has intensified debate over their effects on access, equity, and long-term system sustainability. This paper examines the role of private insurers in the United Kingdom (UK) and South Africa through a case study of the Discovery Group, operating across both settings. We explore how private sector engagement shapes health financing, workforce dynamics, service delivery, digital infrastructure, and governance. Our analysis reveals that the impact of private health insurance on universal health systems is fundamentally context-dependent, mediated by institutional frameworks, regulatory environments, and the stage of universal coverage development. We find that private insurers can contribute meaningfully to digital health innovation and behavioural health interventions. However, expansion also introduces significant risks concerning workforce distribution, financing sustainability, and equity of access. These dynamics manifest differently across contexts. In the UK’s mature universal system, private insurance plays a supplementary role offering expedited access to care for members. In South Africa’s transitional dual system, private insurers more fundamentally shape whether quality care is accessible at all. As health systems evolve, the central challenge lies in developing governance frameworks that enable beneficial private sector contributions while safeguarding equitable access and national health system priorities.
Reinforcement Learning (RL) enables autonomous agents to learn policies from experience, but realistic problems often involve enormous state spaces, making learning and generalisation challenging. Abstraction and approximation are therefore essential. Relational Reinforcement Learning (RRL) offers a way to reason about objects and their relations, and the CARCASS framework by Martijn van Otterlo demonstrates how logical representations can model Markov Decision Processes (MDPs) in first-order domains. Originally implemented in Prologue, CARCASS leverages domain knowledge to create powerful abstractions. We explore Answer-Set Programming (ASP), which is a rich and, contrary to Prologue, fully declarative modelling language, to realise CARCASS abstractions. We evaluate our ASP-based implementation in case studies of two domains, viz. Blocks World and Minigrid. Our results indicate that CARCASS with ASP provides a promising approach to constructing abstractions for RL, especially when domain knowledge is available (our implementation is available at https://github.com/rbankosegger/RLASP-core. Further material (data, encodings, extended documentation) can be found here: https://www.bankosegger.at/iclp26/).
We compute the $K$-theory of the ${C}^{*}$-category generated by order zero, equivariant, properly supported, classical pseudodifferential operators acting on sections of homogeneous bundles over the symmetric space of a real reductive Lie group $G$. Our result uses the Connes-Kasparov isomorphism for $G$, and in fact it is equivalent to the Connes-Kasparov isomorphism. We relate our computation to David Vogan’s well-known parametrization of the tempered irreducible representations of $G$ with real infinitesimal character. When the reductive group $G$ has real rank one, we formulate and prove a Fourier isomorphism theorem for equivariant order zero pseudodifferential operators on the symmetric space, and use it to prove a $K$-theoretic version of Vogan’s theorem.
Learning diagnosis is essential for effective education, with formative assessments shown to significantly enhance academic performance. Diagnostic classification models (DCMs) have been developed to assess students’ learning status and provide remedial instruction. However, the impact of mastery or non-mastery of specific attributes on long-term learning development remains uncertain. If certain non-mastered attributes hinder the growth of mathematical ability, early intervention becomes essential. In this study, we developed a random-effects DCM for multilevel growth curves (RDC–MGC) model to identify the specific effects of attribute mastery on individual-level mathematics ability growth. The simulation studies showed that the Bayesian estimation procedure provided appropriate parameter recovery and coverage probabilities, whereas ignoring the multilevel structure resulted in biased parameter estimates. The model was applied to arithmetic test data from second- to sixth-grade elementary school students. Diagnosis was conducted in the second grade, and the effects of mastery on mathematics ability growth from the third to sixth grades were assessed. The results showed that attribute mastery in second grade was associated with both the intercept and slope of individual ability growth, suggesting the potential importance of early-stage diagnostic information for understanding later mathematical development. Potential extensions of the proposed RDC–MGC model are also discussed.
The Parker Solar Probe mission has observed near-continuous power in parallel ion cyclotron waves (PICWs) in the young, fast solar wind. These waves are unlikely to be directly produced by the turbulent cascade and are likely born of a local instability; yet, they are observed to both cool – and heat – the plasma. We propose that these observations can be self-consistently explained as the natural consequence of PICWs propagating in the inhomogeneous solar wind after they have been driven unstable. In this work, we argue that strong proton heating by a turbulent cascade of oblique ICWs will result in PICWs being driven unstable in a process known as quasi-linear focusing. Because the power in the turbulent cascade is concentrated at scales above the turbulent transition region, PICWs will be driven unstable within a range of wavenumbers parallel to the background magnetic field, $k_\parallel$, that is bounded from above by $k_{\parallel {\mathrm{P}}}^*$, corresponding to the start of the transition region. As unstable PICWs propagate away from the Sun to regions of lower proton density, their $k_\parallel$, multiplied by the proton inertial length $d_{\mathrm{p}}$, increases. Eventually, $k_\parallel d_{\mathrm{p}}$ of the PICWs becomes larger than $k_{\parallel {\mathrm{P}}}^*d_{\mathrm{p}}$ and the waves damp, heating the solar wind. We call this effect ‘cyclotron breaking’, in analogy with ocean waves breaking on the shore. We then discuss the testable predictions of the theory, including a distinct heating signature in which PICWs cool fast protons and heat slow protons at any given heliocentric distance $r$. Finally, we conjecture that cyclotron breaking can lead to net heating by PICWs if the power emitted as PICWs decreases sufficiently rapidly with $r$ that local emission of PICWs is overwhelmed by the local damping of PICWs generated closer to the Sun.