To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Brazil has a longstanding and significant tradition in the development of social housing; however, this topic remains underexplored within the field of social policy. This study adopts qualitative methods, including an analysis of housing legislation, from the past two decades and, and data from 20 semi-structured interviews conducted between June and September 2021 with key stakeholders in housing policy, such as policymakers, and activists. The findings reveal a persistent gap between policy promises and actual implementation, alongside a continuing trend toward the financialization and commodification of social housing – particularly in programs such as Minha Casa, Minha Vida (My House, My Life) and Casa Verde e Amarela (Green and Yellow House). The study offers novel empirical insights into the role of social housing within broader ecosocial policy frameworks. One of the central findings is the interconnection between social housing, environmental concerns, and sustainability. The Brazilian case, in particular, stands out as a distinctive and pioneering contribution to the field.
To describe neuropathological findings in autopsies of patients with isolated, partial or all classic features of the septo-optic-pituitary dysplasia (SOD) triad, speculate on SOD etiology and ascertain the causes of death.
Method:
Retrospective review of autopsy reports of patients with one or more features of the SOD triad.
Results:
Twenty-one (14 females) cases were identified. Median age at death was 2.3 years. Two fetuses died soon after birth, and the rest died at postnatal ages of 3 weeks to 50 years. Ten cases had optic nerve hypoplasia (ONH) with either (i) small pituitary gland/hypopituitarism (five cases) or (ii) absent septum pellucidum (SP)/abnormal corpus callosum (CC) (two cases) or (iii) both (three cases). Eleven cases had one or two features of the SOD triad. A wide spectrum of neuropathological findings was evident, with 12 cases resulting from in utero/perinatal vascular lesions in brain regions that led to ONH/chiasm hypoplasia, hypothalamus/pituitary gland anomalies and agenesis or abnormalities in the SP, CC and olfactory bulbs and tracts. Other suspected causes included three genetic (one with holoprosencephaly), two in utero infection and one arachnoid cyst with hydrocephalus. The most common cause of death was a respiratory illness.
Conclusions:
The autopsy findings appear to be the result of destructive or less commonly impaired developmental processes. Our findings suggest that SOD is not a single disease entity but represents a syndrome with ONH and one or more of: hypothalamic-pituitary dysfunction and absent SP or abnormal CC. We consider ONH an essential part of SOD.
The COVID-19 pandemic exposed the fragility and adaptability of democratic orders. While confinement accelerated cross-border ‘tele-life’, rights and protections remained territorially locked. This essay argues that democracy need not be tied to the Westphalian state: it can be re-imagined as unterritorial democracy – voluntary, overlapping and portable communities of belonging. Building on panarchist thought, Austro-Marxist proposals for non-territorial autonomy and Jewish Bundist experiments with cultural self-rule, I advance a model of pan-citizenship and polycentric governance in which rights and representation follow persons rather than places. The contribution is threefold: (1) a genealogy that situates unterritorial democracy within longer traditions of political imagination; (2) analytical criteria – membership portability, competence clarity, equity and accountability – that render such institutions evaluable; and (3) contemporary proto-examples – from diaspora voting to indigenous electoral registers – showing that elements of unterritorial democracy already exist. By integrating historical, analytical and empirical strands – and by engaging debates on emergency powers and derogations of rights – the essay positions unterritorial democracy as a normative horizon for global constitutionalism, inviting person-linked indicators capable of capturing democratic belonging within a framework of multiterritorial pluralism. In this way, the essay contributes to both the normative debates and the methodological agenda of global constitutionalism.
This article argues that the extent and longevity of dry conservancy systems in urban England between the 1870s and 1920s is underappreciated for its impact on health and disease. Using Birmingham as a case-study, it advances knowledge on the systemized development of municipal pail systems and offers a deeper understanding of living with conservancy. It draws out the importance of looking at the fly problem and the transmission relationship, largely ignored until the second decade of the twentieth century. It also explores and challenges existing ideas in the debates surrounding investment in sanitation infrastructure and mortality decline.
Psychosis and bipolar I disorder are severe mental disorders with significant adverse impacts on patients, their families and society overall. Patients’ follow-up in rural areas is often challenging owing to stigma and limited access to mental health services.
Aims
The primary aim was to evaluate the effectiveness of follow-up by a mobile mental health unit (MMHU) operating in underserved rural areas of Crete in preventing readmissions to hospital across its 10 years of operation. Additionally, we investigated sociodemographic and clinical factors associated with patients’ readmissions.
Method
The study included 288 patients with psychosis (n = 201) or bipolar disorder (n = 87). The effectiveness of the MMHU is assessed by comparing patients’ voluntary and involuntary admissions pre- and post-follow-up.
Results
Hospital readmissions were reduced by half and involuntary readmissions by 50–70%. This effect was significant for patients with both single and multiple prior admissions. Regression analysis revealed that older age, depot medication, no substance misuse history and being ever married were associated with reduced readmissions. Also, the normative visit frequency of 5–9 visits per year (approximately 1 visit every 1.5 months) was associated with reduced readmissions.
Conclusions
The operation of an MMHU in rural Crete is effectively preventing overall and involuntary readmissions, particularly when patients are followed up on a regular basis. These findings highlight the effectiveness of community services in addressing the mental health needs of people living in rural and remote areas with limited access to mental health services.
Galaxies undergo perturbations, either gravitational or hydrodynamic in origin, which can generate extragalactic structures such as rings and tails, where in situ star formation may take place. We selected a sample consisting of JO201 and JW100, undergoing ram-pressure stripping, and NGC 5291 and NGC 7252, formed through gravitational interactions, to investigate how different perturbation mechanisms influence dust content and star formation in extragalactic features. In both cases, star formation can be observed outside the main disks of the galaxies. We present new results of dust attenuation for JO201 and JW100, while for NGC 5291 and NGC 7252 we use results from our previous study, based on high-resolution observations obtained with the Ultraviolet Imaging Telescope onboard AstroSat. Dust attenuation is determined from the ultraviolet continuum slope ($\beta$) calculated using the FUV–NUV colour, and the star formation rates of the star-forming knots are corrected accordingly. It is seen that dust attenuation and dust-corrected SFR densities of the knots in the ram-pressure stripped tails of JO201 and JW100 are comparable to those in the collisional ring of the NGC 5291 system and the tidal tails of the NGC 7252 system. We conclude that, though the formation scenarios of the tails of JO201 and JW100, the NGC 5291 ring, and the NGC 7252 tails are different, their dust content and star formation activity are notably similar.
We present several combinatorial properties of semiselective ideals on the set of natural numbers. The continuum hypothesis implies that the complement of every selective ideal contains a selective ultrafilter, however for semiselective ideals this is not the case. We prove that under certain hypothesis, for instance, $V=L$, there are semiselective ideals whose complement does not contain a selective ultrafilter, and that it is also consistent that the complement of every semiselective ideal contains a selective ultrafilter; specifically, we show that if $V=L$ then there is a generic extension of V where this occurs. We present other results concerning semiselective ideals, namely, an alternative proof of Ellentuck’s theorem for the local Ramsey property, and we prove some facts about the additivity of the ideal of local Ramsey null sets, and also about the generalized Suslin operation on the algebra of local Ramsey sets.
Hospital-attributable central line-associated bloodstream infections (HA-CLABSI) are associated with severe patient outcomes. Published data on HA-CLABSI epidemiology in hospitals locally remains limited. This study aimed to determine the HA-CLABSI incidence and risk factors to inform targeted infection prevention practices.
Methods:
Retrospective, nested case-control study was performed at Singapore General Hospital from January 2018 to December 2020, involving 127 cases and 252 controls. HA-CLABSI cases developed CLABSI ≥ 3 calendar days of hospitalization. Controls had central line inserted but did not develop CLABSI. Cases and controls were matched on 1:2 ratio for central line insertion date. Multivariable conditional logistic regression was performed to identify independent risk factors for HA-CLABSI, with adjusted odds ratio (aOR), 95% confidence intervals (CI) and p-values reported. Variables with p-value < 0.05 were statistically significant. HA-CLABSI incidence rate was calculated per 1,000 central line-days.
Results:
HA-CLABSI incidence rate during the study period was 8.4/1,000 central line-days. Independent risk factors for HA-CLABSI were transfer to high-risk areas (aOR: 2.03, 95% CI: 1.05–3.92), immunocompromised health status (aOR: 4.62, 95% CI: 2.20–9.69), antibiotic administration (aOR: 7.41, 95% CI: 3.24–16.92), and total parenteral nutrition (aOR: 3.61, 95% CI: 1.49–8.77) being included as indications for central line insertion, insertion of PICC (aOR: 13.61, 95% CI: 3.12–55.53), presence of non-tunneled central lines (aOR: 2.95, 95% CI: 1.48–5.87) and prior MRSA acquisition (aOR: 3.41, 95% CI: 1.83–6.35).
Conclusion:
HA-CLABSI remains a significant concern despite on-going infection prevention efforts. Risk factors identified facilitate development of targeted, evidence-based interventions.
Vitamin D deficiency is a common nutritional problem in exclusively breastfed infants. Dilated cardiomyopathy is a rare but potentially fatal complication of this condition. We describe a 15-month-old who presented with cardiogenic shock. Laboratory and radiographic findings were consistent with vitamin D deficiency. Metabolic parameters normalised within one week and echocardiography normalised by 19 months after supplementation. Although rare, severe vitamin D deficiency must be on the differential for young children presenting with new-onset dilated cardiomyopathy. Clinicians must maintain a high index of suspicion for vitamin D deficiency in at-risk populations to prevent potentially life-threatening complications.
Fully resolved three-dimensional simulations of planar gravity currents are conducted to investigate the influence of imposed spanwise perturbations on flow evolution and mixing at two Reynolds numbers ($ \textit{Re}=3450$ and 10 000). The initial perturbations consist of sinusoidal waves with a varying number of repeating waves, $k_y$, with simulations spanning $0 \leqslant k_y \leqslant 8$. At low-$ \textit{Re} $, cases with perturbations ($k_y \gt 0$) exhibit a more rapid breakdown of spanwise coherence compared with the unperturbed case ($k_y = 0$), although the resulting structures retain spatial periodicity and remain relatively ordered. This earlier disruption leads to greater front propagation distances beyond the self-similar inertial phase compared with the unperturbed case. Notably, imposed perturbations exhibit minimal influence on the flow transition; all cases follow the slumping velocity reported in the literature, with the transition into the inertial phase occurring at comparable times across different $k_y$ values at both $ \textit{Re} $. The increased propagation speed is accompanied by reduced mixing efficiency due to the premature disruption of coherent Kelvin–Helmholtz (K–H) billows, which play a key role in maintaining multi-scale mixing. At high-$ \textit{Re} $, the influence of initial spanwise perturbations diminishes, as three-dimensional turbulence induces a more chaotic, fine-scale breakdown of spanwise coherence across all $k_y$ cases, overriding the effects of the initial perturbations. Consequently, the dominant stirring mechanism shifts from K–H billows to vortices within the current head. Nevertheless, the unperturbed case maintains comparatively higher mixing efficiency at both low- and high-$ \textit{Re} $. This is attributed to the persistence of recognisable K–H billow structures, which, despite undergoing chaotic breakdown at high-$ \textit{Re} $, still contribute to effective stirring by stretching and folding the density interface. These results highlight the dual role of K–H billows: they promote efficient mixing, yet the enhanced mixing reduces the density difference between the current and the ambient fluid, weakening buoyancy and slowing front propagation despite stronger stirring. These findings are supported by consistent trends in streamwise density distribution and ‘local’ energy exchange analyses.
This text addresses the materiality of radio art, situating it within the theoretical frameworks of contemporary research on new materialism as well as the materiality of media and sound. The analysis employs perspectives from Christoph Cox’s sonic materialism and approaches by such writers as Salomé Voegelin, Gregory Whitehead, Allen S. Weiss and Margaret Hall, who emphasise the ontological autonomy of sound and its impact on space and listeners. A critical close reading of the relevant literature is conducted with regard to its applicability to radio art. The article analyses radio art practices structurally and phenomenologically across composition, reception, materiality and technology, aligning with practice-informed media analysis. The author’s aim is to outline and systematise diverse theoretical approaches and frameworks that capture the materiality of radio being, as well as to reveal the ways in which the radio medium co-creates artistic sound reality. The results of the literature and artistic practice analysis highlight the significance of sound’s materiality and its relational character, indicating that sound does not exist in isolation but in interaction with the environment, technology and listener. Consequently, seven dimensions of radio art materiality are delineated, which integrate existing concepts and provide a comprehensive perspective on radio artistic works.
DeGAUSS is a privacy-preserving application that ingests addresses and generates output that includes latitude, longitude, census tract, deprivation index and drive times to major hospitals. The application uses a complex command line interface and a container management platform to perform analysis. Our objective was to develop a user-friendly DeGAUSS-based application that simplifies place-based analysis. We also enabled automated geomarker generation by providing an API modality to DeGAUSS.
Methods:
We developed a self-service platform based on the DeGAUSS application. The application was linked to user authentication platforms. The self-service application can be implemented as an API, enabling high-volume geocoding transactions. We surveyed active users for feedback.
Results:
The self-service geomarker application was deployed at Children’s Mercy and the University of Kansas Medical Center. During the period evaluated, more than 2 million addresses were geocoded for 24 users through the user interface and more than 15 million addresses through the API. Users expressed high satisfaction with the system. All respondents used the census block group feature and the core geocoding. Most respondents, 60%, used the deprivation index and 30% used the drive time feature. Population health and social determinants of health were the most common uses (80% each) followed by health equity analyses (70%).
Conclusion:
Population health and social determinants of health research require access to precise geographic information about patients or research subjects. The self-service geomarker capability enables users who may not be comfortable with a command line interface to generate geocoded addresses in support of their research and analysis.
Discussions of social organisation in early complex societies often rely on traditional narratives of a linear progression to hierarchy, but archaeological evidence is increasingly showcasing a spectrum of social structures. Here, examination of burial practices in 50 tombs from Kedurma, Sudan, helps illustrate social stratification and identity negotiation beyond the binary rendering of elite/non-elite during the Meroitic period (third century BC to fourth century AD). The diversity of architectural forms and grave goods highlights the importance of inter-regional exchange networks and a more fluid social dynamic, contributing to our understanding of early African state formation.
We explore the effects of fiscal policy shocks on aggregate output and inflation. We use the Bayesian econometric methodology of Baumeister and Hamilton applied to the fiscal structural vector autoregressive model to evaluate key elasticities and fiscal multipliers using U.S. data. In our baseline specification that ends before Covid pandemic, the government spending multiplier is equal to approximately $0.57$ and tax multiplier is approximately $-0.35$ after one year. The short-term output elasticity of government spending is statistically insignificant and the output elasticity of taxes is approximately equal to $2.26$.
Previous research has highlighted that supplementing standard group-level event-related potential analyses with assessments of individual variation can enhance our understanding of language-related brain activity. The present study pursues this approach by examining bilingual speakers’ brain responses to morphologically complex word forms in both their native (German, L1) and their second language (English, L2). We tested 108 bilingual speakers using an ERP violation paradigm examining overapplications of regular verb inflections (‘regularizations’) and of irregular ones (‘irregularizations’). We found a striking L1/L2 contrast within the same bilingual speakers, a left-anterior negativity for regularizations in the L1 and a positivity (P600) for both violation types in the L2. Consistent with previous research, individuals’ brain responses were found to vary along negativity-/positivity-dominant effects. However, the crucial L1/L2 contrast in participants’ brain responses to regularizations was stable across individual differences. We conclude that linguistic constraints, that is, violation type and language status (L1 vs. L2), limit individual variability.
Glutamatergic neurons represent 40% of neurons in the human central nervous system. Glutamate accounts for approximately 90% of all excitatory neurotransmitters. Previous research reports the presence of glucagon-like peptide-1 (GLP-1) receptors on neurons that produce glutamate. Herein, we aim to evaluate whether GLP-1 receptor agonists’ (GLP-1 RAs) modulate glutamatergic signaling and whether GLP-1 RAs’ anti-obesity effects are mediated through the glutamatergic system. We conducted a systematic review of extant literature published on PubMed, Ovid and Scopus databases from inception to March, 2025. Identified studies were screened independently by two reviewers (S.W. and G.H.L.) using the Covidence platform. We sought to include in vitro, in vivo, and human clinical studies. A total of 31 studies were identified as meeting eligibility for an inclusion in this review. No human studies were identified. Across the included preclinical and pharmacologic studies, GLP-1 RAs were associated with increased glutamate release, NMDA/AMPA receptor activation and increased release of neurotrophic factors associated with neurogenesis, neurodifferentiation, and synaptic plasticity. In addition, GLP-1 RA-induced suppression of food intake was reported to be dependent on AMPA, but not NMDA, receptor signaling. The effect of GLP-1 RAs on feeding behavior is mediated via central glutamatergic signaling. A comprehensive mechanistic framework mediating GLP-1 RA activity implicates crosstalk between GLP-1 and ionotropic glutamate receptors. The aforementioned trends instantiate a need to evaluate the therapeutic efficacy of GLP-1 RAs for disparate neuropsychiatric disorders. Conducting target engagement studies of GLP-1 RAs with the glutamatergic system in humans is a future research vista.
The marked Hawkes risk process is a compound point process where the occurrence and amplitude of past events impact the future. Since data in real life are acquired over a discrete time grid, we propose a strong discrete-time approximation of the continuous-time risk process obtained by embedding from the same Poisson measure. We then prove trajectorial convergence results in both fractional Sobolev spaces and the Skorokhod space, hence extending the theorems proven in Huang and Khabou ((2023). Stoch. Process. Appl.161, 201–241) and Kirchner ((2016). Stoch. Process. Appl.126(8), 2494–2525). We also provide upper bounds on the convergence speed with explicit dependence on the size of the discretization step, the time horizon, and the regularity of the kernel.
We provide a first-order homogenization result for quadratic functionals. In particular, we identify the scaling of the energy and the explicit form of the limiting functional in terms of the first-order correctors. The main novelty of the paper is the use of the dual correspondence between quadratic functionals and PDEs, combined with a refinement of the classical Riemann–Lebesgue lemma.
This study aimed to explore the end-of-life decision-making experiences of bereaved family caregivers of Alzheimer’s disease (AD) patients, focusing on do-not-resuscitate orders. Given the high emotional and ethical burden on caregivers, understanding their challenges and needs is crucial to enhancing palliative care for AD patients.
Methods
A qualitative, exploratory study was conducted using semi-structured interviews with 22 family caregivers recruited through purposive sampling in central Taiwan. Participants were primary caregivers for AD patients who had been bedridden for at least a year before death. Analysis employed inductive thematic coding to identify key themes, with rigor ensured through multiple coding, member checking, and reflective journaling.
Results
Three major themes emerged: (1) Decision-making difficulties, where caregivers felt pressure and conflict when making urgent decisions; (2) Willingness to let go, which involved accepting the inevitability of death when recovery was no longer possible; and (3) Embracing the consequences of the decision, reflecting caregivers’ sense of relief and acceptance post-decision. Cultural factors, such as filial piety, were found to influence decision-making processes, often intensifying emotional conflicts.
Conclusions
Findings underscore the importance of early, culturally sensitive discussions around end-of-life care in palliative settings for AD patients. Healthcare providers are encouraged to initiate these discussions, offering clear explanations and emotional support to assist caregivers through decision-making. This study highlights the need for a family-centered approach that respects cultural nuances, helping to reduce caregiver stress and enhance the quality of palliative care in AD contexts.
We introduce a notion of stratification for rigidly-compactly generated tensor-triangulated categories relative to the homological spectrum and develop the fundamental features of this theory. In particular, we demonstrate that it exhibits excellent descent properties. In conjunction with Balmer’s Nerves of Steel conjecture, we conclude that classical stratification also admits a general form of descent. This gives a uniform treatment of several recent stratification results and provides a complete answer to the question: When does stratification descend? As a new application, we extend earlier work on the tensor triangular geometry of equivariant module spectra from finite groups to compact Lie groups.