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In two studies with 1,275 participants, we examine how values are associated with wine cues and how these associations shape selection across private and professional contexts. Building on signaling theory and identity economics, we propose a utility framework in which choice utility is a context-dependent function of alignment with the private self (personal values), the professional self (role values), and anticipated reputational returns to identity signaling. Signal interpretability depends on a shared code in which observable cues carry similar meanings for senders and receivers. Drawing on Schwartz's value theory, we find evidence that participants systematically attribute distinct values to three observable cues—bottle appearance, short narratives, and tasting notes. Our findings show that in private settings, individuals favor wines linked to self-transcendence and openness to change, whereas in professional settings they prefer wines associated with self-enhancement and conservation. These cross-context patterns suggest that observing wine choice provides a novel tool for researchers to indirectly assess both personal and work-related values. In this respect, our approach relates to revealed preference theory, which infers individual preferences from observed choices.
Magnesium (Mg2+) is essential for plant growth and metabolism, acting as a cofactor in numerous enzymatic and structural processes. This review outlines the main physiological and biochemical functions of Mg2+ and summarizes current knowledge on its transport and homeostatic regulation. We examine how Mg2+ homeostasis intersects with broader signalling networks and metabolic pathways, including its crosstalk with other mineral nutrients, where antagonistic and synergistic interactions influence nutrient acquisition, allocation and stress responses. Emerging evidence further suggests that, beyond its classical roles, Mg2+ may function as a regulatory ion with signalling properties reminiscent of secondary messengers in animal systems. Finally, we highlight recent findings linking Mg2+ dynamics to circadian regulation, suggesting reciprocal interactions between temporal control mechanisms and nutrient fluxes. These insights underscore the central importance of Mg2+ in plant biology and identify key gaps in understanding its regulatory and integrative roles.
With population aging, the establishment of universal long-term care insurance (LTCI) has emerged as a critical policy issue. This paper examines the effects of China’s LTCI pilots on the physical accessibility of home and community-based services (HCBS) and specific services for older adults. Using three-wave panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we analyze the rollout of LTCI pilots across different cities from 2014 to 2021, employing a time-varying difference-in-differences (DID) approach. Our findings indicate that LTCI significantly improves access to HCBS for older adults, particularly in personal daily care. Heterogeneity analysis indicates that LTCI has a stronger positive effect on the accessibility of HCBS for older adults with physical impairment, lower financial transfers from children, or living alone or with a spouse only, and the positive effect is more salient in regions with higher reimbursement for HCBS and more generous coverage. This study provides compelling evidence regarding the pivotal role of institutional design of LTCI in shaping older adults’ care-seeking behavior and system-level resource allocation. It offers nuanced insights into the evaluation of differentiated pilot programs across cities, which can inform the development of a uniform national LTCI policy and carry implications for other developing countries.
The urban canopy affects wind in complex ways, making it challenging to predict wind-driven natural ventilation and cooling in buildings. Using large eddy simulations of coupled outdoor and indoor airflow, we study how the surrounding urban canopy and wind angle influence ventilation rates through four ventilation configurations: cross, corner, dual-room and single-sided. Flow visualisations demonstrate how both large-scale flow patterns and local interference effects can influence ventilation rates by 50 %–85 %. In general, lower density canopies give higher ventilation rates, and wind angles that align with a direct path between two openings also lead to higher ventilation rates. However, interference effects from surrounding buildings can significantly change the local wind speed and direction, thus also changing ventilation rates. The magnitude of these interference effects depends on both the wind angle and surrounding building geometries. The effect of wind angle is less pronounced in a higher density canopy, where the urban canopy geometry more strongly guides the flow. The results demonstrate that the canopy’s effect on ventilation rates is much more complex than those suggested by existing natural ventilation parametrisations.
Surgical site infections (SSIs) pose a significant healthcare challenge, raising patient morbidity, mortality, and costs. Various intrinsic, patient-specific, and perioperative factors contribute to SSIs. This study aims to identify SSI-associated risk factors, microorganism types, and antibiotic susceptibility patterns in surgical patients.
Design:
This is a matched-case control study.
Setting:
The Lebanese American University Medical Center – Rizk Hospital, Beirut Lebanon.
Patients:
The study included surgical patients.
Methods:
This retrospective case-control study analyzed data from surgical patients over a five-year period, matching 113 SSI cases with controls in a 1:3 ratio by gender and surgery type.
Results:
Among 324 patients (81 cases vs 243 controls), hypoalbuminemia (<3.5 g/dL) and age ≥65 years were significantly associated with SSIs (P = .025 and P = .039), respectively. Antibiotic redosing was associated with lower odds of SSIs (OR = 0.19, P = .042), indicating a potential protective effect.
Conclusions:
Our findings were consistent with similar studies. Elderly patients and those with hypoalbuminemia were found to be at significantly higher risk of SSIs. Also, antibiotic redosing during prolonged surgeries was associated with reduced SSI risk. In terms of SSI rates, gastrointestinal surgeries (GIs) were the highest with 42.3% of GI cases followed appropriate antibiotic protocols. Like other studies, predominant microorganisms at wound site included E. coli and coagulase-negative staphylococci.
To understand the challenges of climate change in a specific setting, it is essential to examine the social, cultural, environmental, economic and other national contexts. This paper provides an overview of Bhutan, highlighting the current climate change trends and their potential impacts on both the environment and society. Special attention is given to the impending implications for Bhutan’s education system, particularly how changing climatic conditions may affect learners’ well-being, learning and education. Additionally, the paper discusses the concept of Gross National Happiness (GNH) — the national development philosophy of Bhutan — and how climate change may challenge this aspiration while also presenting opportunities to advance sustainability. Finally, the prospects for further exploration and the role school communities may have in climate actions are underlined.
The pandemic crisis introduced an unprecedented supply-side shock that was global in scope. Despite historically high levels of prior sovereign debt and low bond yields, macroeconomic policy responses included monetised fiscal expansions of extraordinary magnitude. Conventional theory suggests that the combination of supply contractions with such expansions is inflationary, yet central bank discourse during the pandemic expressed little concern about inflation. Our theoretical analysis suggests the presence of strong inflation forces at the time, likely offset by continuing pessimism shocks, consumption constraints and expectations management. In prominent advanced countries over more than a century, monetised fiscal expansions are shown to have preceded inflation surges, most strongly following signature episodes like WWII.
How do we thrive sustainably on planet Earth? This is an urgent question to which this book provides a range of fresh responses. From diverse disciplinary perspectives, academics provide compelling visions for education that disrupt but also open up and inspire new pedagogic opportunities. Responding to these visions, teachers, teaching assistants and school leaders offer practical reflections, describing the ways they are living out these new ideas in their classrooms and schools. Bridging the gap between theory and practice, the book invites us to consider what education can and ought to look like in a world beset by challenges. Despite the seriousness of the manifestos, there is optimism and purpose in each chapter, as well as a desire to raise the voices of children and young people: our compassionate citizens of the future. This title is also available as Open Access on Cambridge Core.
This book offers a critical exploration of climate justice, bringing together diverse perspectives from a wide range of regions and disciplines including law, political science, anthropology, environmental sciences, and economics. It addresses the intersection of environmental, social, and economic issues, highlighting the profound inequalities amplified by the climate crisis. Through theoretical critiques and concrete case studies from different regions, it emphasizes how global politics shape local realities and showcases the voices of those resisting structural injustices. It not only deepens the understanding of climate justice but also proposes practical solutions and alternatives, making it a valuable resource for students, researchers, and practitioners in the fields of climate change, human rights, development, and social movements. With its interdisciplinary approach and global scope, this book will appeal to anyone seeking to engage critically and constructively with the most pressing issues of our time. This title is available as Open Access on Cambridge Core.
Ocrelizumab (OCR) and rituximab (RTX) are anti-CD20 monoclonal antibodies (CD20Mabs) used in the treatment of relapsing multiple sclerosis (RMS). While both are effective at reducing relapses and new MRI lesions in clinical trials, real-world data on discontinuation rates and reasons for stopping therapy are limited.
Methods:
This observational retrospective chart review included patients from two MS clinics in British Columbia, Canada. RMS patients treated with at least one infusion of OCR or RTX between January 2017 and March 2023 were included. Primary outcomes were reasons for discontinuation and discontinuation rates, with a secondary outcome of time to discontinuation.
Results:
In total, 881 RMS patients were included, with 478 on OCR and 403 on RTX. A total of 16.9% of patients on OCR and 14.9% on RTX discontinued therapy over 1643 and 694 patient-years, respectively (p = 0.46). Reasons for discontinuation included: side effects (33.3%), insurance coverage (17.0%) and clinical or radiological disease activity (11.3%). Discontinuation rates at 12, 24 and 36 months were 3.5%, 8.2% and 12.5% for OCR, and 6.4%, 14.8% and 22.2% for RTX, respectively (p = 0.0089). Median time to discontinuation was 21 months on OCR and 11.5 months on RTX (p < 0.0001). On Cox regression analysis, treatment with RTX was the only variable associated with discontinuation (hazard ratio 1.72, 95% CI 1.20–2.45).
Conclusion:
Discontinuation rates of CD20Mabs were low, and the most common reason for stopping was side effects. Although not designed for comparison, our study suggests RMS patients may persist longer on OCR than RTX.
Childhood trauma is a well-established risk factor for the onset and persistence of psychotic symptoms. Consequently, trauma-focused interventions (TFIs) are increasingly incorporated into psychosis treatment, though their effectiveness in reducing hallucinations and delusions remains unclear. This systematic review and meta-analysis evaluated the effects of TFIs on psychosis-related outcomes in individuals with psychotic disorders or subclinical symptoms. Thirty-six studies (N = 1,384) were included, with 18 (N = 806) contributing to meta-analyses. Study quality and risk of bias were assessed using AXIS, Cochrane RoB2, and GRADE. Pre–post analyses showed small reductions in hallucinations (g = −0.37; adjusted g = −0.28; K = 15) and medium reductions in delusions (g = −0.55; K = 14), with younger participants benefiting more. In controlled trials, TFIs did not significantly reduce hallucinations at the end of treatment or follow-up (g = −0.12 and −0.01; both K = 7), whereas delusions showed significant reductions at both time points (g = −0.44 and g = −0.48; both K = 7). No significant effect on negative symptoms was observed at the end of trial (g = −0.02; K = 6), though a small improvement appeared at follow-up (g = −0.26; K = 6). TFIs produced small but significant reductions in PTSD symptoms at both time points (K = 6). No consistent effects were found for secondary outcomes: depression (K = 7), anxiety (K = 5), or quality of life (K = 3), though functioning improved at follow-up (K = 6). TFIs appear particularly effective in reducing delusions, but show limited benefit for hallucinations and other secondary outcomes. Further work is needed to design and test symptom-specific psychological interventions for distinct psychotic experiences.
We construct semiorthogonal decompositions of Donaldson–Thomas (DT) categories for reduced curve classes on local surfaces into products of quasi-BPS categories and Pandharipande–Thomas (PT) categories, giving a categorical analogue of the numerical DT/PT correspondence for Calabi–Yau 3-folds. The main ingredient is a categorical wall-crossing formula for DT/PT quivers (which appear as Ext quivers in the DT/PT wall-crossing) proved in our previous paper. We also study quasi-BPS categories of points on local surfaces and propose conjectural computations of their K-theory analogous to formulas already known for the three-dimensional affine space.
The probability that a disease will manifest is highly variable. Susceptibility to disease is influenced by genetic background, environment and lifestyle choices. In this review, we put forward the premise that evolution of disease susceptibility may be partially influenced by the interaction of divergent pathogen DNA-binding proteins with variable binding sites in the host genome. The hypothesis put forward is derived from recent data obtained from work on the protozoan parasite, Theileria annulata, together with related evidence from viral and bacterial pathogens that have been postulated to modulate host epigenome architecture. The pathogen proteins highlighted have the potential to mimic functions of mammalian epigenome organisers linked to a range of disease syndromes. It is feasible, therefore, that the evolutionary relationship between pathogen and host impacts susceptibility to a range of conditions, such as autoimmune disorders and cancer, which are not directly linked to pathogen infection.
Improving herbicide efficacy under drought stress is essential for improving weed management and limiting the associated challenges. Leaf water content (LWC), a vital ecophysiological trait, can be used to indicate drought stress and improve herbicide efficacy. To investigate how water stress–induced changes in LWC affect glyphosate efficacy across diverse weed types, the broadleaf weed Santa Maria feverfew (Parthenium hysterophorus L.) and the narrow-leaf giant foxtail (Setaria faberi Herrm.) were selected. A controlled greenhouse study was conducted with two treatment factors including three moisture levels (well watered at 100% WHC, moderate drought at 75% WHC, and severe drought at 50% WHC) and glyphosate doses (0, 180, 360, 540, 720, and 900 g ae ha⁻¹). Drought stress significantly reduced LWC and stomatal conductance in both species; while the reduction in LWC was more pronounced in P. hysterophorus (26%) than in S. faberi (23%), the reduction in stomatal conductance was severe and similar for both species (82% and 83%, respectively). Severe drought stress drastically reduced shikimic acid concentration (41% to 59%) in both species. Severe drought stress significantly reduced glyphosate efficacy, suppressing mortality by up to 63% and biomass reduction up to 58%. Shikimic acid concentration and weed mortality both showed a strong positive correlation with change in LWC under all tested water-stress levels. Glyphosate applications when LWC falls below 70% resulted in poor weed control at recommended field rates. Therefore, LWC can be used as a real-time predictive biomarker to monitor drought stress, schedule irrigation before glyphosate application, optimize the dose, and ultimately improve its efficacy.
With major US scientific institutions supporting a program of solar geoengineering research, the UK’s ARIA agency actively pursuing open air experimentation, and the EU in the process of clarifying its position, the question of how such research should be governed has been given new urgency. This paper argues that innovation in the structures and procedures of existing institutions for the oversight of scientific research is highly desirable, to promote the level of legitimacy, procedural justice, and recognition to which recent major proposed research governance frameworks aspire. First, we argue that SRM research is importantly dissimilar from climate research, but bears more similarity to other high-risk research areas, implying the need for special institutional arrangements. Second, we identify the special challenges of legitimacy–particularly its procedural justice component–with respect to the potential global, intergenerational and cross-community scope of legitimation requirements. Third, we argue that achieving legitimacy and procedural justice in the context of SRM research governance must include considerations of justice as recognition. Finally, we consider the institutional implications of legitimate and recognition-inclusive SRM research institutions.
To assess the efficacy of intranasal cryotherapy to treat chronic rhinitis refractory to medical therapy.
Methods
An evaluation was performed for all patients (n = 36) with chronic rhinitis refractory to medical treatment who underwent intranasal cryotherapy between 2022 and 2024 at this centre. The primary outcome measures were changes in validated pre- and post-operative scoring systems (Total Nasal Symptom Score, Sino-Nasal Outcome Test 22 (SNOT-22), Nasal Obstruction Symptom Evaluation and peak inspiratory nasal flow).
Results
Objective scoring pre- and post-procedure showed statistically significant improvement across all measures (p < 0.001): mean Total Nasal Symptom Score (12 hours) 8.4 to 5.3, Total Nasal Symptom Score (2 weeks) 9.2 to 5.9, SNOT-22 56 to 31, Nasal Obstruction Symptom Evaluation 57.5 to 28.5 and peak inspiratory nasal flow 98 to 138 l/min.
Conclusion
This is the only dataset for patients receiving intranasal cryotherapy in the UK to date and follows patients over a two-year period. The results support the ongoing use of intranasal cryotherapy for sustained treatment of refractory chronic rhinitis.
Systematic reviews are often characterized as being inherently replicable, but several studies have challenged this claim. The objective of the study was to investigate the variation in results following independent replication of literature searches and meta-analyses of systematic reviews. We included 10 systematic reviews of the effects of health interventions published in November 2020. Two information specialists repeated the original database search strategies. Two experienced review authors screened full-text articles, extracted data, and calculated the results for the first reported meta-analysis. All replicators were initially blinded to the results of the original review. A meta-analysis was considered not ‘fully replicable’ if the original and replicated summary estimate or confidence interval width differed by more than 10%, and meaningfully different if there was a difference in the direction or statistical significance. The difference between the number of records retrieved by the original reviewers and the information specialists exceeded 10% in 25/43 (58%) searches for the first replicator and 21/43 (49%) searches for the second. Eight meta-analyses (80%, 95% CI: 49–96) were initially classified as not fully replicable. After screening and data discrepancies were addressed, the number of meta-analyses classified as not fully replicable decreased to five (50%, 95% CI: 24–76). Differences were classified as meaningful in one blinded replication (10%, 95% CI: 1–40) and none of the unblinded replications (0%, 95% CI: 0–28). The results of systematic review processes were not always consistent when their reported methods were repeated. However, these inconsistencies seldom affected summary estimates from meta-analyses in a meaningful way.
This special issue analyses how formal independence from colonial rule has impacted institutions and epistemologies of history writing in different parts of the world after 1945. The integrated collection of articles focuses on the transitions and ruptures of knowledge production taking place in the wake of states gaining their formal independence. It explores how different types of decolonisation led to different engagements with history writing, and by doing so we provide fresh perspectives on processes of knowledge decolonisation. In this introduction we situate the special issue in two bodies of literature: firstly, decolonial and postcolonial debates about history and epistemology, and secondly, the literature on the decolonisation process with a specific focus on memory and commemoration. We argue that a fuller understanding of the similarities and differences between knowledge decolonisation then and now requires solid historical contextualisation of the mid-century ideas and vocabularies.
Weed pressure threatens lentil (Lens culinaris Medik.) yields, with metribuzin offering control but risking crop injury. This study used hydroponics to screen metribuzin tolerance in lentils, determining the lethal dose causing 50% mortality (LD50) for lentil cultivar ‘CDC Greenstar’ and profiling metabolites in three genotypes, ‘VIR421’ (susceptible), CDC Greenstar (tolerant), and ‘NZ2022’ (medium tolerant), via liquid chromatography–mass spectrometry (LC-MS). CDC Greenstar plants in a hydroponic deep-water culture system were exposed to metribuzin doses (0.17, 0.25, 0.51, and 2.05 g ai ha⁻1, plus a control) selected based on preliminary trials that identified the effective range for LD50 estimation in hydroponics, where herbicide bioavailability is higher than in soil due to direct root exposure and absence of soil adsorption. These doses are substantially lower than the recommended field application rate of 205 g ha⁻1 as a preemergence treatment for lentils to account for the amplified effects in hydroponics for 24 h, with biomass reductions assessed over 21 d. The LD50 was 0.4407 g ha⁻1 (R2 = 0.94), with dose strongly reducing shoot/root growth (r = −0.92 to −0.99). Untargeted LC-MS identified seven metabolites in CDC Greenstar and VIR421, including desamino-metribuzin (DA) and conjugates, while targeted LC-MS tracked metribuzin, DA, and desamino-diketo-metribuzin (DADK) over 12 d. VIR421 had higher metribuzin levels (105.70 ng g−1 at dry weight at 12 h) compared with CDC Greenstar and NZ2022, which rapidly metabolized metribuzin to DA (58 and 50.41 ng g−1 dry weight at 2 d), with NZ2022 showing further metabolism by 4 d. DA dominated 59- to 167-fold over DADK, suggesting a primary detoxification pathway. Hydroponics enabled precise tolerance screening, revealing genotype-specific metabolism critical for breeding metribuzin-tolerant lentils and thus enhancing weed management strategies.
Given the increasing importance of real-world evidence (RWE) in health technology assessment (HTA) decision-making, we aimed to assess RWE use in Canadian HTA and collect stakeholder insights on when RWE generation should be prioritized in HTA.
We found that RWE was included in one-third of Canadian Drug Agency–L’Agence des médicaments du Canada (CDA-AMC) reimbursement reviews (2017–2022). To further understand drivers of RWE generation for reimbursement, consultations were held with stakeholders (pharmaceutical industry representatives, payers, and patient advocates) to obtain insights in Canada and other global markets. Stakeholders highlighted the value of RWE to complement randomized controlled trials (RCT) data, as well as the need to consider feasibility and multiple stakeholder perspectives.
Our findings indicate there is a need to further support the practical implementation of RWE in policy decision-making. A framework providing guidance on when to prioritize RWE studies for reimbursement would provide value and could be tailored by region.