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This analysis evaluated potential differences in subjective well-being (SW) among patients with early-phase schizophrenia (SZ) randomized to treatment with either long-acting injectable (LAI) or oral aripiprazole or paliperidone within the “European Long-acting Antipsychotics in Schizophrenia Trial” (EULAST).
Methods
A total of 478 patients were followed for up to 19 months. SW was measured using the Subjective Well-being under Neuroleptic Treatment scale (SWN). Linear mixed-effects models assessed treatment differences. Comprehensive analyses included age, sex, symptomatology (Positive and Negative Syndrome Scale [PANSS]), and side effects (Systematic Monitoring of Adverse Events Related to Treatments [SMARTS] and St. Hans rating scale [SHRS] for extrapyramidal syndromes) on SWN changes.
Results
Overall, SW improved over the course of the study. No significant differences emerged between LAI and oral administration (p = 0.1533) or between aripiprazole and paliperidone (p = 0.2008). Similarly, age and sex were not relevant in this regard. In contrast, negative, positive, and affective symptoms (all p < 0.0001) as well as the overall side effect burden (SMARTS sum-score, p < 0.0001) showed significant inverse associations with SW. Certain SHRS subscales correlated with SW in partial models, but associations disappeared in the fully adjusted model.
Conclusions
Patients with SZ initiating LAI or oral treatment with aripiprazole or paliperidone reported comparable SW improvements. Findings emphasize that treatment choice should be guided less by formulation or substance and more by individual patient needs, prioritizing symptom control while minimizing adverse effects. A patient-centered approach remains essential to optimize both clinical outcomes and subjective well-being in early-phase SZ.
Hookworms are common parasites of Eurasian badgers (Meles meles), typically identified as Uncinaria criniformis. The taxonomic distinction from Uncinaria stenocephala, a species found in dogs and foxes, has long been debated. In this study, we molecularly characterized U. criniformis from a Eurasian badger in Romania using genome skimming. We assembled the complete mitochondrial genome and internal transcribed spacer (ITS) rDNA region from 2 adult hookworms morphologically consistent with U. criniformis. Phylogenetic analysis of 12 mitochondrial protein-coding genes demonstrated strongly supported clade of U. criniformis with Ancylostoma spp. ITS rDNA and cox1 sequence comparisons revealed only 92.4–92.8% and 88.0–88.5% identity, respectively, between U. criniformis and U. stenocephala, confirming their molecular distinctiveness. In contrast, our sequences showed >99% identity to sequences from Arthrostoma leucurus, a hookworm recently described from the Asian badger (Meles leucurus), suggesting conspecificity. These findings support the validity of U. criniformis as a distinct species parasitizing M. meles, and we propose A. leucurus as a junior synonym of U. criniformis. Our results highlight the polyphyly of the genus Uncinaria and point to the need for broader mitogenomic sampling of hookworms. The molecular markers generated here provide a reference for future parasitological surveys and wildlife disease studies.
Should people be protected by law from discrimination on the grounds of political affiliation and belief? I argue that individuals’ democratic right to exercise political agency – which implies freedom of association and freedom to express one’s political belief – requires that individuals should not be vulnerable to being treated disadvantageously because of their political affiliation and belief. To accomplish this, the protectorate of discrimination law should be expanded where relevant to include that characteristic. Moreover, in contexts where political and specifically affective polarisation is severe, the risk of such treatment increases, further justifying the legal innovation. While this thesis has received almost no prior discussion in the literature on the normative justification of discrimination law, and is revisionary in the UK and the USA, this absence is striking both in a comparative legal context and especially given the centrality of these freedoms to democratic politics.
Heirs’ property is a form a land tenure that can negatively impact landowners, particularly those who want to use their land for agricultural purposes. Over the past decade there has been an increase in legal reforms and assistance programs aimed at addressing issues associated with heirs’ property. Yet, this phenomenon has received little attention in the applied economics literature. With the aim of motivating future economic research, we make the following two contributions. First, we synthesize the existing multi-disciplinary literature on heirs’ property into an economically tractable framework. Second, we use parcel-level tax record data from 2015 and 2021 to track changes to the amount of heirs’ property over time and examine its rate of formation net of land leaving heirs’ property. We examine the changes to heirs’ property on non-agricultural and agricultural parcels (and the number of acres of land within parcels) separately. We find that the total number of parcels and acres, on non-agricultural lands, declined by about one percent and six percent, respectively. Whereas, acreage on heirs’ property agricultural lands decreased by about two percent. These small changes mask large transitions in and out of heirs’ property. Our estimates suggest that the formation of heirs’ property persists today and offsets most of the reductions obtained from land leaving heirs’ property. Additional analysis reveals significant heterogeneity across regions and localities.
Analysis of feeder and early weaned pig markets, important segments in pork production, is nearly nonexistent. We derive and estimate a structural econometric model relating demand and supply for market hogs, feeder pigs, and early weaned pigs. Estimates from the econometric model predict how disruptions are transmitted through hog and pig markets. Results indicate that hog and pig markets are most sensitive to hog processing plant utilization relative to capacity and that this sensitivity has increased compared to prior estimates. A set of counterfactual scenarios quantify the effects of shocks to hog processing capacity, wholesale pork demand, and supply response.
Epistemic democrats indirectly evaluate democratic decisions by directly evaluating the inputs into the election. However, the fundamental problem of measurement in the philosophy of science shows that procedures are often as difficult to evaluate as outcomes. This paper brings this highly refined framework into political philosophy to show that epistemic democrats face an analogous ‘fundamental problem of evaluation’. This cross-fertilization of political philosophy with the philosophy of science shows that the quality of democratic mechanisms and their inputs regarding their ability to track the truths of justice is as difficult to evaluate as the quality of the resulting decisions themselves.
The efficiency of polymerase chain reaction (PCR) decreases under suboptimal conditions, such as low template concentration combined with high concentrations of similar sequences. Under these circumstances, mis-priming can occur, leading to the generation of erroneous copies. Specifically, in 16S amplicon sequencing of human intestinal biopsy samples, host off-target sequences are frequently generated and subsequently sequenced, particularly when the commonly used V3-V4 primers are employed. This issue not only introduces errors in data interpretation but also results in the unnecessary consumption of sequencing depth. In response to this challenge, we analysed over 1,300 publicly available V3-V4 amplicon sequences related to the human colon, profiling the colon microbiota while elucidating the biases introduced by host off-targets. Briefly, our findings reveal that unaddressed host DNA contamination can lead to false bacterial identifications and obscure significant differences in microbiota composition. Furthermore, we identified human sequences on chromosomes 5, 11, and 17 as the main contributors to the majority of off-target sequences. Finally, we suggest practical approaches to mitigate this issue without altering the original protocol design, retaining the widely used V3–V4 primers. In particular, using a C3 spacer-modified nucleotide targeting the off-target sequence is here proposed as a promising strategy acting upstream of the off-target generation.
To compare temporal trends, variation, and correlations between antibiotic use metrics across U.S. neonatal intensive care units (NICUs) and assess associations with mortality.
Methods:
We conducted a retrospective cohort study of 438,156 infants admitted to 272 NICUs from 2017 to 2021 using the Premier Health Database. Antibiotic use rate (AUR), days of therapy (DOT), and antibiotic spectrum index (ASI) per 1,000 patient or therapy days were calculated both cumulatively by year and at the center level. Mixed-effects models adjusted for center-level characteristics were used for all analyses.
Results:
All three metrics declined over time: AUR by 16.8%, DOT by 19.0%, and ASI by 2.5%. AUR and DOT were highly correlated (r = 0.989, P < 0.001), while ASI showed weaker correlations with AUR (r = 0.247, P < 0.001) and DOT (r = 0.338, P < 0.001). None were significantly associated with center-level mortality. ASI had the least variability, indicating more uniform antibiotic selection and lower center-level discriminatory value.
Conclusions:
DOT and AUR were comparable measures of antibiotic consumption, both showing significant declines. ASI exhibited the least variability, reflecting more consistency in antibiotic selection. The similarity in dispersion and decline between AUR and DOT suggests that neonatal antibiotic exposure is primarily influenced by initiation and discontinuation decisions rather than regimen complexity. Given its ease of calculation, AUR may be the most practical metric for evaluating the impact of antibiotic stewardship interventions at the center level.
Max Nicholls had an almost unique experience as a medical practitioner, researcher and teacher of medical genetics. An earlier paper described his contribution to the etiology of neurofibromatosis. This was followed by Nicholls’ own experience as lecturer in the Faculty of Medicine, University of New South Wales, Australia. This note draws attention to his research in immunology. For example, he was instrumental in the study of the buffy coat leuko-agglutination (BCLA) test, a sensitive assay for cell-mediated immunity that he introduced to detect conditions (including cancer) in preclinical stages.
To estimate the coexistence of autism spectrum disorder (ASD) traits in an adult sample diagnosed with attention-deficit/hyperactivity disorder (ADHD); to compare individuals with ASD traits to those without, in terms of functionality, quality life and clinical outcomes; to explore the effects of ADHD medication on three main outcomes (clinical, quality of life, and functionality) in those with only ADHD and in those with coexistence of ASD and ADHD
Methods:
Prospective longitudinal study of an adult sample diagnosed with ADHD. Data were collected on age, gender, medications and on scales: Autism Spectrum Quotient (AQ-10); Adult ADHD Clinical Outcome Scale; Adult ADHD Quality of Life Questionnaire; Weiss Functional Impairment Rating Scale.
Results:
A sample of 165 participants was recruited. The AQ-10 showed that almost half, n = 74 (44.8%) of the participants had traits of ASD. Longitudinal analyses demonstrated that people with ADHD and ASD traits have worse clinical outcomes, quality of life, social skills, and family functioning, compared to those with ADHD only.
Conclusions:
The study shows a high rate of co-existence of ASD in adults with ADHD. Comorbid ASD traits were associated with poorer overall clinical and functional outcomes, quality of life, social skills, and family functioning. Study limitations with particular reference to dropout rate are considered. Implications for improving services are discussed.
This article examines the little-known experiences of children born of Chinese mothers and Japanese fathers who had consensual relationships during and after the Second Sino-Japanese War in China, with a specific focus on those who migrated to Japan after 1972. To understand how and why they—in their own words—“returned” to their “homeland,” this article analyzes historical circumstances as well as Sino-Japanese children’s experiences, identities, and belonging in comparison with other groups of “children born of war” in different historical and geopolitical settings. Their long-neglected stories point to a missing part in narratives of the 8-year war.
We study mixed identities for oligomorphic automorphism groups of countable relational structures. Our main result gives sufficient conditions for such a group to not admit a mixed identity without particular constants. We study numerous examples and prove in many cases that there cannot be a non-singular mixed identity.
This paper investigates the dynamic effects of environmental and fiscal policy shocks in a New Keynesian dynamic stochastic general equilibrium model featuring price and wage rigidity and a polluting intermediate goods sector. I compare carbon taxes and cap-and-trade systems under abatement cost and government spending shocks, considering three revenue-recycling schemes: lump-sum transfers, labor tax cuts, and consumption tax cuts. Abatement cost shocks reduce output and consumption, with stronger effects under cap-and-trade due to rising permit prices. These effects are mitigated when revenues are used to reduce distortionary taxes, especially consumption taxes. Government spending shocks stimulate output and labor, particularly under lump-sum financing, but their expansionary effects are dampened under cap-and-trade. Nominal rigidities amplify these dynamics. The findings support the double dividend hypothesis and highlight the importance of fiscal design and policy coordination. Carbon taxes, combined with targeted tax reductions, offer superior macroeconomic stabilization in the face of environmental and fiscal shocks.
This article explores the interplay between the individual and the collective in The Blind Owl and illustrates how a distinctive historical perspective emerges from its complex allegorical form. A close reading of the novel reveals how the text superimposes biographical and cultural pasts through the juxtaposition of sexual fetishism and nostalgia, presenting both as symptoms of a fraught relationship with one’s infantile and cultural histories. The article reads The Blind Owl as a satirical critique of a figure whose conflicting desires to commemorate and forget the past drive a series of fetishistic behaviors, culminating in failure. Ultimately, the novel offers a cynical reflection on the nationalist nostalgia cultivated by traditionalist intelligentsia within the peripheral modernity of early twentieth-century Iran.
Past research suggests that novel word learning is facilitated by multimodal contexts, which enrich semantic representations and strengthen memory traces. We explored whether environmental sounds (e.g., a creaking door) facilitate foreign language (FL) word learning. In all, 36 Spanish-speaking natives learned 60 written Spanish–FL word pairs, each accompanied by one of three sound conditions: a congruent sound matching the word pairs’ denotation, a meaningless tone or silence. Participants then completed a semantic priming and lexical decision task where reaction times and accuracy were collected. Performance was similar for congruent sound and tone conditions and, compared to silence, showed lower accuracy in the lexical decision task and a marginal benefit in the semantic task. These findings suggest that environmental sounds can influence learning, with varying effects depending on the task. Results are discussed in terms of current language learning models.
Gorse (Ulex europaeus L.) is a leguminous shrub native to western Europe, voluntarily introduced into Uruguay for ornamental purposes. It is considered among the 100 most problematic invasive species in the world. In Uruguay, it seriously affects both livestock and forestry systems. We evaluated different weed management techniques on a cattle farm invaded by U. europaeus, in the region of Lavalleja. In spring 2020, three treatments were applied—cutting only (C); cutting and grazing (CG); and cutting, applying herbicide, and grazing (CHG)—to 18 plots ranging from 25 m2 to 50 m2. Following treatment, U. europaeus regrowth and the height and the perimeter of five plants per plot, as well as seedling recruitment, were assessed over 16 mo. The livestock were cattle (Bos sp.) and sheep (Ovis sp.). The CHG treatment was the most effective in inhibiting the regrowth of U. europaeus, while grazed plants grew less in height compared with those excluded from grazing (CG = 62.3 cm ± 1.9, C = 84.8 cm ± 2.0, P < 0.05). However, by the end of the study, seedling recruitment was lower in the C treatment (C = 0.3 ± 0.3, CG = 3.1 ± 1.8, CHG = 8.6 ± 4.6 seedlings m−2, P < 0.05), where increased height of herbaceous vegetation may have reduced the success of the emergence and establishment of regenerants. These results encourage further long-term study of this invasive species’ response, as well as an evaluation of the potential impacts of these control measures on non-target species.
Existing research often interprets the limited impact of candidate gender on vote choice as evidence of minimal gender bias in politics. However, this overlooks the dual role of candidate gender, as both a heuristic for substantive representation and a trigger for sexism in voter decision-making. These competing mechanisms can diminish the effects of each other, obscuring the true influence of gender bias in electoral behavior. Using conjoint experiments in South Korea, a context where gender issues are highly politicized and sexism remains widespread, we examine how candidate gender affects voter evaluations in low- and high-information environments. Our findings reveal that in low-information settings, candidate gender serves as a cue for substantive representation, leading to co-sex voting among women, while simultaneously activating hostile sexism among male voters, reducing support for female candidates. In high-information settings, explicit candidate policy positions diminish the reliance on gender cues but do not eliminate gender bias. Instead, sexism manifests through opposition to gender-equity policies rather than direct discrimination against female candidates. These results suggest that information environments shape the expression of gender bias, rather than eliminating it, offering a more nuanced understanding of the conditions under which candidate gender influences electoral preferences.
An observational pilot in walk-in clinics assessed workflow impacts of personal protective equipment (PPE) use for COVID-19 cases. PPE added time, waste, and cost despite a low incidence period of illness. Limited supporting data for contact transmission and operational barriers suggest ambulatory PPE guidance for COVID-19 warrants modification.
During the 1970s and 1980s, over 30,000 people in the UK were infected with HIV and/or hepatitis C because of treatment with blood and blood products for conditions such as haemophilia or through blood transfusion. We used the social harms perspective to understand the experiences of those affected. We conducted in-depth interviews with 41 infected people and 11 family members and analysed the data according to five dimensions of social harm: physical harms, psychological harms, cultural harms, economic harms, and harms of misrecognition. We found that people were harmed by the medical system, the social context that perpetuated stigma and shame against them, and successive governments being largely unwilling to address the many health, social, and economic impacts of infection on families. What stood out were the many reports of harms of misrecognition, which were often experienced as more irreconcilable than the circumstances of infection itself. They were also harms that have been largely ignored.
While patient safety encompasses a broad field of work, much of the research focuses on physical harm and medical error. The social harms lens can provide important insights into patient safety incidents as it can help explain the complexity of the different dimensions of harm that individuals and their families experience.