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Although they are critical for military units’ compliance with international humanitarian law (IHL), junior leaders are often overlooked in the development of ethical and moral decision-making when it comes to education and training. To foster the internalization of IHL principles in this vital cohort, those principles must be better melded with military ethics. Through examination of different military efforts to create ethical warriors, important points from behavioural ethics, the use of warrior ethoses, instances of competing positive values, and ideas for effective and affordable curricula, the present article suggests a path forward for accomplishing this.
Dreams were an important but epistemically ambiguous feature of ancient medicine and a key site of religious experience. Galen of Pergamum, whose father’s dreams were decisive in his becoming a physician, incorporates dreams into diagnostic inquiry, therapeutic innovation and theological speculation. Scholars have long treated Galen’s positive descriptions of his and others’ dreams as indications of religious commitments at odds with his avowed rationalist epistemology. This article re-examines Galenic texts on dream diagnosis, references to dream-based therapies and descriptions of his father’s dreams. Having traced Galen’s sources and descriptions of dreams, it shows that the oneiric is perfectly comprehensible within his rationalist, physiological framework. The article shifts questions of dreams’ significance from their origins to descriptions of their quality and the context of their mention. The article concludes by showing that, consonant with his own epistemological and rhetorical commitments, dreams offer the Pergamene physician confirmatory techniques, means of surprise and innovation and a rhetorical strategy for validating his knowledge, skill and standing.
Pentanchids (Elasmobranchii) are among the most species-rich groups of chondrichthyans. In the North Atlantic Ocean, the Icelandic catshark [Apristurus laurussonii (Saemundsson)], white ghost catshark (Apristurus aphyodes Nakaya & Stehmann), and mouse catshark [Galeus murinus (Collett)] are commonly found in deepwater habitats. However, information on their parasite communities remains scarce. This study provides the first comprehensive characterization of the metazoan parasite communities of the 3 pentanchid species. In total, 56 specimens were collected in Icelandic waters at depths of 466–1322 m between 2023 and 2024 and examined using standardized parasitological protocols, including morphological and molecular methods. Infection patterns were assessed in relation to size, maturity, body condition and capture area of hosts. Parasite intensities in all sharks ranged from 2 to 227 individuals, comprising 15 different taxa and resulting in 27 new parasite–host records, some of which likely representing new species. Eight out of 9 commonly found parasites did not display a high degree of host-specificity, indicating similar feeding habits, niche preferences, and trophic position of these sympatric species. Nonetheless, multivariate analyses revealed significant differences in the structure and composition of their parasite assemblages, with some parasites representing indicator species and occurring more abundantly and frequently in a certain deepwater catshark species. In addition, significant small-scale geographic differences were detected. At a broader geographical scale, North Atlantic pentanchids showed higher parasite richness and diversity, and lower dominance compared to standardized data from Mediterranean counterparts. Ecological factors underlying these patterns on host–parasite dynamics in (deepwater) cat sharks are discussed.
Evaluate whether a complex outpatient antimicrobial therapy (COpAT) program led by advanced practice providers (APPs) conducting transition-of-care (TOC) services improves post discharge patient follow-up and reduces hospital readmission.
Design:
Pre- and postimplementation cohort study comparing outcomes 6 months before and 5 months after COpAT launch.
Setting:
706-bed tertiary university teaching hospital.
Patients:
Adult patients admitted to the hospital with bone and joint infections, seen by our inpatient infectious disease consultation service and discharged with at least fourteen days of antimicrobial therapy, with follow-up at our specialized musculoskeletal infectious diseases clinic.
Intervention:
The APP led pilot COpAT program was launched on March 1st, 2024, with a multidisciplinary team including an infectious diseases physician, APP, nurse, medical assistant, and TOC pharmacists. Patients enrolled at hospital discharge and were scheduled for APP-led TOC visits within fourteen days, followed by a physician visit.
Results:
The pre- and post-intervention groups included 100 and 135 patients, respectively. Mean postdischarge follow-up time decreased from 20.1 to 9.1 days (P < .001), and patients seen within fourteen days increased from 42% to 83% (P < .001). Readmission rates and emergency room visits did not change significantly. TOC pharmacy engagement rose from 8% to 42% (P < .001), and both TOC pharmacy and APP interventions frequently addressed medication errors, side effects, and treatment modifications.
Conclusion:
A structured, COpAT program with APP and TOC pharmacy involvement optimizes postdischarge follow-up, strengthens antimicrobial outpatient monitoring, and supports timely intervention for patients with complex infections.
Task-based language teaching is believed to facilitate language learning opportunities that arise when performing tasks. Although the synergies between task and learner variables in this process rose to prominence recently, little has been undertaken to explore the individual difference-task interaction in textual meaning-making activities. This study thus explored how second language (L2) writing performance under different task complexity conditions was impacted by L2 writing willingness to communicate (WTC) and L2 writing proficiency. Participants with upper-intermediate English proficiency were recruited following a within-between-participant factorial research design. The results confirmed that WTC significantly influenced syntactic complexity, accuracy, and fluency in L2 writing, suggesting that conative individual differences (IDs) might play a more prominent role in L2 writing than cognitive IDs. Among the sub-components of WTC, motivational predispositions performed better than emotional, cognitive, and writing-specific features in affecting L2 writing performance. Additionally, WTC played a more pronounced role in the complex task, supporting the claim of Robinson’s cognition hypothesis that ID effects are more evident in complex tasks than simple tasks. However, no interaction between L2 writing WTC and proficiency was found. Theoretical and pedagogical implications were offered on considering both L2 WTC and task complexity in task-based writing instruction.
Teju Cole’s Open City is one of several recent postcolonial novels that narrate the refugee crisis and the threats to nonhuman species in a way that takes seriously the parallels and interspecies relationships. I am interested in the extent to which novels that explore kinships across boundaries of kind manage to make a space for the nonhuman in the anthropocentric form of the novel. In the case of Open City, I argue that Cole’s figural approach offers a means of formalizing the human representation of nonhuman others as a problem and allows readers to make connections across species boundaries even as the novel raises the specter of moral stasis through the cosmopolitan narrator’s failure to take an ethical stance with respect to those in search of refuge, human or not. This failure is a human one, and in offering an anatomy of such a failure, Cole invites scrutiny of cosmopolitanism as much as of the novel form’s anthropocentrism.
There is clear evidence that rapid warming has been fuelling significant changes in the ocean and cryosphere in the Antarctic Peninsula region. Less is known about how terrestrial biological ecosystems, particularly plants, are responding to warming and hydroclimatic change. We show that high evaporative environmental conditions and microclimate associated with topography lead to humidity-dependent evaporative effects on the oxygen isotope ratios (δ18O) of moss waters and α-cellulose in the northern Antarctic Peninsula, based on a spatial (> 400 km) isotopic survey at 14 sites over 24 days during summer 2020. The δ18O of moss waters define a water line of δ2H = 4 × δ18O + 37 for Polytrichum strictum and δ2H = 3.8 × δ18O + 38.9 for Chorisodontium aciphyllum, indicating enrichment compared to line slopes ranging from 6.7 to 8.5 for snow, standing water, previous published snapshots of moss waters and the long-term local meteoric water lines along the Antarctic Peninsula. The δ18O of moss waters negatively correlated with relative humidity (which ranged from ~50% to 100%) and not with temperature or latitude, where a higher δ18O indicates increased evaporative enrichment or dry conditions. A positive correlation between the δ18O of moss waters and α-cellulose (ρ = 0.397, P = 0.011) for P. strictum (ρ = 0.533, P = 0.007) but not C. aciphyllum suggests that the high evaporative conditions from the season imprinted on the cellulose. Lastly, we found significant positive correlations between topographic aspect (north-exposedness) and the δ18O of moss waters (ρ = 0.569, P < 0.001) and α-cellulose (ρ = 0.579, P < 0.001), indicating that irradiance on north-facing slopes promotes drier conditions and evaporative enrichment. Topographic aspect (and resulting microclimate) is an important and predictable determinant of the δ18O of moss waters and α-cellulose. This study highlights that mosses are sensitive recorders of climatic and non-climatic conditions in polar terrestrial ecosystems.
This paper explores how traditional Chinese vegetarian concerns were adapted to exploit new possibilities in the early twentieth century. Specifically, I examine attempts to promote the vegetarian diet through monosodium glutamate, ventures to manufacture vegan soap, and the emergence of a vibrant culture of urban vegetarian restaurants, all of which were actively supported by the socially conservative monk Yinguang 印光 (1862–1940).
This study aims to evaluate the effectiveness of an adapted methicillin-resistant Staphylococcus aureus (MRSA) decolonization program in an infirmary unit in Hong Kong that was inspired by successful interventions implemented in Orange County, California.
Methods:
Nasal, skin, and rectal swabs were collected to assess MRSA colonization. Decolonization involved applying 10% povidone-iodine ointment to the anterior nares twice daily for five days every other week, along with twice weekly chlorhexidine gluconate (CHG) bathing for six months. Compliance with the application of povidone-iodine and CHG bathing techniques was monitored by measuring their respective levels in the anterior nares and on the skin. Air and environmental samples were collected and analyzed over time using linear regression.
Results:
Among 60 patients in the infirmary unit (78% baseline MRSA carriers), overall MRSA colonization declined during the program, driven by significant reductions in skin colonization (65% to 29%, P < .001). Environmental contamination on high-touch patient-care equipment (bathing trolleys and slings) also significantly decreased over time (P < .001). These reductions coincided with the high-quality implementation of decolonization, evidenced by stable iodophor detection in nares during application weeks and sustained chlorhexidine levels on the skin, detectable 24 hours after bathing. In contrast, MRSA detection in air samples showed no significant change (P = .096), possibly due to dispersal by persistent carriers during care activities even as skin and environmental contamination declined.
Conclusions:
The adapted MRSA decolonization program was effective, significantly reducing overall MRSA colonization, especially at skin sites, while achieving high compliance with the protocol.
Among the most recurring motifs in the prehistoric rock-art corpus, handprints stand out as one of the most significant elements due to their dual nature, both artistic and fossil. These markings represent a unique source of information for characterizing the corresponding artists and the social and cultural context of prehistoric communities. This study focuses on a comprehensive characterization of the phenomenon of Upper Palaeolithic hand representations from a multidimensional perspective, combining various theoretical and methodological approaches. By offering a holistic view, the aim is to contextualize these artistic expressions within a broader framework that includes biological, social, cultural, spatial and technological considerations. The study revisits classical documentation on hand representations and brings new perspectives through experiments and analyses conducted under conditions that replicate, as closely as possible, the physical and technological characteristics of the Upper Palaeolithic. These new perspectives broaden our understanding of these artistic expressions and their significance within prehistoric societies, shedding light on their potential role within rock art and their functional and symbolic meaning.
The politics of knowledge production is a long-standing debate at the heart of the discipline of international relations (IR). The importance of the IR classroom as a site of the politics of knowledge production in the discipline has long been emphasized by critical and feminist IR scholars and has recently received renewed interest. In this article we contribute to this debate through an analysis of the ways in which learner-generated films contribute to address knowledge production politics. Inspired by the distinction between knowledge production and knowledge cultivation, we propose that the practice of knowledge cultivation through filmmaking in the IR classroom can serve as a compass and generates openings to ‘stay with the trouble’ of creating knowledge. We draw on insights from our experience with learner-generated films and from a dialogue with the literature on the politics of knowledge production in IR; visual and arts-based theorizing in IR; and the interdisciplinary literature on filmmaking. The article addresses three key dimensions of the politics of knowledge production: the ethics and politics of filmmaking; affect and embodiment of creating knowledge through films; and non-textual theorizing through filmmaking.
Schizophrenia (SCZ) shows marked biological heterogeneity, with negative symptoms linked to poor outcomes and hypothesised immune dysregulation. This study examined whether a peripheral cytokine–long non-coding RNA (lncRNA) panel could distinguish patients with SCZ and Brief Negative Symptom Scale (BNSS)-defined subgroups from healthy controls (HC).
Methods:
Forty-one hospitalised patients with SCZ completed the BNSS and the Positive and Negative Syndrome Scale (PANSS). Twenty HCs, frequency-matched for age and sex, served as comparison samples. Severe negative-symptom subgroups were defined using two BNSS criteria: a broader (SNS1) and a more restrictive (SNS2) threshold. Serum cytokines – interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), interleukin-10 (IL-10) – and leukocyte lncRNAs (MALAT1, NEAT1, MEG3) were quantified by enzyme-linked immunosorbent assay and quantitative RT-PCR. Covariate-adjusted logistic and multinomial models (adjusting for age, sex, body mass index, and smoking) assessed discrimination using area under the receiver-operating-characteristic curve (AUC) and interquartile-range odds ratios (OR_IQR).
Results:
IL-6 correlated with PANSS Total (ρ = 0.48, p = 0.001) and Negative (ρ = 0.34, p = 0.032) scores and was higher in SCZ than HC (p = 0.033), with further increases in SNS subgroups. NEAT1 was significantly reduced only within BNSS-defined subgroups (p ≤ 0.025). The dual-marker pattern (IL-6 ↑, NEAT1 ↓) showed the strongest discrimination for SNS1 versus HC (AUC = 0.85) and the steepest multinomial contrasts for SNS2 (IL-6 OR_IQR = 4.98; NEAT1 OR_IQR = 0.11).
Conclusions:
Elevated IL-6 and decreased NEAT1 define a peripheral signature linked to negative-symptom severity in SCZ and may support biologically informed stratification and longitudinal research.
We investigate positivity and probabilistic properties arising from the Young–Fibonacci lattice $\mathbb {YF}$, a 1-differential poset on words composed of 1’s and 2’s (Fibonacci words) and graded by the sum of the digits. Building on Okada’s theory of clone Schur functions, we introduce clone coherent measures on $\mathbb {YF}$ which give rise to random Fibonacci words of increasing length. Unlike coherent systems associated to classical Schur functions on the Young lattice of integer partitions, clone coherent measures are generally not extremal on $\mathbb {YF}$. Our first main result is a complete characterization of Fibonacci positive specializations – parameter sequences which yield positive clone Schur functions on $\mathbb {YF}$. Second, we establish a broad array of correspondences that connect Fibonacci positivity with: (i) the total positivity of tridiagonal matrices; (ii) Stieltjes moment sequences; (iii) the combinatorics of set partitions; and (iv) families of univariate orthogonal polynomials from the (q-)Askey scheme. We further link the moment sequences of broad classes of orthogonal polynomials to combinatorial structures on Fibonacci words, a connection that may be of independent interest. Our third family of results concerns the asymptotic behavior of random Fibonacci words derived from various Fibonacci positive specializations. We analyze several limiting regimes for specific examples, revealing stick-breaking-like processes (connected to GEM distributions), dependent stick-breaking processes of a new type, or limits supported on the discrete component of the Martin boundary of the Young–Fibonacci lattice. Our stick-breaking-like scaling limits significantly extend the result of Gnedin–Kerov on asymptotics of the Plancherel measure on $\mathbb {YF}$. We also establish Cauchy-like identities for clone Schur functions whose right-hand side is presented as a quadridiagonal determinant rather than a product, as in the case of classical Schur functions. We construct and analyze models of random permutations and involutions based on Fibonacci positive specializations along with a version of the Robinson–Schensted correspondence for $\mathbb {YF}$.
Scanning electron microscopy (SEM) methods are widely used in the geosciences to determine grain shape and surface characteristics using SEM–secondary electron and backscatter imagery (SEM-SE/BSE) and elemental composition of minerals using SEM–energy dispersive X-ray spectroscopy (SEM-EDS). We discuss applications and best practices for utilizing widely available SEM methods for luminescence dating, including (1) checking sample purity following mineral separation, (2) imaging grain shape and surface characteristics related to weathering and transport, (3) quantifying feldspar-mineral phases in feldspar separates, and (4) determining internal potassium concentration (wt% K) in feldspars for use in estimating internal beta contribution to the dose rate for a sample.
Quartz and feldspar purification checks of mineral separates require the least sample preparation and instrument time. These methods utilize the “environmental” or “low-vacuum” conditions of SEM. These conditions are less conducive to acquiring high-quality compositional data but can be used to quickly determine sample purity.
Conversely, to acquire higher-quality compositional data, SEM working conditions require high vacuum and accelerating voltages. The resulting semiquantitative SEM-EDS results can be used to determine the phase composition of feldspar separates and more accurately determine the internal potassium content for dose-rate and age calculations.
Various item selection algorithms have been proposed for cognitive diagnostic computerized adaptive testing (CD-CAT), with the goal of efficiently diagnosing examinees’ strengths and weaknesses. However, these algorithms often come with significant computational costs, which can hinder their practical implementation. A likelihood-based profile shrinkage (LBPS) algorithm is proposed to simplify the item selection process and reduce the computational cost in CD-CAT. Our simulation results indicate that incorporating LBPS into existing item selection methods yields substantial computational efficiency gains, with greater reductions in computation time as the number of attributes and test length increase. Additionally, LBPS maintains estimation accuracy at both the attribute and pattern levels. These findings suggest that LBPS is a scalable and effective solution for the item selection of CD-CAT in complex scenarios.
Post-Dobbs v. Jackson, abortion regulation is left entirely to the states. Laws that restrict access to abortion generally allow for exceptions when determined necessary for the life or safety of the pregnant patient. Some states, e.g., Ohio, use a “subjective” legal standard when determining whether an abortion is medically necessary. Other states, e.g., Texas, rely on an “objective” legal standard, whereby the necessity of an abortion is not determined by any particular physician’s judgments, but rather by the judgment of a hypothetical “reasonable physician.” Though objective legal standards are widespread in American jurisprudence, they are a poor fit for clinical judgments about the medical necessity of abortion. On the contemporary model of clinical decision-making, medical judgment is irremediably subjective. In addition to being responsive to patient values and medical evidence, medical judgment is, and should be, informed by physician values. Because Texas abortion regulations rely on an objective standard of judgment that fails to correspond to a medically meaningful category, they fail to provide adequate guidance to physicians regarding the circumstances under which abortion is legally protected.
Examining religion and state arrangements in the United States, this study investigates under what conditions religious law, rooted in state establishment, declines in democracies. We argue that when (1) state founders or political elites intentionally refrain from embedding religious arrangements within state institutions, (2) the state apparatus enforces a constitutionalized and explicit prohibition against government-sanctioned religion, and (3) legal justifications shift from religious to secular rationale to maintain their justifiable constitutionality, then reliance on religious law within the state diminishes. However, due to institutional path dependence, laws initially rooted in religious arrangements/traditions may persist but are increasingly framed in secular terms, aligning with the broader secularization of modern Western societies, regardless of the extent of separation between religion and state. Hence, the religious influence and objectives of these laws endure despite the secular disguise.