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.
Acute rhinosinusitis is one of the most common conditions seen in primary care. One in seven adults are diagnosed with ARS annually, resulting in one in five of all antibiotic prescriptions. Yet there has been limited research comparing the effectiveness of widely used treatments such as antibiotics and nasal steroids. Conducting such a trial in the context of decades of established practice poses unique challenges.
Methods:
A feasibility phase was conducted with continuing feedback to provide refinement and guidance regarding the design of a large-scale, pragmatic randomized controlled trial. The pilot trial assessed the ability to enroll, retain, and evaluate adherence to the intervention and assessment protocols.
Results:
The feasibility phase allowed us to seek input from patients and experts. This resulted in changes pre and post pilot that will impact the full study. A priori enrollment targets for the pilot were achieved, and with high adherence rates. In total, 373 patients were pre-screened and 140 patients were enrolled participants. Adherence to data collection via the daily diary was 93% throughout the study, with 95% completing their diary on the day of the primary outcome, 3 post-randomization.
Conclusion:
Expert panels and a patient advisory committee recommended critical changes to our study design. Stakeholder engagement is a key component of this funding source and was widely used throughout the 18-months. An achieved primary goal of the feasibility phase was to evaluate recruitment and study methods prior to implementing a large clinical trial that requires significant resources.
The authors in this special issue explore the ways in which chronotopes are often gendered and gender performance is chronotopic. Articles examine a diverse range of discourses—tradwives, Chinese beauty influencers, paleofantasy health trends, Kiowa War Mothers, and Swahili-language Islamic marital advice—and unpack the ways that notions of gender rely on particular constructions of the “here-and-now” in contrast to various “theres-and-thens.” As this special issue demonstrates, one is not just a gendered subject; one is a particular type of gendered subject, and those types are embedded in imagined times and places.
Chapter 4 explores why Trump has perceived an opportunity to openly test the U.S. military’s commitment to IHL. Section 4.1 analyzes the role of ideological subcultures in overriding formal doctrines relating to IHL. Section 4.2 turns to why Trump has perceived that Fox News and GOP Congress members could help him to appeal to conservatives and pockets of right-wing extremism in America’s military. Section 4.3 documents the rise of far-right subcultures in the military, both before and after Trump’s two electoral wins in 2016 and 2024. Finally, Section 4.4 presents a short case study of disproportionate military involvement in the January 6 Capitol riot. Although not a foreign battlefield, the case illustrates how Trump and his allies could lead combatants to discount norms of restraint, even to the point of attacking civilians on American soil.
Wakes and the dynamic interactions of multiple wakes have been a focal point of numerous research endeavours. Traditionally, wake interaction studies have focused on wakes produced by similar bodies. In contrast, the present study positions a non-shedding porous disc adjacent to periodically shedding solid discs of varying diameters and dimensional shedding frequencies. Using hot-wire measurements, we explore the intriguing interaction between these wakes. Remarkably, our findings reveal that the wake of the non-shedding disc acquires oscillations from the wake of the shedding disc, irrespective of their distinct frequencies. We demonstrate high receptivity of the porous disc’s wake and connect our findings to real-life applications.
Under the migration of the proportionality doctrine to Asia, the dialogue and interaction between public law and private law have deepened and become more fruitful. The proportionality doctrine, usually accompanied by a general human-rights-limitation clause in the constitution, has made human rights reasoning come into the making of private law more directly and extensively. The proportionality principle also equips the judiciary with an analytical tool to assess the constitutionality of the state’s law or actions that limit the constitutional rights of involved parties.
This Article discusses the dialogue between public law and private law under the migration of the proportionality doctrine to several Asian jurisdictions, with a focus on Vietnam. The dialogue can be identified in three aspects: (i) dialogue as the impact of public law on private law; (ii) dialogue as the interaction between public law and private law; (iii) dialogue as the politico-legal interaction between lawmakers and courts. Among Asian jurisdictions, the Vietnamese legal system has arguably witnessed an inadvertent migration of the proportionality doctrine, and therefore provoking interesting and useful debates on the effect of constitutional rights in private law in both theoretical and practical aspects.
Artisanal-and-small-scale gold mining supports millions of livelihoods in the Global South but is the largest anthropogenic source of mercury emissions. Many initiatives promote mercury-free technologies that small miners could employ. Few document mercury impacts. We study an alternative: instead of processing themselves, small miners sell their ore to plants employing larger-scale, mercury-free technologies that also raise gold yields. Some ore-selling occurs without policy intervention, yet impacts on incomes and mercury use remain unclear. We assess ore-selling preferences of female waste-rock collectors (jancheras) in Ecuador, using a discrete-choice experiment. Results demonstrate that jancheras generally are open to ore-selling, yet often reject options similar to a recent pilot intervention. Offers that address formalization hurdles (invoicing), inabilities to meet quantity minima (given limits upon association, storage, and credit), and constraints on trust (including in plants’ ore testing) could increase adoption by tailoring related interventions to the preferences of and challenges for defined populations.
Test whether a dissonance-based transdiagnostic eating disorder treatment, body project treatment (BPT), produces greater reduction in brain reward region response to the thin ideal and behaviors used to pursue this ideal and eating disorder symptoms, and higher abstinence from eating disorder behaviors and remittance from eating disorder diagnoses than a matched transdiagnostic interpersonal psychotherapy (IPT).
Methods
Women with various eating disorders (N = 83) were randomized to 8-week group-implemented BPT or IPT and completed functional magnetic resonance imaging (fMRI) at pretest and posttest, and surveys and masked diagnostic interviews at pretest, posttest, and 6-month follow-up.
Results
BPT versus IPT participants showed significantly greater reductions in mid cingulate cortex response to thin models, anterior cingulate cortex response to eating disorder behavior words, eating disorder symptoms (d = 0.54), and body dissatisfaction (d = 0.57), and marginally greater reductions in psychosocial impairment (d = 0.39) at posttest, as well as significantly greater reductions in body dissatisfaction (d = 0.68) and psychosocial impairment (d = 0.63), and marginally greater reductions in eating disorder symptoms (d = 0.53) at 6-month follow-up. At posttest, BPT versus IPT participants showed significantly greater abstinence from binge eating and purging (48% versus 23%, respectively) but did not differ on remittance from eating disorder diagnoses (52% versus 44%, respectively).
Conclusions
Results provide further evidence of target engagement for BPT and suggest that it is more effective than IPT in treating a range of eating disorders.
How do citizens evaluate lesbian and gay (LG) party leaders? While recent scholarship has provided a window into how individuals evaluate openly gay legislative candidates, few studies have examined voter evaluations of LG individuals in executive positions, where voters may have different expectations of political leaders. This study assesses public perceptions of LG party leaders, with a focus on leader deservingness, competency, and electoral viability. Results from a conjoint experiment in the United Kingdom indicate that LG leaders receive lower leadership evaluations than straight leaders on all dimensions. Additionally, we find that gay women and men face similar penalties. This finding holds regardless of the leader’s level of legislative experience. Thus, LG party leaders face a significant disadvantage compared to their straight counterparts when seeking the top position within their party.
Chapter 2 explains how Trump has gained the means to overtly challenge IHL. Section 2.1 presents case studies of how Fox News and Trump allies in Congress both inspired and defended two rounds of high-profile clemencies during his first term. The first, occurring roughly six months after Trump had pardoned Michael Behenna in May 2019, preempted the court martial of Mathew Golsteyn, commuted the sentence of Clint Lorance, and restored the rank of Eddie Gallagher. The second set occurred roughly a year later, when Trump pardoned four Blackwater contractors, part of the “Raven 23” convoy, who had been jailed for murdering fourteen Iraqi civilians during the 2007 “Nisour Square Massacre.” Section 2.2 documents how these clemencies are not isolated events but part of a broader challenge to international law.
How people experience their own ageing may impact how likely they are to remain engaged with life. This study examined (1) biologically based risk factors in the form of self-reported health and cognition, and (2) age-related stereotypes and frequency of perceived ageism as predictors of engagement with life and number of ‘close’ social connections in older adulthood. We aimed to move beyond studies focusing on direct links between ageism and psychosocial functioning by examining the extent to which ageism could act as a moderating factor, amplifying negative associations between established risk factors and engagement with life. Data were obtained from a community-based sample of 287 South Australians aged 65–103 years (M = 76.41, SD = 7.13; 54.4 per cent female) who participated in a telephone survey. Hierarchical multiple linear regressions were run using Stata v15.1. Overall, frequency of perceived ageism in this community sample was low. More positive age-related stereotypes were related to more ‘close’ social connections, but not greater engagement with life. Counter to expectations, an interaction of frequency of perceived ageism with health indicated that higher engagement with life was associated with more frequent perceived ageism, but only among those in poorer health. No other moderating effects were observed. The findings are discussed in terms of possible underlying mechanisms linking ageism, stereotypes and engagement, including the likelihood that our results in part reflect reverse causality, with those with both greater physical limitations and who remain broadly engaged being at greater risk of experiencing ageism.
Recent geopolitical events remind us of the need for a resilient, global approach to sustainability science. This Commentary argues that a diverse, bottom-up approach is essential to ensure sustainability science progresses, even amid shifting political processes that threaten international collaboration and funding. Locally driven solutions that value diverse perspectives and knowledge systems are vital for resilience. By supporting community-led action, sharing ideas across regions, and recognising that sustainability means different things in different places, we can build a more flexible, inclusive, and resilient path toward achieving the Sustainable Development Goals in an uncertain world.
Technical summary
Recent geopolitical events provide a stark reminder of the need to build a resilient, global approach to sustainability science. Centralised, top-down models of sustainability science are likely to be vulnerable to disruptions, from pandemics to wars, that threaten progress towards the Sustainable Development Goals and jeopardise decades of collaborative advancement that are needed to support future progress. We argue that a decentralised, community-empowered model provides the foundation needed for a resilient sustainability scientific effort. By prioritising local solutions, embracing diverse knowledge systems, and fostering horizontal knowledge exchange, we can create a more resilient and adaptable framework. Sustainability science initiatives need to elevate successful local initiatives, adopt transdisciplinary approaches that include underrepresented knowledge holders, build decentralised knowledge-sharing networks, and recognise that sustainability has different meanings across cultural and geographical contexts.
Social media summary
Decentralised sustainability science: local, diverse, and resilient in a fractious and unpredictable world.
Rapid molecular testing for antimicrobial resistance (AR) provides an indication of resistance faster than phenotypic antimicrobial susceptibility testing. We summarize the adoption of molecular testing for AR among US acute care hospitals and discuss the potential impact on National Healthcare Safety Network’s surveillance for AR.
Chapter 1 introduces President Donald Trump’s all-out assaults on the validity of the law of war. It argues that his behavior differs from other Western leaders in that Trump has been willing to openly challenge international humanitarian law (IHL) not “in the shadows” but “in the daylight.” Section 1.1 explains why the topic matters for political scientists and legal scholars. Section 1.2 discusses the significance of Trump’s impunity agenda for policy and governance. Section 1.3 argues that, regardless of whether Trump has technically violated the law of war in the past, his brazen attacks on the need for IHL distinguish him from other Western leaders. Section 1.4 claims that the constraints in Western democracies that largely prevent democratic leaders from publicly flouting IHL may be more perceived than actual. Section 1.5 justifies the case selection of Trump, explaining how Trump was presented with the “means, motive, and opportunity” to overtly defy the law of war. Section 1.6 previews the puzzles and arguments that guide the rest of the book.
The problem of unconceived alternatives poses a challenge to believing even our most successful scientific theories. Such theories are typically accepted because they explain the available evidence better than any known rival, but such ‘inference to the best explanation’ cannot reliably guide us to the truth unless the truth is among the set of possibilities we have considered. The problem of unconceived alternatives suggests that we have compelling historical grounds to doubt that this crucial condition is satisfied when we theorize about otherwise inaccessible natural domains. Because the historical evidence suggests there are probably many serious alternatives to our own foundational theories that remain presently unconceived despite being well-confirmed by the evidence we have, we should doubt that some of even our most successful scientific theories are in fact true or even close to the truth. After presenting this problem in its original scientific context, I go on to argue that it poses at least as compelling a challenge to our confidence in any particular conception of God and/or divinity. I draw some fairly radical further theological consequences, and I suggest that the problem may ultimately force us to embrace a far more epistemically humble appraisal of our knowledge of God and divinity itself.
This work explores the morphology and dynamical properties of cores within rich superclusters, highlighting their role as transitional structures in the large-scale structure of the Universe. Using projected and radial velocity distributions of member galaxies, we identify cores as dense structures that, despite being gravitationally bound, are not yet dynamically relaxed. However, they exhibit a tendency towards virialisation, evolving in a self-similar manner to massive galaxy clusters but on a larger scale. Morphological analysis reveals that cores are predominantly filamentary, reflecting quasi-linear formation processes consistent with the Zeldovich approximation. Our estimates of the entropy confirm their intermediate dynamical state, with relaxation levels varying across the sample. Mass estimates indicate efficient accretion processes, concentrating matter into gravitationally bound systems. We conclude that cores are important environments where galaxy evolution and hierarchical assembly occur, bridging the gap between supercluster-scale structures and virialised clusters.
The incorporation of technology, and more recently AI [Artificial Intelligence], into our everyday lives has been progressing at an unprecedented pace. Siri, Alexa, Cortana and various other digital assistants and chatbots populate our everyday interactions for most service-related matters. Acknowledging that technology, work, and social relations are deeply entangled with each other, this paper combines a literature review of anthropomorphisation of AI and emerging technology with a focus on gender and work, and empirical examples drawn from real-world applications and chatbots in the service industry in India, to critically analyse the gendering of technology. We unpack the tendency to ascribe a feminine identity to assistive technology and argue that gendering of emergent assistive technology is performative and relational. It materialises through particularistic manifestations drawing from the sociocultural context. Furthermore, this gendering of technology is co-constituted by the sexual division of labour and gendered norms of work.
The paper examines challenges in implementing interoperability requirements in digital markets. Designed to foster innovation and competition in retail payments, interoperability has been central to the EU’s open banking framework under the PSD2. It also plays a key role in the DMA, where interoperability requirements are aimed at supporting innovation and the framework’s goals of contestability and fairness. The paper identifies similarities between the PSD2 and DMA approaches to interoperability and outlines lessons DMA enforcers can learn from the implementation of open banking.
The ELI ERIC facility offers international users ultrashort laser sources via the ALPS facility focusing on few-cycle laser drivers for attosecond pulses, particle beams and ultrahigh intensity interactions. The HR1 system supports attosecond high harmonic generation (HHG) and time-resolved spectroscopy at 100 kHz. However, its high repetition rate, while aiding statistical analysis, poses thermal challenges and limits certain applications requiring lower repetition rates. To address this, the HR Alignment laser system was developed for the HHG beamline at the ELI-ALPS facility. This new system delivers sub-6 fs, 1 mJ pulses with a tunable repetition rate (from 10 Hz to 10 kHz) and carrier-envelope phase (CEP) stabilization. It utilizes an ytterbium-doped potassium gadolinium tungstate front-end, multi-pass cell compression, and chirped mirrors. Characterization confirms excellent energy and CEP stability (below 300 mrad), beam quality and temporal contrast, matching the HR1 laser’s performance. This compact, stable system provides high-flux attosecond generation for reaction microscopy enhancing ultrafast research in the ELI-ALPS facility.