We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
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.
Climate change will increase the occurrence of floods in cities and open areas. As well as the widely documented social and economic impacts of floods, these events can also have a significant and long-lasting impact on water quality. This multidisciplinary edited volume provides a comprehensive overview of the impact of floods on water quality, with chapters written by experts on water chemistry, water management, flood risk management, and urban engineering and planning. It presents global case studies, ranging from Australia and Canada to India and China, and includes contributions by scholars from Asia, Latin America, and Europe. It evaluates precautionary measures, such as the need for early warning systems to predict pluvial flood events, and practical solutions involving urban drainage, in the context of the needs of different regions. This book will be of interest to researchers, policy makers and professionals working in water management, environmental engineering and urban flooding.
In this richly detailed history, Felix Jiménez Botta traces West German mobilization against human rights abuses in Latin America in the late twentieth century. Initially in the ascendant was a market-critical vision adopted by a loose, left-leaning coalition fighting against right-wing regimes seeking to destroy incipient welfare states and implant market fundamentalism. However, during the later 1970s–80s a market-friendly interpretation gained ground, emphasising negative civil and political rights at the expense of positive economic and social rights. Within these debates, the vocabulary of human rights was a malleable political language that served as a multidirectional point of reference for various actors from civil society, politics, and the churches. By analysing these opposing views of human rights, Jiménez Botta questions the revisionist interpretation of post-1970s human rights as an inherently conservative political and intellectual project. Instead, the triumph of market-friendly human rights in West Germany was contested, contingent and ultimately unfinished.
Giant left atrium is extremely rare in the paediatric population, especially in asymptomatic cases. We report a 5-year-old child with a giant left atrium due to “non-rheumatic” mitral valve regurgitation that presented as a stroke secondary to atrial tachycardia. This case is noteworthy for the unusual “silent” manifestation of a giant left atrium.
Coronary artery abnormalities in children that require bypass grafting are infrequent but represent a well-recognised entity with a broad spectrum of indications beyond Kawasaki disease. Although myocardial revascularisation in children is uncommon, studies have shown that it can yield favourable short- and long-term outcomes, allowing affected children to regain health and grow up to live normal lives.
Myocardial revascularisation in children is an extremely rare intervention in Western countries, accounting for less than 1% of all paediatric cardiac surgeries in this region. It is a highly technically demanding procedure that opens a new arena in cardiac surgery, for which cardiovascular surgeons need to be trained to achieve outcomes as good as those shown in the literature.
We present the experience of paediatric coronary artery bypass grafting in a middle-income country, with a wide range of indications.
Methods:
A retrospective descriptive study was conducted on paediatric patients (under 18 years of age) who underwent coronary artery bypass grafting between 2004 and 2023 at a cardiovascular centre in Bogotá, Colombia. Data were collected from electronic medical records, including demographics, preoperative diagnoses, surgical details, and outcomes. Follow-up included clinical assessment and imaging with echocardiography. Ethical approval was obtained, and confidentiality was ensured.
Results:
Nine paediatric patients (ages 6–17) underwent coronary artery bypass grafting between 2004 and 2023. Kawasaki disease was the most common indication, but there are other aetiologies, including post-arterial switch coronary occlusion, anomalous origin of the LCA from the pulmonary artery, anomalous origin of coronary arteries from the aorta, Takayasu disease, and iatrogenic injury. The internal mammary artery was used in most cases, with successful completion of the planned revascularisation in all patients. There were no perioperative deaths or reinterventions. At a mean follow-up of 5.5 years, all patients showed clinical and biventricular improvement, and all grafts evaluated showed graft patency.
Paediatric coronary artery bypass grafting is a safe and effective treatment for selected congenital and acquired coronary pathologies, even in complex cases. Outcomes are optimised with the use of internal mammary arteries and a multidisciplinary heart team approach. In middle-income settings, favourable short- and mid-term results can be achieved despite follow-up challenges. Paediatric coronary artery bypass grafting should be considered a key component of congenital cardiac surgery training.
Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
Since 1994, the Andalusian Institute of Geophysics of the University of Granada group has been monitoring the seismic activity of Deception Island volcano (South Shetland Islands, Antarctica) during summer surveys. In this review, we analyse long-period and volcanic-tectonic events, including tremor episodes, recorded from 2011–2012 to 2021–2022 surveys with a local network and a seismic array. The seismo-volcanic activity on Deception Island occurs very locally, mainly as a result of tectonic destabilization induced by volcanic activity along with regional stresses, as a consequence of rifting and subduction processes spanning the South Shetland Islands, Bransfield Strait and Antarctica Peninsula. During this period, two changes to the volcanic alert level due to different volcanic parameters can be highlighted. The first of them was caused by the 2014–2015 seismic swarm as a consequence of a great regional perturbation located to the north-east of Deception Island, which spread around to the entire volcano. The second one, in the 2019–2020 survey, was established as a result of a significant increase in deformation parameters as a prelude of the August 2020 massive earthquake swarm that occurred in the Bransfield Strait, near the Orca submarine volcano. Furthermore, in the previous 2018–2019 survey, a peak of seismic activity was also recorded.
Approximately three million Venezuelan migrants (VMs) currently reside in Colombia. Many are in need of mental health services but face significant difficulties accessing services. To improve service access and engagement, we culturally adapted and pilot tested an evidence-based mental health intervention integrated within entrepreneurship training in a community setting for VM youth in Colombia. Using participatory research and qualitative methods approaches, we explored the program’s acceptability, appropriateness and feasibility. We recruited and enrolled 67 VM youth (aged 18–30) living in Bogotá, Colombia, who participated in piloting the intervention. We conducted semi-structured interviews with a subset of these participants (n = 16) at post-intervention to explore the intervention’s acceptability, appropriateness and feasibility. Two bilingual research assistants analyzed qualitative data using thematic network analysis. Findings suggested that VM youth viewed the integrated intervention as acceptable and appropriate, noting that it was helpful to have a “safe space” to discuss difficult emotions. They also noted challenges to engaging in the intervention, including transportation time and balancing other life responsibilities with intervention participation. Findings point to the importance of engaging community member participants in the adaptation and testing process of mental health interventions to increase intervention fit with the target population.
Argumentation is often conceived as a rational response to disagreement, even when it does not resolve differences of opinion. Arguing in the face of disagreement has, however, distinctive epistemic effects. Sometimes argumentation achieves convergence of opinion or at least the mutual recognition that a more thorough inquiry is required. But facing disagreement, participants of argumentative exchanges quite often remain steadfast in their initial views or even radicalize them. Can we make sense of these latter situations? To account for their occurrence, it is common to point out that people’s ability to argue is flawed, that an “argumentative culture” is lacking, and that emotional and other non-rational factors often interfere in confrontative situations. But these suggestions do not amount to a thorough satisfactory explanation. In this paper, I provide the outline of a purely epistemic account of these peculiar effects of argumentation in the face of disagreement. I argue that probabilistic models of degrees of confidence (or “credences”) can shed light on the conditions that give rise to several of these effects. This could provide some guidance on how to avoid them.
Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment for major depressive disorder (MDD), but initial outcomes can be modest.
Aims
To compare SSRI dose optimisation with four alternative second-line strategies in MDD patients unresponsive to an SSRI.
Method
Of 257 participants, 51 were randomised to SSRI dose optimisation (SSRI-Opt), 46 to lithium augmentation (SSRI+Li), 48 to nortriptyline combination (SSRI+NTP), 55 to switch to venlafaxine (VEN) and 57 to problem-solving therapy (SSRI+PST). Primary outcomes were week-6 response/remission rates, assessed by blinded evaluators using the 17-item Hamilton Depression Rating Scale (HDRS-17). Changes in HDRS-17 scores, global improvement and safety outcomes were also explored. EudraCT No. 2007-002130-11.
Results
Alternative second-line strategies led to higher response (28.2% v. 14.3%, odds ratio = 2.36 [95% CI 1.0–5.6], p = 0.05) and remission (16.9% v. 12.2%, odds ratio = 1.46, [95% CI 0.57–3.71], p = 0.27) rates, with greater HDRS-17 score reductions (−2.6 [95% CI −4.9 to −0.4], p = 0.021]) than SSRI-Opt. Significant/marginally significant effects were only observed in both response rates and HDRS-17 decreases for VEN (odds ratio = 2.53 [95% CI 0.94–6.80], p = 0.067; HDRS-17 difference: −2.7 [95% CI −5.5 to 0.0], p = 0.054) and for SSRI+PST (odds ratio = 2.46 [95% CI 0.92 to 6.62], p = 0.074; HDRS-17 difference: −3.1 [95% CI −5.8 to −0.3], p = 0.032). The SSRI+PST group reported the fewest adverse effects, while SSRI+NTP experienced the most (28.1% v. 75%; p < 0.01), largely mild.
Conclusions
Patients with MDD and insufficient response to SSRIs would benefit from any other second-line strategy aside from dose optimisation. With limited statistical power, switching to venlafaxine and adding psychotherapy yielded the most consistent results in the DEPRE'5 study.
Prolonged childhood and adolescent loneliness (CAL) is linked to various adverse mental health outcomes, yet its impact on schizophrenia spectrum disorders (SSD) has been understudied. While loneliness is associated with psychosis and worsens symptoms in SSD, few studies have explored the long-term effects of early loneliness on SSD risk. Understanding how CAL interacts with genetic liability to schizophrenia is essential for identification of high-risk individuals.
Aims
This study evaluated whether prolonged CAL is associated with increased SSD risk and examined the interaction between CAL and genetic liability for schizophrenia. Gender differences in these associations were also explored.
Method
Data from the European Gene–Environment Interactions in Schizophrenia (EU-GEI) study were analysed, including 1261 individuals with SSD, 1282 unaffected siblings and 1525 healthy controls. CAL was retrospectively assessed for periods before age 12 years and age 12–16 years. Genetic risk was measured using polygenic risk scores for schizophrenia. Logistic regression models and the Relative Excess Risk due to Interaction (RERI) method were used to examine gene–environment interactions, with stratification by gender.
Results
Prolonged CAL was associated with higher odds of SSD (odds ratio [95% CI] = 5.20 [3.85−7.01] for loneliness before age 12; odds ratio [95% CI] = 7.26 [5.63−9.38] for loneliness during adolescence). The interaction between CAL and genetic risk was strongest during adolescence (RERI [95% CI] = 23.46 [10.75−53.53]). Females showed a greater effect (odds ratio [95 %CI] = 10.04 [6.80−14.94]) than males (odds ratio [95% CI] = 5.50 [3.95−7.66]). Incorporating CAL and genetic interaction increased predictive values to 17% for SSD risk − rising to 22.5% in females − compared with 2.6 and 2.8%, respectively, for genetic risk alone.
Conclusions
Prolonged CAL significantly increases SSD risk, particularly in females. The inclusion of CAL alongside genetic risk substantially enhances predictive accuracy. Early identification of CAL could inform preventive strategies, especially in genetically vulnerable populations.
This chapter offers a critique of experimental jurisprudence. While experimental jurisprudence can make an important contribution to legal knowledge and legal theory, theorists and practitioners of experimental jurisprudence should also be aware of its limitations. Experimental jurisprudence cannot, by itself, resolve legal theoretical debates. It is just one limited tool, with an important but partial role to play in the collective project of understanding and evaluating law and legal rules, institutions, and practices. This chapter offers a summary survey of some of the limitations of experimental jurisprudence in special and general jurisprudence. It also argues that, if we want to fully understand law and legal concepts, practices, and institutions, experimental jurisprudence needs to be supplemented with other perspectives – such as those provided by anthropology, qualitative research, and the humanities. These perspectives can capture precisely what experimental jurisprudence must necessarily ignore: that law is a complex institutionalized social and cultural practice constituted by the thought and talk of legal experts.
The GLEAM 4-Jy (G4Jy) Sample is a thorough compilation of the ‘brightest’ radio sources in the southern sky (Declination $ \lt 30^{\circ}$), as measured at 151 MHz ($S_{\mathrm{151\,MHz}} \gt 4.0$ Jy) with the Murchison Widefield Array (MWA), through the GaLactic and Extragalactic All-sky MWA (GLEAM) Survey. In addition to flux-density measurements, the G4Jy catalogue (https://github.com/svw26/G4Jy.) provides host-galaxy identifications (through careful visual-inspection) and four sets of spectral indices. Despite their brightness in the radio, many of these sources are poorly studied, with the vast majority lacking a spectroscopic redshift in published work. This is crucial for studying the intrinsic properties of the sources, and so we conduct a multi-semester observing campaign on the Southern African Large Telescope (SALT), with optical spectroscopy enabling us to provide new redshifts to the astronomical community. Initial results show that not all of the host galaxies exhibit emission-line spectra in the optical ($\sim$4 500–7 500Å), which illustrates the importance of radio-frequency selection (rather than optical selection) for creating an unbiased sample of active galactic nuclei. By combining SALT redshifts with those from the 6-degree Field Galaxy Survey (6dFGS) and the Sloan Digital Sky Survey (SDSS), we calculate radio luminosities and linear sizes for 299 G4Jy sources (which includes one newly-discovered giant radio-galaxy, G4Jy 604). Furthermore, with the highest redshift acquired (so far) being $z \sim 2.2$ from SDSS, we look forward to evolution studies of this complete sample, as well as breaking degeneracies in radio properties with respect to, for example, the galaxy environment.
Posttraumatic stress disorder (PTSD) is a heterogenous disorder with frequent diagnostic comorbidity. Research has deciphered this heterogeneity by identifying PTSD subtypes and their neural biomarkers. This review summarizes current approaches, symptom-based group-level and data-driven approaches, for generating PTSD subtypes, providing an overview of current PTSD subtypes and their neural correlates. Additionally, we systematically assessed studies to evaluate the influence of comorbidity on PTSD subtypes and the predictive utility of biotypes for treatment outcomes. Following the PRISMA guidelines, a systematic search was conducted to identify studies employing brain imaging techniques, including functional magnetic resonance imaging (fMRI), structural MRI, diffusion-weighted imaging (DWI), and electroencephalogram (EEG), to identify biomarkers of PTSD subtypes. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. We included 53 studies, with 44 studies using a symptom-based group-level approach, and nine studies using a data-driven approach. Findings suggest biomarkers across the default-mode network (DMN) and the salience network (SN) throughout multiple subtypes. However, only six studies considered comorbidity, and four studies tested the utility of biotypes in predicting treatment outcomes. These findings highlight the complexity of PTSD’s heterogeneity. Although symptom-based and data-driven methods have advanced our understanding of PTSD subtypes, challenges remain in addressing the impact of comorbidities and the limited validation of biotypes. Future studies with larger sample sizes, brain-based data-driven approaches, careful account for comorbidity, and rigorous validation strategies are needed to advance biologically grounded biotypes across mental disorders.
Spirometra is a genus of zoonotic cestodes with an ambiguous species-level taxonomic history. Previously, Spirometra mansonoides was considered the only species present in North America. However, recent molecular data revealed the presence of at least three distinct species in the USA: Spirometra sp. 2 and 3, and Spirometra mansoni. This study aimed to elucidate the diversity and potential host associations of Spirometra species among companion animals in the USA. Samples (N = 302) were examined from at least 13 host species, including mammals, amphibians and reptiles. Sample types included eggs isolated from faeces (n = 222), adult specimens (n = 71) and plerocercoids (n = 9) from 18 different states and 2 territories across the USA. Extracted genomic DNA was subjected to PCR targeting a fragment of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Generated sequences (n = 136) were included in a phylogenetic analysis. Spirometra mansoni was detected in domestic cats (n = 76), dogs (n = 12), a White’s tree frog (n = 1), a Cuban knight anole (n = 1), a green iguana (n = 1) and a serval (n = 1) across 15 states and Puerto Rico. Spirometra sp. 2 was found only in dogs (n = 3) from Florida and Spirometra sp. 3 was found only in cats (n = 41) from 17 states. All plerocercoid samples were consistent with S. mansoni. The results confirm that at least three distinct Spirometra species are present and established in companion animals, such as dogs and cats, and likely are using various native and exotic species as paratenic hosts within the USA.