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.
This report investigates excess frame count during radiotherapy sessions using Elekta Versa HD systems with X-ray Volume Imaging (XVI) technology at Singleton Hospital. The hospital has 4 clinical linear accelerators (linacs) with XVI, which were analysed to identity variations in the number of excess frames between machines and imaging protocols. Such deviations could affect imaging dose accuracy, patient safety, and system efficiency.
Method:
XVI log files were gathered from each linac over an 18-month period using data backups. A Python script was created to read and link all the required data in a simple format to generate histograms and tables.
Results:
The excessive frames resulted in increased radiation doses. Although individual doses were negligible, the highest excess dose for a single patient was 0.7 mSv in 1 fraction, leading to a total dose of 3.4 mSv instead of the expected 2.7 mSv scans which is equivalent to 3 months of background radiation extra. The study revealed that 1.7 % of all imaging sessions were affected (417 imaging fractions). It was identified that the ‘Fast’ Breast imaging protocols were more likely to generate excess frames, likely to be due to the increased gantry speed.
Conclusion:
Despite the small individual doses, the findings raise concerns about system performance and patient safety for imaging, emphasising the need for further investigation to ensure optimal treatment accuracy and compliance with the Ionising Radiation (Medical Exposure) (Amendment) 2024), Regulation 11 and 12.
Glufosinate serves as both a primary herbicide option and a complement to glyphosate and other postemergence herbicides for managing herbicide-resistant weed species. Enhancing broadleaf weed control with glufosinate through effective mixtures may mitigate further herbicide resistance evolution in soybean and other glufosinate-resistant cropping systems. Two field experiments were conducted in 2020 and 2021 at four locations in Wisconsin (Arlington, Brooklyn, Janesville, and Lancaster) and one in Illinois (Macomb) to evaluate the effects of postemergence-applied glufosinate mixed with inhibitors of protoporphyrinogen oxidase (PPO) (flumiclorac-pentyl, fluthiacet-methyl, fomesafen, and lactofen; Group 14 herbicides), bentazon (a Group 6 herbicide), and 2,4-D (a Group 4 herbicide) on waterhemp control, soybean phytotoxicity, and yield. The experiments were established in a randomized, complete block design with four replications. The first experiment focused on soybean phytotoxicity 14 d after treatment (DAT) and yield in the absence of weed competition. All treatments received a preemergence herbicide, with postemergence herbicide applications occurring between the V3 and V6 soybean growth stages, depending on the site-year. The second experiment evaluated the effect of herbicide treatments on waterhemp control 14 DAT and on soybean yield. Lactofen, applied alone or with glufosinate, produced the greatest phytotoxicity to soybean at 14 DAT, but this injury did not translate into yield loss. Mixing glufosinate with 2,4-D, bentazon, and PPO-inhibitor herbicides did not increase waterhemp control, nor did it affect soybean yield compared to when glufosinate was applied alone, but it may be an effective practice to reduce selection pressure for glufosinate-resistant waterhemp.
New developments in neuro-navigation and machine learning have allowed for personalised approaches to repetitive transcranial magnetic stimulation (rTMS) to treat various neuropsychiatric disorders. One specific approach, known as the cingulum framework, identifies individualised brain parcellations from resting state fMRI based on a machine-learning algorithm. Theta burst stimulation, a more rapid form of rTMS, is then delivered for 25 sessions, 5 per day, over 5 days consecutively or spaced out over 10 days. Preliminary studies have documented this approach for various neurological and psychiatric ailments. However, the safety and tolerability of this approach are unclear.
Methods:
We performed a retrospective study on 165 unique patients (202 target sets) treated with this personalised approach between January 2020 and December 2023.
Results:
Common side effects included fatigue (102/202, 50%), local muscle twitching (89/202, 43%), headaches (49/202, 23%), and discomfort (31/202, 17%), all transient. The top 10 unique parcellations commonly found in the target sets included L8av (52%), LPGs (28%), LTe1m (21%), RTe1m (18%), LPFM (17%), Ls6–8 (13%), Rs6–8 (9%), L46 (7%), L1 (6%), and L6v (6%). Fatigue was most common in target sets that contained R6v (6/6, 100%) and L8c (5/5, 100%). Muscle twitches were most common in target sets that contained RTGv (5/5, 100%) and LTGv (4/4, 100%).
Conclusion:
These side effects were all transient and well-tolerated. No serious side effects were recorded. Results suggested that individualised, connectome-guided rTMS is safe and contain side-effect profiles similar to other TMS approaches reported in the literature.
This work presents visual morphological and dynamical classifications for 637 spatially resolved galaxies, most of which are at intermediate redshift ($z\sim0.3$), in the Middle-Ages Galaxy Properties with Integral field spectroscopy (MAGPI) Survey. For each galaxy, we obtain a minimum of 11 independent visual classifications by knowledgeable classifiers. We use an extension of the standard Dawid-Skene bayesian model introducing classifier-specific confidence parameters and galaxy-specific difficulty parameters to quantify classifier confidence and infer reliable statistical confidence estimates. Selecting sub-samples of 86 bright ($r\lt20$ mag) high-confidence ($\gt0.98$) morphological classifications at redshifts ($0.2 \le z \le0.4$), we confirm the full range of morphological types is represented in MAGPI as intended in the survey design. Similarly, with a sub-sample of 82 bright high-confidence stellar kinematic classifications, we find that the rotating and non-rotating galaxies seen at low redshift are already in place at intermediate redshifts. We do not find evidence that the kinematic morphology–density relation seen at $z\sim0$ is established at $z\sim0.3$. We suggest that galaxies without obvious stellar rotation are dynamically pre-processed sometime before $z\sim0.3$ within lower mass groups before joining denser environments.
The EU’s Common European Data Space (CEDS) aims to create a single market for data-sharing in Europe, build trust among stakeholders, uphold European values, and benefit society. However, there is the possibility that the values of the EU and the benefits for the common good of European society may get overlooked for the economic benefits of organisations if norms and social values are not considered. We propose that the concept of “data commons” is relevant for defining openness versus enclosure of data in data spaces and is important when considering the balance and trade-off between individual (market) versus collective (societal) benefits from data-sharing within the CEDS. Commons are open-access resources governed by a group, either formally by regulation or informally by local customs. The application of the data commons to the CEDS would promote data-sharing for the “common good.” However, we propose that the data commons approach should be balanced with the market-based approach to CEDS in an inclusive hybrid data governance approach that meets material, price-driven interests, while stimulating collective learning in online networks to form social communities that offer participants a shared identity and social recognition.
Despite high levels of depression and anxiety, there is relatively little attention to psychological treatment approaches to mental health issues for older adults living in nursing homes. Recent studies support the use of cognitive behaviour therapy (CBT) in this population and here we aim to highlight how CBT can be successfully adapted and implemented with beneficial results. The ELders AT Ease (ELATE) program is a unique service delivery model illustrating delivery of CBT with older adults living in nursing homes. The six modules forming the program, based on CBT, are described. A systems wide approach to delivery is emphasised and illustrated through two clinical case descriptions. Innovative mental health programs can have positive benefits for both residents and staff and support the use of CBT in this vulnerable and under-served client group.
Key learning aims
(1) Knowledge of the content and application of CBT for older adults living in nursing homes.
(2) Understanding of CBT session structure as applied to older adults living in nursing homes.
(3) Recognising and utilising specific strategies to highlight a systemic approach as central to implementing CBT strategies, such as behavioural activation and reminiscence, with considered involvement by staff and family.
Foliar-applied postemergence applications of glufosinate are often applied to glufosinate-resistant crops to provide nonselective weed control without significant crop injury. Rainfall, air temperature, solar radiation, and relative humidity near the time of application have been reported to affect glufosinate efficacy. However, previous research may have not captured the full range of weather variability to which glufosinate may be exposed before or following application. Additionally, climate models suggest more extreme weather will become the norm, further expanding the weather range to which glufosinate can be exposed. The objective of this research was to quantify the probability of successful weed control (efficacy ≥85%) with glufosinate applied to some key weed species across a broad range of weather conditions. A database of >10,000 North American herbicide evaluation trials was used in this study. The database was filtered to include treatments with a single postemergence application of glufosinate applied to waterhemp [Amaranthus tuberculatus (Moq.) Sauer], morningglory species (Ipomoea spp.), and/or giant foxtail (Setaria faberi Herrm.) <15 cm in height. These species were chosen because they are well represented in the database and listed as common and troublesome weed species in both corn (Zea mays L.) and soybean [Glycine max (L.) Merr.] (Van Wychen 2020, 2022). Individual random forest models were created. Low rainfall (≤20 mm) over the 5 d before glufosinate application was detrimental to the probability of successful control of A. tuberculatus and S. faberi. Lower relative humidity (≤70%) and solar radiation (≤23 MJ m−1 d−1) on the day of application reduced the probability of successful weed control in most cases. Additionally, the probability of successful control decreased for all species when average air temperature over the first 5 d after application was ≤25 C. As climate continues to change and become more variable, the risk of unacceptable control of several common species with glufosinate is likely to increase.
Geoffrey Pullum has produced countless contributions to linguistic theory over his 50-year career in the field. Given this exceptional scientific achievement, his philosophical work often goes underappreciated. In this article, I discuss and critique three themes from Pullum’s philosophy of linguistics, namely, cardinality neutrality, model-theoretic syntax and normativity in language. I conclude by showing how these seemingly disparate elements might indeed be connected in terms of a normative constructivist approach to linguistics.
Coastal landforms and associated archaeological records are at risk of erosion from a combination of rising sea levels and increasingly frequent high-intensity storms. Improved understanding of this risk can be gained by braiding archaeological and geomorphological methodologies with Indigenous knowledge.1 In this article, archaeological, geomorphological and mātauranga (a form of Indigenous knowledge) are used to analyse a prograded Holocene foredune barrier in northern Aotearoa/New Zealand. Anthropogenic deposits within dune stratigraphy are radiocarbon-dated and used as chronological markers to constrain coastal evolution, alongside geomorphological analyses of topographic data, historical aerial photographs and satellite imagery. These investigations revealed that the barrier is eroding at a rate of 0.45 m/year. A midden in the foredune, which has been radiocarbon dated to 224–270 B.P. (95% Confidence), has been exposed by coastal erosion, confirming that the barrier is in the most eroded state it has been within the past ~300 years. Vertical stratigraphy reveals the presence of midden and palaeosol deposits capped by dune sand deposits in the foredune, indicating that vertical accretion of the foredune continued over the last ~200 years, despite the barrier now being in an eroding state. Mātauranga played a vital role in this project, as it was the coastal taiao (environmental) monitoring unit of Patuharakeke (a Māori sub-tribe) that discovered the midden. The ecological mātauranga shared also played a vital role in this project, adding experiential evidence to empirical observations. The work of local Indigenous groups, like Patuharakeke, demonstrates the active use of mātauranga, woven with Western science methods to preserve or capture the knowledge contained within archaeological sites at risk of being lost to coastal erosion. In this study, we present a method for weaving mātauranga, geomorphological and archaeological approaches to gain a deeper understanding of coastal landscape development.
Contrast-induced encephalopathy (CIE) is an adverse event associated with diagnostic and therapeutic endovascular procedures. Decades of animal and human research support a mechanistic role for pathological blood-brain barrier dysfunction (BBBd). Here, we describe an institutional case series and review the literature supporting a mechanistic role for BBBd in CIE.
Methods:
A literature review was conducted by searching MEDLINE, Web of Science, Embase, CINAHL and Cochrane databases from inception to January 31, 2022. We searched our institutional neurovascular database for cases of CIE following endovascular treatment of cerebrovascular disease during a 6-month period. Informed consent was obtained in all cases.
Results:
Review of the literature revealed risk factors for BBBd and CIE, including microvascular disease, pathological neuroinflammation, severe procedural hypertension, iodinated contrast load and altered cerebral blood flow dynamics. In our institutional series, 6 of 52 (11.5%) of patients undergoing therapeutic neuroendovascular procedures developed CIE during the study period. Four patients were treated for ischemic stroke and two patients for recurrent cerebral aneurysms. Mechanical stenting or thrombectomy were utilized in all cases.
Conclusion:
In this institutional case series and literature review of animal and human data, we identified numerous shared risk factors for CIE and BBBd, including microvascular disease, increased procedure length, large contrast volumes, severe intraoperative hypertension and use of mechanical devices that may induce iatrogenic endothelial injury.
Small-scale organic vegetable farms need strategies to overcome yield, labor, and economic challenges in transitioning to reduced and no-till practices. However, the production tradeoffs associated with different scale-appropriate management practices are not well documented for these operations. We evaluated crop yields, labor, profitability, and soil nutrients over four continuous years of management in Freeville, NY. Cabbage (Y1 and Y3) and winter squash (Y2 and Y4) were managed in permanent beds under four contrasting tillage systems: conventional rototilling to 20 cm depth (CT), shallow rototilling to 10 cm (ST), no-till (NT), and no-till with tarping (NTT), in which an impermeable, black polyethylene tarp was applied to the soil surface between crops. Within each tillage treatment, we compared three mulching systems: rye mulch (RM), compost mulch (CM), and no mulch (NM), where mulches were applied annually to each crop. Crop yields did not vary by tillage, except in RM, where yields were highest in CT and reduced in ST and NT over four years. Mulch treatments were a significant driver of crop yields. When compared to NM, RM reduced crop yields in the first two years and CM increased yields after the first year. Overall, RM systems had the lowest net returns and CM returns were equivalent to NM despite greater yields. No-till consistently required the greatest pre-harvest labor investment, up to two times greater than tilled systems with NM, and the lowest net returns. Labor requirements for NTT were greater than CT but up to 41% lower than NT, and profitability was equivalent to CT. Shallow tillage performed similar to CT across yield, labor, and profitability measures, except when combined with the use of RM. Compost mulching led to dramatic changes in soil properties after four years, including a 49% increase in total soil carbon, a 31% increase in total soil nitrogen, and a 497% increase in extractable phosphorus. Small farms adopting NT practices should: 1) consider the potential tradeoffs associated with annually applied organic mulches, and 2) integrate tarping to increase the profitability of NT over consecutive production years.
This chapter models the idea of economic growth in the period of the Enlightenment in Britain. Using methods developed in the Cambridge Concept Lab, it demonstrates that the ideas of improvement and progress supported the slow evolution of the notion of economic growth as a necessary good. It tracks the thinking of the philosopher and political economist Adam Smith as he formulated his ideas with respect to size and operation of modern capitalist economies.
The aim of this study was to identify and prioritize strategies for strengthening public health system resilience for pandemics, disasters, and other emergencies using a scorecard approach.
Methods:
The United Nations Public Health System Resilience Scorecard (Scorecard) was applied across 5 workshops in Slovenia, Turkey, and the United States of America. The workshops focused on participants reviewing and discussing 23 questions/indicators. A Likert type scale was used for scoring with zero being the lowest and 5 the highest. The workshop scores were analyzed and discussed by participants to prioritize areas of need and develop resilience strategies. Data from all workshops were aggregated, analyzed, and interpreted to develop priorities representative of participating locations.
Results:
Eight themes emerged representing the need for better integration of public health and disaster management systems. These include: assessing community disease burden; embedding long-term recovery groups in emergency systems; exploring mental health care needs; examining ecosystem risks; evaluating reserve funds; identifying what crisis communication strategies worked well; providing non-medical services; and reviewing resilience of existing facilities, alternate care sites, and institutions.
Conclusions:
The Scorecard is an effective tool for establishing baseline resilience and prioritizing actions. The strategies identified reflect areas in most need for investment to improve public health system resilience.
The International Design Engineering Annual (IDEA) Challenge is a virtually hosted hackathon for Engineering Design researchers with aims of: i) generating open access datasets; ii) fostering community between researchers; and, iii) applying great design minds to develop solutions to real design problems. This paper presents the 2022 IDEA challenge and elements of the captured dataset with the aim of providing insights into prototyping behaviours at virtually hosted hackathons, comparing it with the 2021 challenge dataset and providing reflections and learnings from two years of running the challenge. The dataset is shown to provide valuable insights into how designers spend their time at hackathon events and how, why and when prototypes are used during their design processes. The dataset also corroborates the findings from the 2021 dataset, demonstrating the complementarity of physical and sketch prototypes. With this paper, we also invite the wider community to contribute to the IDEA Challenge in future years, either as participants or in using the platform to run their own design studies.
Postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet as few as 10% access evidence-based treatment. One-day cognitive behavioral therapy (CBT)-based workshops for PPD have the potential to reach large numbers of sufferers and be integrated into stepped models of care.
Methods
This randomized controlled trial of 461 mothers and birthing parents in Ontario, Canada with Edinburgh Postnatal Depression Scale (EPDS) scores ⩾10, age ⩾18 years, and an infant <12 months of age compared the effects of a 1-day CBT-based workshop plus treatment as usual (TAU; i.e. care from any provider(s) they wished) to TAU alone at 12-weeks post-intervention on PPD, anxiety, the mother–infant relationship, offspring behavior, health-related quality of life, and cost-effectiveness. Data were collected via REDCap.
Results
Workshops led to meaningful reductions in EPDS scores (m = 15.77 to 11.22; b = −4.6, p < 0.01) and were associated with three times higher odds of a clinically significant decrease in PPD [odds ratio (OR) 3.00, 95% confidence interval (CI) 1.93–4.67]. Anxiety also decreased and participants had three times the odds of clinically significant improvement (OR 3.20, 95% CI 2.03–5.04). Participants reported improvements in mother–infant bonding, infant-focused rejection and anger, and effortful control in their toddlers. The workshop plus TAU achieved similar quality-adjusted life-years at lower costs than TAU alone.
Conclusions
One-day CBT-based workshops for PPD can lead to improvements in depression, anxiety, and the mother–infant relationship and are cost-saving. This intervention could represent a perinatal-specific option that can treat larger numbers of individuals and be integrated into stepped care approaches at reasonable cost.
Religious belief is a topic of longstanding interest to psychological science, but the psychology of religious disbelief is a relative newcomer. One prominently discussed model is analytic atheism, wherein cognitive reflection, as measured with the Cognitive Reflection Test, overrides religious intuitions and instruction. Consistent with this model, performance-based measures of cognitive reflection predict religious disbelief in WEIRD (Western, Educated, Industrialized, Rich, & Democratic) samples. However, the generality of analytic atheism remains unknown. Drawing on a large global sample (N = 3461) from 13 religiously, demographically, and culturally diverse societies, we find that analytic atheism as usually assessed is in fact quite fickle cross-culturally, appearing robustly only in aggregate analyses and in three individual countries. The results provide additional evidence for culture’s effects on core beliefs.
This article is a clinical guide which discusses the “state-of-the-art” usage of the classic monoamine oxidase inhibitor (MAOI) antidepressants (phenelzine, tranylcypromine, and isocarboxazid) in modern psychiatric practice. The guide is for all clinicians, including those who may not be experienced MAOI prescribers. It discusses indications, drug-drug interactions, side-effect management, and the safety of various augmentation strategies. There is a clear and broad consensus (more than 70 international expert endorsers), based on 6 decades of experience, for the recommendations herein exposited. They are based on empirical evidence and expert opinion—this guide is presented as a new specialist-consensus standard. The guide provides practical clinical advice, and is the basis for the rational use of these drugs, particularly because it improves and updates knowledge, and corrects the various misconceptions that have hitherto been prominent in the literature, partly due to insufficient knowledge of pharmacology. The guide suggests that MAOIs should always be considered in cases of treatment-resistant depression (including those melancholic in nature), and prior to electroconvulsive therapy—while taking into account of patient preference. In selected cases, they may be considered earlier in the treatment algorithm than has previously been customary, and should not be regarded as drugs of last resort; they may prove decisively effective when many other treatments have failed. The guide clarifies key points on the concomitant use of incorrectly proscribed drugs such as methylphenidate and some tricyclic antidepressants. It also illustrates the straightforward “bridging” methods that may be used to transition simply and safely from other antidepressants to MAOIs.
A new specimen of Basilosaurus cetoides was discovered on the banks of the Flint River in Albany, Georgia, USA, in 2010. This fossil, which was the most complete specimen of the species from Georgia to date, consisted of five nearly complete and two partial post-thoracic vertebrae, tentatively identified as S4 through Ca6. During excavation, however, the site was looted and most of the specimen was lost to science. Nonetheless, we use this discovery as an opportunity to update the current state of knowledge on the stratigraphic, biogeographic, and environmental distribution of Basilosaurus in North America, as well as the position of the late Eocene shoreline in the southeastern United States. The results show that Basilosaurus was most abundant across the southeastern coastal plain during the early to middle Priabonian, coincident with the late Eocene maximum marine transgression. The decline in Basilosaurus localities is associated with the retreating shoreline of the terminal Eocene. The majority of Basilosaurus localities fall well south of the position of the late Eocene shoreline hypothesized in this study, suggesting the genus favored middle to outer neritic zones of the epicontinental sea. The comparatively low number of Priabonian specimens in the Atlantic Coastal Plain versus the Gulf Coastal Plain, then, suggests the presence of shallow zones in the Atlantic Coastal Plain that may have limited the distribution of Basilosaurus across the region. The hypothesized shoreline of this study ultimately differs from earlier reconstructions by extending the Mississippi embayment at the Bartonian/Priabonian boundary farther north than previously noted.