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.
Transcatheter pulmonary valve replacement (TPVR) is often employed for patients who are poor surgical candidates. We present a case of posterior sternal protrusion into a surgically placed right ventricle to pulmonary artery conduit, making the patient a poor candidate for surgical replacement and leading to significant operator distress during ultimately successful TPVR.
This article introduces the Special Issue ‘South–South Security Cooperation and the (Re)making of Global Security Governance’. The contributions explore security-driven South–South interactions across the globe, assessing empirical, theoretical, and normative aspects. Our aim is to decentre debates on global security governance, traditionally focused on Northern-led cooperation, and to move beyond simplistic and simplifying assessments of South–South engagements. The Special Issue particularly highlights the ambiguities of South–South security cooperation, including varying degrees of global North involvement and differing interpretations of ‘security’ and ‘South–South’ among the involved actors. The contributions examine the practical outlook, normative consequences, and embeddedness of these cooperations within global hierarchies, and their implications for global security governance. This article sets the stage for this endeavor. Unpacking the categories ‘South’, ‘security’, and ‘cooperation’, we first provide a working definition of South–South security cooperation. Next, we offer a historical perspective, emphasising the role of legacy effects, institutional structures, geopolitical junctures, and international hierarchies in shaping South–South security cooperation. The concluding section presents the contributions to the special issue and discusses the implications of South–South security cooperation for understanding contemporary changes in global security governance.
There is a heated debate on whether markets erode social responsibility and moral behavior. However, it is a challenging task to identify and measure moral behavior in markets. Based on a theoretical model, we examine in an experiment the relation between trading volume, prices and moral behavior by setting up markets that either impose a negative externality on third parties or not. We find that moral behavior reveals itself in lower trading volume in markets with a negative externality, while prices mostly depend on the market structure. We further investigate individual characteristics that explain trading behavior in markets with negative externalities.
This article analyses Colombian South–South security cooperation. Drawing upon empirical research findings and by focusing on Colombian security engagements with other Latin American countries in the realm of military transformation, we identify the role of epistemological constructs as key drivers of Colombian South–South security cooperation. We demonstrate that Colombian policy and security actors intentionally created comparability between their own country and its security challenges, and the conditions existing in other countries of the region. This portrayal of idiosyncratic (in)security features as shared attributes across otherwise-different country contexts enables the transfer of security models rooted in Colombia’s expertise and experience. We show how such security-driven homologisation efforts enabled Colombian security practitioners to navigate international hierarchies, particularly unequal US–Colombian relations in their favour, allowing them to secure continued US support and position Colombian security expertise as a blueprint for addressing contemporary security challenges across the region and beyond.
From early on, infants show a preference for infant-directed speech (IDS) over adult-directed speech (ADS), and exposure to IDS has been correlated with language outcome measures such as vocabulary. The present multi-laboratory study explores this issue by investigating whether there is a link between early preference for IDS and later vocabulary size. Infants’ preference for IDS was tested as part of the ManyBabies 1 project, and follow-up CDI data were collected from a subsample of this dataset at 18 and 24 months. A total of 341 (18 months) and 327 (24 months) infants were tested across 21 laboratories. In neither preregistered analyses with North American and UK English, nor exploratory analyses with a larger sample did we find evidence for a relation between IDS preference and later vocabulary. We discuss implications of this finding in light of recent work suggesting that IDS preference measured in the laboratory has low test-retest reliability.
The design of gear boxes is a complex challenge characterized by conflicting requirements and seemingly circular dependencies. Existing tools support engineers but focus on a single predefined design, often leading to costly iterative processes and non-optimal solutions. Solution Space Engineering (SSE) alleviates this by generating multiple designs represented by solution spaces. For this, a particular model structure is needed, and thus restructuring existing models, e.g., from industry standards. The application of solution spaces to a two-stage gear box is presented.
A volatile environment and an increasing number of products along with a growing range of functions pose a challenge for companies when it comes to further development. Existing methods are no longer sufficient to cope with these challenges. In order to develop new methods, the process and challenges in the advancement of product portfolios must be understood. In this paper we conduct an interview study with ten experts to gain a better understanding of the advancement of product portfolios. Triggers, changes and actions are examined and goals and requirements for new methods are derived.
This article proposes a framework of linked software agents that continuously interact with an underlying knowledge graph to automatically assess the impacts of potential flooding events. It builds on the idea of connected digital twins based on the World Avatar dynamic knowledge graph to create a semantically rich asset of data, knowledge, and computational capabilities accessible to humans, applications, and artificial intelligence. We develop three new ontologies to describe and link environmental measurements and their respective reporting stations, flood events, and their potential impact on population and built infrastructure as well as the built environment of a city itself. These coupled ontologies are deployed to dynamically instantiate near real-time data from multiple fragmented sources into the World Avatar. Sequences of autonomous agents connected via the derived information framework automatically assess consequences of newly instantiated data, such as newly raised flood warnings, and cascade respective updates through the graph to ensure up-to-date insights into the number of people and building stock value at risk. Although we showcase the strength of this technology in the context of flooding, our findings suggest that this system-of-systems approach is a promising solution to build holistic digital twins for various other contexts and use cases to support truly interoperable and smart cities.
Diagenetic illite growth in porous sandstones leads to significant modifications of the initial pore system which result in tight reservoirs. Understanding and quantifying these changes provides insight into the porosity-permeability history of the reservoir and improves predictions on petrophysical behavior. To characterize the various stages of diagenetic alteration, a focused ion beam – scanning electron microscopy (FIB-SEM) study was undertaken on aeolian sandstones from the Bebertal outcrop of the Parchim Formation (Early Permian Upper Rotliegend group). Based on 3D microscopic reconstructions, three different textural types of illite crystals occur, common to many tight Rotliegend sandstones, namely (1) feldspar grain alterations and associated illite meshworks, (2) tangential grain coats, and (3) pore-filling laths and fibers. Reaction textures, pore structure quantifications, and numerical simulations of fluid transport have revealed that different generations of nano-porosity are connected to the diagenetic alteration of feldspars and the authigenic growth of pore-filling illites. The latter leads to the formation of microstructures that range from authigenic compact tangential grain coatings to highly porous, pore-filling structures. K-feldspar replacement and initial grain coatings of illite are composed primarily of disordered 1Md illite whereas the epitaxially grown illite lath- and fiber-shaped crystals occurring as pore-filling structures are of the trans-vacant 1Mtv polytype. Although all analyzed 3D structures offer connected pathways, the largest reduction in sandstone permeability occurred during the initial formation of the tangential illite coatings that sealed altered feldspars and the subsequent growth of pore-filling laths and fibrous illites. Analyses of both illite pore-size and crystallite-size distributions indicate that crystal growth occurred by a continuous nucleation and growth mechanism probably controlled by the multiple influx of potassium-rich fluids during late Triassic and Jurassic times. The detailed insight into the textural varieties of illite crystal growth and its calculated permeabilities provides important constraints for understanding the complexities of fluid-flow in tight reservoir sandstones.
In ultra-short laser pulses, small changes in dispersion properties before the final focusing mirror can lead to severe pulse distortions around the focus and therefore to very different pulse properties at the point of laser–matter interaction, yielding unexpected interaction results. The mapping between far- and near-field laser properties intricately depends on the spatial and angular dispersion properties as well as the focal geometry. For a focused Gaussian laser pulse under the influence of angular, spatial and group-delay dispersion, we derive analytical expressions for its pulse-front tilt, duration and width from a fully analytic expression for its electric field in the time–space domain obtained with scalar diffraction theory. This expression is not only valid in and near the focus but also along the entire propagation distance from the focusing mirror to the focus. Expressions relating angular, spatial and group-delay dispersion before focusing at an off-axis parabola, where they are well measurable, to the respective values in the pulse’s focus are obtained by a ray tracing approach. Together, these formulas are used to show in example setups that the pulse-front tilts of lasers with small initial dispersion can become several tens of degrees larger in the vicinity of the focus while being small directly in the focus. The formulas derived here provide the analytical foundation for observations previously made in numerical experiments. By numerically simulating Gaussian pulse propagation and measuring properties of the pulse at distances several Rayleigh lengths off the focus, we verify the analytic expressions.
This paper discusses spatial agency practice within a living lab in Hong Kong. Lab members work in Tai O Village, a historic fishing settlement receiving increased attention due to remnant vernacular housing there. The article presents historical and policy context for ongoing casework conducted with stakeholders in Tai O. It presents Tai O’s history in brief, recent policy developments, and inherent conflicts arising from the interaction of the two. The third section of the article describes informal settlement land tenure conflicts as historical phenomena in Hong Kong. The paper follows this case-specific discussion with global literature review of selected regularisation and settlement upgrading efforts from around the world. These reviews present the article’s thesis that third sector and design-led efforts are critically applicable methods to address informal settlement conflicts that remain due to colonial legacy policies and political inertia. The final section of the article presents ongoing living lab research and initiatives, including collaborative monitoring projects and strategic development proposals. Each living lab initiative presented elaborates the article’s thesis on the interaction between architecture, research, and governance to negotiate complex development transitions. The article contributes to architectural scholarship by summarising unique interactions between history, policy, economics, and demography that engendered the development situation in Tai O. Further, it reflects upon response development methods through architectural science and spatial agency practice, including the role of architectural representation products and discursive distinctions at boundaries between architectural practice and spatial agency practice.
Electoral systems fulfill different functions. Typically, they cannot meet all demands at the same time, so that the evaluation of specific electoral systems depends on subjective preferences about the single demands. We argue that it is the electorate which transfers its power to representatives and, therefore, its preferences should be considered in debates about electoral systems. Consequently, our contribution presents results of citizens’ demands regarding electoral system attributes. Specifically, we rely on a large-scale conjoint experiment conducted in Germany, the Netherlands, and the UK in which subjects were asked to choose between two electoral systems which randomly differed on a set of attributes referring to electoral systems’ core functions. Our results show that all core functions are generally of importance for the respondents but reveal a higher preference for proportional electoral systems. These preferences are largely stable for citizens in different countries but also for other subgroups of subjects.
Previous studies have shown that socioeconomically deprived groups exhibit higher lesion load of the white matter (WM) in aging. The aim of this study was to (i) investigate to what extent education and income may contribute to differences in white matter hyperintensities (WMHs) and (ii) identify risk profiles related to a higher prevalence of age-associated WMH.
Design and Setting:
Population-based adult study of the Leipzig Research Centre for Civilization Diseases (LIFE) in Leipzig, Germany.
Participants:
Dementia-free sample aged 40–80 years (n = 1,185) derived from the population registry.
Measurements:
Information was obtained in standardized interviews. WMH (including the derived Fazekas scores) were assessed using automated segmentation of high-resolution T1-weighted anatomical and fluid-attenuated inversion recovery (FLAIR) MRI acquired at 3T.
Results:
Despite a significant association between income and WMH in univariate analyses, results from adjusted models (age, gender, arterial hypertension, heart disease, and APOE e4 allele) indicated no association between income and WMH. Education was associated with Fazekas scores, but not with WMH and not after Bonferroni correction. Prevalence of some health-related risk factors was significantly higher among low-income/education groups. After combining risk factors in a factor analysis, results from adjusted models indicated significant associations between higher distress and more WMH as well as between obesity and more deep WMH.
Conclusions:
Previously observed differences in WMH between socioeconomically deprived groups might stem from differences in health-related risk factors. These risk factors should be targeted in prevention programs tailored to socioeconomically deprived individuals.
Archaeologists tend to produce slow data that is contextually rich but often difficult to generalize. An example is the analysis of lithic microdebitage, or knapping debris, that is smaller than 6.3 mm (0.25 in.). So far, scholars have relied on manual approaches that are prone to intra- and interobserver errors. In the following, we present a machine learning–based alternative together with experimental archaeology and dynamic image analysis. We use a dynamic image particle analyzer to measure each particle in experimentally produced lithic microdebitage (N = 5,299) as well as an archaeological soil sample (N = 73,313). We have developed four machine learning models based on Naïve Bayes, glmnet (generalized linear regression), random forest, and XGBoost (“Extreme Gradient Boost[ing]”) algorithms. Hyperparameter tuning optimized each model. A random forest model performed best with a sensitivity of 83.5%. It misclassified only 28 or 0.9% of lithic microdebitage. XGBoost models reached a sensitivity of 67.3%, whereas Naïve Bayes and glmnet models stayed below 50%. Except for glmnet models, transparency proved to be the most critical variable to distinguish microdebitage. Our approach objectifies and standardizes microdebitage analysis. Machine learning allows studying much larger sample sizes. Algorithms differ, though, and a random forest model offers the best performance so far.
If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work, long payment of sickness benefits, and unemployment. Existing return-to-work (RTW) programs have mainly focused on “common mental disorders” and often used very elaborate and costly interventions without yielding convincing effects. It was the aim of the RETURN study to evaluate an easy-to-implement RTW intervention specifically addressing persons with mental illnesses being so severe that they require inpatient treatment.
Methods
The RETURN study was a multi-center, cluster-randomized controlled trial in acute psychiatric wards addressing inpatients suffering from a psychiatric disorder. In intervention wards, case managers (RTW experts) were introduced who supported patients in their RTW process, while in control wards treatment, as usual, was continued.
Results
A total of 268 patients were recruited for the trial. Patients in the intervention group had more often returned to their workplace at 6 and 12 months, which was also mirrored in more days at work. These group differences were statistically significant at 6 months. However, for the main outcome (days at work at 12 months), differences were no longer statistically significant (p = 0.14). Intervention patients returned to their workplace earlier than patients in the control group (p = 0.040).
Conclusions
The RETURN intervention has shown the potential of case-management interventions when addressing RTW. Further analyses, especially the qualitative ones, may help to better understand limitations and potential areas for improvement.
Some symptoms are recognised as red flags for cancer, causing the General Practitioner (GP) to refer the patient for investigation without delay. However, many early symptoms of cancer are vague and unspecific, and in these cases, a delay in referral risks a diagnosis of cancer that is too late. Empowering GPs in their management of patients that may have cancer is likely to lead to more timely cancer diagnoses.
Aim:
To identify the factors that affect European GPs’ empowerment in making an early diagnosis of cancer.
Methods:
This was a Delphi study involving GPs in 20 European countries. We presented GPs with 52 statements representing factors that could empower GPs to increase the number of early cancer diagnoses. Over three Delphi rounds, we asked GPs to indicate the clinical relevance of each statement on a Likert scale.
The final list of statements indicated those that were considered by consensus to be the most relevant.
Results:
In total, 53 GPs from 20 European countries completed the Delphi process, out of the 68 GPs who completed round one. Twelve statements satisfied the pre-defined criteria for relevance. Five of the statements related to screening and four to the primary/secondary care interface. The other selected statements concerned information technology (IT) and GPs’ working conditions. Statements relating to training, skills and working efficiency were not considered priority areas.
Conclusion:
GPs consider that system factors relating to screening, the primary-secondary care interface, IT and their working conditions are key to enhancing their empowerment in patients that could have cancer. These findings provide the basis for seeking actions and policies that will support GPs in their efforts to achieve timely cancer diagnosis.
This article applies a knowledge graph-based approach to unify multiple heterogeneous domains inherent in climate and energy supply research. Existing approaches that rely on bespoke models with spreadsheet-type inputs are noninterpretable, static and make it difficult to combine existing domain specific models. The difficulties inherent to this approach become increasingly prevalent as energy supply models gain complexity while society pursues a net-zero future. In this work, we develop new ontologies to extend the World Avatar knowledge graph to represent gas grids, gas consumption statistics, and climate data. Using a combination of the new and existing ontologies we construct a Universal Digital Twin that integrates data describing the systems of interest and specifies respective links between domains. We represent the UK gas transmission system, and HadUK-Grid climate data set as linked data for the first time, formally associating the data with the statistical output areas used to report governmental administrative data throughout the UK. We demonstrate how computational agents contained within the World Avatar can operate on the knowledge graph, incorporating live feeds of data such as instantaneous gas flow rates, as well as parsing information into interpretable forms such as interactive visualizations. Through this approach, we enable a dynamic, interpretable, modular, and cross-domain representation of the UK that enables domain specific experts to contribute toward a national-scale digital twin.
Response to lithium in patients with bipolar disorder is associated with clinical and transdiagnostic genetic factors. The predictive combination of these variables might help clinicians better predict which patients will respond to lithium treatment.
Aims
To use a combination of transdiagnostic genetic and clinical factors to predict lithium response in patients with bipolar disorder.
Method
This study utilised genetic and clinical data (n = 1034) collected as part of the International Consortium on Lithium Genetics (ConLi+Gen) project. Polygenic risk scores (PRS) were computed for schizophrenia and major depressive disorder, and then combined with clinical variables using a cross-validated machine-learning regression approach. Unimodal, multimodal and genetically stratified models were trained and validated using ridge, elastic net and random forest regression on 692 patients with bipolar disorder from ten study sites using leave-site-out cross-validation. All models were then tested on an independent test set of 342 patients. The best performing models were then tested in a classification framework.
Results
The best performing linear model explained 5.1% (P = 0.0001) of variance in lithium response and was composed of clinical variables, PRS variables and interaction terms between them. The best performing non-linear model used only clinical variables and explained 8.1% (P = 0.0001) of variance in lithium response. A priori genomic stratification improved non-linear model performance to 13.7% (P = 0.0001) and improved the binary classification of lithium response. This model stratified patients based on their meta-polygenic loadings for major depressive disorder and schizophrenia and was then trained using clinical data.
Conclusions
Using PRS to first stratify patients genetically and then train machine-learning models with clinical predictors led to large improvements in lithium response prediction. When used with other PRS and biological markers in the future this approach may help inform which patients are most likely to respond to lithium treatment.