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Recent developments in widefield radio telescopes have enabled searches of a new region of parameter space in the time domain: timescales of seconds to minutes, that have been overlooked in traditional surveys. These searches have revealed a new population of sources: long period transients, which typically show periodic behaviour of minutes to hours. In addition they have detected phenomena ranging from extreme scintillation to stellar radio bursts. However, almost all searches to date have involved archival data that has been processed in offline, batch mode. In this context, we present VASTER, the first short-timescale imaging and transient detection pipeline running in real time on a widefield radio telescope. VASTER has been running on the Australian SKA Pathfinder (ASKAP) since July 2025, and images most of the ASKAP survey project data on timescales of 15 minutes. In this paper we describe the VASTER system, and present the results from the first two weeks of operation, including the discovery of two long period transients: ASKAP J165130.3–450520 with a period of 6.48 hours and ASKAP J170036.6–445758 with a period of 4.69 hours. The detection of these two sources adds to the small, but growing, population of long period transients, as well as demonstrating the potential of VASTER to explore this region of transient parameter space.
Background: Invasive Staphylococcus aureus (SA) infections are a common cause of sepsis in premature infants admitted to the neonatal intensive care unit (NICU). While a quality improvement team effectively reduced methicillin resistant (MRSA) invasive infections, methicillin susceptible (MSSA) infections remained problematic. As a result, there was a renewed effort to understand MSSA infection transmission and reduce invasive MSSA infections. Methods: The primary outcome was invasive MSSA infection, most commonly bacteremia, in the NICU. Environmental cultures identified MSSA on high touch point areas and whole genome sequencing (WGS) confirmed there were both endemic strains and independently introduced strains. New interventions to reduce invasive SA infections included additional environmental cleaning of clinical workstations with effectiveness measured by fluorescent marking and a start of shift chlorhexidine (CHG) /alcohol (Avaguard) below the elbow wash for NICU staff. Babies were screened weekly for MSSA/MRSA colonization. Results: In 2023 and 2024 when there were no MRSA infections, there were nine MSSA infections (Figure 1). WGS confirmed that environmental MSSA strains were recovered from infants. Increased screening for MSSA with selective decolonization with mupirocin for high risk infants did not temporally change invasive infection rates and the mupA gene for high level mupirocin resistance was identified in a subset of colonizing strains. There were no significant changes in rates of new colonization for either MSSA or MRSA in 2025. After 1697 days there was one MRSA infection in September 2025. Introducing enhanced environmental cleaning and below the elbow disinfection for staff was temporally associated with a reduction in invasive MSSA infections with only two MSSA infections in 2025, most recently in March. As of January 1, 2026 the NICU has gone nine months without a MSSA infection. Conclusions: Increased environmental cleaning of clinical workstations with a start of shift below the elbow staff disinfection has resulted in a sustained reduction in invasive MSSA infection without a significant reduction in colonization rates. Additional work is ongoing to further understand if SA environmental colonization is reduced and whether current strains colonizing infants are identical to those that have caused invasive infection in the past.
This chapter presents a case of a 73-year-old female with neurologic deficits as a result of hypoglycemia secondary to not eating breakfast after taking glyburide. The case highlights the importance of obtaining an immediate blood glucose level in making the diagnosis and further action beyond the rapid correction of blood glucose with dextrose and maintenance of blood sugar levels because sulfonylurea drugs can cause rebound hypoglycemia for many hours.
Nursing home residents have been disproportionately impacted by respiratory virus-related morbidity and mortality due to inherent vulnerability and communal living environments. This study aims to identify nursing homes with higher infection rates during a period of intense SARS-CoV-2 transmission and explore facility-level characteristics potentially associated with infection surges.
Design:
A longitudinal k-means clustering approach followed by exploratory regression analyses.
Setting:
U.S. Nursing homes reporting to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN).
Methods:
A longitudinal k-means method (kmlShape) classified the facilities based on their weekly SARS-CoV-2 incidence rate epidemic curve, identifying two categories (low vs high infection peak) based on the magnitude of infection peaks. A logistic regression model with bootstrapping was developed to assess facility characteristics associated with higher SARS-CoV-2 infection surges.
Results:
Among 11,990 nursing homes analyzed, 9,058 were classified as having a low infection peak, while 2,932 had a high infection peak. Nursing homes that are for-profit (OR = 1.570, 95% bootstrap confidence interval [BCI] 1.441–1.807), with high staff turnover (OR = 1.292, 95% BCI 1.154–1.451), or located in areas with higher social vulnerability (OR = 1.457, 95% BCI 1.239–1.880) were more likely to experience high infection peaks. Nursing homes with higher residents’ vaccination coverage (OR = .321, 95% BCI .248–.380) and located in urban areas were less likely to experience high infection peaks.
Conclusions:
The facility-level characteristics associated with lower SARS-CoV-2 infection peaks may indicate resiliency and help evaluate the capacity of nursing homes to endure stressors such as respiratory viruses and other communicable illnesses.
Objectives/Goals: The Never-in-mitosis A-related (NEK) kinases are a family of 11 poorly explored kinases that play varying roles in cellular processes. Aberrant NEK activity is implicated in various human diseases, including cancer. We hypothesize that NEK9 drives triple-negative breast cancer (TNBC) motility. Methods/Study Population: Baseline NEK9 expression was determined across five breast cancer and three non-breast cancer cell lines by immunoblot. We expanded the analysis to six additional TNBC cell lines. To determine the impact of NEK9 on TNBC biology, we evaluated the effects of NEK9 pharmacological inhibition with novel inhibitor BA 03-53-11 (BA) at 0µM, 0.5µM, 1µM, and 2µM. We treated TNBC cell lines MDA-MB-231, BT-549, HS578T, and TNBC patient-derived cell line TUBcX-4IC and performed functional assays to assess impacts on cell motility (scratch assay), viability (crystal violet staining), and proliferation (Ki-67 staining). Results/Anticipated Results: NEK9 levels were elevated in the TNBC cell line compared to other breast cancer subtypes, osteosarcoma, and non-cancerous cells. Additionally, NEK9 protein expression was variable across TNBC cell lines. While pharmacological NEK9 inhibition did not significantly alter TNBC cell viability or proliferation, we observed that NEK9 inhibition suppressed cell motility in TNBC cells compared to vehicle control. Taken together, these preliminary results support a role for NEK9 in regulating TNBC progression. Our ongoing studies aim to test NEK9-mediated motility and proliferation in additional TNBC cell lines and evaluate NEK9 as a therapeutic target for this aggressive breast cancer subtype. Discussion/Significance of Impact: TNBC is an aggressive form of breast cancer that lacks targeted therapies. Because aberrant kinase activity underpins oncogenic transformation, kinase inhibitors have emerged as ideal therapeutic agents. Elucidation of NEK9 function in TNBC is essential for the development of novel therapeutics.
Human metapneumovirus (HMPV), which belongs to the a family, has shown the emergence of the A2b2 clade as the dominant global genotype. Whether this represents true evolutionary selection or surveillance artefacts remains unclear. We analysed 315 complete HMPV genome sequences (1994–2024) from the Nextstrain database using sampling-corrected statistical approaches, including temporal homogeneity testing, rarefaction analysis, and entropy-based dynamics to examine non-random patterns in A2b2 emergence. Temporal homogeneity testing revealed strong directional evolution towards A2b2 dominance (Z = −46.62, p < 0.001), confirming non-random patterns rather than surveillance artefacts. The clade showed strong persistence (206 self-transitions) with limited backward transitions. After controlling for sampling bias, A2b2 represented 68.3% (95% CI: 58.2–78.4) of isolates in 2023–2024. A2b2 demonstrated significantly higher temporal entropy (2.1) than other clades (A1: 1.2, A2a: 1.5, A2b1: 2.0), indicating more complex dynamics. Geographic rarefaction revealed significant regional structuring, with Africa showing the highest diversity (3.00, 95% CI: 1.00–3.05) despite lower sampling. HMPV A2b2’s global expansion represents genuine directional evolution with potential selective advantages, similar to patterns in respiratory syncytial virus. These findings underscore the need for enhanced genomic surveillance and integration of HMPV monitoring into respiratory virus surveillance frameworks to track emerging variants and assess public health implications.
International evidence suggests that Early Intervention for Psychosis (EIP) services are both effective and cost-effective. Such evidence, however, comes almost exclusively from high-income countries.
Aims
Our aim was to estimate the cost-effectiveness of EIP services in a Latin American setting.
Method
We compared EIP services against community mental health teams (CMHT) from the Chilean health system perspective. We developed a six-state Markov model to estimate the costs, benefits (measured as quality-adjusted life-years (QALYs)) and incremental cost-effectiveness ratio (ICER) for a 10-year time horizon. The model was populated with data from a Chilean EIP cohort, published literature and expert opinion. We characterised uncertainty through probabilistic sensitivity analysis and calculated the value of information to reduce such uncertainty.
Results
In the base case analysis, EIP was cost-effective compared with CMHT, with an ICER of 5 550 044 Chilean pesos per QALY (USD 13 742 adjusted for purchasing power parity). Uncertainty analysis revealed an 80% probability of EIP services being the most cost-effective option at a willingness-to-pay threshold of one gross domestic product per capita (USD 15 923). Sensitivity analysis showed that the results were sensitive to parameters such as intervention effectiveness and cost, suggesting that a new trial might be worthwhile to reduce uncertainty.
Conclusions
This model suggests that implementing EIP services in Chile may cost more, but it is likely to be cost-effective. Nonetheless, more evidence about affordability, equity and broader perspectives is needed to improve the economic case of implementing EIP services in less-resourced settings, such as in Latin America.
Grazing impacts on soil organic carbon (SOC) are vexingly difficult to predict due to intricate interactions among site-specific weather, vegetation and specified grazing treatments. This longitudinal study capitalizes on a multi-decadal grazing experiment in the semiarid northern mixed-grass prairie of the North American Great Plains with grazing treatments of season-long light and heavy stocking rates, and exclosures (non-grazed) established in 1982 and soils sampled in 1993, 2003 and 2013. Increasing grazing intensity from non-grazed to heavy grazed reduced annual aboveground standing crop biomass and shifted the plant community dominance from cool-season (C3) to warm-season (C4) perennial grasses. Concentrations of SOC and soil nitrogen (N) decreased from 1993 to 2013 for the 0-5, 5-15 and 15-30 cm depths for all grazing treatments, but grazing intensity did not affect SOC and N with the exception of greater N concentrations observed in the 0-5 cm depth with season-long light grazing. Annual precipitation decreased 4.2 mm yr-1 from 1982 to 2013; conversely, mean annual maximum and minimum temperatures did not change. Observed directional trends in precipitation may likely impact ecosystem functioning for soil SOC and N concentrations more than grazing-induced changes in plant communities and aboveground production in this semiarid rangeland resulting in reducing expectations of increased SOC and N with livestock grazing in semiarid rangeland ecosystems of the North American Great Plains.
We need to identify novel, tractable therapeutic targets for anxiety disorders. Converging evidence suggests the endogenous opioid system plays a role in modulating affective processing, but its contribution to regulation of threat processing in humans remains unclear.
Aims
We investigated the neural correlates of non-specific opioid antagonism on explicit and implicit regulation of threatening stimuli in healthy volunteers, using functional magnetic resonance imaging (fMRI).
Method
In a randomised, double-blind, placebo-controlled, crossover design, 38 healthy participants received the opioid antagonist naltrexone (50 mg) or placebo before completing two tasks during fMRI: (a) a cognitive emotional reappraisal task probing explicit regulation and (b) a face-viewing task probing implicit processing.
Results
Contrary to our hypothesis, we found naltrexone reduced distress ratings during the reappraisal task (p = 0.044) without impairing regulation success. Explicit regulation in the reappraisal task engaged lateral prefrontal regions similarly across drug conditions. However, naltrexone attenuated ventromedial prefrontal cortex, thalamus and caudate activation when viewing negative images. Naltrexone additionally altered ventromedial prefrontal cortex activity and in task-positive regions including right premotor area and frontal pole compared with placebo when viewing emotional faces. In particular, naltrexone increased left middle frontal gyrus activity when viewing fearful faces.
Conclusions
Our results support a role for opioid signalling in automatic emotional regulation, but not in explicit regulation. Furthermore, naltrexone appeared to diminish activity in task-positive regions in response to emotional faces. These findings are consistent with a model where endogenous opioids ‘fine-tune’ affective responses to both negative and positive stimuli. Future research should explore dose–response effects, kappa-opioid contributions and whether similar results are seen in clinical populations.
The Woven EndoBridge (WEB) device has emerged as a promising option for treating wide-neck bifurcation aneurysms. This multicenter study aimed to evaluate the impact of postoperative aspirin (ASA) use on clinical and angiographic outcomes in patients treated with the WEB device.
Methods:
We conducted a retrospective multicenter study across 10 academic institutions, analyzing patients with ruptured or unruptured intracranial aneurysms treated with the WEB device.
Results:
A total of 225 patients were included, with 163 (72.4%) receiving postoperative ASA and 62 (27.6%) in the no antiplatelet (No AP) group. Before propensity score matching (PSM), the ASA group demonstrated significantly higher rates of excellent functional outcomes (mRS 0−1: 84% vs. 70%, p = 0.031) and lower mortality (3.3% vs. 13%, p = 0.014). Retreatment rates were also significantly lower in the ASA group (8.6% vs. 23%, p = 0.005). After PSM, 120 patients remained (74 ASA, 46 No AP). Retreatment rates remained significantly lower in the ASA group (5.4% vs. 24%, p = 0.003), whereas the other outcomes did not reach statistical significance after matching.
Conclusion:
Postoperative aspirin use following WEB device treatment for intracranial aneurysms was associated with significantly lower retreatment rates, without compromising functional outcomes or mortality rates. These findings support the potential role of aspirin in enhancing aneurysm stability. Further prospective studies are needed to confirm.
Scimitar syndrome is a rare CHD involving anomalous pulmonary venous drainage and lung hypoplasia. Severe cases complicate single ventricle palliation, prompting a shift to transplantation. Our case series highlights suboptimal outcomes despite this shift, emphasising the need for further research to optimise treatment in this challenging population.
Soil porewater chemistry underpins the quantification of carbon dioxide removal (CDR) in enhanced rock weathering (ERW), where alkalinity and dissolved ion measurements are used within monitoring, reporting and verification (MRV) frameworks. The reliability of these measurements depends on the extraction method, with many in-field techniques constrained by soil moisture availability. This dependence can limit data continuity, reduce comparability across sites and seasons and introduce uncertainty into CDR-relevant interpretations. Here, we present and evaluate a new soil porewater extraction method, SATuration–Centrifugation (SAT-C), designed to obtain porewater from a defined soil volume independent of moisture conditions. The method combines saturation of intact soil cores using deionized water with centrifugation to recover porewater for chemical analysis. We compare SAT-C with conventional sampling using soils collected from grassland field sites, including sites amended with crushed basalt as part of ERW field trials. Across sites, SAT-C porewater chemistry shows strong agreement with rhizon samples for major ions, and bicarbonate concentrations inferred from charge balance are consistent with measured alkalinity. These initial results show that SAT-C provides a robust and reproducible approach for soil porewater extraction, with the potential to improve sampling reliability across variable conditions and thereby support more reliable carbon accounting in ERW.
This chapter discusses the problematic social construction of crime, law enforcement, and jurisprudence and highlights some of the consequences of these media portrayals for the public and students of this topic. It then sets out an ethic of phenomenological reduction of crime and the incumbent legal processes as a solution. The chapter draws upon the work of Jean-Luc Marion, Claude Romano, Werner Marx, James Mensch, and Immanuel Levinas, to describe how reducing the complex experience of crime, law enforcement, and jurisprudence opens new understanding and new potential for exploring the very complex nature of crime and the resulting legal processes. The reduction, in this case, entails an ethical argument to reduce what is given to those experiencing these processes and to us as observers. In the case of the one accused of crime, a reduction of their experience often breaks our understanding free of the “good-guy, bad-guy” portrayals in media. Likewise, a reduction of the experience and activity of law-enforcement and jurisprudence professionals highlights their professional, personal, and interpersonal complexities as they do their jobs. Finally, it proposes that this phenomenological ethic, when taken up by the media, would actually not only increase the portrayals of these processes in a more authentic manner, but increase the potential for sharing the dramatic stories of the criminal, law-enforcement, and legal professionals. This would serve to further their agenda of telling marketable and engaging stories by highlighting the incredible personal and interpersonal complexities of the people caught up in these experiences.
David Matthews explores how Caxton’s awareness of linguistic change informed his editing methods. Caxton’s editing of Trevisa's translation of Higden’s Polychronicon, for example, shows a distinct diachronic consciousness and a desire to forge something new out of Trevisa's ‘old’ English. This stands in contrast to his more deferential treatment of Chaucer. Matthews thus differentiates between philology as a tool for understanding another language and as an editorial practice focused on rendering texts transparent.
When thoroughly assessed, the prevalence of attention-deficit hyperactivity disorder (ADHD) in children/adolescents is estimated at 5%. There is no evidence that ADHD is over-diagnosed in the UK. Indeed, available data point to under-diagnosis, even though rigorous updated post-COVID-19 pandemic data are not available. Some cases may be misdiagnosed due to low-quality assessment, poor adherence to national guidance or inappropriate differential diagnosis. Beyond the controversy around over- or under-diagnosis and over-medicalisation of ordinary behaviours or emotions, the main issue is that UK clinical services cannot adequately support individuals with ADHD who need help. There is a risk that the narrative claiming ‘ADHD is over-diagnosed’ could be used to deny people with properly-diagnosed ADHD the care they deserve.
Cognitive symptoms are common in functional neurological disorder (FND), yet evidence of impaired neurocognitive test performance is variable. We aimed to assess self-reported cognitive symptoms, neurocognitive test performance, and metacognitive confidence in patients with functional seizures (FS) and functional motor symptoms (FMS).
Methods
Participants with FS (n = 50) and FMS (n = 50) were compared to age- and gender-matched healthy controls (HC, n = 50), and clinical controls with depression and/or anxiety disorders (CC, n = 50). The Cambridge Neuropsychological Test Automated Battery was used to examine response speed, working memory, executive functions, and social–emotional processing, with subjective confidence rated for each test. Intellectual functioning, performance validity, and self-reported cognitive symptoms were also assessed.
Results
The FND groups reported elevated cognitive symptoms compared to HC and CC (p-values<0.001). Impaired performance was demonstrated in both FND groups on tests of sustained attention (p-values = 0.03- < 0.001) and set-shifting (p-values = 0.01–0.001). Performance validity was comparable between groups (p = 0.64). The FND groups reported reduced post-diction confidence for sustained attention (p < 0.001). Executive performance deficits correlated with reduced test-specific confidence in FS/FMS (p-values = 0.02- < 0.001). In FMS, post-diction confidence for sustained attention performance correlated negatively with cognitive symptoms (p = 0.002). Cognitive symptoms were associated with psychological/physical symptom load, quality-of-life, and/or general functioning in FND and CC groups (p-values = 0.04- < 0.001).
Conclusions
Patients with FS and FMS displayed localized deficits on tests of executive functioning, with reduced domain-specific metacognitive confidence, alongside significant cognitive symptoms. These neurocognitive features were associated with poorer clinical status, warranting interventions targeting cognitive control and/or cognitive symptoms in everyday life.
The question of how audiences form to watch specialised and mainstream films within regional film provision goes to the heart of current debates in audience studies. Audience reception studies have made audiences increasingly visible, while audience surveys track trends and film policy makers gather information about audience preferences and demographics. Little attention has been paid to the specific contextual relationships and interactions between films and individuals that generate and sustain audiences. Online film consumption and an increasing array of cultural events mean that the nature and formation of film audiences is changing and that film watching is a diverse and extensive experience. This has sharpened the debate about how to conceptualise audiences and their formation. This monograph extends and develops the conceptualisation of audiences as being interactive and relational by introducing three innovative concepts: ‘personal film journeys’, five types of audience formation, and five geographies of film provision within new theorisation of audiences that sees them as a process. A challenge of audience research is how to capture the richness of people’s social and cultural engagement with film that materialises in broader audience trends within contexts of provision; to achieve this, an innovative mixed-methods research and computational ontology approach is used. The book is significant because it develops new, ground-breaking theory and concepts and an innovative research methodology based on an extensive dataset derived from empirical research in the under-researched area of regional film audiences.
Chapter 8 develops a new theory of film audiences in particular – which is that the contemporary audience is a process that results in five types of audiences and audience experiences. The audience as a process involves the ways people develop relationships with film and the level and types of provision open to them. This process is realised through key relations with: screens; venues and places; audience types; and other people, socially and culturally, in lived film culture and through interactions with: friends, family and wider communities; screens and venues; film throughout the lifecourse; film stories through interpretive work; and the practices of audiences. These relations and interactions form audiences as a process. Film audiences’ relations and interactions are interwoven and come together in varying ways, depending on: audience members’ personal life experiences; life stage and circumstance; access and engagement with culture; the media (broadly defined) and screens; and with place-based film culture at the local level. These relations and interactions are composed of: personal film journeys; geographies of film provision; a mixed economy of film provision and policy; types of audience experience; lived film culture; and the social and cultural value of film. Together, these aspects coalesce to form a process that underpins and characterises audience formation.
Chapter 4 compares UK film policy with the research data to set out five modes of place in relation to film provision across the four English regions studied in Beyond the Multiplex (BtM). It argues that a small number of cities and towns have a diverse film offer, but most are dominated by mainstream types of film, and there are areas with very limited or no level of specialised film provision. The chapter adds that this unevenness is not necessarily linked to the socio-cultural profiles of people living there but, rather, it reflects cultural inequalities between different places which are especially prominent within the regions. Using the BtM audience interviews enables insights to be drawn out about how the diversity of film provision in different places shapes people’s sense of place. Together, the chapter demonstrates that the uneven distribution of specialised film exhibition provision across England shapes how people view where they live, but that people are reflexive and often creative in finding ways to overcome limitations, by seeking out film online or in other ways.