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This is a study of the dynamics of partisan polarization in the United States. It has three objectives: (1) to identify and explain why some Republicans and Democrats – but not others – have polarized, particularly over the last twenty years; (2) to demonstrate that they have done so not on this or that issue but systematically, programmatically – domain versus issue sorting; and (3) to bring into the open profound asymmetries in polarization between the two parties, not least that Republicans polarized early and thoroughly on issues of race, while Democrats in the largest number stayed neutral or even conservative until only recently. Emerging from the reasoning and results is a revised theory of party identification that specifies the conditions under which ordinary Republicans and Democrats can become ideological partisans – real-life conservatives and liberals in their behavior – in the choices they make on candidates, policies, and parties.
Quantum field theory predicts a nonlinear response of the vacuum to strong electromagnetic fields of macroscopic extent. This fundamental tenet has remained experimentally challenging and is yet to be tested in the laboratory. A particularly distinct signature of the resulting optical activity of the quantum vacuum is vacuum birefringence. This offers an excellent opportunity for a precision test of nonlinear quantum electrodynamics in an uncharted parameter regime. Recently, the operation of the high-intensity Relativistic Laser at the X-ray Free Electron Laser provided by the Helmholtz International Beamline for Extreme Fields has been inaugurated at the High Energy Density scientific instrument of the European X-ray Free Electron Laser. We make the case that this worldwide unique combination of an X-ray free-electron laser and an ultra-intense near-infrared laser together with recent advances in high-precision X-ray polarimetry, refinements of prospective discovery scenarios and progress in their accurate theoretical modelling have set the stage for performing an actual discovery experiment of quantum vacuum nonlinearity.
Moths are a hyperdiverse taxon and contribute to important ecosystem services, including herbivory, pollination, and as food for other animals. Artificial light is an effective means by which to attract nocturnal moths for ecological study, but many traditional light-trapping approaches require the use of heavy, lead acid batteries, whereas novel light-emitting diodes (LEDs) use much lighter and energy-efficient lithium-ion batteries. Employing replicated forest stands being used for a longer-term study on the effects of Bacillus thuringiensis subsp. kurstaki (Btk) application, we assessed how traps fitted with either black-light fluorescent (BLF) or LED lights differed in the moth assemblages they attracted. The macromoth assemblages captured by the two light sources differed significantly in their composition, with some species almost exclusively collected by a particular light type. We collected significantly more moths in the BLF traps overall. However, we found a higher diversity of species using the LED light traps but only in the Btk–treated sites. We show that, although these lights appear to attract significantly different species assemblages, LEDs represent an effective, efficient, and environmentally safer approach for attracting macromoths. More empirical studies will help elucidate which species are most attracted to various light sources and if broader phylogenetic patterns exist.
The so-called credibility revolution dominates empirical economics, with its promise of causal identification to improve scientific knowledge and ultimately policy. By examining the case of rural electrification in the Global South, this opinion paper exposes the limits of this evidence-based policy paradigm. The electrification literature boasts many studies using the credibility revolution toolkit, but at the same time, several systematic reviews demonstrate that the evidence is divided between very positive and muted effects. This bifurcation presents a challenge to the science-policy interface, where policymakers, lacking the resources to sift through the evidence, may be drawn to the results that serve their (agency's) interests. The interpretation is furthermore complicated by unresolved methodological debates circling around external validity as well as selective reporting and publication decisions. These features, we argue, are not particular to the electrification literature but inherent to the credibility revolution toolkit.
Accurate diagnosis of bipolar disorder (BPD) is difficult in clinical practice, with an average delay between symptom onset and diagnosis of about 7 years. A depressive episode often precedes the first manic episode, making it difficult to distinguish BPD from unipolar major depressive disorder (MDD).
Aims
We use genome-wide association analyses (GWAS) to identify differential genetic factors and to develop predictors based on polygenic risk scores (PRS) that may aid early differential diagnosis.
Method
Based on individual genotypes from case–control cohorts of BPD and MDD shared through the Psychiatric Genomics Consortium, we compile case–case–control cohorts, applying a careful quality control procedure. In a resulting cohort of 51 149 individuals (15 532 BPD patients, 12 920 MDD patients and 22 697 controls), we perform a variety of GWAS and PRS analyses.
Results
Although our GWAS is not well powered to identify genome-wide significant loci, we find significant chip heritability and demonstrate the ability of the resulting PRS to distinguish BPD from MDD, including BPD cases with depressive onset (BPD-D). We replicate our PRS findings in an independent Danish cohort (iPSYCH 2015, N = 25 966). We observe strong genetic correlation between our case–case GWAS and that of case–control BPD.
Conclusions
We find that MDD and BPD, including BPD-D are genetically distinct. Our findings support that controls, MDD and BPD patients primarily lie on a continuum of genetic risk. Future studies with larger and richer samples will likely yield a better understanding of these findings and enable the development of better genetic predictors distinguishing BPD and, importantly, BPD-D from MDD.
Loneliness has become a major public health issue of the recent decades due to its severe impact on health and mortality. Little is known about the relation between loneliness and social anxiety. This study aimed (1) to explore levels of loneliness and social anxiety in the general population, and (2) to assess whether and how loneliness affects symptoms of social anxiety and vice versa over a period of five years.
Methods
The study combined data from the baseline assessment and the five-year follow-up of the population-based Gutenberg Health Study. Data of N = 15 010 participants at baseline (Mage = 55.01, s.d.age = 11.10) were analyzed. Multiple regression analyses with loneliness and symptoms of social anxiety at follow-up including sociodemographic, physical illnesses, and mental health indicators at baseline were used to test relevant covariates. Effects of loneliness on symptoms of social anxiety over five years and vice versa were analyzed by autoregressive cross-lagged structural equation models.
Results
At baseline, 1076 participants (7.41%) showed symptoms of social anxiety and 1537 (10.48%) participants reported feelings of loneliness. Controlling for relevant covariates, symptoms of social anxiety had a small significant effect on loneliness five years later (standardized estimate of 0.164, p < 0.001). Vice versa, there was no significant effect of loneliness on symptoms of social anxiety taking relevant covariates into account.
Conclusions
Findings provided evidence that symptoms of social anxiety are predictive for loneliness. Thus, prevention and intervention efforts for loneliness need to address symptoms of social anxiety.
School-based interventions encouraging children to replace sugar-sweetened beverages with water show promise for reducing child overweight. However, students with child food insecurity (CFI) may not respond to nutrition interventions like children who are food-secure.
Design:
The Water First cluster-randomised trial found that school water access and promotion prevented child overweight and increased water intake. This secondary analysis used mixed-effects regression to evaluate the interaction between the Water First intervention and food insecurity, measured using the Child Food Security Assessment, on child weight status (anthropometric measurements) and dietary intake (student 24-h recalls, beverage intake surveys).
Setting:
Eighteen elementary schools (serving ≥ 50 % children from low-income households), in which drinking water had not been previously promoted, in the San Francisco Bay Area.
Participants:
Students in fourth-grade classes (n 1056).
Results:
Food insecurity interacted with the intervention. Among students with no CFI, the intervention group had a lower prevalence of obesity from baseline to 7 months (–0·04, CI –0·08, 0·01) compared with no CFI controls (0·01, CI –0·01, 0·04) (P = 0·04). Among students with high CFI, the intervention group had a pronounced increase in the volume of water consumed between baseline and 7 months (86·2 %, CI 21·7, 185·0 %) compared with high CFI controls (–13·6 %, CI –45·3, 36·6 %) (P = 0·02).
Conclusions:
Addressing food insecurity in the design of water promotion interventions may enhance the benefit to children, reducing the prevalence of obesity.
Background: Duchenne muscular dystrophy (DMD) is caused by DMD gene mutations. Delandistrogene moxeparvovec is an investigational gene transfer therapy, developed to address the underlying cause of DMD. We report findings from Part 1 (52 weeks) of the two-part EMBARK trial (NCT05096221). Methods: Key inclusion criteria: Ambulatory patients aged ≥4-<8 years with a confirmed DMD mutation within exons 18–79 (inclusive); North Star Ambulatory Assessment (NSAA) score >16 and <29 at screening. Eligible patients were randomized 1:1 to intravenous delandistrogene moxeparvovec (1.33×1014 vg/kg) or placebo. The primary endpoint was change from baseline in NSAA total score to Week 52. Results: At Week 52 (n=125), the primary endpoint did not reach statistical significance, although there was a nominal difference in change from baseline in NSAA total score in the delandistrogene moxeparvovec (2.6, n=63) versus placebo groups (1.9, n=61). Key secondary endpoints (time to rise, micro-dystrophin expression, 10-meter walk/run) demonstrated treatment benefit in both age groups (4-5 and 6-7 years; p<0.05).There were no new safety signals, reinforcing the favorable and manageable safety profile observed to date. Conclusions: Based on the totality of functional assessments including the timed function tests, treatment with delandistrogene moxeparvovec indicates beneficial modification of disease trajectory.
Background: High grade gliomas (HGGs) shed extracellular vesicles (EVs) into the bloodstream. EV-derived RNA (EV-RNA) can be detected in plasma, making it a potential biomarker for HGG recurrence after treatment. We sought to establish a baseline relationship between EV-RNA in plasma and hypervascular HGG tissue on MRI. Methods: Eight patients with a new diagnosis of HGG had measurements of plasma EV-RNA and contemporaneous dynamic susceptibility contrast (DSC) MRI. Patient-specific median signal intensity of corpus callosum (mSI-CC) was determined from 10 measurements on the relative cerebral blood volume (rCBV) map. Tumour tissue with signal intensity > mSI-CC and > 2x, > 3x, > 4x and > 5x mSI-CC was segmented on the rCBV map. EV-RNA plasma concentration was correlated with tissue volumes. Results: Pearson correlation showed a significant positive relationship between EV-RNA plasma concentration and tissue volume with signal intensity > mSI-CC (r(6) = 0.899, p = 0.002). No significant relationship could be detected for progressively smaller tissue volumes with signal intensity > 2x, > 3x, > 4x and > 5x mSI-CC. Conclusions: EV-RNA plasma concentration correlates strongly with the total volume of hypervascular HGG tissue on DSC MRI at baseline and merits further evaluation as a biomarker of tumour behaviour in longitudinal imaging studies.
Workplace sugar-sweetened beverage (SSB) sales bans can reduce SSB consumption. Because stress and anxiety can promote sugar consumption, we examined whether anxiety among hospital employees during the COVID-19 pandemic was associated with changes in SSB consumption and explored whether this relationship varied by exposure to a workplace SSB sales ban.
Design:
In a prospective, controlled trial of workplace SSB sales bans, we examined self-reported anxiety (generalised anxiety disorder-7) and self-reported SSB consumption (fluid ounces/d) before (July 2019) and during (May 2020) the COVID-19 pandemic.
Setting:
Hospital sites in two conditions (four with SSB sales bans and three without sales bans) in Northern California.
Participants:
We sampled 580 participants (hospital employees) from a larger trial of sales bans; all were regular consumers of SSB (minimum 3/week at main trial enrollment). This subsample was chosen based on having appropriately timed data for our study questions.
Results:
Across conditions, participants reduced SSB consumption over the study period. However, participants with higher pandemic-era anxiety scores experienced smaller reductions in SSB consumption after 9 months compared with those with lower anxiety scores (β = 0·65, P < 0·05). When the sample was disaggregated by sales ban condition, this relationship held for participants in the control group (access to SSB at work, β = 0·82, P < 0·05), but not for those exposed to an SSB sales ban (β = 0·42, P = 0·25).
Conclusions:
SSB sales bans likely reduce SSB consumption through multiple pathways; buffering stress-related consumption may be one mechanism.
Dilute aqueous solutions of quinoline were contacted with Na-montmorillonite to elucidate the sorption process of the neutral and protonated species. Sorption occurs via a combination of ion exchange and molecular adsorption and yields S-type isotherms. Exchange between the quinolinium ion (QH+) and Na can be described by means of Vanselow selectivity coefficients and a thermodynamic exchange constant (Kex). Due to the apparent adsorption of the neutral species at high mole fractions (x) of the solid phase, the thermodynamic standard state was defined as 0.5 mole fraction. The selectivity at pH ~4.95 of the QH+ species over Na (at XQH+ = 0.5) was determined to be Kv = 340. At pH ≥ 5.5 surface mole fractions of 0.5 could not be obtained without adsorption of the neutral species. This study suggests that at dilute solution concentrations quinoline is sorbed preferentially as the cation even at pHs ≫ pKa. A critical surface-solution concentration is apparently necessary for adsorption of the neutral species.
Chromate (CrO42−) adsorption was investigated on kaolinite (0.2–2 μm) saturated with NaClO4 over a range of pH. Adsorption increased with decreasing pH because of protonation of chromate and/or variable charge sites on kaolinite. Chemical pretreatment to remove noncrystalline and crystalline oxide contaminants affected the magnitude of CrO42− adsorption, but not the pH range over which CrO42− adsorbed. Chromate adsorption at different sorbate and sorbent concentrations increased below the pHzpc for the kaolinite edge, suggesting the formation of weak surface complexes. If CrO42− and SO42− were present at equal concentration (5.0 × 10−7 M), the two solutes sorbed independently, suggesting binding to separate sites. The presence of excess SO42− (5.0 × 10−4 M), however, unexplainably enhanced CrO42− adsorption. The adsorption of both Chromate and sulfate can be described in terms of a site-binding model of the kaolinite edge, in which the edge is viewed as composite layers of Al and Si oxide. Surface complexation constants for CrO42− on kaolinite were similar to those for alumina, pointing to the importance of Al-OH edge sites in Chromate adsorption.
Limited analyses based on national samples have assessed whether early attention-deficit/hyperactivity disorder (ADHD) symptoms predict later internalizing and externalizing symptoms in youth and the influence of sex and pubertal timing on subsequent psychiatric symptoms. This study analyzed data (n = 2818) from the Environmental influences on Child Health Outcomes Program national cohort. Analyses used data from early childhood (mean age = 5.3 years) utilizing parent-reported ADHD symptoms to predict rates of internalizing and externalizing symptoms from late childhood/adolescence (mean age = 11.9 years). Within a subsample age at peak height velocity (APHV) acted as a proxy to assess pubertal timing from early childhood (mean age = 5.4 years) to adolescence (mean age = 12.3 years). Early-childhood ADHD symptoms predicted later psychiatric symptoms, including anxiety, depression, aggressive behavior, conduct problems, oppositional defiant disorder, and rule-breaking behavior. Earlier APHV was associated with increased Conduct Disorder symptoms from late childhood to adolescence for females only. A stronger relation between ADHD symptoms and later aggression was observed in females with earlier APHV, whereas this same pattern with aggression, conduct problems and depression was observed in males with later APHV. Clinicians should consider that both young girls and boys with elevated ADHD symptoms, particularly with off-set pubertal timing, may be at risk for later psychiatric symptoms.
The overuse of antibiotics in medicine has led to concerns over management of wound infections where antibiotic-resistant bacteria are involved. Wound infections exhibit both acquired and biofilm-associated antibiotic resistance; innovative non-antibiotic therapeutic and preventive treatments are needed to limit emergence of conventional antimicrobial resistance and to address biofilm-associated resistance. Toward this goal, natural antibacterial clays have been identified that are effective at killing drug-resistant human pathogens in planktonic and biofilm states, in vitro. To move toward clinical testing of antibacterial clays, the present study was conducted to evaluate the topical application of a natural antibacterial clay to wounds in mice experimentally infected with methicillin-resistant Staphylococcus aureus (MRSA). Five preliminary animal trials were conducted to test various methods of applying hydrated antibacterial clay to infected wounds. None of the experiments yielded significantly reduced MRSA infection in vivo, compared to controls. Several hypotheses were tested to explore the diminished clay antibacterial activity in vivo including: (1) pH and Eh of mineral-bacterial suspensions may differ in wound fluids compared to growth media; (2) antibacterial reactants may complex with components of the wound; (3) hydrated clays may dry out in the wound; and (4) limited dissolved oxygen may reduce Fenton reactions. Ancillary in vitro tests were performed to explore these hypotheses. Results indicate that the clay application to wounds may require enhanced oxidation and possibly a longer treatment regimen. The experimental results foster understanding of the natural clay–bacterial interactions in wounds and may improve designs for medicinal applications.
Patients with Fontan failure are high-risk candidates for heart transplantation and other advanced therapies. Understanding the outcomes following initial heart failure consultation can help define appropriate timing of referral for advanced heart failure care.
Methods:
This is a survey study of heart failure providers seeing any Fontan patient for initial heart failure care. Part 1 of the survey captured data on clinical characteristics at the time of heart failure consultation, and Part 2, completed 30 days later, captured outcomes (death, transplant evaluation outcome, and other interventions). Patients were classified as “too late” (death or declined for transplant due to being too sick) and/or “care escalation” (ventricular assist device implanted, inotrope initiated, and/or listed for transplant), within 30 days. “Late referral” was defined as those referred too late and/or had care escalation.
Results:
Between 7/2020 and 7/2022, 77 Fontan patients (52% inpatient) had an initial heart failure consultation. Ten per cent were referred too late (6 were too sick for heart transplantation with one subsequent death, and two others died without heart transplantation evaluation, within 30 days), and 36% had care escalation (21 listed ± 5 ventricular assist device implanted ± 6 inotrope initiated). Overall, 42% were late referrals. Heart failure consultation < 1 year after Fontan surgery was strongly associated with late referral (OR 6.2, 95% CI 1.8–21.5, p=0.004).
Conclusions:
Over 40% of Fontan patients seen for an initial heart failure consultation were late referrals, with 10% dying or being declined for transplant within a month of consultation. Earlier referral, particularly for those with heart failure soon after Fontan surgery, should be encouraged.
Identifying youths most at risk to COVID-19-related mental illness is essential for the development of effective targeted interventions.
Aims
To compare trajectories of mental health throughout the pandemic in youth with and without prior mental illness and identify those most at risk of COVID-19-related mental illness.
Method
Data were collected from individuals aged 18–26 years (N = 669) from two existing cohorts: IMAGEN, a population-based cohort; and ESTRA/STRATIFY, clinical cohorts of individuals with pre-existing diagnoses of mental disorders. Repeated COVID-19 surveys and standardised mental health assessments were used to compare trajectories of mental health symptoms from before the pandemic through to the second lockdown.
Results
Mental health trajectories differed significantly between cohorts. In the population cohort, depression and eating disorder symptoms increased by 33.9% (95% CI 31.78–36.57) and 15.6% (95% CI 15.39–15.68) during the pandemic, respectively. By contrast, these remained high over time in the clinical cohort. Conversely, trajectories of alcohol misuse were similar in both cohorts, decreasing continuously (a 15.2% decrease) during the pandemic. Pre-pandemic symptom severity predicted the observed mental health trajectories in the population cohort. Surprisingly, being relatively healthy predicted increases in depression and eating disorder symptoms and in body mass index. By contrast, those initially at higher risk for depression or eating disorders reported a lasting decrease.
Conclusions
Healthier young people may be at greater risk of developing depressive or eating disorder symptoms during the COVID-19 pandemic. Targeted mental health interventions considering prior diagnostic risk may be warranted to help young people cope with the challenges of psychosocial stress and reduce the associated healthcare burden.
Appropriateness of transmission-based precautions after positive result for a non-SARS-CoV-2 virus was evaluated. Most patients (77.2%) lacked appropriate precautions within 3 hours of virus detection; 36.9% remained without appropriate precautions during their stay. With recent cessation of universal masking, adherence to infection control best practices is needed to optimize safety.
Text comprehension frequently demands the resolution of no longer plausible interpretations to build an accurate situation model, an ability that might be especially challenging during second language comprehension. Twenty-two native English speakers (L1) and twenty-two highly proficient non-native English speakers (L2) were presented with short narratives in English. Each text required the evaluation and revision of an initial prediction. Eye movements in the text and a comprehension sentence indicated less efficient performance in the L2 than in L1 comprehension, in both inferential evaluation and revision. Interestingly, these effects were determined by individual differences in inhibitory control and linguistic proficiency. Higher inhibitory control reduced the time rereading previous parts of the text (better evaluation) as well as revisiting the text before answering the sentence (better revision) in L2 comprehenders, whereas higher proficiency reduced the time in the sentence when the story was coherent, suggesting better general comprehension in both languages.