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Burkholderia cepacia is a rare cause of prosthetic valve endocarditis. We report an 18-year-old male with Tetralogy of Fallot and two sequential transcatheter pulmonary valves (Melody and Myval), presenting with persistent bacteraemia unresponsive to antibiotics. Surgical explantation of both valves with homograft replacement and tricuspid repair achieved complete recovery, emphasising surgery in refractory infections.
Historians continue to debate what form colonial rule took in early modern Ireland. This article explores how the reception and resistance to anglicisation, located in the everyday body language of submission and subordination encoded in gesture, might be understood in the experience of colonial rule. Exploring the gestural code operating in early modern Ireland, this article examines the role of body politics in the reception of and reaction to English rule. English ‘manners and apparel’ were central to the project of anglicisation. The body played a central role in representing and articulating social hierarchies in the early modern world. Body language offered a troubling everyday reminder of the inequalities signalled in the — non-reciprocal or non-reciprocated — gestures expected of ‘subordinates’ towards ‘superiors’. If the enforcement of the gestural order was important to the establishment of English rule, this also made gesture a focus for resistance and opposition. A body politics that exploited a shared understanding of the meaning of particular gestures could be drawn on in both everyday politics and collective protests to subvert, resist and retaliate against the political agenda of anglicisation. Looking forward to the eighteenth century and beyond state action, the article calls for more work on gesture.
We introduce a new family of coalescent mean-field interacting particle systems by producing a pinning property that acts over a chosen sequence of multiple time segments. Throughout their evolution, these stochastic particles converge in time (i.e. get pinned) to their random ensemble average at the termination point of any one of the given time segments, only to burst back into life and repeat the underlying principle of convergence in each of the successive time segments, until they are fully exhausted. Although the architecture is represented by a system of piecewise stochastic differential equations, we prove that the conditions generating the pinning property enable every particle to preserve their continuity over their entire lifetime almost surely. As the number of particles in the system increases asymptotically, the system decouples into mutually independent diffusions, which, albeit displaying progressively uncorrelated behaviour, still close in on, and recouple at, a deterministic value at each termination point. Finally, we provide additional analytics including a universality statement for our framework, a study of what we call adjourned coalescent mean-field interacting particles, a set of results on commutativity of double limits, and a proposal of what we call covariance waves.
In this study, we investigate the chemical enrichment and structural evolution of the isolated elliptical relic galaxy Mrk1216 through X-ray observations. As a red-nugget relic, Mrk1216 provides a rare window into the early Universe, owing to its minimal interaction with the surrounding environment. Using data from the XMM-Newton telescope, we model the X-ray emission of its interstellar medium to derive radial temperature and abundance profiles. We find that the central region exhibits an elevated [Mg/Fe] ratio compared to typical early-type galaxies, consistent with a brief but intense star formation episode during its early assembly – a hallmark of relic systems. The nearly flat SNIa ratio profile ($R_{Ia} \sim 0.17$) extending to $\sim0.42R_{500}$ supports an early-enrichment scenario. These results highlight the importance of relic galaxies as benchmarks for studying early galaxy evolution and chemical enrichment. Future high-resolution missions and more advanced theoretical models incorporating more realistic initial mass functions are needed to fully assess their implications.
Field experiments were conducted near Beresford and South Shore, South Dakota, in 2023 and 2024 to determine weed control and soybean yield with 2,4-D and glufosinate applied alone, mixed, and sequentially. Sequential applications were made 12 d after the initial application. 2,4-D plus glufosinate additively controlled and reduced the height of all tested weed species. Sequential applications increased common lambsquarters, waterhemp, redroot pigweed, and velvetleaf control compared with 2,4-D, glufosinate, or 2,4-D plus glufosinate applied alone. The herbicide order in the sequential application did not influence broadleaf weed control. Yellow foxtail control was greater with sequential applications of glufosinate. Soybean yield at Beresford was similar across all treatments. Yields were generally greater with sequential herbicide applications, where glufosinate was applied initially at South Shore. The experiment results suggest that weed control and soybean yield are greater with 2,4-D plus glufosinate or sequential application treatments utilizing 2,4-D and glufosinate.
Let K be an infinite field. If $\alpha $ and $\beta $ are algebraic and separable elements over K, then by the primitive element theorem, it is well known that $\alpha +u\beta $ is a primitive element for $K(\alpha , \beta )$ for all but finitely many elements $u\in K$. If we let
be the exceptional set, then by the primitive element theorem, $|\xi _K(\alpha , \beta )| < \infty $. Dubickas [‘An effective version of the primitive element theorem’, Indian J. Pure Appl. Math.53(3) (2022), 720–726] estimated the size of this set when $K = \mathbb {Q}$. We take K to be a finite extension over $\mathbb {Q}$ or $\mathbb {Q}_p$, the field of p-adic numbers for some prime p, and estimate the size of the exceptional set.
Cavitation inception and the associated flow structure in the tip region of a ducted propeller are investigated experimentally at varying advance ratios (J) using high-speed imaging and stereoscopic particle image velocimetry (SPIV) measurements in a refractive index-matched facility. At design and higher J values, inception occurs in axially aligned secondary vortices, located between the blade suction side and the tip leakage vortex (TLV), circumferentially after the trailing edge. With decreasing J, the inception shifts first to the TLV, and then along its core towards the leading edge. High-resolution SPIV data follow the evolution of TLV, tip leakage flow, near wake and several secondary vortices. Time-resolved SPIV at 30 kHz enables calculation of all three mean vorticity components, hence capturing axial vortices, and identifies the origin of flow structures. At high J values, inception occurs when quasi-axial vortices are stretched by the circumferential TLV and co-rotating secondary vortices located in the shear layer connecting the TLV to the suction side blade tip. With decreasing J, inception shifts to the TLV and towards the leading edge owing to earlier rollup and higher vortex strength, along with earlier breakup, evidenced by high core turbulence and a decrease in peak vorticity despite an increase in circulation.
Significant changes in Taiwan’s psychiatric services over recent decades include expansion of community-based clinics and implementation of the Schizophrenia Pay-for-Performance programme.
Aims
This study aimed to assess the trend of the quality of healthcare for individuals with schizophrenia, using various indicators of the treatment process and outcomes between 2010 and 2019.
Method
Individuals with schizophrenia were identified using Taiwan’s National Health Insurance claims database. The quality of healthcare for individuals with schizophrenia was assessed using treatment process and outcome indicators, including antipsychotic types, medication adherence, daily dose for antipsychotics and concurrent use of other psychotropic agents. Outcome indicators included all-cause mortality, suicide deaths, psychiatric hospitalisation, emergency department visits and employment status.
Results
Antipsychotic medication usage has shifted towards second-generation antipsychotics (SGAs) and long-acting injectable antipsychotics (LAIs), with declines in first-generation antipsychotics. The percentage of medication adherence declined, while that of individuals with an adequate daily dose increased. Concurrently, anticholinergic and benzodiazepine use decreased while antidepressant and mood stabiliser use increased. Outcome indicators showed no significant change in all-cause mortality or suicide rates over time, but there were reductions in psychiatric hospitalisations and emergency department visits. Employment rates increased overall, particularly in urban areas.
Conclusions
The quality of healthcare for individuals with schizophrenia, as measured by treatment process and outcome indicators, improved alongside changes in Taiwan’s psychiatric services; however, causality cannot be inferred from our findings. Future research should evaluate the effectiveness of psychiatric service policies and continuously monitor healthcare quality to further enhance the lives of individuals with schizophrenia.
An experimental investigation is conducted to examine the tonal noise generation and flow structures of under-expanded jets interacting with a flat plate. The study combines surface pressure, far-field noise and time-resolved Schlieren visualisations to analyse jet dynamics across a range of isentropic Mach numbers (1.1–1.44) and jet-to-plate distances ($H/D$ = 1, 1.5 and 2.5). The results reveal a distinctly non-monotonic relationship between plate height and the amplitude of screech and plate-induced tones. This behaviour is governed by the constructive and destructive interference between the direct acoustic feedback waves of the jet and those reflected from the plate surface. This interference dictates whether the inherent screech mechanism is suppressed or a new plate-induced tone is amplified. Dynamic mode decomposition and wavenumber-spectral analysis reveal that the plate interaction disrupts the balance between downstream-propagating Kelvin–Helmholtz instabilities and upstream-travelling acoustic waves, fundamentally altering the jet’s resonant feedback loops. A key contribution of this work is the establishment of a direct link between flow dynamics and acoustics through advanced statistical analysis. It is shown that the plate installation asymmetrically amplifies the energy of coherent structures within the jet’s lower shear layer. Crucially, the energy content of these dominant shear-layer structures is found to be the primary driver of the far-field tonal noise magnitude. These findings provide a deeper understanding of the complex coupling between flow and acoustics in installed supersonic jets and offer refined guidance for the development of noise mitigation strategies.
In this article, I center substantial improvement in subnational democracy in the U.S. states as an object of inquiry and seek to explain it. I theorize that strong unions, high Democratic Party control of state government, an especially liberal Democratic Party, a large population of people of color, and a particularly liberal public mood may each contribute to substantial improvement in democratic quality. Using Coincidence Analysis (CNA), a configurational causal method, I assess the evidence for my hypotheses. The CNA identifies three alternative paths to substantial improvement in electoral democracy in the states. The results of my analysis highlight that substantial improvement in electoral democracy is the product of political struggle centrally involving unions and the Democratic Party.
The present experiments investigated the combustion dynamics of single and coaxial laminar diffusion flames within a closed cylindrical acoustic waveguide, focusing on their response to acoustic forcing at a pressure antinode. Nine alternative fuel injectors were used to examine the effect of injector jet diameter and configuration, tube wall thickness, annular-to-inner area and velocity ratio, and jet Reynolds number (below 100) on flame behaviour under different applied frequencies and pressure perturbation amplitudes. Fundamental flame–acoustic coupling phenomena were identified, all of which involved symmetric flame perturbations. These included sustained oscillatory combustion (SOC), multi-frequency periodic liftoff and reattachment (PLOR), permanent flame lift-off (PFLO) with low-level oscillations, and flame blowoff (BO). The phase lag between acoustic forcing and flame response was quantified, providing valuable insights into the coupling dynamics and transition behaviours. Findings revealed how various geometrical and flow characteristics could affect flame stability and resistance to blowoff, even under similar acoustic forcing conditions. Analysis of high-speed spatiotemporal visible imaging using proper orthogonal decomposition (POD) uncovered additional distinct phase portraits and spectral signatures associated with instability transitions, which, coupled with specific dynamical characteristics, enabled new insights into the relevance of injector geometrical characteristics and flow conditions in addressing acoustically coupled combustion instabilities.
This study presents a conceptual replication of Jacob et al.’s (2018) comparison of L2 early-stage processing of derived vs. inflected words. Previous studies on this issue focused predominantly on L2 learners from morphologically complex, alphabetic L1s, and generally showed L2 decompositional processing of derived but not inflected words. This replication study examined whether the previous claim for a qualitative difference in L2 early-stage processing of derived and inflected words could generalize to L2 English learners from a morphologically isolating, logographic L1, i.e., Chinese learners of L2 English. Results from a masked priming lexical decision task showed qualitatively the same magnitude of priming in the derivational, inflectional, and form control conditions for Chinese learners of English, suggesting reliance on surface form information in the early-stage processing of both derived and inflected words. Results of the current study add to the literature on L2 early-stage processing of derived vs. inflected words.
Iron deficiency anemia is a major health problem worldwide. Iron is an essential micronutrient in the human body; its demand increases with fetal growth and gestation. Although it has been reported that glucose metabolism is also affected by iron deficiency, only few studies have investigated the influence of iron deficiency during gestation and in offspring. In this study, glucose metabolism in newborns was investigated in terms of maternal iron deficiency prior to pregnancy in a rat model. Briefly, rats were divided into control (CL) and iron deficiency (ID) groups. The levels of serum glucose and insulin and the protein expression of liver GLUT2 in neonates born to dams in the ID group increased. In contrast, the mRNA and protein expression levels of GLUT2 and GLUT4 in the skeletal muscle tended to decrease. In addition, the expression of p-Akt (Thr308), which is involved in GLUT4 membrane translocation, decreased, suggesting that GLUT4 translocation to the plasma membrane may not have been sufficiently promoted. These results suggest that maternal iron deficiency may influence glucose metabolism in neonates and potentially increase the risk of developing metabolic abnormalities and lifestyle-related diseases later in life.
Archaeological evidence suggests that the transition to food-producing economies in the Western Valleys of northern Chile led to a decline in foraging in highland areas around AD 650, yet colonial records from the sixteenth and eighteenth centuries attest to the continued existence of foraging groups. Taking the Camarones River Basin as a test case, this study identifies small-scale settlements and hunting installations in upland areas using remote-sensing data. In considering these new data alongside ethnohistorical accounts, the author proposes that foraging endured into the late colonial era, possibly coexisting with herder and agropastoral communities and precipitating tethered settlement patterns.
While around one-fifth of UK secondary school pupils exhibit clinically significant eating pathology, in-school mental health provision does not include interventions to address such eating pathology.
Aims:
This preliminary qualitative study aimed to explore the views of staff, parents and pupils, on the idea of introducing a school-based brief cognitive behavioural therapy programme for non-underweight eating disorders.
Method:
31 pupils, 22 parents and 27 staff participated in 12 focus groups across four schools. The semi-structured interview guide covered topics around the practicalities of a potential eating disorders treatment programme, the acceptability of the intervention, and likelihood of future uptake.
Results:
Five over-arching themes and 12 subthemes emerged, reflecting the scale of eating and body image concerns, management limitations, and the importance of prioritising mental health over education. Advantages, challenges, considerations, and solutions were proposed for an in-school eating disorders treatment programme.
Conclusions:
These qualitative data show that there is support for an appropriately implemented in-school delivery of brief, evidence-based treatment, demonstrating the potential scope of such an approach to support children and adolescents to receive early help with their eating problems and body image concerns.