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This study quantitatively investigates the two-dimensional pseudosteady shock refraction at an inclined air–water interface, referred to as the water wedge, in the weak and strong incident shock strength groups. Numerical simulations are employed to validate the predicted refraction sequences from a previous study (Anbu Serene Raj et al. 2024 J. Fluid Mech.998, A49). A distinctive irregular refraction pattern, referred to as the bound precursor refraction with a Mach reflection, is numerically validated in the weak shock group. Based on the numerical simulations, an enhanced formulation is proposed to determine the sonic line of the incident flow Mach number ($M_b$) in water, thereby providing an appropriate transition condition for an irregular refraction with a Mach reflection to a free precursor refraction with a Mach reflection transition. Furthermore, comparative studies on solid and water wedges of wedge angle $20^\circ$ reveal discernible differences in the shock reflection patterns. The interplay of the energy dissipation due to the transmitted shock wave and the Richtmyer–Meshkov instability at the air–water interface results in the variation of the triple-point trajectory and transition angles between single Mach reflection (SMR) to transitional Mach reflection (TMR) occurring in air.
Time series of counts often display complex dynamic and distributional characteristics. For this reason, we develop a flexible framework combining the integer-valued autoregressive (INAR) model with a latent Markov structure, leading to the hidden Markov model-INAR (HMM-INAR). First, we illustrate conditions for the existence of an ergodic and stationary solution and derive closed-form expressions for the autocorrelation function and its components. Second, we show consistency and asymptotic normality of the conditional maximum likelihood estimator. Third, we derive an efficient expectation–maximization algorithm with steps available in closed form which allows for fast computation of the estimator. Fourth, we provide an empirical illustration and estimate the HMM-INAR on the number of trades of the Standard & Poor’s Depositary Receipts S&P 500 Exchange-Traded Fund Trust. The combination of the latent HMM structure with a simple INAR$(1)$ formulation not only provides better fit compared to alternative specifications for count data, but it also preserves the economic interpretation of the results.
This study presents an innovative system for upper limb rehabilitation, combining a variable stiffness device, the ReHArm prototype, with a dynamic and engaging user interface, known as Arms Rehabilitation Management System. The proposed system offers a highly customisable approach to rehabilitation, ensuring real-time adaptability to patients’ specific needs while maintaining compactness and ease of use. Key features include a modular design allowing precise stiffness adjustments, a robust control architecture, and interactive rehabilitation phases designed to enhance user engagement. Extensive multidisciplinary analyses, including kinematic, dynamic, and structural evaluations, demonstrate the system’s ability to improve therapy effectiveness through tailored interaction and feedback. Validation tests demonstrated the prototype’s reliability and robustness, and initial usability assessments suggest its potential to improve rehabilitation outcomes. Further clinical studies involving patients will be necessary to fully evaluate its therapeutic effectiveness.
The spatio-temporal evolution of very large-scale coherent structures, also known as superstructures, is investigated in both smooth- and rough-wall boundary layers by means of direct numerical simulations up to a frictional Reynolds number of ${\textit{Re}}_\tau = 3\,150$. One smooth-wall and four rough-wall cases are considered, all developing over a region as long as $\sim$60 times the incoming boundary-layer thickness in the streamwise direction. Bio-inspired, biofouling-type topographies are employed for the rough-wall cases, following the previous work of Womack et al. (2022 J. Fluid Mech. vol. 933, p. A38) and Kaminaris et al. (2023 J. Fluid Mech. vol. 961, p. A23). We utilise three-dimensional time series, as well as multiple two-point correlation functions along the boundary layer to capture the detailed length- and time-scale evolution of the superstructures. The results suggest that the presence of roughness significantly amplifies both the strength and the streamwise growth rate of superstructures. Interestingly, however, their ratios relative to the local boundary-layer thickness, $\mathscr{L}_{\!x}/\delta$ and $\mathscr{L}_z/\delta$, remain constant and independent of the streamwise coordinate, indicating that such scaled length scales might constitute a possible flow invariant. Volumetric correlations revealed that all cases induce structures inclined with respect to the mean-flow direction, with those over the rough-wall topographies exhibiting steeper inclination angles. Finally, via proper orthogonal decomposition, pairs of counter-rotating roll modes were detected and found to flank the high- and low-speed superstructures, supporting the conjecture in the literature regarding the mechanisms responsible for the lateral momentum redistribution. The latter also suggests that the way momentum organises itself in high Reynolds number wall-bounded flows might be independent of the roughness terrain underneath.
Obesity is characterised by chronic low-grade inflammation, which is a key factor in the development of obesity-related co-morbidities. Intake of n-3 long-chain PUFAs is associated with anti-inflammatory effects. Recent studies suggest that also n-11 long-chain MUFAs may reduce the concentrations of inflammatory markers, possibly by increasing the biosynthesis of EPA. The primary aim was to investigate if diets added herring oil containing cetoleic acid (CA, C22:1n-11) or a CA concentrate (CECO) affected the fatty acid composition in tissues from obese rats with chronic inflammation. Secondary aims included investigating the effects on inflammatory markers. Thirty male obese Zucker fa/fa rats were fed diets containing herring oil (HERO) or a CECO, containing 0·70 or 1·40 wt% CA, respectively, with a comparable content of EPA (0·17 and 0·20 wt%, respectively), or a control diet with soyabean oil for 5 weeks. Data were analysed using one-way ANOVA. CA from HERO and CECO diets were recovered in liver, adipose tissue, muscle and blood cells. The EPA concentration was similar between HERO and CECO groups in tissues, whereas the hepatic concentrations of fatty acid desaturases were lower or similar to Controls. The concentrations of TNFα, matrix metalloproteinase-3, IL6, monocyte chemotactic protein 1 and integrin α M in adipose tissue, and the hepatic concentration of CD68 were lower after CECO intake but were not affected by the HERO diet. To conclude, rats fed the CECO diet had lower concentrations of inflammatory and macrophage infiltration markers, but this effect was probably not mediated through increased EPA biosynthesis.
There is growing evidence that optimising dietary quality and engaging in physical activity (PA) can reduce dementia and cognitive decline risk and improve psychosocial health and quality of life (QoL). Multimodal interventions focusing on diet and PA are recognised as significant strategies to tackle these behavioural risk factors; however, the cost-effectiveness of such interventions is seldom reported. A limited cost consequence based on a 12-month cluster-randomised Mediterranean diet (MedDiet) and walking controlled trial (MedWalk) was undertaken. In addition, QoL data were analysed. Programme costs ($AUD2024) covered staff to deliver the MedWalk programme and foods to support dietary behaviour change. The primary outcome measure of this study was change in QoL utility score, measured using the Assessment of Quality of Life (AQoL-8D). Change scores were compared for the groups using general linear models while controlling for demographic factors associated with baseline group differences and attrition. Change in QoL (decreased, maintained or improved) was determined using a cross-tabulation test. MedWalk programme costs were estimated at $2695 AUD per participant and control group cost at $165 per person – a differential cost of $2530. Mean change in utility scores from baseline to 12 months was not statistically significant between groups. Nevertheless, the MedWalk group was significantly less likely to experience a reduction in their QoL (20·3 % MedWalk v. 42·6 % control group) (P = 0·020). A MedDiet and walking intervention may have a role in preventing decline in QoL of older Australians; however, longer-term follow-up would be beneficial to see if this is maintained.
Characters—parts, properties, or activities of organisms—can be individuated in multiple, non-equivalent ways. This paper aims to show how these differences matter, to frame the problem of character individuation methodologically, and to outline a path to resolving it. I describe the main scientific roles for the character concept, and analyze three broad approaches to character individuation: functional, descriptive, and developmental. I explore which approaches are appropriate for which roles, and propose two evolutionary hypotheses to explain why functionally and developmentally individuated characters diverge.
The study was conducted to determine the relationship between spirituality and the quality of life among women with breast cancer.
Methods
This study utilized descriptive correlational research and a purposive sampling technique that involved women with breast cancer. Patients with breast cancer from particular breast cancer societies and organizations in Manila made up the sample. A total of 123 participants were included in the study. The Spiritual Index of Well-Being (SIWB) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire were used to collect the needed data. Descriptive and inferential statistics were used to determine the relationship between spirituality and quality of life among women with breast cancer.
Results
A high level of spirituality and quality of life were found among the participants. Overall, the mean score of the SIWB among the participants was 4.48 (±0.670), while the quality of life score was 62.6 (±10.9). A significant negative correlation was found between spirituality and quality of life (r = -0.127, p = 0.031), while significant positive correlations were noted between quality of life and self-efficacy (r = 0.683, p < 0.001) and life schemes or meaning in life (r = 0.704, p < 0.001).
Significance of results
Although spirituality and quality of life had a negative correlation, the subscales of self-efficacy and life scheme had high positive correlations, indicating the complex dimensions of spirituality. In addition to providing coping strategies, spirituality offers patients the emotional, social, and existential support they need to deal with the unknowns of illness.
As part of healthcare-associated infections prevalence survey, we examined the prevalence of antibiotic allergies among inpatients and the possibility to de-label reported penicillin and sulfa allergies. Results show that most of the patients with a penicillin or sulfa allergy label are eligible for either direct de-labeling or oral antibiotic challenge.
In this paper we study the class of optimal entropy-transport problems introduced by Liero, Mielke and Savaré in Inventiones Mathematicae 211 in 2018. This class of unbalanced transport metrics allows for transport between measures of different total mass, unlike classical optimal transport where both measures must have the same total mass. In particular, we develop the theory for the important subclass of semi-discrete unbalanced transport problems, where one of the measures is diffuse (absolutely continuous with respect to the Lebesgue measure) and the other is discrete (a sum of Dirac masses). We characterize the optimal solutions and show they can be written in terms of generalized Laguerre diagrams. We use this to develop an efficient method for solving the semi-discrete unbalanced transport problem numerically. As an application, we study the unbalanced quantization problem, where one looks for the best approximation of a diffuse measure by a discrete measure with respect to an unbalanced transport metric. We prove a type of crystallization result in two dimensions – optimality of a locally triangular lattice with spatially varying density – and compute the asymptotic quantization error as the number of Dirac masses tends to infinity.
The Collaborative Assessment and Management of Suicidality (CAMS) framework is an evidence-based approach to treating individuals with suicidality. It involves collaboration between patients and clinicians to assess, plan and treat suicidal risk, using the Suicide Status Form. This study applies the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to explore the experiences of Irish higher education counselling staff in implementing CAMS, providing insight into the factors that influence its successful integration into student mental health services.
Methods:
A mixed-methods approach was adopted, via an online survey and follow-up interviews with student counselling staff to explore the implementation of the CAMS framework. Sixty-four staff members from student counselling services in Irish higher education institutions completed the online survey. Ten participants engaged in follow-up interviews to further explore survey findings. Data on reach, effectiveness, adoption, implementation and maintenance were gathered through the RE-AIM framework.
Results:
Survey respondents report treating approximately 44% of individuals presenting with suicidal risk using the CAMS framework. The majority (88.1%) of respondents reported positive outcomes for suicidal patients. Most respondents (91%) found the training beneficial and had ‘definitely’ or ‘somewhat’ incorporated CAMS into their management of suicidal patients. There were three main themes identified from interview data: diverse approaches to implementation, the value of CAMS in practice and challenges in implementing CAMS.
Conclusions:
CAMS has provided a strong toolkit for improving suicide-specific skills, communication and collaboration, but fidelity varies due to resource and support limitations. Additional resourcing, increased staff buy-in and further research could lead to smoother implementation in student counselling services.
Benzodiazepine use among physicians is an important public health issue related to physicians’ well-being and patient safety.
Aims
This study aimed to evaluate the patterns and correlates of benzodiazepine use in physicians by comparing the characteristics of heavy users with those of low-dose users.
Method
We identified 4844 physicians with a history of benzodiazepine use as the benzodiazepine cohort from 32 080 physicians from the population-based Taiwan National Health Insurance Research Database from 2014 to 2020. Benzodiazepine users were divided into low-dose, intermediate and heavy users based on their yearly equivalent dosage of <20, 20–150 and >150 defined daily dose (DDD) per year, respectively. Differences in demographic characteristics and specialities between the benzodiazepine and control cohorts were compared via univariate and multivariate logistic regression models. A generalised estimating equation was used to investigate the relationship between benzodiazepine use and comorbidities.
Results
Among all of the physicians, 15.1% used benzodiazepine. Male physicians were more likely to use benzodiazepines and become heavy users. Older age, sleep disorders and depression were significantly associated with heavy benzodiazepine use. Regarding physician specialities, the highest prevalence of benzodiazepine use was observed in otorhinolaryngology (19.8%), followed by family medicine (19.1%). Odds of benzodiazepine use were 2.20 and 2.90 times greater in physicians with sleep disorders and depression, respectively.
Conclusions
Comorbidities of depression and sleep disorders are associated with increased probability of benzodiazepine use. Providing stress-coping strategies and appropriate treatment for mental disorders is recommended to support the overall well-being of physicians.
A prediction framework for the mean quantities in a compressible turbulent boundary layer (TBL) with given Reynolds number, free-stream Mach number and wall-to-recovery ratio as inputs is proposed based on the established scaling laws regarding the velocity transformations, skin-friction coefficient and temperature–velocity (TV) relations. The established velocity transformations that perform well for collapsing the compressible mean profiles onto incompressible ones in the inner layer are used for the scaling of such inner-layer components of mean velocity, while the wake velocity scaling is determined such that self-consistency is achieved under the scaling law for the skin-friction coefficient. A total of 44 compressible TBLs from six direct numerical simulations databases are used to validate the proposed framework, with free-stream Mach numbers ranging from 0.5 to 14, friction Reynolds numbers ranging from 100 to 2400, and wall-to-recovery ratios ranging from 0.15 to 1.9. When incorporated with the scaling laws for velocity transformation from Griffin et al. (2021, Proc. Natl Acad. Sci., vol. 118, e2111144118), the skin-friction coefficient from Zhao & Fu (2025, J. Fluid Mech., vol. 1012, R3) and the TV relation from Duan & Martín (2011, J. Fluid Mech., vol. 684, pp. 25–59), the prediction errors in the mean velocity and temperature profiles remain within $4.0\,\%$ and $6.0\,\%$, respectively, across all tested cases. Correspondingly, the skin-friction and wall-heat-transfer coefficients are also accurately predicted, with root mean square prediction errors of approximately $3 \,\%$. When adopting different velocity transformation methods that are valid for inner-layer scaling, the root mean square prediction errors in the mean velocity and temperature profiles remain below $2.3\,\%$ and $3.6\,\%$, respectively, which further highlights the universality of the proposed framework.
In the summer of 2016, a case of potentially herbicide-resistant redroot pigweed (Amaranthus retroflexus L.) was reported in Saint-Louis-de-Gonzague (QC, Canada) in an identity-preserved soybean [Glycine max (L.) Merr.] field where imazethapyr and chlorimuron-ethyl were applied preemergence, two active ingredients that inhibit acetolactate synthase (ALS). A few years earlier, several A. retroflexus populations resistant to ALS-inhibiting herbicides were reported in Manitoba (MB). Amaranthus retroflexus samples from these fields were collected and analyzed to characterize the presence of a resistance mechanism and the associated level of resistance. Sequencing of the ALS gene revealed a mutation resulting in a serine to asparagine substitution at amino acid position 653. Dose–response experiments indicated resistance factors of 27.7 to 194.0 to imazethapyr (imidazolinones) among these populations, but susceptibility to members of all other ALS inhibitor families that were tested. In one MB population, a serine to isoleucine substitution at position 653 was observed for the first time in A. retroflexus in some of the plants, and this contributed to the detection of resistance to thifensulfuron-methyl when compared with most susceptible control population. The response of the two MB control populations to thifensulfuron-methyl differed, and resistance factors were influenced by the level of susceptibility of the control populations to thifensulfuron-methyl. The same was not observed with imazethapyr. Non–target site resistance (NTSR) was not detected in the MB populations when they were exposed to malathion before exposure to the herbicide. We identified two new mutations on the ALS gene in A. retroflexus that result in ALS inhibitor–specific cross-resistance patterns. Further investigation into NTSR and the mechanism behind the differential response of the control populations to thifensulfuron-methyl are warranted.
Iraq is among the countries most vulnerable to climate change, and it is faced with extreme heat, drought and environmental degradation.
Aims
To examine the prevalence of climate anxiety and its association with depression and generalised anxiety disorder in the Iraqi population.
Method
A cross-sectional survey recruited 1019 adult participants (47.8% males, 52.2% females). Most participants were aged 18–41 years (n = 854, 83.8%); 16.2% (n = 165) were aged 42–72 years. Regionally, 75.6% (n = 770) were from the Kurdistan Region and 24.4% (n = 249) from provinces in central and southern Iraq. The study used the Climate Change Anxiety Scale (CCAS), Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7). Statistical analyses, included descriptive analysis, analysis of variance (ANOVA), t-tests, Pearson’s correlations and regression models, examined variations in climate anxiety by demographics and associations with depression and anxiety.
Results
Overall, 71.4% of participants reported severe climate anxiety, with a higher prevalence in the Kurdistan Region (73.2%) compared with central and southern Iraq (65.9%). Five provinces were found to have significantly higher levels of climate anxiety: Ninawa, Basrah, Najaf, Duhok and Erbil. Age was a significant predictor, and older participants (42–72 years) reported higher levels than younger participants (P = 0.008). A positive correlation was observed between climate anxiety and both depression (r = 0.382, P < 0.001) and generalised anxiety (r = 0.361, P < 0.001). Simple linear regression revealed that climate anxiety was significantly associated with both depression (β = 0.25, P < 0.001) and generalised anxiety (β = 0.214, P < 0.01), accounting for the 14.6 and 13% variance, respectively.
Conclusions
Climate anxiety is prevalent in Iraq and significantly associated with mental health problems. The findings endorse the need for integration of mental health into Iraq’s national climate adaptation and public health policies.
We consider the propagation dynamics of a single species with a birth pulse and living in a shifting environment driven by climate change. We describe how birth pulse and environment shift jointly impact the propagation properties. We show that a moderate environment shifting speed promotes the spatial–temporal propagation represented by a stable forced KPP wave, and that the birth pulse shrinks the survival region.
Since the 1990s, the relocation of psychiatric patients from long-stay institutions to community-based supported living has increased globally. However, most evidence on suitable residential services comes from high-income countries, with little from low- and middle-income contexts. This study explored the experiences of residents and carers in three residential care homes for people living with serious mental illness in Sedibeng District, South Africa.
Methods
Three organisations were purposefully selected as in-depth case studies. Ninety-one face-to-face qualitative interviews were conducted with service providers, residents, and family members between October 2022 and June 2023.
Findings
Residents described severe psychosocial disability when living with families, but improved functioning in residential homes. Organisations 1 and 3 operated small 3–4-roomed houses in township areas, accommodating 21 and 40 residents respectively, who had community access and social interaction. In Organisation 3, residents formed romantic relationships, undertook paid work, and lived semi-independently. Organisation 2, a repurposed school-like building with four large dormitories for 86 residents, imposed strict movement controls; medication was used to manage behaviour, and caregivers reported safety concerns.
Conclusions
Smaller residential homes offer more autonomy and integration than large dormitory-style facilities. Policies and funding should support smaller, community-based supported accommodation for people with serious mental illness.
This article looks at the final years of French colonial rule in Dahomey through the lens of development policies concerning the territory’s main resource: the oil palm tree. It examines how the Dahomean leaders dealt with the issue of development once the Loi Cadre allowed them to have a say in the matter. I argue that the Dahomeans were crucial in finding new development strategies even before formal independence. It also tries to assess the extent to which these solutions followed or departed from previous colonial attempts. The article therefore first describes the main features of colonial oil palm development in Dahomey since the end of the Second World War. Second, it depicts how Dahomean leaders rethought the development approach and why they found in the “syndicate association” the institutional tool to implement it. Finally, it argues that this solution, which combined features of Soviet and Israeli cooperatives with approaches specific to African socialism, was different from any other option previously considered by the colonial administration. By analysing late colonialism from a non-French perspective, this article argues that the Africans were no less crucial actors than the Europeans in the making of the late colonial state.