To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Cognitive decline is intricately linked to various factors such as obesity, stress, poor sleep, and circadian rhythm misalignment, which are interrelated in their impact on cognitive health. Irregular food-intake timing further compounds these issues. The practice of prolonged nightly fasting (PNF) may help synchronize food intake with circadian rhythms, potentially mitigating adverse effects of cognitive decline and associated factors.
Methods:
A pilot nationwide, remotely delivered, 2-arm randomized controlled trial was conducted to assess the 8-week outcomes of cognition, stress, and sleep, after a PNF intervention (14-hr nightly fast, 6 nights/week, no calories after 8 pm) compared to a health education (HED) control condition. Participants were living with memory decline, stress, and obesity and had weekly check-in calls to report fasting times (PNF) or content feedback (HED).
Results:
Participants were enrolled from 37 states in the US; N = 58, 86% women, 71% white, 93% non-Latinx, mean (SD) age 50.1 (5.1) years and BMI 35.6 (3.6) kg/m2. No group differences existed at baseline. Linear mixed-effects models were used to compare outcome change differences between groups. Compared to the HED control, the PNF intervention was associated with improved sleep quality (B = −2.52; SE = 0.90; 95% CI −4.30–−0.74; p = 0.006). Perceived stress and everyday cognition significantly changed over time (p < 0.02), without significant difference by group.
Discussion:
Changing food intake timing to exclude nighttime eating and promote a fasting period may help individuals living with obesity, memory decline, and stress to improve their sleep. Improved sleep quality may lead to additional health benefits.
Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease, routinely diagnosed by direct light microscopy. The sensitivity of this method is dependent on the number of parasites present in the lesion. Immunoexpression of CD1a surface antigen by Leishmania amastigotes and its application as a diagnostic tool has been recently demonstrated in several species including Leishmania major, Leishmania tropica and Leishmania infantum. Leishmania donovani is the only reported species in Sri Lanka primarily causing CL and its CD1a status remains unexplored. We studied CD1a expression by amastigotes of L. donovani in skin biopsies from 116 patients with suspected CL. The biopsy sections were stained with CD1a clones O10 and MTB1 separately. Slit skin smear (SSS) results were considered the gold standard for diagnosis of CL. 103 cases were confirmed through SSS where 73 of them showed positive parasite staining for CD1a clone MTB1 with 70.9% sensitivity. Positivity was seen mostly in parasites closer to the epidermis. CD1a clone O10 failed to detect any amastigotes. Test sensitivity improved to 74.1% when the analysis was applied only to patients with low/no discernible Leishman-Donovan (LD) bodies in histology. Our findings show that CD1a clone MTB1 successfully stains amastigotes of L. donovani species and can be used as a supplementary diagnostic tool in detecting CL, especially when LD bodies are low in number. This method could be validated to detect other forms of leishmaniasis caused by L. donovani in Indian and sub-Saharan regions.
Graph-based semi-supervised learning methods combine the graph structure and labeled data to classify unlabeled data. In this work, we study the effect of a noisy oracle on classification. In particular, we derive the maximum a posteriori (MAP) estimator for clustering a degree corrected stochastic block model when a noisy oracle reveals a fraction of the labels. We then propose an algorithm derived from a continuous relaxation of the MAP, and we establish its consistency. Numerical experiments show that our approach achieves promising performance on synthetic and real data sets, even in the case of very noisy labeled data.
To determine the associations among iron status, depressive/anxiety symptoms, and quality of life (QoL) throughout pregnancy.
Design:
This longitudinal study recruited participants in their 1st trimester (< 13 weeks; n=116) and followed in their 2nd (n=71) and 3rd (n=71) trimesters. Sociodemographic, food security, anxiety, depressive symptoms, and QoL questions were collected. Hemoglobin (Hb), ferritin (Ft), and transferrin saturation (TSAT) were determined. Women were categorized as iron improvers or non-improvers based on changes in iron status. Associations were assessed using difference-in-difference analyses.
Setting:
Cape Coast, Ghana between October 2017 to September 2018.
Participants:
Pregnant women, 18-38 years.
Results:
Improvement in Ft levels from the 1st to 2nd trimester were associated with reduced depressive symptoms (-2.96 vs -0.58, p=0.028), and higher overall QoL (13.99 vs 1.92, p=0.006) particularly role physical (23.32 vs -2.55, p=0.025) and role emotional (27.50 vs 10.06, p=0.025) subscales. Improvement in Hb levels during the same period were linked to less anxiety, particularly fear factor (-2.62 vs -0.51, p=0.020); and worsened physical health aspect of QoL (-21.80 vs -3.75, p=0.005). Improvement in TSAT levels from 2nd to 3rd trimester were associated with increased total anxiety (1.56 vs -0.64, p=0.030) and panic factor (0.45 vs -0.26, p=0.004) and decreased total QoL (-1.08 vs 7.94, p=0.017), specifically role physical (-10.98 vs 11.93, p=0.018).
Conclusion:
Increases in iron status from first to second trimester were related to improvements in psychosocial wellbeing, implying potential benefit of iron supplementation on affect in early pregnancy. Larger studies are needed to confirm these findings.
We describe our experience implementing an intensive quality improvement cohort pilot focused on managing asymptomatic bacteriuria in 19 critical access hospitals. Participation in the pilot was high, and almost all sites identified an improvement goal and collected clinical data. Barriers to implementation included staffing shortages, turnover, and lack of bandwidth.
Prior studies have documented that working-class individuals rarely become parliamentarians. We know less about when in the career pipeline to parliament workers disappear, and why. We study these questions using detailed data on the universe of Swedish politicians’ careers over a 50-year period. We find roughly equal-sized declines in the proportion of workers on various rungs of the political career ladder ranging from local to national office. We reject the potential explanations that workers lack political ambition, public service motivation, honesty, or voter support. And while workers’ average high school grades and cognitive test scores are lower, this cannot explain their large promotion disadvantage, a situation that we label a class ceiling. Organizational ties to blue-collar unions help workers advance, but only to lower-level positions in left-leaning parties. We conclude that efforts to improve workers’ numerical representation should apply throughout the career ladder and focus on intra-party processes.
This study extends the upper echelons literature by shedding light on the role of top management team (TMT) dissimilarity, a specific conceptualization of team diversity. TMTs are typically composed of members from different functional areas who have unique information and values. The perception of the degree to which TMT members view themselves as dissimilar from other team members affects the TMT’s decision-making and, therefore, organizational outcomes. However, research does not address this perspective of TMT diversity. We examine how informational and value dissimilarity among TMT members is associated with incremental and radical innovation capability. We survey top managers from various industries and use partial least squares structural equation modeling analysis to explore the association between TMT dissimilarity and innovation capability empirically. The findings show that informational dissimilarity is positively associated with incremental innovation capability. Value dissimilarity is negatively associated with incremental innovation capability, whereas it is positively associated with radical innovation capability.
Temporal energy intake (EI) and physical activity (PA) patterns may be associated with obesity. We aimed to derive and characterise temporal EI and PA patterns, and assess their cross-sectional association with weight status, in 6-to-14-year-old Portuguese participants of the National Food, Nutrition and Physical Activity Survey 2015–2016. We extracted times and EI of all eating occasions from two 1-d food diaries/24-h recalls, while types and times of PA from 4-d PA diaries. We derived EI patterns (n 714) and PA patterns (n 595), using, respectively, a hierarchical and K-means cluster analysis, considering the average proportion of total daily EI (%TEI) and PA intensity (%TPA), within each 2-h interval across the 24-h day. Patterns were labelled based on the 2-h intervals of %TEI/TPA peaks. We assessed the association between patterns and overweight or obesity (BMI z-score ≥ +1 sd) using adjusted logistic regressions (OR (95 % CI)). Three EI patterns emerged: 1 – ‘Early afternoon and early evening’; 2 – ‘Early afternoon and late evening’; and 3 – ‘Late morning, early and mid-afternoon and late evening’. EI Pattern 3 v. Pattern 1 was negatively associated with overweight or obesity (0·49 (0·26, 0·92)). PA Pattern 1 – ‘Late morning, mid-afternoon and early evening’ v. Pattern 2 – ‘Late afternoon’, was not associated with weight status (0·95 (0·65, 1·38)). A daily EI pattern with more and even %TEI peaks at earlier daytime periods, rather than fewer and higher, may be negatively associated with overweight or obesity amongst this population whereas the identified PA patterns might have no relationship.
Let $\mathcal {O}$ be a maximal order in the quaternion algebra over $\mathbb Q$ ramified at p and $\infty $. We prove two theorems that allow us to recover the structure of $\mathcal {O}$ from limited information. The first says that for any infinite set S of integers coprime to p, $\mathcal {O}$ is spanned as a ${\mathbb {Z}}$-module by elements with norm in S. The second says that $\mathcal {O}$ is determined up to isomorphism by its theta function.
During the ill-fated 1897 Andrée balloon expedition, Nils Strindberg allegedly dropped a small tin containing a last message for his fiancée onto the island Fuglesongen in northwestern Svalbard, as the expedition crew passed over it in their hydrogen balloon, Örnen. Despite at least one lengthy search on Fuglesongen, the tin has never been found. This paper investigates the hypothesis that the tin was accidentally dropped onto Klovningen, a neighbouring island similar in size and shape, situated approximately 2.4 km east of Fuglesongen. A re-analysis of Strindberg’s original handwritten notes from the balloon flight, along with other primary sources and meteorological analyses, suggests that a targeted search for the tin on Klovningen could be a promising next step in solving this enduring mystery.
In this note we provide an upper bound for the difference between the value function of a distributionally robust Markov decision problem and the value function of a non-robust Markov decision problem, where the ambiguity set of probability kernels of the distributionally robust Markov decision process is described by a Wasserstein ball around some reference kernel whereas the non-robust Markov decision process behaves according to a fixed probability kernel contained in the ambiguity set. Our derived upper bound for the difference between the value functions is dimension-free and depends linearly on the radius of the Wasserstein ball.
While Stephen Greenblatt’s 1980 book, Renaissance self-fashioning: from More to Shakespeare, was methodologically innovative within the field of literary criticism, his work also grew from the roots of Jacob Burckhardt’s old cultural history, and his method of new historicism developed alongside the new cultural history. Although certain parts of Burckhardt’s arguments have been discarded, the work of Greenblatt and others has continued to build upon his foundation. Courtiership, anxiety, and the relationship between outward and interior identities, text and context, hybridity, and individuation are all useful concepts for constructing less monolithic understandings of early modern identities. With a European scale, this article traces early modern historiography and literary criticism from the nineteenth century to 2024 and introduces historical examples of identity formation from early modern England, France, Iberia, the Italian peninsula, and the Holy Roman Empire. The article reflects upon early modern examples of self-fashioning in the light of Burckhardt, the Annales, Greenblatt, and others who have contributed to our understanding of agency and identity up to the present day, arguing that these historians and literary scholars have worked together to answer questions that are fundamentally psychological in nature.
Adults of the genus Posthodiplostomum, Dubois, 1936 are parasites of fish-eating birds, mainly of the family Ardeidae, and are globally distributed. The genus currently comprises 35 species, although recent molecular evidence has shown that the diversity of the genus is underestimated since several candidate species have been recognized. In the Neotropical region of Mexico, at least 6 Posthodiplostomum lineages have been detected with metacercaria stages recovered from unrelated fish hosts. Here, we obtained adult specimens of Posthodiplostomum from 6 fish-eating birds representing 2 families (Butorides virescens, Ardea herodias, Nycticorax nycticorax, Tigrisoma mexicanum – Ardeidae, and Rynchops niger and Leucophaeus atricilla – Lariidae) from 4 localities in southern Mexico. Specimens were sequenced for 2 nuclear (28S and ITS1–5.8S–ITS2) and 1 mitochondrial (cox1) molecular marker. Phylogenetic analyses allowed us to link metacercariae and adult specimens and recognized a lineage, which was described morphologically. The new species can be distinguished from its congeners by its prosoma morphology and body size; this is the first described species in the Neotropical region of Mexico. Additionally, new host and locality records for P. macrocotyle and P. pricei are presented, expanding their geographical distribution range in the Americas.
Authentic leadership studies are often criticised for the limited use of causally defined research designs. To advance scholarship is this area, this article presents a scoping review on the use of experimental designs to examine causality in authentic leadership. Eleven publications were identified, which presented 16 experiments that met the inclusion criteria. Generally, these experiments tested authentic leadership as an antecedent; were conducted online; used a one-factor design; involved large samples, typically of working adults or residents; involved a manipulation check; involved the use of written vignettes to manipulate levels of authentic leadership; included counterfactual conditions; culminated with outcomes pertaining to followers; and established the causal effects of authentic leadership on the outcome(s) of interest. These findings suggest the value of: written vignettes; multi-method approaches; and online experiments. They also highlight opportunities to advance authentic leadership research through the use of sequential experiments and immersive technologies.
On September 17, 2024, an unforeseen attack due to the Pagers Explosion targeting a military party in Lebanon left more than 2750 casualties. A total of 38 injured patients presented to the Lebanese American University Medical Center-Rizk Hospital (LAUMC-RH), a private university hospital. Most injuries were amputated fingers and eye injuries. Intensive training and regular drills are conducted at the hospital level to ensure readiness. This report highlights major challenges that were encountered during this explosion and provides possible strategies to overcome them.
Various studies have highlighted the increased incidence and symptoms of depression and anxiety in paediatric cancer survivors (PCS). Yet no meta-analysis has focused on post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms (PTSS) in PCS and their family nucleus.
Aims
To evaluate the overall risk of PTSD and severity of PTSS in PCS and their family nucleus. Secondary objectives include identifying potential risk factors of PTSD and high PTSS.
Method
We systematically searched PubMed, Embase and PsycINFO for studies comparing the risk of PTSD and PTSS severity among PCS, their family nucleus and non-cancer controls. PRISMA reporting guidelines were followed. Random effects meta-analyses and meta-regressions were conducted.
Results
From 1089 records, we included 21 studies. PCS have an increased risk of PTSD (risk ratio 2.36, 95% CI 1.37–4.06) and decreased PTSS severity (standardised mean difference −0.29, 95% CI −0.50 to −0.08). Subgroup analyses of other categorical study-level characteristics revealed that female PCS who were older at diagnosis and data collection had a significantly higher risk of PTSD. Meta-regression were insignificant. Family nucleus did not show a significantly increased risk of PTSD (risk ratio 1.13, 95% CI 0.59–5.00) and PTSS severity (standardised mean difference 0.53, 95% CI −0.00 to 1.06). Systematically reviewing studies on the family nucleus found that the majority reported a significantly increased risk of psychological trauma compared with the comparator. Lower education, income and social status were also risk factors.
Conclusions
Timely identification and interventions are imperative for policy makers and healthcare providers to prevent trauma from worsening in this population group.
This article explores how Protestants defended the co-existence of multiple translations of the Bible into English in Elizabethan England. The matter of biblical plurality is considered through the prism of the debates surrounding bible translation which occurred throughout the 1580s between the Catholic translator of the Bible into English, Gregory Martin (c. 1542–1582), and the English Protestant polemicist William Fulke (1537/8–1589). It is contended that this debate, which has tended to be cast as a storm in a teacup, reveals how Protestants responded, innovatively, to the publication of the Catholic English New Testament. Attention is paid to how Martin attacked the existence of the many different Protestant English bible translations in circulation and, reciprocally, how Fulke defended them. This study of the Martin and Fulke debate thereby unsettles some long-standing assumptions about the combative relationship between different versions of the English Bible and it points, instead, to ways in which contemporaries might have seen the plurality of translations as spiritually and polemically advantageous. Fulke's arguments help us to comprehend how, prior to early seventeenth-century attempts to restrict the existence of multiple English bibles, some Elizabethans responded to, and even defended, the plurality of English bible translations which had come to exist.
Asymptomatic bacteriuria (ASB) treatment is a common form of antibiotic overuse and diagnostic error. Antibiotic stewardship using the inappropriate diagnosis of urinary tract infection (ID-UTI) measure has reduced ASB treatment in diverse hospitals. However, critical access hospitals (CAHs) have differing resources that could impede stewardship. We aimed to determine if stewardship including the ID-UTI measure could reduce ASB treatment in CAHs.
Methods:
From October 2022 to July 2023, ten CAHs participated in an Intensive Quality Improvement Cohort (IQIC) program including 3 interventions to reduce ASB treatment: 1) learning labs (ie, didactics with shared learning), 2) mentoring, and 3) data-driven performance reports including hospital peer comparison based on the ID-UTI measure. To assess effectiveness of the IQIC program, change in the ID-UTI measure (ie, percentage of patients treated for a UTI who had ASB) was compared to two non-equivalent control outcomes (antibiotic duration and unjustified fluoroquinolone use).
Results:
Ten CAHs abstracted a total of 608 positive urine culture cases. Over the cohort period, the percentage of patients treated for a UTI who had ASB declined (aOR per month = 0.935, 95% CI: 0.873, 1.001, P = 0.055) from 28.4% (range across hospitals, 0%-63%) in the first to 18.6% (range, 0%-33%) in the final month. In contrast, antibiotic duration and unjustified fluoroquinolone use were unchanged (P = 0.768 and 0.567, respectively).
Conclusions:
The IQIC intervention, including learning labs, mentoring, and performance reports using the ID-UTI measure, was associated with a non-significant decrease in treatment of ASB, while control outcomes (duration and unjustified fluoroquinolone use) did not change.
Reynolds-Averaged Navier–Stokes (RANS) simulations, both steady and unsteady, are used to investigate supersonic, chemically reacting, flow fields inside a strut-stabilised supersonic combustion ramjet (scramjet) engine operating under different fuel flow rates. Fully supersonic, fully subsonic and mixed modes of operations inside the combustor, obtained at different fuel flow rates, are studied numerically through shock wave visualisations and top-wall static-pressure probing. The effect of changing fuel flow rates, imposed both suddenly and gradually, on the behaviour of shock waves and wall pressure profiles are studied in detail. For certain modes of combustion characterised by the presence of oblique shocks at the strut, shockwaves in the combustor respond predictably to an increase or decrease in fuel flow rate attaining the steady state flow fields as predicted by RANS simulations for those fuel flow rates. For certain other modes of combustion, characterised by the presence of shockwaves in the isolator and the absence of oblique shocks at the leading edge of the strut, shockwaves in the flow field appear unstable to fuel flow rate modulations. For such cases, any change in fuel flow rates, sudden or gradual, increase or decrease, causes the isolator shocks to immediately move upstream and eventually out of the isolator. A plausible physics-based explanation of the observed phenomena is presented.
Growing evidence suggests that direct oral anticoagulants (DOACs) may be suitable for cerebral venous thrombosis (CVT). The optimal strategy regarding lead-in parenteral anticoagulation (PA) prior to DOAC is unknown.
Methods:
In this post hoc analysis of the retrospective ACTION-CVT study, we compared patients treated with DOACs as part of routine care: those given “very early” DOAC (no PA), “early” (<5 days PA) and “delayed” (5–21 days PA). We compared baseline characteristics and outcomes between the very early/early and delayed groups. The primary outcome was a composite of day-30 CVT recurrence/extension, new peripheral venous thromboembolism, cerebral edema and intracranial hemorrhage.
Results:
Of 231 patients, 11.7% had very early DOAC, 64.5% early (median [IQR] 2 [1–2] days) and 23.8% delayed (5 [5–6] days). More patients had severe clinical/radiological presentations in the delayed group; more patients had isolated headaches in the very early/early group. Outcomes were better in the very early/early groups (90-day modified Rankin Scale of 0–2; 94.3% vs. 83.9%). Primary outcome events were rare and did not differ significantly between groups (2.4% vs. 2.1% delayed; adjusted HR 1.49 [95%CI 0.17–13.11]).
Conclusions:
In this cohort of patients receiving DOAC for CVT as part of routine care, >75% had <5 days of PA. Those with very early/early initiation of DOAC had less severe clinical presentations. Low event rates and baseline differences between groups preclude conclusions about safety or effectiveness. Further prospective data will inform care.