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The Whitham equation is a non-local, nonlinear partial differential equation that models the temporal evolution of spatial profiles of surface displacement of water waves. However, many laboratory and field measurements record time series at fixed spatial locations. To directly model data of this type, it is desirable to have equations that model the spatial evolution of time series. The spatial Whitham (sWhitham) equation, proposed as the spatial generalization of the Whitham equation, fills this need. In this paper, we study this equation and apply it to water-wave experiments on shallow and deep water. We compute periodic travelling-wave solutions to the sWhitham equation and examine their properties, including their stability. Results for small-amplitude solutions align with known results for the Whitham equation. This suggests that the systems are consistent in the weakly nonlinear regime. At larger amplitudes, there are some discrepancies. Notably, the sWhitham equation does not appear to admit cusped solutions of maximal wave height. In the second part, we compare predictions from the temporal and spatial Korteweg–de Vries and Whitham equations with measurements from laboratory experiments. We show that the sWhitham equation accurately models measurements of tsunami-like waves of depression, waves of elevation, and solitary waves on shallow water. Its predictions also compare favourably with experimental measurements of waves of depression and elevation on deep water. Accuracy is increased by adding a phenomenological damping term. Finally, we show that neither the sWhitham nor the temporal Whitham equation accurately models the evolution of wave packets on deep water.
This paper reviews the existing literature to identify specific challenges that may arise in the context of providing palliative and end-of-life (EOL) care for Hindu patients in the physical, psychological, and spiritual domains. We offer practical strategies where appropriate to mitigate some of these challenges. We review how the Hindu faith impacts EOL decision-making, including the role of the family in decision-making, completion of advance directives, pain management, and decisions around artificial nutrition and hydration (ANH) and cardiopulmonary resuscitation (CPR).
Methods
The PubMed, MEDLINE Complete, Cochrane, and Embase databases were searched for articles using the search strings combinations of keywords such as Palliative care, Hindu, Hinduism, End of Life Care, India, Spirituality, and South Asian. Once inclusion criteria were applied, 40 manuscripts were eligible for review.
Results
Our results are organized into the following 4 sections – how Hindu religious or spiritual beliefs intersect with the physical, psychological, and spiritual domains: and decision-making at the EOL.
Significance of results
Hindu beliefs, in particular the role of karma, were shown to impact decision-making regarding pain management, ANH and CPR, and advance directive completion. The complexity of Hindu thought leaves a significant role for interpretation and flexibility for individual factors in decision-making at the EOL.
This article considers three “unanswered questions” raised by R. (McConnell) v Registrar General for England and Wales (AIRE Centre Intervening) [2020] EWCA Civ. 559, which held that a trans man (with a Gender Recognition Certificate) who gave birth must be registered as “mother” on his child’s birth certificate. This article considers these questions to clearly situate McConnell within the context of the UK’s legal regimes concerning access to fertility treatment, gender recognition and legal parenthood in cases involving assisted reproduction. The article argues that clearly establishing the current legal position will provide the proper context to facilitate any subsequent legal reforms.
Sustainability is becoming a major strategic driver within the aviation industry, which has moved from providing primarily economic benefits to delivering the ‘triple bottom line’, including social and environmental impact as well as financial performance. Sustainable aviation is also being tracked by the International Civil Aviation Organisation (ICAO) Global Collation for Sustainable Aviation. Operations and Infrastructure is an important near-term opportunity to deliver sustainability benefits. Digital Technologies, Integrated Vehicle Health Management (IVHM) and Maintenance Repair and Overhaul (MRO) play a prominent role in implementing these benefits, with a particular focus on operational efficiencies. As part of this, the sustainable smart hangar of the future is a concept that is becoming more and more important in forming the future of the aviation industry. The Hangar of the Future is an excellent opportunity for innovation, combining the progress in manufacturing, materials, robotics and artificial intelligence technologies. Succeeding in developing a hangar with these characteristics will provide us with potential benefits ranging from reduced downtime and costs to improved safety and environmental impact. This work explores some of the key features related to the sustainable smart hangar of the future by discussing research that takes place in DARTeC’s (Digital Aviation Research and Technology Centre) hangar led by the IVHM Centre in Cranfield. Additionally, the paper touches on some longer-term aspirations.
The proto-Milky Way epoch forms the earliest stars in our galaxy and sets the initial conditions for the subsequent disk formation. Recent observations showed that the [$\alpha$/Fe] ratio among in situ metal-poor stars declined between [Fe/H] $=-3$ and $-1.3$ until it reached the lowest value ($\sim$0.25) and rose to the traditional value associated with the high-[$\alpha$/Fe] thick disk ($\sim$0.3) at [Fe/H] $\approx$ -1.0. It was suggested that the rise in [$\alpha$/Fe] could be caused by an increase in the star formation efficiency (SFE), known as the ‘simmering’ phase scenario. However, gas inflow also plays a vital role in shaping the star formation history and chemical evolution of galaxies, especially during the earliest epoch of the universe. We investigate this unexpected [$\alpha$/Fe]-rise with an experiment involving a galactic chemical evolution model. Our model has five free parameters: the mass of the initial reservoir of the cold interstellar medium (ISM) at birth, the frequency of Type Ia supernovae (SNe Ia), the cooling timescale of the warm ISM, the SFE, and the inflow rate of fresh gas. The last two free parameters were allowed to change after [$\alpha$/Fe] reached its lowest value, dividing the proto-Galaxy epoch into two phases. The models that reproduced the observed [Fe/H]-[$\alpha$/Fe]-track provided estimates for these fundamental parameters of the proto-Milky Way. We find that the rise in [$\alpha$/Fe] could also be caused by a large inflow of high-[$\alpha$/Fe] gas and conclude that the [$\alpha$/Fe]-rise could be a signature of the gas accretion that fuelled the formation of the Milky Way disk.
The interaction between deformable surfaces and oscillatory driving is known to produce complex secondary time-averaged flows due to inertial and elastic nonlinearities. Here, we revisit the problem of oscillatory flow in a cylindrical tube with a deformable wall, and analyse it under a long-wave theory for small deformations, but for arbitrary Womersley numbers. We find that the oscillatory pressure does not vary linearly along the length of a deformable channel, but instead decays exponentially with spatial oscillations. We show that this decay occurs over an elasto-visco-inertial length scale that depends on the material properties of the fluid and the elastic walls, the geometry of the system, and the frequency of the oscillatory flow, but is independent of the amplitude of deformation. Inertial and geometric nonlinearities associated with the elastic deformation of the channel drive a time-averaged secondary flow. We quantify the flow using numerical solutions of the perturbation theory, and gain insight by developing analytic approximations. The theory identifies a complex non-monotonic dependence of the time-averaged flux on the elastic compliance and inertia, including a reversal of the flow. Finally, we show that our analytic theory is in excellent quantitative agreement with the three-dimensional direct numerical simulations of Pande et al. (Phys. Rev. Fluids, vol. 8, no. 12, 2023, 124102).
Patients with advanced cancer present various symptoms as their disease progresses. Among these, fatigue is a frequent symptom in patients with advanced cancer and is associated with decreased quality of life (QOL). However, there are few reports regarding its association with thiamine deficiency (TD).
Methods
We report a case in which we found TD in a patient with advanced lung cancer who presented with weight loss, significant fatigue, and appeared to have a worsening general condition, for whom symptoms were dramatically improved within a short period of time by intravenous administration of thiamine.
Results
The patient was a 76-year-old woman who had been diagnosed with lung cancer and liver metastases 6 months earlier. Due to interstitial pneumonia, she was not a candidate for chemotherapy and so palliative care was started. At 8 months after initial diagnosis, the patient complained of fatigue during a medical examination, so a blood sample was taken. A week later, she visited the hospital with a cane. She felt extremely fatigued and was unable to stand, but results from the previous blood test revealed that a TD. The fatigue disappeared 15 minutes after intravenous administration of thiamine and she was able to return home without the cane.
Significance of results
Fatigue is a frequent symptom in advanced cancer patients, and TD may be the underlying cause. Inclusion of TD in the differential diagnosis may contribute to improving patient QOL.
Medications with anticholinergic properties are associated with a range of adverse effects that tend to be worse in older people.
Aims
To investigate medication regimens with high anticholinergic burden, prescribed for older adults under the care of mental health services.
Method
Clinical audit of prescribing practice, using a standardised data collection tool.
Results
Fifty-seven trusts/healthcare organisations submitted data on medicines prescribed for 7915 patients: two-thirds (66%) were prescribed medication with anticholinergic properties, while just under a quarter (23%) had a medication regimen with high anticholinergic burden (total score ≥3 on the anticholinergic effect on cognition (AEC) scale). Some 16% of patients with a diagnosis of dementia or mild cognitive impairment were prescribed medication regimens with a high anticholinergic burden, compared with 35% of those without such diagnoses. A high anticholinergic burden was mostly because of combinations of commonly prescribed psychotropic medications, principally antidepressant and antipsychotic medications with individual AEC scores of 1 or 2.
Conclusions
Adults under the care of older people's mental health services are commonly prescribed multiple medications for psychiatric and physical disorders; these medication regimens can have a high anticholinergic burden, often an inadvertent consequence of the co-prescription of medications with modest anticholinergic activity. Prescribers for older adults should assess the anticholinergic burden of medication regimens, assiduously check for adverse anticholinergic effects and consider alternative medications with less anticholinergic effect where indicated. The use of a scale, such as the AEC, which identifies the level of central anticholinergic activity of relevant medications, can be a helpful clinical guide.
Microplastics pollution is a widely recognized issue, although significant analytical challenges remain to be overcome in order to achieve a more comprehensive ecological understanding. The complex nature of this pollutant, with its variable physical and chemical properties, presents considerable challenges when it comes to establishing standardized methods for studying it. One crucial factor that influences its toxicity is particle size, yet even this parameter lacks a well-established framework, especially in the case of nanoplastics. Although the size range limits are already proposed in the literature, where the most acceptable values for microplastics are from 1 to 5,000 μm and for nanoplastics are from 1 to 1,000 nm, we propose narrowing these limits to 0.1–1,000 μm and 10–100 nm, respectively. We based our discussion on conceptual terminology, polymer structure and toxicity, highlighting the significance of accurately defining their size range. The standardization of these limits will allow the development of more efficient approaches to studying this pollutant, enabling a comprehensive understanding of its ecological consequences and potential risks.
Literature emphasises the importance of identifying and intervening in the adoption of unhealthy lifestyle behaviours (ULBs) during adolescence at an early stage, to mitigate their long-term detrimental effects. Among the possible associated factors contributing to ULBs, attention-deficit hyperactivity disorder (ADHD) has been shown to play an important role. However, little is known about ADHD subclinical manifestations.
Aims
The present study aimed to bridge the gap in the literature and shed light on the relationship between subclinical ADHD and early adoption of ULBs during adolescence. Through a clinimetric approach, prevalence of ULBs, severity of ADHD symptoms and psychosocial factors (i.e. allostatic overload, abnormal illness behaviour, quality of life, psychological well-being) were investigated among adolescents. The associations between different degrees of ADHD, ULBs and psychosocial factors were also explored.
Method
This multicentre cross-sectional study involved 440 adolescents (54.5% females; mean age 14.21 years) from six upper secondary schools. Participants completed self-report questionnaires on sociodemographic characteristics, ULBs, ADHD symptoms and psychosocial factors.
Results
The most common ULBs were energy drinks/alcohol consumption and problematic smartphone use. Of the sample, 22% showed subclinical ADHD and 20.2% showed clinical ADHD. The subclinical ADHD group showed several ULBs (i.e. altered mindful eating, impaired quality of sleep, problematic technology use) and psychosocial factors, akin to those of ADHD group and different from peers without ADHD symptoms.
Conclusions
Since subclinical ADHD manifestation is associated with ULBs, similarly to clinical ADHD, identifying subthreshold symptoms during adolescence is crucial, as it could improve health-related outcomes in adulthood across different domains.
To bring linguistic theory back in touch with commonplace observations concerning the resilience of language in use to language change, language acquisition and ungrammaticality, Pullum and colleagues have argued for a ‘model-theoretic’ theory of syntax. The present paper examines the implications for linguists working in standard formal frameworks and argues that, to the extent that such theories embrace monotonicity in syntactic operations, they qualify as model-theoretic under some minor modifications to allow for the possibility of unknown words.
This study aimed to explore the experiences and support requirements of psychiatrists undergoing investigations within their mental health organisation. An anonymous online survey was distributed to all non-training psychiatrists registered as members of the Royal College of Psychiatrists.
Results
Of the 815 psychiatrists who responded to the survey, 287 (35%) had been investigated. The majority (76%) were unaware of the concerns before being notified, 36% lacked understanding and 62% experienced timeline deviations. Furthermore, 34% had concerns over conflicts of interest, with 52% perceiving the investigation as unfair, 62% were not informed of their rights. Many respondents reported feeling isolated and lacking support and experienced significant psychological distress, such as symptoms of post-traumatic stress disorder. Suggestions for improvement included better communication, transparency, impartiality, adherence to timelines, proactive support and oversight, and opportunities for learning and reparation post-investigation.
Clinical implications
Mental health service providers should recognise the multifaceted nature of complaints and provide comprehensive support and guidance to psychiatrists undergoing investigations.
Oloyede and colleagues advocate for updating haematological monitoring requirements for clozapine, arguing that current protocols overestimate the risk of clozapine-induced agranulocytosis. Their research suggests that stringent monitoring may unnecessarily limit access to clozapine, a crucial treatment for resistant schizophrenia. The editorial supports calls for international consensus to carefully weigh the pros and cons of relaxing monitoring guidelines while ensuring comprehensive care for patients.
Bioethics as a philosophical discipline deals with matters of life and death. How it deals with them, however, depends on the kind of life particular bioethicists focus on and the kind of value they assign to it. Natural-law ethicists and conservative Kantians emphasize biological human life regardless of its developmental stage. Integrative bioethicists also embrace nonhuman life if it can be protected without harming humans. Liberal and utilitarian moralists concentrate on life that is sentient and aware of itself, to the exclusion of biological existence devoid of these. Extinctionist and antinatalist philosophers believe that life’s value is negative and that its misery should be alleviated and terminated by not bringing new individuals into existence. As the last-mentioned approach reverses the idea of life’s positive value, it could be called oibethics.
Numerous differences exist between and within research projects related to assessment and operationalization of potentially traumatic events (PTEs) for youth, especially when measuring polyvictimization. However, few studies have systematically examined how polyvictimization measurement differences influence PTE’s relation to functioning. This study sought to address these knowledge gaps by conducting a secondary data multiverse replication (SDMR) to systematically (re)evaluate PTE polyvictimization measurement approaches. Participants included 3297 adolescents (Mage = 14.63; 50.59% female; 65.15% white) from the National Survey of Adolescents-Replication study who completed a structured interview on PTE exposure and emotional and behavioral health (i.e., posttraumatic stress and major depressive disorder, drug and alcohol use, and delinquency). Results indicated that PTE operationalizations using a count variable tended to demonstrate better model performance and prediction of youth at-risk of emotional and behavioral health challenges, compared to models using a binary (yes/no) PTE operationalization. Differences in model performance and prediction were less distinct between models examining multiple forms of a single type of PTE (e.g., maltreatment, community violence), compared to models examining multiple PTE types. These findings emphasize the importance of using multidimensional approaches to PTE operationalization and the need for more multiverse analyses to improve PTE evidence-based assessment.
Water shapes the planet and all life upon it. Breaking down traditional disciplinary barriers, this accessible, holistic introduction to the role and importance of water in Earth's physical and biological environments assumes no prior knowledge. It provides the reader with a clear and coherent explanation of the unique properties of water and how these allow it to affect landscapes and underpin all life on Earth. Contemporary issues surrounding water quality – such as the rise of microplastics and climate change – are highlighted, ensuring readers understand current debates. Giving all of the necessary background and up-to-date references, and including numerous examples and illustrations to explain concepts, worked mathematical calculations, and extensive end-of-chapter questions, this is the ideal introductory textbook for students seeking to understand the inextricable links between water and the environment.