We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
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 [email protected]
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.
In recent years, the rapid convergence of artificial intelligence (AI) and low-altitude flight technology has driven significant transformations across various industries. These advancements have showcased immense potential in areas such as logistics distribution, urban air mobility (UAM) and national defense. By adopting the AI technology, low-altitude flight technology can achieve high levels of automation and operate in coordinated swarms, thereby enhancing efficiency and precision. However, as these technologies become more pervasive, they also raise pressing ethical or moral concerns, particularly regarding privacy, public safety, as well as the risks of militarisation and weaponisation. These issues have sparked extensive debates. In summary, while the integration of AI and low-altitude flight presents revolutionary opportunities, it also introduces complex ethical challenges. This article will explore these opportunities and challenges in depth, focusing on areas such as privacy protection, public safety, military applications and legal regulation, and will propose strategies to ensure that technological advancements remain aligned with ethical or moral principles.
High intake of dietary advanced glycation end products (AGE) could induce oxidative stress, inflammation and the gut microbiota dysbiosis processes that play a major role in the development of functional gastrointestinal disorders (FGID). There is limited data on the association between AGE intake and FGID. Therefore, this study aimed to examine the association of AGE with FGID in Iranian adults. In a cross-sectional analysis under the framework of the Isfahan functional disorders study, data on 1892 Iranian healthy adults aged 18–65 years were examined. Participants’ dietary intakes were collected using a validated dish-based, 106-item FFQ. Dietary AGE content of seventy-two food items was measured for all participants. FGID were assessed using Rome IV criteria. In total, 38 % of subjects had one of the most prevalent upper or lower FGID. The mean of AGE intake was 14690·10 (sd 8797·25) (kU/gr). In the fully adjusted model, being in the highest v. lowest tertile of AGE intake was associated with increased odds of FGID (OR = 1·78; 95 % CI: 1·01, 3·36). In stratified analysis by sex, males in the highest tertile of AGE intake showed higher odds of FGID than those in the lowest tertile (OR = 2·15; 95 % CI: 1·04, 4·45). However, in females, the AGE intake was not significantly associated with the risk of FGID in the fully adjusted model. Higher AGE intake was significantly associated with an increased risk of FGID, particularly in men. Further prospective studies are warranted to confirm these findings.
Attention deficit/hyperactivity disorder (ADHD) prevalence has increased in the last 10 years, most likely due to increased recognition by clinicians. Even so, an issue with under-diagnostics may persist. Historically ADHD has been described as a male-dominant disorder. However, recent evidence shows that ADHD prevalence is similar between the sexes, but that the related impairment or symptomatology might vary. This study estimated the prevalence of undiagnosed ADHD symptoms (pADHD) and explored the sex-stratified symptomatology and associations with self-perceived health-related quality of life (HRQL) and experience of depressive symptoms.
Methods
This was done in a unique cohort of 50,937 healthy blood donors – individuals who successfully maintain regular commitments despite potential ADHD symptoms. ADHD symptoms were estimated using the Adult ADHD Self-Report Scale (ASRS), health-related quality of life (HRQL) measured using mental and physical component scores (MCS/PCS) estimated based on a 12-item Short-Form Health Survey (SF-12) with a higher score indicating better HRQL, and depressive symptoms were measured using Major Depression Inventory (MDI) with higher score indicating more depressive symptoms.
Results
In total, 3% were classified with pADHD (sex ratio 1:1). pADHD was associated with reduced MCS and PCS, and increased MDI score. Males scored on average higher on inattentive symptoms compared to females, whereas females scored on average higher on hyperactive-impulsive symptoms. Individuals scoring high on the combined inattentive and hyperactive-impulsive ADHD symptom presentation were most likely to be impaired in terms of higher MDI scores and lower PCS when compared to non-ADHD controls.
Conclusions
In conclusion, ADHD symptoms are common in this seemingly healthy and undiagnosed population. Symptom presentations differ between sexes and the type of presentation seems to impact the association with depressive symptoms and level of reduced HRQL.
Understanding wave kinematics is crucial for analysing the thermodynamic effects of sloshing, which can lead to pressure drops in non-isothermal cryogenic fuel tanks. In the research reported here, Faraday waves in a horizontal circular tank (partially filled with water) under vertical excitation are investigated. The tank geometry is referred to as a horizontal circular tank throughout, with its circular face oriented perpendicular to the horizontal plane. Firstly, this paper addresses the eigenvalue problem through linear potential flow theory, in order to provide theoretical evidence of Faraday waves in horizontal circular tanks, the impact the density ratio has on the eigenvalues is then considered. Secondly, an experimental investigation testing multiple liquid fill levels is conducted. A soft-spring nonlinear response is demonstrated throughout the parameter space. The results showed larger sloshing amplitudes for low fill levels and smaller sloshing amplitudes for high fill levels. Asymmetry between anti-nodes at the container sidewalls and through the tank centreline are evident for low fill levels. Moreover, the sloshing wave amplitude at which breaking waves occur is smaller for high fill level conditions. Finally, period tripling was observed for all fill levels tested, confirming nonlinear mode interactions before the onset to wave breaking.
Of 313 patients whose outpatient parenteral antimicrobial therapy was managed by an ID physician, only 39 [12.5%, 95% CI (8.8%–16.1%)] had clinical decisions influenced by erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), or both. ESR/CRP ordering was associated with $530 in excess cost per treatment course (average duration 5.1 weeks) representing a diagnostic stewardship opportunity.
Natoli et al present a comprehensive higher level framework aligning dimensional personality pathology assessment with treatment delivery through a hierarchical model. Their approach integrates common therapeutic factors with trait-specific interventions, offering a promising pathway for clinical implementation. Despite strong evidence supporting the superiority of dimensional models and the field's shift towards dimensional classification, they remain largely unused in clinical practice after a decade, despite evidence of clinical utility and learnability. Although the authors’ framework demonstrates how dimensional approaches could work in practice, particularly through matching severity to treatment intensity and traits to specific interventions, healthcare systems require evidence of improved clinical outcomes before undertaking systemic change. Without controlled trials demonstrating enhanced treatment effectiveness, dimensional models risk remaining theoretically superior but practically unused. While healthcare systems remain tethered to categorical diagnostic approaches, the authors’ framework offers a practical pathway for implementing dimensional models – one that now requires testing in real-world settings.
The tradition of sepulchre, the recognition that a human body has intrinsic emotional and moral worth to those left behind after death and thus should be handled with dignity and respect, is timeless and knows few cultural boundaries. Its basic tenets are codified in international humanitarian law (IHL) – but codification and interpretation are entirely different things. What does it mean to state that parties to a conflict should ensure that bodies are handled with “adequate care”? What constitutes adequate? What precisely does it mean that bodies should not be “despoiled”? US courts have wrestled with the rights of surviving family members – and the corresponding duties of society – for over 200 years and have slowly crafted a cohesive and comprehensive consensus body of law as it relates to sepulchre. This article presents some of the logic and rationale used by American jurists in the evolution of US common and statutory law controlling the management of the dead in the hope that it may provide some insight into the interpretation of IHL.
Irenaeus has tended to be a bit player in modern narratives of the Nestorian controversy. Where the count features in accounts of the church politics of the 430s, it is as an essentially ‘secular’ figure: a conduit to the palace and supplier of coercive force for Nestorius and his Syrian episcopal allies. This article argues that Irenaeus was much more directly involved in doctrinal debate and the maintenance of ecclesiastical alliances than has been appreciated. The theological engagement and startling career shifts of this imperial count-turned-heresiarch-turned-bishop exemplify the significance of elite Christian patronage and official doctrinal engagement in 430s Constantinople.
The methods of economic evaluation and HTA should be based on best practices and standards, tailored to unique country contexts that can be systematically applied to inform decisions. This paper outlines standards for the conduct of economic evaluations for HTA in Ghana.
Methods
A five-step process was followed to develop the HTA reference case as a methodological and reporting benchmark. These include (a) a review of literature and evidence synthesis, (b) a review of country policies, (c) a review and adaption of international frameworks, (d) expert/stakeholder consultations, and (e) the development of a methodological framework. A series of stakeholder consultations were done to refine, finalize, and validate the outcomes of the processes to generate a finalized reference case.
Results
The Ghana reference case is made up of 14 components comprising: evidence synthesis, evaluation type, perspectives on cost, perspectives of outcomes, choice of comparator, data sources, outcome measures, discount rate, uncertainty, equity considerations, time horizon, heterogeneity, transparency, and budget impact. These provide methodological considerations and reporting requirements for economic evaluations for HTA. It provides a framework to ensure the best research methods are adopted to harmonize the evidence-generation process with the expectations of policy and decision-makers and ensure that policy decisions are based on uniform evidence.
Conclusion
Recommendations set out in this reference case when followed can provide context-specific evidence to support a rigorous and transparent system for evaluating healthcare interventions and technologies. It will support decision-making, ultimately improving the quality and efficiency of healthcare delivery in the country.
In the UK, access to dignified and compassionate palliative care is increasingly being reported as inadequate. This is a particular issue in South-West England, where there is an ageing population, historical lack of research, and particular challenges due to its rural and coastal location. The aim of this study was to provide a holistic view of patient and family experiences of care toward the end-of-life in this location and to collaboratively identify the challenges they face.
Methods
Six qualitative focus groups were held with people who were toward the end of their life, family/carers, and people who were bereaved. Participants were recruited via hospice networks. Most focus groups were face-to-face, and all were facilitated by two researchers.
Results
A range of challenges were identified at different stages of the patient and family carer journey near the end-of-life. These included issues related to the delivery of care, such as communication challenges, a lack of out of hours care, and also a lack of personalized care. Patients and families also experienced everyday challenges due to the impact of living with a life-shortening condition and altered family dynamics as family members became carers. There were also some traumatic experiences of death and a sense of abandonment when care could not be accessed.
Significance of results
This study provides a core first step in developing partnership working with members of the public, which can be built upon to develop future research agendas. This work has identified areas for improvement, so that ultimately, end-of-life experience for the individual, their carers, and families can be improved.
In this study, we focus on European immigration attitudes in the perspective of deservingness perceptions and political orientation. Our data are conducted from the European Social Survey (2016) database, which contains 21 European countries and 39,400 participants. We used the multilevel method to study the relationship between immigration attitudes and deservingness perceptions. The results demonstrate that the more negative deservingness perceptions are, the more negative immigration attitudes more likely become. Moreover, country-level political orientation moderate the relationship between immigration attitudes and deservingness perceptions. Deservingness perceptions have a greater role in explaining immigration attitudes on countries with political left-context, which gives us a new perspective to understand the public debates about immigration.
Chronic headache after aneurysmal subarachnoid hemorrhage (aSAH) remains an ongoing area of investigation, with uncertainty regarding its prevalence and long-term outcomes.
Methods:
A systematic review was conducted across five databases – Medline (Ovid), the Cochrane Central Register of Controlled Trials (Ovid), PsychInfo (Ovid), Embase (Ovid) and Scopus (Elsevier) – to identify all studies investigating the prevalence of chronic headaches after aSAH. A total of five studies were identified and included in our review.
Results:
There were five observational studies (three cohort and two cross-sectional). The overall prevalence of chronic headaches after aSAH ranged from 16.1% to 41%, albeit across a follow-up time frame of 12 months to 7.5 years. Outcome measurements included quantitative pain scores and opioid usage; however, these were inconsistent across studies, and the studies did not address the long-term impacts of chronic headaches on quality of life or their psychosocial implications.
Conclusion:
The prevalence of chronic headache after aSAH is not well-characterized, and long-term outcomes are seldom studied, highlighting a critical gap in the current literature. Longitudinal cohort studies with standardized approaches to ascertain the psychosocial and physiological burden associated with post-aSAH chronic headaches are urgently needed.
We propose a family of weighted statistics based on the CUSUM process of the WLS residuals for the online detection of changepoints in a Random Coefficient Autoregressive model, using both the standard CUSUM and the Page-CUSUM process. We derive the asymptotics under the null of no changepoint for all possible weighing schemes, including the case of the standardized CUSUM, for which we derive a Darling–Erdös-type limit theorem; our results guarantee the procedure-wise size control under both an open-ended and a closed-ended monitoring. In addition to considering the standard RCA model with no covariates, we also extend our results to the case of exogenous regressors. Our results can be applied irrespective of (and with no prior knowledge required as to) whether the observations are stationary or not, and irrespective of whether they change into a stationary or nonstationary regime. Hence, our methodology is particularly suited to detect the onset, or the collapse, of a bubble or an epidemic. Our simulations show that our procedures, especially when standardising the CUSUM process, can ensure very good size control and short detection delays. We complement our theory by studying the online detection of breaks in epidemiological and housing prices series.
This paper proposes a compact coplanar waveguide-fed slot antenna for ultra-wideband wearable applications, featuring six notch bands. The antenna utilizes a flexible liquid crystal polymer substrate with a thickness of 0.1 mm. The antenna achieves six band-notched characteristics by incorporating a split concentric ring etched on the radiating patch and L-shaped branches loaded on the ground plane. The proposed flexible antenna has dimensions of 30 × 30 mm2(0.65λ0*0.65λ0,λ0 is the free space wavelength at 6.5 GHz.). Measurement results show an impedance bandwidth ranging from 2.37 to 13.7 GHz and a fractional bandwidth of 134%. The notch bands cover 2.9–3.77 GHz for WiMAX applications, 4.14–4.9 GHz for the ARN band, 5.09–5.55 GHz for the WLAN downlink band, 5.86–6.46 GHz for the C-band uplink band, 6.66–7.39 GHz for the C-band/INSAT/super-extended band, and 7.93–8.43 GHz for ITU-8 GHz. The maximum gain in the operating band is 6.5 dBi. The performances of the flexible antenna are analyzed under bending conditions. The ANSYS HFSS electromagnetic simulator was used for the design and simulation of the proposed antenna. The flexible antenna is suitable for wearable applications.
Eye gaze tracking is increasingly popular due to improved technology and availability. In the domain of assistive device control, however, eye gaze tracking is often used in discrete ways (e.g., activating buttons on a screen), and does not harness the full potential of the gaze signal. In this article, we present a method for collecting both reactionary and controlled eye gaze signals, via screen-based tasks designed to isolate various types of eye movements. The resulting data allows us to build an individualized characterization for eye gaze interface use. Results from a study conducted with participants with motor impairments are presented, offering insights into maximizing the potential of eye gaze for assistive device control. Importantly, we demonstrate the potential for incorporating direct continuous eye gaze inputs into gaze-based interface designs; generally seen as intractable due to the ‘Midas touch’ problem of differentiating between gaze movements for perception versus for interface operation. Our key insight is to make use of an individualized measure of smooth pursuit characteristics to differentiate between gaze for control and gaze for environment scanning. We also present results relating to gaze-based metrics for mental workload and show the potential for the concurrent use of eye gaze for control input as well as assessing a user’s mental workload both offline and in real-time. These findings might inform the development of continuous control paradigms using eye gaze, as well as the use of eye tracking as the sole input modality to systems that share control between human-generated and autonomy-generated inputs.
Acquired chylothorax is an established complication of CHD surgery, affecting 2–9% of patients. CHD places a child at risk for failure to thrive, with subsequent chylothorax imposing additional risk.
Objective:
We conducted a retrospective chart review to ascertain quantitative markers of nutrition and growth in children affected by chylothorax following CHD surgery between 2018 and 2022 compared to controls.
Methods:
We utilised electronic medical record system, EPIC, at Children’s Hospital, New Orleans, targeting subjects < 18 years old who underwent CHD surgery between 2018 and 2022 and developed a subsequent chylothorax. Study subjects were identified using the 10th revision of the International Classification of Diseases codes (ICD-10 codes: J94.0, I89.8, and J90.0). Each chylothorax case (n = 20) was matched by procedure type and age to a control with no chylothorax (n = 20). Data were recorded in REDCap and analysed using SPSS.
Results:
After removal of outliers, we analysed 19 total matched pairs. There was no statistical difference in growth velocity (p = 0.12), weight change (operation to discharge) (p = 0.95), weight change (admission to discharge) (p = 0.35), Z-score change (operation to discharge) (p = 0.90), Z-score change (admission to discharge) (p = 0.21), serum protein (p = 0.88), or serum albumin (p = 0.82). Among cases, linear regression demonstrated no significant association between maximum chylous output and growth velocity (p = 0.91), weight change (operation to discharge) (p = 0.15), or weight change (admission to discharge) (p = 0.98).
Conclusions:
We did not observe statistically significant markers of growth or nutrition in children with chylothorax post-CHD surgery compared to those without chylothorax. Multisite data collection and analysis is required to better ascertain clinical impact and guide clinical practice.
This letter presents an improved analytical model for analyzing probe-fed microstrip antennas loaded by metallic vias with lumped terminations. The proposed formulation is based on the resonant cavity model and enables efficient analysis of such perturbed radiators for various types of terminations. The model is validated through the analysis of two antennas: one operating in a TM00 mode and the other with four capacitive terminations to produce circular polarization. Moreover, a reconfigurable RHCP/LHCP antenna based on the patch with capacitive terminations has been manufactured and tested, showing a broadside axial ratio below 0.5 dB at 1.575 GHz.
Ambient air pollution remains a global challenge, with adverse impacts on health and the environment. Addressing air pollution requires reliable data on pollutant concentrations, which form the foundation for interventions aimed at improving air quality. However, in many regions, including the United Kingdom, air pollution monitoring networks are characterized by spatial sparsity, heterogeneous placement, and frequent temporal data gaps, often due to issues such as power outages. We introduce a scalable data-driven supervised machine learning model framework designed to address temporal and spatial data gaps by filling missing measurements within the United Kingdom. The machine learning framework used is LightGBM, a gradient boosting algorithm based on decision trees, for efficient and scalable modeling. This approach provides a comprehensive dataset for England throughout 2018 at a 1 km2 hourly resolution. Leveraging machine learning techniques and real-world data from the sparsely distributed monitoring stations, we generate 355,827 synthetic monitoring stations across the study area. Validation was conducted to assess the model’s performance in forecasting, estimating missing locations, and capturing peak concentrations. The resulting dataset is of particular interest to a diverse range of stakeholders engaged in downstream assessments supported by outdoor air pollution concentration data for nitrogen dioxide (NO2), Ozone (O3), particulate matter with a diameter of 10 μm or less (PM10), particulate matter with a diameter of 2.5 μm or less PM2.5, and sulphur dioxide (SO2), at a higher resolution than was previously possible.
We report the first shock-tube experiments on Richtmyer–Meshkov instability at a single-mode light–heavy interface accelerated by a strong shock wave with Mach number higher than 3.0. Under the proximity effect of the transmitted shock and its induced secondary compression effect, the interface profile is markedly different from that in weakly compressible flows. For the first time, the validity of the compressible linear theory and the failure of the impulsive model in predicting the linear amplitude evolution in highly compressible flows are verified through experiments. Existing nonlinear and modal models fail to accurately describe the perturbation evolution, as they do not account for the shock proximity and secondary compression effects on interface evolution. The shock proximity effect manifests mainly in the early stages when the transmitted shock remains close to the interface, while the effect of secondary compression manifests primarily at the period when interactions of transverse shocks occur at the bubble tips. Based on these findings, we propose an empirical model capable of predicting the bubble evolution in highly compressible flows.
Acoustic resonances in cascade structures may cause structural damage and instability problems in aero-engines and other industrial plants; thus, developing corresponding prediction methods is important. However, works published in the open literature mostly focus on the special case of the stationary Parker modes and provide little knowledge into the rotating resonances in annular cascades, especially in the presence of non-zero background mean flows. This paper develops a three-dimensional semi-analytic model to study the acoustic resonances in an annular cascade in the presence of axial mean flow. The model applies an unsteady cascade response based on the three-dimensional lifting surface method to construct a matrix equation. Characteristic frequencies are solved in the complex domain by numerically searching for singular points. Both the oscillation frequency and the growth rate of the three-dimensional resonance modes are theoretically calculated for the first time under non-zero mean flow conditions. The results reveal an organised distribution with varying inter-blade phase angle and show obvious change with the background flow speed. It is found that the unsteady vortex shedding from the trailing edges of the cascade is a key factor influencing the dissipation rate of the resonance modes. In addition, the important effects of acoustic scattering by the cascade during resonances are examined, which qualitatively corroborate some previous experimental observations.