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In his well-known memoir Confessions of an English Opium-Eater (1821), Thomas De Quincey seeks to disprove popular perceptions about the effects of opium. As he observes: “It is not so much affirmed as taken for granted, by all who ever mention opium, formally or incidentally, that it does, or can produce intoxication.”1 Taking issue with this assumption, De Quincey states: “Now reader, assure yourself, meo periculo, that no quantity of opium ever did, or could intoxicate.”2 Instead, according to De Quincey, it is wine that “disorders the mental faculties.”3 What is significant about these statements is not so much the information they convey about the somnolent qualities of opium vis-à-vis wine as the confidence and authority with which De Quincey writes them. He evidently writes from experience and familiarity with opium. He writes with the conviction of someone who knows of what he writes: “now reader, assure yourself …” Indeed, given the autobiographical thrust of Confessions, which details De Quincey’s lifelong addiction to opium, he does seem uniquely qualified to dispense advice on opium. He of all people seems best suited to judge the relative merits as it were of “Turkish opium” and “East Indian opium.
Almost 30% of the world’s stunted children reside in India. This study examined sibling linkage in childhood stunting by assessing the extent of clustering of stunted children born to the same mother. Data were taken from 225,002 children under the age of five from the Indian National Family and Health Survey (NFHS)-4 conducted in 2015–16. States with high fertility and lower socioeconomic development displayed higher clustering of childhood stunting among siblings. Simulating removal of this clustered burden showed an almost 10 percentage point reduction in stunting in India. Multinomial regression analysis highlighted that the propensity to have multiple stunted births was higher among less-educated women, scheduled caste/tribes and poor households. The multilevel model results indicated that the odds of stunting for the index child increased by 1.93 if the older sibling was stunted. The odds of the index child being stunted if the previous child was stunted were high, irrespective of the differences in state-level public health performances and political commitments. Although socioeconomic correlates play a crucial role in determining child stunting status, they also act as proxies for poor-quality intra-generational health. Clustering of stunting among siblings is an indicator of both genetic and environmental association with the height-for-age (HAZ) of children. Mothers with repeated stunted births should be prioritized and monitored over a substantial part of their lives. Inclusion of multiple child beneficiaries in nutrition policies and revisiting the ‘one size fits all’ concept at the micro level, owing to the substantial village/ward-level variation, might be an effective policy measure.
Retinoblastoma is the most common primary intraocular tumor of childhood with >95% survival rates in the US. Traditional therapy for retinoblastoma often included enucleation (removal of the eye). While much is known about the visual, physical, and cognitive ramifications of enucleation, data are lacking about survivors' perception of how this treatment impacts overall quality of life.
Qualitative analysis of an open-ended response describing how much the removal of an eye had affected retinoblastoma survivors' lives and in what ways in free text, narrative form.
Four hundred and four retinoblastoma survivors who had undergone enucleation (bilateral disease = 214; 52% female; mean age = 44, SD = 11) completed the survey. Survivors reported physical problems (n = 205, 50.7%), intrapersonal problems (n = 77, 19.1%), social and relational problems (n = 98, 24.3%), and affective problems (n = 34, 8.4%) at a mean of 42 years after diagnosis. Three key themes emerged from survivors' responses; specifically, they (1) continue to report physical and intrapersonal struggles with appearance and related self-consciousness due to appearance; (2) have multiple social and relational problems, with teasing and bullying being prominent problems; and (3) reported utilization of active coping strategies, including developing more acceptance and learning compensatory skills around activities of daily living.
Significance of results
This study suggests that adult retinoblastoma survivors treated with enucleation continue to struggle with a unique set of psychosocial problems. Future interventions can be designed to teach survivors more active coping skills (e.g., for appearance-related issues, vision-related issues, and teasing/bullying) to optimize survivors' long-term quality of life.
Various methods have been applied to evaluating the economic viability of public investments in tourism. In this article, we capitalize on the strengths of computable general equilibrium and cost-benefit analytical techniques and develop an integrated approach to evaluating public investments in tourism. We apply the approach to the evaluation of a US$6.25 million investment in tourism in Uruguay from the perspective of a multilateral development bank and a beneficiary government. These perspectives differ in a cost-benefit analysis (CBA) due to the timing of the costs incurred. The integrated approach is powerful in that it captures first and subsequent rounds of investment impacts of benefits and costs; resource diversion and constraints are accounted for, and the estimation of benefits is consistent with the welfare economics underpinnings of CBA.
Among an array of techniques proposed to speed-up reinforcement learning (RL), learning from human demonstration has a proven record of success. A related technique, called Human-Agent Transfer, and its confidence-based derivatives have been successfully applied to single-agent RL. This article investigates their application to collaborative multi-agent RL problems. We show that a first-cut extension may leave room for improvement in some domains, and propose a new algorithm called coordination confidence (CC). CC analyzes the difference in perspectives between a human demonstrator (global view) and the learning agents (local view) and informs the agents’ action choices when the difference is critical and simply following the human demonstration can lead to miscoordination. We conduct experiments in three domains to investigate the performance of CC in comparison with relevant baselines.
Duck production has the potential to play a major role in agricultural economy. Asian countries alone contribute 84.2% of total duck meat produced in the world. Driven by the demand of processed foods among consumers, the global duck meat market is expected to grow at a steady pace, reaching a value of about $11.23 billion in the coming years. Duck meat has higher muscle fibre content in breast meat compared to chicken, and is considered as red meat. Moreover, due to a higher fat content (13.8%) than chicken and a stronger gamey flavour, duck meat can be less appreciated by the consumer. Development and diversification of ready-to-eat duck meat products is expected to increase consumption levels. Hence, the status of duck meat production, physicochemical properties, processing, including traditional products, and development of novel value-added ready-to-eat products from spent duck meat is discussed in detail to explore its importance as an alternative to chicken.
Point-of-care ultrasound (POCUS) is used increasingly during resuscitation. The aim of this study was to assess whether combining POCUS and electrocardiogram (ECG) rhythm findings better predicts outcomes during cardiopulmonary resuscitation in the emergency department (ED).
We completed a health records review on ED cardiac arrest patients who underwent POCUS. Primary outcome measurements included return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge.
POCUS was performed on 180 patients; 45 patients (25.0%; 19.2%–31.8%) demonstrated cardiac activity on initial ECG, and 21 (11.7%; 7.7%–17.2%) had cardiac activity on initial POCUS; 47 patients (26.1%; 20.2%–33.0%) achieved ROSC, 18 (10.0%; 6.3%–15.3%) survived to admission, and 3 (1.7%; 0.3%–5.0%) survived to hospital discharge. As a predictor of failure to achieve ROSC, ECG had a sensitivity of 82.7% (95% CI 75.2%–88.7%) and a specificity of 46.8% (32.1%–61.9%). Overall, POCUS had a higher sensitivity of 96.2% (91.4%–98.8%) but a similar specificity of 34.0% (20.9%–49.3%). In patients with ECG-asystole, POCUS had a sensitivity of 98.18% (93.59%–99.78%) and a specificity of 16.00% (4.54%–36.08%). In patients with pulseless electrical activity, POCUS had a sensitivity of 86.96% (66.41%–97.22%) and a specificity of 54.55% (32.21%–75.61%). Similar patterns were seen for survival to admission and discharge. Only 0.8% (0.0–4.7%) of patients with ECG-asystole and standstill on POCUS survived to hospital discharge.
The absence of cardiac activity on POCUS, or on both ECG and POCUS together, better predicts negative outcomes in cardiac arrest than ECG alone. No test reliably predicted survival.
Metallo-dielectric screens are periodic structures, which are at resonance with the infrared (IR) wavelength of interest: a standing wave of surface charges is formed at resonance conditions, which enables transmission or, reflection of certain IR bands. Graphene is a monolayer thick crystal of carbon. It is chemically inert and exhibits very large electronic mobility. Recently, we succeeded in fabricating mono and a few-layered suspended graphene on top of these screens. We combined these two unique components in fabricating novel platforms, which enhance IR signals of soft bio-species. Specifically, we used these platforms to examine IR spectra of a model protein, cytochrome c from a bovine heart tissue. Clear Raman signal variation as a function of platform orientation has been demonstrated. Accentuation of the IR absorption spectra was shown as well.
Glaciological ablation is computed from point-scale data at a few ablation stakes that are usually regressed as a function of elevation and averaged over the area-elevation distribution of a glacier. This method is contingent on a tight control of elevation on local ablation. However, in debris-covered glaciers, systematic and random spatial variations of debris thickness modify the ablation rates. We propose and test a method to compute sub-debris ablation where stake data are interpolated as a function of debris-thickness alone and averaged over the debris-thickness distribution at different parts of the glacier. We apply this method on Satopanth Glacier located in Central Himalaya utilising ~1000 ablation measurements obtained from a network of up to 56 stakes during 2015–2017. The estimated mean sub-debris ablation ranges between 1.5±0.2 to 1.7±0.3 cm d−1. We show that the debris-thickness-dependent regression describes the spatial variability of the sub-debris ablation better than the elevation dependent regression. The uncertainties in ablation estimates due to the corresponding uncertainties in the measurement of ablation and debris-thickness distribution, and those due to interpolation procedures are estimated using Monte Carlo methods. Possible biases due to a finite number of stakes used are also investigated.
Here, a well crystalline 3D flower-like structured MoS2 (~420 nm) has been successfully synthesized on a large scale by a simple hydrothermal technique. The evolution of morphology in the formation process has also been investigated. The crystallinity, purity, and morphology of the sample are characterized by powder X-ray diffraction, Fourier-transform infrared spectroscopy, fieldemission scanning electron microscopy (FESEM), and transmission electron microscopy (TEM) techniques. The FESEM and TEM images reveal that the sample exhibits a uniform 3D flower-like microsphere shape with folded nanosheets, which are stretched out along the edge of the microsphere. The electrochemical performance of the sample has been investigated by cyclic voltammogram, galvanostatic charge–discharge, and electrochemical impedance spectroscopy studies. The results of the electrochemical analysis suggest that the material delivers a maximum specific capacitance (Csp) of 350 F/g at a discharge current density of 0.25 A/g with energy density 17.5 Wh/kg. It also exhibits good capability and excellent cyclic stability (94% capacity retention after 1,000 cycles in 1 A/g) owing to the coupling effect of electrical conductivity with the interesting morphology and larger active surface area. Hence, the sample may be used as a promising electrode material for high-performance energy storage devices.
This article offers a comprehensive set of explanations for why people vote. Based on evidence from Indian elections, where voter turnouts remain consistently high—and rising—despite voting not being compulsory, the article shows that two broad sets of reasons exist. First, a set of transactional factors, labelled ‘money’ here, encompass within it the instrumental and coercive reasons that propel people to vote. Secondly, evidence shows that people also attribute ‘meaning’ to the act of voting itself so they vote for the sake of performing the act itself. Drawing from the wider literature and the author's own ethnographic work, including comparative ethnographic research conducted by a team across India, this article brings together these diverse set of reasons to propose a holistic explanation for why people vote.