To send 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 sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.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 sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent 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.
Non-communicable chronic diseases (NCCDs) are the main cause of morbidity and mortality globally. Demographic aging has resulted in older populations with more complex healthcare needs. This necessitates a multilevel rethinking of healthcare policies, health education and community support systems with digitalization of technologies playing a central role. The European Innovation Partnership on Active and Healthy Aging (A3) working group focuses on well-being for older adults, with an emphasis on quality of life and healthy aging. A subgroup of A3, including multidisciplinary stakeholders in health care across Europe, focuses on the palliative care (PC) model as a paradigm to be modified to meet the needs of older persons with NCCDs. This development paper delineates the key parameters we identified as critical in creating a public health model of PC directed to the needs of persons with NCCDs. This paradigm shift should affect horizontal components of public health models. Furthermore, our model includes vertical components often neglected, such as nutrition, resilience, well-being and leisure activities. The main enablers identified are information and communication technologies, education and training programs, communities of compassion, twinning activities, promoting research and increasing awareness amongst policymakers. We also identified key ‘bottlenecks’: inequity of access, insufficient research, inadequate development of advance care planning and a lack of co-creation of relevant technologies and shared decision-making. Rethinking PC within a public health context must focus on developing policies, training and technologies to enhance person-centered quality life for those with NCCD, while ensuring that they and those important to them experience death with dignity.
Determining the shape of the stellar initial mass function (IMF) and whether it is constant or varies in space and time is the Holy Grail of modern astrophysics, with profound implications for all theories of star and galaxy formation. On a theoretical ground, the extreme conditions for star formation (SF) encountered in the most powerful starbursts in the Universe are expected to favour the formation of massive stars. Direct methods of IMF determination, however, cannot probe such systems, because of the severe dust obscuration affecting their starlight. The next best option is to observe CNO bearing molecules in the interstellar medium at millimetre/ submillimetre wavelengths, which, in principle, provides the best indirect evidence for IMF variations. In this contribution, we present our recent findings on this issue. First, we reassess the roles of different types of stars in the production of CNO isotopes. Then, we calibrate a proprietary chemical evolution code using Milky Way data from the literature, and extend it to discuss extragalactic data. We show that, though significant uncertainties still hamper our knowledge of the evolution of CNO isotopes in galaxies, compelling evidence for an IMF skewed towards high-mass stars can be found for galaxy-wide starbursts. In particular, we analyse a sample of submillimetre galaxies observed by us with the Atacama Large Millimetre Array at the peak of the SF activity of the Universe, for which we measure 13C/18O⋍1. This isotope ratio is especially sensitive to IMF variations, and is little affected by observational uncertainties. At the end, ongoing developments of our work are briefly outlined.
A new locality for low-latitudinal, Early Triassic fishes was discovered in the Candelaria Hills, southwestern Nevada (USA). The fossils are derived from the lower Candelaria Formation, which was deposited during the middle–late Dienerian (late Induan), ca. 500 ka after the Permian-Triassic boundary mass extinction event. The articulated and disarticulated Osteichthyes (bony fishes), encompassing both Actinistia (coelacanths) and Actinopterygii (ray-fins), are preserved in large, silicified concretions that also contain rare coprolites. We describe the first actinopterygians from the Candelaria Hills. The specimens are referred to Pteronisculus nevadanus new species (Turseoidae?), Ardoreosomus occidentalis new genus new species (Ptycholepidae), the stem neopterygian Candelarialepis argentus new genus new species (Parasemionotidae), and Actinopterygii indet. representing additional taxa. Ardoreosomus n. gen. resembles other ptycholepids, but differs in its more angulate hyomandibula and lack of an elongate opercular process. Candelarialepis n. gen. is one of the largest parasemionotids, distinguished by its bipartite preopercle and scale ornamentation. Presented new species belong to genera (Pteronisculus) or families (Ptycholepidae, Parasemionotidae) that radiated globally after the mass extinction, thus underlining the striking similarities between Early Triassic (pre-Spathian) osteichthyan assemblages. The current data suggest that the diversity of low-latitudinal, Early Triassic bony fishes may have been greater than indicated thus far by the fossil record, probably due to sampling or taphonomic failure. All 24 fossils from the Candelaria Hills represent mid-sized or large osteichthyans, confirming the obvious absence of very small species (≤ 10 cm adult body length) in the beginning of the Mesozoic Era—even in low latitudes.
Metastatic castration-resistant prostate cancer (mCRPC) is an incurable disease and represents a significant clinical, economic, and social burden. The therapeutic scenario of mCRPC has completely changed over the last years with the approval of several treatments (1). Radium-223 is a new target-alpha therapy showing a significant survival benefit in mCRPC patients (2,3). The study aimed to evaluate the introduction of radium-223 in Italy using Health Technology Assessment methodology.
To assess epidemiological, clinical, economic, organizational, social, and ethical aspects, a literature review was carried out. A cost-effectiveness and a budget impact analysis were performed from the National Health Service (NHS) perspective to compare radium-223 with other treatments and determine the budgetary impact of the utilization of radium-223 for the treatment of mCRPC.
In Italy, prostate cancer represents the most diagnosed cancer in men and the third in the whole population. When the disease becomes metastatic, approximately 80 percent of patients develop bone metastases, commonly associated to skeletal-related events (SREs) with a significant impact on survival, quality of life, and costs (1). Radium-223 is a novel alpha particle emitting therapeutic agent which targets new bone growth surrounding bone metastases. Different from other radiopharmaceuticals, radium-223 prolongs overall survival with a favorable safety profile (2,3). In order to optimize patient outcome, the management of radium-223 should be viewed in a multidisciplinary context. The administration is quite simple and requires only basal shielding. Currently it can be administered in hospital inpatient settings and in some regions the outpatient usage is allowed. Finally, radium-223 showed a favorable budget impact profile and cost-effectiveness when compared with best supportive care and new therapeutic agents (abiraterone, enzalutamide, cabazitaxel) (1).
The introduction of radium-223 allows provision of a new therapy, offering a valid alternative to patient with mCRPC without any increase of costs for the NHS.
The discrepancy between abundances computed using optical recombination lines (ORLs) and collisionally excited lines (CELs) is a major, unresolved problem with significant implications for the determination of chemical abundances throughout the Universe. In planetary nebulae (PNe), the most common explanation for the discrepancy is that two different gas phases coexist: a hot component with standard metallicity, and a much colder plasma enhanced in heavy elements. This dual nature is not predicted by mass loss theories, and direct observational support for it is still weak. In this work, we present our recent findings that demonstrate that the largest abundance discrepancies are associated with close binary central stars. OSIRIS-GTC tunable filter imaging of the faint O ii ORLs and MUSE-VLT deep 2D spectrophotometry confirm that O ii ORL emission is more centrally concentrated than that of [Oiii] CELs and, therefore, that the abundance discrepancy may be closely linked to binary evolution.
Large volumes of data and multiple computing platforms are now universal components of paediatric cardiovascular medicine, but are in a constant state of evolution. Often, multiple sets of related data reside in disconnected “silos”, resulting in clinical, administrative, and research activities that may be duplicative, inefficient, and at times inaccurate. Comprehensive and integrated data solutions are needed to facilitate these activities across congenital heart centres. We describe methodology, key considerations, successful use cases, and lessons learnt in developing an integrated data platform across our congenital heart centre.
Models of galaxy formation in a hierarchical universe predict substantial scatter in the halo-to-halo stellar properties, owing to stochasticity in galaxies' merger histories. Currently, only few detailed observations of stellar halos are available, mainly for the Milky Way and M31. We present the stellar halo color/metallicity and density profiles of red giant branch stars out to ~60 kpc along the minor axis of six massive nearby Milky Way-like galaxies beyond the Local Group from the Galaxy Halos, Outer disks, Substructure, Thick disks and Star clusters (GHOSTS) HST survey. This enlargement of the sample of galaxies with observations of stellar halo properties is needed to understand the range of possible halo properties, i.e. not only the mean properties but also the halo-to-halo scatter, what a ‘typical’ halo looks like, and how similar the Milky Way halo is to other halos beyond the Local Group.
Stars in low-mass dwarf galaxies show a larger range in their chemical properties than those in the Milky Way halo. The slower star formation efficiency make dwarf galaxies ideal systems for testing nucleosynthetic yields. Not only are alpha-poor stars found at lower metallicities, and a higher fraction of carbon-enhanced stars, but we are also finding stars in dwarf galaxies that appear to be iron-rich. These are compared with yields from a variety of supernova predictions.
Tidal streams of globular clusters are ideal tracers of the Galactic gravitational potential. Compared to the few known, complex and diffuse dwarf-galaxy streams, they are kinematically cold, have thin morphologies and are abundant in the halo of the Milky Way. Their coldness and thinness in combination with potential epicyclic substructure in the vicinity of the stream progenitor turns them into high-precision scales. With the example of Palomar 5, we demonstrate how modeling of a globular cluster stream allows us to simultaneously measure the properties of the disrupting globular cluster, its orbital motion, and the gravitational potential of the Milky Way.
We have obtained deep g, r, and i-band Subaru and ultra-deep 3.6 μm IRAC images of parts of the multiply-wrapped stellar stream around the nearby edge-on galaxy NGC 5907. We have fitted the surface brightness measurements of the stream with FSPS stellar population synthesis models to derive the metallicity and age of the brightest parts of the stream. The resulting relatively high metallicity ([Fe/H] = −0.3) is consistent with a major merger scenario but a satellite accretion event cannot be ruled out.
Gaia's Radial Velocity Spectrometer (RVS) has been operating in routine phase for over one year since initial commissioning. RVS continues to work well but the higher than expected levels of straylight reduce the limiting magnitude. The end-of-mission radial-velocity (RV) performance requirement for G2V stars was 15 km s−1 at V = 16.5 mag. Instead, 15 km s−1 precision is achieved at 15 < V < 16 mag, consistent with simulations that predict a loss of 1.4 mag. Simulations also suggest that changes to Gaia's onboard software could recover ~0.14 mag of this loss. Consequently Gaia's onboard software was upgraded in April 2015. The status of this new commissioning period is presented, as well as the latest scientific performance of the on-ground processing of RVS spectra. We illustrate the implications of the RVS limiting magnitude on Gaia's view of the Milky Way's halo in 6D using the Gaia Universe Model Snapshot (GUMS).
This paper reports the results of the application of a calcined bone dating protocol to samples collected from the Sanctuary of Zeus on Mt. Lykaion in southern Greece. The site is a mountaintop ash altar rich in anthropogenic sediments, burned bone, and artifacts offered to the god Zeus. Experiments involving time series hydrolysis measurements were conducted on calcined bones from stratified layers throughout the sequence to determine if any of the samples underwent surface contamination from carbonate exchange with the surrounding sedimentary matrix. It was determined that such exchange was unlikely, but samples were acid-etched before pretreatment as a precautionary measure. Paired samples of seeds, charcoal, and calcined animal bone collected from a sediment column in the altar demonstrate the effectiveness of the calcined bone dating technique in this context. The results of dating indicate that the altar was in use from the Mycenaean period through the late Classical period, though samples were not collected from the upper levels of the site due to possible mixing of surface sediments. Fourier transform infrared spectroscopy (FTIR) measurements were taken and crystallinity index values calculated, confirming that the bone samples are indeed calcined. The results presented here correspond with literary accounts of ritual animal sacrifice from historical texts from the 8th century BCE, including the Homeric epics.
In many people's minds, the Middle East stands out as the
world's most dangerous place. I often remark to my colleagues and
friends, however, that I feel safer doing field research in most Middle
Eastern countries than I would in much of Africa or Latin America. To
begin with, few parts of the Middle East suffer from high rates of random
crime. Rather, the region's violence is mostly political in nature,
and, with the right approach, a researcher can take several steps to
minimize risks. I have conducted research in the Kurdish regions of
Turkey, Iran, Syria, and Iraq (before and after the 2003 war), in Lebanon,
and in Israel-Palestine during the first Intifadah. In this article, I
discuss various strategies and issues one faces while “in the
field” in regions such as these.The
author would like to acknowledge research support provided by the Canadian
Department of National Defence, the Inter-University Consortium for Arab
and Middle East Studies (ICAMES), and the University of Montreal's
Centre d'Études et de Recherches Internationales.
Following the Treaty of Lausanne, Britain and the League of Nations in 1925 attached the Mosul Vilayet and the rest of today's Iraqi Kurdistan to the British-occupied Mesopotamian vilayets of Basra and Baghdad. Out of these holdings Iraq was created. The British installed Hashemite Emir Faysal, a prince from the Arabian peninsula, as King of the new Iraq, and Britain's mandate over Iraq was supposed to last twenty-five years. Some Kurdish leaders who had been friendly towards Britain, in the hope that they would be helped to establish a Kurdish state in the area, were gravely disappointed. The opportunity structure of foreign support for their Kurdish nationalist aims was not as favorable as they had imagined. The British had decided that creating and controlling a single Iraq, including the Kurdish areas in question, would be the best way to exploit the oil fields around Kirkuk and Mosul, as well as to protect their colonial holdings elsewhere.
Sporadic Kurdish unrest and agitation against being included within the new Iraq had begun even before the Treaty of Sèvres. Lacking sufficient troops to quell the unrest, as early as 1919 the British deployed the RAF to aerially bombard Kurdish rebels and civilian areas in rebellion, setting an enduring precedent for both the region and the world.
At first glance, ethnic nationalist movements may seem amongst the least likely of social movement phenomena amenable to a rational choice (RC) analysis. We have a tendency to view ethnic nationalism as an expression of identity and the strong emotional values attached to identity. This chapter does not attempt to dispute the idea that powerful non-material values underpin ethnic identity and that these may act as strong behavioral motivators. If, however, we accept that identity is a dynamic phenomenon and that ethnic nationalist movements often play a major role in fostering ethnic identification in the first place, then resource mobilization (RM) and rational choice analysis can provide some very useful insights. If a given population lacks a strong sense of ethnic identity, or possesses a non-politicized ethnic identity, then an ethnic nationalist movement may not be able to attract their support with ideological appeals centered around the ethnicity and non-material values of the ethnic group. Instead, the initial attempts to garner large-scale support may have to appeal to the material self-interest of the target population. Additionally, rational, material interest-based appeals, as well as strategic use of recruitment networks and other mobilizational vehicles, may serve as the crucial extra inducement to action for a population receptive to the politicized ethnic ideology of a movement but needing additional motivation.
As discussed earlier, RC theory derives from economics, and its basic premise is that rational actors will choose options that maximize their gain and minimize their risk, based on the information available to them.