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Collective memory can make and break political culture around the world. Representations and reinterpretations of the past intersect with actions that shape the future. A nation's political culture emerges from complex layers of institutional and individual responses to historical events. Society changes and is changed by these layers of memory over time. Understanding them gives us insight into where we are today. Encompassing examples from colonization and decolonization, revolving around the critical junctures of the world wars, this book illustrates how collective memory is produced and organized, through commemoration, through monuments, and through individuals sharing stories. Using concrete examples from around the world, James H. Liu shows how different disciplines can come together through shared concepts like narratives and generational memories to provide mutually enriching perspectives on how political culture is made, and how it changes.
Background: Chordomas are rare malignant skull-base/spine cancers with devastating neurological morbidities and mortality. Unfortunately, no reliable prognostic factors exist to guide treatment decisions. This work identifies DNA methylation-based prognostic chordoma subtypes that are detectable non-invasively in plasma. Methods: Sixty-eight tissue samples underwent DNA methylation profiling and plasma methylomes were obtained for available paired samples. Immunohistochemical staining and publicly available methylation and gene expression data were utilized for validation. Results: Unsupervised clustering identified two prognostic tissue clusters (log-rank p=0.0062) predicting disease-specific survival independent of clinical factors (Multivariable Cox: HR=16.5, 95%CI: 2.8-96, p=0.0018). The poorer-performing cluster showed immune-related pathway promoter hypermethylation and higher immune cell abundance within tumours, which was validated with external RNA-seq data and immunohistochemical staining. The better-performing cluster showed higher tumour cellularity. Similar clusters were seen in external DNA methylation data. Plasma methylome-based models distinguished chordomas from differential diagnoses in independent testing sets (AUROC=0.84, 95%CI: 0.52-1.00). Plasma methylomes were highly correlated with tissue-based signals for both clusters (r=0.69 & 0.67) and leave-one-out models identified the correct cluster in all plasma cases. Conclusions: Prognostic molecular chordoma subgroups are for the first time identified, characterized, and validated. Plasma methylomes can detect and subtype chordomas which may transform chordoma treatment with personalized approaches tailored to prognosis.
Anti-corruption efforts are inherently political. Corruption charges can be levied against political opponents as an instrument of repression; they can also be used against troublesome allies in the same party coalition to further consolidate power. In this paper, we focus on Indonesia and ask: Do major corruption charges follow a presidential electoral cycle—and if so, how? We contend charges against prominent members of the government coalition are more likely to happen before an election, allowing the government to replace intra-party rivals with loyal allies. Conversely, charges against prominent opposition members are more likely to happen after an election when fears of retaliation are low, opportunities for credit-claiming are high, and there is an incentive to remove veto players who may inhibit implementing the government's agenda. To test this argument, we use an original, newly assembled dataset of all major corruption charges—i.e., those involving high-profile politicians and garnering international attention—in Indonesia from 1998–2015 as reported in the Associated Press. We find a significant and robust relationship between the electoral calendar and major corruption charges. This relationship is robust across presidential administrations. These results yield insights into how anti-corruption efforts can become a political tool and counsel caution about the effectiveness of “good governance,” especially in new democracies. Finally, we discuss how contextual political factors external to Indonesia's anti-corruption commission, reinforce this empirical pattern.
OBJECTIVES/GOALS: Exposure to arsenic, cadmium, manganese, and lead have been linked to adverse neurocognitive outcomes in adults/children, but effects in adolescents are not fully characterized. This study aims to examine the association between exposure to a mixture of metals (As, Cd, Mn, Pb, Se) and cognitive function in adolescents. METHODS/STUDY POPULATION: The Metals, Arsenic, & Nutrition in Adolescents Study (MANAS) is a cross-sectional study of 572 Bangladeshi adolescents. Blood levels of As, Cd, Mn, Pb, and Se were measured via ICP-MS. An abbreviated Cambridge Neuropsychological Test Automated Battery (CANTAB) was administered, with subtests assessing cognitive function and executive function tasks. Linear regression and Bayesian kernel machine regression (BKMR) were used to examine associations between individual metals, the overall mixture of metals, and cognitive function as measured by the CANTAB. RESULTS/ANTICIPATED RESULTS: Linear regression showed that As (B=−2.40) and Mn (B=−5.31) were negatively associated with Spatial Working Memory (p<0.05). Negative associations were also observed between Cd and Spatial Recognition Memory (SRM) (B=−2.77, p<0.05), and between Pb and Delayed Match to Sample (DMS), a measure of visual recognition and memory (B=−3.67, p<0.05). Se and Spatial Span Length (B=0.92, p<0.05) were seen to be positively associated. BKMR showed no overall effect of the mixture but indicated that Pb was negatively associated with DMS, and that Cd was negatively associated with SRM. Se was positively associated with Planning, Reaction Time, and Spatial Span. Posterior inclusion probability consistently rated Se as the most influential mixture component. DISCUSSION/SIGNIFICANCE: Se was positively associated with cognition, while Mn and As were linked to poorer working memory, and Cd and Pb were associated with poorer visual recognition and memory. We saw agreement between linear regression and BKMR in analyzing metal mixture exposures. Findings suggest interventions aimed at adolescents might influence lifelong cognition.
What explains the treatment of ethnic minorities in Southeast Asia? This Element conceptually disaggregates ethnicity into multiple constituent markers – specifically language, religion, and phenotype. By focusing on the interaction between these three ethnic markers, Liu and Ricks explore how overlap between these markers can affect whether a minority integrates within a broader ethnic identity; successfully extracts accommodation as unique group; or engages in a contentious and potentially violent relationship with the hegemon. The argument is tested through six case studies: (1) ethnic Lao in Thailand: integration; (2) ethnic Chinese in Thailand: integration; (3) ethnic Chinese in Malaysia: accommodation; (4) ethnic Malays in Singapore: accommodation; (5) ethnic Malays in Thailand: contention; and (6) ethnic Chinese in Indonesia: contention.
Large-eddy simulations of turbulent flow in partially filled pipes are conducted to investigate the effect of secondary currents on the friction factor, first- and second-order statistics and large-scale turbulent motion. The method is validated first and simulated profiles of the mean streamwise velocity, normal stresses and turbulent kinetic energy (TKE) are shown to be in good agreement with experimental data. The secondary flow is stronger in half- and three-quarters full pipes compared with quarter full or fully filled pipe flows, respectively. The origin of the secondary flow is examined by both the TKE budget and the steamwise vorticity equation, providing evidence that secondary currents originate from the corner between the free surface and the pipe walls, which is where turbulence production is larger than the sum of the remaining terms of the TKE budget. An extra source of streamwise vorticity production is found at the free surface near the centreline bisector, due to the two-component asymmetric turbulence there. The occurrence of dispersive stresses (due to secondary currents) reduces the contribution of the turbulent shear stress to the friction factor, which results in a reduction of the total friction factor of flows in half and three-quarters full pipes in comparison to a fully filled pipe flow. Furthermore, the presence of significant secondary currents inhibits very-large-scale motion (VLSM), which in turn reduces the strength and scales of near-wall streaks. Subsequently, near-wall coherent structures generated by streak instability and transient growth are significantly suppressed. The absence of VLSM and less coherent near-wall turbulence structures is supposedly responsible for the drag reduction in partially filled pipe flows relative to a fully filled pipe flow at an equivalent Reynolds number.
Experiments are conducted in a wave tank to investigate wave scattering by a three-dimensional submerged horizontal rectangular plate in a channel. The free-surface elevation around the plate is presented for various water depths and depths of submergence of the plate. The wave forces and moments are obtained using an underwater load measuring system. The numerical simulations are performed with a parallelized three-dimensional boundary element method. The numerical set-up follows closely the set-up of the laboratory experiments. The numerical results are compared with the experimental results for non-breaking waves. In most cases a good agreement is found for the free-surface elevation, the vertical force and the moment. A physical interpretation of the flow around the plate is provided. The pressure distribution on the lower surface of the plate differs from the linear distribution from the leading edge to the trailing edge that is obtained in the equivalent two-dimensional problem. The reflection by the lateral walls is investigated.
We surveyed healthcare professionals at a cancer center regarding their knowledge and perceptions of antibiotic use. Most knew the term “antimicrobial stewardship.” Nurses and other staff were less likely than pharmacists or providers to answer knowledge-based questions correctly. Opportunities exist to improve antibiotic knowledge among cancer center staff.
To study the effectiveness of unilateral cochlear implantation, binaural-bimodal hearing devices, and bilateral cochlear implantation in children with inner-ear malformation.
Methods
This study comprised 261 patients who were allocated to inner-ear malformation or control groups. Twenty-four months after surgery, aided sound-field thresholds were tested, and the Meaningful Auditory Integration Scale, Infant-Toddler Meaningful Auditory Integration Scale, Meaningful Use of Speech Scale, Categories of Auditory Performance scale and Speech Intelligibility Rating test were completed.
Results
Aided sound-field thresholds were significantly better for bilateral cochlear implantation patients than for unilateral cochlear implantation or binaural-bimodal hearing device patients. There was no significant difference in Meaningful Auditory Integration Scale, Infant-Toddler Meaningful Auditory Integration Scale, or Categories of Auditory Performance scores among the three groups. The binaural-bimodal hearing device patients outperformed unilateral cochlear implantation patients on both Meaningful Use of Speech Scale and Speech Intelligibility Rating scores. No statistical difference was observed between the two subgroups.
Conclusion
Children who received bilateral cochlear implants have the best auditory awareness in a quiet environment. Children with binaural-bimodal hearing devices have better voice control and verbal skills than unilateral cochlear implantation patients, and people are more likely to understand them. Children with inner-ear malformations benefit from cochlear implantation.
Sleep disturbance is an important factor in the pathophysiology and progression of psychiatric disorders, but whether it is a cause, or a downstream effect is still not clear.
Methods
To investigate causal relationships between three sleep-associated traits and seven psychiatric diseases, we used genetic variants related to insomnia, chronotype and sleep duration to perform a two-sample bidirectional Mendelian randomisation analysis. Summary-level data on psychiatric disorders were extracted from the Psychiatric Genomics Consortium. Effect estimates were obtained by using the inverse-variance-weighted (IVW), weights modified IVW, weighted-median methods, MR-Egger regression, MR pleiotropy residual sum and outlier (MR-PRESSO) test and Robust Adjusted Profile Score (RAPS).
Results
The causal odds ratio (OR) estimate of genetically determined insomnia was 1.33 (95% confidence interval (CI) 1.22–1.45; p = 5.03 × 10−11) for attention-deficit/hyperactivity disorder (ADHD), 1.31 (95% CI 1.25–1.37; p = 6.88 × 10−31) for major depressive disorder (MDD) and 1.32 (95% CI 1.23–1.40; p = 1.42 × 10−16) for post-traumatic stress disorder (PTSD). There were suggestive inverse associations of morningness chronotype with risk of MDD and schizophrenia (SCZ). Genetically predicted sleep duration was also nominally associated with the risk of bipolar disorder (BD). Conversely, PTSD and MDD were associated with an increased risk of insomnia (OR = 1.06, 95% CI 1.03–1.10, p = 7.85 × 10−4 for PTSD; OR = 1.37, 95% CI 1.14–1.64; p = 0.001 for MDD). A suggestive inverse association of ADHD and MDD with sleep duration was also observed.
Conclusions
Our findings provide evidence of potential causal relationships between sleep disturbance and psychiatric disorders. This suggests that abnormal sleep patterns may serve as markers for psychiatric disorders and offer opportunities for prevention and management in psychiatric disorders.
Prior to the COVID-19 pandemic, adolescents (N = 1,330; Mages = 15 and 16; 50% female), mothers, and fathers from nine countries (China, Colombia, Italy, Jordan, Kenya, Philippines, Sweden, Thailand, United States) reported on adolescents’ internalizing and externalizing problems, adolescents completed a lab-based task to assess tendency for risk-taking, and adolescents reported on their well-being. During the pandemic, participants (Mage = 20) reported on changes in their internalizing, externalizing, and substance use compared to before the pandemic. Across countries, adolescents’ internalizing problems pre-pandemic predicted increased internalizing during the pandemic, and poorer well-being pre-pandemic predicted increased externalizing and substance use during the pandemic. Other relations varied across countries, and some were moderated by confidence in the government’s handling of the pandemic, gender, and parents’ education.
Emerging evidence suggests low vision may be a modifiable risk factor for cognitive decline. We examined effects of baseline visual acuity (VA) on level of, and change in, cognitive test performance over 9 years.
Method:
A population-based sample of 1,621 participants (average age 77 years) completed a comprehensive neuropsychological evaluation and VA testing at baseline and reassessed at nine subsequent annual visits. Linear regression modeled the association between baseline VA and concurrent cognitive test performance. Joint modeling of a longitudinal sub-model and a survival sub-model to adjust for attrition were used to examine associations between baseline VA and repeated cognitive test performance over time.
Results:
Better baseline VA was associated cross-sectionally with younger age, male sex, greater than high school education, and higher baseline neuropsychological test scores on both vision-dependent (B coefficient range −0.163 to −0.375, p = .006 to <.001) and vision-independent tests (−0.187 to −0.215, p = .003 to .002). In longitudinal modeling, better baseline VA was associated with slower decline in vision-dependent tests (B coefficient range −0.092 to 0.111, p = .005 to <.001) and vision-independent tests (−0.107 to 0.067, p = .007 to <.001).
Conclusions:
Higher VA is associated with higher concurrent cognitive abilities and slower rates of decline over 9 years in both vision-dependent and vision-independent tests of memory, language, and executive functioning. Findings are consistent with emerging literature supporting vision impairment in aging as a potentially modifiable risk factor for cognitive decline. Clinicians should encourage patient utilization of vision assessment and correction with the added aim of protecting cognition.
Background: We describe an infant with a diagnosis of GM3 synthase deficiency, presenting with severe neuroirritability from birth. He required multiple admissions due to extreme agitation and caregiver burnout. Multiple pharmacological agents were tried, and the effect of each medication was modest and short-lasting at best. The literature on the management of neuroirritability in children with progressive genetic and metabolic conditions is sparse, and a neuroirritability management protocol has yet to be developed at our institution. Methods: We searched for relevant primary research and articles on PubMed. We reviewed the evidence of each pharmacological agent and added non-pharmacological strategies. We developed management guidelines for neuroirritability at our hospital. This protocol was reviewed by several pediatric neurologists and pediatric palliative care specialists at the Stollery and SickKids Hospitals. Results: We present the Pediatric Neuroirritability Management Protocol for the Stollery Children’s Hospital. Conclusions: Further study is required to assess whether this protocol can be adapted to treat irritability in the context of other neurological conditions such as hypoxic-ischemic encephalopathy and non-accidental injury. In addition, we will expand our guidelines to include other symptoms such as spasticity, dystonia, and autonomic dysfunction.
The aim of the present study was to perform a retrospective review of the lesion sites in congenital middle-ear cholesteatoma and any accompanying ossicular defects, as well as to explore the possible aetiology of congenital middle-ear cholesteatoma associated with such ossicular chain defects.
Method
The clinical characteristics and pathogenic mechanisms of ossicular chain defects were investigated in 10 patients with early-stage congenital middle-ear cholesteatoma confirmed by surgery, from August 2011 to February 2019.
Results
Monofocal cholesteatoma was located in the anterosuperior quadrant in 3 cases and in the posterosuperior quadrant in 7 cases; all 10 cases showed an absence of the long crus of incus, and 8 cases showed a complete or partial absence of stapes superstructure. The lesions were confined to the vestibular window and the stapes region and had no contact with the long crus of the incus or stapes in nine cases. None of the 10 patients had any recurrence of cholesteatoma.
Conclusion
Although cholesteatoma can cause erosion of ossicles, the present cases suggest that residual epithelium of the cholesteatoma may coexist with ossicular malformations. Therefore, the aetiology of the clinical characteristics in these patients may derive from residual epithelial hinderance of ossicle development.
This study investigates water waves generated by a bottom obstacle translating at a subcritical speed in constant water depth, using a combination of analytical and numerical approaches. The newly derived analytical solutions reveal two types of waves – the transient free waves that propagate radially outwards, and the trapped wave that stays on top of the translating bottom obstacle. Closed-form asymptotic solutions for both the free surface and the flow velocities are derived in the far field, and near the leading wave or in the shallow water limit. The far-field leading waves are mathematically shown to be insensitive to the exact shape of the obstacle. Numerical long-wave models are employed to examine effects unaccountable by the linear analytical solutions. Nonlinear effects are found to cause only small deviations from the linear solutions. The effects of the obstacle's acceleration and deceleration are also examined numerically. Overall, the idealised linear analytical solutions predict well the characteristics of water waves generated by a bottom obstacle, and therefore can serve as the cornerstone of a theory-based model for quickly predicting the tsunamis generated by a submarine landslide.
Coronavirus disease 2019 (COVID-19) vaccination effectiveness in healthcare personnel (HCP) has been established. However, questions remain regarding its performance in high-risk healthcare occupations and work locations. We describe the effect of a COVID-19 HCP vaccination campaign on SARS-CoV-2 infection by timing of vaccination, job type, and work location.
Methods:
We conducted a retrospective review of COVID-19 vaccination acceptance, incidence of postvaccination COVID-19, hospitalization, and mortality among 16,156 faculty, students, and staff at a large academic medical center. Data were collected 8 weeks prior to the start of phase 1a vaccination of frontline employees and ended 11 weeks after campaign onset.
Results:
The COVID-19 incidence rate among HCP at our institution decreased from 3.2% during the 8 weeks prior to the start of vaccinations to 0.38% by 4 weeks after campaign initiation. COVID-19 risk was reduced among individuals who received a single vaccination (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.40–0.68; P < .0001) and was further reduced with 2 doses of vaccine (HR, 0.17; 95% CI, 0.09–0.32; P < .0001). By 2 weeks after the second dose, the observed case positivity rate was 0.04%. Among phase 1a HCP, we observed a lower risk of COVID-19 among physicians and a trend toward higher risk for respiratory therapists independent of vaccination status. Rates of infection were similar in a subgroup of nurses when examined by work location.
Conclusions:
Our findings show the real-world effectiveness of COVID-19 vaccination in HCP. Despite these encouraging results, unvaccinated HCP remain at an elevated risk of infection, highlighting the need for targeted outreach to combat vaccine hesitancy.
How can the growing personalization of power be identified and measured ex ante? Extant measures in the authoritarian literature have traditionally focused on institutional constraints and more recently on individual behaviour – such as purging opposition members from (and packing allies into) government bodies. This article offers a different strategy that examines leaders’ individual rhetoric. It focuses on patterns of pronoun usage for the first person. The author argues that as leaders personalize power, they are less likely to use ‘I’ (a pronoun linked to credit claiming and blame minimizing) and more likely to use ‘we’ (the leader speaks for – or with – the populace). To test this argument, the study focuses on all major, scheduled speeches by all chief executives in the entire Chinese-speaking world – that is, China, Singapore and Taiwan – since independence. It finds a robust pattern between first-person pronouns and political constraints. To ensure the results are not driven by the Chinese sample, the rhetoric of four other political leaders is considered: Albania's Hoxha, North Korea's Kim Il Sung, Hungary's Orbán and Ecuador's Correa. The implications of this project suggest that how leaders talk can provide insights into how they perceive their rule.