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The dispersion of solutes has been extensively studied due to its important applications in microfluidic devices for mixing, separation and other related processes. Solute dispersion in fluids can be analysed over multiple time scales; however, Taylor dispersion specifically addresses long-term behaviour, which is primarily influenced by advective dispersion. This study investigates Taylor–Aris dispersion in a viscoelastic fluid flowing through axisymmetric channels of arbitrary shape. The fluid’s rheology is described using the simplified Phan-Thien–Tanner (sPTT) model. Although the channel walls are axisymmetric, they can adopt any geometry, provided they maintain small axial slopes. Drawing inspiration from the work of Chang & Santiago (2023 J. Fluid Mech. vol. 976, p. A30) on Newtonian fluids, we have developed a governing equation for solute dynamics that accounts for the combined effects of fluid viscoelasticity, molecular diffusivity and channel geometry. This equation is expressed using key dimensionless parameters: the Weissenberg number, the Péclet number and a shape-dependent dimensionless function. Solving this model allows us to analyse the temporal evolution of the solute distribution, including its mean and variance. Our analysis shows that viscoelasticity significantly decreases the effective solute diffusivity compared with that observed in a Newtonian fluid. Additionally, we have identified a specific combination of parameters that results in zero or negative transient growth of the variance. This finding is illustrated in a phase diagram and provides a means for transient control over dispersion. We validated our results against Brownian dynamics simulations and previous literature, highlighting potential applications for the design and optimisation of microfluidic devices.
Anorexia nervosa is associated with high personal and financial costs for sufferers, carers and society in general, but little is known about the long-term health economic burden.
Aims
To examine healthcare utilisation, social assistance, sick leave and disability pension in individuals with anorexia nervosa over a period of 30 years.
Method
Fifty-one individuals with adolescent-onset anorexia nervosa and 51 matched comparison cases (COMP) were recruited in the community and followed prospectively from 1985. All individuals were examined on five occasions. At the 30-year follow-up, mean age 44, data on in- and out-patient care, prescribed medications, social assistance, sick leave and disability pension were collected from Swedish national registers.
Results
The anorexia nervosa group had more days of in-patient care (p < 0.001) and out-patient visits to psychiatry (p < 0.001), more days of sick leave (p = 0.006), more days of disability pension (p = 0.002) and were prescribed more psychotropic medication (p = 0.045) compared with the COMP group. Of the anorexia nervosa group, 22% had ever received a disability pension compared with 2% in the COMP group (p = 0.004) and less than half the anorexia nervosa group worked full-time at the 30-year follow-up. In the anorexia nervosa group, 45% had received social assistance at some point, compared with 22% in the COMP group (p = 0.02). Age at onset of anorexia nervosa emerged as a predictor of healthcare utilisation with significant odds ratios for psychiatric in-patient (odds ratio 0.61, 95% CI: 0.39, 0.94; p = 0.027) and out-patient care (odds ratio 0.63, 95% CI: 0.40, 0.98; p = 0.042), i.e. individuals with a later onset of anorexia nervosa were less likely to require psychiatric care.
Conclusions
The long-term burden of adolescent-onset anorexia nervosa comprises increased utilisation of healthcare and dependence on society for a significant minority. A later onset of anorexia nervosa predicted a lower healthcare utilisation.
We evaluated whether patient perceptions of cleanliness are associated with objective measures of Clostridioides difficile infection (CDI), as an early indicator of facility-level CDI rates and prevention.
Design:
Cross-sectional analysis of Medicare-certified hospitals across the United States.
Methods:
Data from the CMS Hospital Compare website and U.S. Census Bureau from 2023 were analyzed using multivariate logistic regression models. The primary outcome was C. difficile standardized infection ratios (SIRs) compared to the national average. The primary exposure was patient-rated cleanliness star ratings from the Hospital Consumer Assessment of Healthcare Providers and Systems survey.
Results:
The population studied was 3,616 medicare-certified hospitals with an estimated 17,994,034 unique patient admissions. There was no association between better patient-rated cleanliness and improved CDI performance. Facilities with a 5-star cleanliness rating were not more likely to have an SIR less than or equal to the national average compared to those with a lower star rating. For every 1% increase in patients who reported their room and bathroom as always clean, the odds of CDI observed cases being higher than predicted increases by 4.2% (ie, increasing patient-related cleanliness was weakly associated with worse CDI performance).
Conclusions:
Patient-rated cleanliness was not associated with improved CDI performance in U.S. national hospital data. Findings were consistent across multiple operationalizations of cleanliness and CDI suggesting patient perceptions of cleanliness are not a strong indicator of CDI control measure performance.
Disaster medicine (DM) prepares health care professionals to manage emergencies caused by significant societal disruptions. Training recent graduates and final-year students is an essential element of disaster preparedness. This review aims to examine the use of Virtual Simulation (VS) in undergraduate students’ DM training.
Methods
The research team searched Scopus, PubMed, WOS, and Scielo. The team followed the 6-step approach described by Mak to conduct Scoping Reviews. We identified 262 reports, and 17 articles met the inclusion criteria. We extracted and analyzed data, focusing on educational settings, professions involved, and intervention characteristics. The report followed PRISMA guidelines.
Results
The implementation of VS in DM training has been geographically concentrated, with most studies focused on nursing education. Most programs use virtual reality, with limited augmented or mixed reality integration, principally in nursing students. The training focused primarily on triage, disaster preparedness, evacuation, decontamination, improving knowledge retention, self-confidence, and decision-making.
Conclusions
Although VS has effectively enhanced technical skills and disaster preparedness, its use remains limited in undergraduate health education. Further research is needed to expand its application in interprofessional and non-nursing contexts, with deliberate practice principles to maximize efficiency. Integrating VS into community training can reduce costs and enhance large-scale emergency response.
The spatial organisation of a passive scalar plume originating from a point source in a turbulent boundary layer is studied to understand its meandering characteristics. We focus shortly downstream of the isokinetic injection ($1.5\leqslant x/\delta \leqslant 3$, $\delta$ being the boundary-layer thickness) where the scalar concentration is highly intermittent, the plume rapidly meanders and breaks up into concentrated scalar pockets due to the action of turbulent structures. Two injection locations were considered: the centre of the logarithmic region and the wake region of the boundary layer. Simultaneous quantitative acetone planar laser-induced fluorescence and particle image velocimetry were performed in a wind tunnel, to measure scalar mixture fraction and velocity fields. Single- and multi-point statistics were compared with established works to validate the diagnostic novelties. Additionally, the spatial characteristics of plume intermittency were quantified using ‘blob’ size, shape, orientation and mean concentration. It was observed that straining, breakup and spatial reorganisation were the primary plume-evolution modes in this region, with little small-scale homogenisation. Further, the dominant role of coherent vortex motions in plume meandering and breakup was evident. Their action is found to be the primary mechanism by which the injected scalar is transported away from the wall in high concentrations (‘large meander events’). Strong spatial correlation was observed in both instantaneous and conditional fields between the high-concentration regions and individual vortex heads. This coherent transport was weaker for wake injection, where the plume only interacts with outer vortex motions. A coherent-structure-based mechanism is suggested to explain these transport mechanisms.
We study the mortgage rate channel of monetary policy transmission under two different mortgage regimes by analyzing the United States with primarily long-term fixed-rate mortgages (FRMs) and Spain with mainly annually resetting adjustable-rate mortgages (ARMs). We find a robust transmission of mortgage rate changes to spending in both regimes, with marginal propensities to consume ranging between 0.58–0.67 in Spain and 0.27–0.52 in the United States. Under ARMs, transmission is stronger when rate changes are expected to persist, whereas under FRMs, the effect is larger when rate changes are expected to revert. We further document the important role of mortgage type in shaping the variation in transmission across mortgagors—while the mortgage rate effect is fairly homogeneous across diverse household characteristics under ARMs, it is more heterogeneous under FRMs and largest among potential refinancers.
This study analyzed medium-to-long-term trends in long-term care insurance expenditures in Katsurao Village, which underwent complete evacuation following the Fukushima Daiichi Nuclear Power Plant accident, to elucidate the disaster’s impact on care needs. Long-term care insurance expenditure data of Katsurao Village from 2010 to 2023 were analyzed. Per capita long-term care expenditure was calculated by dividing the total long-term care insurance benefits by the population aged ≥65 years and compared to national averages. In 2016, when evacuation orders were largely lifted, per capita long-term care insurance expenditure reached JPY 562,970, approximately three times pre-disaster levels (JPY 197,461 in 2010). Although expenditures gradually decreased thereafter, they remained high at JPY 415,884 in 2023. Evacuation due to nuclear disaster leads to sustained increases in long-term care burden.
The increasing levels of job demands and work stress experienced daily by workers in multiple contexts have increased the experience of the need for recovery after work. This study aims to provide validity evidence for the Danish Need for Recovery (NFR) Scale. We analyzed the psychometric properties of the scale, its factor structure, internal consistency, measurement invariance, and validity based on relationships with other variables (job stress, general health, and affective states) in two samples of Spanish workers. The results obtained through exploratory and confirmatory factor analyses strongly support the unidimensional structure of the Spanish version of the NFR in its full eight-item version after eliminating one item not applicable in our cultural context, with good data fit. The values obtained regarding internal consistency, besides measurement invariance across groups, ensure the scale’s reliability and applicability. The validity and associations with other constructs tested were also confirmed in the hypothesized relationships with the respective variables analyzed. However, the short three-item version does not present a better fit compared to the full version in its Spanish validation. The Spanish adaptation of the Danish NFR scale in its full eight-item version constitutes a reliable and valid instrument for the assessment of this construct. The methodological and practical implications of the Spanish version of the NFR scale are detailed in the discussion.
New experimental results on gas flow through a long tube in the viscous, slip and transitional regimes are presented, obtained using an improved constant-volume measurement technique. This method is based on measuring the pressure variation in the inlet tank while the outlet tank is evacuated to a low pressure. Experimental pressure data for helium, neon, argon, nitrogen, krypton and xenon are used to extract the Poiseuille coefficient through a newly developed methodology. The obtained values show good agreement with theoretical predictions. Additionally, the velocity slip coefficient is also extracted from the same pressure data for all tested gases.
“Dual disorders” (DD) refers to the co-occurrence of addiction and other mental health conditions, which often interact and complicate care. Despite scientific evidence showing shared brain mechanisms, current diagnostic systems treat them separately, leading to fragmented treatment and stigma. The World Association on Dual Disorders urges adopting “dual disorders” as a unified term to improve clarity, care integration, and outcomes.
Women’s labor in African urban centers permeates every sphere of urban life, yet its full scope remains understated in scholarly accounts. Akinwole introduces “holistic articulation” as a method for reading African women’s discursive labor. Holistic articulation names an analytical strategy of linking discursive fragments about women’s labor across multiple archives: social history, African literature, popular journalism, mythography, and everyday expressions. By tracing these connections, holistic articulation highlights the breadth of African women’s space-making and performative labor. This approach extends existing frameworks for analyzing African women’s labor by foregrounding its discursive and imaginative dimensions.
To assess interagency emergency response capabilities for radiological threats through a tabletop exercise (TTX) simulating a nuclear power plant accident, with focus on communication protocols, patient referral pathways, and public information management in Ukraine’s current security context.
Methodology
A structured 3-day TTX was conducted in September 2024 by the WHO Ukraine Country Office, simulating a cooling system failure at a fictional North-West Nuclear Power Plant. Twelve organizations participated, including regional health authorities, emergency services, and international partners. The exercise employed a progressive scenario that injects testing accident notification, media management, medical response, and evacuation procedures. Performance was evaluated using structured criteria (Achieved, Partially Achieved, Not Achieved) across predefined indicators.
Results
The exercise identified critical preparedness gaps including the absence of regular radiological-nuclear emergency drills in regions without nuclear facilities, challenges in potassium iodide procurement and distribution, staff hesitancy due to inadequate insurance coverage, and lack of standardized decontamination procedures. Communication protocols functioned effectively, though coordination delays were noted. Patient referral pathways required strengthening, particularly for contaminated casualties.
Conclusions
While Ukraine demonstrates functional emergency response frameworks, specific radiological preparedness requires enhancement. Regular multiagency drills, improved staff protection policies, standardized decontamination protocols, and robust public information systems are essential for effective radiological emergency response.
On April 28, 2025, a large-scale blackout affected mainland Spain and Portugal for over ten hours, severely impacting Emergency Medical Services (EMS). Although the cause remains uncertain and initially cyberattack was a concern, it has most probably been related to infrastructure failure. This event exposed critical vulnerabilities in EMS preparedness, as no region had a specific contingency plan for power outages.
The blackout led to wide-spread disruption, including traffic signal failures that caused accidents and delayed emergency response, and the collapse of communication networks that affected 1-1-2 emergency calls. Fuel shortages also emerged as gas stations became non-operational. Patients using home medical devices faced life-threatening situations, with at least one death reported due to a ventilator failure. The reliance on technology proved to be a major weakness, as many EMS systems lacked backup communication tools like satellite phones or analog radios, and many hospitals and ambulance bases were not prepared with stable generators and adequate fuel access.
Coordination between EMS, hospitals, and other emergency services was challenged by incompatible protocols and equipment. Despite these difficulties, EMS demonstrated adaptability by prioritizing urgent care and reallocating resources. The event exposed systemic fragilities and underscored the need for robust emergency planning, interagency drills, technological redundancy, and investment in resilient infrastructure. This incident serves as a global wake-up call, emphasizing that health systems must be prepared for increasing risks from climate change, cyber threats, and energy insecurity. Emergency preparedness should shift from being reactive to proactive, focusing on flexible systems, coordinated action, and workforce training to ensure continuity of health care during future blackouts.
Metabolomics of faecal samples offers a non-invasive method to monitor gastrointestinal (GI) development and microbial activity in dairy heifers during key physiological transitions. In this longitudinal study, faecal metabolites from 10 Holstein heifers were analyzed from birth to first calving using targeted metabolomics. Faecal samples were collected at 12 h post-birth, week 6 (pre-weaning), week 14 (weaning), 8 months (post-weaning), and at first calving (26 ± 2.3 months). Calves were fed 3.8 L of colostrum within 2 h of birth, followed by 6 L of maternal transition milk for 5 days, then 6 L of milk replacer twice daily. Group housing began at 14 days. Partial least squares discriminant analysis (PLS-DA) showed distinct temporal clustering of faecal metabolites. Heatmap analysis revealed significant metabolite alterations, particularly between pre- and post-weaning stages. A linear mixed-effects model identified significant stage effects for all 17 amino acids. Of the 55 biogenic amines and amino acid-related metabolites, 48 significantly differed across stages. Elevated amino acids and polyamines early in life reflected colostrum intake and immature digestion, decreasing post-weaning, indicating improved nutrient absorption and rumen functionality. Increased microbiota-derived compounds, including β-alanine, serotonin, and indole derivatives, reflected microbial colonization and co-regulation with the host. Elevated dopamine, homocysteine, and phenylethylamine in late gestation indicated neuroactive and redox adaptations. Overall, faecal metabolite profiles provide insights into metabolic remodelling related to nutrition, GI maturation, and reproductive development, highlighting faecal metabolomics as a useful non-invasive tool for monitoring heifer development.