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Aortopulmonary window is a rare CHD, which comprises a communication between the ascending aorta and the pulmonary artery. The standard treatment of aortopulmonary window is surgical; however, few cases are amenable to closure via percutaneous intervention. We present a case of aortopulmonary window closure using Lifetech™ Konar-MF occluder device (Lifetech Scientific Co. Ltd., Shenzhen).
Warfarin is used as anticoagulation for children for a wide range of cardiac indications but carries the disadvantage of requiring international normalised ratio monitoring and dose adjustment. Management of warfarin therapy is challenging due to its narrow therapeutic window and is further complicated in children by dietary changes, frequent illnesses, and developing systems of metabolism and haemostasis.
A retrospective review was performed of patients’ medical records to assess the indication for warfarin use, percentage of international normalised ratio values in target range (%ITR), and frequency of phlebotomy.
Twenty-six patients were identified. The most common indication for warfarin use was in patients post-total cavo-pulmonary connection (n = 19, 73%). We demonstrated a variability in duration of warfarin therapy following total cavo-pulmonary connection (median of 11.1 months). Nineteen (73%) patients had used the CoaguChek machine for home measurement of international normalised ratio. The median frequency of phlebotomy for all indications was once every 10 days, and the median %ITR was 55.4 % (29.7–86.4%). Of note, the percentage under target range in the patients with mechanical mitral (n = 2) and aortic valves (n = 1) was found to be 23% and 33%, respectively.
These data demonstrate a high frequency of international normalised ratio values outside of the target range as seen in previous studies of warfarin in children. This necessitates frequent phlebotomy and dose changes, which can have a significant effect on the quality of life of these patients and their families highlighting the need to focus on quality improvement in the area of anticoagulation in paediatric cardiac patients.
Identifying persons with HIV (PWH) at increased risk for Alzheimer’s disease (AD) is complicated because memory deficits are common in HIV-associated neurocognitive disorders (HAND) and a defining feature of amnestic mild cognitive impairment (aMCI; a precursor to AD). Recognition memory deficits may be useful in differentiating these etiologies. Therefore, neuroimaging correlates of different memory deficits (i.e., recall, recognition) and their longitudinal trajectories in PWH were examined.
Design:
We examined 92 PWH from the CHARTER Program, ages 45–68, without severe comorbid conditions, who received baseline structural MRI and baseline and longitudinal neuropsychological testing. Linear and logistic regression examined neuroanatomical correlates (i.e., cortical thickness and volumes of regions associated with HAND and/or AD) of memory performance at baseline and multilevel modeling examined neuroanatomical correlates of memory decline (average follow-up = 6.5 years).
Results:
At baseline, thinner pars opercularis cortex was associated with impaired recognition (p = 0.012; p = 0.060 after correcting for multiple comparisons). Worse delayed recall was associated with thinner pars opercularis (p = 0.001) and thinner rostral middle frontal cortex (p = 0.006) cross sectionally even after correcting for multiple comparisons. Delayed recall and recognition were not associated with medial temporal lobe (MTL), basal ganglia, or other prefrontal structures. Recognition impairment was variable over time, and there was little decline in delayed recall. Baseline MTL and prefrontal structures were not associated with delayed recall.
Conclusions:
Episodic memory was associated with prefrontal structures, and MTL and prefrontal structures did not predict memory decline. There was relative stability in memory over time. Findings suggest that episodic memory is more related to frontal structures, rather than encroaching AD pathology, in middle-aged PWH. Additional research should clarify if recognition is useful clinically to differentiate aMCI and HAND.
The posterior pharyngeal wall is an anatomical subsite of both the oropharynx and hypopharynx. The treatment outcomes of squamous cell carcinoma (SCC) of these sites are generally published together, which makes the interpretation of data challenging. The aim of this analysis was to determine if there is any difference in the treatment outcomes of these two rare disease entities.
Materials and Methods
Retrospetive analysis showed that the posterior pharyngeal wall was the primary subsite in 17 patients (1.65 per cent) out of 1031 patients with oropharyngeal SCC, and in 23 patients (11.73 per cent) out of 196 patients with hypopharyngeal SCC.
Results
The five-year overall survival was 45 per cent for oropharyngeal origin and 53 per cent for hypopharyngeal origin patients. There was no significant difference in survival and locoregional control between these two groups of patients.
Conclusion
Squamous cell carcinoma of the posterior pharyngeal wall is a rare entity, which in our series represents 1.65 per cent of oropharyngeal cases and 11.73 per cent of hypopharyngeal tumours. There was no difference in treatment outcomes between the two groups.
In this paper, a high-order-mode (HOM) (TE330) cavity-fed 45° linear polarized 6×6 slot array antenna is proposed. The 45° linear polarization is achieved by introducing asymmetric cross slots on the HOM cavity, resulting in low profile and wide bandwidth. The antenna array was verified using standard printed circuit board technology. Measured results show that the impedance bandwidth ( $|S_{11}|\le$ −10 dB) is 13.9% (36.98–42.92 GHz), and the peak gain is 19.3 dBi with a 3-dB gain bandwidth of 13.6%. Attributed to its simple structure, low profile, and wide bandwidth, the presented antenna is a good candidate for 5G applications.
Ediacaran fossils, obtained in stratigraphic context in 1993, 1995, and 1996, with the assistance of A. Seilacher, IGCP project 320 scientists, and the Geological Survey of Namibia, are described for the first time. Most are from the Kliphoek and Buchholzbrunn members of the Dabis Formation and the Huns and Spitskop members of the Urusis Formation, Witputs subbasin, but a significant number, including Pteridinium, are from the Kliphoek Member, Zaris Formation, and the Neiderhagen Member, Nudaus Formation, north of the Osis arch, which separates the two subbasins. We extend the stratigraphic ranges and geographic distributions of several important taxa, including Archaeichnium, Ernietta, Pteridinium, and Swartpuntia, provide reassessments of the paleobiology of these and other organisms, and describe a new sponge—possibly an unmineralized archaeocyath—Arimasia germsi n. gen. n. sp. We also describe and illustrate various ichnofossils (including the oldest known traces from the Nama Group), narrow down the first appearance of Treptichnus in the Nama succession, and reinforce the idea that there was a prolific infauna of micrometazoans during the latest Ediacaran by naming and describing previously reported microburrows found on the surfaces of gutter casts as Ariichnus vagus n. igen. n. isp.
This paper presents a substrate-integrated waveguide (SIW) differential antenna for full duplex applications. The proposed antenna consists of two square SIW cavities named as outer and inner. The inner cavity is nested into the outer cavity. The outer cavity is differentially excited with a pair of coaxial feed lines, while the inner square patch is orthogonally excited with another pair of differential coaxial feed lines. This orthogonal feeding arrangement results in high isolation between the differential ports. The modified hybrid TE130/310 mode of the outer cavity radiates through a pair of arc-shaped slots at 9.35 GHz, while the TM01 mode of the inner square patch is responsible for the radiations at 8.65 GHz. The proposed antenna prototype is fabricated and measured for validation. Moreover, the designed antenna has a front-to-back ratio better than 22 dB and measured maximum gain values of 6.1 dBi and 7.6 dBi at 8.65 GHz (Port 2 ON) and 9.35 GHz (Port 1 ON), respectively.
Maura Dykstra's 2022 monograph Uncertainty in the Empire of Routine: The Administrative Revolution of the Eighteenth-Century Qing State (Harvard Asia Center, 2022) has attracted controversy in the academic community. This paper analyses the book's use of documents from the Ba County Archive, held in the SIchuan Provincial Archive. While reviewing the monograph's arguments drawn from these materials, the paper also introduces the Ba Archives and the methodologies that may be employed to interpret them.
We study the quasi-ergodicity of compact strong Feller semigroups $U_t$, $t> 0$, on $L^2(M,\mu )$; we assume that M is a locally compact Polish space equipped with a locally finite Borel measue $\mu $. The operators $U_t$ are ultracontractive and positivity preserving, but not necessarily self-adjoint or normal. We are mainly interested in those cases where the measure $\mu $ is infinite and the semigroup is not intrinsically ultracontractive. We relate quasi-ergodicity on $L^p(M,\mu )$ and uniqueness of the quasi-stationary measure with the finiteness of the heat content of the semigroup (for large values of t) and with the progressive uniform ground state domination property. The latter property is equivalent to a variant of quasi-ergodicity which progressively propagates in space as $t \uparrow \infty $; the propagation rate is determined by the decay of . We discuss several applications and illustrate our results with examples. This includes a complete description of quasi-ergodicity for a large class of semigroups corresponding to non-local Schrödinger operators with confining potentials.
It has been thirty years since the end of political apartheid in South Africa in 1994. Those decades have been marked by single-party dominance under the African National Congress (ANC), and the expansion of democratic rights and public goods like education, as well as neoliberal economic policies, growing inequality and, in recent years, corruption and maladministration scandals. On the heels of a historic election in May 2024, one which marked the end of the ANC's electoral dominance and was shaped, in part, by government mismanagement of the energy sector and extensive infrastructural decline, it is a timely moment to consider the history of South Africa's state and its relation to industries of extraction and energy production. Two new books do just that. Residual Governance: How South Africa Foretells Planetary Futures, by Gabrielle Hecht, takes a long view of the impact of extractive industries, arguing that contemporary South Africa may offer a cautionary tale of the devastating impacts of the Anthropocene, one that ‘foretells planetary futures’ in the way that the state has failed to reckon with the enduring communal and environmental impacts of the mining industry. Apartheid's Leviathan: Electricity and the Power of Technological Ambivalence, by Faeeza Ballim, historicizes the development of South Africa's electricity sector under the apartheid state and traces the roots of the current energy crisis back to the pursuit of authoritarian high modernism in the mid-twentieth century.
What are the origins and effects of legal ambiguity in authoritarian regimes? Using a detailed case study of nationality rights in Jordan – which draws from interviews with 210 Jordanian political officials, judges, lawyers, activists, and citizens/residents – we develop a framework for understanding how legal ambiguity emerges, and how it matters, under authoritarianism. We first conceptualize four discrete forms in which legal ambiguity manifests: lexical ambiguity (in legal texts); substantive ambiguity (in status as law); conflictual ambiguity (between contradictory legal rules); and operational ambiguity (in enforcement processes). We then scrutinize the emergence and effects of legal ambiguity in Jordanian nationality policy by integrating historical process tracing, detailed interview evidence, and a content analysis of archival documents, laws, and court verdicts pertaining to nationality rights. Our findings contribute to scholarship on legal ambiguity, authoritarian legality, and discretionary state authority by showing that (1) crisis junctures make the emergence of legal ambiguity more likely; (2) legal ambiguity takes a variety of different forms that warrant conceptual disaggregation; and (3) different forms of legal ambiguity often have disparate effects on how authoritarian state power is organized and experienced in public life.
Access challenges for China researchers have increased, including for online research. This paper focuses on one subset of such challenges: policy documents. As no studies have to date analysed variation in data availability over time, researchers studying official documents risk conflating variation in transparency with actual policy change. This paper analyses missingness and finds that publication of policy documents under China's “open government information” initiative increased until the mid-late 2010s but then began to decrease. A key determinant of policy transparency is whether a document is related to citizens’ daily lives, as opposed to national security. Furthermore, nearly 20 per cent of policy documents become unavailable two years after their publication. The paper concludes with a discussion on how to mitigate these challenges.
Although the interaction between microswimmers and walls during near-wall swimming has been extensively studied, the effect of microswimmer shapes and slip boundary conditions on the dynamic characteristics of near-wall microswimmers has received less attention. In this study, elliptical microswimmer models have been developed with various aspect ratios based on circular microswimmers. The lattice Boltzmann method has been used for the numerical simulation of the dynamic behaviour of microswimmers near walls. Under slip boundary conditions, the escape or capture of microswimmers by the walls is influenced by the swimming Reynolds number (Res), wall slip length (ls) and the aspect ratio (Cab) of a microswimmer. Changes in the Cab value of a microswimmer considerably affect its swimming state, especially for puller-type microswimmers. The tendency of pullers to be captured by the wall increases with increasing Cab. Moreover, changes in ls within the slip boundary condition of a puller can induce a transition in its movement state from a wall oscillation state to a stable sliding state and eventually to a wall lock-up state, a process influenced by the Cab value of the puller. Pusher-type microswimmers show a considerably increased tendency to escape from walls with increasing Cab and no wall lock-up state is observed, which is opposite to the case of pullers. Pushers and pullers show an increased tendency to be captured by the wall with increasing initial swimming angle of the microswimmer. The findings of this study enhance our understanding of the swimming patterns of natural microswimmers near walls and are of substantial importance for the design of artificial microswimmers and microfluidic devices.
A boundary integral representation is derived for the translational oscillations of a triaxial ellipsoid in a uniformly stratified fluid. The representation is of single-layer type, a distribution of sources and sinks over the surface of the ellipsoid. The added mass tensor of the ellipsoid is deduced from it and, from this tensor, the impulse response function together with the energy radiated away as internal waves. Horizontal oscillations correspond to the generation of an internal or baroclinic tide by the oscillation of the barotropic tide over ellipsoidal topography at the bottom of the stratified ocean. Such topography is unconditionally supercritical, namely of slope larger than the slope of the wave rays, irrespective of the frequency of oscillation. So far, analytical work on supercritical topographies has been limited, for the most part, to two-dimensional set-ups. Here, for the ellipsoidal seamount, the orientation of the barotropic tide and the anisotropy of the topography have their effects analysed in detail. As the height of the seamount increases, the rate of conversion of barotropic energy into baroclinic form is seen to first increase according to the square law expected for a topography of small slope, then saturate and eventually decrease.
The age at first calving (AFC) is an important trait to be considered in breeding programmes of dairy buffaloes, where new approaches and technologies, such as genomic selection, are constantly applied. Thus, the objective of this study was to compare the predictive ability of different genomic single-step methods using AFC information from Murrah buffaloes. From a pedigree file containing 3320 buffaloes, 2247 cows had AFC records and 553 animals were genotyped. The following models were performed: pedigree-based BLUP (PBLUP), single-step GBLUP (ssGBLUP), weighted single-step GBLUP (WssGBLUP), and single-step Bayesian regression methods (ssBR-BayesA, BayesBπ, BayesCπ, Bayes-Lasso, and BayesRR). To compare the methodologies, the accuracy and dispersion of (G)EBVs were assessed using the LR method. Accuracy estimates for the genotyped animals ranged from 0.30 (PBLUP) to 0.39 (WssGBLUP). Predictions with the traditional model (PBLUP) were very dispersed from what was expected, while BayesCπ (0.99) and WssGBLUP (1.00) obtained the lowest dispersion. The results indicate that the use of genomic information can improve the genetic gain for AFC by increasing the accuracy and reducing inflation/deflation of predictions compared to the traditional pedigree-based model. In addition, among all genomic single-step models studied, WssGBLUP and single-step BayesA were the most advantageous methods to be used in the genomic evaluation of AFC of buffaloes from this population.
An exceptional Late Neolithic burial discovered at Puisserguier, southern France, contains a skeleton buried with its head deposited on its torso; the disposal of the rest of the body follows a standard pattern for individual burials of this period. The authors discuss the nature of this deposit in terms of its funerary status.
Guided-jet waves have been shown to close resonance loops in a myriad of problems such as screech and impingement tones in jets. These discrete, upstream-travelling waves have long been identified in linear-stability models of jet flows, but in this work they are instead considered in the context of an acoustic-scattering problem. It is shown that the guided-jet mode results from total internal reflection and transmission of acoustic waves, arising from the shear layer behaving like a duct with some given wall impedance. After total reflection, only discrete streamwise wavenumbers may be supported by the flow, with these wavenumbers dictated by the fact that the standing wave formed inside of the jet must fit between the two shear layers. Close to the sonic line, the transmission of this mode to the outside is maximum, leading to a net-energy flux directed upstream, which dictates the direction of propagation of this mode, providing a clear connection to the better understood soft-duct mode (Towne et al., J. Fluid Mech., vol. 825, 2017, pp. 1113–1152). The model also indicates that these waves are generated in the core of the flow and can only be efficiently transmitted to the quiescent region under certain conditions, providing an explanation as to why screech is only observed at conditions where the discrete mode is supported by the flow. The present results explain, for the first time, the nature and characteristics of the guided-jet waves.
Let f and g be two distinct normalized primitive holomorphic cusp forms of even integral weight $k_{1}$ and $k_{2}$ for the full modular group $SL(2,\mathbb {Z})$, respectively. Suppose that $\lambda _{f\times f\times f}(n)$ and $\lambda _{g\times g\times g}(n)$ are the n-th Dirichlet coefficient of the triple product L-functions $L(s,f\times f\times f)$ and $L(s,g\times g\times g)$. In this paper, we consider the sign changes of the sequence $\{\lambda _{f\times f\times f}(n)\}_{n\geq 1}$ and $\{\lambda _{f\times f\times f}(n)\lambda _{g\times g\times g}(n)\}_{n\geq 1}$ in short intervals and establish quantitative results for the number of sign changes for $n \leq x$, which improve the previous results.