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A 65-day-old girl presented to the emergency room with lethargy, requiring emergency venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock. Initially, hypoplastic left heart syndrome was suspected. However, cor triatriatum with a pinpoint opening on the membrane was diagnosed based on a detailed echocardiographic examination. After membrane resection, the left heart size was restored. However, follow-up echocardiography performed 4 months later showed occlusion of both upper pulmonary veins and stenosis in both lower pulmonary veins. Hybrid balloon angioplasty was performed in all pulmonary veins, and stents were inserted into the right upper and lower pulmonary veins. Despite repeated balloon angioplasty, all pulmonary vein stenosis progressed over 6 months and the patient expired while waiting for a heart-lung transplant. Even after successful repair of cor triatriatum, short-term close follow-up is required for detecting the development of pulmonary vein stenosis.
The North-Eastern region (NER) of India falls under the Eastern Himalayan region and it is a bio-diversity hub. Diverse maize landraces with wide adaptability to extreme climatic and soil scenario like heavy rainfall, drought and acidic soil conditions have been grown in NER since time immemorial. However, maize diversity in NER region has drastically reduced due to introduction of high yielding varieties and hybrids. Modern maize breeding programmes are focused on high yield but other unique traits like stay green trait, prolificacy (more than one fertile ear per plant), self-fertilizing ability are also important and the local germplasm of the NER region can contribute with these unique traits. Prior to the selection of any lines in several breeding programmes, assessment of genetic diversity and population structure are basic requirements. Hence, in the present study assessment of genetic diversity and population structure study in 30 maize inbreds developed from different germplasm of NER was undertaken using SSR markers, selected for their broad distribution throughout the genome, in order to assess the extent of allelic diversity among the lines and whether any population structure could be established. In addition to assessing molecular diversity, the study aims to evaluate the potential for yield and other beneficial and unique alleles that have high potential to contribute in the genetic enhancement programme of maize.
Brain ageing, the primary risk factor for cognitive impairment, occurs because of the accumulation of age-related neuropathologies. Identifying effective nutrients that increase cognitive function may help maintain brain health. Tomatoes and lemons have various bioactive functions and exert protective effects against oxidative stress, ageing and cancer. Moreover, they have been shown to enhance cognitive function. In the present study, we aimed to investigate the effects of tomato and lemon ethanolic extracts (TEE and LEE, respectively) and their possible synergistic effects on the enhancement of cognitive function and neurogenesis in aged mice. The molecular mechanisms underlying the synergistic effect of TEE and LEE were investigated. For the in vivo experiment, TEE, LEE or their mixture was orally administered to 12-month-old mice for 9 weeks. A single administration of either TEE or LEE improved cognitive function and neurogenesis in aged mice to some extent, as determined using the novel object recognition test and doublecortin immunohistochemical staining, respectively. However, a significant enhancement of cognitive function and neurogenesis in aged mice was observed after the administration of the TEE + LEE mixture, which had a synergistic effect. N-methyl-d-aspartate receptor 2B, postsynaptic density protein 95, and brain-derived neurotrophic factor (BDNF) levels and tropomyosin receptor kinase B (TrkB)/extracellular signal-regulated kinase (ERK) phosphorylation also synergistically increased after the administration of the mixture compared with those in the individual treatments. In conclusion, compared with their separate treatments, treatment with the TEE + LEE mixture synergistically improved the cognitive function, neurogenesis and synaptic plasticity in aged mice via the BDNF/TrkB/ERK signalling pathway.
How do ordinary people choose survival strategies during intense, surprising political violence? Why do some flee violence, while others fight back, adapt, or hide? Individual decision-making during violence has vast political consequences, but remains poorly understood. I develop a decision-making theory focused on individual appraisals of how controllable and predictable violent environments are. I apply my theory, situational appraisal theory, to explain the choices of Indian Sikhs during the 1980s–1990s Punjab crisis and 1984 anti-Sikh pogroms. In original interviews plus qualitative and machine learning analysis of 509 oral histories, I show that control and predictability appraisals influence strategy selection. People who perceive “low” control over threats often avoid threats rather than approach them. People who perceive “low” predictability in threat evolution prefer more-disruptive strategies over moderate, risk-monitoring options. Appraisals explain behavior variation even after accounting for individual demographics and conflict characteristics, and also account for survival strategy changes over time.
The objectives of this study were to investigate the effect of level and timing of silage supplementation during early lactation on animal performance and dry matter intake (DMI). Two farm-lets were established with a high (1253 kg DM/ha) and low (862 kg DM/ha) grass availability at turnout. In spring, cows were assigned to one of two treatments as they calved over 2 years; high grass (HG) and low grass (LG). During period 1 (week 1–6), cows on the HG treatment were offered a high daily herbage allowance (DHA) with low silage and the LG treatment were offered a low DHA with high silage. In period 2 (week 7–12), half of the cows from the HG treatment in P1 switched to the LG treatment in P2 and vice versa as 20 LG cows in P1 switched to the HG treatment in P2. Cows on the HG treatment in P2 received a high DHA with no silage and the LG treatment received a low DHA with 3 kg DM/cow silage. Grass DMI was significantly higher for the HG treatment during both periods (+1.6 and +3.4 kg DM/cow/day, respectively). The HG treatment produced +0.9 kg milk/cow/day and had a higher protein concentration (+1.1 g/kg milk) compared to cows on the LG treatment during period 2. Differences in animal performance observed in period 2 were maintained throughout the 8-week carryover period.
We study a nonlinear Beltrami equation $f_\theta =\sigma \,|f_r|^m f_r$ in polar coordinates $(r,\theta ),$ which becomes the classical Cauchy–Riemann system under $m=0$ and $\sigma =ir.$ Using the isoperimetric technique, various lower estimates for $|f(z)|/|z|, f(0)=0,$ as $z\to 0,$ are derived under appropriate integral conditions on complex/directional dilatations. The sharpness of the above bounds is illustrated by several examples.
To determine the effectiveness of dry hydrogen peroxide (DHP) in reducing environmental bioburden in occupied areas.
Design:
Prospective environmental cohort study.
Setting:
The study was conducted in 2 tertiary-care hospitals and 1 free-standing emergency department.
Intervention:
Environmental air and surface sites were cultured before and after continuous deployment of DHP systems in targeted hospital areas.
Methods:
In total, 1,554 surface and 1,036 air samples were collected from 74 patient areas among the 3 facilities on 3 consecutive days before DHP deployment and on days 14, 30, 60, and 90 after deployment. At each sampling time, 2 air samples were collected at each facility from 1 room without DHP, along with 2 outdoor samples from each facility. The impact of negative-pressure usage on the efficacy of DHP was also evaluated, with 1 hospital continuously using negative pressure, another utilizing it only in patient isolation scenarios, and another without negative pressure.
Results:
In the 2 facilities without continuous negative pressure, exposure to DHP was associated with a significant reduction in surface bioburden, characterized as total colony-forming units (P = .019; P = .002). Significant associations between DHP exposure and reductions in airborne bacterial load at the 2 hospitals were observed (P ≤ .001; P = .041), and the free-standing emergency department experienced a reduction that did not achieve statistical significance (P = .073).
Conclusions:
Our findings confirm that DHP has the potential to reduce microbial air and surface bioburden in occupied patient rooms with standard ventilation parameters.
This research aims to unpack how digital technologies can facilitate the flourishing of circular business practices in small- and medium-sized enterprises by structuring a detailed going circular path that explains businesses’ evolution toward circularity. In doing so, it outlines how the observed organizations have adopted – or are adopting – circular economy principles thanks to business digitalization. Following an inductive approach based on a multiple case study methodology, we investigated 16 small- and medium-sized enterprises operating in industries that put considerable pressure on the environment (e.g., manufacturing, chemical, construction, fashion, food, and beverage). Our findings confirm how digital technologies, as well as Industry 4.0 structures, play a fundamental role in shaping, enabling, enhancing, and refining circular products and processes development. Accordingly, we outline a generalizable step-by-step process to pursue circular economy by employing digital technologies. The present study represents a practical handout for guiding companies through their going circular path.
We provide conditions under which a generalized shift-invariant (GSI) system can be approximated by a GSI system for which the generators have compact support in the Fourier domain. The approximation quality will be measured in terms of the Bessel bound (upper frame bound) for the difference between the two GSI systems. In particular, this leads to easily verifiable conditions for a perturbation of a GSI system to preserve the frame property.
The proliferation of English as an international language has had significant ramifications for the teaching and learning of languages in various educational contexts (Yu & Liu, 2022). Within the realm of higher education, the adoption of English-medium instruction (EMI) has been a particularly contentious issue, with debates raging over its potential benefits and drawbacks (Bolton et al., 2022; Bolton, Botha & Lin, 2023). One potential approach to addressing the challenges posed by EMI is the adoption of translanguaging practices, which involve the utilization of multiple languages or language varieties in communication and learning. While the concept of translanguaging has gained increasing traction in recent years, there remains a paucity of empirical research on its implementation and impact within Sino-US educational institutions where translanguaging and EMI are facing enviable pedagogical dueling.
Let $n$ be an integer congruent to $0$ or $3$ modulo $4$. Under the assumption of the ABC conjecture, we prove that, given any integer $m$ fulfilling only a certain coprimeness condition, there exist infinitely many imaginary quadratic fields having an everywhere unramified Galois extension of group $A_n \times C_m$. The same result is obtained unconditionally in special cases.
How do Asian Americans think about their ethnic origin? How do ethnic identities affect political preferences? Drawing on interviews with a diverse group of Asian Americans, I provide a nuanced understanding of how they think about their ethnic origin and pan-ethnic identities. The findings reveal that ethnicity plays a significant role in shaping electoral preferences, as Asian Americans exhibit coethnicity preferences, conditional on partisanship. Moreover, I uncover several factors that have been underexplored in the existing literature, including transnational ties, news consumption, and political preferences on foreign policies related to their home country. This article provides a more comprehensive and nuanced understanding of Asian American identities by showing that the ethnic origin roots of Asian Americans can have significant influence on their political interests and candidate preferences.
Given a fixed graph $H$ and a constant $c \in [0,1]$, we can ask what graphs $G$ with edge density $c$ asymptotically maximise the homomorphism density of $H$ in $G$. For all $H$ for which this problem has been solved, the maximum is always asymptotically attained on one of two kinds of graphs: the quasi-star or the quasi-clique. We show that for any $H$ the maximising $G$ is asymptotically a threshold graph, while the quasi-clique and the quasi-star are the simplest threshold graphs, having only two parts. This result gives us a unified framework to derive a number of results on graph homomorphism maximisation, some of which were also found quite recently and independently using several different approaches. We show that there exist graphs $H$ and densities $c$ such that the optimising graph $G$ is neither the quasi-star nor the quasi-clique (Day and Sarkar, SIAM J. Discrete Math. 35(1), 294–306, 2021). We also show that for $c$ large enough all graphs $H$ maximise on the quasi-clique (Gerbner et al., J. Graph Theory 96(1), 34–43, 2021), and for any $c \in [0,1]$ the density of $K_{1,2}$ is always maximised on either the quasi-star or the quasi-clique (Ahlswede and Katona, Acta Math. Hung. 32(1–2), 97–120, 1978). Finally, we extend our results to uniform hypergraphs.
A fleet of aircraft can be seen as a set of degrading systems that undergo variable loads as they fly missions and require maintenance throughout their lifetime. Optimal fleet management aims to maximise fleet availability while minimising overall maintenance costs. To achieve this goal, individual aircraft, with variable age and degradation paths, need to operate cooperatively to maintain high fleet availability while avoiding mechanical failure by scheduling preventive maintenance actions. In recent years, reinforcement learning (RL) has emerged as an effective method to optimise complex sequential decision-making problems. In this paper, an RL framework to optimise the operation and maintenance of a fleet of aircraft is developed. Three cases studies, with varying number of aircraft in the fleet, are used to demonstrate the ability of the RL policies to outperform traditional operation/maintenance strategies. As more aircraft are added to the fleet, the combinatorial explosion of the number of possible actions is identified as a main computational limitation. We conclude that the RL policy has potential to support fleet management operators and call for greater research on the application of multi-agent RL for fleet availability optimisation.
Grassland production based on cutting-only and an increasing frequency of prolonged periods of drought due to climate change could lead to decreased productivity in Lolium perenne. In field experiments, we tested whether Festuca arundinacea and Phleum pratense could be suitable alternatives to L. perenne on intensively managed grassland on clay, peat and sandy soil. The three grasses were sown in mixture with Poa pratensis and Trifolium repens and subjected to different frequencies of defoliation representing a cutting-only system, simulated grazing system and a mixed system. We found that in systems with at least six defoliations, F. arundinacea represented an acceptable compromise between feed quality (6.4 MJ net energy/kg dry matter (DM), 19.3% crude protein, CP), persistence (mass proportion >90%), and DM yield (12.7 Mg/ha). However, for dairy production based on intensive cutting-only systems, the quality of F. arundinacea was insufficient (5.9 MJ net energy/kg DM, 15.6% CP). Mixtures with P. pratense as the main sown species did not differ significantly in production of net energy and CP from L. perenne in cutting-only systems on sandy soil. On peat land, all sown mixtures were invaded by Holcus lanatus. We found that under frequent defoliation conditions, H. lanatus-rich swards had comparatively good DM yields (9.2 Mg/ha) and a feed quality that would be sufficient for dairy cow nutrition (net energy, 6.2–6.4 MJ/kg DM; 18.8–20.4% CP). We conclude that there is potential to adapt the choice of grasses and mixtures in different production systems to meet the challenges of climate change.
Childhood maltreatment is associated with wide-ranging psychopathology at all stages of life. In the current study, we investigated whether posttraumatic stress disorder (PTSD) severity mediated the association between childhood maltreatment and internalizing and externalizing disorders among 262 South African trauma-exposed adolescents (aged 12–18 years). Childhood maltreatment and PTSD symptom severity were assessed using the Childhood Trauma Questionnaire and the Child PTSD Checklist, respectively. Psychiatric disorders were assessed utilizing the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version and were grouped into internalizing or externalizing disorders. Hierarchal logistic regression was used to assess the association of childhood maltreatment subtype with internalizing and externalizing disorders, controlling for age and gender, with PTSD symptom severity added to the final model. We found that sexual abuse was significantly associated with internalizing disorders, although this effect was no longer significant when PTSD was added to the model demonstrating that PTSD mediated the association between sexual abuse and internalizing disorders. Physical abuse, but not PTSD, was associated with externalizing disorders. Physical abuse, emotional neglect, and PTSD were associated with comorbid internalizing and externalizing disorders. These findings have implications for intervention and prevention strategies targeted at trauma-exposed adolescents with a history of childhood maltreatment.
In recent years, the architectural legacy and so-called ‘difficult heritage’ of Fascist Italy has become a flourishing field of research. These topics have also begun to make their way into the undergraduate classroom. To date, however, there has been little research carried out into the methods we use to teach the history of Fascism in particular. In this short article, we outline how we have applied problem-based learning and scenario-based learning approaches to tackle this topic. After presenting three assignments, we explain the benefits associated with a PBL/SBL approach, summarised under the headings of interdisciplinarity, creativity and authenticity, before highlighting some aspects on which colleagues may wish to reflect if they are considering adopting a similar approach in their teaching.