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This is the first study to report on the impact of race on differences in the prevalence of echocardiographic left ventricular hypertrophy and left ventricular adaptation at the time of diagnosis of essential hypertension in children.
Methods:
This cross-sectional, single-centre study included patients aged 3–18 years who had newly diagnosed essential hypertension. Echocardiography was used to assess left ventricular mass index and left ventricular relative wall thickness. An left ventricular mass index > the 95th percentile for age and gender, and an left ventricular relative wall thickness > 0.42, were used to diagnose left ventricular hypertrophy and concentric adaptation. Various echocardiographic parameters were compared between African Americans and Caucasians.
Results:
The study included 422 patients (289 African Americans and 133 Caucasians) diagnosed with essential hypertension at a median age of 14.6 (interquartile range; 12.1–16.3) years. Eighty-eight patients (20.9%) had left ventricular hypertrophy. There was no statistically significant difference in the prevalence of left ventricular hypertrophy between African Americans and Caucasians (22.5% versus 17.3%, p=0.22). The median left ventricular relative wall thickness was 0.35 (0.29–0.43), and 114 patients (27.0%) had an left ventricular relative wall thickness > 0.42. The presence of an left ventricular relative wall thickness > 0.42 was significantly higher among African Americans compared to Caucasians (30.1% versus 20.3%, p = 0.04). The African American race was a strong predictor for an left ventricular relative wall thickness > 0.42 (odds ratio 1.7, p = 0.04), but not for left ventricular mass index > the 95th percentile (p = 0.22). Overweight/obesity was a strong predictor for an left ventricular mass index > the 95th percentile.
Conclusions:
There was no difference in the prevalence of left ventricular hypertrophy in children with essential hypertension of different races. Obesity, rather than being African American, is associated with left ventricular hypertrophy.
This study focuses on numerically investigating the impact of fluid viscoelasticity on the flow dynamics around a transversely forced oscillating cylinder operating in the laminar vortex shedding regime at a fixed Reynolds number of $Re = 100$. Specifically, we explore how fluid viscoelasticity affects the boundary between the lock-in and no lock-in regions and the corresponding wake characteristics compared with a simple Newtonian fluid. Our findings reveal that fluid viscoelasticity enables the synchronization of the vortex street with the cylinder motion at lower oscillation frequencies than those required for a Newtonian fluid. Consequently, the lock-in region boundary for a viscoelastic fluid differs from that of a Newtonian fluid and expands in the non-dimensional cylinder oscillation amplitude and frequency parameter space. In the primary synchronization region, the wake of a Newtonian fluid exhibits ‘2S’ (two single vortices) and ‘P+S’ (a pair of vortices and a single vortex) shedding modes. In contrast, a ‘2P’ (two pairs of vortices) vortex mode is observed for a viscoelastic fluid within the same region. To gain a deeper understanding of the differences in the coherent flow structures and their associated frequencies between the two fluids, we employ the data-driven reduced-order modelling technique, known as the dynamic mode decomposition (DMD) technique. Utilizing this technique, we successfully extract and visualize the two competing fundamental frequencies (cylinder oscillation and natural vortex shedding frequencies) and their associated flow structures in the case of the no lock-in state, whereas only the dominant cylinder oscillation frequency and associated flow structure in the case of the lock-in state. Furthermore, we propose that the presence of excess strain resulting from the stretching of polymer molecules in viscoelastic fluids leads to a distinct difference in the wake structure compared with Newtonian fluids. This observation aligns with the findings obtained from the $Q$-criterion and vorticity transport analysis of the wake.
This study aimed to investigate the optimal frozen embryo transfer (FET) strategy for recurrent implantation failure (RIF) patients with three consecutive failed cleaved embryo implantations and no blastocyst preservation. This retrospective analysis was divided into three groups based on the FET strategy: thawed day 3 embryo transfer (D3 FET group); and extended culture of frozen–thawed day 3 embryos to day 5 blastocysts transfer (D3–D5 FET group); thawed blastocyst transfer (D5 FET group). Transplant cycle data were compared between the three groups. In total, 43.8% of vitrified–thawed cleavage embryos developed into blastocysts. Analysis of the three transplantation strategies showed that, compared with the D3 FET group, D3–D5 had a significantly better hCG-positivity rate and live-birth rate (P < 0.05). Pregnancy outcomes in the D3–D5 FET group and D5 FET group were similar regarding hCG-positivity rate, implantation rate, clinical pregnancy rate, and live-birth rate. Our findings propose two potentially valuable transfer strategies for patients experiencing repeated implantation failures. The D3–D5 FET approach presents a greater potential for selecting promising embryos in cases without blastocyst preservation; however, this strategy does entail the risk of cycle cancellation. Conversely, in instances where blastocyst preservation is an option, prioritizing consideration of the D5 FET strategy is recommended.
Do well-informed politicians make more effective spending decisions? In experiments with 70% of all elected politicians in Malawi ($ N=460 $), we tested the effects of information on public spending. Specifically, we randomly provided information about school needs, foreign aid, and voting patterns prior to officials making real decisions about the allocation of spending. We show that these information interventions reduced inequalities in spending: treatment group politicians were more likely to spend in schools neglected by donors and in schools with greater need. Some information treatment effects were strongest in remote and less populated communities. These results suggest that information gaps partially explain inequalities in spending allocation and imply social welfare benefits from improving politicians’ access to information about community needs.
We obtain a new bound on the second moment of modified shifted convolutions of the generalized threefold divisor function and show that, for applications, the modified version is sufficient.
Quasistatic magnetoconvection of a fluid with low Prandtl number (${\textit {Pr}}=0.025$) with a vertical magnetic field is considered in a unit-aspect-ratio box with no-slip boundaries. At high relative magnetic field strengths, given by the Hartmann number ${\textit {Ha}}$, the onset of convection is known to result from a sidewall instability giving rise to the wall-mode regime. Here, we carry out three-dimensional direct numerical simulations of unprecedented length to map out the parameter space at ${\textit {Ha}} = 200, 500, 1000$, varying the Rayleigh number (${\textit {Ra}}$) over the range $6\times 10^5 \lesssim {\textit {Ra}} \lesssim 5\times 10^8$. We track the development of stable equilibria produced by this primary instability, identifying bifurcations leading to limit cycles and eventually to chaotic dynamics. At ${\textit {Ha}}=200$, the steady wall-mode solution undergoes a symmetry-breaking bifurcation producing a state that features a coexistence between wall modes and a large-scale roll in the centre of the domain, which persists to higher ${\textit {Ra}}$. However, under a stronger magnetic field at ${\textit {Ha}}=1000$, the steady wall-mode solution undergoes a Hopf bifurcation producing a limit cycle which further develops to solutions that shadow an orbit homoclinic to a saddle point. Upon a further increase in ${\textit {Ra}}$, the system undergoes a subsequent symmetry break producing a coexistence between wall modes and a large-scale roll, although the large-scale roll exists only for a small range of ${\textit {Ra}}$, and chaotic dynamics primarily arise from a mixture of chaotic wall-mode dynamics and arrays of cellular structures.
We demonstrate that gravity acting alone at large length scales (compared to the capillary length) can produce a jet from a sufficiently steep, axisymmetric surface deformation imposed on a quiescent, deep pool of liquid. Mechanistically, the jet owes it origin to the focusing of a concentric, surface wave towards the axis of symmetry, quite analogous to such focusing of capillary waves and resultant jet formation observed during bubble collapse at small scales. A weakly nonlinear theory based on the method of multiple scales in the potential flow limit is presented for a modal (single-mode) initial condition representing the solution to the primary Cauchy–Poisson problem. A pair of novel, coupled, amplitude equations are derived governing the modulation of the primary mode. For moderate values of the perturbation parameter $\epsilon$ (a measure of the initial perturbation steepness), our second-order theory captures the overshoot (incipient jet) at the axis of symmetry quite well, demonstrating good agreement with numerical simulation of the incompressible, Euler equation with gravity (Popinet 2014, Basilisk. http://basilisk.fr) and no surface tension. We demonstrate that the underlying wave focusing mechanism may be understood in terms of radially inward motion of nodal points of a linearised, axisymmetric, standing wave. This explanation rationalises the ubiquitous observation of such jets accompanying cavity collapse phenomena, spanning length scales from microns to several metres. Expectedly, our theory becomes inaccurate as $\epsilon$ approaches unity. In this strongly nonlinear regime, slender jets form with surface accelerations exceeding gravity by more than an order of magnitude. In this inertial regime, we compare the jets in our simulations with the inertial, self-similar, analytical solution by Longuet-Higgins (J. Fluid Mech., 1983, vol. 127, pp. 103–121) and find qualitative agreement with the same. This analysis demonstrates, from first principles, an example of a jet created purely under gravity from a smooth initial perturbation and provides support to the analytical model of Longuet-Higgins (J. Fluid Mech., 1983, vol. 127, pp. 103–121).
In this study, the effects of antagonistic muscle actuation on the propulsion of a bilaminar-structure fish fin ray were investigated using a two-dimensional computational flow–structure interaction (FSI) model. The structure and material properties of the model were based on the realistic biological data of the sunfish fin. The effect of muscle actuation was modelled using root displacement offset between the two hemitrichs. Parametric FSI simulations were conducted by assuming a sinusoidal function of the offset over a cycle and varying the amplitude and phase difference between the actuations and pitching/plunging motions. The results show that the phase of muscle actuation is a critical factor affecting its effects. Three performance regions can be identified with different phase ranges, including a thrust-favour region, an efficiency-favour region and a thrust-efficiency-unfavour region. In each region, the relationships among the root actuations, fin-ray kinematics, vortex dynamics and resulting performance are studied and discussed. Furthermore, a strong positive correlation between the trailing–leading amplitude ratio and thrust coefficient as well as a negative relationship between the efficiency and angle of attack at the centre of mass of the fin ray are observed.
We investigate the effects of fluid elasticity on the flow forces and the wake structure when a rigid cylinder is placed in a viscoelastic flow and is forced to oscillate sinusoidally in the transverse direction. We consider a two-dimensional, uniform, incompressible flow of viscoelastic fluid at $Re=100$, and use the FENE-P model to represent the viscoelastic fluid. We study how the flow forces and the wake patterns change as the amplitude of oscillations, $A^*$, the frequency of oscillations (inversely proportional to a reduced velocity, $U^*$), the Weissenberg number, $Wi$, the square of maximum polymer extensibility, $L^2$, and the viscosity ratio, $\beta$, change individually. We calculate the lift coefficient in phase with cylinder velocity to determine the range of different system parameters where self-excited oscillations might occur if the cylinder is allowed to oscillate freely. We also study the effect of fluid elasticity on the added mass coefficient as these parameters change. The maximum elastic stress of the fluid occurs in between the vortices that are observed in the wake. We observe a new mode of shedding in the wake of the cylinder: in addition to the primary vortices that are also observed in the Newtonian flows, secondary vortices that are caused entirely by the viscoelasticity of the fluid are observed in between the primary vortices. We also show that, for a constant $Wi$, the strength of the polymeric stresses increases with increasing reduced velocity or with decreasing amplitude of oscillations.
The well-known Erdős-Hajnal conjecture states that for any graph $F$, there exists $\epsilon \gt 0$ such that every $n$-vertex graph $G$ that contains no induced copy of $F$ has a homogeneous set of size at least $n^{\epsilon }$. We consider a variant of the Erdős-Hajnal problem for hypergraphs where we forbid a family of hypergraphs described by their orders and sizes. For graphs, we observe that if we forbid induced subgraphs on $m$ vertices and $f$ edges for any positive $m$ and $0\leq f \leq \binom{m}{2}$, then we obtain large homogeneous sets. For triple systems, in the first nontrivial case $m=4$, for every $S \subseteq \{0,1,2,3,4\}$, we give bounds on the minimum size of a homogeneous set in a triple system where the number of edges spanned by every four vertices is not in $S$. In most cases the bounds are essentially tight. We also determine, for all $S$, whether the growth rate is polynomial or polylogarithmic. Some open problems remain.
The phylum Acanthocephala is an important group of parasites with more than 1,300 species parasitizing intestine of all major vertebrate groups. However, our present knowledge of the mitochondrial genomes of Acanthocephala remains very limited. In the present study, we sequenced and annotated the complete mitochondrial genome of Acanthogyrus (Acanthosentis) bilaspurensis (Gyracanthocephala: Quadrigyridae) for the first time based on the specimens recovered from the intestine of common carp Cyprinus carpio Linnaeus (Cyprinidae) in Pakistan. The mitochondrial genome of A. bilaspurensis is 13,360 bp in size and contains 36 genes, representing the smallest mitogenome of acanthocephalans reported so far. The mitogenome of A. bilaspurensis also has the lowest level of overall A+T contents (59.3%) in the mitogenomes of Eoacanthocephala, and the non-coding region 3 (NCR3) lies between trnS2 and trnI, which is different from all of the other acanthocephalan species. Phylogenetic analyses based on concatenating the amino acid sequences of 12 protein-coding genes using maximum likelihood (ML) and Bayesian inference (BI) methods revealed that the family Pseudoacanthocephalidae is a sister to the Arhythmacanthidae rather than the Cavisomatidae, and the families Rhadinorhynchidae and Cavisomatidae showed sister relationships.
Insights gained from modal analysis are invoked for predictive large-eddy simulation (LES) wall modelling. Specifically, we augment the law of the wall (LoW) by an additional mode based on a one-dimensional proper orthogonal decomposition (POD) applied to a two-dimensional turbulent channel. The constructed wall model contains two modes, i.e. the LoW-based mode and the POD-based mode, and the model matches with the LES at two, instead of one, off-wall locations. To show that the proposed model captures non-equilibrium effects, we perform a priori and a posteriori tests in the context of both equilibrium and non-equilibrium flows. The a priori tests show that the proposed wall model captures extreme wall-shear stress events better than the equilibrium wall model. The model also captures non-equilibrium effects due to adverse pressure gradients. The a posteriori tests show that the wall model captures the rapid decrease and the initial decrease of the streamwise wall-shear stress in channels subjected to suddenly imposed adverse and transverse pressure gradients, respectively, both of which are missed by currently available wall models. These results show promise in applying modal analysis for turbulence wall modelling. In particular, the results show that employing multiple modes helps in the modelling of non-equilibrium flows.
This paper offers a unified explanation for the procreation asymmetry and the non-identity thesis – two of the most intractable puzzles in population ethics. According to the procreation asymmetry, there are moral reasons not to create lives that are not worth living but no moral reasons to create lives that are worth living. I explain the procreation asymmetry by arguing that there are moral reasons to prevent the bad, but no moral reasons to promote the good. Various explanations for the procreation asymmetry have failed to explain the non-identity thesis: if one could create a person with a good life or a different person with a better life, one has a moral reason to create the better life. I argue that reflections on the misfortune of unfulfilled potential allow us to circumvent the non-identity problem.
En este trabajo se discute un conjunto de indicios de poblamiento humano en diferentes locus de la Pampa Occidental: el sitio 1 de la localidad Tapera Moreira, El Carmel y Casa de Piedra. El poblamiento inicial de este territorio ha estado restringido a un solo dato cronológico correspondiente al Holoceno temprano, proveniente del sitio Casa de Piedra 1 (8620 ± 190 años aP) que no ha sido replicado en ese u otros sitios de la región. Por ello no ha sido incorporado en la agenda de la discusión sobre esta temática en publicaciones recientes. Sin embargo, en años posteriores a su publicación se han suscitado diversos hallazgos cuyos contextos señalan gran potencial informativo en relación con la ocupación humana inicial de paisajes sin historia previa. Se presentan indicadores de cultura material (puntas de tipo cola de pescado, litos discoidales y materias primas muy seleccionadas y con tratamiento térmico) recuperados en asociación en diferentes locus pampeanos, que se relacionan con las expectativas generadas para una etapa de ocupación inicial del paisaje. Se propone un modelo de exploración lenta y discontinua que utilizó vías de transitabilidad de distinto rango en el proceso de conocimiento y colonización de estos ambientes desérticos.
Through computational-assisted analysis of the Weibo corpus of the Chinese Communist Youth League (CYL) spanning from 2013 to 2020, this paper unveils the strategic utilization of fandom culture by the CYL, the youth wing of the ruling party, in its nationalistic propaganda on the internet. Specifically, the CYL deliberately associates with the pop idols of the younger generation on Weibo, harnessing their influence to promote nationalistic content that encompasses both “pride-oriented” and “hostility-oriented” themes. Subsequent analysis reveals a greater propensity for nationalistic content to generate audience response compared to other types of content, particularly when endorsed by these pop idols. This research enriches our understanding of the CYL's propaganda efforts and contributes to the burgeoning scholarship on “soft propaganda” in China.
Epistemic uncertainties are included in probabilistic risk assessment (PRA) as second-order probabilities that represent the degrees of belief of the scientists that a model is correct. In this article, I propose an alternative approach that incorporates the scientist’s confidence in a probability set for a given quantity. First, I give some arguments against the use of precise probabilities to estimate scientific uncertainty in risk analysis. I then extend the “confidence approach” developed by Brian Hill and Richard Bradley to PRA. Finally, I claim that this approach represents model uncertainty better than the standard (Bayesian) model does.