To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Nursing home residents have been disproportionately impacted by respiratory virus-related morbidity and mortality due to inherent vulnerability and communal living environments. This study aims to identify nursing homes with higher infection rates during a period of intense SARS-CoV-2 transmission and explore facility-level characteristics potentially associated with infection surges.
Design:
A longitudinal k-means clustering approach followed by exploratory regression analyses.
Setting:
U.S. Nursing homes reporting to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN).
Methods:
A longitudinal k-means method (kmlShape) classified the facilities based on their weekly SARS-CoV-2 incidence rate epidemic curve, identifying two categories (low vs high infection peak) based on the magnitude of infection peaks. A logistic regression model with bootstrapping was developed to assess facility characteristics associated with higher SARS-CoV-2 infection surges.
Results:
Among 11,990 nursing homes analyzed, 9,058 were classified as having a low infection peak, while 2,932 had a high infection peak. Nursing homes that are for-profit (OR = 1.570, 95% bootstrap confidence interval [BCI] 1.441–1.807), with high staff turnover (OR = 1.292, 95% BCI 1.154–1.451), or located in areas with higher social vulnerability (OR = 1.457, 95% BCI 1.239–1.880) were more likely to experience high infection peaks. Nursing homes with higher residents’ vaccination coverage (OR = .321, 95% BCI .248–.380) and located in urban areas were less likely to experience high infection peaks.
Conclusions:
The facility-level characteristics associated with lower SARS-CoV-2 infection peaks may indicate resiliency and help evaluate the capacity of nursing homes to endure stressors such as respiratory viruses and other communicable illnesses.
This essay critically examines the relationship between antiracism, public policy, and liberal democratic accountability standards. Drawing on a set of standards derived from the political philosophies and constitutional structures of liberal democracies, the gap between these ideals and the realities of racial injustice are examined in light of Frederick Douglass’ position on the U.S. Constitution as an anti-slavery document, the persistence of a “racial contract,” and recent conceptualization of antiracism. By grounding antiracist policies in democratic accountability standards and recognizing the gap between the ideal and the real, the essay then examines the contemporary efforts of an “antiwoke” movement to purge policies and practices that focus on social equity and antiracism from government operations and assesses the efficacy of such efforts in light of core democratic standards and American ideals.
Let A be a subset of an additive abelian semigroup S and let $hA$ be the h-fold sumset of A. The following question is considered. Let $(A_q)_{q=1}^{\infty }$ be a strictly decreasing sequence of sets in S and let $A = \bigcap _{q=1}^{\infty } A_q$. When does one have
$$ \begin{align*} hA = \bigcap_{q=1}^{\infty} hA_q \end{align*} $$
We show that spatio-temporal non-Markovianity of a Gaussian random synthetic velocity field is an essential property for modelling turbulent mixing. We demonstrate this using synthetically generated Gaussian incompressible velocity fields for passive scalar mixing. Including a separate velocity decorrelation time scale for each spatial scale (random sweeping) yields an essentially non-Markovian velocity field with a finite time memory decaying as $\tau ^{-6}$ (for a decaying spectrum) instead of an exponential decay (Markovian), which is obtained by including a constant time scale for all spatial scales, irrespective of the filtering function. We characterise the Lagrangian mixing statistics of both the Markovian and the non-Markovian synthetic fields and compare them against a corresponding incompressible direct numerical simulation (DNS). We show that the average pair dispersion is well captured by the non-Markovian fields across the ballistic, inertial and diffusive regimes. We also study diffusive passive scalar mixing in the Schmidt number range $\textit{Sc}\leqslant 1$ using the DNS and the synthetic fields. Both the synthetic fields recover the $-17/3$ scalar spectrum for low Schmidt numbers and inertial subrange in kinetic energy spectra. However, the mean fluctuation gradient magnitudes are severely under predicted by the Markovian synthetic fields compared with the non-Markovian synthetic fields. Additionally, the fluctuation gradients parallel to the mean gradient exhibit smaller skewness when stirred by the Markovian synthetic field compared with the non-Markovian fields. Finally, we show that the non-Markovian synthetic fields perform better in decaying scalar gradient simulations initialised by a concentrated sphere with high passive scalar concentration. Throughout, we compare our results with companion three-dimensional DNS to show the necessity of non-Markovianity in synthetic fields to capture mixing dynamics.
The mechanical response of elastic porous media confined within rigid geometries is central to a wide range of industrial, geological and biomedical systems. However, current models for these problems typically overlook the role of wall friction and particularly its interaction with confinement. Here, we develop a theoretical framework to describe the interplay between the mechanics of the medium and Coulomb friction at the confining walls for slow, quasistatic deformations in response to two canonical uniaxial forcings: piston-driven loading (i.e. an imposed effective stress at the top boundary) and fluid-driven loading (i.e. an imposed fluid pressure at the top boundary) followed by unloading. We find that, during compression, the stress field evolves according to a quasistatic advection–diffusion equation, extending classical poroelasticity results. The magnitude of friction is controlled by a single dimensionless number ($\mathcal{F}$) proportional to the friction coefficient and the aspect ratio of the confining geometry. During decompression, a portion of the solid matrix remains stuck due to friction, leading to hysteresis and to the propagation of a slip front. In piston-driven loading the frictional stress is directly coupled to the solid effective stress, leading to exponential damping of the loading and striking changes to the displacement field. However, this coupling limits the energy dissipated by friction. In fluid-driven loading the pressure gradient locally adds energy, decoupling elastic energy storage and frictional energy dissipation. The displacement remains qualitatively unchanged but is quantitatively reduced due to large energy dissipation. In both cases, friction can have a substantial impact on the apparent mechanical properties of the medium.
The extreme heat fluxes characteristic of hypersonic flows significantly limit the flight envelope of hypersonic vehicles. The role of hydrodynamic instability and the onset of laminar-to-turbulent boundary layer transition is of notable importance. The effect of streaks on the suppression of planar (second Mack mode) instabilities has been previously investigated, but a potentially passive and non-intrusive control method has not been established yet. Recent work shows that streaks can be generated through a spanwise variation in surface temperature. This method exploits the aerothermodynamic characteristics of the flow, and therefore promises to be robust. This work uses direct numerical simulations to determine and quantify the effectiveness of this novel control method in the suppression of second Mack mode instability for a hypersonic boundary layer over a flat plate. The computational analyses cover a range of Mach numbers, 4.8–6, and wall temperature ratios representative of both wind tunnel testing and flight scenarios. Among the range of configurations investigated, the energy of the second Mack mode is reduced by up to approximately 60 % by the steady streaks. The streak wavelength parameter plays a significant role in the stabilisation benefits. For a Mach 6 configuration, for the most linearly amplified second Mack mode disturbance frequency, nearly optimum performance is achieved for a spanwise wavelength of approximately 8–10 times the local boundary layer thickness. These findings open new avenues for controlling hypersonic boundary layers and offer valuable guidance for future experimental campaigns aimed at validating this novel control strategy.
Through emerging interpretations of individual “medical freedoms,” a panoply of state legislative bills seeks to undermine long-standing public health and health care requirements including recommendations to test, screen, treat, and vaccinate persons. To the extent these bills could upend decades of laws and policies protecting individual and communal health, especially among vulnerable individuals, they threaten the health — and freedoms — of all persons.
The objective is to describe energy, macro-, and micronutrient intake according to Nova food groups and to estimate its association with ultra-processed foods (UPF) energy participation in the diets of children, stratified by age (6–23m/24–59m). A single 24-hour recall from 12,553 children in the Brazilian National Survey on Child Nutrition was used to estimate the relative energy contribution of Nova groups: unprocessed or minimally processed foods and culinary ingredients (G1+G2); processed foods (G3); and UPF (G4). Age-stratified linear regression and 95%CI assessed differences in nutrient intake (per 1,000kcal) across UPF energy quintiles. The G1+G2 group accounted for most of the energy consumed (6–23m: 74.5%; 24–59m: 65.1%) compared to G3 or G4. For both age groups, in the lowest quintile of UFP participation, ≤2% of energy came from UPF, while in the highest quintile, this proportion was >55%; and the G1+G2 group provided most nutrients. In 6–23m, higher UPF quintiles were associated with lower fat [β: -3.1 (-3.6; -2.5)], potassium [β: -49.7 (-67.9; -31.4)], and vitamin A RAE [β: -113.7 (-136.7; -90.6)] intake, but higher calcium [(β: 75.5 (57.6; 93.4)], iron [β: 2.9 (2.5; 3.3)], vitamin A RE [β: 104.3 (72.3; 136.3)], and folate [β: 15.7 (12.0; 19.5)] intake. In 24–59m, nutrient intake generally decreased with increasing UPF quintiles. For 6–23m/24–59m, UPF consumption was positively associated with energy [β: 73.6 (44.6; 102.7); 92.8 (66.7; 118.8), respectively] and carbohydrate [β: 7.3 (5.8; 8.7); 2.3 (1.2; 3.3), respectively], while contributing little to overall micronutrient intake.
The aim of this review was to examine what existing low FODMAP diet (LFD) trials can tell us about whether reductions in FODMAP intake plausibly explain symptom improvement in irritable bowel syndrome (IBS). Although the LFD is an effective treatment, supported by multiple randomised controlled trials and meta-analyses, the mechanisms through which it exerts its effects remain unclear. Symptom improvement is commonly attributed to reduced FODMAP intake, yet this assumption has rarely been evaluated directly. Using a mediation-informed framework, we examined whether published LFD trials assessed two key elements required to support a mechanistic role for FODMAP intake: whether the intervention altered FODMAP intake (a path), and whether variation in intake was associated with symptom outcomes independent of intervention group (b path). We found that evidence for clinical efficacy has not been matched by equivalent evidence explaining how the diet works. While many trials demonstrate that LFD interventions reduce FODMAP intake, few examine whether differences in intake account for differences in symptom improvement between individuals. As a result, it remains uncertain to what extent symptom benefits are driven by FODMAP reduction itself versus other factors accompanying dietary change. Strengthening future trial design to link dietary intake measurement with mechanistic analysis is essential for informing less restrictive, targeted, and personalised dietary strategies in IBS.
We consider the response of a flexibly mounted square prism placed in inertial-viscoelastic fluid flow with one degree-of-freedom in the cross-flow direction. Under these flow conditions, both inertia and elastic effects are significant. We model the system numerically using a two-way coupling scheme to simulate the interaction between the fluid and the spring–mass system at a Reynolds number of $\textit{Re}=200$ for two mass ratios of $m^* = 2$ and 20, and a Weissenberg number of $\textit{Wi}=2$, across a range of reduced velocities. We demonstrate that introducing fluid elasticity suppresses vortex-induced vibrations of square prisms, consistent with prior findings for circular bluff bodies. However, we find that fluid elasticity amplifies the galloping response in comparison with the response in a Newtonian fluid, leading to larger oscillation amplitudes and the onset of galloping at lower reduced velocities. The predicted enhancement in galloping is significant, particularly at low mass ratios, where no galloping is observed over the wide reduced velocity range tested for Newtonian fluids. We show that this enhancement of galloping is likely the result of the observation that the addition of viscoelasticity increases the magnitude of the rate of change of the transverse flow-induced force on the prism with increasing angle of attack of the incoming flow.
The European Union stands at a crossroads. Its founding promises of peace, convergence, and multilateralism are increasingly strained by debt, migration, sovereignty, and militarization. The introduction to this Special Issue begins with the question: who is the EU for? To stretch this question analytically we move beyond conventional debates on globalization and sovereignty foregrounding the colonial and racialized conditions that shape European integration. Colonialism, we argue, remains operative, structuring the production of race, racism, and anti-Blackness within and beyond Europe. Drawing on radical traditions of thought on colonialism and anti-Blackness, critical political economy, postcolonial theory, and institutional analysis, the introduction reframes the analytic of who the EU is for by showing how the Union’s commitment to universal values coexists with practices that reproduce hierarchies of life and death. We argue that the EU operates as a form of global power that mobilizes race and racism as constitutive mechanisms of legitimacy, authority, mobility, and value. Contemporary militarization, through defense integration, rearmament, and strategic autonomy, intensifies these dynamics by recoding racial hierarchies as security imperatives. Competing responses, from right-wing sovereign internationalism to left critiques of neoliberalism, rarely confront Europe’s colonial and racialized constitutive role in sustaining global inequalities. These unresolved contradictions and failures open up urgent questions about how Europe’s political and economic order continues to reproduce global hierarchies of power. It is precisely this tension that the special issue takes up, responding by engaging the intertwined colonial and racist projects in the EU. The contributors collectively frame crisis as a key site through which colonial violence is reconfigured, displaced, and normalized in contemporary EU governance. In so doing, they reposition the EU not as a neutral arbiter of order, but as an active geopolitical site where racialized and imperial forms of power are continuously produced, contested, and reimagined.
Left ventricular pseudoaneurysm is an exceedingly rare, life-threatening complication following percutaneous balloon aortic valvuloplasty. We report a 1-month-old infant presenting with a large left ventricular pseudoaneurysm after successful valvuloplasty for critical aortic stenosis. Multimodal imaging confirmed the diagnosis. The patient underwent successful surgical resection and bovine pericardial patch repair. This case emphasises the importance of early surgical intervention for favourable outcomes.
We use a recent result of Orevkov and Pakovich [‘On intersection of lemniscates of rational functions’, Arnold J. Math.11 (2025), 7–26] to obtain a bound on the frequency with which elements in an orbit of polynomial iterations can fall on the unit circle.
We study the long-time behaviour of solutions to a free boundary model in river networks with small water flow speeds. First, we establish the well-posedness of our model. Under suitable assumptions, we then establish a spreading–vanishing dichotomy result for solutions to our model. By introducing a parameter $\sigma $ in the initial data, we derive sharp threshold behaviours.
Efforts to decolonize archaeology have gained significant momentum in the last few decades, but have yet to extend robustly to zooarchaeology. Zooarchaeology is, however, well positioned to make unique contributions to decolonial practice. Drawing on insights from Indigenous studies, animal studies, and models of Indigenous science, we argue that North American zooarchaeology must engage in decolonization if reconstructions of past human–animal relationships are to be robust and ethically grounded. We identify some of the colonial legacies embedded in zooarchaeology’s methods, classifications, and interpretive frameworks, and highlight how these structures constrain knowledge production. We offer a series of interventions and actionable recommendations—from analytical protocols to disciplinary practice—that create pathways for zooarchaeologists to participate in the wider decolonial project.