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CHDs correspond to 28% of all congenital anomalies, being the leading cause of infant mortality in the first year of life. Thus, it is essential to explore risk factors for CHDs presentation, allowing the detection of probable cases within a population.
Methods:
We identified newborns with CHDs within a cohort from the Program for the Prevention and Monitoring of Congenital Defects in Bogota and Cali, 2002–2020. Cases were classified as isolated, complex isolated, polymalformed, and syndromic. Variables were analysed by comparing case and control averages with Student’s t test using a 95% confidence level.
Results:
Prevalence obtained was 19.36 per 10 000 live births; non-specified CHD, ventricular septal defect, and atrial septal defect were the most prevalent. As risk factors were found: paternal and maternal age above 45 years, pregestational diabetes, mother’s body mass index above 25, low educational level, and socio-economic status. As protective factors: folic acid consumption within the first trimester and pregestational period.
Conclusion:
Different risk and protective factors associated with the presentation of CHDs have been described. We consider that public health strategies should be aimed to reduce risk factors exposure. Also, improving diagnosis and prognosis by having a close monitoring on high-risk patients.
In this article, using an Halpern extragradient method, we study a new iterative scheme for finding a common element of the set of solutions of multiple set split equality equilibrium problems consisting of pseudomonotone bifunctions and the set of fixed points for two finite families of Bregman quasi-nonexpansive mappings in the framework of p-uniformly convex Banach spaces, which are also uniformly smooth. For this purpose, we design an algorithm so that it does not depend on prior estimates of the Lipschitz-type constants for the pseudomonotone bifunctions. Furthermore, we present an application of our study for finding a common element of the set of solutions of multiple set split equality variational inequality problems and fixed point sets for two finite families of Bregman quasi-nonexpansive mappings. Finally, we conclude with two numerical experiments to support our proposed algorithm.
Effective doctor–patient communication is a core competency for healthcare professionals. With the pivot to online clinical education and assessment due to the COVID-19 pandemic, there was a need to explore the views of psychiatric trainees and examiners on assessment of communication skills during online high stakes postgraduate examinations.
Methods:
The study was designed as descriptive qualitative research. All candidates and examiners of the September and November 2020 sitting of online Basic Specialist Training exam (a clinical Objective Structured Clinical Examination exam completed in the first 4 years of psychiatry training) were invited to participate. The respondents were interviewed by Zoom which was transcribed verbatim. Data were analyzed by NVivo20 pro and various themes and subthemes were drawn using Braun and Clarke thematic analysis.
Results:
A total of seven candidates and seven examiners were interviewed with an average duration of 30 minutes and 25 minutes, respectively. Four main themes emerged: Communication, Screen optimization, Continuation postpandemic and Overall experience. All candidates preferred to continue an online format post pandemic for practical reasons e.g., avoiding travel and overnight stay, while all examiners preferred to go back to in-person Objective Structured Clinical Examination. However, continuation of online Clinical Formulation and Management Examination was agreed by both groups.
Conclusion:
The participants were largely satisfied with the online examination but did not consider it equal to face-to-face for picking up nonverbal cues. Overall minimal technical issues were reported. These findings may be helpful to modify current psychiatry membership examinations or similar assessments in other countries and specialties.
We present pore-resolved compressible direct numerical simulations of turbulent flows grazing over perforated plates, that closely resemble the acoustic liners found on aircraft engines. Our direct numerical simulations explore a large parameter space including the effects of porosity, thickness and viscous-scaled diameter of the perforated plates, at friction Reynolds numbers $\textit {Re}_\tau = 500\unicode{x2013}2000$, which allows us to develop a robust theory for estimating the added drag induced by acoustic liners. We find that acoustic liners can be regarded as porous surfaces with a wall-normal permeability and that the relevant length scale characterizing their added drag is the inverse of the wall-normal Forchheimer coefficient. Unlike other types of porous surfaces featuring Darcian velocities inside the pores, the flow inside the orifices of acoustic liners is fully turbulent, with a magnitude of the wall-normal velocity fluctuations comparable to the peak in the near-wall cycle. We provide clear evidence of a fully rough regime for acoustic liners, also confirmed by the increasing relevance of pressure drag. Once the fully rough asymptote is reached, canonical acoustic liners provide an added drag comparable to that of sand-grain roughness with viscous-scaled height matching the inverse of the viscous-scaled Forchheimer permeability of the plate.
We develop the theory of relative regular holonomic $\mathcal {D}$-modules with a smooth complex manifold $S$ of arbitrary dimension as parameter space, together with their main functorial properties. In particular, we establish in this general setting the relative Riemann–Hilbert correspondence proved in a previous work in the one-dimensional case.
Assume that f is a real ρ-harmonic function of the unit disk $\mathbb{D}$ onto the interval $(-1,1)$, where $\rho(u,v)=R(u)$ is a metric defined in the infinite strip $(-1,1)\times \mathbb{R}$. Then we prove that $|\nabla f(z)|(1-|z|^2)\le \frac{4}{\pi}(1-f(z)^2)$ for all $z\in\mathbb{D}$, provided that ρ has a non-negative Gaussian curvature. This extends several results in the field and answers to a conjecture proposed by the first author in 2014. Such an inequality is not true for negatively curved metrics.
In this Modern Asian Studies book symposium, scholars of South Asia analyse the political, ethical, and epistemic aspects of market life. They build on the 2020 Cambridge volume, Rethinking Markets in Modern India: Embedded Exchange and Contested Jurisdiction, edited by Ajay Gandhi, Barbara Harriss-White, Douglas Haynes, and Sebastian Schwecke. This interdisciplinary conversation approaches transactional realms from the disciplines of history, anthropology, development studies, and political economy. The symposium’s contributors examine a range of pertinent issues that encompass customary forms of exchange and capitalist aspects of trade. Among the topics discussed are those of market fetishism, bazaar knowledge, social embeddedness, forms of transactional representation and translation, and institutional and regulatory contexts for commerce.
We present macrobotanical, starch, and phytolith data from artifacts and sediments from Middle Formative La Blanca (1000–600 cal BC) and Late Formative El Ujuxte (600 cal BC–cal AD 115 ) in the Soconusco region in Guatemala. Potential economic plants identified included palm (cf. Arecaceae), two varieties of maize (Zea mays), guava (Psidium guajava), bean (Phaseolus), chili peppers (Capsicum), squash (Cucurbitaceae), custard apple (Annonaceae), coco plum (Chrysobalanaceae), lerén (Calathea), arrowroot (Maranta), and bird-of-paradise (Heliconia). The results suggest that control of food production and consumption was critical for the transition from complex chiefdoms during the Middle Formative to the archaic state in the Late Formative. The arrival of a more productive South American variety of maize at El Ujuxte (about 2549 BP) allowed elites to exploit an already existing broad-based economic system and to use the maize-based religious system to increase control over maize agricultural practices and maintain power through ideology and disciplinary power. These data suggest that the arrival of fully domesticated South American maize likely influenced the overall development of Mesoamerican state-level societies.
From the ‘real’ stage performance in the late 1980s to the ‘virtual’ stage performance in April 2020, when China, after months of being locked down due to the COVID-19 pandemic, was gingerly reopening for life again, Chinese theatre artists have persisted in their efforts to adapt the Beckettian play for their sociocultural, artistic and existential needs in the Beckettian spirit of ‘Try again. Fail again. Fail better’.
Premature birth, bronchopulmonary dysplasia or restrictive nutrition in the first weeks of postnatal life may have repercussions on lung development and affect long-term lung function outcomes. This prospective observational study is based on a cohort of 313 very low birth weight (VLBW) neonates, born between 1 January 2008 and 1 December 2016. The daily intake of calories, protein, fat and carbohydrates during the first week of life and evidence of inadequate weight gain (Δwt) until week 36 of gestational age (GA) were recorded. FEV1, FEF25–75 %, forced vital capacity (FVC) and the FEV1/FVC ratio were determined. The relations between these parameters were determined by regression analysis. Spirometric parameters were obtained for 141 children with a mean age of 9 years (95 % CI 7, 11); 69 of them (48·9 %) had presented wheezing episodes on more than three occasions. In addition, 60 (42·5 %) had a history of bronchopulmonary dysplasia. Of these, n 40 (66·6 %) had a history of wheezing. Significant association between protein/energy intake in the first week of life and the lung function parameters analysed was observed. Poor Δwt to GA week 36 was significantly associated with decreased mean pulmonary flow. Inadequate protein/energy intake in the first week of life of VLBW newborns and poor Δwt to week 36 of GA is associated with a significant worsening of lung function parameters.
Greenhouses are inflated structures with transparent covering that are used to grow crops under controlled climatic conditions. Crops are protected from extreme climate-related events by being enclosed. Furthermore, the greenhouse design ratio impacts the temperature and humidity distribution profile uniformity as well as the greenhouse. As a result, by effectively designing the greenhouse structure, building materials, dimensions, and shapes, the cost of cooling management strategies can be reduced. Structures with changed arch shapes showed to be more effective at reducing greenhouse cooling demands in hot areas. To demonstrate the tropical region’s inherent capabilities for generating a proper atmosphere for plant development, the optimal temperature, humidity, light, and PH for greenhouse production of crops were supplied. Greenhouse cooling systems are dominated by local environmental characteristics that have an immediate impact on their indoor climatic conditions. Photovoltaic systems in greenhouses have proven technological capacity in real-world settings in this area. This could increase the energy efficiency of some agrivoltaic greenhouse design options.
Two kinetic models are proposed for high-temperature rarefied (or non-equilibrium) gas flows with internal degrees of freedom and radiation. One of the models uses the Boltzmann collision operator to model the translational motion of gas molecules, which has the ability to capture the influence of intermolecular potentials, while the other adopts the relaxation time approximations, which has higher computational efficiency. In our kinetic model equations, not only the transport coefficients such as the shear/bulk viscosity and thermal conductivity but also their underlying relaxation processes are recovered. The non-equilibrium dynamics of gas flow and radiation are tightly coupled, where the transport properties of gas molecules and photons are correlatively dependent. The proposed kinetic models are validated by the direct simulation Monte Carlo method in several non-radiative rarefied gas flows (e.g. the normal shock wave, Fourier flow, Couette flow and the creep flow driven by the Maxwell demon), and the experimental data of planar heat transfer and normal shock waves in nitrogen. Then, the rarefied gas flows with strong radiation are studied based on the kinetic models, not only in the above one-dimensional gas flows, but also in the two-dimensional radiative hypersonic flow passing a cylinder. The characteristics of heat transfer in the tightly coupled fields of gas and radiation are systematically investigated, particularly the influence of the non-equilibrium photon transport and their interactions with gas molecules are revealed. It is found that the radiation makes a profound contribution to the total heat transfer in radiative hypersonic flow at an intermediate photon Knudsen number.
We report the first shock-tube experiments on two-dimensional dual-mode air–SF$_6$ interfaces with different initial spectra subjected to a convergent shock wave. The convergent shock tube is specially designed with a tail opening to highlight the Bell–Plesset (BP) and mode-coupling effects on amplitude development of fundamental mode (FM). The results show that the BP effect promotes the occurrence of mode coupling, and the feedback of high-order modes to the FM also arises earlier in convergent geometry than that in its planar counterpart. Relatively, the amplitude growth of the FM with a higher mode number is inhibited by the feedback, and saturates earlier. The FM with a lower mode number is affected more heavily by the BP effect, and finally dominates the flow. A new model is proposed to well predict the amplitude growths of the FM and high-order modes in convergent geometry. In particular, for FM that reaches its saturation amplitude, the post-saturation relation is introduced in the model to achieve a better prediction.
This manuscript presents a 50 Ω microstrip-fed quad-element high isolated ultra-wideband (UWB) multiple-input multiple-output (MIMO) antenna with band-notched characteristics. The overall area of the proposed structure is 0.33λo × 0.33λo mm2 (where λo depicts the free space wavelength corresponding to the lower cutoff frequency, i.e. 2.54 GHz), etched on an FR-4 substrate of thickness 0.8 mm. The top layer has four semicircular disc-shaped radiating elements that are identical and orthogonal to obtain better inter-element isolation and compactness. A reverse two-shaped slot is etched onto the radiating patches to attain a band-rejection capability. Moreover, a decoupling structure is also placed at the top layer to suppress the unwanted surface waves. The bottom layer consists of a ground plane, which is further modified with quasi-self complementary and meandered line slots. A rectangular slot is also etched below the feed line to better match the impedance near the lower cutoff frequencies. The simulated reflection coefficients (S11) of the proposed antenna are less than −10 dB over 2.54 to 10.74 GHz frequencies except at 3.37 to 4.15 GHz (WiMAX/C band), and the simulated inter-port isolation (S21) is greater than −15 dB over the entire UWB range of frequencies (3.1 to 10.6 GHz). Also, the measured S-parameter results well agreed with the simulated ones. Furthermore, the simulation study of the 20-element UWB-MIMO antenna is also investigated using the proposed quad-element structure.
Numerous studies have characterised the establishments registered with meal delivery apps (MDA) in several countries. However, little evidence is available regarding these platforms in Latin America (LA). The purpose of this study is to characterise food establishments registered with an MDA in nine LA cities. The establishments (n 3339) were characterised by the following keyword groups: ‘Typical cuisine’, ‘Meat and fish’, ‘Snacks’, ‘Breakfast’, ‘Desserts’ and ‘Healthy’. In addition, we identified the marketing strategies present in the establishments’ advertisements: photos, discounts and free delivery. Mexico City had the highest number of establishments registered with MDA (773), followed by Bogotá (655), Buenos Aires (567) and São Paulo (454). There is a direct relationship between the number of inhabitants of the cities and the number of the registered establishments. ‘Snacks’ was the keyword group most used by establishments in five of the nine cities. Establishments in two cities were most often characterised by the terms ‘Typical cuisine’ (Mexico City and Santiago de Chile) and ‘Meats and fish’ (Quito and San Jose). Photos were present in the advertisements of at least 84·0 % of the establishments. In addition, at least 40 % of establishments in Montevideo, Bogotá, São Paulo, Lima and Santiago de Chile offered discounts. Free delivery was present in at least 50 % of establishments in Quito, San Jose, Mexico City, Santiago de Chile and Lima. Photos were also the most common marketing strategy used by the establishments classified in all groups of keywords, while free delivery and discounts differed among them.
How do White Americans evaluate the politics of belonging in the United States across different ethnoreligious identity categories? This paper examines this question through two competing frameworks. On the one hand, given the salience of anti-Muslim attitudes in the United States, we consider whether White Americans penalize Muslim immigrants to the United States regardless of their ethnoracial background. On the other hand, Muslim identity is often conflated by the general public with Middle Eastern and North African (MENA) ethnoracial identity. We argue MENA-Muslim identity should be understood through the lens of intersectionality. In this case, White Americans may penalize MENA-Muslims immigrants to the United States more than Muslims from other ethnoracial groups. We test these two frameworks through a conjoint experimental design wherein respondents are asked to evaluate immigrants and indicate to whom the United States should give a green card—signaling legal belonging—and how likely the immigrant is to assimilate into America—signaling cultural belonging. Although White Americans believe White Muslims may assimilate better to the United States relative to MENA-Muslims, race does not moderate how White Americans evaluate who should be allowed to belong in the United States.
Double-chambered right ventricle is a rare and progressive condition that is characterised by obstruction of the right ventricular tract. Double-chambered right ventricle is usually associated with ventricular septal defect. Early surgical intervention is recommended in patients with these defects. Based on this background, the present study aimed to review early and midterm outcomes of primary repair after double-chambered right ventricle.
Methods:
Between January 2014 and June 2021, 64 patients with a mean age of 13.42 ± 12.31 years underwent surgical repair for double-chambered right ventricle. The clinical outcomes of these patients were reviewed and assessed retrospectively.
Results:
An associated ventricular septal defect was present in all the recruited patients; 48 (75%) patients of sub-arterial type, 15 (23.4%) of perimembranous, and 1 (1.6%) patient of muscular type. The patients were followed up for a mean period of 46.73 ± 27.37 months. During their follow-up, a significant decrease in the mean pressure gradient from 62.33 ± 5.52 mmHg preoperatively to 15.73 ± 2.94 mmHg postoperatively was observed (p < 0.001). Notably, there were no hospital deaths.
Conclusions:
The development of double-chambered right ventricle in association with ventricular septal defect results in an increased pressure gradient within the right ventricle. The defect needs correction in a timely manner. In our experience, the surgical correction of double-chambered right ventricle is safe and shows excellent early and mid-term results.