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Although carotid endarterectomy (CEA) or carotid artery stenting (CAS) is recommended for symptomatic extracranial carotid stenosis of 50–99%, the COVID-19 pandemic significantly impacted resources. CAS therefore offered potential advantages as access to the angiosuite was seemingly easier than access to operating rooms. The primary objective was to determine the frequency of serious and non-serious complications following CAS before and during the COVID-19 pandemic.
Methods:
We performed a retrospective cohort study of consecutive patients who received CAS at the Ottawa Hospital, Canada, from June 2019 to May 2021. We reviewed baseline demographics, imaging, as well as intraprocedural and postprocedural complications based on chart review. We performed multivariable logistic regression to determine associations between clinical and safety outcomes.
Results:
We included 47 patients in the pre-pandemic period and 93 patients in the pandemic period (mean age = 70.4 years; 54% female; P = 0.287 for age and P = 0.962 for sex, respectively). The combined rate of intraprocedural and postprocedural serious complications (ischemic stroke, intracerebral hemorrhage, myocardial infarction or death) was 7.1%. Eight strokes occurred, and one patient with a postprocedural ischemic stroke died 11 days after stenting. Complication rates were similar before and during the pandemic (aOR 1.040, 95% CI 0.466–2.321). The number of referrals for CEA during the pandemic period decreased by 50%.
Conclusion:
In this cohort of consecutive patients undergoing CAS at a Canadian comprehensive stroke center before and during the COVID-19 pandemic, the rates of stroke and death were similar to pre-pandemic conditions and were generally consistent with the published literature.
Government procurement is a highly important area to explore in seeking to advance the capacity of enterprises to achieve green technological innovation and promote green development more broadly. Research for this article focused on A-share listed manufacturing enterprises in Shanghai and Shenzhen as samples, and used the government procurement contract data published by the China Government Procurement Network to explore the effect on technological innovation in the manufacturing industry. The results show that government procurement has a significant and positive effect on green technology innovation. Moreover, the larger the scale of government procurement, the more obvious is the promotion effect on green innovation. A mechanism test found that government procurement can promote corporate green technology innovation by raising awareness of climate change (especially in the eastern regions of China), while a heterogeneity analysis found that government procurement promotes green invention patents more significantly than green utility model patents. Government procurement was also found to have a greater effect on enterprises without ISO14001 certification. Further analysis revealed that overall demand-side innovation procurement and supply-side innovation subsidies have a mutually reinforcing synergistic effect on firm innovation. While government synergies vary significantly depending on the policy implementation sequence, this article provides an important reference in identifying further ways to improve government procurement policies.
The connection between the drag and vorticity dynamics for viscous flow over a bluff body is explored using the Josephson–Anderson (J–A) relation for classical fluids. The instantaneous rate of work on the fluid, associated with the drag force, is related to the vorticity flux across the streamlines of a background potential flow. The vorticity transport itself is examined by aid of the Huggins vorticity-flux tensor. The analysis is performed for three flows: flow over a sphere at Reynolds numbers $Re=200,3700$, and flow over a prolate spheroid at $Re=3000$ and $20^{\circ }$ incidence. In these flows, the vorticity transport shifts the flow away from and towards the ideal potential flow, with a net balance towards the former effect thus making an appreciable contribution to the drag. The J–A relation is first demonstrated for the flow over a sphere at $Re=200$. The drag power injection is related to the viscous flux of azimuthal vorticity from the wall into the fluid, and the advection of vorticity by the detached shear layer. In the wake, the azimuthal vorticity is advected towards the wake centreline and is annihilated by viscous effects, which contributes a reduction in drag. The analysis of the flow over a sphere at $Re=3700$ is reported for the impulsively started and stationary stages, with emphasis on the effects of unsteady two-dimensional separation and turbulent transport in the transitional wake. The turbulent flux in the wake enhances the transport of mean azimuthal vorticity towards the wake centreline, and is the main driver of the recovery of enthalpy between the rear point of the sphere and far downstream. The rate of work on the fluid by the drag force for a prolate spheroid is mostly due to the transport of vorticity along the separated boundary layers. Primary and secondary separation contribute oppositely to the power injection by the drag force, while the large-scale vortices only re-distribute vorticity without a net contribution. A mechanism for secondary separation is proposed based on the theory of vortex-induced separation.
Population is a key factor of national power. Declining fertility rates, especially in major economies, are reshaping global power dynamics by shrinking workforces amidst aging populations. In response, more nations are adopting techno-natalist policies, promoting reproductive technologies (“reprotech”) like IVF to increase birth rates. Advances in genetic embryo selection, gene editing, in vitro gametogenesis, and artificial wombs could further enhance these policies by improving birth rates, health, and human capital. This article examines current and emerging reprotechnologies, the policy landscape, socioeconomic and geopolitical implications, and future research directions. By shaping national and global gene pools, reprotech policies and practices offer a paradigmatic case of gene–culture coevolution. If these technologies prove safe and effective, nations that embrace them are likely to gain geopolitical and evolutionary advantages over those that do not.
This study investigates the interactions between flexural-gravity waves and interfacial waves in a two-layer fluid, focusing on wave blocking. Both liquid layers are of finite depth bounded on top by a viscoelastic thin plate. Both liquids are incompressible and inviscid, and their flows are two-dimensional and potential. Linear wave theory and a linear equation of a thin floating viscoelastic plate of constant thickness are used. We analyse the phenomenon of wave blocking and Kelvin–Helmholtz (KH) instability in a two-layer fluid with a discontinuous background mean flow. A quartic dispersion relation for frequency as a function of wavenumber and other parameters of the problem is derived. Two cases of uniform current and layers moving with different velocities are studied. Wave blocking occurs when roots of the dispersion relation coalesce without accounting for plate viscosity, leading to zero group velocity. Our findings indicate that wave blocking can occur for both flexural-gravity and interfacial waves under various frequency and current speed conditions, provided that plate viscosity is absent. The role of different parameters and the flow velocities of the upper and lower layers are investigated in the occurrence of wave blocking and KH instability. The loci of the roots of the dispersion relation involving plate viscosity depict that no root coalescence occurs irrespective of the values of wavenumber and frequency in the presence of plate viscosity. The amplitude ratio of the interfacial wave elevation to that of floating viscoelastic plate deflection exhibits the dead-water phenomenon as a density ratio approaches unity.
We compare the Emory 10-item, 4-choice Rey Complex Figure (CF) Recognition task with the Meyers and Lange (M&L) 24-item yes/no CF Recognition task in a large cohort of healthy research participants and in patients with heterogeneous movement disorder diagnoses. While both tasks assess CF recognition, they differ in key aspects including the saliency of target and distractor responses, self-selection versus forced-choice formats, and the length of the item sets.
Participants and Methods:
There were 1056 participants from the Emory Healthy Brain Study (EHBS; average MoCA = 26.8, SD = 2.4) and 223 movement disorder patients undergoing neuropsychological evaluation (average MoCA = 24.3, SD = 4.0).
Results:
Both recognition tasks differentiated between healthy and clinical groups; however, the Emory task demonstrated a larger effect size (Cohen’s d = 1.02) compared to the M&L task (Cohen’s d = 0.79). d-prime scoring of M&L recognition showed comparable group discrimination (Cohen’s d = 0.81). Unidimensional two-parameter logistic item response theory analysis revealed that many M&L items had low discrimination values and extreme difficulty parameters, which contributed to the task’s reduced sensitivity, particularly at lower cognitive proficiency levels relevant to clinical diagnosis. Dimensionality analyses indicated the influence of response sets as a potential contributor to poor item performance.
Conclusions:
Emory CF Recognition task demonstrates superior psychometric properties and greater sensitivity to cognitive impairment compared to the M&L task. Its ability to more precisely measure lower levels of cognitive functioning, along with its brevity, suggests it may be more effective for diagnostic use, especially in clinical populations with cognitive decline.
This article tries to explain the flourishing of geopolitical alternatives to the nation-state form and foreign policies organized around giant militarized power blocs during the two decades after World War II. The first section presents these new approaches to organizing the world. The first set of alternatives consisted of ideas and practices of the federation and the amalgamation of states into larger political units. These included Senghor’s vision of a postcolonial federation in which France and its former colonies would be equals; Nkrumah’s vision of a United States of Africa; and various short-lived amalgamations of states, including the Mali Federation and the United Arab Republic. These new geopolitical alternatives also included nonalignment, which originated with Jawaharlal Nehru of India and culminated with Josip Broz Tito of Yugoslavia but also encompassed Ireland between 1957 and 1961 and France in the early Fifth Republic. One of the distinctive features of this conjuncture is that these experiments were not limited to the global peripheries, colonies, and recently decolonized states, but also characterized certain nonhegemonic European core countries. The second section examines a set of four factors in this period that created an opportunity structure or space of possibilities for geopolitical experimentation: (1) late colonialism; (2) the Cold War; (3) the character of decolonization; and (4) the United Nations. The coexistence of these factors opened spaces of maneuver and autonomy for a flourishing of geopolitical imaginaries. The final section discusses possible reasons for the end of this period of experimentation.
This preliminary longitudinal web-based study examines the progression of anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms among individuals affected by severe flooding in Rio Grande do Sul, Brazil. The aim is to provide data that can inform early interventions and future research on mental health following disasters.
Methods
Sixty-four participants were assessed during the flood (T1) and 1 month later (T2). Evaluations included sociodemographic data, trauma exposure, and symptoms of depression, anxiety, acute stress disorder (ASD), and PTSD.
Results
Depression and anxiety symptoms remained relatively stable between T1 and T2, while posttraumatic symptoms increased significantly, particularly re-experiencing and avoidance. This progression suggests a shift from initial hyperarousal to more entrenched symptoms of reliving trauma and avoidance, indicating that the long-term effects of trauma may be more closely tied to PTSD. Additionally, trauma exposure and specific ASD symptoms predicted PTSD severity at T2.
Conclusions
The results suggest a time-dependent progression of PTSD symptoms, with initial hyperarousal giving way to re-experiencing and avoidance, which are central to PTSD. Early psychoeducational interventions targeting re-experiencing symptoms and avoidance may help reduce PTSD severity. Further research in larger, more diverse samples is needed to assess generalizability.
A numerical study is presented on flow-induced vibration of a circular cylinder, under the effect of a downstream stationary cylinder-induced proximity interference. The interference-induced various types of gap-flow regimes and characteristics of vibration and gap-flow rate $Q^*_g$ are presented, by considering various non-dimensional gaps $G^* = 0.1{-}2.5$ and reduced velocities $U^* = 3{-}20$ at a constant Reynolds number $Re = 100$, mass ratio $m^*= 2$ and damping ratio $\zeta = 0.005$. Decreasing $G^*$ or increasing proximity leads to the four gap-flow regimes: bi-directional gap flow at $G^* \geqslant 1.0$, uni-directional non-orthogonal gap flow at $G^* = 1.5{-}1.0$, uni-directional orthogonal gap flow at $G^* \leqslant 0.5$ and uni-directional one-sided gap flow at $G^* \leqslant 0.3$. Further, the respective regimes at larger $U^*$ are associated with proximity-induced modified vortex-induced vibration (PImVIV), proximity-induced galloping (PIG), transitional PImVIV–PIG, and proximity-induced staggered vibration (PISV). Quantitative presentation of maximum gap-flow rate $Q^*_{{g,max}}$, phase $ \phi _g$ (between $Q^*_{g}$ and displacement $y^*$) and phase portraits ($Q^*_{g}$ versus $y^*$) provides clear demarcation between the various gap-flow regimes. Flow mechanisms are presented for the PImVIV, PIG and PISV responses. For the PIG, the mechanism is presented for the first time on generation of galloping instability, asymptotically increasing $A^*$ and existence of optimum gap $G^* = 0.5$ for the maximum amplitude. This work is significant as it provides new insights into the proximity interference-induced gap-flow dynamics between two cylinders, associated flow mechanism for both vibration mitigation and enhancement and promising potential applications for energy harvesting.
The study introduces a novel dual-reflector antenna featuring a modified sub-reflector design aimed at improving aperture efficiency. A cylindrical-shaped keeper is introduced to enhance the performance of the sub-reflector. The dual-reflector configuration comprises a main parabolic reflector and a modified sub-reflector, with diameters of 16.5 λ and 2.2 λ, respectively, operating at 5.5 GHz. The antenna demonstrates a bandwidth (BW) of approximately 25.4% (4800–6200 MHz). Experimental measurements indicate favorable characteristics, including low cross-polarization levels (<−25 dB), minimal back lobe levels (F/B > 30 dB), high isolation between ports (>38 dB), and VSWRs less than 1.5:1 for both port1 and port2. The antenna exhibits an efficiency of around 58% and achieves a measured peak gain of approximately 32 dBi within the operating BW.
This study investigates the transport of particles in turbulent channel flow with friction Reynolds number $Re_\tau = 1000$ by direct numerical simulation. We focus on how large-scale flow structures, namely the $Qs$ structures (Lozano-Durán et al. 2012, J. Fluid Mech., vol. 694, pp. 100–130), affect the wall-normal transport of particles. Despite occupying less than $10\,\%$ of the physical domain, our results highlight the critical role played by $Qs$ structures in the particle transport, namely that the particle number and momentum flux inside the $Qs$ structures are substantially higher than outside. The fraction of particle wall-normal momentum flux inside $Qs$ structures is considerably larger than their volume fraction, suggesting highly efficient transport inside the $Qs$ structures. This prominent role played by $Qs$ structures in the transport of inertial particles is more effective by diminishing the inertia of particles. Notably, the long-distance transport of particles in the wall-normal direction is driven primarily by the continuous effect of $Qs$ structures. In summary, our findings advance the understanding of the effects of $Qs$ structures on particle transport, and demonstrate their significant role in the process.
The electromagnetically driven magnetised spherical Couette flow is studied experimentally, theoretically and numerically in the laminar regime. The working fluid, Galinstan, is contained in the spherical gap between two concentric spheres at rest. The electromagnetic stirring is primarily generated due to the interaction of a direct current, which is injected through two ring-shaped electrodes located at the equatorial zone of each sphere, and a dipolar magnetic field produced by a permanent magnet located inside the inner sphere. The flows were explored experimentally for a Reynolds number ranging from 450 to 2230 and a Hartmann number of 240. Ultrasound Doppler velocimetry and particle image velocimetry were used to characterise the flow. For low Reynolds numbers, given the symmetry of the problem, a one-dimensional analytic solution is obtained in the equatorial plane from the magnetohydrodynamic equations. The analytical solution reproduces the main characteristics of the flow. In addition, a full three-dimensional numerical model is able to reproduce both the analytical solution and the experimental measurements. To the best knowledge of the authors, this is the first time experimental results of the magnetised spherical Couette flow have been reported with electromagnetic forcing using a liquid metal as the working media.
Viscoplastic fluids exhibit yield stress, beyond which they flow viscously, while at lower stress levels they behave as solids. Despite their fundamental biological and medical importance, the hydrodynamics of swimming in viscoplastic environments is still evolving. In this study, we investigate the swimming of an ellipsoidal squirmer and the associated tracer diffusion in a Bingham viscoplastic fluid. The results illustrate that neutral squirmers in viscoplastic fluids experience a reduction in swimming speed and an increase in power dissipation as the Bingham number increases, with swimming efficiency peaking at moderate Bingham numbers. As the aspect ratio of a squirmer increases, ellipsoidal squirmers exhibit significantly higher swimming speeds in viscoplastic fluids. The polar and swirling modes can either enhance or reduce swimming speed, depending on the specific scenarios. These outcomes are closely related to the confinement effects induced by the yield surface surrounding the swimmer, highlighting how both swimmer shape and swimming mode can significantly alter the yield surface and, in turn, modify the swimming hydrodynamics. In addition, this study investigates the influence of viscoplasticity on swimmer-induced diffusion in a dilute suspension. The plasticity enforces the velocity far from the swimmer to be zero, thus breaking the assumptions used in Newtonian fluids. The diffusivity reaches its maximum at intermediate aspect ratios and Bingham numbers, and increases with the magnitude of the squirmer’s dipolarity. These findings are important to understand microscale swimming in viscoplastic environments and the suspension properties.
Historians of colonial and postcolonial attempts to deal with undernutrition in Africa have generally argued that, after the Second World War, scientists and doctors “medicalized” hunger by emphasizing specific deficiencies that could be medically “cured” or alleviated through dietary supplements, thereby covering up the economic, social, and political causes of (post)colonial hunger. This article argues that this explanation obscures the persistence of a more holistic approach immediately after the Second World War, which rejected this narrow vision of hunger and, on the contrary, framed it as a very broad problem requiring interdisciplinary research and ambitious economic and social solutions. It focuses in particular on the work of British nutrition specialist B. S. Platt and his “experiment” in The Gambia that was meant to devise a replicable recipe to cure colonial malnutrition through mechanization and agricultural development. Like many other such colonial projects, the project ended in dismal failure, but it illustrates how malnutrition was understood at the end of the war as a broad economic and social problem. It also shows how this more holistic approach was tightly associated with the postwar project of colonial “development” and was predicated on an ambition to thoroughly re-engineer colonial landscapes and subjects.
The U.S. Supreme Court is often regarded as an impartial arbiter of justice, yet various prejudices may influence its decisions. This article examines Supreme Court justices’ biases, focusing on how they invoke racialized stereotypes of criminality. We argue that justices are more likely to vote in favor of white, nonviolent litigants, reinforcing stereotypes that depict nonwhite defendants as inherently more criminal and violent. Drawing on the U.S. Supreme Court Database’s criminal procedure cases from 2005–2017, combined with an original dataset of litigants’ racial identities, we estimate a series of multilevel logistic regressions. Our findings show that litigant race, crime type, and justice ideology jointly shape judicial votes. We further investigate how bias appears in justices’ written opinions, revealing language that perpetuates racialized conceptions of criminality. Overall, our results underscore the Court’s role in constructing what it means to be both “criminal” and “nonwhite,” suggesting that the Court is not a neutral interpreter of law, but an institution shaped by broader social and political biases.