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.
The design of filters used in waveguides, which are crucial components of high-frequency communication systems, plays a significant role in improving system performance. In this study, the usage of metamaterials is first proposed, the SLA 3D printing method is used to design and fabricate CSRR meta-resonators-based bandpass waveguide filters (WGFs) with different filter orders for C-band (4-7.5 GHz), and simulated and measured filter performances are compared. Since the proposed novel WG structure is modular, it allows the design of C-band WGFs using different thicknesses of substrate materials. Also, the number of unit elements can be increased and any number of meta-resonators can be inserted to design filters of different orders ranging from 1 to 5. The electrical length of the WGF/WG structure can be changed according to the needs of the applications. The resulting WGFs demonstrated superior RF performance, being 50% lighter than comparable models found in the literature. Over the relevant frequency range, the filter exhibited return losses between 31-43 dB, insertion losses from 0.1 to 0.35 dB, FBW ranging from 12% to 16%, and quality factors between 6.23 and 8.28, depending on the filter order. The obtained experimental results align closely with the simulation predictions, confirming the effectiveness of the design.
Medical shelters are frequently utilized after major disasters to care for displaced individuals with severe mobility limitations and chronic medical conditions that may be inadequately addressed in general population sheltering. A retrospective chart review was conducted on 680 patients served in state-operated Medical Needs Shelters (MNS) in Louisiana following three major hurricanes from 2020 to 2021. The authors aimed to produce a descriptive analysis of the degree and variety of medical complexity of patients within the shelters to guide future shelter planning. Data illustrate demographic characteristics, clinical attributes, and outcomes among shelter patients. Patients were found to have numerous medical comorbidities, often with serious concomitant neuropsychiatric, cardiovascular, and pulmonary conditions. The shelter population was highly dependent on nursing staff for medication management and activities of daily living. They also had high utilization of respiratory therapies, hemodialysis, and wound care. Clinically significant events (e.g., falls, mental status changes, vital sign abnormalities), often resulting in transport to local hospitals, occurred in approximately 20% of all patient stays. Limitations of the study include suspected underreporting of disease prevalence and the study’s retrospective approach. Public health planners should consider the clinical needs of this population when designing strategic and tactical approaches to mass care for medically vulnerable individuals. Future research might examine which factors place individuals at higher risk for decompensation within a medical shelter.
Percutaneous device closure is the preferred method for closing patent ductus arteriosus (PDA), even in preterm infants. We report our experience using the new KONAR-MFO™ ventricular septal defect occluder for transcatheter closure of preterm patent ductus arteriosus as an alternative device in resource-limited centres.
Methodology:
Case 1: A preterm baby with Down’s syndrome and tracheobronchomalacia was born at 29 weeks, weighing 1.68 kg with multiple cardiac defects, including a 4 mm PDA and a 6 mm mid-muscular ventricular septal defect (VSD), stuck on a ventilator. Case 2: Another preterm baby born at 35 weeks, weighing 1.89 kg, with anorectal malformation and a right inguinal hernia. The echocardiogram revealed a 4 mm PDA with severe PAH. In both cases, the patent ductus arteriosus was occluded using a 6 mm × 4 mm Konar MFO device on day 14 (case 1) and day 20 (case 2).
Results:
The baby (case 1) was weaned off the ventilator and discharged on the 28th postnatal day at 2.09 kg. As for case 2, the baby was weaned off the ventilator within 2 days and discharged on day 30 at 2.23 kg. A follow-up echocardiogram of both cases confirmed a well-positioned device with no obstructions. At 18 months, in the follow-up, both babies were gaining weight and thriving.
Conclusions:
The KONAR MFO device is a safe and effective option for patent ductus arteriosus closure in preterm infants, even in resource-limited settings. Its versatility accommodates various duct sizes and morphologies, and its self-expandable design ensures easy deployment, addressing the anatomical challenges often seen in preterm infants.
Women are the fastest growing prison population in Canada and the United States. Women who are criminalized and incarcerated are almost always prior victims of physical and/or sexual abuse, often at a young age. Foucault’s concept of the “carceral society” allows us to understand how people are deemed criminal or innocent based on a hegemonic system of “norms” which reinforce institutional violence. This article details how those who transgress the norms of being white, male, cisgender, neurotypical, and heterosexual (among others) are often subject to violence and criminalized by default, both in their homes and communities, as well as in the eyes of the state. This “home to prison pipeline” (HTPP) is especially harmful for Black women and women of colour, who face multiple, intersecting oppressions of state policy and violence. Rooted in domestic violence and carcerality in the home, the HTPP operates as a system of close surveillance, honing on those who do not conform to institutional norms. This paper is based in the testimony of incarcerated women, and draws on Foucault’s conceptions of criminality, surveillance, and the development of the modern prison, as well as that of feminist and criminology scholars.
For upper semi-continuous potentials defined on shifts over countable alphabets, this paper ensures sufficient conditions for the existence of a maximizing measure. We resort to the concept of blur shift, introduced by T. Almeida and M. Sobottka as a compactification method for countable alphabet shifts consisting of adding new symbols given by blurred subsets of the alphabet. Our approach extends beyond the Markovian case to encompass more general countable alphabet shifts. In particular, we guarantee a convex characterization and compactness for the set of blur invariant probabilities with respect to the discontinuous shift map.
This study explores the rationale and impact of the Raising the Participation Age (RPA) policy within Further Education (FE), drawing on my experience lecturing Health and Social Care. Introduced following the 2007/08 financial crisis and fully implemented in 2015, the RPA requires young people to remain in education or training until the age of eighteen, aiming to address skills shortages and reduce unemployment. Existing research indicates limited understanding of the policy’s effects on FE learners, particularly within health and social care. This study examines how the RPA has shaped students’ academic and career trajectories, with a focus on the notion of ‘effective participation’. Using a combination of policy analysis and reflective qualitative insights from practice, the study identifies both benefits and limitations of the RPA. While participation rates have increased, the policy has also contributed to larger class sizes and students enrolling through compulsion rather than choice. This has led to disengagement and heightened mental health concerns, often compounded by inadequate support for diverse learning needs. The findings suggest that an emphasis on numerical participation overlooks students’ holistic development. Addressing social inequalities and reconsidering the causes of NEET status are essential to achieving meaningful engagement and improved educational and societal outcomes.
Unmet healthcare needs remain a major barrier to achieving universal health coverage (UHC) globally. The intersection of aging and disability intensifies individual vulnerability and deepens structural health inequalities. Using Andersen’s Behavioural Model of healthcare utilisation as the theoretical framework, this study examines the determinants of healthcare utilisation at the individual and contextual levels among older adults with disabilities living in China. We use a dataset in China from 319 prefectures, with a total sample size of 634,445 individuals. Our findings reveal the presence of higher-income and urban-residence advantages in healthcare utilisation for older adults with disabilities in China. Regional economic development positively affects healthcare utilisation and reduces urban-rural inequality in healthcare utilisation, but its impact on income-based inequality is limited. These results highlight the need for targeted social assistance programmes for low-income groups to promote universal healthcare coverage and social equity.
This article examines whether social investment (SI) stock (education), flow (family support), and buffer (safety net) policy functions reduce poverty risk across age groups and family types. To contribute to the discussion on SI’s capability to promote the livelihoods of the vulnerable groups in society, this research focuses on the poverty risk of young adults and single mothers in the twenty-first-century Germany. Logistic regression analysis with longitudinal German Socio-Economic Panel (G-SOEP) micro data matched with various policy indicators shows that the policy functions reduce poverty risk among working age men and women more than disadvantaged young adults. The results demonstrate that flow and stock functions reinforce each other’s poverty-alleviating impact if social protection buffers are weak, more so among young women than men. Further, all SI policy functions are found to alleviate the high poverty risk of single mothers, but poverty-reducing policy complementarities take place only if family support is strong.
Timely access to endovascular treatment (EVT) for ischaemic stroke patients is critical for optimal outcomes, but Canada’s size and population distribution create barriers to access. EVT is mostly available in tertiary centres located in large urban cities, and patients that arrive at intravenous thrombolysis (IVT)-only stroke centres need to be transferred for EVT.
Methods:
Geographic modelling of access to an IVT-only centre and an EVT-capable centre was conducted for Canada. Canada was divided into small grid sections. Drive times from the centre of each grid section to the closest stroke centres and the population of each grid section were obtained. The onset to paramedic arrival time and on-scene time were assumed to be 30 and 30 minutes, respectively. In the suboptimal and optimal scenarios, the door-in-door-out (DIDO) times were 150 minutes and 45 minutes, respectively. The poor access regions and population were calculated for onset to thrombolysis at 4.5 hours and to EVT-capable centre arrival for EVT within 6 and 3 hours.
Results:
The results show 99.37% of the population having access to thrombolysis within 4.5 hours. However, with a suboptimal DIDO time, 13.6% (5.2 million people) and 42.7% (16.2 million people) do not have access to EVT within 6 and 3 hours, respectively. With an efficient DIDO time, an additional 5.6% (2.1 million people) and 15.7% (6.0 million people) have access to EVT within 6 and 3 hours, respectively.
Conclusion:
There is an imperative to reduce DIDO times to an ambitious median of 45 minutes to ensure optimal access to EVT across Canada.
In this work, we study a class of elliptic problems involving nonlinear superpositions of fractional operators of the form
\begin{equation*}A_{\mu,p}u := \int_{[0,1]} (-\Delta)_{p}^{s} u \, d\mu(s),\end{equation*}
where $\mu$ is a signed measure on $[0,1]$, coupled with nonlinearities of superlinear type. This kind of operator was introduced by S. Dipierro, K. Perera, C. Sportelli, and E. Valdinoci in [11]. Our analysis covers a variety of superlinear growth assumptions, beginning with the classical Ambrosetti–Rabinowitz condition. Within this framework, we construct a suitable variational setting and apply the Fountain Theorem to establish the existence of infinitely many weak solutions. The results obtained are novel even in the special cases of superpositions of fractional $p$-Laplacians, or combinations of the fractional $p$-Laplacian with the $p$-Laplacian. More generally, our approach applies to finite sums of fractional $p$-Laplacians with different orders, as well as to operators in which fractional Laplacians appear with ‘wrong’ signs. A distinctive contribution of the paper lies in providing a unified variational framework that systematically accommodates this broad class of operators.
Textbooks continue to serve as essential central repositories of knowledge for postgraduate education in paediatric cardiology, despite the widespread availability of digital learning tools. Recent studies confirm that trainees still value textbooks for their structure, depth, and accessibility, while also requesting improved pedagogy and organisation. In preparing the 5th edition of Anderson’s Pediatric Cardiology, our editorial team implemented several deliberate educational innovations. These included (1) re-focusing towards our target audience, the congenital cardiac trainee and practicing congenital cardiologist; (2) adoption of a consistent lesion-based framework, termed the “red line,” linking anatomy, physiology, and clinical features; (3) expansion of concise visual elements such as tables, figures, algorithms, and flowcharts; and (4) incorporation of clear learning objectives throughout. These modifications were informed by feedback from trainees, educators, and practicing providers, balancing the desires and needs of the modern learner, and firmly grounded in principles of cognitive and educational science. This paper outlines the rationale, design, and pedagogical implications of these innovations within the broader context of modern medical education.