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The sutureless repair technique has been favoured due to its purported reduction in post-operative pulmonary venous obstruction rates. This study aims to compare the outcomes of conventional versus sutureless repair techniques in Total Anomalous Pulmonary Venous Drainage.
Methods:
In this retrospective single-centre analysis (2012–2022), we evaluated children who underwent conventional or sutureless repair for isolated total anomalous pulmonary venous drainage, excluding complex cardiac anomalies and incomplete data. Patients were categorised into conventional (Group C, n = 58) and sutureless (Group S, n = 41) groups. Primary outcomes included mortality, morbidity, and post-operative complications. Statistical analysis included Mann–Whitney U, chi-square, and Fisher’s exact tests where appropriate.
Results:
Supracardiac type predominated in both groups (53.4% in Group C and 70.7% in Group S), with higher cardiac type frequency in Group C (24.1% versus 2.4%, p = 0.016). Early complications occurred in 58.5% versus 53.4% of cases in Groups S and C, respectively (p = 0.767). The mortality rate (17.2% versus 14.6%, p = 0.944) and post-operative pulmonary venous obstruction (21.2% versus 19.0%, p = 0.809) were higher in Group C, though not significantly. Mean cardiopulmonary bypass times were comparable between groups (105 versus 89 minutes, p = 0.424).
Conclusions:
In this comprehensive analysis of paediatric Total Anomalous Pulmonary Venous Drainage repair, both conventional and sutureless techniques demonstrated comparable safety profiles and clinical outcomes. These findings suggest that surgical approach selection should be individualised based on patient characteristics and surgeon expertise. Further prospective studies with larger cohorts are needed to validate these observations.
The manuscript is devoted to the boundary behavior of mappings with bounded and finite distortion. We consider mappings of domains of the Euclidean space that satisfy weighted Poletsky inequality. Assume that, the definition domain is finitely connected on its boundary and, in addition, on the set of all points which are pre-images of the cluster set of this boundary. Then the specified mappings have a continuous boundary extension provided that the majorant in the Poletsky inequality satisfies some integral divergence condition, or has a finite mean oscillation at every boundary point.
The Canada-wide Early Learning and Child Care Plan promises to help low-income parents, especially women, participate in the economy. But even under this plan, care will be too expensive for many families. Several provinces offer targeted subsidies to reduce fees—unfortunately, these benefits are often hard to access and their popularity with voters is unclear. Using a pre-registered survey experiment (N=821), this research note investigates support for a hypothetical child care supplement to help low-income families. Overall, we find strong support for such an initiative, but little enthusiasm to pay for it through new income taxes. We then manipulate the ease of accessing this benefit. We find little evidence that burdensome child care benefits are more popular than easily accessible benefits. If anything, burdensome benefits reduce support. We then briefly consider how partisanship influences support. We conclude with timely recommendations for government and discuss the need for accessible child care benefits.
A través del lente de la conciencia jurídica, este trabajo analiza la insatisfacción institucional en el marco de un profundo escepticismo hacia las instituciones formales, particularmente en el contexto de la sociedad chilena post-Octubre de 2019. El artículo busca investigar la relación entre la expresión de una profunda antipatía hacia el estado y la postura que los individuos manifiestan con respecto a la legalidad. El trabajo reporta los hallazgos derivados de 12 grupos focales categorizados por edad, género, y locación. Encontramos que, a pesar de los sentimientos negativos prevalentes que albergan las personas hacia estas instituciones, los participantes continúan usando el lenguaje del derecho, expresando su insatisfacción como derechos formales frustrados o por una falta de aplicación de la ley con respecto a las élites corruptas. Concluimos que la existencia de una brecha entre las expectativas normativas y el agudo rechazo por su incumplimiento por parte de actores institucionales abre una estructura de oportunidades para la emergencia de formas más autoritarias de poder estatal.
We investigate natural variations of behaviourally correct learning and explanatory learning—two learning paradigms studied in algorithmic learning theory—that allow us to “learn” equivalence relations on Polish spaces. We give a characterization of the learnable equivalence relations in terms of their Borel complexity and show that the behaviourally correct and explanatory learnable equivalence relations coincide both in uniform and non-uniform versions of learnability and provide a characterization of the learnable equivalence relations in terms of their Borel complexity. We also show that the set of uniformly learnable equivalence relations is $\boldsymbol {\Pi }^1_1$-complete in the codes and study the learnability of several equivalence relations arising naturally in logic as a case study.
Given a Polish group G, let $E(G)$ be the right coset equivalence relation $G^\omega /c(G)$, where $c(G)$ is the group of all convergent sequences in G. We first established two results:
(1) Let $G,H$ be two Polish groups. If H is TSI but G is not, then $E(G)\not \le _BE(H)$.
(2) Let G be a Polish group. Then the following are equivalent: (a) G is TSI non-archimedean; (b)$E(G)\leq _B E_0^\omega $; and (c) $E(G)\leq _B {\mathbb {R}}^\omega /c_0$. In particular, $E(G)\sim _B E_0^\omega $ iff G is TSI uncountable non-archimedean.
A critical theorem presented in this article is as follows: Let G be a TSI Polish group, and let H be a closed subgroup of the product of a sequence of TSI strongly NSS Polish groups. If $E(G)\le _BE(H)$, then there exists a continuous homomorphism $S:G_0\rightarrow H$ such that $\ker (S)$ is non-archimedean, where $G_0$ is the connected component of the identity of G. The converse holds if G is connected, $S(G)$ is closed in H, and the interval $[0,1]$ can be embedded into H.
As its applications, we prove several Rigid theorems for TSI Lie groups, locally compact Polish groups, separable Banach spaces, and separable Fréchet spaces, respectively.
John Harris has made many seminal contributions to bioethics. Two of these are in the ethics of resource allocation. Firstly, he proposed the “fair innings argument” which was the first sufficientarian approach to distributive justice. Resources should be provided to ensure people have a fair innings—when Harris first wrote this, around 70 years of life, but perhaps now 80. Secondly, Harris famously advanced the egalitarian position in response to utilitarian approaches to allocation (such as maximizing Quality Adjusted Life Years [QALYs]) that what people want is the greatest chance of the longest, best quality life for themselves, and justice requires treating these claims equally. Harris thus proposed both sufficientarian and egalitarian approaches. This chapter compares these approaches with utilitarian and contractualist approaches and provides a methodology for deciding among these (Collective Reflective Equilibrium). This methodology is applied to the allocation of ventilators in the pandemic (as an example) and an ethical algorithm for their deployment created. This paper describes the concept of algorithmic bioethics as a way of addressing pluralism of values and context specificity of moral judgment and policy, and addressing complex ethics.
This study examines how the managerial interpretation of incentive arrangement affects corporate engagement in social areas, as reflected in corporate social performance, from two interrelated perspectives: the political influence view and the normative agency view. Building the theoretical framework on state-owned enterprise (SOE) executives' dual-career tracks perspective, we contend that economic factors (performance decline and relative pay gap) and political factors (socialist imprints and political career horizon) could divergently reshape the interpretation of incentive arrangement on corporate social performance. Using ‘Pay Ceiling Order’ as a quasi-natural experiment context, a secondary analysis, and a controlled experiment reveal that compensation restriction on top executives causes a decrease in corporate social performance. This relationship is weakened when there are stronger socialist imprints inherited by a focal firm and when the executives have a longer political prospect. In contrast, the relationship is strengthened when firms face severe performance declines and when the executives' compensation is relatively lower than peers. The findings show that compensation is an indispensable incentive joining with political and economic factors, enabling SOEs to engage in social areas. We discuss the implications of understanding top executive incentives with incentive arrangements and how the government purpose influences top executive responses to compensation incentive in ways that matter for long-term social value.
Not only has Wolff–Parkinson–White syndrome been associated with congenital cardiac abnormalities and cardiomyopathies, but familial clustering of Wolff–Parkinson–White syndrome has also been reported. Despite these well-known associations, direct genetic aetiology is rarely implicated in patients with Wolff–Parkinson–White syndrome. We report a 17-year-old girl with Wolff–Parkinson–White syndrome and left ventricular non-compaction cardiomyopathy due to a rare genetic variant in PR-domain containing protein 16. The report is supplemented by a comprehensive review of literature on association between PRDM16, left ventricular non-compaction and Wolff–Parkinson–White syndrome.
This article examines Kazantzakis’ travel writing in his 1926 newspaper series on ‘the Land of Palestine’, which introduces Zionism, and in his posthumously published chapter ‘Jerusalem’ in Journeying (1961). Revisiting the relation between the two, I argue that each is to be seen as a distinct work. While free from the antisemitic sentiment of Venizelist circles, the Greek author's reportage has three important silences – and these are matched by a sweeping lack of scholarly interest in this material. This article hopes to generate renewed interest so that Kazantzakis’ 1926 reportage may help construe a more complex reception of Zionism in interwar Greece.
Let E be an elliptic curve defined over $\mathbb {Q}$ with good ordinary reduction at a prime $p\geq 5$ and let F be an imaginary quadratic field. Under appropriate assumptions, we show that the Pontryagin dual of the fine Mordell–Weil group of E over the $\mathbb {Z}_{p}^2$-extension of F is pseudo-null as a module over the Iwasawa algebra of the group $\mathbb {Z}_{p}^2$.
The multi-robot path planning problem is an NP-hard problem. The coati optimization algorithm (COA) is a novel metaheuristic algorithm and has been successfully applied in many fields. To solve multi-robot path planning optimization problems, we embed two differential evolution (DE) strategies into COA, a self-adaptive differential evolution-based coati optimization algorithm (SDECOA) is proposed. Among these strategies, the proposed algorithm adaptively selects more suitable strategies for different problems, effectively balancing global and local search capabilities. To validate the algorithm’s effectiveness, we tested it on CEC2020 benchmark functions and 48 CEC2020 real-world constrained optimization problems. In the latter’s experiments, the algorithm proposed in this paper achieved the best overall results compared to the top five algorithms that won in the CEC2020 competition. Finally, we applied SDECOA to optimization multi-robot online path planning problem. Facing extreme environments with multiple static and dynamic obstacles of varying sizes, the SDECOA algorithm consistently outperformed some classical and state-of-the-art algorithms. Compared to DE and COA, the proposed algorithm achieved an average improvement of 46% and 50%, respectively. Through extensive experimental testing, it was confirmed that our proposed algorithm is highly competitive. The source code of the algorithm is accessible at: https://ww2.mathworks.cn/matlabcentral/fileexchange/164876-HDECOA.
We incorporate the liquidity trap and private behavioral preferences into a New Keynesian dynamic stochastic general equilibrium model to analyze fiscal multipliers. The results indicate that the influence of the liquidity trap on fiscal policy is driven by a combination of the interest rate transmission effect and the precautionary savings effect, showing a notable amplification of multipliers based on estimates from U.S. data. Furthermore, we examine two types of private behavioral preferences: habit formation and investor confidence. Habit formation significantly boosts short-term government spending multipliers while exhibiting diverse impacts on different types of taxation. Compared to superficial habits, deep habits result in flatter multiplier curves. Investor confidence, being highly sensitive to output fluctuations, enhances both spending and tax multipliers over the medium to long term. Additionally, the investor confidence channel slightly amplifies the expansionary effect of the liquidity trap on multipliers, contrasting with the impact of habit formation.
Prior studies report a decline in male twin live births during economically stressful periods, presumably owing to higher selection in utero against frail male gestations, yet no study has examined the natural corollary: whether provision of economic support increases rates of male twin births. We examined whether male twin live births increase following income gains from the Alaska Permanent Fund Dividend (PFD)—the longest running unconditional cash transfer program in the US. We obtained the monthly volume of male (and female) twin and singleton live births, from January 1980 to December 2019, from Alaska’s Department of Health. Data on PFD timing and payment amounts came from Alaska’s Department of Revenue. We used time-series analyses to gauge whether the odds of male twin live births increase within 2−6 months following PFD receipt, controlling for autocorrelation. Results suggest that for every $1000 increase in PFD payments, the odds of male twin live births increase by 0.002 (p < .05) three months following PFD disbursement. This corresponds with 50 additional (individual) male twin live births statistically attributable to the cumulative PFD amount disbursed over our study period. Income gains through the PFD may correspond with reduced male-specific selection in utero in Alaska.
Glenn procedure carries low morbidity and mortality within stages of single-ventricle palliation. However, some patients with Glenn failure need a stage reversal, while others require unanticipated surgical interventions. Our understanding of perioperative factors and outcomes associated with such unexpected interventions is extremely limited.
Methods:
Patients who underwent unexpected surgery after the Glenn procedure between January 2010 and December 2019 within the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) were identified with a subgroup analysis of those reverting to stage I physiology. Patient’s requiring reversal to stage I palliation were matched 1:5 with controls. Multivariable logistic regression analysis was performed to evaluate risk factors for reintervention.
Results:
A total of 16,913 patients underwent Glenn procedure with 1221 (7.2%) requiring unexpected cardiac surgical intervention and 95 (0.56%) patients required takedown to a stage I. Significant clinical and operative risk factors were identified for such unexpected interventions.
The overall mortality after Glenn procedure was 1.2%, while mortality after unexpected reintervention was 6.6% at 30 days and after Glenn takedown was 27.5% at last follow-up. Unexpected surgical intervention and right ventricular dominance were significant risk factors for mortality.
Conclusion:
Unexpected reinterventions, including need for takedown after the Glenn procedure, are associated with significantly higher mortality. Further studies should focus on improving our patient selection, understanding the risk factors mechanistically, including impact of the right ventricle as systemic ventricle in order to avoid need for unexpected surgical interventions.
Altered reinforcement learning (RL) and decision-making have been implicated in the pathophysiology of anorexia nervosa. To determine whether deficits observed in symptomatic anorexia nervosa are also present in remission, we investigated RL in women remitted from anorexia nervosa (rAN).
Methods:
Participants performed a probabilistic associative learning task that involved learning from rewarding or punishing outcomes across consecutive sets of stimuli to examine generalization of learning to new stimuli over extended task exposure. We fit a hybrid RL and drift diffusion model of associative learning to model learning and decision-making processes in 24 rAN and 20 female community controls (cCN).
Results:
rAN showed better learning from negative outcomes than cCN and this was greater over extended task exposure (p < .001, ηp2 = .30). rAN demonstrated a reduction in accuracy of optimal choices (p = .007, ηp2 = .16) and rate of information extraction on reward trials from set 1 to set 2 (p = .012, ηp2 = .14), and a larger reduction of response threshold separation from set 1 to set 2 than cCN (p = .036, ηp2 = .10).
Conclusions:
rAN extracted less information from rewarding stimuli and their learning became increasingly sensitive to negative outcomes over learning trials. This suggests rAN shifted attention to learning from negative feedback while slowing down extraction of information from rewarding stimuli. Better learning from negative over positive feedback in rAN might reflect a marker of recovery.
A transverse ledge climbing robot inspired by athletic locomotion is a customized robot aiming to travel through horizontal ledges in vertical walls. Due to the safety issue and complex configurations in graspable ledges such as horizontal, inclined ledges, and gaps between ledges, existing well-known vision-based navigation methods suffering from occlusion problems may not be applicable to this special kind of application. This study develops a force feedback-based motion planning strategy for the robot to explore and make feasible grasping actions as it continuously travels through reachable ledges. A contact force detection algorithm developed using a momentum observer approach is implemented to estimate the contact force between the robot’s exploring hand and the ledge. Then, to minimize the detection errors due to dynamic model uncertainties and noises, a time-varying threshold is integrated. When the estimated contact force exceeds the threshold value, the robot control system feeds the estimated force into the admittance controller to revise the joint motion trajectories for a smooth transition. To handle the scenario of gaps between ledges, several ledge-searching algorithms are developed to allow the robot to grasp the next target ledge and safely overcome the gap transition. The effectiveness of the proposed motion planning and searching strategy has been justified by simulation, where the four-link transverse climbing robot successfully navigates through a set of obstacle scenarios modeled to approximate the actual environment. The performance of the developed grasping ledge searching methods for various obstacle characteristics has been evaluated.
We proxy retail investor attention through Google Trends and find that fungible and non-fungible crypto tokens generate greater attention from high-gambling propensity regions. Crypto attention is higher during bubble-like episodes in the crypto market and for more lottery-like tokens. Moreover, retail crypto attention decreases after sports gambling is legalized. Higher token attention is associated with more contributors and higher fundraising. However, consumer credit default rates spike after periods of high crypto attention, but solely in the subprime segment. Overall, our findings suggest that gambling preferences strongly predict retail investor interest in the crypto market.
State-owned enterprises (SOEs) in China play a critical role in national economic development and the country's positioning on the global stage. Chinese SOEs have undergone substantial transformations from traditional government-run entities to a variety of corporate forms exhibiting different levels of state involvement. Despite their substantial influence, the internal diversity of SOEs – from wholly state-owned to mixed-ownership – has not been thoroughly examined. This paper provides an overview of SOEs' critical roles in the Chinese economy, the relationship between SOEs and privately owned enterprises (POEs), and the challenges of SOEs in different stages of Chinese economic development. It then introduces five research papers that explore the institutional, strategic, and organizational perspectives on how SOEs manage the dual pressures of state and market logic, respond to policy adjustments, tackle leadership challenges, and navigate current global trends such as digital transformation, technological innovation, and environmental sustainability. In this paper, we provide important implications for policy and managerial practices and highlight a future research agenda for the heterogeneity of Chinese SOEs, and how SOEs respond to these challenges in the evolving geopolitical landscape, adapt their strategies, and manage relationships with foreign governments and enterprises under such conditions.
While the pathophysiology affecting patients after Fontan palliation versus those with orthostatic intolerance is quite different, a common therapeutic approach exists. Exercise training, specifically augmenting the lower extremity skeletal muscle pump, improves the suboptimal haemodynamics of “preload failure” and thus clinical outcomes for each patient group. In this review, we will describe the problematic physiology affecting these patients, examine the anatomy and haemodynamics of the skeletal muscle pump, and finally review how exercise benefits both groups of patients through augmentation of musculovenous force.