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Malacca Portuguese Creole (MPC) (ISO 639-3; code: mcm), popularly known as Malacca Portuguese or locally as (Papiá) Cristang, belongs to the group of Portuguese-lexified creoles of (South)east Asia, which includes the extinct varieties of Batavia/Tugu (Maurer 2013) and Bidau, East Timor (Baxter 1990), and the moribund variety of Macau (Baxter 2009). MPC has its origins in the Portuguese presence in Malacca, and like the other creoles in this subset, it is genetically related to the Portuguese Creoles of South Asia (Holm 1988, Cardoso, Baxter & Nunes 2012).
Significant ethnic and socio-economic disparities exist in infectious diseases (IDs) rates in New Zealand, so accurate measures of these characteristics are required. This study compared methods of ascribing ethnicity and socio-economic status. Children in the Growing Up in New Zealand longitudinal cohort were ascribed to self-prioritised, total response and single-combined ethnic groups. Socio-economic status was measured using household income, and both census-derived and survey-derived deprivation indices. Rates of ID hospitalisation were compared using linked administrative data. Self-prioritised ethnicity was simplest to use. Total response accounted for mixed ethnicity and allowed overlap between groups. Single-combined ethnicity required aggregation of small groups to maintain power but offered greater detail. Regardless of the method used, Māori and Pacific children, and children in the most socio-economically deprived households had a greater risk of ID hospitalisation. Risk differences between self-prioritised and total response methods were not significant for Māori and Pacific children but single-combined ethnicity revealed a diversity of risk within these groups. Household income was affected by non-random missing data. The census-derived deprivation index offered a high level of completeness with some risk of multicollinearity and concerns regarding the ecological fallacy. The survey-derived index required extra questions but was acceptable to participants and provided individualised data. Based on these results, the use of single-combined ethnicity and an individualised survey-derived index of deprivation are recommended where sample size and data structure allow it.
We prove that, given ε > 0 and k ≥ 1, there is an integer n such that the following holds. Suppose G is a finite group and A ⊆ G is k-stable. Then there is a normal subgroup H ≤ G of index at most n, and a set Y ⊆ G, which is a union of cosets of H, such that |A △ Y| ≤ε|H|. It follows that, for any coset C of H, either |C ∩ A|≤ ε|H| or |C \ A| ≤ ε |H|. This qualitatively generalises recent work of Terry and Wolf on vector spaces over
The dynamics of an interface between a thin liquid–vapour bilayer undergoing evaporation is studied. Both phases are considered to be hydrodynamically and thermally active, with momentum and thermal inertia taken into account. A reduced-order model based on the weighted-residual integral boundary layer method is used to investigate the dynamical behaviour for two cases, viz., phase change in the absence of gravity and then phase change in the presence of gravity. In the first case, it is shown that evaporative instability may cause rupture of either liquid or vapour layer depending on system parameters. Close to interfacial rupture, the disjoining pressure due to intermolecular forces results in the formation of drops (bubbles) separated by a thin film for low liquid (vapour) hold-up. Momentum inertia is shown to have a stabilizing effect, while thermal inertia has a destabilizing effect. In the second case, evaporative suppression of Rayleigh–Taylor (R–T) instability shows emergence of up to two neutral wavenumbers. Weak nonlinear analysis of these neutral wavenumbers suggests that the instability may be either supercritical or subcritical depending on the rate of evaporation. At high rates of evaporation, both neutral wavenumbers are supercritical and computations on the interface evolution lead to nonlinear saturated steady states. Momentum inertia slows down the rate of interface deformation and results in an oscillatory approach to saturation. Thermal inertia results in larger interface deformation and the saturated steady state is shifted closer to the wall. At very low evaporation rates, only one neutral wavenumber of subcritical nature exists. The nonlinear evolution of the interface in this case is then similar to pure R–T instability, exhibiting spontaneous lateral sliding as it approaches the wall.
The nonlinear evolution of an interface between a perfect conducting liquid and a perfect dielectric gas subject to periodic electrostatic forcing is studied under the long-wave approximation. It is shown that inertial thin films become unstable to finite-wavelength Faraday modes at the onset, prior to the long-wave pillaring instability reported in the lubrication limit. It is further shown that the pillaring-mode instability is subcritical in nature, with the interface approaching either the top or the bottom wall, depending on the liquid–gas holdup. On the other hand, the Faraday modes exhibit subharmonic or harmonic oscillations that nonlinearly saturate to standing waves at low forcing amplitudes. Unlike the pillaring mode, wherein the interface approaches the wall, Faraday modes may exhibit saturated standing waves when the instability is subcritical. At higher forcing amplitudes, the interface may approach either wall, again depending on the liquid–gas holdup. It is also shown that a gravitationally unstable configuration of such thin films, under the long-wave approximation, cannot be stabilized by periodic electrostatic forcing, unlike mechanical Faraday forcing. In this case, it is observed that the interface exhibits oscillatory sliding behaviour, approaching the wall in an ‘earthworm-like’ motion.
The outcome of transcatheter closure in ostium secundum atrial septal defects is determined by the morphology of the defects. Modified techniques such as balloon assistance, pulmonary vein deployment, left atrial roof technique, and so on are used for circumventing the anatomic complexities and increasing the success rates.
We planned a prospective study looking at the outcomes of transcatheter closure in secundum atrial septal defects with modified techniques in different anatomic complexities identified in transoesophageal echocardiography and their association with outcome of transcatheter closure.
Transcatheter closure was successful in 295 out of 346 (82%) patients with modified techniques. Balloon-assisted technique offered a success rate of 87%. The mean defect size was 34.7±2.78 mm (95% confidence interval (CI) 30.67–43.1 mm) with success and 40.16±4.5 mm (95% CI 32.16–44.7) with failure (p = 0.02). The mean total septal length was 38.11±0.63 (95% CI 35.21–40.56 mm) with success and 42.54±0.34 (95% CI 38.79–43.21 mm) with failure. The defect to septal ratios were 0.82 and 0.94 in success and failure groups, respectively (p=0.02). However, the absence of a retro-aortic margin, septal aneurysm, and multiple defects did not affect the success rate. Deficient inferior vena caval margin, deficient posterior margin, and size⩾40 mm had a high risk of failure with transcatheter closure. The odds ratio for procedural failure was 25.3 (4.3–143.8) in patients with malaligned septum, 8.3(1.4–48.5) with deficient inferior vena caval margin, and 4.1(2.5–19) for size⩾40 mm.
The modified techniques for device deployment offer substantial chances of success in transcatheter closure of secundum atrial septal defects with anatomical complexity (82%). Variants such as defect size of⩾40 mm and deficient inferior and posterior margins have high failure rates with a modified technique.
A heavy-over-light configuration of a fluid bilayer may be stabilized in the presence of a phase change if the system consists of a single component. However, if the fluid is composed of a binary mixture with the more volatile component having the lower surface tension, it is known that a Marangoni instability occurs. This instability owes its origin to concentration gradients created by the phase change, even though the phase change otherwise has a stabilizing effect. In this study, it is shown via a nonlinear model under a long-wavelength approximation, that this Marangoni destabilization is insufficient to cause a rupture of the interface under practical operating conditions. Computations reveal that the stabilizing effect of the phase change dominates as the film becomes thin by reversing the direction of the Marangoni flow, thereby halting the instability and any hope of rupture.
To validate a newly introduced cartilage rim augmented temporalis fascia tympanoplasty technique by statistically comparing it with the morphological and audiological outcomes of traditional temporalis fascia tympanoplasty.
A retrospective comparative study was conducted on 115 patients who underwent tympanoplasty during 2013 and 2015. Fifty-eight patients underwent temporalis fascia tympanoplasty and 57 underwent cartilage rim augmented fascia tympanoplasty.
In the cartilage fascia group, graft healing was achieved in 94.7 per cent of cases; in the temporalis fascia group, the graft take-up rate was 70 per cent. In those with a normal ossicular chain, the post-operative air–bone gap was within 20 dB in 92.6 per cent of cartilage fascia group cases and in 69.7 per cent of the temporalis fascia group cases, which was a statistically significant difference. Among the defective ossicular chain cases, the post-operative air–bone gap was within 20 dB in 76.9 per cent in the cartilage fascia group, as against 57.1 per cent in the temporalis fascia group.
Cartilage rim augmented temporalis fascia tympanoplasty has a definite advantage over the temporalis fascia technique in terms of superior graft take up and statistically significant hearing gain in those with normal ossicular mobility.
Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.
Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.
Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51–2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.
Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.
We give an algebraic description of the structure of the analytic universal cover of a complex abelian variety which suffices to determine the structure up to isomorphism. More generally, we classify the models of theories of ‘universal covers’ of rigid divisible commutative finite Morley rank groups.
To explore, for the first time, whether a modified mindfulness-based cognitive therapy (MBCT) course has the potential to reduce stress and burnout among National Health Service (NHS) General Practitioners.
There is a crisis of low morale among NHS GPs, with most describing their workload as ‘unmanageable’. MBCT has been demonstrated to improve stress and burnout in other populations, but has not yet been evaluated in a cohort of NHS GPs.
NHS GPs in South East England (n=22) attended a modified version of the MBCT course approved by National Institute for Health and Care Excellence for prevention of depressive relapse. This comprised eight weekly 2-h sessions with homework (mindfulness practice) between sessions. Participants completed the Maslach Burnout Inventory (MBI) and Perceived Stress Scale (PSS) before (baseline) and then again one month (T2) and three months (T3) after attending the course. We also obtained qualitative data on participants’ experiences of the course.
Compliance with the intervention was very high. All GPs attended at least six sessions and all completed baseline questionnaires. At T2, data were obtained from 21 participants (95%); PSS scores were significantly lower than at baseline (P<0.001), as were MBI emotional exhaustion (P<0.001) and depersonalization scores (P=0.0421). At T3 we obtained data for 13 participants (59%); PSS scores and MBI emotional exhaustion scores were significantly lower (P<0.001; P=0.0024, respectively) and personal accomplishment scores were significantly higher (P<0.001) than at baseline. Participants reported that the course helped them to manage work pressures, feel more relaxed, enjoy their work and experience greater empathy and compassion (for self, colleagues and patients). Findings of this preliminary evaluation are promising. Further research is needed to evaluate this approach within a larger randomized-controlled trial.
Oestrogen–progesterone signalling is highly versatile and critical for the maintenance of healthy endometrium in humans. The genomic and nongenomic signalling cascades initiated by these hormones in differentiated cells of endometrium have been the primary focus of research since 1920s. However, last decade of research has shown a significant role of stem cells in the maintenance of a healthy endometrium and the modulatory effects of hormones on these cells. Endometriosis, the growth of endometrium outside the uterus, is very common in infertile patients and the elusiveness in understanding of disease pathology causes hindrance in selection of treatment approaches to enhance fertility. In endometriosis, the stem cells are dysfunctional as it can confer progesterone resistance to their progenies resulting in disharmony of hormonal orchestration of endometrial homeostasis. The bidirectional communication between stem cell signalling pathways and oestrogen–progesterone signalling is found to be disrupted in endometriosis though it is not clear which precedes the other. In this paper, we review the intricate connection between hormones, stem cells and the cross-talks in their signalling cascades in normal endometrium and discuss how this is deregulated in endometriosis. Re-examination of the oestrogen–progesterone dependency of endometrium with a focus on stem cells is imperative to delineate infertility associated with endometriosis and thereby aid in designing better treatment modalities.
For G a group definable in a saturated model of a NIP theory T, we prove that there is a smallest type-definable subgroup H of G such that the quotient G / H is stable. This generalizes the existence of G00, the smallest type-definable subgroup of G of bounded index.
It is disappointing to many that the GDP growth paradigm, while the subject of critical debate, has reasserted itself after the 2007–2009 financial crisis. As the science of human-induced climate change becomes irrefutable, the global power elites, employing the art of paradigm maintenance, have morphed the hegemony of neoliberal economics into what is called the ‘green economy’ – a continuation of the post-Brundtland attempt to reduce ‘sustainable development’ to ‘sustain development’ (Wanner 2007). In this new phase, green technologies are rolled out to buttress the notion that economic growth can be ‘decoupled’ from resource depletion and carbon emissions. In other words, we can have our cake and eat it.
These ideas have filtered down into South Africa's National Development Plan (NDP), which maintains a commitment to the minerals–energy complex, informalised jobs growth and continued massive social inequality – but with a green twist. Indeed, there has been a concerted rollout of renewable energy in South Africa, but this is still by far subsumed under a fossil fuel-based growth economy (given this country's abundance of coal), with the threat of expanded nuclear energy.
Can South Africa, or any developing country, escape this extractivist growth paradigm? Indeed, should developing countries commit much to the global efforts towards reducing carbon emissions, given their massive social deficits (including jobs, education, health care, housing)? Or can they leapfrog dirty development pathways, using green technologies? Is the emerging ‘degrowth’ paradigm only applicable to ‘overdeveloped’ countries of the north, which need to stop growing in order for developing countries to grow – thus lowering the average growth rate for the global economy? Indeed, is the measurement of growth using the GDP metric a useful indicator of both economic growth and social welfare, or should we be considering alternatives? Should alternatives embrace a radical eco-socialist utopian vision, notwithstanding massive resistance, from above and below – given the manner in which society has become invested in the consumer economy? These are questions that are increasingly occupying centre stage as the world considers post-carbon futures.
This chapter situates the argument within the global ecological–economic– social crisis, the GDP problem and global hegemonic interests.