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Rising adult mortality is an essential feature of the mortality transition. Vulnerability to disease and infection decreases with age, and adult mortality is more likely to be from unnatural causes such as suicide, homicide and road traffic accidents. This study aimed to assess the patterns of unnatural deaths in India as a whole and for various population subgroups. Data were obtained from the fourth wave of the National Family Health Survey (NFHS-4) conducted in 2015–16 in 29 states and 7 union territories of India. The survey collected information on deaths in households occurring in the 3 years before the survey. Rate of unnatural mortality and years of life lost were calculated separately for males and females as well as for urban and rural populations. Unnatural mortality in India was found to make up 10.3% of total deaths, and was greater among the population aged 10 to 45 years. The unnatural mortality rate in India was 0.67 per 1000 population: 0.84 per 1000 among the male population and 0.49 per 1000 among the female population. A strict positive association was found between the unnatural mortality rate and a state’s development level. In addition, a substantial loss of person-years of life due to unnatural mortality was observed. The results serve as a reminder of the need to adopt measures to reduce this avoidable loss of life in India. Prevention strategies should be targeted at the most vulnerable populations to limit young-age fatality, with its resulting loss of productive years of life.
The effect of fluid on the natural frequencies of a vertical rectangular lock gate is investigated. The fluid is assumed to be inviscid and incompressible having an irrotational flow field. The far boundary of fluid domain is truncated near the lock gate structure by solving the Laplace equation using Fourier half range cosine series expansion. The formulation of lock gate structure is governed using Mindlin’s plate theory. The coupled interaction between the fluid domain and the lock gate structure is established using finite element method (FEM) and a computer code is written using FORTRAN. Convergence study and validation of the formulation are carried out to minimise the computational error. The natural frequencies of lock gate coupled with and without fluid are determined for undisturbed and linearised free surface conditions. By varying extent of fluid domain, the effect on the natural frequencies of lock gate is evaluated. The results of natural frequencies obtained may be useful to the designer when the reservoir lock gate structure is exposed to the natural disasters.
Conventional planar manipulators have their links in a single plane. Increasing payload at the end effector/mobile platform can induce high stress in the links due to the cantilever nature of links. Thus, it limits the total vertical load that can be applied on the mobile platform. In contrast to the links in conventional planar parallel mechanisms, non-planar links are proposed in this paper, that is, links are made inclined to the horizontal plane and non-planar legs are constructed. Though the links are made non-planar, the end effectors’ planar motion is retained. For studying the application of such non-planar links in planar manipulators, new models of inertia, stiffness and leg dynamics have to be developed. In this article, these models are developed by the static analysis of the planar manipulators with non-planar links, and the performance is compared with the corresponding conventional planar manipulators.
In this study, AA5083-reinforced multiwalled carbon nanotubes (MWCNT) nanocomposites were selected as the alternate material for a redundant articulated robot (RAR) design by varying the composition of MWCNT wt%. By assigning AA5083-reinforced MWCNT as a custom material to the parts of RAR developed by Solid Works and exported to MATLAB/SimMechanics platform to convert the model into multi-body system blocks. The dynamic parameter torque was observed utilising simulation capability in a SimMechanics second-generation environment. The simulation results inferred that AA5083 reinforced with increased wt% of MWCNT has better properties suitable for RAR design.
Online learning has become an increasingly expected and popular component for education of the modern-day adult learner, including the medical provider. In light of the recent coronavirus pandemic, there has never been more urgency to establish opportunities for supplemental online learning. Heart University aims to be “the go-to online resource” for e-learning in CHD and paediatric-acquired heart disease. It is a carefully curated open access library of paedagogical material for all providers of care to children and adults with CHD or children with acquired heart disease, whether a trainee or a practising provider. In this manuscript, we review the aims, development, current offerings and standing, and future goals of Heart University.
The aim of this study was to evaluate contact endoscopy in detecting local treatment failures post-radiotherapy in squamous cell carcinoma of the upper aerodigestive tract.
A total of 135 consecutive patients with suspected residual or recurrent cancer after definitive radiotherapy underwent contact endoscopy before biopsy. Contact endoscopy findings were compared with histopathological examination findings. Contact endoscopy could not be completed in 7 patients (5.9 per cent) and histopathological examination was inconclusive in 5 patients (3.7 per cent). The findings of the remaining 123 patients were compared.
The sensitivity, specificity and accuracy of contact endoscopy were 88.75, 88.72 and 86.99 per cent, respectively, with similar results across various sites of upper aerodigestive tract. Inter-observer kappa value was 0.86 (95 per cent confidence interval: 0.79–0.93). The intra-observer kappa value was 0.93 (95 per cent confidence interval: 0.87–1.00) for the first observer and 0.95 (95 per cent confidence interval: 0.90–1.00) for second and third observers.
Contact endoscopy showed the same high sensitivity and specificity with low inter- and intra-observer variability in detecting post-radiotherapy failures in cancer of the upper aerodigestive tract as has been shown in non-irradiated tissues in earlier studies.
Dynamic wetting failure in shear-thinning and shear-thickening liquids is examined in this paper. Flow visualization experiments using a curtain-coating geometry suggest that shear thinning postpones the onset of wetting failure and the resulting air entrainment. To advance the fundamental understanding of the underlying physical mechanisms, a hydrodynamic model consisting of liquid displacing air in a rectangular channel in the absence of inertia is developed. Both shear thinning and shear thickening are considered by using Carreau-type models to describe the liquid rheology. Steady-state solutions are calculated using the Galerkin finite-element method and the critical capillary number where wetting failure occurs is identified. Shear thinning is found to postpone the onset of wetting failure whereas shear thickening is found to promote it. The underlying mechanism involves thickening/thinning of the air film as a consequence of shear thinning/thickening of the liquid and the tangential stress balance. The results can be interpreted in terms of an effective viscosity, and demonstrate that similar physical mechanisms govern dynamic wetting failure in Newtonian, shear-thinning and shear-thickening liquids.
Castor is a prime industrial crop belonging to a monotypic genus and its genetic improvement depends on creating desired variability in the primary gene pool. This study reports the development of tetraploid castor plants through colchicine treatment. Seeds of three castor genotypes were soaked in aqueous solutions of colchicine with variable concentrations, and the LD50 value was determined. Of 1010 treated field-raised plants, three were identified as potential polyploids based on increases in a guard cell size and reductions in the number of stomata. The putative polyploid plants were selfed and the progeny were subjected to meiotic analysis. All the progeny were found to be tetraploid. The pairing of chromosomes was abnormal with univalent to octavalent configurations during meiosis-I, but the later parts of meiosis were normal. Seasonal variations in pollen fertility indicated the possible role of temperature-sensitive male sterility in causing the sterility in tetraploid plants. The tetraploid plants were phenotypically comparable with their diploid counterparts, but produced substantially bigger seeds. Thus, these tetraploid plants are valuable resources for basic and applied research in castor.
The Indian subcontinent is prone to tropical cyclones that used to originate in the North Indian Ocean. Through this study, an inventory of disease outbreaks for the tropical cyclone-affected regions from 2010 to 2018 has been compiled. This inventory is used to assess the success of recent sanitation intervention, Swachh Bharat Mission, also known as the Clean India Mission.
Meteorological parameters from the Indian satellites were used to demarcate the cyclone-affected area. Disease outbreaks and epidemics during the tropical cyclones were compiled from the Integrated Disease Surveillance Program and other relevant sources. The inventory has been used to track the effect of recent sanitation interventions on disease outbreaks.
Districts in the eastern coast of India are frequently affected due to tropical cyclones that have originated from the North Indian Ocean. Infectious diseases like the acute diarrheal diseases, vector-borne diseases, viral fevers, enteric fevers, and food poisoning have recursively occurred during the cyclonic events and persisted up to 2 weeks from the cyclonic episode. The effectiveness of the Clean India Mission is evident during the recent cyclones, Ockhi, Titli, and Gaja, where a significantly lower number of infectious disease outbreaks were recorded.
The Clean India Mission has exhibited positive results on the public health consequences associated with tropical cyclones.
We study the asymptotic behaviour of the powers of a composition operator on various Banach spaces of holomorphic functions on the disc, namely, standard weighted Bergman spaces (finite and infinite order), Bloch space, little Bloch space, Bloch-type space and Dirichlet space. Moreover, we give a complete characterization of those composition operators that are similar to an isometry on these various Banach spaces. We conclude by studying the asymptotic behaviour of semigroups of composition operators on these various Banach spaces.
The Single Ventricle Reconstruction Trial randomised neonates with hypoplastic left heart syndrome to a shunt strategy but otherwise retained standard of care. We aimed to describe centre-level practice variation at Fontan completion.
Centre-level data are reported as median or median frequency across all centres and range of medians or frequencies across centres. Classification and regression tree analysis assessed the association of centre-level factors with length of stay and percentage of patients with prolonged pleural effusion (>7 days).
The median Fontan age (14 centres, 320 patients) was 3.1 years (range from 1.7 to 3.9), and the weight-for-age z-score was −0.56 (−1.35 + 0.44). Extra-cardiac Fontans were performed in 79% (4–100%) of patients at the 13 centres performing this procedure; lateral tunnels were performed in 32% (3–100%) at the 11 centres performing it. Deep hypothermic circulatory arrest (nine centres) ranged from 6 to 100%. Major complications occurred in 17% (7–33%). The length of stay was 9.5 days (9–12); 15% (6–33%) had prolonged pleural effusion. Centres with fewer patients (<6%) with prolonged pleural effusion and fewer (<41%) complications had a shorter length of stay (<10 days; sensitivity 1.0; specificity 0.71; area under the curve 0.96). Avoiding deep hypothermic circulatory arrest and higher weight-for-age z-score were associated with a lower percentage of patients with prolonged effusions (<9.5%; sensitivity 1.0; specificity = 0.86; area under the curve 0.98).
Fontan perioperative practices varied widely among study centres. Strategies to decrease the duration of pleural effusion and minimise complications may decrease the length of stay. Further research regarding deep hypothermic circulatory arrest is needed to understand its association with prolonged pleural effusion.
To assess the effect of tranexamic acid on intra-operative bleeding and surgical field visualisation.
Fifty patients undergoing various endoscopic ear surgical procedures, including endoscopic tympanoplasty, endoscopic atticotomy or mastoidectomy, endoscopic ossiculoplasty, and endoscopic stapedotomy, were randomly assigned to: a study group that received tranexamic acid or a control group which received normal saline. The intra-operative bleeding and operative field visualisation was graded using the Das and Mitra endoscopic ear surgery bleeding and field visibility score, which was separately analysed for the external auditory canal and the middle ear.
The Das and Mitra score was better (p < 0.05) in the group that received tranexamic acid as a haemostat when working in the external auditory canal; with respect to the middle ear, no statistically significant difference was found between the two agents. Mean values for mean arterial pressure, heart rate and surgical time were comparable in both groups, with no statistically significant differences.
Tranexamic acid appears to be an effective haemostat in endoscopic ear surgery, thus improving surgical field visualisation, especially during manipulation of the external auditory canal soft tissues.
In interventions for at-risk children, Tom Dishion strongly exhorted programs that are short term, cost-effective, and delivered in families’ own communities, just as resilience researchers underscore the need for programs that provide ongoing support for children's primary caregivers, and are implementable on a large scale. Presented here are preliminary results on a short-term intervention for mothers, the Authentic Connections Virtual Groups. A previous randomized trial of the in-person version of this program, conducted with mothers at high risk for stress and burnout, showed significant benefits. There had been zero dropouts across the 3-month program, and participants showed significant improvements on psychological indices as well as cortisol, even 3 months after the program ended. In the present study, virtual groups were conducted with five sets of women, all white-collar professionals with highly stressful, exacting careers, and most also primary caregivers of their children. Again, there were zero dropouts. Mean satisfaction ratings were 9.6 of 10, and the Net Promoter Score (promoters vs. detractors) fell in the “world class” range. To illuminate mechanisms of change, participants’ responses to open-ended questions on the groups’ value are presented verbatim. Recurrently mentioned were the development of new, authentic connections and invaluable ongoing support. These results, with the low costs and ease of women's attendance, attest to the value of expanding offerings such as these, toward benefiting even more highly stressed mothers themselves as well as the children for whose care they are responsible.
In this paper, longitudinal and lateral-directional aerodynamic characterisation of the Cropped Delta Reflex Wing (CDRW) configuration–based unmanned aerial vehicle is carried out by means of full-scale static wind-tunnel tests followed by full-scale flight testing. A predecided set of longitudinal and lateral/directional manoeuvres is performed to acquire the respective flight data, using a dedicated onboard flight data acquisition system. The compatibility of the acquired dynamics is quantified, in terms of scale factors and biases of the measured variables, using Kinematic consistency check. Maximum likelihood (ML), least squares and newly emerging neural Gauss–Newton (NGN) methods were implemented for a wing-alone delta configuration, mainly to capture the dynamic derivatives for both longitudinal and lateral directional cases. Estimated damping and weak dynamic derivatives, which are in general challenging to capture for a wing alone configuration, are consistent using ML and NGN methods. Validation of the estimated parameters with aerodynamic model is performed by proof-of-match exercise and are presented therein.
This paper aims at understanding the texture evolution in extruded oxide dispersion strengthened 18Cr ferritic steel during high-temperature uniaxial compression testing at 1,423 K at a strain rate of 0.01/s based on extensive electron back scatter diffraction characterization. The α-fiber texture is observed along the extrusion direction (ED) in the initial microstructure. The flow curves generated during uniaxial compression test are used to determine the associated hardening parameters. In addition, the degree of texture evolution after deformation along the ED and the transverse direction (TD) with respect to the initial condition has been predicted using VPSC-5 constitutive model. The prediction shows that the deformation along the ED produces a dominant γ-fiber texture in contrast to the TD. This is in agreement with the experimental results where γ-fiber texture is observed, due to enhanced dynamic recrystallization at high-temperature deformation.
Pre-weaning animals exit a flock through death induced by various reasons, causing significant economic losses to the goat producers. In this study, we investigated the survival from birth to weaning of Sirohi goat kids within framework of the survival analysis. Kid records were accessed from 1997 to 2017, with the information on 4417 pre-weaning animals of farmed Sirohi goat native to the Rajasthan State of India. A multivariable Cox regression was fitted to the data after checking the assumptions of regression. The explanatory variables were sex, type of birth, season of birth, birthweight, doe weight at kidding and year of birth. Model selection eliminated doe weight from the model, and sex, type of birth, season of birth, birthweight and year of birth were retained in the model. With model calibration also, these five covariates were retained in the model. The mortality on the first day after birth was 0.3%, constituting 3.5% of all pre-weaning mortality. The mortality until the end of weaning period was 7.8%. Regression analysis revealed that the higher birthweight at kidding was associated with reduced hazard of death among the kids. Male kids had higher hazards of death compared with female kids. The single-born kids had lower risks of death compared with twin-born kids after accounting for heterogeneity. The winter season had a very high adverse effect on the survival of the kids. With each passing year, risks of death decreased. The results of this study indicate that better survival of kids can be achieved by controlling both environmental and animal-related factors.
At GE Research, we are combining “physics” with artificial intelligence and machine learning to advance manufacturing design, processing, and inspection, turning innovative technologies into real products and solutions across our industrial portfolio. This article provides a snapshot of how this physical plus digital transformation is evolving at GE.