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To explore the feasibility and effect of video-assisted minimally invasive surgery for combined heart valvular diseases through an intercostal incision.
Method:
From July 2022 to April 2025, a total of 50 video-assisted minimally invasive combined heart valve surgeries were performed in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Anhui Medical University. Combined heart valve procedures include mitral and tricuspid valve surgery and mitral and aortic valve surgery, as well as large atrial septal defect repair combined with mitral and tricuspid valve surgery. The 4th right intercostal incision along the anterior axillary line was set as the primary access for the surgical procedure of combined mitral and tricuspid valves. The 3rd intercostal incision next to the sternum was set as the primary access for the surgical procedure of combined aortic and mitral valves. The 4th right intercostal incision along the midclavicular line was set as the primary access for the surgical procedure of combined mitral and tricuspid valves concomitant with a large defect of the atrial septal. The perioperative data of patients was collected.
Results:
All patients underwent the video-assisted minimally invasive surgery completely. A total of 49 patients were discharged as expected except for only 1 older patient who was transferred into a local medical institution for extended rehabilitation due to delayed postoperative awakening. Postoperatively, excellent function of replaced prosthetic valves without paravalvular leaking has been confirmed. Moreover, there was no or less than mild regurgitation for repaired mitral and tricuspid valves. Also, postoperative complications, including III atrioventricular block, renal failure, and severe hypoxaemia, have not been found.
Conclusion:
Video-assisted minimally invasive surgery for combined heart valves is safe and effective with a short-term satisfactory outcome.
Using an administrative nationwide dataset of 1,673 tea producers, this study examines the key factors that drive tea pricing. Empirical results indicate that price levels vary across production regions, tea varieties, altitude, and certification status. On average, black tea commands higher prices, while other teas (green, Oolong, and Baozhong) are typically lower. However, as a special local tea, Oriental Beauty (and other teas) has the highest price. The cultivation altitude and organic certification are significantly associated with price premiums. In summary, this study provides strong evidence to show that regional origin, growing conditions, and certification may greatly influence tea’s market price, offering practical insights for producers and policymakers.
Double-peaked Lyman-$\alpha$ (Ly$\alpha$) profiles provide critical insights into gas kinematics and the distribution of neutral hydrogen (H i) from the interstellar to the intergalactic medium (ISM to IGM) and serve as valuable diagnostics of ionising Lyman continuum (LyC) photon escape. We present a study of the global and spatially resolved properties of double-peaked Ly$\alpha$ emitters (LAEs), based on VLT/MUSE data from the Middle Ages Galaxy Properties with Integral Field Spectroscopy (MAGPI) survey. From a parent sample of 417 LAEs at $z = 2.9 - 6.6$ in the first 35 fields, we identify 108 double-peaked LAEs using an automated peak classification technique. We measure a double-peak fraction of $\sim$37% at $z \lt 4$, decreasing to $\sim$14% at $z \gt 4$, likely due to enhanced IGM attenuation. Approximately 17% of the double-peaked LAEs are blue-dominated, possibly tracing gas inflows, though backscattering remains a viable alternative for sources without systemic redshift. The blue-to-total flux ratio exhibits a luminosity dependence: fainter lines generally show higher blue flux, though a few luminous sources also show strong blue peaks. We find a significant narrowing of the red peak at $z\gt4$, despite the presence of the blue peak, indicating intrinsic galaxy evolution rather than an effect of IGM attenuation. Several LAEs exhibit residual flux in the absorption trough, with normalised trough flux anticorrelating with peak separation, reflecting variations in H i column density. We further investigate spatially resolved properties of ten red-dominated LAEs with extended Ly$\alpha$ halos. Despite azimuthal variations, both the blue-to-total flux ratio and normalised trough flux density increase with radius, while peak separation decreases. The red peak asymmetry shows only minor radial changes. These trends are consistent with variations in shell outflow velocity and H i column density across the halos. However, some exceptions to these patterns are also noted. Based on peak separation, red peak asymmetry, and residual trough flux, we identify five LAEs as strong LyC leaker candidates.
Idiopathic infantile arterial calcification is a rare autosomal recessive disorder characterised by extensive calcification and proliferation of the intimal layer of the large and medium sized arteries.
Methods and objectives:
The diagnosis is usually made at autopsy or in the neonatal period, when there is cardiac failure. Prenatal diagnosis is possible in the latter half of pregnancy when there are hyperechoic vessel walls, hypertrophied ventricular musculature, and nonimmune fetal hydrops. The number of cases diagnosed before birth is low.
Results:
This study presents a 27-week pregnant patient diagnosed with widespread calcification in the aorta and pulmonary arteries, severe pericardial effusion, and hydrops fetalis during fetal echocardiographic examination.
Conclusion:
This case report reminds paediatric cardiologists, radiologists, and perinatologists that they should be familiar with widespread arterial calcification. It emphasises that idiopathic infantile arterial calcification, a very rare condition, should be considered among the etiologic factors when hydrops fetalis is detected on ultrasound.
Let M be a smooth manifold with $\dim M\geq 3$ and a base point $x_{0}$. Surgeries along the oriented circle $S^{1}\times \{x_{0}\}$ on the product $S^{1}\times M$ yield two manifolds $\Sigma _{0}M$ and $\Sigma _{1}M$, called the suspensions of M.
These suspension operations play a fundamental role in the construction and classification of smooth manifolds admitting free circle actions. This paper presents corresponding results and supporting evidence.
In this paper, a sliding mode guidance law for impact angle control without violating a seeker’s field-of-view limits is proposed against targets with various motions and unknown acceleration, including stationary, constant-velocity moving and manoeuvring targets. To develop the guidance law, the kinematic conditions for engagement geometry are defined, and the sliding mode control is applied to satisfy the homing constraint and impact angle control. Then, the relation between look angle, the desired line-of-sight angle and desired impact angle is established to guarantee the target in the field of the missile’s view. The stability of the proposed approach is analysed using Lyapunov theory. Furthermore, the look angle is examined to verify the field-of-view constraint, and a capturability analysis is conducted. To evaluate the performance of the proposed law, numerical simulations demonstrate that the proposed approach achieves satisfactory miss distance and impact angle error while adhering to the field-of-view limit.
We present a combined experimental and theoretical exploration of three-layer, horizontal core–annular pipe flow, in which two fluids are separated by a deformable elastic solid. In the experiments, an elastic solid created by an in situ chemical reaction maintains the separation of the core and annular fluids. Corrugations of the elastic interface are observed, and stable pipelining, where the elastic shell created separating the two fluids remains intact, is successfully demonstrated even when the core fluid is buoyant. The theoretical model combines lubrication theory for the fluids with standard shell theory for the elastic solid. The model is used to predict the buckling states resulting from radial compression of the shell, and to explore the sedimentation of a buoyant core. The self-sculpting of the shell by buckling cannot by itself generate hydrodynamic lift owing to symmetry in the direction of flow. Instead, we demonstrate that hydrodynamic lift can be achieved by other elastohydrodynamic effects, when that symmetry becomes broken during the bending of the shell.
Our study examines chunking ability in the processing of auditory multi-word expressions (MWEs) in first (L1) and second languages (L2) using a single- and dual-task paradigm. The findings reveal that divided attention caused by dual tasks does not impair L1 speakers’ ability to bind individual words into a complete MWE (i.e., a unitary chunk). In contrast, L2 learners struggle to form complete MWEs under dual tasks, representing them as smaller, multiple chunks in memory. Divided attention also reduces the overall number of chunks recalled for both groups. Additionally, increased language proficiency and repeated practice through training are positively correlated with the formation of larger chunks, whereas greater working memory capacity is associated with the recall of a greater number of chunks. These findings underscore the challenges L2 learners face in acquiring relatively large chunks and suggest that L2 learning improves through gradually binding smaller units into larger chunks over time.
A lingering feature of academic publications in political science is persistent gender gaps. In the aggregate, men are dominant in the discipline, and on the individual level, men publish and submit more articles and books than women do. In this article, we explore one way that journals may potentially reduce the gender gap in publishing. Focusing on the composition of editorial boards, we hypothesize that a higher share of female editorial board members, particularly if such representation is coupled with a high share of female editors, can increase women’s presence as journal authors. We test this argument using data from 120 political science journals. Through quantitative analyses, we find a relatively strong association between a high presence of female board members and female authors, especially in situations with a high percentage of female editors.
Media attention to policing has brought a proliferation of narratives seeking to contextualize incidents of police violence. Here, we test whether exposure to such narratives shift Americans’ opinion or behavior. To do so, we first identify and track the media prevalence of two of these narratives: one focused on racial bias in policing and a second focused on the dangers of the profession. Despite the presence of these narratives in media, we find, experimentally, that public opinion about police violence is stable, regardless of the media narrative used. Finally, to better understand these null results, we use a content analysis of open-ended responses to uncover the demographic and ideological characteristics that are most more deterministic of their reactions to police violence. Altogether, these findings indicate attitudes about policing and planned political participation are ossified and unresponsive to media narratives.
An ever-increasing availability of digital texts has opened new research opportunities for political scientists. Yet, researchers who want to utilise these data face several challenges. This paper presents the results of a community-wide survey tapping into various research challenges, training needs, and preferences of scholars using text analysis methodologies. The survey involved respondents from various academic fields and career levels. Our findings indicate that text-as-data methods are gaining momentum in various political science subfields and are used on a wide range of political texts. However, relevant training is not easily accessible to all. Only half of the respondents have ever participated in a training event, though there is a high demand for training opportunities in different formats and at different levels. In ‘Conclusions’, we discuss how the inaccessibility of training risks narrowing the field of researchers.
The History of Mankind-project (HoM) was carried out from 1944–76 under the auspices of UNESCO with the aim of producing a non-eurocentric history of the world from prehistory to the present. The article analyses how the mid-century wave of independence changed the HoM-project. In hindsight a trajectory can be identified from decolonisation as a marginal concern to a new situation where decolonisation as political process and epistemological agenda influenced the HoM with respect to its political aims, organisational structure, the selection of authors, and the narrative of world history it presented. As such it is a clear story of how the end of empire altered how world history has been conceptualised and written. The article explores this theme across four HoM volumes and breaks fresh ground by investigating the agency of individual author-editors and the actual historical narratives they produced in the published volumes. We argue that the approaches and the organisation of the HoM were challenged as anti-eurocentrism in history writing became coupled increasingly to decolonisation and the quest for epistemological sovereignty.
This article argues that power–dependence relations are a crucial dimension of analysis to understand how states navigate between realist and liberal logics and particularly between the balancing and integration strategies. Specifically, I distinguish between three types of power–dependence relationships: limitation, neutralisation, and competition. Limitation and neutralisation make the balancing strategy viable by allowing power to offset dependence and thus preserve the autonomy of the state. On the other hand, when limitation and neutralisation are no longer workable, particularly in the case of cross-temporal interdependence, the balancing strategy becomes unreliable, and integration tends to become an attractive alternative. In the case of competition between a state’s different sources of dependence, the loss of flexibility brought about by integration may prove costly by limiting the state’s ability to address various dependencies simultaneously. Empirically, I illustrate these mechanisms by showing that post-war European integration started as a response to a situation of cross-temporal interdependence between France and West Germany, which tended to make the limitation and neutralisation strategies unreliable. However, military integration was later hindered by the tension between competing sources of dependence for France, which increased the cost of the loss of flexibility entailed by military centralisation.
West Nile virus (WNV) is a zoonotic mosquito-borne Flavivirus, with bird populations reservoirs. Although often asymptomatic, infection in humans can cause febrile symptoms and, more rarely, severe neurological symptoms. Previous studies assessed environmental drivers of WNV infections, but most overlooked areas with potential WNV circulation despite no reported human case, and mixed mechanisms affecting hosts vs. vectors. Our objective was to generate a WNV Bird Risk Index (BRI) mapping the potential of WNV circulation in bird communities across Europe. We first used a bird traits-based model to estimate WNV seroprevalence in European wild bird species and identify eco-ethological characteristics associated with it. This allowed us to build a map of the WNV BRI that showed a strong spatial heterogeneity across Europe. To validate this metric, using a Besag-York-Mollie 2 spatial model in a Bayesian framework, we showed a positive association between the BRI and the number of years with notified WNV human cases between 2016 and 2023, at the NUTS administrative region scale. To conclude, we provide a map quantifying the suitability for WNV to circulate in the bird reservoir. This allows to target surveillance efforts in areas at risk for WNV zoonotic infections in the future.
This article addresses the proposition that the lower Lahontan drainage basin (LLDB) is “unique” within the Intermountain West in terms of the use of caves and rockshelters as burial locations, and that such burials are “rare” elsewhere (Thomas et al. 2025). We compare archaeologically known cave burials in the Bonneville basin (BB), ranging in age from approximately 10,700 to approximately 1000 cal BP, to those in the LLDB. There are 18 such sites in the BB and an additional five in the upper Lahontan basin within the foraging range of late Holocene BB farmer-foragers. Although this number is roughly half of that in the LLDB, such sites are not “rare” or even uncommon in the BB. The difference in numbers may be attributed more to differences in population sizes in the two basins than to differences in burial practices. After about 5000 cal BP, many caves and rockshelters containing burials in the LLDB were occupied residentially, diurnally, or while storing and retrieving cached material. Given that Thomas and colleagues (2025:246) indicate the Northern Paiute tended to avoid such caves, it is likely that it was the ancestors of other groups who lived in them. Ethnographic and archaeological evidence suggests that at least some of these caves were occupied by the ancestral Washoe, whose historic territory extended into the LLDB, and possibly by related tribes who now reside exclusively in California.
This article examines whether strategic narratives and grand strategies exhibit continuity or change after traumatic geopolitical events. It scrutinises Israel’s response to the 7 October 2023 attacks and Czechia’s reaction to Russia’s February 2022 Ukraine invasion. Through (i) qualitative content analysis of leaders’ speeches and (ii) delineating Israeli and Czech grand strategies, it finds that the degree of change was proportional to the level of shock and threat. Israel responded to a first order critical situation with a grand strategic overhaul; Czechia answered a second order critical situation with a less substantial grand strategic adjustment. Yet both cases exhibited a key commonality: leaders drew on existing perceptions to frame and justify policy shifts, demonstrating that continuity and change are co-dependent in grand strategy. In sum, this article contributes new primary source data pertinent to two contemporary conflicts, challenges grand strategy’s great power centrism, and demonstrates the importance of rhetoric in preventing or facilitating grand strategic change.