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During the second wave of COVID-19 pandemic, an increasing number of patients experienced breathlessness, which progressed to acute respiratory distress syndrome, leading to the need for supplemental oxygen therapy and mechanical ventilation. With each passing day, the need for medical oxygen increased and simultaneously medical oxygen reserves in the country were getting depleted. Government agencies deployed multipronged strategies to ensure that the hospitals had an adequate supply of medical oxygen. Mechanisms and formulae were devised for the rational allocation of medical oxygen to various regions in the country; the production of medical oxygen was boosted along with the curtailment of oxygen usage in industries; and efficient supply chain management, which included “Oxygen Express”— special trains for transporting oxygen, aircrafts for transporting medical oxygen, creating green corridors and real-time monitoring of oxygen levels using information technology. The usage and promotion of indigenous PSA oxygen technology augmented the medical oxygen generation capacity at the health care facility level. This emergency situation demonstrated a need for strengthening established intersectoral coordination mechanisms for swift and effective responses to similar situations in future. Various strategies adopted by the Central Government and other government agencies to a large extent helped in addressing the medical oxygen emergencies.
This study aims to evaluate the clinical characteristics and outcomes of children diagnosed with sinus node dysfunction.
Methods:
This was a retrospective review of patients diagnosed with sinus node dysfunction in two tertiary paediatric cardiology centres in Turkey from January 2011 to June 2022.
Results:
In all, 77 patients (50, 64.9% males) were included, with a mean age of 8.2 ± 6.3 years and a mean weight of 28.2 ± 18.8 kg. While age-incompatible bradycardia and pauses were the most common rhythm disturbances, syncope, presyncope, and dizziness (n:33, 43%) were the most frequent initial symptoms. Structural heart disease was present in 58 (75.3%) of the 77 patients, 47 (61%) of whom were congenital. The most commonly associated CHDs were transposition of the great arteries (n:8), atrial septal defect (n:7), and atrioventricular septal defect (n:5). Seven of them also had left atrial isomerism. The remaining 19 patients were isolated. Four patients had SCN5A mutation (two of them were siblings) and two of them had Emery–Dreifuss muscular dystrophy.
Conclusion:
Although sinus node dysfunction is rare in children, it has been diagnosed with increasing frequency with structural heart disease, especially in patients who have undergone corrective cardiac surgery related to atrial tissue. Since sinus node dysfunction can occur at any time postoperatively, these patients should be kept under constant control. If symptomatic sinus node dysfunction is confirmed, permanent pacing is an effective therapeutic modality.
Endogenous biological rhythms synchronise human physiology with daily cycles of light-dark, wake-sleep and feeding-fasting. Proper circadian alignment is crucial for physiological function, reflected in the rhythmic expression of molecular clock genes in various tissues, especially in skeletal muscle. Circadian disruption, such as misaligned feeding, dysregulates metabolism and increases the risk of metabolic disorders like type 2 diabetes. Such disturbances are common in critically ill patients, especially those who rely on enteral nutrition. Whilst continuous provision of enteral nutrition is currently the most common practice in critical care, this is largely dictated by convenience rather than evidence. Conversely, some findings indicate that intermittent provision of enteral nutrition aligned with daylight may better support physiological functions and improve clinical/metabolic outcomes. However, there is a critical need for studies of skeletal muscle responses to acutely divergent feeding patterns, in addition to complementary translational research to map tissue-level physiology to whole-body and clinical outcomes.
This study investigates the hydrogenetic ferromanganese crust (HFMC) from the Magellan Seamounts in the northwest Pacific Ocean, focusing on its mineralogy, crystal chemistry, and paleoclimatic records. Given that ferromanganese is composed of poorly crystalline MnOx phases, such as vernadite, structural determination using conventional X-ray diffraction (XRD) methods is challenging and has very limited effectiveness. Therefore, synchrotron-based pair-distribution function (PDF) analysis of total X-ray scattering and high-resolution electron microscopy techniques were employed to characterize the structures and compositions of HFMC. The results from the synchrotron XRD and transmission electron microscopy (TEM) reveal that the studied HFMC consists primarily of poorly crystalline Fe-bearing vernadite. The chemical analysis of the HFMC layers indicates that the rare-earth elements (REE) and P were preferentially adsorbed on the Fe-rich vernadite, whereas platinum-group elements (PGE), Co, and Ni were enriched in the Mn-rich vernadite. The top layers of the HFMC display fine-scale compositional variations (cycle of ~1600 y) that signify millennial-scale paleoclimate oscillations during the Middle-Late Pleistocene and Holocene periods linked to the glacial termination event that occurred ~126,000 y ago. This millennial-scale oscillation correlates with sea-level variations influenced by the expansion and contraction of ice sheets, offering a crucial signal for understanding the paleoclimatic interpretation throughout the glacial periods. To fully decipher the fine-scale paleoclimate signals and assist in forecasting future climatic conditions, a more extensive examination of ferromanganese crusts from diverse depths, sources, and locations is necessitated.
Although medical advancements have improved the mortality of CHD, morbidity still exists, impacting patient quality of life. Returning to baseline in the early surgical recovery phase is an area of potential improvement. This preliminary project aims to qualitatively understand CHD family perspectives concerning the immediate postoperative recovery phase. The participating patients enrolled in the Enhanced Recovery After Surgery program, a postsurgical symptom management tool utilised in adult centres and broadening into pediatrics. Twenty-three of 27 contacted families answered open-ended questions 1 to 3 months postoperatively regarding difficulties experienced during their first week home. They reviewed a list of symptoms including: difficulties with pain, nausea, activity, sleep, appetite, bowel or urinary systems, and taking medications. A qualitative thematic analysis was performed with the open responses, as well as a quantitative assessment of the types of issues that made recovery challenging. Participants struggled most with sleep (78%), returning to activity (70%), and pain (57%). Open-ended responses suggested that an inability to do daily activities, sleep (frequently impacted by pain), and inadequate resources most negatively impacted recovery. Given these findings, investigating postoperative sleep regimens and effective pain plan components may prove useful, in addition to the further development of early mobility programs. The positive and negative experiences highlighting the desire for readily available medical guidance enforce the need for open communication between families and team members, potentially aided by digital tools. Ultimately, further data could support the development of a standardised protocol to better the immediate postoperative quality of life for CHD families.
Monitoring cerebral and renal near-infrared spectroscopy for regional venous oxygenation is a common practice in the postoperative care of neonates recovering from surgery for CHD. In this study, we aimed to test the feasibility of using this technology for monitoring changes in splanchnic perfusion during feeds in infants recovering from cardiac surgery.
Methods:
We monitored renal and splanchnic near-infrared spectroscopy in 29 neonates once recovered from the critical postoperative state and tolerating full enteral nutrition. Infants were tested over 3 feeds for splanchnic regional oxygenation (rO2), arterial to splanchnic saturation difference and splanchnic to renal regional oxygenation ratio.
Result:
Splanchnic regional oxygenation data were obtained with no failure or interruptions. Interclass correlation for agreement between measurements suggested good repeatability: 0.84 at baseline and 0.82 at end of feed. Infants with physiologic repair (n = 19) showed a trend towards increased splanchnic regional oxygenation at the end of feeds and were more likely to achieve regional oxygenation > 50% compared to infants with shunt-dependent circulation (n = 10, p = 0.02). Calculating AVO2 and regional oxygenation index did not result in improved test sensitivity.
Conclusion:
Monitoring splanchnic regional oxygenation during feeds for infants recovering from congenital heart surgery is feasible and reliable. These results suggest that near-infrared spectroscopy could be further studied as a tool for bedside monitoring to assist in feeding management and prevention of necrotising enterocolitis in this sensitive patient population.
This article presents a dual-band planar microwave sensor to characterize the permittivity of liquid samples. The sensor utilizes a splitter–combiner microstrip segment loaded with two pairs of triangular-shaped complementary split-ring resonators (CSRRs). By integrating a meander slot into the CSRRs and incorporating inter-resonator coupling between the CSRRs, the proposed sensor achieves enhanced frequency shifts, resulting in improved sensitivity. An adulteration detection experiment is conducted to validate the sensor’s performance by mixing mineral oil into castor oil with a polydimethylsiloxane container placed on the sensing area. The variations in resonant frequency and peak attenuation are employed to extract the permittivity of the loaded liquid sample. The peak sensitivities in determining the real permittivity are measured to be 6.34% and 5.7% for the first and second frequency bands, respectively. The measured errors for extracting the real and imaginary parts of the complex permittivity are approximately 3.95% and 7.47% for the first frequency band and 3.67% and 6.28% for the second frequency band, respectively. The proposed dual-band microwave sensor, with its high sensitivity, compact size, small sample volume, and low cost, demonstrates great potential for applications in the quality monitoring of agricultural and industrial products.
Quasi-Keplerian flow, a special regime of Taylor–Couette co-rotating flow, is of great astrophysical interest for studying angular momentum transport in accretion disks. The well-known magnetorotational instability (MRI) successfully explains the flow instability and generation of turbulence in certain accretion disks, but fails to account for these phenomena in protoplanetary disks where magnetic effects are negligible. Given the intrinsic decrease of the temperature in these disks, we examine the effect of radial thermal stratification on three-dimensional global disturbances in linearised quasi-Keplerian flows under radial gravitational acceleration mimicking stellar gravity. Our results show a thermo-hydrodynamic linear instability for both axisymmetric and non-axisymmetric modes across a broad parameter space of the thermally stratified quasi-Keplerian flow. Generally, a decreasing Richardson or Prandtl number stabilises the flow, while a reduced radius ratio destabilises it. This work also provides a quantitative characterisation of the instability. At low Prandtl numbers $Pr$, we observe a scaling relation of the linear critical Taylor number $Ta_c\propto Pr^{-6/5}$. Extrapolating the observed scaling to high $Ta$ and low $Pr$ may suggest the relevance of the instability to accretion disks. Moreover, even slight thermal stratification, characterised by a low Richardson number, can trigger the flow instability with a small axial wavelength. These findings are qualitatively consistent with the results from a traditional local stability analysis based on short wave approximations. Our study refines the thermally induced linearly unstable transition route in protoplanetary disks to explain angular momentum transport in dead zones where MRI is ineffective.
In addition to representing a main source of data in linguistic research, example sentences are a core vehicle for linguists in teaching a wide range of phenomena to our students. However, the content of these sentences often reflects the biases of the researchers who construct them: referents are typically given Anglocentric proper names like John and Mary, reflecting (at least implicitly) dominant white culture and conformity to heteronormative gender roles. To support linguists in shifting these practices, we present the Diverse Names Database, a database of 78 names from a variety of languages and cultures, confirmed with native speakers. We outline the goals for the project, introduce our process of developing and adjusting the design, and present some additional issues and reflections for consideration, such as how to use the database as one component of an affirming, anti-racist, and gender-equitable linguistics pedagogy. We aim to generate meta-level discussions about disciplinary conventions and canons, and to challenge the idea that underlying linguistic structures are, or should be, the only things of relevance when constructing example sentences. How we teach linguistics is part of how we practise it, and how we do both matters to the composition and direction of the field.
Analytic Theology and the Academic Study of Religion aims to explain analytic theology to other theologians, and to scholars of religion, and to explain those other fields to analytic theologians. The book defends analytic theology from some common criticisms, but also argues that analytic theologians have much to learn from other forms of inquiry. Analytic theology is a legitimate form of theology, and a legitimate form of academic inquiry, and it can be a valuable conversation partner within the wider religious studies academy. I aim to articulate an attractive vision of analytic theology, foster a more fruitful inter-disciplinary conversation, and enable scholars across the religious studies academy to understand one another better. Analytic theology can flourish in the secular academy, and flourish as authentically Christian theology.
Early childhood growth is associated with cognitive function. However, the independent associations of fat mass (FM) and fat-free mass (FFM) with cognitive function are not well understood. We investigated associations of FM and FFM at birth and 0–5 years accretion with cognitive function at 10 years. Healthy-term newborns were enrolled in this cohort. FM and FFM were measured at birth, 1·5, 2·5, 3·5, 4·5 and 6 months and 4 and 5 years. Cognitive function was assessed using the Peabody Picture Vocabulary Test (PPVT) at 10 years. FM and FFM accretions were computed using statistically independent conditional accretion from 0 to 3 months, 3 to 6 months, 6 months to 4 years and 4 to 5 years. Multiple linear regression was used to assess associations. At the 10-year follow-up, we assessed 318 children with a mean (sd) age of 9·8 (1·0) years. A 1 sd higher birth FFM was associated with a 0·14 sd (95 % CI 0·01, 0·28) higher PPVT at 10 years. FFM accretion from 0 to 3 and 3 to 6 months was associated with PPVT at 10 years: β = 0·5 sd (95 % CI 0·08, 0·93) and β = −0·48 sd (95 % CI −0·90, −0·07, respectively. FFM accretion after 6 months showed no association with PPVT. Neither FM at birth nor 0–5 years accretion showed an association with PPVT. Overall, birth FFM, but not FM, was associated with cognitive function at 10 years, while the association of FFM accretion and cognitive function varied across distinct developmental stages in infancy. The mechanisms underlying this varying association between body composition and cognitive function need further investigation.
A routine chemical procedure was developed at the Ede Hertelendi Laboratory of Environmental Studies (HEKAL), in Debrecen which can measure the dissolved organic radiocarbon content of groundwater as well as the inorganic and total fraction. The typical background of this non-purgeable dissolved organic radiocarbon preparation is 0.73 ± 0.14 percent modern carbon (pMC), using a carbon contamination correction on fossil dissolved material (potassium hydrogen phthalate) samples.
where $n\geq3$, $0 \lt p\leq1$. By establishing an equivalent integral equation, we give a lower bound of the Kelvin transformation $\bar{u}$. Then, by constructing a new comparison function, we apply the maximum principle based on comparisons and the method of moving planes to obtain that u only depends on xn. Based on this, we prove the non-existence of non-negative solutions.
I survey my career in philosophy, which encompasses 44 years of teaching in Halifax, but begins in London, England with a thesis on self-deception. I describe a practice of using works of literature as a guide to conceptual analysis, and pause in Vienna to translate On Last Things (Weininger, 2001). A line of Wittgenstein's is the basis for reflections on the concept of a Last Judgement. I discuss in some detail a paper of mine for the Atlantic Region Philosophers’ Association in 2018, “One Last Thing,” which takes as its basis The Sense of an Ending, a novel by Julian Barnes. I conclude with some claims about Wittgenstein's relation to religion. I add an Appendix, in which I comment briefly on each of the other articles that make up this symposium.
Individuals may experience health issues attributable to environmental pollution, sedentary lifestyles, and unhealthy dietary habits. In response, numerous non-pharmaceutical treatments and techniques have emerged, with therapy mud being one such approach. The primary aim of this research was to analyze the chemical and mineralogical compositions of peloids obtained from six salt lakes: Taigan (LI), Duruu (LII), Khadaasan (LIII), Ikhes (LIV), Tonkhil (LV), and Khulmaa (LVI) in the Gobi-Altai province of Mongolia. Sample analyses involved X-ray diffraction for mineralogical assessment and inductively coupled plasma-mass spectrometry (Agilent Technologies 7800 series in Canada) for determining the chemical composition of the solid phase. Among essential macro- and microelements, Mg, Cа, Na, K, Sr, Ga, Mo, and Se had been leached from peloid to artificial sweat. Sn (0.01 μg g–1) at LIV and LVI lakes and Cu (0.01 μg g–1) at LV lake transferred from peloids to sweat, but no mobility of these elements in other peloids was detected. Li (0.02–0.04 μg g–1) was adsorbed from the sweat to potential peloids in LV, LIV, LIII, and LI lakes, while As (0.04–0.09 μg g–1) leached from peloids to sweat in all lakes except for LII. Zn (0.01 μg g–1) and Cr (0.04 μg g–1) transferred from the sweat to peloids in all lakes. Macroelements (Na, K, Ca, and Mg) and microelements (Mo, Se), which are essential for the human body, leached from the peloid to sweat. However, the mobility of toxic elements was minimal. Among micro-elements, the transition of Sr occurred the most, which can be explained by the Sr content in the peloid.
School food has a major influence on children’s diet quality and has the potential to reduce diet inequalities and non-communicable disease risk. Funded by the UK Prevention Research Partnership, we have established a UK school food system network. The overarching aim was to build a community to work towards a more health-promoting food and nutrition system in UK schools. The network has brought together a team from a range of disciplines, while the inclusion of non-academic users and other stakeholders, such as pupils and parents, has allowed the co-development of research priorities and questions. This network has used a combination of workshops, working groups and pump-priming projects to explore the school food system, as well as creating a systems map of the UK school food system and conducting network analysis of the newly established network. Through understanding the current food system and building network expertise, we hope to advance research and policy around food in schools. Further funding has been achieved based on these findings, working in partnership with policymakers and schools, while a Nutrition Society Special Interest Group has been established to ensure maximum engagement and future sustainability of the network. This review will describe the key findings and progress to date based on the work of the network, as well as a summary of the current literature, identification of knowledge gaps and areas of debate, according to key elements of the school food system.
This article is inspired by two of Steven Burns's many philosophical interests — self-deception and Wittgenstein — as well as by a wariness that we share of the analytic-continental divide in contemporary philosophy. I argue here that, despite obvious differences of temperament and concern, Sartre and Wittgenstein share a scepticism about the “epistemic model” of first-person authority. This shared scepticism emerges in a striking way in their challenges to the idea that psychological phenomena should be understood on the model of objects in physical space. Wittgenstein's scepticism is more thorough-going, but emphasizing the similarity allows us to see Sartre as making an important contribution to our understanding of first-person authority, even if we are wary of the voluntarism of his approach.
This article is an appreciative exegesis of Steven Burns's article “If a Lion Could Talk.” In his essay, Burns clarifies Ludwig Wittgenstein's enigmatic remark “If a lion could talk, we wouldn't be able to understand him” by locating it within the broader context of Wittgenstein's work in the philosophy of psychology. We read Burns's interpretation of the remark as opening core Wittgensteinian issues of meaning and (mis)understanding, and we situate it within the context of the work of Burns's teacher, Peter Winch. Our discussion is a close exegesis of the immediate content of the lion remark and it highlights connections to Wittgenstein's remarks on James George Frazer's The Golden Bough. We show how Burns and Winch employ Wittgenstein's methods of dissolving philosophical puzzles by drawing attention to intermediate familiar cases. We conclude with some impressionistic remarks about Socrates in a short discussion of the difficulty of the philosophical technique and activity Burns demonstrates and recommends.