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Ductal stenting in late presenters with transposition of great arteries with intact ventricular septum retrains the left ventricle before arterial switch operation. However, the experience is limited for its efficacy and safety. This study aims to highlight the efficacy and safety of ductal stenting for retraining the left ventricle.
Methods:
Eight children with transposition of great arteries-intact ventricular septum and regressed left ventricle underwent ductal stenting. Serial echocardiographic measurements of left ventricle shape, mass, volume, free wall thickness, and function were done, and arterial switch operation was performed once the left ventricle was adequately prepared. Post-operative outcome in terms of duration of mechanical ventilation, ICU stay, and improvement in left ventricle function were monitored.
Results:
The procedure was successful in all patients. Babies were divided into two groups on basis of age at ductal stenting (group 1 age less than 90 days and group 2 age more than 90 days) and were evaluated for the degree of left ventricle retraining as evidenced by echocardiographic parameters and post-operative variables. The left ventricle posterior wall thickness and mass index after ductal stenting increased significantly in both the groups. Postoperatively, one baby of group two expired after seven days due to severe left ventricle dysfunction. Rest babies had an uneventful post-operative ICU stay with no statistical difference in the duration of invasive mechanical ventilation or ICU stay. On six-month follow-up, all surviving babies were doing well with normal left ventricle function.
Conclusion:
Ductal stenting is a good alternative measure as compared to surgical procedures for left ventricle retraining in transposition of great arteries with regressed left ventricle.
Using a national audit of mayors in the United States, this paper examines responsiveness to Latine lesbian and gay constituents who request that their city issue an LGBTQ pride proclamation. Drawing on theories of intersectionality, descriptive representation, and political institutions, we articulate the conditions under which mayors are responsive to public-facing constituency service requests to issue LGBTQ pride proclamations. We find that mayors are more responsive to requests from lesbian couples than gay couples. In addition, baseline responsiveness to our inquiry was influenced by mayors’ identity characteristics. LGBTQ mayors were more likely to respond than non-LGBTQ mayors, but Latine mayors were less likely to respond than non-Latine mayors. In addition, mayors who represent cities where nondiscrimination ordinances protect LGBT people from discrimination were more responsive than mayors who represent cities where LGBT people are not protected from discrimination. These findings demonstrate how intersectional frameworks can advance audit experiments and that shared descriptive characteristics do not inevitably translate into responsiveness, a common assumption in single-axis studies of representation.
U.S. states are sovereign entities and can’t declare bankruptcy as cities and municipalities. This paper examines the impact of a switch in sovereign bankruptcy rules that allows declaring bankruptcy from an economics model perspective. Allowing bankruptcy increases ex-ante risks for the government to refuse repayment, but provides ex-post benefits of reducing default costs and saving federal bailouts. This paper provides a simple framework to analyze this tradeoff. Event analysis shows that an unexpected switch in bankruptcy rules that allows for bankruptcy would decrease government debt-to-GDP ratio by 9.2 percentage points, increase consumption by 0.69 percent, but increase spread by 1.1 percentage points.
To delineate score differences between the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and the WAIS-IV México in the assessment of balanced bilingual Mexican Americans and to determine the efficacy of five hold measures in predicting summary scores in each version.
Methods:
Hold measures were WAIS-IV Information, Vocabulary, and Matrix Reasoning subtests, picture vocabulary, and the Test of Premorbid Function (English)/Word Accentuation Test (Spanish). Using a repeated measures design, 60 neurologically intact participants were tested in a counterbalanced order, with WAIS-IV version as the repeated measure (mean intertest interval = 5.68 days). To minimize practice effects, the five visual-perceptual subtests, which contain the same items in each version, were administered only once during the initial session.
Results:
All mean WAIS-IV México index/subtest scores were significantly higher than the U.S. equivalents (Full-Scale IQ by about .5 SD). Unexpectedly, most (83%) participants educated in the US to at least a high school level had numerically equal or higher scores on the U.S. version. Means on WAIS-IV language format indices/subtests were lower than those of visual-perceptual format indices/subtests within both versions (excepting Processing Speed Index/subtests in the U.S. version). All hold measures significantly predicted WAIS-IV summary scores for the U.S. version. Similarly for the México version, except for the Word Accentuation Test.
Conclusions:
When evaluating a balanced bilingual Mexican American, opting for the WAIS-IV México version will yield higher scores across the Full-Scale IQ, indices, and all core subtests unless the patient was educated in the US to at least a high school level.
This article explores creative processes in the many settings of the prosula BENEDICAMUS in laude ihesu, transmitted in a large number of European manuscripts during a period of at least three hundred years. The fourteen different polyphonic elaborations reveal a desire for multi-voiced performance shared across the whole period and geographical area under discussion. Moreover, while many of the compositional techniques are similarly widespread, the individual settings remain insistently discrete, suggesting that it was more common for a community to produce its own version of the chant than to absorb another community’s practices. This study includes a list of all known sources with polyphonic inscriptions of the prosula, highlighting the hitherto unrecognized prominence of BENEDICAMUS in laude ihesu in musical and liturgical traditions of the fourteenth to seventeenth centuries.
We analyze a dataset from a numerically simulated, temporally evolving turbulent wake (Zhou, Phys. Rev. Fluids, vol. 7, 2022, 104802) that exhibits spontaneous anisotropic layering under strong stratification, alongside significant spatiotemporal variability within the flow. This analysis focuses on the irreversible flux coefficient, $\varGamma$, defined as the ratio between turbulent potential and kinetic energy dissipation rates. We find that the volume-averaged $\varGamma$ initially rises, reaches a plateau between 0.45 and 0.49 when the layering dynamics become dominant, and then decreases as viscosity plays a larger role. These peak $\varGamma$ values are consistent with those from prior simulations under strongly stratified conditions. Such efficient mixing occurs when the Ozmidov to Thorpe length scale ratio is between 0.37 and 0.52, consistent with numerical and field data reported by Mashayek et al. (J. Fluid Mech., vol. 826, 2017, pp. 522–552). To account for the coexistence of dynamically distinct regions within the flow, we perform conditional sampling of $\varGamma$ against a locally defined gradient Richardson number, ${\textit {Ri}}$. This reveals a flux-gradient relation between $\varGamma$ and ${\textit {Ri}}$ that remains largely consistent over time. This relation features a large, approximately constant value of $\varGamma$ for ${\textit {Ri}}$ values greater than one, echoing the ‘constant-power’ scenario postulated by Balmforth et al. (J. Fluid Mech., vol. 355, 1998, pp. 329–358).
We investigated the influence of availability as well as type of organic substrate on the growth of the cyanolichen Peltigera membranacea. A total of 145 lichen lobes were grown in a plant growth chamber for 28 days. Of these, 73 were kept in permanent darkness and another 72 were exposed to a diurnal light-dark cycle. A third of the lobes from both treatments were grown on pulverized leaf litter, the second third on pulverized bryophytes, and the remainder were grown without an organic substrate to serve as a control group. Growth was quantified via relative growth rate, relative thallus area growth rate, and changes in specific thallus mass. The lobes kept in a diurnal light-dark cycle showed higher growth rates than those kept in darkness, as is expected for an organism that obtains its carbon from its photoautotrophic symbiosis partner. Furthermore, growth rates were higher in lobes growing on organic substrates. The results show that the availability of an organic substrate positively affects lichen growth in a growth cabinet. Leaf litter led to a higher biomass gain in lichen lobes, whereas area gain was unrelated to substrate type.
This article advances research at the intersection of macro talent management (TM) and the career capital of expatriates. It does so by reporting the findings of a qualitative study of self-initiated expatriates’ strategies of engaging the practices of a city-level TM institution to facilitate career capital formation. Strategies of engaging city-level practices of TM have diverse, at times paradoxical implications. Self-initiated expatriates employ strategies of engaging institutional practices to (1) support global career mobility without considerable adjustment, (2) develop local networks and careers in the host country, and (3) even actively escaping an expanding sphere of international institutions. The article explains how dynamics of career capital formation occur as (un)anticipated consequences of being exposed to institutional logics of adopted TM practices. Corporate and market-oriented logics of TM realized in an international city institution ambiguously combined with community logics, for some self-initiated expatriates resembling those of traditional expatriate institutions.
Understanding the effect of intricate surface wettability conditions on microswimmers is crucial for precisely navigating them across narrow microcirculatory networks. Here, we adopt the spherical squirmer model and Navier slip condition to delineate the microswimmer locomotion under a Poiseuille flow in a slit microchannel. Through a combined analytical–numerical approach utilizing bispherical coordinates and the superposition technique, we resolve the slip-modulated simultaneous hydrodynamic interaction with substrate boundaries. Phase portraits reveal that slip significantly alters propulsion mechanisms, destabilizing centreline stable oscillations of pullers beyond a threshold slip length. Superhydrophobic surfaces suppress near-wall rheotaxis states but preserve centreline focusing, facilitating slip-assisted directed transport without surface accumulation. Under strong background flows, subcritical Hopf bifurcation emerges for pullers at a critical slip length, transitioning dynamics from coexisting stable and unstable states to purely unstable behaviour. Contrastingly, for pushers, slip causes a transition from unstable to either stable or fixed-amplitude oscillations. Increased slip length reduces hydrodynamic repulsion on pullers from the walls by enhancing rotational velocity near the walls, whereas it counteracts the torque that causes unstable oscillations of pushers. Three-dimensional analysis of the trajectories reveals the significant role of the out-of-plane orientation of the microswimmer in its transitions between different swimming states. The presented regime maps offer parametric combinations for specific motion behaviours, guiding the development of smart microfluidic drug delivery systems and preventing biofilm deposition in biomedical devices.
Outcomes for children with heart disease improved over the past decades. Quality improvement (QI) research in paediatric cardiac critical care is a key driver of improvement. The availability and variability of QI research across the field is unknown. This project represents a step in understanding the role. The Pediatric Cardiac Intensive Care Society (PCICS) can serve to support institutions’ needs, drive collaborations, and utilise available infrastructure at member institutions for improvement work.
Methods:
The PCICS Quality Improvement and Safety Committee developed a survey to assess the state of QI research. The survey was disseminated over several months and available via QR code at the World Congress of Pediatric Cardiology and Cardiac Surgery in 2023.
Results:
Fifty-eight respondents completed the survey representing at least 38 unique institutions. Most respondents participated in QI research (52/58, 90%). Most QI projects were single centre (41% of respondents), and of those, the majority were from a minority of institutions (13 institutions [34% of total institutions]). QI support is available at slightly more than half of units, and 55% (32/58) have access to a QI specialist. QI support and rate of publications is significantly lower for small/medium units as compared to large units. Respondents suggested most interest from PCICS in networking with other members with similar project ideas (50/58, 86%).
Conclusion:
PCICS member institutions are committed to QI research, with limitations in support, local specialists, and networking. Increasing connectivity and accessibility to QI resources may reduce burden to individual members and institutions to achieve QI research.
Women are globally underrepresented as political leaders; as of January 2023, only 17 countries had a woman head of government. Included in this small group is Samoa, which elected Fiame Naomi Mata’afa as its first woman prime minister in 2021 after a fiercely contested election and subsequent protracted legal disputes centered around interpretations of Samoa’s 10% gender quota. Drawing on data from the Pacific Attitudes Survey, the first large-scale, nationally representative popular political attitudes survey conducted in the Pacific region, this article examines how the political environment in Samoa shapes opportunities for women’s political participation and leadership. Using the theoretical framework of cohabitation, it finds that although there is an enabling environment for women’s participation and leadership in formal politics, women’s access to decision-making spaces more broadly is still constrained by norms of traditional leadership. This speaks to traditional and nontraditional political norms and practices that coexist, at times uneasily, alongside one another.
The present study investigated the relationships between maternal characteristics and subjective well-being (life satisfaction and optimism) among overweight Brazilian adult pregnant women. A cross-sectional study utilising baseline data from a randomised controlled clinical trial was conducted. A total of 330 women were investigated. Maternal characteristics (sociodemographic, obstetric and lifestyle) were obtained through a structured questionnaire. Data on dietary intake were collected through two 24-h dietary recalls, and the usual diet was estimated using the Multiple Source Method. Life satisfaction and optimism were assessed using validated instruments. Both unadjusted and adjusted linear regression models were employed to investigate the relationship between maternal characteristics and subjective well-being. Sleep quality was found to be positively associated with life satisfaction. Miscarriage and smoking during pregnancy were negatively associated with this sentiment. Additionally, a positive association was observed between optimism and maternal characteristics such as sleep quality, desired pregnancy and alcohol consumption in the previous 30 d. Furthermore, it was found that the consumption of sugary drinks, dietary fibre and Ca were positively associated with this same feeling. The present study showed that some maternal and food consumption characteristics were associated with subjective well-being among overweight pregnant women. It is, therefore, essential to recognise predictors of maternal mental health given their relevance to the field of public health.
As a result of the partial privatization and public listing of two large state-owned enterprises in 2001, the Norwegian state became the largest owner at the Oslo stock exchange. A new mode of corporate governance was developed, through which retainment of the corporate headquarters (HQ) of hybrid state-owned enterprises became the sole political goal of continued state ownership in these corporations. This article explores the perceived benefits to the national economy of these company HQ through an investigation of public documents and interviews with key stakeholders. The article argues that the main function of the goal of HQ retainment was to portray national interests and political goals as mere (positive) externalities of HQ location, and that this goal was formalized due to a perceived need to depoliticize the corporate governance of hybrid state-owned enterprises.
This article presents the results of a corpus study of clausal postpositioning, that is, the occurrence of a sentential constituent in the postfield of the matrix clause to which it is syntactically linked, in German regional language. Analysis of 11,027 clauses from 60 spoken regiolect and dialect texts reveals that clausal postpositionings occur most frequently as non-relative finite clauses, followed by relative clauses, and lastly, infinitival constructions. Notably, while non-relative finite clauses comprise a smaller proportion of postpositionings in regiolect compared to dialect, relative clauses and infinitival constructions show the opposite trend. Adjunct clauses occur most frequently, followed by complement clauses, in both regiolect and dialect. Furthermore, in both varieties, postpositioning is more prevalent in verb-first and verb-second clauses than in verb-final clauses. This finding is attributed to restrictions on syntactic subordination. Finally, non-relative finite clause and relative clause types that may be embedded in both the postfield and inner field are center-embedded at mean relative frequencies of 13.42% and 28.17%, respectively. These findings shed light on contradictory claims in the literature regarding the possibility and frequency of clausal embedding in the inner field.
The spatial distribution of maize plants influences the number of kernels set per plant by modifying the radiation environment during the critical period for kernel number determination. A two-year field experiment was conducted in Sardinia to explore whether, in a Mediterranean environment, a reduction in row distance can have a positive effect on grain yield of full-season maize hybrids and, if it does, whether this effect is also affected by plant density. Treatments were a factorial combination of three plant densities (6, 8 and 10 plants/m2) and two row spacings (35 and 70 cm). Grain yield and grain number benefited from a reduction in row distance from the canonical 70 cm to 35 cm irrespective of plant density and yield level (14.7 t/ha on average in 2021, 9.9 t/ha in 2022 vs 13.7 and 8.8 t/ha with canonical row distance). Row distance did not affect either the coefficient of extinction of radiation or the intercepted photosynthetically active radiation (PAR) during the critical period for grain number determination. The higher grain number per unit area at the smaller row distance translated into a greater grain yield, which cannot solely be attributed to radiation interception and plant growth rate during the period of kernel number determination. Halving the common row distance is a valuable management option for full-season hybrids grown in Mediterranean environments without nitrogen and water limitations as it seems capable of increasing grain yield via an increase in kernel number per unit area, regardless of plant density and yield level.
The turbulent wake behind a flat-back Ahmed body is investigated using stacked stereoscopic particle image velocimetry. The wake is disturbed by a steady jet from the centre of the base and the effects are quantified for key blowing rates. The unactuated wake exhibits bistable dynamics in the horizontal plane that are completely subdued for the optimal blowing case, yielding a base drag reduction of 9 %. The three-dimensional mean wake is reconstructed and used to evaluate the wake mass fluxes whose equilibrium determines the recirculation length. The results for the unactuated wake show that up to 80 % of replenishment fluid flux entering the recirculation bubble from the free-stream flow is provided through the low-pressure side of the base, where the symmetry-breaking shear layer roll-up occurs near the base. For the optimal blowing configuration, where the wake becomes symmetric, the flux of wake replenishment is severely reduced. This flow configuration results in elongated shear layers on all sides, which terminate the bubble with a roll-up of reduced intensity at a further downstream location. The dominant cause of bubble growth and the accompanying drag reduction is attributed to the momentum of the base blowing, and the new regime is referred to as the ‘favourable momentum regime’. Similar trends are observed when the model is at $5^{\circ }$ yaw where a reduction of drag and yaw-induced asymmetry are obtained. Proper orthogonal decomposition of the wake reveals the coherent structures related to the bistable flow and the symmetric wake under optimal blowing coefficient.
To study two-dimensional dispersive waves propagating through turbulent flows, a new and less restrictive fast waves approximation is proposed using a multiscale setting. In this ansatz, large and small scales of the turbulence are treated differently. Correlation lengths of the random small-scale turbulence components can be considered negligible in the wave packet propagating frame. Nevertheless, the large-scale flow can be relatively strong, to significantly impact wavenumbers along the propagating rays. New theoretical results, numerical tools and proxies are derived to describe ray and wave action distributions. All model parameters can be calibrated robustly from the large-scale flow component only. We illustrate our purpose with ocean surface gravity waves propagating in different types of surface currents. The multiscale solution is demonstrated to efficiently document wave trapping effects by intense jets.
The 2022 Agreement on Fisheries Subsidies (AFS) is the culmination of over 20 years of negotiations within the WTO's Doha Development Round. Although it can be considered a small victory in the fight against declining fish stocks, the Agreement remains unfinished and underdeveloped. Of particular concern is the enforceability of the Agreement. While WTO Members recognize that the AFS was created to deal with a problem that has both socioeconomic and environmental implications, the Agreement relies on established WTO dispute settlement rules, which were created to resolve trade disputes. The paper assesses the difficulties of enforcing the AFS under these rules and considers additional provisions that could be included in subsequent negotiating rounds to ensure an effective and enforceable agreement. Recommendations cover different stages of the dispute settlement process and include alternative means of dispute resolution, measures to expedite proceedings, and retaliation procedures adapted to the AFS.
The scope of environmental impact assessments (EIAs) has traditionally been limited to on-site effects. This approach faces limitations when dealing with intricate value chains. Particularly for projects involving biomass-to-energy facilities, the primary environmental impacts often originate from off-site biomass production. This article considers the resulting limitations of EIAs by using two legal disputes in France as illustrative examples. In the Gardanne and the La Mède cases, French Administrative Courts sought to establish the necessity for project proponents to incorporate supply-related impacts into the EIA process. Strategies aimed at broadening the scope of EIAs, either by expanding the assessed project boundaries or by invoking the concept of cumulative impacts, were not deemed the most relevant approaches. Instead, the concept of ‘indirect impact’ emerged as a valuable tool for incorporating supply-related impacts. However, to prevent the indirect impact concept from being disregarded as too ambiguous or ineffective, it should be complemented by precise criteria to determine whether an impact may be considered indirect. We study these avenues within the broader evolving landscape of EIA laws, and by exploring ways to harmonize EIAs with other regulatory instruments governing value chains.
To date, implantation is the rate-limiting step for the success of in vitro fertilization (IVF) treatment. Accumulating evidence suggests that immune cells contribute to embryo implantation, and several therapeutic approaches have been proposed for the treatment of recurrent implantation failure (RIF). Endometrial immune modulation with autologous activated peripheral blood mononuclear cells (PBMCs) is one of the most widely used protocols. However, the effect of intrauterine insemination of mixed paternal and maternal-activated PBMCs has not yet been attempted and studied. The aim of our study is to test the effect of the addition of paternal lymphocytes on the implantation rate in RIF patients. Mononuclear cells were isolated from the peripheral blood of 98 RIF patients and cultured for 72 h before insemination into the endometrial cavity 48 h before embryo transfer. Our patients were divided into 4 groups according to the type and number of PBMCs inseminations. Our study shows that activated PBMCs promoted clinical pregnancy rates (CPR) in all groups. Moreover, we found that the groups injected with more than 2 million cells showed a better clinical outcome and, more interestingly, patients inseminated with both paternal and maternal activated PBMCs showed the highest CPR, reaching 47.2%, in addition to the highest implantation rate 31. 2% and the live birth rate 41.39%. Our work demonstrates the importance of administering a large number of activated PBMCs with the addition of paternal activated PBMCs to immunomodulate the endometrium for the success of in vitro fertilization in RIF patients.