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Bicuspid aortic valve is the most common CHD and commonly associated with activity restrictions that may lead to a sedentary lifestyle known to increase obesity risk. It is unknown whether obesity is associated with changes in aortic dimensions or aortic valve function in young people with bicuspid aortic valve. This study investigates whether overweight and obese children with bicuspid aortic valve have worse aortic valve function or increased aortic dimensions compared to healthy weight children with bicuspid aortic valve.
Methods:
This was a single centre retrospective cohort study comprised of patients 5 to 25 years old with a diagnosis of bicuspid aortic valve between 1 January, 2019 and 31 December, 2020. Patients were classified as healthy weight or overweight/obese. Values for aortic dimensions as well as peak and mean aortic valve gradients were obtained from echocardiogram reports.
Results:
About 251 patients were analysed. Demographics were similar between groups. When indexed to height, the aortic valve annulus (1.28 ± 0.14 vs. 1.34 ± 0.15, p = 0.001) and sinotubular junctions (1.44 ± 0.21 vs. 1.49 ± 0.24, p = 0.038) were larger in the overweight/obese group, with no differences in aortic root or ascending aorta sizes. The obese/overweight group had a higher peak aortic valve gradient (23.03 ± 1.64 mmHg vs. 16.17 ± 1.55 mmHg, p = 0.003) compared to the healthy weight group.
Conclusion:
Healthy weight patients did not have larger aortic dimensions compared to the overweight/obese patients. There was evidence of worsening aortic valve stenosis in overweight/obese patients compared to those at a healthy weight.
Biofortification – the process of increasing the concentrations of essential nutrients in staple crops – is a means of addressing the burden of micronutrient deficiencies at a population level via existing food systems, such as smallholder farms. To realise its potential for global impact, we need to understand the factors that are associated with decisions to adopt biofortified crops and food products. We searched the literature to identify adoption determinants, i.e. barriers to (factors negatively associated) or facilitators of (factors positively associated) adoption, of biofortified crops and food products. We found 41 studies reporting facilitator(s) and/or barrier(s) of adoption. We categorised the factors using the Consolidated Framework of Implementation Research 2.0, resulting in a set of factors that enable or constrain adoption of biofortified foods across twenty-four constructs and five domains of this meta-theoretical determinant framework from implementation science. Facilitators of orange sweet potato adoption included knowledge about importance, relative advantage, efficient production and management practices; barriers included lacking timely access to quality vines and market remoteness (28 studies total). Facilitators of vitamin A cassava adoption included awareness of its benefits and access to information; barriers included poor road networks and scarcity of improved technology including inadequate processing/storage facilities (8). Facilitators of high-iron bean adoption included farmers’ networking and high farming experience; barriers included low knowledge of bean biofortification (8). Barriers to vitamin A maize adoption included low awareness and concerns regarding yield, texture and aflatoxin contamination (1). These barriers and facilitators may be a starting point for researchers to move towards testing implementation strategies and/or for policymakers to consider before planning scale-up and continuous optimisation of ongoing projects promoting adoption of biofortified crops and food products.
This article analyses a selection of archival material written by Paul Tillich, particularly his early parish sermons and sermons from World War I. Although the themes of ‘eternity’ and ‘the soul’ are rare in the early parish sermons and only appear in the context of death or suffering, they play a predominant role in the World War I sermons. This article suggests that this is because, for Tillich, suffering became the interpretative key. Through his sermons amidst the suffering and devastation of war Tillich employed what he called the immanent way of theology.
Feature-based models of sign language use distinctive features to describe the phonological structure of signs. We use near-minimal pairs and phonological phenomena like productivity and neutralisation in French Sign Language to show that the feature [web], which refers to the webbing part of the fingers, should be (re)introduced into the list of phonologically active features. In discussing potential cases of [web] in other sign languages and the impact on the shape of phonological inventories, we first offer an account of [web] in terms of a location feature in line with most traditional feature-geometry models. We then offer some speculations on why a more uniform characterisation of [web] and the features in the same subclass in terms of the orientation type results in more economical models.
Lunatic Asylums, published 130 years ago, is a fascinating insight into how these institutions were managed in the late Victorian era. This brief article considers what it reveals about the zeitgeist of the time and the book's author, the remarkable Charles Mercier.
Liu [‘On a congruence involving q-Catalan numbers’, C. R. Math. Acad. Sci. Paris358 (2020), 211–215] studied congruences of the form $\sum _{k=0}^{n-1} q^k\mathcal {C}_k$ modulo the cyclotomic polynomial $\Phi _n(q)^2$, provided that $n\equiv \pm 1\pmod 3$. Apparently, the case $n\equiv 0\pmod 3$ has been missing from the literature. Our primary purpose is to fill this gap. In addition, we discuss a certain fascinating link to Dirichlet character sum identities.
Vitamin B12, cobalamin, is indispensable for humans owing to its participation in two biochemical reactions: the conversion of l-methylmalonyl coenzyme A to succinyl coenzyme A, and the formation of methionine by methylation of homocysteine. Eukaryotes, encompassing plants, fungi, animals and humans, do not synthesise vitamin B12, in contrast to prokaryotes. Humans must consume it in their diet. The most important sources include meat, milk and dairy products, fish, shellfish and eggs. Due to this, vegetarians are at risk to develop a vitamin B12 deficiency and it is recommended that they consume fortified food. Vitamin B12 behaves differently to most vitamins of the B complex in several aspects, e.g. it is more stable, has a very specific mechanism of absorption and is stored in large amounts in the organism. This review summarises all its biological aspects (including its structure and natural sources as well as its stability in food, pharmacokinetics and physiological function) as well as causes, symptoms, diagnosis (with a summary of analytical methods for its measurement), prevention and treatment of its deficiency, and its pharmacological use and potential toxicity.
The release of ICD-11 has resulted in an expansion of diagnostic entities for trauma- and stress-related disorders. This resulted, at least temporarily, in discrepancies with the DSM-5. This situation is outlined and a look is taken at the potential diagnosis of ‘continuous traumatic stress reaction’.
Accurate measurement of transcutaneous oxygen saturation is important for the assessment of cyanosis in CHD. Aim of this study was the evaluation of a supplementary transcutaneous oxygen saturation measurement with an Apple watch® in children with cyanotic heart disease.
Material and methods:
During a six-minute walk test, measurement of transcutaneous oxygen saturation was performed simultaneously with an Oximeter (Nellcor, Medtronic, USA) and an Apple watch® Series 7 (Apple inc, USA) in 36 children with cyanotic heart disease.
Results:
Median age was 9.2 (IQR 5.7–13.8) years. Transcutaneous oxygen saturation measurement with the Apple watch® was possible in 35/36 and 34/36 subjects before and after six-minute walk test. Children, in whom Apple watch® measurement was not possible, had a transcutaneous oxygen saturation < 85% on oximeter. Before six-minute walk test, median transcutaneous oxygen saturation was 93 (IQR 91–97) % measured by oximeter and 95 (IQR 93–96) % by the Apple watch®. After a median walking distance of 437 (IQR 360–487) m, transcutaneous oxygen saturation dropped to 92 (IQR 88–95, p < 0.001) % by oximeter and to 94 (IQR 90–96, p = 0.013) % measured with the Apple watch®.
Conclusion:
In children with mild cyanosis measurement of transcutaneous oxygen saturation with an Apple watch® showed only valid results if transcutaneous oxygen saturation was > 85%, with higher values being measured with the smart watch. In children with moderate or severe cyanosis transcutaneous oxygen saturation, measurement with the Apple watch® was not reliable and cannot be recommended to monitor oxygen saturation at home.
Large-scale coherent structures in incompressible turbulent pipe flow are studied for a wide range of Reynolds numbers ($Re_\tau =180, 550, 1000, 2000$ and $5200$). Employing the Karhunen–Loève decomposition and a novel approach based on the Voronoi diagram, we identify and classify statistically coherent structures based on their location, dimensions and $Re_{\tau }$. With increasing $Re_{\tau }$, two distinct classes of structures become more energetic, namely wall-attached and detached eddies. The Voronoi methodology is shown to delineate these two classes without the need for specific criteria or thresholds. At the highest $Re_{\tau }$, the attached eddies scale linearly with the wall-normal distance with a slope of approximately $l_y\sim 1.2y/R$, while the detached eddies remain constant at the size of $l_y \approx 0.26R$, with a progressive shift towards the pipe centre. We extract these two classes of structures and describe their spatial characteristics, including radial size, helix angle and azimuthal self-similarity. The spatial distribution could help explain the differences in mean velocity between pipe and channel flows, as well as in modelling large and very-large-scale motions (LSM and VLSM). In addition, a comprehensive description is provided for both wall-attached and detached structures in terms of LSM and VLSM.
The coupling between advection and diffusion in position space can often lead to enhanced mass transport compared with diffusion without flow. An important framework used to characterize the long-time diffusive transport in position space is the generalized Taylor dispersion theory. In contrast, the dynamics and transport in orientation space remains less developed. In this work we develop a rotational Taylor dispersion theory that characterizes the long-time orientational transport of a spheroidal particle in linear flows that is constrained to rotate in the velocity-gradient plane. Similar to Taylor dispersion in position space, the orientational distribution of axisymmetric particles in linear flows at long times satisfies an effective advection–diffusion equation in orientation space. Using this framework, we then calculate the long-time average angular velocity and dispersion coefficient for both simple shear and extensional flows. Analytic expressions for the transport coefficients are derived in several asymptotic limits including nearly spherical particles, weak flow and strong flow. Our analysis shows that at long times the effective rotational dispersion is enhanced in simple shear and suppressed in extensional flow. The asymptotic solutions agree with full numerical solutions of the derived macrotransport equations and results from Brownian dynamics simulations. Our results show that the interplay between flow-induced rotations and Brownian diffusion can fundamentally change the long-time transport dynamics.
This article challenges the view that canon law was insignificant in the development of tenth-century English administrative and judicial institutions through a new study of Oda of Canterbury's Constitutiones, an important but neglected episcopal capitulary. Particular attention is paid to Oda's sources, the text's place in the legislative programme of King Edmund and the influence of wider European approaches to episcopal justice. The article shows that Oda's statutes endorsed an emerging system of collaborative justice between secular and ecclesiastical elites, thus demonstrating that tenth-century English governance was informed by a wider range of normative legal traditions than usually thought.
Stegenga (forthcoming) formulates and defends a novel account of scientific progress, according to which science makes progress just in case there is a change in scientific justification. Here, we present several problems for Stegenga’s account, concerning, respectively, (i) obtaining misleading evidence, (ii) losses or destruction of evidence, (iii) oscillations in scientific justification, and (iv) the possibility of scientific regress. We conclude by sketching a substantially different justification-based account of scientific progress that avoids these problems.
After reading these volumes one can hardly conclude otherwise than that the study of urban space in Roman Italy is thriving. These large volumes, collectively exceeding 1,800 pages and comprising 86 chapters/articles (in addition to supplementary materials), include contributions in four languages – though, perhaps surprisingly, none contain contributions in German. The array of contributors suggests that even more modern languages could have been included, if desired. The authors range from early career scholars to renowned professors.
This paper distinguishes news about short-lived events from news about changes in longer term prospects using surveys of expectations. Employing a multivariate GARCH-in-Mean model for the US, the paper illustrates how the different types of news influence business cycle dynamics. The influence of transitory output shocks can be relatively large on impact but gradually diminishes over two to three years. Permanent shocks drive the business cycle, generating immediate stock price reactions and gradually building output effects, although they have more immediate output effects during recessions through the uncertainties they create. Markedly different macroeconomic dynamics are found if these explicitly identified types of news or uncertainty feedbacks are omitted from the analysis.
The English Preposing in PP construction (PiPP; e.g., Happy though/as we were) is extremely rare but displays an intricate set of stable syntactic properties. How do people become proficient with this construction despite such limited evidence? It is tempting to posit innate learning mechanisms, but present-day large language models seem to learn to represent PiPPs as well, even though such models employ only very general learning mechanisms and experience very few instances of the construction during training. This suggests an alternative hypothesis on which knowledge of more frequent constructions helps shape knowledge of PiPPs. I seek to make this idea precise using model-theoretic syntax (MTS). In MTS, a grammar is essentially a set of constraints on forms. In this context, PiPPs can be seen as arising from a mix of construction-specific and general-purpose constraints, all of which seem inferable from general linguistic experience.