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We aim to investigate nutritional management of chyle leaks by a systematic review of the published literature.
Methods
We searched the following databases (Medline, Embase, Cochrane) for literature incorporating nutritional aspects in chyle leak management. We excluded non-English papers, paediatric studies, conference papers, and studies without nutritional intervention.
Results
Among 260 patients (out of 26,270), 81.5.% (n=212/260) achieved chyle leak resolution with nutritional management, while 18.5% (n=48/260) required surgery. Median resolution duration with nutritional management was 8.7 days (range: 4.3 to 22.2), compared to surgical treatment’s median of 32 days (range: 18 to 40).
Conclusion
We recommend use of nutritional management in all patients with chyle leaks. There is no evidence supporting one diet over the other however clinically we suggest starting with medium–chain triglyceride/non–/low–fat diets and moving onto total parenteral nutrition, unless medically indicated otherwise.
Building on Oliver’s (2020) concept of governmentality-effected neglect and applying an ethical lens, this paper examines how ideas and discourse shape migration and social policy during crises, particularly the role of state assumptions in fostering ethical contradictions in policy. We analyse secondary material and original qualitative data from semi-structured interviews with macro-level policymakers, meso-level civil societal actors and individuals at the micro-level directly affected by policy decisions. We argue that the pandemic led to a crisis-induced bricolage of policy, reflecting an ethical void. This approach, rooted in long-standing ideas about the value and role of temporary migrants in Australia, continues to influence policymaking, perpetuating systemic exclusions and reinforcing ethical challenges.
Organized crime generates violence, economic instability, and institutional challenges, forcing millions of citizens worldwide to change their place of residence annually. While the experiences of those fleeing violence are well-documented, less attention has been given to frontline workers assisting them. This study addresses this gap by examining the types of coping mechanisms that frontline officials use to protect women escaping organized crime in Mexico. Drawing on 24 in-depth interviews with key actors from governmental and non-governmental organizations, we identify three types of coping mechanisms: individual, institutional, and social. These strategies demonstrate the resilience and ingenuity of workers navigating resource shortages, legal constraints, and personal safety risks. Our findings contribute to the literature on organized crime by illuminating how those working on the ground adapt to systemic deficiencies and protect victims. By understanding these strategies, we hope to inform more effective policies to support frontline officials and mitigate the societal harms of organized crime.
This article examines “Salām Farmāndeh” as a case study of soruds (state-sponsored songs produced to advance ideological narratives and maintain cultural hegemony). The article argues that “Salām Farmāndeh” represents a significant shift in the Islamic Republic’s cultural strategy: blending religious themes, nationalist sentiment, and popular music elements to mobilize younger generations, particularly Generations A and Z. Through qualitative analysis of the song’s musical structure, lyrical content, and state-led promotional campaigns, the article demonstrates how “Salām Farmāndeh” operates as an ideological state apparatus (ISA)—a tool for reinforcing loyalty to the principles of velāyat-e faqīh (guardianship of the Islamic jurist) and the Islamic Republic’s ideological foundations. Guided by Gramsci’s theory of cultural hegemony and Althusser’s concept of ISAs, this study reveals how contemporary soruds such as “Salām Farmāndeh” reflect the regime’s adaptation of propaganda techniques to secure consent, not merely through coercion, but via emotional, cultural, and generational appeal. The findings contribute to broader discussions on the intersection of music, power, and ideological reproduction in modern Iran.
The concept partnership has developed since Sherry Arnstein first created the ladder of citizen participation. Within mental health discourse, this was first acknowledged by “A Vision for Change” (2006) and later, through adopting co-production (2017). In 2011, the College of Psychiatrists of Ireland, created a collective called Recovery Experience Forum of Carers and Users of Services (REFOCUS) which became a leading example of partnership between stakeholders in the organisation. However, REFOCUS’s impact on stakeholders needs to be examined.
Methods:
A qualitative investigation using an autoethnography methodology is proposed. The approach allows for the interweaving of personal experiences with culture to create new knowledge. A focus group was conducted, and transcripts were subject to reflexive thematic analysis.
Results:
Seven out of fourteen participants, representing all three stakeholders, were available at time of interview. From the process of reflexive thematic analysis, five themes were constructed. Each with a number of sub-themes attached, which in turn represented stakeholder perspectives regarding REFOCUS.
Discussion:
This paper highlights several issues that need addressing in future research on REFOCUS. The paper demonstrates the continuous presence of stigma within Irish mental health services. However, it also highlights a number of beneficial aspects to REFOCUS including informal peer support, service users, and family member involvement in college activities as well as increasing meaning and purpose in one’s life along with a renewed identity different to that of the service user or family member.
A key component of the authoritarian worldview is social conformity, which manifests in a need to minimize threats to social order. This desire for stability often leads authoritarians to hold systematic and approving attitudes toward law enforcement. Previous scholarship suggests that authoritarianism is linked to attitudes shaped by the social dominance of one’s group identity. We extend this framework to Hispanic populations, whose identities historically fall outside the dominant social order, to examine whether authoritarianism predicts support for law enforcement. Using data from the 2020 American National Election Study (ANES), we employ regression models to examine the relationship between authoritarianism, ethnicity, and attitudes toward law enforcement. Results indicate that authoritarians express more favorable views of law enforcement across non-Hispanic white and Hispanic respondents, with a stronger effect among Hispanics. Positive feelings toward whites are also associated with higher levels of authoritarianism and greater support for police, underscoring the importance of white identity salience in shaping political attitudes. These findings demonstrate that authoritarianism functions as a psychological orientation emphasizing order and conformity rather than a defensive response to marginalization. Our results contribute to understanding how racial identity salience and acculturation processes shape the relationship between worldview and support for state authority.
How does settler colonialism shape world politics? While the framework of settler colonialism has become increasingly established across disciplines to analyse the structure and logics of settler societies, international relations (IR) scholarship continues to treat it as peripheral to global politics. This article challenges the view that settler colonialism is a matter of domestic politics with little relevance for world politics, demonstrating that it functions as an imperial logic and practice that continues to shape the norms, practices, and distribution of power that underpin world politics. By foregrounding the relationships between settler colonialism and imperialism, the article argues that, in international relations, settler colonialism is a function of imperial ordering that both relies on and reproduces racialised hierarchies of sovereignty. The argument is illustrated through a critical examination of Australia as a case study. As a settler colony that emerged within, and continues to benefit from, imperial networks, Australia exemplifies the enduring entanglements of settler colonialism and imperial ordering in the Asia-Pacific. This article contributes to emerging efforts to bring settler colonial analysis to IR. It offers a critique of the discipline’s limited engagement with settler colonialism in the analysis of imperial politics and underscores the need to confront how settler colonialism continues to structure international relations, particularly in the Asia-Pacific region.
The triadic interactions and nonlinear energy transfer are investigated in a subsonic turbulent jet at $Re = 450\,000$. The primary focus is on the role of these interactions in the formation and attenuation of streaky structures. To this end, we employ bispectral mode decomposition, a technique that extracts coherent structures associated with dominant triadic interactions. A strong triadic correlation is identified between Kelvin–Helmholtz (KH) wavepackets and streaks: interactions between counter-rotating KH waves generates streamwise vortices, which subsequently give rise to streaks through the lift-up mechanism. The most energetic streaks occur at azimuthal wavenumber $m = 2$, with the dominant contributing triad being $[m_1, m_2, m_3] = [1, 1, 2]$. The spectral energy budget reveals that the net effect of nonlinear triadic interactions is an energy loss from the streaks. As these streaks convect downstream, they engage in further nonlinear interactions with other frequencies, which drain their energy and ultimately lead to their attenuation. Further analysis identifies the dominant scales and direction of energy transfer across different spatial regions of the jet. While the turbulent jet exhibits a forward energy cascade in a global sense, the direction of energy transfer varies locally: in the shear layer near the nozzle exit, triadic interactions among smaller scales dominate, resulting in an inverse energy cascade, whereas farther downstream, beyond the end of the potential core, interactions among larger scales prevail, leading to a forward cascade.
Secondary flows induced by spanwise heterogeneous surface roughness play a crucial role in determining engineering-relevant metrics such as surface drag, convective heat transfer and the transport of airborne scalars. While much of the existing literature has focused on idealized configurations with regularly spaced roughness elements, real-world surfaces often feature irregularities, clustering and topographic complexity for which the secondary flow response remains poorly understood. Motivated by this gap, we investigate multicolumn roughness configurations that serve as a regularized analogue of roughness clustering. Using large-eddy simulations, we systematically examine secondary flows across a controlled set of configurations in which cluster density and local arrangement are varied in an idealized manner, and observe that these variations give rise to distinct secondary flow polarities. Through a focused parameter study, we identify the spanwise gap between the edge-most roughness elements of adjacent columns, normalized by the channel half-height ($s_a/H$), as a key geometric factor governing this polarity. In addition to analysing the time-averaged structure, we investigate how variations in polarity affect the instantaneous dynamics of secondary flows. Here, we find that the regions of high- and low-momentum fluid created by the secondary flows alternate in a chaotic, non-periodic manner over time. Further analysis of the vertical velocity signal shows that variability in vertical momentum transport is a persistent and intrinsic feature of secondary flow dynamics. Taken together, these findings provide a comprehensive picture of how the geometric arrangement of roughness elements governs both the mean structure and temporal behaviour of secondary flows.
Exposure to certain parasites can occur when hosts encounter clumps of infective larvae during ingestion. Compared to more typical transmission pathways involving the cumulative penetration or ingestion of single larvae, clumped transmission can be expected to lead to complex and variable epidemiological patterns of infection within exposed hosts. We explored this idea in a spatiotemporal survey of wood ants (Formica spp.) infected with metacercariae of the host-manipulating trematode, Dicrocoelium dendriticum. Ant second intermediate hosts are exposed to clumps of cercariae during ingestion of ‘slimeballs’ that are released onto pasture by land snail first intermediate hosts. In a total sample of >650 ants collected during the host-manipulation phase when ants were attached to plants, metacercariae prevalence was 97% and mean intensity was 27 ± 25 (range in intensity = 1–168; variance:mean ratio = 23.1). None of the observed variation in mean metacercariae intensity could be attributed to year (2021, 2022), month (May to August), or nest. Although the recruitment of metacercariae into ants occurred within a narrow window of transmission each summer, the mixed-age structure of our ant samples likely limited our ability to detect seasonal patterns of mean intensity. The absence of significant spatiotemporal patterns in metacercariae intensity in samples of ants likely also reflects infrequent and variable rates of encounter with cercariae-containing slimeballs by individual ants.
Disasters significantly challenge societal resilience, individual psychological health, and sustainable development. This study aimed to culturally adapt the Disaster Adaptation and Resilience Scale (DARS) into Turkish and evaluate its psychometric properties for use in Türkiye. Participants (N = 335) aged 18 and older who had experienced a disaster in the past 5 years completed the Turkish version of the DARS following rigorous translation and expert review procedures. Exploratory and confirmatory factor analyses revealed a 5-factor structure: Problem-Solving, Optimism, Stress Management, Social Resources, and Physical Resources, accounting for 61.3% of the total variance. Internal consistency was high (Cronbach’s Alpha = 0.910), with subscale values ranging from 0.785 to 0.901. Test-retest reliability and discriminant validity were also established. The Turkish DARS is a valid and reliable tool for evaluating disaster-related adaptation and resilience. Its implementation supports sustainable mental health responses and community preparedness in disaster-prone regions.
A fully resolved numerical study was performed to investigate interfacial heat and mass transfer enhanced by the fully developed Rayleigh–Bénard–Marangoni instability in a relatively deep domain. The instability was triggered by evaporative cooling modelled by a constant surface heat flux. The latter allowed for temperature-induced variations in surface tension giving rise to Marangoni forces reinforcing the Rayleigh instability. Simulations were performed at a fixed Rayleigh number (${\textit{Ra}}_h$) and a variety of Marangoni numbers (${\textit{Ma}}_h$). In each simulation, scalar transport equations for heat and mass concentration at various Schmidt numbers (${\textit{Sc}}=16{-}200$) were solved simultaneously. Due to the fixed (warm) temperature prescribed at the bottom of the computational domain, large buoyant plumes emerged quasi-periodically both at the top and bottom. With increasing Marangoni number a decrease in the average convection cell size at the surface was observed, with a simultaneous improvement in near-surface mixing. The presence of high aspect ratio rectangular convection cell footprints was found to be characteristic for Marangoni-dominated flows. Due to the promotion of interfacial mass transfer by Marangoni forces, the power in the scaling of the mass transfer velocity, $K_{\!L}\!\propto\! \textit{Sc}^{-n}$, was found to decrease from $n=0.50$ at ${\textit{Ma}}_h=0$ to $\approx 0.438$ at ${\textit{Ma}}_h=13.21\times 10^5$. Finally, the existence of a buoyancy-dominated and a Marangoni-dominated regime was investigated in the context of the interfacial heat and mass transfer scaling as a function of ${\textit{Ma}}_h+\varepsilon {\textit{Ra}}_h$, where $\varepsilon$ is a small number determined empirically.
Both experiments and direct numerical simulation (DNS) of hypersonic flow over a compression ramp show streamwise aligned streaks/vortices near the corner as the ramp angle is increased. The origin of this three-dimensional disturbance growth is not definitively known in the existing literature, but is typically connected to flow deceleration, centrifugal (Görtler) and/or baroclinic effects. In this work we consider the hypersonic problem with moderate wall cooling in the high Reynolds/Mach number, weak interaction limit. In the lower deck of the corresponding asymptotic triple-deck description we pose the linearised, three-dimensional, Görtler stability equations. This formulation allows computation of both receptivity and biglobal stability problems for linear spanwise-periodic disturbances with a spanwise wavelength of the same order as the lower-deck depth. In this framework the dominant response near the ramp surface is of constant density and temperature (at leading order) ruling out baroclinic mechanisms. Nevertheless, we show that there remains strong energy growth of upstream spanwise-varying perturbations and ultimately a bifurcation from two-dimensional to three-dimensional ramp flow. The unstable eigenmodes are localised to the separation region. The bifurcation points are obtained over a range of ramp angle, wall-cooling parameter and disturbance wavelength. Consistent with DNS results, the three-dimensional perturbations in this asymptotic formulation are streamwise aligned streaks/vortices, displaced above the separation region. In addition, the growth of upstream disturbances peaks near to the reattachment point, whilst the streaks persist beyond it, decaying relatively slowly downstream along the deflected ramp.
Mastitis, an inflammation of the mammary gland, is a disease of significant clinical and economic importance. In recent years, advances in omics technologies have provided powerful tools to unravel the complex biological mechanisms underlying mastitis. These approaches encompass diverse fields such as genomics, proteomics, transcriptomics, metagenomics, metabolomics, epigenomics, lipidomics, glycomics, pharmacogenomics, foodomics, interactomics and exposomics. However, despite the rapid growth of omics research, the thematic structure of this literature has not been systematically examined. In this study, latent dirichlet allocation (LDA) was employed to perform topic modelling on publications related to omics and mastitis retrieved from Scopus and Web of Science. The LDA analysis revealed ten distinct topics, labelled according to the most frequent terms within each cluster: ‘proteomics’, ‘pathogen genomics’, ‘differential expression’, ‘metabolism’, ‘genetic selection’, ‘disease economy’, ‘molecular diagnostics’, ‘microbiome’, ‘antimicrobial resistance’ and ‘genetic variation.’ Among these, the topics of ‘genomics’, ‘differential expression’ and ‘antimicrobial resistance’ accounted for the highest number of publications, while ‘metabolism’ emerged more recently. All topics exhibited an increasing trend in publication volume over time, likely driven by the declining costs and greater accessibility of high-throughput omics technologies. This study provides a comprehensive thematic overview of omics research on mastitis, identifies key areas of emphasis and emerging directions, and highlights knowledge gaps that may inform future investigations and the development of targeted strategies for disease control and prevention.
The purpose of the study is to analyze bloodstream infection (BSI) data reported by outpatient hemodialysis facilities to understand temporal trends, the potential impact of infection prevention practices and the COVID-19 pandemic on BSI rates.
Methods:
Outpatient hemodialysis facilities report BSI data to the National Healthcare Safety Network. We used interrupted time series with mixed effects negative binomial modeling to estimate the annual change of BSI rates from 2012 to 2021, using March 2020 as the COVID-19 inflection point. The model controlled for seasonal factors, vascular access types, and facility characteristics.
Results:
The number of facilities used for analysis increased from 5,581 in 2012 to 7,313 in 2021. Most facilities were freestanding (range: 90%–93%) and belonged to for-profit organizations (range: 85%–88%). The annual adjusted BSI rates decreased by an average of 8.90% (95% CI: −9.10 %, −8.71%) January 2012-February 2020. The annual decrease in BSI rate was not significant during March 2020-December 2021 (P = 0.15). There was a level drop of 32.03% (95%CI: −33.84%, −30.17%) in BSI rates in the period of March 2020-December 2021 compared with the period of January 2012-February 2020.
Conclusions:
BSI rates decreased steadily from January 2012 to February 2020 likely due to the identification and adoption of evidence-based prevention practices. BSI rates plateaued at lower levels during March 2020-December 2021. This suggests that infection prevention measures implemented by facilities prior to the emergence of COVID-19 contributed to substantial decreases in BSI rates and may have helped to stabilize BSI rates after March 2020.
Sea surface films significantly influence air–sea interaction. While their damping effect on gravity–capillary waves is well recognised, the detailed mechanisms by which surface films alter small-scale wave dynamics – particularly energy dissipation and near-surface flow patterns – remain insufficiently understood. This paper presents experimental observations focusing on small-scale wave profiles and surface-flow dynamics in the presence of surfactants, providing direct experimental evidence of underlying mechanisms such as Marangoni effects. The experiments demonstrate enhanced energy dissipation and significant alterations in near-surface flow caused by surfactants, including the transformation of typical circular motion into elliptical-like trajectories and the emergence of reverse surface drift.