Capillary leak syndrome is a serious postoperative complication in neonates and infants after open-heart surgery for CHD. The aim of this study was to investigate the relationship between sternal opening width and the occurrence of capillary leak syndrome in patients undergoing cardiac surgery with delayed sternal closure.

We retrospectively analysed the clinical data of neonates and infants (aged < 12 months) who underwent open-heart surgery with delayed sternal closure at our institution between January 2016 and December 2021. Patients were categorised into groups based on postoperative diagnosis of capillary leak syndrome, defined as delayed sternal closure exceeding 3 days in combination with established clinical criteria. Stent length per kilogram (SL/kg) was calculated as the ratio of the sternal stent length to the patient”s body weight (mm/kg).

Of the 164 patients, 12 (7.3%) met capillary leak syndrome criteria. Capillary leak syndrome patients had higher median SL/kg (19.7%, p = 0.02), higher prenatal diagnosis rate (31.3%, p = 0.03), longer cardiopulmonary bypass time (24 min, p = 0.01), inotrope use (155 hours, p < 0.001), drainage time (99 hours, p < 0.001), duration of invasive ventilation (168 hours, p < 0.001), delayed sternal closure (3.8 days, p < 0.001), postoperative paediatric ICU length of stay (8.0 days, p < 0.001), and total hospital length of stay (8.5 days, p = 0.002). Nine deaths occurred, three of which were in the capillary leak syndrome group.

Univariate analysis identified higher SL/kg (OR:1.17, 95% CI:1.00–1.38) as a risk factor for postoperative mortality. Multivariate analysis identified SL/kg (OR:1.28, 95% CI:1.05–1.58) and prolonged paediatric ICU length of stay (OR:1.11, 95% CI:1.03–1.21) as significant risk factors for mortality.

In conclusion, capillary leak syndrome after open-heart surgery in neonates and infants with delayed sternal closure is associated with postoperative morbidity. Increased SL/kg and prolonged paediatric ICU length of stay are associated with mortality. Importantly, patients requiring wider sternal separation often present with greater haemodynamic instability and require more extensive postoperative support and prolonged intensive care. Thus, SL/kg may function as a surrogate marker of overall illness severity, rather than as an independent risk factor for capillary leak syndrome or mortality.

Longstanding public support for the Supreme Court of Canada is well-documented and contributes to its public legitimacy. However, the sources of this support and how vulnerable it may be to political factors or negative coverage of events are not well understood. In February of 2023, Justice Russell Brown took a leave of absence from the Supreme Court following a conduct complaint under review by the Canadian Judicial Council. Justice Brown retired from the bench in June of that year, before the CJC concluded its investigation. In the intervening period, media coverage of the events that prompted the attention from the CJC thrust the Court into the spotlight. Using data from an original two-wave survey experiment (n = 1,222) from May and November of 2023, we investigate whether perspectives toward the circumstances surrounding Brown’s retirement hurt perceptions of the Court’s legitimacy. We find that the event did not disrupt support for the Court over time but also point to the ways in which opinion toward the Court changed pre- and post-resignation. These findings suggest that support toward Canada’s high court is at present largely stable even in the case of negative coverage of a high-profile event. However, we also acknowledge the potential vulnerabilities that negative coverage of the Court may present.

This paper presents an archaeological material science study of pottery production and use at the Bronze Age Minoan town of Palaikastro, east Crete, from Middle Minoan IIA to Late Minoan IIIA2 (c. 1850 to 1300 BC), through petrographic analysis of thin sections and wavelength dispersive X-ray fluorescence spectroscopy. The compositions of 288 archaeological samples are compared with geological references collected from the site and its adjacent hinterland. The results of this study indicate that throughout this period the majority of the archaeological pottery assemblage was probably produced using materials from a small number of geological outcrops local to the town; however, the manner in which these resources were utilised changed significantly over time, particularly between the Proto- and Neopalatial periods.

Recent years have seen a remarkable revival of research on Cassius Dio and his Roman History, including the publication of numerous volumes of collective essays, and this has been accompanied by a much higher estimation of his achievement than used to be customary. This article seeks to assess the progress made on a range of key issues relating to Dio and his history and to point ahead to further directions for research. The chief topics considered are Dio’s career as senator and historian, central aspects of his history (transmission, sources and models, structure, speeches), and Dio’s handling of politics and system change.

The prehistoric human habitation of the Tibetan Plateau (TP) is well evidenced by the archaeological record, but poorly constrained in time and space. To test the plausibility of in situ survival during the last glacial maximum (LGM) and the coldest periods of the Pleistocene, this paper gauges the effects of LGM conditions and varying local ice coverage on the climate. Three different climate model scenarios are generated, and their outputs are used to drive vegetation simulations. This allows us to evaluate 10 archaeological sites that show evidence of human activity either pre- or post-LGM as possible human refugia. The results show that the higher the level of ice coverage on the plateau, the colder and drier the climate becomes, and barren unproductive land extends farther south. However, there are sites that remain habitable in all scenarios, with the southern and northeastern plateau identified as the areas with the highest likelihood of refugia during the LGM, specifically at the locations of Baishiya Karst Cave and Siling Co. There is a high probability of the TP being habitable during the LGM, as even the scenario with the most ice yields some regions with favourable conditions that are within the habitability criteria.

Between 1980 and 2020, more than 120 countries—Canada included—enfranchised emigrants. While the diffusion of democratic practices is a well-established international phenomenon, we know little about the domestic process. How does international policy diffusion influence domestic debate? To explain the structure of Canadian debate about emigrant voting rights, we draw on concepts from the constructivist literature on international norms. In examining the structure of normative discourse within a domestic context, we argue that emulation involves three rhetorical elements that can generate disagreement: (1) setting peer countries to emulate; (2) identifying existing policy positions; and (3) envisioning the preferred policy position vis-à-vis peers. We find that in the Canadian debate about emigrant voting, contestation increased over time; where only peer groups were contested in the early debates leading up to the initial 1993 enfranchisement, all three elements were contested when discussing the removal of temporal restrictions two decades later.

Cheese-whey is a valuable byproduct of the dairy industry, rich in various nutritional components such as minerals, lactose, and proteins. Whey proteins, often used in concentrate form, are widely applied in the food industry due to their diverse chemical, physical, and techno-functional properties. This study aimed to investigate the physicochemical composition and biochemical characteristics of camel and bovine whey after partial demineralization at a laboratory scale. Camel whey exhibited lower pH values compared to bovine whey, while showing comparable levels of total solids, ash, and lactose, but significantly higher protein content. Analysis of both types of whey, before and after dialysis filtration, demonstrated partial demineralization, a significant reduction in lactose content, and a decrease in β-lactoglobulin levels in bovine whey. These findings suggest that demineralized camel and bovine whey hold significant potential for applications in the agricultural and food industries.

Bringing one’s authentic self to work is important to employees’ psychological well-being and performance. Although literature has examined how organizational factors influence authentic self-expression, it has largely overlooked the role of leaders. Drawing from leadership research, this study investigates the impact of perceived leader concern on authentic self-expression and its downstream effects on job attitudes. Findings provide empirical support for our predictions. Specifically, perceived leader concern is positively associated with authentic self-expression, which in turn relates positively to perceived self-concept-job fit. Regarding downstream outcomes, self-concept-job fit is positively related to organizational commitment and negatively to turnover intentions. Serial mediation analyses show that leader concern indirectly affects commitment and turnover intentions through authentic self-expression and self-concept-job fit. These findings highlight that leaders who show genuine concern foster open communication and authentic self-expression, enhancing alignment between identity and work, thereby strengthening commitment and reducing turnover. Implications for practice and future research are discussed.