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Heart failure in children is a clinical and pathophysiological syndrome arising from ventricular dysfunction and pressure or volume overload of the circulatory system. Features of paediatric heart failure include feeding problems, poor weight gain, exercise intolerance, or dyspnoea. The aetiology of heart failure in children is complex, with the primary causes being CHD and cardiomyopathies. Cardiomyopathies occur at an incidence of 1.13–1.24 cases per 100,000 children. The prevalence of cardiomyopathy is estimated to be 7.8–8.3 cases per 100,000 infants, particularly common in patients under one year of age presenting with severe heart failure symptoms. Mitral valve insufficiency is a significant source of morbidity in children with dilated cardiomyopathy. Severe mitral insufficiency can lead to a decrease in cardiac output, independent of the left ventricular ejection fraction, exacerbating the clinical course of heart failure in patients with dilated cardiomyopathy. As ventricular systolic function deteriorates, the options for treating mitral insufficiency decrease, leading to a loss of surgical intervention opportunities and making heart transplantation the only viable option. Close monitoring of mitral valve insufficiency in children with dilated cardiomyopathy is essential, as it may lead to decompensated heart failure. In patients who have lost the chance for valve surgery due to decompensation, the application of left ventricular assist device can help improve the decompensatory state and contribute to the reduction of left ventricular diastolic and systolic dimensions, consequently leading to improvements in the dilation of the mitral annulus and severe mitral insufficiency findings. Further studies are needed to determine the optimal timing for surgery in patients who have not missed the chance for valve surgery due to a decrease in ejection fraction.
Let $t\geq 2$ and $k\geq 1$ be integers. A t-regular partition of a positive integer n is a partition of n such that none of its parts is divisible by t. Let $b_{t,k}(n)$ denote the number of hooks of length k in all the t-regular partitions of n. In this article, we prove some inequalities for $b_{t,k}(n)$ for fixed values of k. We prove that for any $t\geq 2$, $b_{t+1,1}(n)\geq b_{t,1}(n)$, for all $n\geq 0$. We also prove that $b_{3,2}(n)\geq b_{2,2}(n)$ for all $n>3$, and $b_{3,3}(n)\geq b_{2,3}(n)$ for all $n\geq 0$. Finally, we state some problems for future works.
In recent years, analysts have raised concerns about the threat misinformation poses to democracy, yet efforts to counter misinformation have been met with charges of bias and censorship, predominantly from the political right. This article asks who sets the terms of debate over misinformation: what it is, how much there is, whether it is a problem, and what to do about it. It frames the past decade’s controversies around misinformation as an implicit struggle for authority and offers a framework to interpret the arguments of the actors involved. It identifies three coalitions with distinct institutional and ideological profiles that have articulated consistent stances on misinformation. The analysis demonstrates how contestation among competing coalitions plays out in five distinct domains of misinformation: content, attribution, scale, consequences, and policy. Viewing the misinformation debate as part of broader political and cultural struggles within democracies at a time of low trust in institutions helps explain why (mis)information is so fiercely contested. The issue takes on outsize proportions because whoever prevails in shaping the discourse surrounding misinformation stands to gain authority over the rules governing the public sphere, with implications for the future of free speech and democratic participation.
The Nova classification(1) categorises foods according to the degree of food processing. Ultra-processed food have undergone a high level of industrial processing and typically contain cosmetic additives(1). Increased consumption of ultra-processed food has been associated with adverse health outcomes, including obesity and chronic diseases(2). Evaluating household food acquisition according to the Nova classification allows the assessment of dietary quality within populations, a strategy of nutrition surveillance that can support the development of effective public health actions to improve dietary quality. In Aotearoa New Zealand (NZ), there is limited up-to-date information on population dietary habits and a lack of data on ultra-processed food consumption. This study aimed to: i) develop a methodology to classify food items purchased by NZ households according to the Nova food groups: unprocessed/minimally processed foods (Group 1 [G1]), processed culinary ingredients (Group 2 [G2]), processed foods (Group 3 [G3]), and ultra-processed foods (Group 4 [G4]) and; ii) to describe the proportions of unique food items purchased according to Nova. We obtained data on food items purchased by NZ households from the 2019 NielsenIQ Homescan® panel, a national dataset of approximately 2,000 households who recorded their grocery purchases over 1-year. In total, 28,824 unique items were purchased. Using barcodes, we merged the products with the 2019 Nutritrack dataset, an inventory of NZ supermarkets foods(2), to obtain the products’ ingredient lists. We followed best practices for classification according to Nova(3). Where available, the ingredient lists were used to classify products. Of the total unique products, 13,263 (46%) were matched to Nutritrack and classified based on their ingredient lists. For the remaining 15,561 products (54%), we identified whole Nielsen product categories (PC) that were exclusively associated with a single Nova group. Items classified by PC level included rice, fresh fruits, eggs and coffee beans in G1; baking powder, liquid cooking oils and salt in G2; beer and wine in G3; and margarine, carbonated soft drinks and bubble gum in G4. An additional 6,398 products were identified at this stage, representing 41.1% of the total 15,561 products without ingredient lists. We classified the remaining 9,163 items (58.9% of those 15,561 without ingredient list) based on the distribution of Nova groups for the 60% most purchased items within their PC. If the ingredient list was absent for any item under the 60% most purchased group, it was obtained from a search of online supermarkets. The final unweighted distribution of unique products purchased in NZ according to the Nova classification were 5583 (21.7%) in G1, 671 (2.6%) in G2, 3043 (11.8%) in G3, and 16466 (63.9%) in G4. Further stages of the research will estimate the energy from Nova groups derived from household food purchases in NZ, examining socioeconomic distribution and temporal trends.
The Noctuidae (Lepidoptera) comprise the most diverse and abundant lepidopteran families in the Canadian Prairie Ecozone. Within this group, some species are agricultural pests that require monitoring. Pheromone lures target specific species, whereas food-bait lures attract a broader range. This study reports the diversity and abundance of noctuid moths captured in traps baited with female sex pheromones of pest species and with food-bait lures consisting of acetic acid and 3-methyl-1-butanol (AAMB) with fermented byproduct or floral volatile compounds. Food-bait lures that attract pests and nonpest species can provide insight into moth populations and species richness in human-managed ecosystems. We trapped moths in wheat (Poaceae) and canola (Brassicaceae) fields in central Alberta, Canada. We captured and identified to species approximately 7900 noctuid moths. Community composition was similar in both crops. Sex pheromone–baited traps had variable specificity and low nontarget diversity. Traps baited with AAMB captured greater moth diversity than unbaited traps did. Noctuinae were the most diverse and abundant in AAMB-baited traps (62 species across 8 tribes). The AAMB lures captured more cutworm and armyworm pests than unbaited traps did. Fermented byproduct food–bait lures captured more noctuid pests than floral volatiles did. The AAMB lures can be implemented to monitor Noctuinae diversity and potentially assess local noctuid pest density in agroecosystems on the Canadian prairies.
Ceylon cinnamon (Cinnamomum zeylanicum), a native spice of Sri Lanka, is rich in bioactive compounds known for their potent antioxidant properties, which contribute to various health benefits such as anti-diabetic, anti-cancer, lipid-lowering and anti-inflammatory effects(1). However, the concentration of these bioactives can fluctuate throughout the plant’s life due to internal and external factors such as light, temperature, and stress responses. This study aimed to investigate the changes in total phenolic content (TPC), total flavonoid content (TFC), and the 2,2-Diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging activity at different stages of maturity (1st to 4th year), using two extraction methods: ultrasonic extraction and accelerated solvent extraction. The identification and quantification of key bioactive compounds, including cinnamaldehyde, eugenol, and cinnamic acid, were performed using high-performance liquid chromatography (HPLC). The accelerated solvent extraction proved to be more effective in extracting TPC, TFC, cinnamaldehyde, eugenol and inhibiting DPPH. The extracts obtained from the accelerated solvent extractor showed a notable decrease in TPC (from 55.89±4.28 to 14.12±0.75 mg/g gallic acid equivalent) and TFC (from 170.08±13.75 to 39.35±9.39 mg/100g quercetin equivalent) up to the 3rd year, followed by an increase in TPC (from 14.12±0.75 to 19.71±0.49 mg/g gallic acid equivalent) and TFC (from 39.35±9.39 to 68.82±9.44 mg/100g quercetin equivalent) thereafter. The highest and lowest DPPH inhibition of 85.30 ± 0.39% and 40.68 ± 1.08% was observed with the 1st year and 3rd year plants. There was no significant difference between the DPPH inhibition of the 2nd and 4th year plants (p>0.05). The highest yields of eugenol (18.2485±0.02 mg/g of dry weight) and cinnamaldehyde (22.1475±0.024 mg/g of dry weight) were observed in the 3rd-year plant extracts obtained via accelerated solvent extraction. Conversely, the highest yield of cinnamic acid (0.4161±0.00 mg/g of dry weight) was found in 4th-year plants extracted using ultrasonic extraction. A statistically significant correlation was observed between cinnamaldehyde and eugenol content (p<0.05, R²=0.992), TPC and cinnamic acid (p<0.05, R²=0.906), and TFC and cinnamic acid (p<0.05, R²=0.956) across all ages. This study offers valuable insights into the variation of essential bioactive compounds in cinnamon as the plant matures, facilitating the optimization of its applications.
Grounded in institutional theory, this study delves into the heterogeneous responses of politically connected top executives (PCTEs) to uniform institutional requirements for corporate environmental responsibility (CER). Specifically, we scrutinized the moderating role of organizational visibility in shaping the association between PCTEs and both environmentally responsible and irresponsible practices. Analyzing data from listed Chinese firms in heavily polluting industries spanning from 2010 to 2018, the findings indicate that PCTEs contribute to an increase in firms’ environmentally responsible activities and a decrease in their environmentally irresponsible activities. Notably, the impact on environmentally responsible activities is significant only for privately controlled PCTEs. Furthermore, the moderating influence of organizational visibility is validated. The implications of these findings for the broader research on political connections and CER are thoroughly discussed.
The prognosis of neonatal Ebstein’s anomaly requiring early surgery is poor, especially with a circular shunt. We report a critically ill case managed with emergency two-stage Starnes surgery immediately after birth. We hypothesised that the three components of the Starnes procedure, right ventricle exclusion, atrial septal defect creation, and systemic-to-pulmonary shunt, could be organised and reconstructed in a consecutive two-stage strategy to control postoperative circulatory fluctuations.
To investigate socio-economic and clinical disparities in the utilisation of robotic surgery for head and neck cancer.
Methods
Using the National Cancer Database (2010–2020), 212 449 surgically treated patients were analysed. Multivariate logistic regression identified predictors of robotic versus non-robotic surgery (p < 0.05).
Results
Robotic surgery utilisation increased over time during the study period. The following characteristics positively correlated with the use of robotic surgery: male, aged 41–80 years, White race, insured (with private insurance, Medicaid and Medicare) and treatment at an Academic/Research centre. Metropolitan residency, higher income/education levels, lower comorbidity (Charlson–Deyo score of 0) and Stage I disease were also associated with increased robotic surgery utilisation.
Conclusion
Significant socio-economic disparities exist in robotic surgery access, potentially exacerbating outcome inequities. Targeted interventions are needed to improve equity in treatment access and standardise care protocols. Further research should validate trends and address systemic barriers.
Efficacy of gastric inlet patch (GIP) ablation using argon plasma coagulation (APC) for patients presenting with persistent throat symptoms was evaluated.
Methods
Retrospective observational study from a single university hospital. Consecutive patients who had GIP ablation for persistent throat symptoms between 01/10/2018-31/10/2023 were reviewed and patients who met all of the set inclusion and exclusion criteria were included in this study for analysis.
Results
50% (n = 18/36) of patients responded to APC ablation (median follow-up 3 months) with their post-ablation GETS score decreasing by 30-100%. Long-term follow-up results could be obtained from 22 patients (n = 22/36) and 75% (n = 9/12) had their clinical effects maintained (median follow-up 4.5 years; range 2.7–5.8 years).
Conclusion
GIP ablation can be a very effective treatment for patients with persistent throat symptoms with its therapeutic effects long-lasting. Future studies should focus on evaluating the optimal patient selection process for GIP ablation for persistent throat symptoms.
Malnutrition is a significant issue among older New Zealanders, with 24% malnourished and 35% at high risk(1). Oral nutritional supplements (ONS) are prescribed to improve nutrient intake in malnourished or at-risk individuals. Evidence supports that ONS can enhance energy and protein intake(2). However, efficacy depends on regular and adequate consumption. Fonterra Research and Development Centre sponsored a research programme of three interventions with the aim of assessing the liking, absorption, and compliance of ONS formulations (containing functional proteins at 9.6% and 14.4% w/v protein) versus commercial comparators. A feasibility study was also done to assess whether ONS could be used to fortify foods in a residential care setting. All trials received ethics approval. In study one (trial registration: NCT04397146), the palatability and satiating effects were evaluated in 104 participants. Fonterra’s 14.4% protein ONS was well-received for sweetness, creaminess, and texture, while the 9.6% protein ONS had lower palatability. Satiety levels were similar across all products. Key drivers of overall liking included smooth texture, pleasant taste, and ease of drinking. In study two (ACTRN12621000127808), a randomized, double-blind crossover trial of 18 healthy adults, the post-prandial effects of Fonterra’s formulation compared to energy and protein matched commercial products on amino acid (AA) appearance and gastric emptying were examined. Fonterra’s 14.4% protein ONS significantly increased the incremental area under the curve and peak concentration of essential and branched-chain AA, including leucine, compared to control (p<0.05). These findings suggest potential benefits for muscle mass preservation in at-risk patients. In study three (ACTRN12622000842763), a randomized, single-blind crossover trial, 100 older adults completed compliance and tolerance assessments of Fonterra’s formulation compared to energy and 9.6% protein matched commercial product. Compliance for all three ONS was high, with mean compliance rates of 96.1% for Fonterra 9.6%, 94.5% for Fonterra 14%, and 95.2% for comparator. Palatability scores were not significantly different. Adverse events were minimal and short-lived, mainly occurring on the first day; 30-50% of participants reported tolerance issues, such as flatulence, bloating, and burping, regardless of the product. No significant differences in satiety were observed between the interventions. Lastly, a pilot study assessed the feasibility of incorporating ONS into foods in a residential care setting. The chef found the ONS easy to work with and add to desserts, which subsequently increased the protein and calcium content of main meals. Residents found the fortified desserts palatable and acceptable. This research programme supports the use of ONS assisting older adults to meet their nutrient requirements and demonstrates that formulations containing Fonterra’s functional proteins are well-accepted, effective in increasing amino acid appearance, and easily incorporated into institutional diets, with high consumption compliance and minimal adverse effects.
This paper contends that the intractability of food insecurity as a social policy issue may have arisen in part because food access has become central to the interpretation of what is required to be food secure. We revisit key features of the evolution of the right to food and examine developments in the instruments used to monitor right to food progress. We articulate how the materiality of food access has come to the forefront of food systems policy, within which food insecurity is embedded but its structural underpinnings are lost. In turn, civil society food-based responses to growing food insecurity prevalence prevail. The pre-eminence of objectified food access as a socio-political orientation to food insecurity has refabricated the social problem of food need. A conscious uncoupling of food access from how we study and respond to food insecurity is needed to re-design food insecurity policy that is grounded in poverty alleviation.
Cor triatriatum sinister is a rare congenital cardiac anomaly, occurring in approximately 1 in 1,000 congenital cases. Although typically diagnosed in infancy because of significant haemodynamic consequences, cases in adulthood are uncommon and may present with nonspecific symptoms.
Case presentation:
A 31-year-old male presented with progressive dyspnoea and haemoptysis. Transthoracic echocardiography revealed a fibrous membrane dividing the left atrium, with a 5-mm fenestration permitting communication between an accessory chamber and the main left atrial cavity; four pulmonary veins drained into the accessory chamber. In addition, an atrial septal defect and pulmonary hypertension were identified. The patient underwent surgical correction, which included resection of the membrane, closure of the atrial septal defect using a Dacron patch, and DeVega tricuspid annuloplasty. Intraoperative transesophageal echocardiography confirmed absence of residual shunt and tricuspid regurgitation with improved pulmonary artery pressures.
Conclusion:
This case underscores the necessity for early recognition and timely surgical intervention in adult cor triatriatum sinister cases to prevent complications such as right ventricular failure and severe pulmonary hypertension.
To evaluate the prognostic value of electrocardiographic ventricular repolarisation parameters in children with dilated cardiomyopathy.
Methods:
A retrospective study was conducted involving 89 children with dilated cardiomyopathy [age 5.24 (4.32, 6.15) years] as the research group, and a control group consisting of 80 healthy children matched for age and sex. Within the research group, there were 76 cases in the survival subgroup and 13 cases in the death subgroup. Ventricular repolarisation parameters were measured.
Results:
(1) Compared to the control group, both QTcmax and QTcmin were significantly prolonged in the research group (P < 0.01). Additionally, Tp-Te /QT ratios for leads III, aVL, V1, V2, and V3 showed an increase (P < 0.05), while T-wave amplitudes for leads I, II, aVL, aVF, V4, V5, and V6 exhibited a decrease (P < 0.05). (2) In comparison to the survival subgroup, the diameters of the LV, RV, LA, and RA in the death subgroup were enlarged, while the left ventricular ejection fraction and eft ventricular fractional shortening were decreased (P < 0.05). The Tp-Te /QT ratios for leads aVR, V5, and V6 also increased notably (P < 0.05 or P < 0.01). The T-wave amplitude readings from leads II, aVF, and V6 demonstrated significant reductions (P < 0.05).
Conclusion:
Abnormal ventricular repolarisation parameters were found in dilated cardiomyopathy children. Increased Tp-Te /QT ratios in aVR, V5, and V6 leads and decreased T-wave amplitudes in II, aVF, and V6 leads were risk factors for predicting mortality in children with dilated cardiomyopathy.
This article examines whether characteristic modeling practices in economics lead to progress, that is, improved explanations and predictions. We question the widespread assumption that progress in modeling occurs solely through successive vertical refinements toward a single “best” model. Instead, we propose that progress can occur through multiple pathways. Specifically, we identify five distinct horizontal paths to progress: increased isolation of causal factors, differentiation of targets and purposes, derivation of robust theorems, multiplication of inconsistent perspectival models, and exploration of novel possibilities. We argue that these pathways, when properly constrained, increase explanatory and predictive power and therefore lead to scientific progress.
Family dynamics can significantly influence entrepreneurship, yet the temporal complexities of this relationship remain inadequately explored. This special issue addresses this gap by emphasizing the intricate interplay between internal family evolvability such as generational transitions and identity shifts, cultural continuity, and external adaptability to rapidly changing economic, institutional, and technological contexts in China. We introduce a dual tuning model that highlights how entrepreneurial and family firms (FFs) strategically synchronize their internal and external temporal rhythms to manage conflicts and optimize performance. This lead article reviews existing literature, articulates the dual tuning model, and synthesizes insights from the articles in this special issue to illuminate how Chinese FFs navigate tensions between evolving internal dynamics and external market demands. We conclude by identifying promising future research avenues that leverage this temporal perspective to deepen our understanding of family dynamics and entrepreneurship in China.