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Shone complex is a rare congenital cardiovascular anomaly characterized by multiple left-sided obstructive lesions. Adult presentation is uncommon and may result in atypical clinical manifestations, particularly when complicated by infective endocarditis. Coarctation of the aorta–associated infective endocarditis is especially rare and carries significant clinical risk.
Case Summary:
We report a 25-year-old male with partial Shone complex consisting of a parachute mitral valve, mitral stenosis, and coarctation of the aorta. The patient presented with persistent high-grade fever and was diagnosed with methicillin-sensitive Staphylococcus aureus infective endocarditis based on positive blood cultures. Transthoracic and transesophageal echocardiography revealed obstructive left-sided lesions, mitral valve pathology, and moderate aortic regurgitation. Positron emission tomography demonstrated intense hypermetabolic activity at the coarctation site, consistent with active infection and confirming a saccular aneurysm. The patient underwent prolonged intravenous cefazolin therapy followed by surgical repair. The early postoperative course was stable; however, seven months later he re-presented with recurrent fever. Repeat imaging demonstrated graft infection, vegetation on the prosthetic material, and a perforated mitral leaflet. A second course of intravenous antibiotics (cefazolin and rifampicin) was administered, followed by long-term suppressive oral therapy. Subsequent follow-up showed persistent moderate-to-severe mitral regurgitation with stable postoperative anatomy.
Conclusion:
This case highlights a rare adult manifestation of partial Shone complex complicated by coarctation of the aorta-site methicillin-sensitive Staphylococcus aureus infection, saccular aneurysm formation, and recurrent graft-associated infective endocarditis. The clinical course underscores the importance of vigilant multimodality imaging, early multidisciplinary evaluation, and long-term follow-up in adults with complex CHD, particularly when infectious complications are present.
Prior research on technology entrepreneurship has been grounded almost exclusively in capitalist frameworks developed in the Global North. We argue that context matters, and that scholars should examine technology entrepreneurship in the roughly half of the world where socialism provides the economic foundation. As a step in this direction, we investigate how the principle of common prosperity shapes technology entrepreneurship in socialist contexts. Focusing first on China – a global technological leader and one of the world’s largest generators of patents – we show through two cases that concern for the poor is not incidental but integral to technology entrepreneurship under socialism. We then extend the analysis to a second socialist context outside China, demonstrating the broader relevance of common prosperity for understanding the relationship between technology entrepreneurship and poverty alleviation. Taken together, these cases suggest that research on technology entrepreneurship should move beyond Global North capitalist assumptions and instead account for societal context, particularly the socialist emphasis on common prosperity. Incorporating such perspectives invites scholars to reconsider the role of technology and entrepreneurship in advancing the common good and reducing poverty.
Slender fibres, including textile-derived microplastics, are abundant in aquatic environments and often extend beyond the Kolmogorov length scale. While breakup at dissipative scales has been characterised by velocity-gradient statistics, no closure existed for inertial-range spans where eddy turnover sets the clock. Here we develop a turbulence-informed kinetic theory of fibre fragmentation bridging turbulence forcing and slender-beam mechanics. First, we derive a load-to-curvature mapping showing that spanwise forcing generates peak bending moments scaling as $\sim U_L L^2$, with $U_L$ the velocity increment across fibre length $L$. Second, we construct a breakup hazard $h(L)$ from curvature-threshold exceedances over eddy-time blocks, which identifies a turbulence-defined critical span $\ell _c$. For $L\gt \ell _c$, breakup is eddy-time-limited, $h(L)=O(\bar \varepsilon ^{1/3}L^{-2/3})$ with $\bar \varepsilon$ the mean turbulent energy dissipation rate, whereas for $L\lt \ell _c$, it is a rare-event process with $h(L)\propto L^{5/3+\alpha }$, $\alpha$ denoting the small correction from intermittency. Embedding this hazard in a self-similar binary kernel yields a closed population-balance equation for the fragment distribution $n(L,t)$ with sources and sinks. The framework produces explicit predictions: intermittency-corrected curvature scalings, critical spans set by material and flow parameters, start-up and halving times linked to surf-zone conditions and scaling profiles in the cascade. The steady-state bulk distribution on the subcritical branch, with vertical removal induced by horizontal convergence, follows $n(L)\propto L^{-8/3-\alpha }\simeq L^{-2.7}$, in striking agreement with the mean slope $\simeq -2.68$ observed for environmental microfibres in recent surveys. The reported variability of slopes is naturally explained in our framework by the coexistence of supercritical and subcritical branches together with $L$-dependent removal-driven sinks.
This article deals with late antique Jewish and Christian discourse on social hierarchy, martyrology, and attitudes toward the law and the commandments. I place Jewish and Christian attitudes to martyrdom in late antiquity within the larger system of the commandments. Beyond the circumstantial connections between martyrdom and the affirmation or violation of laws, I argue that martyrdom constitutes an important lens for the examination of the rule of the law and for the negotiation of socio-religious hierarchies. I argue that the elevation of martyrdom creates inner tension vis-à-vis the idea of life-long righteousness based on adherence to the law. I discuss the construction of martyrdom as the final and ultimate commandment, necessary for reaching a state of perfection. Through addressing a case where martyrdom is presented as competing with, if not substituting, a life according to the law, I discuss the theme of an upside-down world, which appears in both Christian and Rabbinic literature, concerning martyrs. In this framework, I discuss the view of martyrdom as a kind of stairway to heaven—an instrument for rapid advancement allowing to overtake those who lived according to the law—and the unique perception of law and martyrology in the fourth-century Syriac-Christian Book of Steps, which places the martyrs below the perfect.
Tendon-driven Continuum Robots (TDCRs) excel at operating in confined and complex environments due to their inherent flexibility and high degrees of freedom. Despite these advantages, achieving precise control in multi-section TDCRs remains challenging because of their infinite degrees of freedom, nonlinear behaviour, and coupled tendon actuation. This paper introduces a generalised virtual actuation space framework that significantly simplifies kinematic modelling and control of multi-section TDCRs. By formulating a novel concept of virtual actuation space that converts each bending section of the TDCR two-input actuation system, the proposed method reduces the complexity of TDCR modelling and control, enabling unique and simplified representations of each section. Furthermore, the formulation decouples each section via a generalised tendon mapping matrix that handles coupling effects. Experimental validation on a two-section TDCR demonstrates tracking performance with a root mean square error below 3 mm, corresponding to approximately 1% of the robot’s length. These results confirm the method’s efficacy in improving TDCR precision for minimally invasive surgery, industrial applications, and other constrained environments.
We describe the marine horsehair worm Nectonema shimadaisp. nov., which was parasitic in a snapping shrimp (Alpheus sp.) collected at 4 m depth from the coastal water of Kikaijima Island, Japan, northwestern Pacific. The nematomorph was a female, 49 mm in length and 340 μm in width, salmon-pink when alive, with a translucent anterior body region and a distinct anterior chamber. The 18S sequence from N. shimadaisp. nov. was 12.8%, 9.8%, 9.6%, and 9.3% divergent in Kimura 2-parametar (K2P) distance from Nectonema sp. parasitic in the isopod Natatolana japonensis, Nectonema sp. parasitic in the crab Chionoecetes bairdi, N. munidae, and N. agile, respectively. In an 18S tree, N. shimadaisp. nov. was the sister taxon to a clade comprising three decapod-parasitic species, and species sharing the same host group or ocean were not monophyletic. The tree may reflect genetically distant warm- and cold-water lineages within decapod-parasitic nematomorphs.
To understand the early modern Caribbean, we must understand the societies that inhabited it. The parameters through which historians approach these societies have changed drastically in the last decade. While recent interventions have proven useful for framing our attitude to how populations in the Caribbean formed, they are less effective when applied to societies whose longevity was uncertain that, in some cases, fractured or collapsed. It is in this context that some historians have identified what they term “sinew populations”: communities whose “off-grid” nature necessitates different ways of thinking about how they functioned. Recent works have discussed how sinew populations ensured the long-term viability of their communities, but this approach also requires attention to the factors that could render a sinew population’s existence unviable.
This article uses an eighteenth-century Caribbean population of pirates as a case study to illustrate the issue of viability within sinew populations. In particular, the article emphasizes the weak social foundations on which this sinew population was built and the lack of interest among the pirates themselves, after 1718, in maintaining a large pirate population. In thinking about how pirates related to one another and what this meant for the long-term survival of the pirate sinew population, this article demonstrates the importance of social maintenance for understanding how Caribbean societies operated.
This study uncovers a previously overlooked chapter in the historiography of civil disobedience: Menachem Begin’s resistance to Israeli emergency legislation between 1948 and 1954, which he argued undermined foundational democratic principles. It presents the first scholarly analysis of Begin’s resistance, contending that it constitutes a clear instance of civil disobedience, embodying its core tenets. At the heart of this historical case study lies a paradigmatic question: how can laws that erode foundational—yet abstract—democratic principles, such as the separation of powers, be effectively resisted, and can such resistance be accommodated within traditional frameworks of civil disobedience? Begin’s struggle brings these questions into sharp relief, illuminating longstanding critiques of the framework’s overly restrictive boundaries and underscoring the tension between theoretical frameworks and political reality. More broadly, the article engages central debates at the intersection of law, politics, and democratic thought. By examining the democratic convictions of a prominent right-wing leader, it contributes to historical scholarship on the role of conservative and right-wing movements in shaping democratic ideologies, while also providing a historical reference point for subsequent ideological transformations and radicalization processes within these movements. Finally, by illuminating the complexities inherent in opposing laws that erode core-yet abstract-democratic principles, this study resonates with contemporary debates on democratic backsliding, offering a historical lens through which civil disobedience has served as a principled response to such challenges.
During the COVID-19 lockdown, Latin American artists turned low-cost, open platforms such as Mozilla Hubs, Twitch, Jitsi, YouTube and OBS into ephemeral infrastructures for collaborative VR concerts, 3D live-coding sessions, collective streaming events and networked Algoraves. Drawing on participant observation, event documentation and informal interviews, this article examines these cases with a focus on La Fábrica VR (TOPLAP México) and related experiences in Mexico, Peru, Colombia, Argentina and Costa Rica. We argue that these practices materialise a situated, collaborative and tactically informal technological production that reconfigures agency, embodiment and listening in immersive environments.
Turbulent flows, despite their apparent randomness, exhibit coherent structures that underpin their dynamics. Proper orthogonal decomposition (POD) has been widely used to extract these structures from experimental data. Periodic features such as vortex shedding can appear as POD mode pairs in strongly periodic flows, but detecting propagating structures in more complex flows is challenging. Hilbert proper orthogonal decomposition (HPOD) addresses this by applying POD to the analytic signal of the turbulent fluctuations, which yields complex modes with a $\pi /2$ phase shift between the real and imaginary components. These modes capture propagating structures effectively but introduce spectral leakage from the Hilbert transform used to derive the analytic signal. The current work investigates the relationship between the modes of the POD and those of the HPOD on the velocity fluctuations in the wake of a sphere. By comparing their outputs, POD mode pairs that correspond to the same propagating structures revealed by HPOD are identified. Furthermore, this study explores whether computing the analytic signal of the POD modes can replicate the HPOD modes, offering a more computationally efficient method for determining the pairs of POD modes that represent propagating structures. The results show that the pairs of POD modes identified by the HPOD can be determined more efficiently using the Hilbert transform directly on the POD modes. This method enhances the interpretive power of POD, enabling more detailed analysis of the turbulent dynamics without the need to compute the analytic signal of the entire turbulent fluctuation data.
Suicide is among the most pressing public health problems of the 21st century. Fictional depictions of suicide have long been known to influence the public’s understanding of suicide and, in some cases, can impact suicide rates. Unrecognised to date is that J.K. Rowling is, arguably, the most prolific popular author on the topic of suicide. Dozens of Rowling’s characters and, indeed, each of her books, have a connection to suicide. This review summarises Rowling’s coverage of suicide and discusses the implications. In particular, it explores how her books/series generally include a protagonist who survives a crisis and a foil who succumbs to despair and trauma, and how these narratives relate to what Rowling has said publicly about her own story of survival. Although her treatment of suicide does not always align with recommendations for responsible media portrayals, overall, Rowling’s works have exposed numerous people worldwide to messages of hope and survival, and this deserves scientific attention.
Does Benatar’s anti-natalism – the view that it is better never to have been – imply that death is better than continued living? This is known as the pro-mortalist question, a compelling, unresolved question surrounding anti-natalist discourse. In order to answer this question, I analyse two theories about the badness of death that Benatar uses to argue against the idea that anti-natalism implies pro-mortalism. The first is that death deprives one of the good things in life. The second is that death annihilates the person. However, I argue that these theories fail to block pro-mortalism. As such, I conclude that Benatar’s anti-natalism implies pro-mortalism, suggesting that if it is better never to have been, then it is better to cease to be.
In 1958, the Israeli Broadcasting Authority established a fifteen-minute daily Persian-language program targeting Iranian listeners, restarting segments that had begun almost a decade earlier. These broadcasts were written and produced by recent Iranian Jewish immigrants to the country, who brought press and activism experience and expertise from their country of origin. The purpose of these broadcasts was to highlight Israel’s economic and technological achievements, convey its foreign policy perspectives, and strengthen elite connections with Iran. In the process, such broadcasts also became the focal point for an increasingly internationalizing Iranian population, a fact that remained true up to and beyond the country’s 1978–79 revolution. Studies of radio in Israel have noted the medium’s function in both domestic constructions of the new state’s identity and culture as well as public diplomacy facing its enemies and allies. This article shows that Persian-language radio broadcasts served both these purposes, as well as positing a further function in their use as a point of transnational connectivity, beyond relations with Israel alone. In so doing, this article points to the power of listeners in structuring their own communities, even in response to state-centric media campaigns.
CHD affect approximately 1% of live births globally and are the most common congenital anomaly. Contemporary data on CHD risk in offspring of affected mothers remains limited. This study evaluated CHD incidence in offspring of mothers with CHD at a southeastern U.S. academic medical centre.
Methods:
We conducted a retrospective review of patients with CHD who received prenatal care between 2015 and 2023 at a multidisciplinary Cardio-Obstetrics clinic. Patients with acquired heart disease, syndromic or inherited CHD, and deliveries at outside hospitals with missing delivery data were excluded. The primary outcome was infant CHD incidence, confirmed by postnatal echocardiography. Secondary outcomes were neonatal intensive care unit admission, early in-hospital cardiac surgery, and in-hospital infant mortality.
Results:
A total of 186 mothers with 195 pregnancies and 198 infants were included. CHD was diagnosed in 16 infants (8.1%), most commonly ventricular septal defect. Of affected infants, none required early in-hospital surgery, and one experienced in-hospital mortality, though this infant had severe extracardiac anomalies concerning an underlying genetic syndrome.
Conclusion:
The incidence of CHD among offspring of mothers with CHD in our cohort was higher than the general population; however, the majority of defects were non-critical and did not require early intervention. These findings offer important context for prenatal counselling and tailored fetal/neonatal echocardiography screening in this high-risk population.
Human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma (OPSCC) exhibits a favourable prognosis compared to non-HPV OPCSCC. Tumour infiltrating lymphocytes (TILs) may predict better survival outcomes for patients with HPV+OPSCC.
Methods
A retrospective review of patients treated for HPV+OPSCC between 2003-2018. TIL density scores for each patient’s tumour specimen were determined. Patients were categorised as TIL-Hi or TIL-Lo. Survival outcomes for the two TIL groups were compared.
Results
Fifty-seven patients, 33 in the TIL-Hi group, were included. 5-year overall survival was 81.8% in the TIL-Hi and 75% in the TIL-Lo groups. 5-year disease specific survival was 87.9% and 87.5%, respectively. There was no statistically significant difference in survival outcomes between TIL-Hi and TIL-Lo.
Conclusion
TIL density in HPV+OPSCC has been reported to predict survival outcomes. This is not supported by the findings of this study. Further prospective evaluation with a standardised scoring technique may fully elicit the prognostic value of TILs in HPV+OPSCC.
A droplet impacting a deep fluid bath is as common as rain over the ocean. If the impact is sufficiently gentle, the mediating air layer remains intact, and the droplet may rebound completely from the interface. In this work, we experimentally investigate the role of translational bath motion on the bouncing to coalescence transition. Over a range of parameters, we find that the relative bath motion systematically decreases the normal Weber number required to transition from bouncing to merging. Direct numerical simulations demonstrate that the depression created during impact combined with the translational motion of the bath enhances the air-layer drainage on the upstream side of the droplet, ultimately favouring coalescence. A simple geometric argument is presented that rationalises the collapse of the experimental threshold data, extending what is known for the case of axisymmetric normal impacts to the more general three-dimensional scenario of interest herein.