The clinical case describes a 13-year-old boy with a history of transposition of the great arteries, ventricular septal defect, and pulmonary stenosis who underwent surgical correction at age 1 with the REV procedure and the Lecompte maneuver. At age 2, severe subaortic obstruction required reoperation for subaortic tunnel reconstruction, myectomy, and reimplantation. Due to severe right ventricular outflow tract dysfunction, a 19 mm No-React Injectable BioPulmonic prosthesis was implanted. At 12 years, the patient presented with reduced exercise tolerance. Echocardiography and cardiac catheterisation demonstrated severe stenosis and regurgitation of the pulmonary bioprosthesis, right ventricular dilatation and hypertrophy, and an increased right ventricular–pulmonary artery gradient with normal pulmonary artery pressures. The manuscript presents an in vitro test demonstrating that the No-React Injectable BioPulmonic prosthesis frame can be modified using high-pressure balloons to increase its true inner diameter. The patient subsequently underwent transcatheter valve-in-valve implantation of a 23 mm Sapien 3 following pre-dilation and frame modification of the 19 mm No-React Injectable BioPulmonic prosthesis with a 22 × 20 mm Atlas Gold balloon, achieving an favourable haemodynamic outcome. Post-implant pulmonary arteriography excluded any intra-perivalvular regurgitation. Post-procedure haemodynamic assessment showed a residual peak-to-peak gradient of 10 mmHg, with systolic right ventricular pressures below half of systemic pressure. At the 6-month follow-up after the procedure, the post-procedural peak echocardiographic gradient across the pulmonary prosthesis was measured at 28 mmHg, with no evidence of regurgitation. Short-term results have been optimal, which encourages the use of this strategy for the treatment of similar cases.

This paper investigates the everyday use of coins at the Roman Red Sea ports of Berenike and Myos Hormos, challenging their conventional interpretation as mere indicators of trade prosperity. Adopting a contextualized approach, the paper analyzes coin finds alongside non-numismatic evidence – including ceramics, botanical and zoological remains, and epigraphic records – to uncover their role in daily economic activities. The study demonstrates how coins functioned across diverse settings such as marketplaces, industrial zones, religious sites, and residential areas, highlighting their integration into the economic, social, and cultural fabric of the ports. Beyond serving as a medium of exchange, coins played crucial roles in taxation, service payments, and religious offerings. By reconstructing the transactional dynamics of the ancient ports, the paper provides new insights into the interactions between residents and visitors, enriching our understanding of daily life in these vibrant hubs through a holistic archaeological perspective.

In the final decades of its existence, the Qing imperial state sought to unify and standardize policies of frontier management. In this context, mapping and surveying practices developed as socio-technological discourses that transformed how Qing authorities asserted their territorial claims in the Eastern Himalayas. Most scholarship on the history of Qing-era frontier management has tended to focus on Chinese nation-building practices. However, this article foregrounds the deconstruction of the epistemic regime governing the production of geo-knowledge about the Eastern Himalayas by investigating the appropriation and rejection of the interlocutors of local and indigenous knowledge, networks, and actors.

How did military surveyors establish authoritative ideas about their own expertise? This article focuses on the late-Qing surveys of the Dzayul river basin commissioned by Zhao Erfeng and carried out by his subordinate officials Cheng Fengxian, Duan Pengrui, and Xia Hu. Between 1910 and 1911, Zhao Erfeng ordered new surveys of the regions located at the north-easternmost tip of modern-day Arunachal Pradesh, to demarcate the Qing Tibetan dominions and Chinese territory from that of British India. The surveyors Cheng Fengxian, Duan Pengrui, and Xia Hu, mapped the route of the Dzayul River which flowed into British Indian territory through the Mishmi hills into Assam as the Lohit. These surveys largely claimed that natural features marked the “natural” or “traditional” boundaries of the imperial state, against local knowledge productions that framed those same topographical features as connectors rather than dividers. By dissembling the various strands that informed this archive of Qing colonial knowledge, I investigate the processes by which state-produced narratives created new kinds of citational practices to designate who could be recognized as an “expert” of the mountainous geography of Tibet and the trans-Himalayan regions.

À partir d’une enquête articulant des observations en contexte scolaire, des entretiens avec des parents et des questionnaires adressés aux enfants à partir d’un jeu de carte, l’article met en évidence le rôle que jouent les figures symboliques représentant des animaux dans la prime-socialisation enfantine (3-6 ans). Dans un premier temps, je reviens sur la manière dont la notion de totémisme a permis d’analyser les usages symboliques des espèces animales pour penser des catégories sociales, chez des auteurs tels qu’Émile Durkheim, Claude Lévi-Strauss et Philippe Descola. L’article revient ensuite sur la manière donc ces questionnements peuvent se voir adaptés à l’étude des représentations enfantines, afin de comprendre les usages symboliques élémentaires des animaux. J’explicite alors les méthodes employées pour enquêter sur la genèse des modalités enfantines d’appréhension des animaux. Enfin, l’article reprend les résultats de cette recherche, qui mettent en lumière la façon dont les différences entre animaux peuvent servir aux enfants à penser des différences sociales et à intérioriser des dispositions associées à leur position dans différents rapports sociaux, de genre et de classe. Ce faisant, leurs pratiques ludiques impliquant la mise en scène ou l’imitation de comportements animaux, ou l’expression d’un vif intérêt pour différents types d’animaux, peuvent ainsi constituer des vecteurs indirects d’apprentissage de leur place dans le monde social.

Excavations at the Iron Age site of Worlebury hillfort during the mid-late 19th century revealed a large number of human skeletal remains, interpreted as victims of a ‘massacre’. Reanalysis of these remains, combining AMS dating, osteological, aDNA, histotaphonomy, and isotope analysis, has enabled a re-evaluation of this hypothesis. AMS dating lends support to the notion that many of these individuals may have died during a single episode, while osteological analysis has identified significant evidence for perimortem trauma, and the histology supports a short period between death and deposition. The genetic data suggest that the human remains represent a group with biological links through the maternal line and connections to another nearby site, while the isotope values are consistent with a local population, consuming animals raised in a salt-marsh environment like the Severn Estuary. Our results demonstrate the value of returning to often unpromising antiquarian collections using an integrated suite of modern analytical approaches.

Medicaid serves vulnerable populations that experience deep health inequities and significant health-related social needs. In recent years, reforms to Medicaid have sought to respond to those needs, with mixed results. Value based payment methods, which in theory link payment to outcome metrics, are emerging in commercial insurance markets and can be adapted to the needs of Medicaid programs and their beneficiaries. These methods seek to tie payment for services to the forging of connections between medical and social care including housing supports and nutrition services for vulnerable populations. This paper describes the merits and some pitfalls of the attempt to turn Medicaid from its roots as a medical insurance program to a broader health insurance program. It describes the benefits of employing community care hubs – intermediaries between community-based organizations and large payers and hospital systems – as a way to spur the move to social care in Medicaid. It also addresses some of the barriers to this move, including the perceived danger of “medicalizing” society’s failures and the apparent turn by the current federal administration away from commitment to health equity.

This paper explores the moral import of Kant’s theory of the beautiful in relation to his systematic aim of bridging the gulf between nature and freedom. The aim is to preserve the importance of the beautiful – whether natural or artistic – while also accounting for Kant’s emphasis on the pre-eminence of natural beauty. Drawing on Kant’s distinction between intellectual and empirical interest in the beautiful, this paper argues that only natural beauty enables a transition to the supersensible both within the subject and externally. It concludes by examining whether intellectual interest in natural beauty might be regarded as a duty.

The period between 450 and 350 BC is regarded as a time of significant social change during the European Iron Age, with numerous processes of transformation, instability, conflict, and mobility unfolding across the European continent. However, in contrast to other episodes of abrupt social transformation, this period has received considerably less attention: it has been understood as a starting point or a sudden change but not usually researched in its own right.

The present study begins by reviewing different European archaeological contexts, exploring how this century is usually interpreted as a significant break. Next, the focus will shift to a specific region, north-west Iberia, in order to identify changes in patterns of occupation and social dynamics. The primary objective is to examine the shift that occurred around 400 BC, identify any common pattern or trend across different regions, and assess long-term consequences. Finally, I propose a series of interpretations at different scales, aiming to raise some possible hypotheses for understanding the development of this brief yet eventful period.