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Cardiac catheterisation in the postoperative period emerges as a primary tool, providing effectiveness and safety in diagnosis, treatment guidance, and resolution of major residual lesions.
Materials and methods:
This is a retrospective case-control study. We collected the clinical records of patients who underwent cardiac catheterisation between January 2003 and December 2022 within the initial 72 hours after surgery in the pediatric cardiac ICU of a national referral hospital in Mexico City. Descriptive, univariate, and multivariate analyses were performed.
Results:
A total of 6,243 surgeries were performed, of which 264 were cardiac catheterizations carried out within the first 72 hours of the postoperative period;these included 73 diagnostic procedures and 191 interventional procedures. One hundred and thirty-five (135) catheterisations targeted recent suture intervention sites. The primary indications for cardiac catheterisation included low cardiac output and the suspicion of major residual lesions. Approximately 65% of interventions occurred within the first 24 hours and solved 426 residual lesions. No significant associations were found between mortality, complications, and the need for surgical reintervention in patients who underwent interventional catheterisation at recent suture sites (OR 1.93;95% CI:0.94–4.07:p = 0.076). Seventeen patients (17) were extubated in the initial 24 hours post-catheterisation. Two major complications were identified: rupture of the systemic-to-pulmonary shunt in the anastomosis, and a pulmonary artery laceration requiring emergency surgery. One patient died.
Conclusion:
Cardiac catheterisation has evolved into a vital instrument to diagnose and resolve abnormalities and significant residual lesions without increasing the morbidity and mortality risks.
In this paper, we develop an analytical model to investigate the generation of instability waves triggered by the upstream acoustic forcing near the nozzle lip of a supersonic jet. This represents an important stage, i.e. the jet receptivity, of the screech feedback loop. The upstream acoustic forcing, resulting from the shock-instability interaction (SII), reaches the nozzle lip and excites new shear-layer instability waves. To obtain the newly excited instability wave, we first determine the scattered sound field due to the upstream forcing using the Wiener–Hopf technique, with the kernel function factored using asymptotic expansions and overlapping approximations. Subsequently, the unsteady Kutta condition is imposed at the nozzle lip, enabling the derivation of the dispersion relation for the newly excited instability wave. A linear transfer function between the upstream forcing and the newly excited instability wave is obtained. We calculate the amplitude and phase delay in this receptivity process and examine their variations against the frequency. The analytically obtained phase delay enables us to evaluate the phase condition for jet screech and predict the screech frequency accordingly. The results show improved agreement with the experimental data compared with classical models. It is hoped that this model may help in developing a full screech model.
Tetralogy of Fallot is the most common cyanotic congenital malformation of the heart. The right ventricular outflow tract is of great interest in this setting, but most of the focus on this feature has been on the size of the so-called pulmonary valvar “annulus”. We aimed to characterise other aspects of the morphology of the pulmonary root in heart specimens with tetralogy of Fallot.
Methods:
We reviewed archived hearts with tetralogy of Fallot from four registries. The pulmonary root was examined with specific attention to the number of sinuses, the number of leaflets, presence of any fusion of leaflets, and the direction of the zone of apposition between the leaflets. Cluster analyses were then conducted to see if the features permitted segregation into groups.
Results:
We examined a total of 155 hearts. The pulmonary valve had two leaflets in 62%, three leaflets in 34%, and one leaflet in 3%. Irrespective of leaflet morphology, most hearts had two sinuses. Cluster analysis permitted segregation into three groups, with the direction of the zone of apposition being the most important feature for segregation.
Conclusion:
In two-thirds of our hearts with tetralogy of Fallot, the pulmonary valve had two leaflets. Most frequently there were three sinuses. In the setting of a valve with two sinuses, the zone of apposition between the leaflets pointing towards the aorta. Cluster analysis permitted statistically sound segregation of the heart and highlights the importance of delineating these features, specifically the leaflet and sinus morphology, with clinical imaging.
Research published in the last decade, which has provided data from both technological and morphometrical analyses of lithic points from southeastern and southern Brazil and Uruguay, suggests that there is much more cultural diversity among hunter-gatherers during the Early to Mid-Holocene than previously suggested by the Umbu Tradition model. Some of these studies have suggested new archaeological cultures and new definitions of lithic industries. In this article we present new data on another lithic assemblage that we associate with the Garivaldinense lithic industry and is found at the Pedro Fridolino Schmitz site. We also present, for the first time, the definition of two new types of lithic bifacial stemmed points. Our data suggest a low-density occupation of the site from the Middle to Late Holocene (8000–1000 BP) and some variability within the Garivaldinense industry throughout time and space.
When an oblate droplet translates through a viscous fluid under linear shear, it experiences a lateral lift force whose direction and magnitude are influenced by the Reynolds number, the droplet’s viscosity and its aspect ratio. Using a recently developed sharp interface method, we perform three-dimensional direct numerical simulations to explore the evolution of lift forces on oblate droplets across a broad range of these parameters. Our findings reveal that in the low-but-finite Reynolds number regime, the Saffman mechanism consistently governs the lift force. The lift increases with the droplet’s viscosity, aligning with the analytical solution derived by Legendre & Magnaudet (Phys. Fluids, vol. 9, 1997, p. 3572), and also rises with the droplet’s aspect ratio. We propose a semi-analytical correlation to predict this lift force. In the moderate- to high-Reynolds-number regime, distinct behaviours emerge: the $L\hbox{-}$ and $S\hbox{-}$mechanisms, arising from the vorticity contained in the upstream shear flow and the vorticity produced at the droplet surface, dominate for weakly and highly viscous droplets, respectively. Both mechanisms generate counter-rotating streamwise vortices of opposite signs, leading to observed lift reversals with increasing droplet viscosity. Detailed force decomposition based on vorticity moments indicates that in the $L\hbox{-}$mechanism-dominated regime for weakly to moderately viscous droplets, the streamwise vorticity-induced lift approximates the total lift. Conversely, in the $S\hbox{-}$mechanism-dominated regime, for moderately to highly viscous droplets, the streamwise vorticity-induced lift constitutes only a portion of the total lift, with the asymmetric advection of azimuthal vorticity at the droplet interface contributing additional positive lift to counterbalance the $S\hbox{-}$mechanism’s effects. These insights bridge the understanding between inviscid bubbles and rigid particles, enhancing our comprehension of the lift force experienced by droplets in different flow regimes.
Donald Trump has run for president three times with a distinct slogan of “Make America Great Again” (MAGA), endorsing an agenda that advocates for a return to traditional values, renewed support for gender hierarchies, and the exclusion of outsiders. This agenda has received widespread support from Americans mostly along party lines, but partisanship reflects only the tip of the iceberg. Going beyond party, we focus on the existing cross-pressures and intersections between race and gender to demonstrate the importance of attitudes supporting right-wing authoritarianism in explaining how Americans perceive the MAGA agenda. In contrast to the notion that women—characterized as primarily Democrats and supporters of peaceful activism—are less supportive of the MAGA agenda, our analyses demonstrate that white women do not meet this expectation. Utilizing a race-gendered intersectional methodology and data from the 2023 University of Notre Dame Attitudes Toward Democracy Survey (NDATD), we illustrate the nuances of right-wing authoritarianism as a political ideology that works differently across race-gender intersections in driving support for the MAGA agenda. Variation within gender by race, and in complementary fashion within race by gender, reveals crucial insight into the varied reactions within the electorate. Doing so challenges monolithic narratives of women voters and voters of color and highlights the advantages of an intersectional approach to analyzing contemporary politics.
Internationally, the home is legally protected as a bastion of private life, where one may retreat to and recollect oneself after a day’s work and enjoy family life. With the outbreak of the Covid-19 pandemic, working from home – facilitated by new collaborative information and communications technology (ICT) platforms and tools – became mandatory in several countries. For many, the workplace was brought into the home. This article examines how working from home on a mandatory basis during the pandemic affected employees’ perceptions and practices of privacy, and its implications for the legal understanding of privacy. With Norway as a case, it investigates the measures taken by employees and employers to safeguard privacy during this period. The data collection and method combine an interpretation of legal sources with qualitative interviews. The analysis shows experiences and practices that suggest a blurring of roles and physical spaces, and the adoption of boundary-setting measures to safeguard privacy.
We investigate the fluid–solid interaction of suspensions of Kolmogorov-size spherical particles moving in homogeneous isotropic turbulence at a microscale Reynolds number of $Re_\lambda \approx 140$. Two volume fractions are considered, $10^{-5}$ and $10^{-3}$, and the solid-to-fluid density ratio is set to $5$ and $100$. We present a comparison between interface-resolved (PR-DNS) and one-way-coupled point-particle (PP-DNS) direct numerical simulations. We find that the modulated energy spectrum shows the classical $-5/3$ Kolmogorov scaling in the inertial range of scales and a $-4$ scaling at smaller scales, with the latter resulting from a balance between the energy injected by the particles and the viscous dissipation, in an otherwise smooth flow. An analysis of the small-scale flow topology shows that the particles mainly favour events with axial strain and vortex compression. The dynamics of the particles and their collective motion studied for PR-DNS are used to assess the validity of the PP-DNS. We find that the PP-DNS predicts fairly well both the Lagrangian and Eulerian statistics of the particle motion for the low-density case, while some discrepancies are observed for the high-density case. Also, the PP-DNS is found to underpredict the level of clustering of the suspension compared with the PR-DNS, with a larger difference for the high-density case.
Environmental problems have become increasingly evident in post-revolutionary Iran. As a result, the field of environment has come to be a focus of research studies and technical management in the country. The recent proliferation of scientific analyses of the so-called environment indicates that the schemes of modern science are developing to combat the problems therein. Research findings also suggest, however, that environmental discourses and practices are not entirely reducible only to the terms of the natural sciences; distinctively, differing ideas of “nature” are drawn on to conceptualize differing schemes of environmental activities. This article explores how the materiality of national symbols brings to light particular social histories that reflect on and unfold through environmental discourses and practices encountered in Tehran.
Hanging Topic Left Dislocations are widely deemed to constitute root phenomena, though they occasionally appear in embedded contexts. I submit that the apparent embeddability of left dislocations is merely illusory: they are in actuality matrix phenomena in disguise. A novel cross-linguistic contrast is brought to light: in English, subordinate hanging topics are broadly attested, and they can occur with or without a secondary complementizer. In Spanish, by contrast, embedded hanging topics that are not followed by a secondary complementizer are not part of the grammar, a pattern that extends to Dutch. Left-peripheral analyses assuming an elaborated left periphery fall short of capturing this contrast non-stipulatively. Nevertheless, the recent paratactic approach to recomplementation (i.e. double-complementizer) structures, which assumes that such constructions involve two matrix sentences linked paratactically and that the secondary complementizer flags a restart in discourse, provides a more satisfactory account of the English–Spanish asymmetry: the difference between the two languages ultimately reduces to the possibility of omitting subordinating complementizers in English but not in Spanish. On this view, embedded left dislocations are in fact undercover root constructions, in line with their generally accepted characterization as Main Clause Phenomena.
The past two decades have seen many social, political, and international relations (IR) theorists make extensive use of Michel Foucault’s theory of biopolitics—or how political power interacts with biological life. What has so far passed unnoticed, however, is that Foucault formulated his highly influential theory about how living populations became political objects in the context of an overarching concern with what he termed “the power to kill life itself.” This essay reassesses Foucault’s biopolitics in light of his broader discussion of the potentially existential threats posed by nuclear weapons and gene editing technology. In doing so, it invites readers to reassess Foucault’s famous critiques of both sovereignty and political universalism, while also providing a succinct introduction to his theories of power and the general history of anthropogenic existential threats. The article concludes by raising fundamental questions for political and IR theory concerning what happens when the biological survival of the human species ceases to be a necessary prerequisite for politics and instead becomes a contingent outcome of politics.
Distinctness, uniformity and stability (DUS) studies are essential components of assessment and registration processes for plant varieties, including those within the Morus alba species, commonly known as white mulberry. M. alba L. holds a unique place in agriculture sciences due to its historical significance in silk production and its cultivation for its edible fruits. This study provides an overview of DUS studies in M. alba carried out in the Department of Tree Improvement and Genetic Resources, Dr Yashwant Singh Parmar University of Horticulture and Forestry, Nauni, Solan (Himachal Pradesh) India, highlighting the critical features and characteristics evaluated to distinguish between different cultivars. It explores the factors contributing to uniformity and the stability of these characteristics over time, emphasizing the importance of these studies in guiding breeding programmes, supporting agricultural practices and preserving the diversity within this species. The study includes DUS characterization of M. alba germplasm based on 3 qualitative, 11 pseudo-qualitative and 11 quantitative characteristics. DUS studies play a pivotal role in ensuring the accuracy of cultivar identification, thus facilitating the sustainable cultivation and conservation of M. alba, a species with deep-rooted cultural and economic significance. It is concluded that many varieties with distinct and distinguishable characteristics and better economic and genetic values can be registered for their protection under the PPV&FR Act, 2001 and can be used in breeding programmes.