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Observers were randomized to time and location across two different Neonatal Intensive Care Units (NICUs) to count hand hygiene opportunities (HHOs). Mean hourly HHO was lower at night and during use of precautions, and higher in shared rooms. HHO benchmarks can support implementation of group electronic monitoring systems in NICUs.
Sudden cardiac death is a significant concern among patients with congenital heart disease (CHD). We assessed the risk of remote sudden cardiac death after congenital heart surgery.
Methods:
Patients undergoing congenital heart surgery before 21 years of age between 1982 and 2003 in the Pediatric Cardiac Care Consortium registry were linked to National Death Index data through 2019. Sudden cardiac death was defined as death associated with a cardiac arrest or ventricular fibrillation diagnosis code. Standardised mortality ratios relative to the general population were calculated using Centers for Disease Control and Prevention data.
Results:
Among 30,566 patients discharged after their initial surgery, 2,718 deaths occurred over a median period of 23 years (IQR 19–27). Of 463 (17%) sudden cardiac deaths, the median age was 1.7 years (IQR 0.5–16.5). The mean incidence was 7 per 10,000 person-years (95% CI: 0.64–0.77), ranging from 2.7 for left-to-right shunt lesions to 37 for single-ventricle physiology. Cardiac comorbidities including heart failure (13.6%) and arrhythmias (7.1%) were more frequent among sudden cardiac death patients. Standard mortality ratios for sudden cardiac death were elevated across all CHD types, ranging from 8.0 (95% CI: 6.3–9.6) for left-to-right shunts to 107.7 (95% CI: 88.9–126.5) for single-ventricle physiology.
Conclusion:
Sudden cardiac death risk is higher post-congenital heart surgery compared to the general population. Even patients with mild CHD are at risk, highlighting the need for long-term follow-up for all patients. Heart failure and arrhythmia prevalence suggest potential therapeutic targets to reduce sudden cardiac death risk.
The room-temperature X-ray powder diffraction data for bosentan monohydrate, an API used in the treatment of pulmonary arterial hypertension, is presented. Bosentan monohydrate is monoclinic, P21/c (No. 14), with unit cell parameters a = 12.4520(7) Å, b = 15.110(1) Å, c = 15.0849(9) Å, β = 95.119(5)°, V = 2827.0(3) Å3, Z = 4. All the diffraction maxima recorded were indexed and are consistent with the P21/c space group. The crystal structure of this material corresponds to the phase associated with Cambridge Structural Database entry NEQHEY, which was determined at 123 K. The successful Rietveld refinement, carried out with TOPAS-Academic, showed the single-phase nature of the material and the good quality of the data. A comprehensive analysis of intra- and intermolecular interactions corroborates that the structure is dominated by extensive hydrogen bonding, accompanied by C▬H⋯π and π⋯π interactions. Hirshfeld surface analysis and fingerprint plots indicate that the most important interactions are H⋯H and O⋯H/H⋯O in bosentan and the water molecule and C⋯H/H⋯C interactions in bosentan.
Low birthweight is a risk factor for type 2 diabetes. We hypothesised that differential associations between birthweight and clinical characteristics in persons with and without type 2 diabetes may provide novel insights into the role of birthweight in type 2 diabetes and its progression. We analysed UK Biobank data from 9,442 persons with and 254,446 without type 2 diabetes. Associations between birthweight, clinical traits, and genetic predisposition were assessed using adjusted linear and logistic regression, comparing the lowest and highest 25% of birthweight to the middle 50%. Each kg increase in birthweight was associated with higher BMI, waist, and hip circumference, with stronger effects in persons with versus without type 2 diabetes (BMI: 0.74 [0.58, 0.90] vs. 0.21 [0.18, 0.24] kg/m2; waist: 2.15 [1.78, 2.52] vs. 1.04 [0.98, 1.09] cm; hip: 1.65 [1.33, 1.97] vs. 1.04 [1.04, 1.09] cm). Family history of diabetes was associated with higher birthweight regardless of diabetes status, albeit with a twofold higher effect estimate in type 2 diabetes. Low birthweight was further associated with prior myocardial infarction regardless of type 2 diabetes status (OR 1.33 [95% CI 1.11, 1.60] for type 2 diabetes; 1.23 [95% CI 1.13, 1.33] without), and hypertension (OR 1.25 [1.23, 1.28] and stroke 1.24 [1.14, 1.34]) only among persons without type 2 diabetes. Differential associations between birthweight and cardiometabolic traits in persons with and without type 2 diabetes illuminate potential causal inferences reflecting the roles of pre- and postnatal environmental versus genetic aetiologies and disease mechanisms.
This agenda identifies future research trajectories for the corpus revolution, proposing five specific research tasks designed to explore and advance the application of corpus linguistics in language education. These tasks focus on: (1) contrastive data-driven learning, (2) the development of corpus research for informing national language curricula, (3) the use of artificial intelligence for corpus informed language teaching and learning, (4) the reconsideration of the design and development of pedagogical corpora, and (5) the need for stakeholder engagement with corpus research design. Addressing these tasks requires a unified and collaborative effort as they sit at a number of key intersections in corpus applications to language pedagogy. We ask scholars executing them to engage in broad and cooperative research to meet the evolving needs of learners globally, to examine the potential of corpus linguistics for addressing new challenges in language education, and to influence and shape future directions in applied linguistics.
Evolution of solitary waves and an undular bore intruding through an abrupt transition from a wide basin into a narrow channel with opposing current is investigated. The laboratory experiments are performed in a wave tank that is crafted to achieve a steady and symmetrical shallow-water jet in the basin. The channel has a breadth comparable to the wave lengths, and the flow has Froude number approximately 0.1. The opposing current amplifies and slows the incoming waves on the jet in the basin, but the propagation speed is faster than the local Doppler effect of the current due to the influence of the wave propagating in the flank of the jet. At the channel mouth, the wave amplitude is enhanced due to the waveform altered by the current in the basin, although the amplification in the upstream channel is similar with and without the current. The longer incident waves have greater amplification into the channel. The leading wave of the undular bore is impacted by the opposing flow and transition similarly to the solitary waves. In contrast, the subsequent waves of the undular bore have a complex phase interference on the jet that causes disconnection in the lateral wave formation across the breadth of the jet. At the transition, the subsequent waves exhibit greater amplification than the leading one due to accumulated wave energy at the channel mouth. The intrusion of the undular bore against the current further enhances a rise in mean water level in the channel.
The study analysed corn harvested areas from 1960 to 2030, using data from the USDA open-access official dataset and 1000 autoregressive integrated moving average models. The global corn harvested area experienced a steady growth rate of 1.0 % in the 1960s, followed by a slight setback in the 1980s and a recovery in the 1990s. The early 2000s saw significant expansion, while the 2010s saw a slightly slower pace of 1.4 %. From 2020 to 2024, the global growth rate declined to 0.0 %, suggesting a potential shift towards a more stable or slower growth phase. The most likely scenario for the global corn area is an optimistic outlook with a 37 % likelihood of steady growth. China’s most likely scenario is a gradual expansion with a rate of 2.0 %. The United States’ most likely scenario suggests a neutral trend. Brazil has remarkable growth trajectories in its areas, reflecting land availability. Ukraine’s area by 2030 is projected to experience varying outcomes due to uncertainties in the agricultural landscape.
Bergelson and Richter [‘Dynamical generalizations of the prime number theorem and disjointness of additive and multiplicative semigroup actions’, Duke Math. J.171(15) (2022), 3133–3200] established a new dynamical generalisation of the prime number theorem (PNT) and the PNT for arithmetic progressions. Let $h\ge 1, k\ge 2$. Mirsky [‘Note on an asymptotic formula connected with r-free integers’, Quart. J. Math. Oxford Ser.18 (1947), 178–182] showed that the numbers n such that $n+l_1,\ldots , n+l_h$ are k-free have a natural density for any given nonnegative integers $l_1,\ldots , l_h$. In this note, we show that the Bergelson–Richter theorem holds for the numbers studied by Mirsky.
The bauxite beneficiation process in the Amazon generates a significant amount of tailings, which were historically stored in large basins without a designated purpose. One of these materials is clay obtained from the bauxite washing process, which is rich in Al2O3 minerals, primarily gibbsite and kaolinite, and currently lacks practical applications. This study aimed to explore an application of this tailing in the production of low-temperature geopolymers, considering its material characteristics and availability. Geopolymer synthesis was conducted following a Doehlert-type experimental design to evaluate the properties of the raw materials. The tailing was characterized by X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), thermogravimetry-differential scanning calorimetry (TG-DSC), X-ray fluorescence (XRF), and inductively coupled plasma optical emission spectroscopy (ICP-OES), whereas the geopolymers were characterized by XRD, FTIR, and mechanical compressive strength testing. The mineralogical composition of the bauxite tailings consists of 45% of low-ordered kaolinite, 34% of gibbsite, and 21% of other minerals. Compressive strength values of the geopolymer produced ranged from 8.99 to 41.89 MPa, a good value for the type of geopolymer produced. The best compressive strength results were obtained at a low Na/Al ratio (0.5–0.6) and low curing temperature, which favors the application of the material for the synthesis of geopolymer, contributing to lower energy consumption and lower CO2 emissions compared with usual geopolymers.
Reliable seasonal weather forecasts are essential for irrigation management and crop yield prediction, particularly in regions with limited water resources. This study aimed to improve the usability of the North American Multi-Model Ensemble (NMME), an experimental real-time seasonal weather forecast system, for regional crop modelling and irrigation decision-making. Coarse resolution of NMME may introduce bias and uncertainty at regional/local scales. To address this, a statistical downscaling method with bias correction for both mean and variability was used to produce 1-km gridded daily weather projections for temperature and precipitation across the contiguous United States from a representative NMME model, the Canadian Coupled Climate Model version 4 (CanCM4). The daily surface weather and climatological summaries (DAYMET) data were used to calibrate the downscaled hindcast projections of CanCM4. The reliability of downscaled CanCM4 forecasts for local crop modelling was evaluated at lead times of up to six months using a calibrated DSSAT model at a research station in the semi-arid Texas Rolling Plains region. Cross-validation during the hindcast period demonstrated strong forecast skill, with R2 values of 0.72 and 0.71 for maximum and minimum temperatures, respectively. The precipitation forecast remained sensitive to extreme events, with seasonal and annual relative errors of 31 and 1 %, respectively. Crop yield predictions had a relative error of 9 %, and irrigation water requirements closely matched field observations, outperforming both raw CanCM4 and multi-model mean methods. The downscaling method used in this study significantly improved NMME data reliability, although the degree of improvement may vary with time and location.
Transcatheter pulmonary valve replacement is the first choice to treat residual or recurrent right ventricular outflow tract dysfunction. Surgery is an effective option when anatomy is not permissive for transcatheter procedures. When surgical risk is too high, hybrid procedures might be considered.
In this paper, we describe the first use of Harmony valve in Europe in a 59 years old patient with a huge right ventricular outflow tract. The procedure was performed by a hybrid approach: before valve deployment, through an anterior mini-thoracotomy, the pulmonary artery was plicated to create a landing zone. The valve was deployed by trans-femoral venous approach. It was secured by putting a suture on the distal stent raw under fluoroscopic guidance. The procedure was uneventful and patient’s New York Heart Association class rapidly improved from III–IV to II.
In conclusion, hybrid strategies might represent an acceptable option for huge right ventricular outflow tract, to be less invasive and to minimise device embolisation risks. When a good match between patient’s anatomy and device can be achieved, a mini-invasive or micro-invasive surgical approach might be considered to minimise bleeding risks and shorten the hospital’s length of stay.
The crystal structure of diroximel fumarate has been solved and refined using synchrotron X-ray powder diffraction data, and optimized using density functional theory techniques. Diroximel fumarate crystallizes in space group P-1 (#2) with a = 6.12496(15), b = 8.16516(18), c = 12.7375(6) Å, α = 85.8174(21), β = 81.1434(12), γ = 71.1303(3)°, V = 595.414(23) Å3, and Z = 2 at 298 K. The crystal structure consists of interleaved double layers of hook-shaped molecules parallel to the ab-plane. The side chains form the inner portion of the layers, and the rings comprise the outer surfaces. There are no classical hydrogen bonds in the structure, but 9 C▬H⋯O hydrogen bonds contribute to the crystal energy. The powder pattern has been submitted to ICDD for inclusion in the Powder Diffraction File™ (PDF®).
Thomassen’s chord conjecture from 1976 states that every longest cycle in a $3$-connected graph has a chord. The circumference $c(G)$ and induced circumference $c'(G)$ of a graph G are the length of its longest cycles and the length of its longest chordless cycles, respectively. Harvey [‘A cycle of maximum order in a graph of high minimum degree has a chord’, Electron. J. Combin.24(4) (2017), Article no. 4.33, 8 pages] proposed the stronger conjecture: every $2$-connected graph G with minimum degree at least $3$ has $c(G)\geq c'(G)+2$. This conjecture implies Thomassen’s chord conjecture. We observe that wheels are the unique Hamiltonian graphs for which the circumference and the induced circumference differ by exactly one. Thus, we need only consider non-Hamiltonian graphs for Harvey’s conjecture. We propose a conjecture involving wheels that is equivalent to Harvey’s conjecture on non-Hamiltonian graphs. A graph is $\ell $-holed if all its holes have length exactly $\ell $. We prove that Harvey’s conjecture and hence also Thomassen’s conjecture hold for $\ell $-holed graphs and graphs with a small induced circumference.
This article opens with a mystery: why was Zizang 子臧 assassinated in the seventh century bce, and why was his assassination justified in the Zuozhuan by his fondness of snipe-feather caps? It is well established that feathers were a common item of clothing in early and medieval China, used to confer status, to flaunt wealth, to embellish rituals. This article argues that there may also have been accompanying beliefs surrounding their use; beliefs that feathers might bestow upon the wearer certain imagined characteristics of the birds from which they came. It uses case studies of soldiers and their relationship to brown-eared pheasants, dancers and their relationship to long-tailed pheasants, and immortals and their relationship to cranes and egrets. Finally, it returns to Zizang's snipe-feather cap, and suggests reasons for his fate.
The Thamudic D script is only partially deciphered. This article attempts to advance our understanding of the script by identifying all the Thamudic D glyphs and their phonemic values with varying degrees of certainty. It also discusses the major writing formulae associated with this script type and offers a few notes on the language it inscribes.
On the basis of textual scrutiny and intertextual comparisons, this study highlights that Vādidevasūri's attribution of a quotation to the Cārvāka/Lokāyata philosopher Udbhaṭabhaṭṭa in the Syādvādaratnākara is, in fact, part of a broader passage sourced from Arcaṭa's Hetubinduṭīkā and, consequently, its expungement from the corpus of source material attributed to the Cārvāka/Lokāyata authors is suggested.
Adopting a human rights-based approach, this paper scrutinizes the treatment of illicit trafficking in cultural property as a human rights issue. The study focuses on the Iraqi contribution to the international agenda, revealing that Iraq co-sponsored at least 13 UN resolutions on the restitution of illegally expropriated cultural property, actively contributing to the negotiation of others, along with submitting its legal opinions on the drafts of relevant international documents, starting from as early as 1936 to culminate with the calls to stop cultural plunder feeding Western markets since the 1990s. Centering the Iraqi voices and adopting a critical decolonial rights-based perspective, the study showcases how illicit trade in cultural property clearly emerges as a violation of a state’s permanent sovereignty over its wealth and resources, negatively impacting its ability to guarantee the right to pursue economic, social, and cultural development for its people, as well as to freely dispose of their resources, the key components of the right to self-determination.