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Pulmonary valve replacement in small children is rarely needed; when performed, it is usually done surgically. Herein, we describe a hybrid technique for pulmonary valve replacement through a small subxiphoid incision in a Toddler without utilising the cardiopulmonary bypass machine. The procedural technique is thoroughly explained. Collaboration between paediatric cardiology and cardiovascular surgery teams achieved optimal outcome with minimised invasiveness.
We report an uncommon case of tetralogy of Fallot with absent pulmonary valve and extreme right pulmonary artery dilatation in patient with 22q11.2 deletion syndrome.
In this paper, fractional-order (FO), intelligent, and robust sliding mode control (SMC) and stabilization of inherently nonlinear, multi-input, multi-output 6-DOF robot manipulators are investigated. To ensure robust control and better performance of the robot system, significant studies on various control transactions have been explored. First, a sliding proportional-integral-derivative (PID) surface is conceived and then its FO constitute is developed. It is an important fact that in SMC, the reaching phase is fast and the chattering is abated in the sliding phase. In particular, the discontinuity in the SMC is prevented in view of the boundary layer obtained by recommending the sigmoid function together with fuzzy logic to eliminate the chattering phenomenon. A hybrid tuning method consisting of gray wolf optimization and particle swarm optimization (GWO-PSO) algorithms is applied to tune the parameters of PID sliding mode control (PIDSMC), FO PIDSMC (FOPIDSMC), fuzzy PIDSMC (FPIDSMC), and FO fuzzy PIDSMC (FOFPIDSMC) controllers. In simulation results, the tuned FOFPIDSMC controller consistently outperforms PIDSMC, FOPIDSMC, and FPIDSMC controllers tuned by the GWO-PSO in dynamic performance, trajectory tracking, disturbance rejection, and mass uncertainty scenarios. It has been seen through a thorough performance analysis that 91.93% and 44.13% improvement are, respectively, obtained for mean absolute error (MAE) and torques root mean square (RMS) values of the joints when using from the PIDSMC to the FOFPIDSMC. Finally, the simulation outcomes reveal the superior aspects of the designed FOFPIDSMC and also demonstrate that the FOFPIDSMC controller enhances the dynamic performances of the 6-revolute universal robots 5 (6R UR5) robot manipulator under a variety of operating conditions.
Where, on the face of a contract, the existence of a debt is conditional on the occurrence of a particular fact, and that fact has not occurred, because the person who promised payment has prevented it from occurring, does the debt arise nevertheless on the notion that the condition is then to be deemed fulfilled? In King Crude Carriers SA v Ridgebury November LLC,1 a unanimous Court of Appeal, reversing the judge, endorsed the effect of that notion while appearing to resituate it as a matter of contractual construction, based upon the objective intention of the contracting parties. That would be a step in the right direction. The precise nature of that notion remains murky, however, and would profit from further clarification.
This article traces the evolution of Sidney Weintraub’s Post-Keynesian identity during the four decades following WW II, as seen through the eyes of his son E. Roy Weintraub. I explore Roy’s notion that Sidney’s career can be seen as the result of defense mechanisms associated with those of a borderline personality, such as splitting and projection. As Sidney transformed from an aspiring mainstream macroeconomist into a reclusive warrior for ideas, developing a polarized view of the economics profession, his work eventually became subsumed as a branch of Post-Keynesian economics. At the same time, he nudged his son into a symbiotic dependency, standing in for his career as a mathematical economist and coauthor, while also being made complicit in his adultery. Roy’s eventual distancing from this role ultimately led to a rupture prior to Sidney’s death in 1983. It was only then that Roy was able to establish a scholarly profile as a historian of economics and gain the understanding of his father that informs this text.
The present study describes the feeding effects of Neoseiulus cucumeris Athias-Henriot (Acari: Phytoseiidae) on western flower thrips (WFT), Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae) and two-spotted spider mite (TSSM), Tetranychus urticae Koch (Acari: Tetranychidae). In addition, daily and total predation capacity, preference, and prey switching potential of this predator were studied on both pest species. WFT had a boosting effect on the biological parameters of N. cucumeris, primarily resulting in shorter developmental time, higher fecundity, and higher population growth potential than TSSM. Although immatures and males of N. cucumeris consumed significantly more TSSM than WFT, there was no significant difference in net predation rate, stable and finite predation rates of the predator between two prey species. We found an average of 10.58 and 7.93 TSSM and WFT are required to produce a single predator egg, respectively. WFT is preferred over TSSM by the predator. Negative switching behaviour was seen in N. cucumeris as it switched from the abundant prey to the rare prey. Both prey species were suitable for N. cucumeris, being able to develop successfully on them. The predator performed optimally on WFT compared with TSSM owing to its enhanced biological parameters as well as its preference, indicating that thrips are a more relevant resource than spider mites.
The elusive southern river otter (Lontra provocax; huillín in Spanish) is critically endangered in the Argentine portion of Tierra del Fuego, and low social awareness may be one of the major threats to its conservation. Our survey of local residents’ knowledge and valuation of the huillín showed that only 14% recognized photographs of the species, almost half did not know that it is endangered and most erroneously thought it was an introduced species. Greater knowledge about the huillín was related to higher respondent education levels. Younger and more knowledgeable residents valued the species more for ecological and relational reasons; its instrumental value was considered least important. More communication should be targeted at older people and groups not directly interacting with nature via informal education methods, including combining positive messages about the huillín and other native species with ongoing outreach efforts warning about biological invasions. Understanding perceptions and valuations of biodiversity can make conservation efforts more effective and inclusive.
In One Savings Bank plc v Catherine Waller-Edwards,1 the Court of Appeal considered – for the first time – whether banks are put on constructive notice to potential undue influence in joint benefit remortgage/suretyship hybrid transactions. At a time where there is an increasing awareness of economic abuse as a form of domestic abuse,2 this appeal offered an important opportunity to reassess banks’ responsibilities in assisting potential victim-survivors. Unfortunately, that opportunity was not seized. In this case comment, I set out the negative impacts the Court of Appeal judgment could have on victim-survivors of economic abuse going forward, and how these concerns could – since this case has now been given leave to appeal – be addressed by the Supreme Court.
The relationships between the Japanese beetle (JB) Popillia japonica Newman, 1841 and the grapevine agroecosystem were investigated in Piedmont in 2020 and 2021, to assess the impact of the species and its distribution within vineyards in relation to the proximity of environmental risk factors. Grubs were sampled by soil coring in the inter-rows of vineyards, whereas both adult beetles and defoliation were counted directly on grapevine plants. The presence of spatial autocorrelation was assessed and the influence of environmental variables (distance from woodlands, meadows and the margin of the vineyard, soil parameters, year of sampling, and year of first detection of the JB) was evaluated through generalized linear mixed models. Beetles and defoliation were more clustered at the edges of vineyards, whereas grubs were localized in few hot spots, generally close to meadows. Spatial autocorrelation was weaker for grubs with respect to adults and defoliation. Grub density depended on distance from meadows, and partially on soil features. Adults abundance was influenced by the proximity to meadows, woodlands, and their presence was clustered at the margin of vineyards. The JBs seem to rely on grapevine mainly as a food source rather than a reproductive site, preferring meadows for egg-laying: therefore, pest management in vineyards should be more focused on adult beetles rather than larvae in the vineyard inter-rows.
Employees’ organizational citizenship behavior (OCB) is an important determinant of organizational effectiveness; hence, scholars and practitioners are particularly interested in the factors, mechanisms, and conditions that promote such behaviors. Guided by the ability–motivation–opportunity framework, we draw on the social cognitive theory of moral thought and action to conceptualize a model that delineates the role of ethics-oriented human resource management (HRM) systems in promoting OCBs through the mediating role of employees’ moral attentiveness. We also refer to the job demands–resources theory to describe the moderating role of work-family balance in the indirect relationship between HRM systems and OCBs. The findings of an experiment involving 157 working adults (Study 1) and a three-wave field survey of 328 employees (Study 2) converge to support the hypothesized direct and indirect (via moral attentiveness) relationships between ethics-oriented HRM systems and OCBs as well as the first-stage moderating role of work-family balance.
A youth mental health crisis is considered one of the great challenges of our time, and research and clinical services in child and adolescent psychiatry have become a priority for governments and funders. Academic leadership is needed to drive forward research. It is not clear how many senior academic leadership posts (professorships) there are in child and adolescent psychiatry, nor how this benchmarks against a similarly sized medical specialty.
Aims
This study aimed to determine the number of professorships in child and adolescent psychiatry in the UK and Ireland compared to a similarly sized specialty. A secondary aim was to identify the number of clinical trials registered for mental and behavioural disorders in children.
Method
We identified registered specialists in child and adolescent psychiatry and a similarly sized specialty who held full professorships in medical schools. We searched the International Standard Randomised Controlled Trial Number (ISRCTN) and ClinicalTrials.gov for trials.
Results
As of 23 March 2023, there were 1725 doctors on the General Medical Council's (GMC) specialist register in child and adolescent psychiatry. The closest specialty in terms of number of registered specialists was neurology (N = 1724). We identified 24 professors in child and adolescent psychiatry across the UK and Ireland, compared to 124 in neurology. For every intervention trial registered for mental and behavioural disorders in children, there were approximately ten trials registered for diseases of the nervous system.
Conclusions
Despite equivalent numbers of medical specialists in child and adolescent psychiatry and neurology, there is a striking disparity in the number of professorship appointments. While young peoples’ mental health has, ostensibly, become a priority for policy-makers and funders, this is not reflected in medical professorship appointments. The paucity of senior academic child and adolescent psychiatrists has real-world implications for training, research, innovation and service development in mental health services.
Natasha Abrahart was a physics student at the University of Bristol. She was suffering from depression and social anxiety disorder, which seriously impacted her ability to partake in oral assessments. Eventually, Natasha sadly took her own life. Her father, Dr Robert Abrahart, as personal representative and estate administrator, sued the University of Bristol for negligence and breach of sections 15, 19 and 20 of the Equality Act 2010, read with section 91(2)(a) and/or (f) of the same Act.1 Under such provisions, universities have a duty to provide reasonable adjustments and support, in educational provision and assessments, to disabled students, defined by section 6(1) of the Equality Act 2010 as ‘a physical or mental impairment’ which has ‘a substantial and long-term adverse effect’ on the ability to ‘carry out normal day-to-day activities’. However, Schedule 13, para 4(2), to the Equality Act 2010 exempts those assessments which constitute a competency standard, defined as ‘an academic, medical or other standard applied for the purpose of determining whether or not a person has a particular level of competence or ability’.2
This study aims to assess the therapeutic effects of probiotic oral therapy in paediatric patients with anorexia nervosa (AN) and to investigate its impact on intestinal flora composition, brain–gut peptide levels and overall clinical outcomes. A retrospective study was conducted involving 100 children diagnosed with AN at Xingtang County People’s Hospital between January 2023 and June 2024. Patients were divided into two groups: a control group (n 50) receiving zinc gluconate oral solution alone and an observation group (n 50) receiving zinc gluconate plus probiotics. Outcome measures included intestinal flora analysis, brain–gut peptide levels (somatostatin (SS) and nitric oxide (NO)), clinical efficacy, serum trace element levels (Ca, Zn and Fe) and prognosis, including recurrence rates 6 months post-treatment. Baseline characteristics were similar between the two groups (P > 0·05). After treatment, the observation group showed significantly higher levels of Bifidobacterium and Lactobacillus and lower levels of Enterobacter compared with the control group (P < 0·05). Additionally, the observation group had lower levels of SS and NO (P < 0·05), indicating improved brain–gut communication. Clinical efficacy was significantly higher in the observation group (P < 0·05), with improved serum trace element levels (P < 0·05 for Ca, Zn and Fe). Furthermore, the recurrence rate 6 months post-treatment was significantly lower in the observation group compared with the control group (P < 0·05). Probiotic supplementation in children with AN effectively modulates intestinal flora, improves brain–gut peptide levels and enhances clinical outcomes.
H. H. Chan, K. S. Chua and P. Solé [‘Quadratic iterations to $\pi $ associated to elliptic functions to the cubic and septic base’, Trans. Amer. Math. Soc.355(4) (2002), 1505–1520] found that, for each positive integer d, there are theta series $A_d, B_d$ and $C_d$ of weight one that satisfy the Pythagoras-like relationship $A_d^2=B_d^2+C_d^2$. In this article, we show that there are two collections of theta series $A_{b,d}, B_{b,d}$ and $C_{b,d}$ of weight one that satisfy $A_{b,d}^2=B_{b,d}^2+C_{b,d}^2,$ where b and d are certain integers.
As relations between the United States and China have grown tenser, how has the Chinese Communist Party's (CCP) portrayal of the United States changed? And what might portrayals of the United States tell us about domestic messaging in China? This study systematically investigates CCP messaging about the United States in the contemporary era. To do this, we hand code, categorize and analyse 1,761 editorials about the United States published between 2003 and 2022 in People's Daily, the Party's flagship newspaper. In addition to showing a sustained rise in critical portrayals since 2018, we identify and elaborate three distinct critical narratives about the United States: it is a dangerous hegemon abroad, it has poor values at home, and it is increasingly weak and in decline. These narratives appear both independently and in combination and are often framed to contrast with portrayals of China. We argue that these narratives are not just negative propaganda to discredit the United States but can also be a strategy to promote a positive vision of the CCP's virtues and governance at home. This study contributes empirically and theoretically to research on propaganda and legitimation in China.
In 2017, the authors supervised the recovery of a pre-Hispanic stone sculpture near the community of La Victoria, in the Sierra de los Tuxtlas, southern Veracruz, Mexico. The fortuitous discovery of this monument afforded a rare research opportunity to conduct a controlled, systematic archaeological investigation of a known, but poorly documented, Early Classic–period (a.d. 300–450) sculptural tradition. Moreover, this archaeological salvage project facilitated a crucial dialogue with local stakeholders regarding the recovery and final disposition of the monument. This collaborative effort enabled researchers to wed governmental oversight and academic interests with the concerns of local stakeholders, thereby furthering the investigation, conservation, and public appreciation of Classic-period archaeology along Mexico's southern Gulf Lowlands.
The current review will examine the field of food intake biomarkers and the potential use of such biomarkers. Biomarkers of food intake have the potential to be objective measures of intake thus addressing some of the limitations associated with self-reported dietary assessment methods. They are typically food-derived biomarkers present in biological samples and distinct from endogenous metabolites. To date, metabolomic profiling has been successful in identifying several putative food intake biomarkers. With respect to food intake biomarkers, there has been a proliferation of publications in this field. However, caution is needed when interpreting these as food intake biomarkers. Many have not been validated thus hampering their use. While much of the focus to date is on discovery of food intake biomarkers there are excellent examples of how to utilise these biomarkers in nutrition research. Applications include but are not limited to: (1) measurement of adherence to diets in intervention studies (2) objectively predicting intake with no reliance on self-reported data and (3) calibrating self-reported data in large epidemiological studies. Examples of these applications will be covered in this review. While significant progress is achieved to date in the food intake biomarkers field there are a number of key challenges that remain. Examples include lack of databases focused on food-derived metabolites thus hindering the discovery of new biomarkers and the need for new statistical approaches to deal with multiple biomarkers for single foods. Addressing these and other key challenges will be key to development of future opportunities.