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Amiodarone is a frequently used medication in paediatric patients to manage atrial and ventricular arrhythmias, but its acute haemodynamic effects, particularly in children, remain underexplored. This retrospective, single-centre study aimed to characterise the clinical impact of amiodarone intravenous infusions on heart rate, blood pressure, oxygen delivery, and transaminase levels within the first 48 hours of amiodarone initiation in paediatric cardiac ICU patients.
Methods:
Single-centre, retrospective study of patients receiving amiodarone infusions, with measurements taken at baseline and at various intervals up to 48 hours after initiation. The primary outcome was the effect on heart rate, while secondary outcomes included blood pressure, arterial saturation, near-infrared spectroscopy values, central venous pressure, and transaminase levels. Several types of analysis models were employed to assess the results.
Results:
Data were collected from 87 paediatric patients. No significant changes in liver enzymes, blood pressure, or renal oxygen extraction were observed. These findings provide novel insights into the acute haemodynamic effects of amiodarone infusions in paediatric patients, suggesting that while amiodarone significantly lowers heart rate, it does not substantially affect oxygen delivery or necessitate increased vasoactive support.
Conclusion:
Amiodarone infusions are associated with a significant decrease in heart rate without greatly impacting oxygen delivery or requiring increased vasoactive support. Heart rate decreases most until a cumulative dose of 30,000 mcg/kg, and heart rate decrease is most pronounced in those with ventricular tachycardia.
International organisations (IOs) hold important governance functions and power. Yet, they are several steps detached from the constituencies that have entrusted them with functions and resources to carry them out, even as accountability expectations remain significant for their legitimacy. This article presents a broadly generalisable theoretical framework for understanding the variable accountability of IOs, seeking to advance the understanding of international accountability in three new ways. First, it elaborates on the concept of the scope of IO accountability, which can vary across organisations, over time, and across contexts. The idea of a scope of accountability moves beyond the dichotomy of accountable versus non-accountable power holders and advances an understanding of accountability as a multi-layered phenomenon, whereby both the expectations and practices of accountability can evolve over time and with respect to different audiences. Second, the article identifies three political factors – namely the formal and informal excercise of power, institutional structure, and public salience – that can shape, in important ways, the variable scope of IO accountability. Finally, it critically explores the tensions and contradictions between these political dynamics, and the implications for access to and the efficacy of accountability systems.
In the introduction to this roundtable, we argue that global governance currently faces hard times because it is affected by a set of significant developments revolving around the changing distribution of state power, the rise of nationalist populism, and the frequent occurrence of transnational crises, while seeking to facilitate collective action on complex cooperation problems. Against this backdrop, the essay identifies two major institutional dynamics of global governance in hard times: first, the drift of formal intergovernmental organizations (FIGOs) that is caused by them being gridlocked in a period of significant changes in their social, (geo)political, economic, and technological environment. Second, the proliferation of various types of low-cost institutions. To help us think systematically about how these two interrelated institutional dynamics affect global governance, the essay develops the innovation thesis and the decline thesis. The “innovation thesis” suggests that by transitioning from a rather exclusive and hierarchical system revolving around FIGOs into a more inclusive and heterarchical system revolving around institutional diversity, global governance is currently being adapted to its new environment. The “decline thesis,” by contrast, argues that the two institutional dynamics undermine rules-based multilateralism and may lead to a shift back toward traditional (great) power politics that does not respect institutional constraints.
The rise of visually driven platforms like Instagram has reshaped how information is shared and understood. This study examines the role of social, cultural, and political (SCP) symbols in Instagram posts during Taiwan’s 2024 election, focusing on their influence in anti-misinformation efforts. Using large language models (LLMs)—GPT-4 Omni and Gemini Pro Vision—we analyzed thousands of posts to extract and classify symbolic elements, comparing model performance in consistency and interpretive depth. We evaluated how SCP symbols affect user engagement, perceptions of fairness, and content spread. Engagement was measured by likes, while diffusion patterns followed the SEIZ epidemiological model. Findings show that posts featuring SCP symbols consistently received more interaction, even when follower counts were equal. Although political content creators often had larger audiences, posts with cultural symbols drove the highest engagement, were perceived as more fair and trustworthy, and spread more rapidly across networks. Our results suggest that symbolic richness influences online interactions more than audience size. By integrating semiotic analysis, LLM-based interpretation, and diffusion modeling, this study offers a novel framework for understanding how symbolic communication shapes engagement on visual platforms. These insights can guide designers, policymakers, and strategists in developing culturally resonant, symbol-aware messaging to combat misinformation and promote credible narratives.
The patient, the first of twins, weighed 714 g at birth. On day 14, ultrasound revealed a large methicillin-resistant Staphylococcus aureus-induced atrial vegetation; the tumour grew to 6 mm by day 19. Percutaneous removal was selected due to the risk of pulmonary embolism. We used a three-loop EN Snare system. The procedure was safe and successful.
This article examines the process of drafting the authoritarian Portuguese Constitution of 1933, which took place during the military regime. The aim is to identify the powers involved, their objectives and the strategies they developed, and to find insights that shed light on the adoption of constitutions by authoritarianisms. The results suggest that conflict between political forces is endemic to the constitutional process, and that those who hegemonise support and aim to demilitarise the system are able to impose the new constitution even without guaranteeing the existence of democratic political parties. There is also a promising point of analysis: the emergence of an authoritarian constitution is based on path dependence, ie, it has many links with the material constitutionalism that precedes it, where there are already normalised authoritarian elements.
This article examines how subnational fiscal competition over foreign direct investment affects both the siting of new projects and the ability of local governments to raise tax revenue for social spending. We leverage a quasi-natural experiment, an unexpected declaration by the Brazilian Supreme Court in 2017 that reduced states’ ability to offer investors differentiated tax subsidies. Our results show that disadvantaged regions did not see a major shift in investment patterns after the change in investment law. We do not find a consistent relationship between the incentive law change and state revenue generation, but we do find that incentives are associated with less revenue. The results are consistent with arguments that investment incentives exacerbate inequality by reducing states’ capacity to collect revenue while doing little to affect investment location. Our results illustrate that economic agglomeration is difficult to reverse through tax policy and that fiscal federalism often cannot provide strong enough inducements to drive investment into less advantaged regions.
Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of cancer treatment, significantly affecting patients’ quality of life. Current pharmacological treatments are often ineffective or poorly tolerated, necessitating alternative therapeutic approaches. Scrambler Therapy (ST), a non-invasive neuromodulation technique, has shown potential for reducing neuropathic pain, but optimal dosing regimens remain undefined.
Objective
This case study aims to evaluate the effectiveness of Scrambler Therapy in reducing pain levels and improving functional status in a patient with chemotherapy-induced peripheral neuropathy.
Methods
A single patient diagnosed with CIPN was treated with Scrambler Therapy over a series of sessions. Pain levels and functional status were measured using standardized assessment tools before, during, and after the therapy to evaluate the impact of ST on symptom relief and daily functioning.
Results
After completing the Scrambler Therapy sessions, the patient reported significant reductions in pain intensity and notable improvements in functional status. These improvements were sustained several weeks and months following the therapy, indicating the potential long-term benefits of ST for managing CIPN.
Conclusion
This case study demonstrates the potential of Scrambler Therapy as an effective treatment option for reducing pain and improving functional status in patients with chemotherapy-induced peripheral neuropathy. These findings suggest that ST may provide a promising non-invasive alternative to current treatments for managing neuropathic pain in cancer patients.
Determining whether cryptic remnant animal populations survive within specific landscapes is a conservation challenge and may require multiple types of information. Hainan Island, China, has lost most of its large mammal fauna, with no recent evidence for persistence of large carnivores. We conducted a survey of local ecological knowledge in communities around seven protected areas in 2015, collecting sighting reports of the Asiatic black bear Ursus thibetanus. Respondents living near Wuzhishan National Nature Reserve reported the highest number of dated sightings as well as the most recent sightings. In follow-up interviews, wildlife rangers at Wuzhishan reported recent signs of bears and local hunting, and a possible bear photograph was taken inside the Reserve in 2017. Characteristic bear signs, including fresh diagnostic claw marks on trees, were detected at Wuzhishan in 2021, confirming bear presence. Wuzhishan is the last area in Hainan where large herbivores and carnivores survive, and where local conservation efforts still have the potential to maintain functional forest ecosystems that support megafaunal assemblages.
In Wisconsin, herbicide resistance in waterhemp [Amaranthus tuberculatus (Moq.) Sauer] has been confirmed to five herbicide sites of action, including protoporphyrinogen oxidase (PPO) inhibitors. Following a report of a suspected PPO inhibitor–resistant A. tuberculatus population (A92 accession), our objective was to characterize resistance to PPO inhibitors applied preemergence or preemergence to this accession, along with two PPO inhibitor–susceptible control accessions (A66 and A82). We hypothesized that PPO-inhibitor resistance in A92 was driven by target site–resistance mechanisms. According to our results, the A92 accession is resistant to sulfentrazone (3.1-fold; P-value = 0.0278) and fomesafen (3.1-fold; P-value = 0.0745) preemergence and to lactofen (18.6-fold; P-value = 0.0003) and fomesafen (5.9-fold; P-value= < 0.0001) preemergence. Resistance to PPO inhibitors was not explained by the presence of any known target-site mutations in PPX1 or PPX2 genes. Our study represents the first confirmed case of an A. tuberculatus accession resistant to PPO inhibitors applied preemergence in Wisconsin. Consistent with previous research, our results demonstrate that the A92 accession, compared with control accessions, is less sensitive to fomesafen regardless of the application timing. Further research is necessary to identify other potential PPO-inhibitor resistance mechanisms in the A92 accession, including potential non–target site resistance mechanisms associated with cytochrome P450 monooxygenases or glutathione S-transferases.
The current study probes Mandarin-learning toddlers’ sensitivity to two grammatical noun phrase orders differing in typological markedness. With three visual fixation experiments, we find that by age 2;6, children distinguish the cross-linguistically common order – but not the typologically rare one – from an ungrammatical order; however, their sensitivity to the two grammatical orders does not differ significantly. Further, we conduct a corpus analysis and demonstrate that for early acquisition, both grammatical orders are neither sufficiently nor consistently supported in the linguistic input. The sensitivity patterns and input profile outlined in our study constitute the first step of testing, in a natural language setting, a bias for typologically common ordering discussed in the artificial language learning literature. Although the findings remain inconclusive, they underscore the potential for future investigations in this direction.
In this paper, we consider an approach introduced in term rewriting for the automatic detection of non-looping non-termination from patterns of rules. We adapt it to logic programing by defining a new unfolding technique that produces patterns describing possibly infinite sets of finite rewrite sequences. We present an experimental evaluation of our contributions that we implemented in our tool NTI (Non-Termination Inference).
The influence of compressibility on shear flow turbulence is investigated within a self-preservation framework. This study focuses on the axisymmetric jet to examine compressibility effects in a slowly spatially evolving flow, unlike mixing layers, where the convective Mach number remains constant. Revisiting self-preservation, an a priori description of the compressible scaling for Reynolds stresses and higher-order velocity moments is developed. Turbulence moments are found to scale with powers of the spreading rate, suggesting Reynolds stress anisotropy results from compressibility effects consistent with self-preservation of the governing equations. Particle image velocimetry measurements for Mach 0.3 and perfectly expanded Mach 1.25 jets confirm the scaling predictions. The attenuation function, $\varPhi (M_c)$, describing the relationship between the convective Mach number, $M_c$, and the spreading rate, follows a similar trend in jets and mixing layers, where a higher $M_c$ results in reduced spreading rates. In the jet where $M_c$ decays, the relationship between the local $M_c$ and turbulence attenuation remains captured through $\varPhi (M_c)$, which scales proportionally with the spreading rate. A new scale is introduced, where the pressure in the mean momentum equation is substituted. The difference between the streamwise and radial-Reynolds-normal stresses was found to be a scale which is independent of Mach number and spreading rate. Further analysis of the Reynolds-stress-transport budget shows that internal redistribution of energy occurs within the Reynolds-normal stresses, and the role of pressure modification in turbulence attenuation supports previous observations. These findings confirm that the compressible axisymmetric jet exhibits self-preservation, with scaling extending into supersonic regimes.
This study examines the interplay between psychological contract fulfillment, distributive justice, and leader–member exchange (LMX) in shaping affective organizational commitment among university academics. Drawing on social exchange theory, and using simple random sampling, we propose a moderated mediation model to explore how these variables interact. To test the hypotheses, we used the linear moderated mediation test, applying PROCESS for SPSS. Specifically, on a sample of 465 academics, the study tests the hypothesis that distributive justice mediates the relationship between psychological contract fulfillment and affective commitment, with LMX acting as a moderator. Findings reveal that distributive justice is not always necessary for fostering affective commitment when psychological contracts are fulfilled, unless the quality of LMX is low. In low-quality leader–member relationships, perceptions of distributive justice become crucial when it comes to translating contract fulfillment into affective commitment. These results highlight the importance of relational dynamics in academic settings, especially when resources are limited. The study concludes with a discussion of its theoretical and practical implications, as well as limitations and avenues for future research.