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As the Association for European Paediatric and Congenital Cardiology, the largest paediatric cardiology organisation globally, we are dedicated to safeguard the health, safety, and wellbeing of children, adolescents, and adults with congenital and acquired heart disease, as well as to support the professionals who care for them across the globe. As both a scientific and ethical community, we are profoundly troubled by the devastating humanitarian consequences of armed conflicts. Across the world, we are witnessing an immense toll on civilians, particularly children, who are always the most vulnerable in times of war. The destruction of healthcare infrastructure, obstruction of access to medical care, and the severe psychological and physical trauma endured by children are deeply alarming. While the Association for European Paediatric and Congenital Cardiology does not engage in political debate, we cannot remain silent when children’s lives and futures are endangered. We stand firmly by our values of compassion, equity, and peace and voice our deep concern for all (children) affected by violence and conflict, irrespective of their country, ethnicity, nationality, or faith. We invite our members and partner societies to join in upholding the principle that every child, everywhere, deserves to grow up in peace, with access to healthcare, and to live free from violence.
The article analyses the development of the Brazilian textile industry from the late 19th to the mid-20th century, focusing on the impact of the relative costs of capital and labor on efficiency and manufacturing costs globally. It argues that England’s early 20th-century dominance in textile production was attributable to the relatively low cost of capital, despite the high wages. The escalating costs of machinery following World War I contributed to the industry’s relocation to regions with lower labor costs, such as Asia and Latin America. In these regions, the increased utilization of machinery and the increased number of machines per worker became economically feasible. In the context of Brazil, the rise in capital costs during the 1910s and 1920s resulted in diminished efficiency. The challenges associated with importing machinery during the 1930s led to the utilization of outdated equipment, thereby contributing to diminished productivity over an extended period.
This report presents the provenance and technological analysis of two large obsidian bifaces recovered from a Middle Horizon (ca. AD 600–1000) ritual abandonment context at the coastal site of Cerro de Oro in the Cañete Valley, Peru. Portable X-ray fluorescence (pXRF) analysis identifies Quispisisa as the obsidian source, thereby documenting its circulation beyond highland Wari contexts. Technological analysis indicates contrasting trajectories: one biface shows no evidence of use, whereas the other exhibits macro use wear consistent with woodworking. Its location in a residential complex suggests community participation in the acquisition and ritual re-signification of prestigious nonlocal materials.
Chiral particles are experimentally investigated while settling in water with various turbulence intensity levels. The locations and orientations of the particles are tracked over time, allowing the close investigation of the particles’ settling dynamics. The generated turbulent flow is measured using laser Doppler anemometry, and the turbulence strength varies between experiments in the range $0 \leqslant \textit{Re}_\lambda \leqslant 250$. Starting with quiescent particle settling, the chiral particle’s orientation dynamics is studied, revealing a preferred alignment and a strong translation–rotation coupling. The particle chirality determines the preferred rotation direction, though the alignment and translation–rotation coupling gradually weaken with increasing turbulence. We identify multiple settling modes for the chiral particles, which are characterised by the evolution of the rotation angles. Finally, a theoretical model assuming a simplified chiral particle in Stokes flow clarifies the emergence of each settling mode.
Montmorillonite (MMT) is a component used to adsorb toxins and bacteria in animal feed. However, its effect on the horizontal gene transfer of antibiotic resistance genes remains unclear. This study investigated the removal characteristics of MMT towards multidrug-resistant Escherichia coli and its subsequent impact on plasmid conjugation. The results showed that 5 mg mL–1 MMT exhibited the highest removal ratio (84.60%), reaching saturation within 15 min. MMT showed a transient inhibitory effect on planktonic bacterial growth, resulting in a significant decrease in bacterial concentration at 2 and 4 h. In conjugation assays, while MMT significantly reduced the planktonic concentrations of donor and recipient strains via sedimentation, it did not reduce the absolute number of transconjugants. Consequently, the apparent conjugation frequency within the planktonic phase significantly increased at MMT concentrations ≥5 mg mL–1. These findings suggest that although MMT has application value as an adsorbent in feed to physically remove bacteria, its surface may act as a ‘hotbed’ that facilitates cell-to-cell contact, thereby promoting the conjugative transfer of resistance plasmids. Therefore, when assessing the safety of MMT as a feed additive, its potential role in accelerating the dissemination of antibiotic resistance genes must be considered alongside its pathogen-removal capability. Future research should focus on the functional modification of MMT to mitigate its risk of facilitating gene transfer.
This article considers the interaction of the expansion of international law and the rising politicization of domestic institutions. As international legal processes frequently incorporate domestic institutions, how citizens react to the development of international law may become influenced by their perceptions of those institutions. We argue that involving politicized domestic institutions in the international legal decision-making process affects support for rulings through individuals’ perceptions of the domestic judiciary vis-a-vis an international court. Contra our preregistered expectations, a survey experiment fielded in Hungary shows that opposition partisans withdraw support for a European Union law decision when it is issued by a Hungarian court rather than directly by the European Court of Justice, while the involvement of a national court does not increase support for European Union law among government supporters. Further exploratory analyses of government supporters suggest that court decisions are broadly unlikely to move these individuals’ attitudes toward international law.
This study investigated cross-linguistic influence (CLI) in spoken word recognition in a typologically distinct language pair. Japanese–English bilinguals performed auditory lexical decision tasks in both L1 (Japanese) and L2 (English), presented in counterbalanced order, responding to cognates varying in cross-linguistic overlap and to matched nonwords. This design allowed direct comparison of L1 and L2 processing within the same individuals. Response times measured from stimulus onset and offset were compared to capture changes in effects across the time course of processing. In both languages, phonological and semantic similarities significantly facilitated responses, though phonological similarity effects varied slightly over time. Cognate frequency inhibited responses later in time, varying by language, and L2 proficiency further modulated performance. Importantly, these effects emerged spontaneously, without priming, demonstrating bidirectional cognate facilitation even across linguistically distant languages. The results support the applicability of the BIA+ model to auditory processing, even for different-script bilinguals.
Reading ability is commonly used as a proxy for educational quality but may be unsuitable for cross-cultural comparisons. This study aimed to evaluate a novel Brief Mathematics Achievement Test (BMAT) as a proxy measure of quality of education (QoE) in culturally and linguistically diverse populations.
Methods:
Data on demographic variables, socioeconomic status (SES), country-level QoE, and performance on the BMAT and brief cognitive tests, were collected from 157 cognitively healthy participants (18–89 years) including native-born and immigrant populations in five European countries.
Results:
No significant differences were found between females and males or between participants with native-born and immigrant backgrounds in BMAT scores. In correlation analyses, BMAT scores were strongly correlated with SES, level of education, and performance on a brief cognitive composite, moderately with student–teacher ratio, country income classification, and a quality of education index, and weakly with age. In regression models controlling for key demographic variables and socioeconomic status, BMAT scores were significantly associated with level of education and the QoE index, while showing no significant relationship with immigrant status. Also, after controlling for demographic variables, SES, and the quality of education index, BMAT scores were the only significant predictor of performance on the brief cognitive composite.
Conclusions:
These findings provide preliminary evidence supporting the potential utility of the BMAT as an objective proxy measure of QoE in culturally and linguistically diverse populations.
Understanding the long-term implications of CHD has become a priority as survival rates have improved. Little is understood about the economic implications of living with CHD into adulthood.
Objectives:
We aimed to determine the prevalence and risk factors of financial fragility (i.e., ability to pay $2,000 for an emergency expense) among adults with CHD in the United States and compare outcomes to their healthy siblings.
Methods:
We conducted a cross-sectional study using data from the CHD Project to Understand Lifelong Survivor Experience survey (2021–2023). The survey assessed demographics, medical history, and economic outcomes, including financial fragility. Analyses included chi-square and Wilcoxon rank-sum tests with multivariable logistic regression models adjusted for demographic and socioeconomic factors.
Results:
There were 3074 adults with CHD and 324 siblings who answered the financial fragility question. The prevalence of financial fragility was 20.6% for individuals with CHD versus 12.7% in siblings (p = 0.02); individuals with CHD had higher odds (OR 1.50, 95% CI 1.04–2.17, p = 0.029) of financial fragility compared to siblings. Single ventricle anatomy was the only CHD group significantly associated with financial fragility (aOR 1.59, 95% CI 1.12–2.26). Financially fragile individuals were more likely to report blindness, be female or a race other than non-Hispanic white, and have single ventricle CHD.
Conclusion:
Adults with CHD experience greater financial fragility than their siblings and disease severity is associated with increased risk. Addressing financial fragility is essential to mitigate the long-term economic burden of CHD on patients and families.
This paper addresses the challenge of obtaining accurate finite element model updating (FEMU) results for complex flexible aircraft structures without relying on prohibitively large numbers of direct finite element evaluations. An adaptive two-stage framework is proposed by integrating Bayesian regularisation neural networks (BR-ANN) with trust-region resampling. In the global stage, a coarse-grained surrogate model is constructed via Latin hypercube sampling (LHS) and Bayesian inference, enabling the non-dominated sorting genetic algorithm II (NSGA-II) to identify the Pareto-front region containing promising candidate solutions. Subsequently, a trust-region strategy performs high-fidelity resampling within the local neighbourhood of the knee-point solution, establishing a refined surrogate model that reduces local surrogate bias and improves parameter convergence. Validation using the GARTEUR SM-AG19 benchmark aircraft demonstrates that the proposed method effectively mitigates the smoothing effect inherent in conventional global surrogate models while maintaining computational efficiency. The average modal frequency error was reduced from 4.56% to 2.39%, and the method supports physically interpretable updating of material and equivalent beam parameters, providing a reliable baseline for subsequent aeroelastic predictions.
Banco do Brasil played a central role in Brazil’s macroeconomic management during the Military Regime (1964–1985), a period marked by ambitious development strategies and heightened monetary instability. While previous research has emphasized its involvement with the Treasury and balance-of-payments financing, the broader scope of its functions has remained underexplored. Drawing on newly digitized balance-sheet data, this article reconstructs and classifies Banco do Brasil’s operations across its main areas of activity. It shows that Banco do Brasil acted as a multipurpose policymaking institution, mediating between competing objectives of growth, stabilization, and external adjustment. By tracing changes over time, the article highlights how Banco do Brasil’s functions evolved with shifting policy priorities across military governments, revealing a more complex and adaptive role in shaping Brazil’s macroeconomic outputs.
Śrīvidyā is a Tantric tradition which includes a form of religious initiation into an esoteric practice. Descriptions of initiation allude to and often describe the initiator sharing an experience with the initiand. In this article, we will suggest that such experiences can be understood in terms of a ‘shared token experience’. To make a case for taking such an experience into account, we use an argument for the epistemic value of religious experience. Our defence of the sharing of token experience across subjects also opens up questions as to the limits of consciousness or subjecthood. The phenomenon of Śrīvidyā initiatory experience also undermines two assumptions regarding what it means to be a subject. The first assumption is that each conscious subject is a unified whole insofar as its different experiential parts are mereologically connected to one subject. The second assumption is that each subject’s experiential field is bounded to one subject such that no two subjects can share the same experiential field. We argue that these assumptions do not necessarily preclude the possibility of a shared token experience.
Black constituents often receive lower-quality responsiveness from elected officials, particularly white representatives. This issue is exacerbated by partisan gerrymandering, which packs Black voters into districts with high majority populations. This trend has led to heightened concerns about increased vote dilution for minority and Democratic voters. This poses an important question: do legislators respond to shifts in their district’s racial demographics? Using data from before and after the 2010 redistricting cycle, we examine whether MCs engaged in policy responsiveness to Black constituents. Consistent with prior research, MCs did not sponsor or cosponsor more civil rights bills in response to increases in their Black constituency. However, Democratic MCs are more likely to mention civil rights in floor speeches, and Republican MCs are more likely to vote on bills in a manner consistent with LCCR priorities. These findings provide new insight into the representation Black Americans receive in Congress.
Natural language processing (NLP) has moved from a specialized research field into the everyday infrastructure of writing, search, translation, education, journalism, public administration, and scientific work. This transition changes what counts as progress. Accuracy, fluency, and benchmark performance remain important, but they are no longer sufficient when language technologies shape knowledge, decisions, identities, and public trust. This column introduces Responsible NLP as a research orientation that integrates fairness, transparency, privacy, safety, cultural diversity, environmental awareness, and human agency across the full life cycle of language technologies. It argues that responsibility is not an external constraint on innovation, but a condition for meaningful and trustworthy innovation. Future research must therefore ask not only whether an NLP system works but also for whom it works, under which assumptions, with what risks, and with what forms of accountability.
Across 13 surveys of 590 residents in seven ventilator-capable SNFs, residents in ventilator-designated beds had markedly higher ESBL (48.1% vs 28.2%; aOR = 1.64) and C. auris (38.6% vs 15.2%, aOR = 2.89), but lower MRSA colonization (35.2% vs 45.5%; aOR = 0.47), supporting the need for MDRO prevention beyond current Enhanced Barrier Precautions.
This article considers how European mountaineers, Bolivian elites, and Aymara communities perceived mountains, glaciers, and one another in the final years of the nineteenth century at the height of a campaign to dispossess Indigenous communities’ land and determined Aymara resistance. To do so, it takes a microhistorical approach, focusing on the interactions among Aymara community members, members of the Sociedad Geográfica de La Paz, and British mountaineer Martin Conway and his Swiss guides during Conway’s 1898 climbs in the Cordillera Real. Each of these groups was devoted to glaciated mountains, but in different ways and for diverging purposes. While Aymaras revered mountains as powerful ancestral deities, paceño geographers valued them as sites of marketable resources. For foreign mountaineers, glaciated peaks were sites for adventure, conquest, and profit. Divergent approaches to mountains and glaciers led to conflicts between foreign mountaineers and Aymara community members rooted in deeper disputes over race, gender, and nature.
Force/motion transmissibility serves as an essential performance metric in the kinematic analysis of parallel mechanisms. The initial step in evaluating force/motion transmissibility involves identifying the basis elements of twist and wrench spaces. In parallel mechanisms consisting of PRS, RPS, SPR, and PU limbs, the identification of the basis elements of a given limb is relatively straightforward, as the limb constraints can be evaluated as pure forces and torques. However, in limbs where the axes of the joints are offset, determining these basis elements becomes quite complex. Typically, the constraints of these limbs involve the interconversion between general screws and line vectors or couples. This paper focuses on a 3-PRRU parallel mechanism. Procedures for identifying the basis elements are investigated. Screw theory is used to elucidate the relationships between the variations in the basis elements and the configurations of the mechanism. Moreover, the influence of an offset between two revolute joint axes on the force/motion transmissibility is systematically analyzed. The results indicate that, compared to the case without offsets, the introduction of offsets enhances the force transmissibility of the mechanism.
Emergency department (ED) urine culture stewardship may reduce low-value testing, but downstream effects on antibiotic use and postdischarge utilization remain uncertain.
Methods:
We evaluated an intervention in which an infectious diseases physician and microbiologist reviewed pyuric urinalysis-with-reflex encounters, assessed culture indications, and contacted clinicians to recommend cancellation when absent. Adult ED encounters from February–July 2025 to September 2025-February 2026 were included; August was washout. Outcomes were urinalysis with reflex within 24 hours, urine culture within 24 hours, antibiotic days of therapy (DOT) per 100 patient-days, length of stay (LOS), and 30-day ED revisit among ED discharges. We fit biweekly interrupted time series models.
Results:
Among 17,621 encounters, the intervention was associated with lower postintervention slopes for urinalysis with reflex within 24 hours (−0.5 percentage points per biweekly period; 95% CI, −0.9 to −0.1) and urine culture within 24 hours (−0.2 percentage points; 95% CI, −0.4 to −0.0). DOT showed no sustained change (postintervention slope change, 0.00; 95% CI, −0.23 to 0.24). LOS showed a lower postintervention slope (−0.05 d; 95% CI, −0.08 to −0.02). Thirty-day ED revisit showed a higher postintervention slope (0.8 percentage points; 95% CI, 0.3 to 1.3).
Conclusions:
The intervention reduced urinary testing but did not reduce antibiotic DOT and was associated with increased 30-day ED revisit. Diagnostic stewardship in the ED may need to be paired with antimicrobial stewardship and prospective safety monitoring.