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Takotsubo cardiomyopathy, also known as stress cardiomyopathy or broken heart syndrome, is named for echocardiographic features that look like the “tako-tsubo” (octopus trap). While classically associated with older women after experiencing significant emotional distress, it can also occur in paediatrics. Our patient is an 11-year-old male with a complex medical history who developed Takotsubo cardiomyopathy after cardiac arrest during anaesthesia induction. He was successfully resuscitated, but this case highlights an example of an unusual drug interaction and the first of its description in paediatrics.
How do local officials in China initiate and sustain policy experiments within a bureaucratic system that often obstructs innovation? This article examines local policy experimentation through the lens of bureaucratic power networks, identifying three key challenges: agenda-setting challenges related to superiors, coordination challenges involving peers and implementation challenges concerning subordinates. When formal power networks fail, entrepreneurial officials develop informal interpersonal networks, positioning themselves as “uninvited advisors” to superiors, “rhetorical allies” to peers and “supportive mentors” to subordinates. Using the case of “police–business cooperation” in Shanghai, the study reveals how the committee on comprehensive management of public security mobilized property management companies to maintain social stability. This article contributes to research on policy experimentation by situating experiments within bureaucratic power dynamics and highlighting the role of informal networks in overcoming institutional barriers. It also reveals the mechanisms by which the Party assigns social control tasks to commercial entities.
The lack of commercial treatments or vaccines against myxozoan parasites underscores the urgent need for a deeper understanding of the parasite infection in the fish and annelid hosts. Yet, progress in this research area is hindered by the lack of in vitro culture systems and the scarce number of in vivo models available. In addition, it is crucial to develop new protocols for the purification of spores and early developmental stages, as contamination of isolated parasite populations with host material remains a major obstacle for downstream biological applications, including the preparation of next-generation sequencing libraries, proteomics, pathology and immunological studies. Here, we lay the foundation for establishing the life cycle of Ellipsomyxa mugilis in an indoor laboratory mesocosm by co-housing thinlip grey mullet Chelon ramada and polychaetes Hediste diversicolor. A sustained infection of H. diversicolor was achieved, providing enduring access to E. mugilis actinospores. A purification protocol for actinospores was also developed using fluorescence-activated cell sorting and the lectin wheat-germ agglutinin in conjunction with 2 viability dyes, DAPI and propidium iodide, yielding a significantly pure parasite population with approximately 98% viability. This work establishes the basis for the development of a new myxozoan in vivo model and provides an effective, simple and rapid procedure for purifying viable E. mugilis actinospores. Together, these advances establish a framework for future studies on actinospore infectivity in the fish host.
This Research Communication describes a pilot study to validate a rumination sensor for pre-weaned dairy calves. There is increasing interest in precision livestock farming (PLF) tools to capture behaviours and health parameters in farm animals. However, much of the research has focused on devices suitable for adult animals, and few devices have been validated for young animals. The aim of our pilot study was to validate the rumination estimates from Nedap rumination sensors® (NRS) when worn by dairy calves less than 2 months of age. Eight Norwegian Red dairy calves were raised in a cow-directed cow-calf-contact system such that cows could visit their calves through a smartgate. At 21 days of age, an NRS was secured around the neck of each calf, to record the amount of time spent ruminating/24 h. Cameras were placed above the calf areas to record the calves for the entirety of the study. When the calves were 28 and 58 d old, four trained observers recorded rumination behaviour 24 h/d from the video recordings. The video data and the NRS data recorded over 24 h on the same days were compared using the Wilcoxon signed-rank test, the Spearman’s rank correlation and concordance correlation. NRS estimates were moderately correlated with calf rumination behaviour as measured from video observations but underestimated the duration of time spent ruminating by approximately 76%. Perhaps the calves’ rumination movements were too subtle for the NRS to detect, or the NRS needed a different placement on the calf’s small neck to record the behaviour accurately. Although automatic recordings from PLF tools may save observation time, our results indicate that the NRS may not yet accurately detect rumination behaviour in pre-weaned dairy calves.
Thoracotomy-assisted arterial duct stenting is a palliative option for patent ductus arteriosus-dependent systemic circulation, typically reserved for infants at high risk for open-heart surgery, such as those with genetic syndromes or very low birth weight. We report the first documented case of thoracotomy-assisted arterial duct stenting in a patient with Kleefstra syndrome, resulting in systemic stabilisation and long-term survival.
For any patient’s cancer journey, effective communication and helpful information are key to staying informed and reducing anxiety; for radiotherapy, ideally before treatment commencement. This paper details the initial design and service evaluation of a virtual tour (VT) aimed at familiarising patients with the department before treatment starts.
Methods:
Created by local digital science students, with input from hospital Patient Public Involvement groups, patients were recruited (after their initial planning visit) into non-VT and VT groups; the latter viewing the VT before their first treatment. Both groups completed identical online surveys with Likert-style questions and free-text entry to assess knowledge and understanding.
Results:
Twenty-three completed survey responses were received: 9 and 14 from the non-VT and VT groups, respectively.
• 66.7% of the non-VT group felt anxious attending the department for the first time; compared with 28.6% in the VT group. Key comments included ‘not now that I’ve seen the video’
• 92.9% of the VT group understood the queue calling and changing room systems compared with 55.6% in the non-VT group.
• 85.7% of the VT group knew what to expect in the treatment room, compared to 33.3% in the non-VT group. Key comments included ‘the video helped’.
Other comments included ‘excellent idea’ and ‘alleviates the concerns about where to go and what to expect ahead of that first visit’.
Conclusion:
The implementation of the VT has proved beneficial to patients, providing key information prior to treatment start, alleviating concerns and resulting in improved patient experience without the need for an extra visit.
We prove that in the space of $C^r$ maps $(r=2,\ldots ,\infty ,\omega )$ of a smooth manifold of dimension at least 4, there exist open regions where maps with infinitely many corank-2 homoclinic tangencies of all orders are dense. The result is applied to show the existence of maps with universal two-dimensional dynamics, that is, maps whose iterations approximate the dynamics of every map of a two-dimensional disk with an arbitrarily good accuracy. We show that maps with universal two-dimensional dynamics are $C^r$-generic in the regions under consideration.
The magician Robert Heller performed virtuoso piano repertoire as part of his magic act while touring in the 1860s. He linked other musical performances in his shows to minstrelsy and spiritualist seances, and briefly featured an unsuccessful musical effect, ‘Tartini’s Dream’, that illustrated the limits of transnational marketing. Expectations of recital audiences shifted in the 1870s, leading to questions about Heller’s capacity to play ‘serious’ repertoire. Throughout his career, he benefited from an emergent celebrity culture that treated conjurers and virtuosos as kin, with musicians like Liszt, Thalberg, and Paganini frequently described in magical terms. Heller’s musical virtuosity functioned as an illusory effect, transforming the piano’s sound while masking his physical presence.
This paper investigates the impact of environmental regulations on inward foreign direct investment (FDI) using a novel index that distinguishes between the implementation and enforcement of environmental policy across 111 countries from 2001 to 2018. Leveraging bilateral FDI data and a structural gravity model, we find robust evidence of a Pollution Haven Effect: weaker environmental regulations in host countries are associated with higher levels of inward FDI. The effect is more pronounced in emerging markets and in environments with higher corruption. Importantly, we show that FDI responds more strongly to policy implementation, capturing formal regulatory commitment, than to enforcement, measured as deviations between predicted and actual emissions. In addition, bilateral FDI patterns are shaped by the environmental stringency gap between source and host countries, consistent with regulatory arbitrage behavior.
A pattern knot in a solid torus defines a self-map of the smooth knot concordance group. We prove that if the winding number of a pattern is even but not divisible by 8, then the corresponding map is not a homomorphism, thus partially establishing a conjecture of Hedden.
We determine explicit generators for the ring of modular forms associated with the moduli spaces of K3 surfaces with automorphism group $(\mathbb {Z}/2\mathbb {Z})^2$ and of Picard rank 13 and higher. The K3 surfaces in question carry a canonical Jacobian elliptic fibration and the modular form generators appear as coefficients in the Weierstrass-type equations describing these fibrations.
This study aimed to assess the relationship between selected parameters of nutritional status and the occurrence of frailty syndrome in older adults by analysing clinical and socio-demographic factors. Methods: The study included 150 community-dwelling participants aged > 60 years who were qualified in the medical centre. The following research tools were used: activity of daily living, instrumental activities of daily living, survey of health, aging, and retirement in Europe, geriatric depression scale, mini mental state examination (MMSE), anthropometric measurements, mini nutritional assessment (MNA), body composition measurements, and biochemical blood tests. Results: The study included 150 people over 60 years of age (mean age 76.2/SD 4.9), including 104 women and 46 men. Participants in the frail group were significantly older (KW-H: P < 0.001) and had a higher level of depression (P = 0.008), whereas on the MMSE scale, they achieved a lower result (P < 0.001) than those in the non-frail and pre-frail groups. People in the frail group had significantly lower levels of nutritional status (P < 0.001) according to the MNA scale, assessment of basic activities in everyday life (P = 0.005), complex activities of everyday life (P < 0.001), hand grip strength of the right hand (P = 0.038) and left hand (P = 0.028), and energy drop (P < 0.001). They were also characterised by difficulties walking (P < 0.001), less frequent physical activity (P < 0.001), loss of appetite (P < 0.001), and weight loss more often (P < 0.05). Conclusion: Advanced age, a greater number of diseases, worse functional and mental performance, and differences in nutritional status and body composition were observed in people with frailty syndrome.
It was proved in [11, J. Funct. Anal., 2020] that the Cauchy problem for some Oldroyd-B model is well-posed in $\dot{B}^{d/p-1}_{p,1}(\mathbb{R}^d) \times \dot{B}^{d/p}_{p,1}(\mathbb{R}^d)$ with $1\leq p \lt 2d$. In this paper, we prove that the Cauchy problem for the same Oldroyd-B model is ill-posed in $\dot{B}^{d/p-1}_{p,r}(\mathbb{R}^d) \times \dot{B}^{d/p}_{p,r}(\mathbb{R}^d)$ with $1\leq p\leq \infty$ and $1 \lt r\leq\infty$ due to the lack of continuous dependence of the solution.
Burgers equation is a classic model, which arises in numerous applications. At its very core, it is a simple conservation law, which serves as a toy model for various dynamics phenomena. In particular, it supports explicit heteroclinic solutions, both fronts and backs. Their stability has been studied in detail. There has been substantial interest in considering dispersive and/or diffusive modifications, which present novel dynamical paradigms in such a simple setting. More specifically, the KdV–Burgers model has been shown to support unique fronts (not all of them monotone!) with fixed values at $\pm \infty$. Many articles, among which [11], [9] and [10], have studied the question of stability of monotone (or close to monotone) fronts. In a breakthrough paper [2], the authors have extended these results in several different directions. They have considered a wider range of models. The fronts do not need to be monotone but are subject of a spectral condition instead. Most importantly, the method allows for large perturbations, as long as the heteroclinic conditions at $\pm \infty$ are met. That is, there is asymptotic attraction to the said fronts or equivalently the limit set consists of one point. The purpose of this paper is to extend the results of [2] by providing explicit algebraic rates of convergence as $t\to \infty$. We bootstrap these results from the results in [2] using additional energy estimates for two important examples, namely KdV–Burgers and the fractional Burgers problem. These rates are likely not optimal, but we conjecture that they are algebraic nonetheless.
Earth oven baking pits are common occurrences within the Indigenous archaeological record of North America, yet archaeologists have paid minimal attention to evaluating how earth oven technology varies over the long term. The extensively sampled record of thermal features from Wyoming represents a unique opportunity to evaluate changes in earth oven technology through time and consider how earth ovens relate to other facets of Indigenous land use and subsistence strategies. This article is based on a sample of nearly 1,300 radiocarbon-dated features dating from 11,000 to 4000 cal BP. It evaluates diachronic shifts in feature morphology from the Early through Middle Holocene. Major changes in earth ovens include increasing size and the use of cook stone, first after 10,000 cal BP and then after 7500 cal BP. The observed variation indicates that Indigenous peoples adapted their cooking technology to address changes in types and quantities of resources processed, as well as changing requirements of the overall adaptive system. Recognizing how the diversity of thermal features and earth ovens change through time and across space allows researchers to ask more specific questions about Indigenous cooking technology, subsistence resources, and the role(s) these features played within broader lifeways.