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The association of hypoplastic left heart syndrome with pulmonary valvular abnormalities such as dysplasia, stenosis, or insufficiency is rare and not well defined in the literature. We report a rare case of hypoplastic left heart syndrome with a thickened four-leaflet, four-sinus pulmonary valve. After stage I palliation, this neo-aortic valve developed clinically significant insufficiency in the setting of increased pulmonary blood flow.
The main objective of this article is to examine history textbooks as sites of discursive contestation regarding the treatment of the 1986 Jeltoqsan protests, a pivotal moment in post-independence Kazakhstani collective memory. This research analyzes the multilayered and inter-discursive domains of Jeltoqsan across the History of Kazakhstan textbooks published between 1992 and 2024. It focuses on four key contested themes between official narratives and those of protest mourners and sufferers: the portrayal of Dinmukhamed Qonaev, whose dismissal sparked the protests; the role of former President Nursultan Nazarbaev in handling the aftermath; the framing of Jeltoqsan as either an ordinary event or an uprising for significant political change; and ethnic or non-ethnic dimension of the protests. The findings reveal discursive competition and conflict in articulating the official and protestor narratives.
This paper examines Cyrenaica’s capacity for cereal production, focusing on Cyrene’s wheat output supporting the Greek cities. It also explores the region’s favourable agricultural conditions and presents local Hellenistic inscriptions that document cereal cultivation over three centuries. The paper argues that the wheat sent from Cyrene to the Greeks during the Hellenistic period was offered as a donation rather than exported for profit. This argument is supported by three main points: first, the quantities mentioned represent only a quarter, or possibly less, of Cyrene’s annual wheat production; second, a Greek poetic inscription from Cyrene (second or early third century AD) praises the city for donating one hundred ships of grain to aid the Greeks; and, third, literary references describe Cyrenaica and Cyrene as renowned for cereal production, particularly wheat. Literary references, together with epigraphic evidence, also reflect the ongoing demand for wheat among both Greeks and Romans. It concludes that Cyrene was one of the important sources of wheat for these nations, and that it was widely known as a provider of free wheat shipments during times of hardship. It also suggests that Cyrene commemorated the Hellenistic wheat consignment because it was given as a gift.
Improving udder health on dairy farms requires knowledge about the prevailing mastitis pathogens in order to take appropriate measures. The aim of this research communication was to evaluate the association between two sampling approaches for determining the prevalence of mastitis pathogens in dairy herds. Sampling approaches tested included (a) bacteriological investigation of randomly selected cows independent from stage of lactation (random sampling) and (b) sampling of cows two weeks prior to drying off (dry-off sampling). Using linear regression, the prevalence of mastitis pathogens were compared on herd-level for groups of specific pathogens. Associations between the prevalence estimated by the two approaches were found for Staphylococcus aureus, Streptococcus dysgalactiae, Streptococcus uberis and Gram-negative bacteria but not for other esculin-positive streptococci. This study indicated that both sampling approaches provide farmers with an overview of the prevalence of mastitis pathogens in their herds, with the dry-off results also being used to target antibiotic use to infected quarters.
Autistic adolescents are at higher risk of self-harm, suicidal behaviours, and emotion dysregulation compared with their non-autistic peers. Dialectical behaviour therapy (DBT) is an evidence-based treatment for self-harm and suicidal behaviour with emerging literature of the application of DBT for autistic populations. Despite this, no qualitative research has investigated the experiences of autistic adolescents of standard DBT. Therefore, this study aimed to explore autistic adolescents’ experiences of non-adapted DBT. Ten adolescents who had or were seeking an autism diagnosis, and were in a DBT programme, completed semi-structured interviews. Qualitative data from the interviews were analysed using reflexive thematic analysis. Themes were generated for each objective. Objective 1 included themes about the lived experience of autistic adolescents accessing DBT, including: ‘The impact of invalidation’, ‘Fostering acceptance and understanding’, ‘What does autism mean to me?’, and ‘Autism and mental health difficulties’. The themes regarding Objective 2 were about the experiences of the various modes of DBT and were organised by each client-facing mode. Objective 3 included themes highlighting the experience of utilising DBT skills in daily life, which included: ‘Barriers to skills use’, ‘Supporting skills use’, and ‘Skills practice or masking?’. Finally, Objective 4 included themes regarding the recommendations participants had for optimising DBT for autistic people: ‘Improving written materials’ and ‘General accessibility advice’. These findings suggest for DBT therapists to embody cultural humility, curiosity, validation, and flexibility when building neuro-affirmative competencies for supporting autistic individuals. Results are discussed in relation to the application and acceptability of DBT for this group.
Key learning aims
(1) Recent publications (e.g. Keenan et al., 2023) have explored the experience of autistic adults accessing DBT and highlighted the need for clinicians to work collaboratively with clients and make reasonable adjustments to improve autistic adults’ understanding and adherence to DBT.
(2) To date, no qualitative studies have explored the experience of autistic adolescents accessing the Rathus and Miller (2015) Adolescent DBT model. The current study explores the views of autistic adolescents on how autism is discussed and considered by clinicians when supporting them to access different components of DBT when describing the strengths and barriers they experience.
(3) Adopting a bottom-up approach, we identify key themes from adolescents’ perspectives on how to support them to access and engage with different DBT components, ranging from making environmental adaptations to meet individual sensory needs to improve accessibility, to providing more opportunities for personalised learning using neuro-affirmative examples that can improve generalisability of skills in everyday life. We provide recommendations for clinicians to consider on ways of adapting the process and content of DBT to increase accessibility and engagement for autistic adolescents in treatment.
We offer a novel analysis of conspiracy theorizing, according to which conspiracy theory communities are engaged in collective projects of storytelling. Other recent accounts start by analyzing individual conspiracy theorists’ psychologies. We argue that a more explanatorily unifying account emerges when we start by analyzing conspiracy theorizing as a social practice. This helps us better account for conspiracy theorists’ psychological heterogeneity. Some individual theorists care about uncovering the truth, while others incorporate truth into their theorizing in subtler ways; viewed as a social phenomenon, though, the function of conspiracy theorizing is not to discover the truth, but to tell good stories.
Few village-born social movements have influenced international relations as much as the campaign against Myitsone Dam in Burma (Myanmar). This village-born resistance led in 2011 to the suspension of a major Burmese and Chinese infrastructure project. This suspension became a symbol of democratization in Burma and a much-discussed setback of Chinese development-investment abroad. However, research literature on the Myitsone Dam has tended to conflate the local rural resistance with the broader ethnic Kachin and Burmese anti-dam movements. In contrast, this study focuses specifically on the local villages directly affected by the project, exploring their diverse stories and responses to the mega-project. Combining diverse published sources with ethnographic fieldwork and interviews done since 2010, it tells a story of displacement, resistance, social divisions, and complex relations with outsiders. This is a two-part article series. Another article – Part 1 – explores the Myitsone Dam’s rural story from its earliest days until the mega-project’s fall. This article – Part 2 – examines what has occurred after the mega-project’s suspension. It explores local village experiences after most residents had been resettled into relocation villages, from 2010 until now. This story begins with a bomb attack against the project and traces the village struggles until a post-coup gold mining boom.
Left atrial appendage aneurysms are uncommon cardiac anomalies often discovered incidentally, with potential to cause arrhythmias or thromboembolic events, prompting surgical correction. Herein, we present the successful surgical treatment of a left atrial appendage aneurysm identified in a 7-year-old asymptomatic patient.
The desegregation of Dallas Theological Seminary (DTS) offers a critical case study for scholars of American religious history, illuminating how white evangelical institutions responded to the racial transformations of the post-civil rights era. Unlike southern evangelical colleges that defended segregation on overt theological grounds, DTS never explicitly framed its exclusion of Black students within a scriptural mandate. Instead, the seminary’s shift from racial exclusion to intentional Black student recruitment in the 1970s reflects what Martin Luther King Jr. once described as a “more cautious than courageous” approach. Anchored in biblical literalism, DTS president John Walvoord’s reluctance to use scripture to justify segregation played a key role in the school’s transformation. This article fills a gap in the historiography by examining how institutional culture, theological commitments, and broader cultural pressures converged to produce a quiet and incremental model of desegregation—neither overtly racist nor actively prophetic—offering a more complex portrait of evangelicalism and race in the second half of the twentieth century.
Let a group Γ act on a paracompact, locally compact, Hausdorff space M by homeomorphisms and let 2M denote the set of closed subsets of M. We endow 2M with the Chabauty topology, which is compact and admits a natural Γ-action by homeomorphisms. We show that for every minimal Γ-invariant closed subset $\mathcal{Y}$ of 2M consisting of compact sets, the union $\bigcup \mathcal{Y}\subset M$ has compact closure.
As an application, we deduce that every compact uniformly recurrent subgroup of a locally compact group is contained in a compact normal subgroup. This generalizes a result of Ušakov on compact subgroups whose normalizer is compact.
This study discusses the intersection between Black/African Digital Humanities, and computational methods, including natural language processing (NLP) and generative artificial intelligence (AI). We have structured the narrative around four critical themes: biases in colonial archives; postcolonial digitization; linguistic and representational inequalities in Lusophone digital content; and technical limitations of AI models when applied to the archival records from Portuguese-colonized African territories (1640–1822). Through three case studies relating to the Africana Collection at the Arquivo Histórico Ultramarino, the Dembos Collection, and Sebestyén’s Caculo Cangola Collection, we demonstrate the infrastructural biases inherent in contemporary computational tools. This begins with the systematic underrepresentation of African archives in global digitization efforts and ends with biased AI models that have not been trained on African historical corpora.
Surgical site infections (SSIs) are among the most common postoperative complications in colorectal surgery, and associate with increased morbidity, prolonged recovery, and higher healthcare costs. Most studies combine all SSI categories, potentially overestimating economic burden due to higher severity of organ/space infections. The specific cost impact of incisional SSIs—superficial and deep infections—remains underexplored, despite its prevention potential. This study aimed to evaluate hospital costs associated with incisional SSIs following colorectal resection.
Methods:
A retrospective cohort study was conducted at a tertiary oncologic center, including patients who underwent surgical resection for primary neoplasms of the colon, rectum, or anal canal between 2018 and 2023. Patients with incisional SSIs were matched 1:1 to controls without SSI using propensity scores based on demographic and surgical variables. Total hospital costs within 60 days postoperatively were analyzed using real-world, institution-specific cost data. Multivariate regression was used to identify independent cost predictors.
Results:
Among 985 eligible patients, 176 (17.9%) developed an incisional SSI. After matching, 346 patients (173 pairs) were included in the cost analysis. Mean hospital costs were significantly higher in the SSI group (€6,065.93 vs €5,089.97; P < 0.001), primarily due to prolonged hospitalization and increased outpatient care use (medical and nursing consultations). Incisional SSI was an independent predictor of higher costs, along with open surgery, comorbidities and stoma presence.
Conclusions:
Incisional SSIs associated with higher hospital costs after colorectal surgery. These findings support the implementation of targeted SSI prevention strategies to reduce complications and optimize healthcare resource use.
The Darband Wall in southern Uzbekistan marks an important political border in the Classical world, yet the dating of its construction is largely relative and contested. Presenting 10 new radiocarbon dates from the wall, the authors argue that construction began in the early or middle third century BC, likely under Seleucid or early Greco-Bactrian rule, while later reconstruction efforts coincide with Kushan expansion around the first and second centuries AD. Early Hellenistic-style fortifications reveal a defensive, and possibly an orientational, shift during Kushan rule that underscores both the strategic significance of the wall and the need for more extensive investigation.
This paper examines American public attitudes toward corrective measures against uncooperative security allies through a preregistered survey experiment on a nationally representative sample of 1,502 American citizens. The findings demonstrate strong public support for corrective measures, particularly coercive strategies such as economic sanctions and military aid reduction, against allies whose policies conflict with the dominant power’s interests. While alliance discord also triggers demands for reduced American contributions to the alliance, public response varies substantially based on the nature of the misalignment and the characteristics of the uncooperative ally. Notably, the ally regime type significantly moderates support for corrective measures, with Americans demonstrating marked reluctance to endorse punitive actions against democratic allies. However, neither the ally’s military capabilities nor the presence of formal treaty arrangements significantly moderates public preferences. These findings contribute to our understanding of alliance management and the domestic foundations of international cooperation while offering insights into the pressures leaders face when addressing alliance noncompliance.
In this paper, the upper bounds of non-real eigenvalues of indefinite Sturm–Liouville (S-L) problems with boundary conditions depend on the eigenparameter are studied. The upper bounds of real parts, imaginary parts and absolute values of non-real eigenvalues are given under the condition that the coefficients are integrable.
Research finds genetic predisposition for depression is associated with increases in depression across adolescence and adulthood. In turn, depressive symptoms in adolescence are associated with substance use. However, there has been modest examination of genetic predisposition for depression, growth in depressive symptoms, and substance use from late childhood through adolescence, and mostly in White samples. Also, psychosocial interventions can attenuate associations between genetic predisposition and psychopathology, a genotype by intervention (GxI) effect. We examined associations among polygenic risk for depression, growth in depressive symptoms from age 7 to 16, and substance use at age 16, as well as moderation by a family-based preventive intervention. Participants were African-ancestry (n = 154) and European-ancestry (n = 219) youth from the Early Steps Multisite Study, half of whom participated in the Family Check-Up intervention. A small polygenic by intervention effect was found on reductions in depressive symptoms for African-ancestry youth, and growth in depressive symptoms was positively associated with substance use at age 16. In sensitivity analyses, a small GxI effect was detected in European-ancestry youth on reductions in depressive symptom slopes from age 10 to 16. These findings highlight how early intervention can buffer genetic effects on depressive symptoms over time.
We numerically investigate the hydrodynamics of an actively heaving flexible foil flapping under a wave surface. The coupled level set and volume-of-fluid method is used to capture the air–water interface, and the immersed-boundary method is used to capture the fluid–structure interaction. A sinusoidal heaving motion is imposed at the foil’s leading edge, and its posterior parts oscillate passively according to its flexible characteristics, allowing dynamic interactions with the wave-induced flow. The propulsive performance of the foil is examined for the influence of three main factors: the ratio of the heaving frequency ($f_{\!f}$) to the wave frequency ($f_w$), the phase difference between the heaving motion and the incident wave ($\mathit \varPhi$) and the submergence depth of the foil ($D$). At $\mathit \varPhi = 0$, the results reveal that the propulsion of the flexible foil benefits from flapping near the wave surface when $f_{\!f}/f_w = 0.5$, and the propulsive efficiency is optimised at $D/L = 1$, where $L$ is the foil’s length. However, when $f_{\!f}/f_w$ = 1.0 and 2.0, the propulsion of the flexible foil is hindered near the wave surface. This hydrodynamic hindrance is closely related to vortex splitting and roll-up phenomena, which induce the formation of a drag wake. By adjusting the phase difference $\mathit \varPhi$, the hindrance in the flexible foil propulsion can be mitigated to enhance propulsive performance. To further understand the relationship between the flapping kinematics and propulsive dynamics, we perform a scaling analysis based on lift force and added mass force, offering good quantification of propulsive performance.