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The Fontan Outcomes Network was created to improve outcomes for children and adults with single ventricle CHD living with Fontan circulation. The network mission is to optimise longevity and quality of life by improving physical health, neurodevelopmental outcomes, resilience, and emotional health for these individuals and their families. This manuscript describes the systematic design of this new learning health network, including the initial steps in development of a national, lifespan registry, and pilot testing of data collection forms at 10 congenital heart centres.
Male factor infertility is receiving greater emphasis in IVF programs. This book reviews the scientific evidence for various medical, environmental and lifestyle factors that can affect male fertility, such as chromosome abnormalities, age, anti-sperm antibodies and endocrine disruptors. Part of a four-book series on improving IVF success, this volume subsequently explores a range of treatments and strategies to improve sperm quality, including FSH treatment and antioxidants. It also discusses methods to prevent male infertility from childhood through to adulthood. Concise, practical and evidence-based - and with insights from global experts in the field - this text will enable gynecologists, urologists and andrologists to make evidence-based decisions that can influence the success rate of fertilization in subsequent IVF cycles.
We propose a Boussinesq-type model to study the surface/interfacial wave manifestation of an underlying, slowly varying, long-wavelength baroclinic flow in a two-layer, density-stratified system. The results of our model show numerically that, under strong nonlinearity, surface waves, with their typical wavenumber being the resonant $k_{res}$, can be generated locally at the leading edge of the underlying, slowly varying, long-wavelength baroclinic flow. Here, the resonant $k_{res}$ satisfies the class 3 triad resonance condition among two short-mode waves and one long-mode wave in which all waves propagate in the same direction. Moreover, when the slope of the baroclinic flow is sufficiently small, only one spatially localized large-amplitude surface wave packet can be generated at the leading edge. This localized surface wave packet becomes high in amplitude and large in group velocity after the interaction with its surrounding waves. These results are qualitatively consistent with various experimental observations including resonant surface waves at the leading edge of an internal wave. Subsequently, we propose a mechanism, referred to as the modulation-resonance mechanism, underlying these surface phenomena, based on our numerical simulations. The proposed modulation-resonance mechanism combines the linear modulation, ray-based, theory for the spatiotemporal asymmetric behaviour of surface waves and the nonlinear class 3 triad resonance theory for the energy focusing of surface waves around the resonant wavenumber $k_{res}$ in Fourier space.
Letting ℳ denote the space of finite measures on ℕ, and μλ ∊ ℳ denote the Poisson distribution with parameter λ, the function W : [0, 1]2 → ℳ given by W(x, y) = μc log x log y is called the PAG graphon with density c. It is known that this is the limit, in the multigraph homomorphism sense, of the dense preferential attachment graph (PAG) model with edge density c. This graphon can then in turn be used to generate the so-called W-random graphs in a natural way, and similar constructions also work in the slightly more general context of the so-called PAGκ models. The aim of this paper is to compare these dense PAGκ models with the W-random graph models obtained from the corresponding graphons. Motivated by the multigraph limit theory, we investigate the expected jumble-norm distance of the two models in terms of the number of vertices n. We present a coupling for which the expectation can be bounded from above by O(log3/2n · n−1/2), and provide a universal lower bound that is coupling-independent, but without the logarithmic term.
We have examined the relationship between star formation and polycyclic aromatic hydrocarbons (PAHs) by fitting the spectral energy distributions (SED) of AKARI selected galaxies. PAHs are excited by the ultraviolet (UV) photons of young stars and can trace star formation in galaxies, but they are disassociated by the strong UV radiation in starbursts. AKARI covered the mid-infrared, where the PAHs emit their radiation, with a high density of photometric bands. These observations allow us to estimate the star formation rate and the PAH mass fraction of the dust in galaxies. In the future the James Webb Space Telescope (JWST) will also make measurements in this wavelength range. This research can therefore be considered as a pathfinder to similar studies that will come later from JWST observations.
How are we to understand what happens to Oedipus? What or who is the cause of the terrible deeds—predicted by oracles to both Laius and Oedipus—that he has already committed before the play begins and that are revealed in its course? The purpose of the present essay, whose title alludes to a well-known article by E.R. Dodds, is to draw attention to aspects of the play that have been ignored or explained away. To give them their due it will be necessary to take issue with two views of Dodds (one of which he owes to Wilamowitz) that I regard as mistaken. To argue against an article that is more than fifty years old might be thought a pointless exhumation, but Dodds's highly influential formulations, I will argue, have caused what Sophocles wrote to be either overlooked or misconstrued and are still causing misunderstanding in the second decade of the present century. It is time these views were examined critically.
Adults with congenital heart disease face psychological challenges although an understanding of depression vs. anxiety symptoms is unclear. We analyzed the prevalence of elevated symptoms of anxiety and depression and explored associations with demographic and medical factors as well as quality of life.
Methods
Adults with congenital heart disease enrolled from an outpatient clinic completed the Hospital Anxiety and Depression Scale and two measures of quality of life: the Linear Analogue Scale and the Satisfaction with Life Scale. Medical data were obtained by chart review.
Results
Of 130 patients (median age = 32 years; 55% female), 55 (42%) had elevated anxiety symptoms and 16 (12%) had elevated depression symptoms on subscales of the Hospital Anxiety and Depression Scale. Most patients with elevated depression symptoms also had elevated anxiety symptoms (15/16; 94%). Of 56 patients with at least one elevated subscale, 37 (66%) were not receiving mental health treatment. Compared to patients with 0 or 1 elevated subscales, patients with elevations in both (n=15) were less likely to be studying or working (47% vs. 81%; p=0.016) and reported lower scores on the Linear Analogue Scale (60 vs. 81, p<0.001) and the Satisfaction with Life Scale (14 vs. 28, p<0.001).
Conclusions
Among adults with congenital heart disease, elevated anxiety symptoms are common and typically accompany elevated depressive symptoms. The combination is associated with unemployment and lower quality of life. Improved strategies to provide psychosocial care and support appropriate engagement in employment are required.