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Cardiac rhabdomyomas represent the most common primary paediatric cardiac tumour and typically regresses over time in the majority of patients. Among those who are symptomatic, surgical resection or catheterisation procedures have traditionally proven effective. More recently, those invasive or challenging tumours have been successfully treated with mammalian target of rapamycin inhibitors, typically everolimus and sirolimus. This review outlines the current medical literature of the state-of-the-art medical treatment of these tumours. We specifically focus on dosing regimens, duration of therapy, and side-effect profiles of mammalian target of rapamycin inhibitors among this population. Although the majority of cases responded to mammalian target of rapamycin inhibition, standardised guidelines for dosing and duration of treatment remain to be defined.
In turning over the Journals of the House of Coms in the time of Oliver Cromwell, it was with very singular satisfaction, that I found, that the first Idea that ever existed in this Country of encouraging the growth of Corn by allowing & encouraging the Importation of it, originated from my Great-Grandfather, as appears from the appointment of the Commee on 6th Octr 1654, & from the report on the 27th Octr. – This gentleman, who is here & in several other parts of the Journal, call'd Captn. Hatsell, was a Country-Gentleman, who liv'd at Saltram, at the House which is now Mr Parker's; His Father, as I have heard, was a considerable Clothier in Devonshire; Captn. Hatsell enter'd eagerly into Cromwell's Party, & in this Parliament which met on the 3d Septr 1654, was one of eleven Knights of the Shire elected from the County of Devon; In the Parliament, which met on 17th Septr. 1656, he was again return'd for the County, & in Richard's Parlt. which met on 27th Jany 1658, he was return'd for Tavistock & Plympton, & on 11th March made his election for Plympton. His name appears very frequently in the Journals, as taking a very active part in all the transactions of that time, But in none, that do him so much honour, as the proposal abovemention'd, & which was the cause of my introducing his name here.
Inclos'd I have sent You some of the Cases I alluded to Yesterday about the Kg’s Adjournmt of the Parlt. From everything I have heard & read, I take the doctrine to be, “That the Adjournment must be the Act of the House” & they may therefore comply or not, as they please, with the King's pleasure; but I am pretty confident there is no instance, but where this pleasure has been ultimately complied with.
We report two cases of respiratory toxigenic Corynebacterium diphtheriae infection in fully vaccinated UK born adults following travel to Tunisia in October 2019. Both patients were successfully treated with antibiotics and neither received diphtheria antitoxin. Contact tracing was performed following a risk assessment but no additional cases were identified. This report highlights the importance of maintaining a high index of suspicion for re-emerging infections in patients with a history of travel to high-risk areas outside Europe.
We investigate the real space H of Hermitian matrices in
with respect to norms on
. For absolute norms, the general form of Hermitian matrices was essentially established by Schneider and Turner [Schneider and Turner, Linear and Multilinear Algebra (1973), 9–31]. Here, we offer a much shorter proof. For non-absolute norms, we begin an investigation of H by means of a series of examples, with particular reference to dimension and commutativity.
Online learning has become an increasingly expected and popular component for education of the modern-day adult learner, including the medical provider. In light of the recent coronavirus pandemic, there has never been more urgency to establish opportunities for supplemental online learning. Heart University aims to be “the go-to online resource” for e-learning in CHD and paediatric-acquired heart disease. It is a carefully curated open access library of paedagogical material for all providers of care to children and adults with CHD or children with acquired heart disease, whether a trainee or a practising provider. In this manuscript, we review the aims, development, current offerings and standing, and future goals of Heart University.
Atom probe tomography (APT) is used to quantify atomic-scale elemental and isotopic compositional variations within a very small volume of material (typically <0.01 µm3). The small analytical volume ideally contains specific compositional or microstructural targets that can be placed within the context of the previously characterized surface in order to facilitate a correct interpretation of APT data. In this regard, careful targeting and preparation are paramount to ensure that the desired target, which is often smaller than 100 nm, is optimally located within the APT specimen. Needle-shaped specimens required for atom probe analysis are commonly prepared using a focused ion beam scanning electron microscope (FIB-SEM). Here, we utilize FIB-SEM-based time-of-flight secondary ion mass spectrometry (ToF-SIMS) to illustrate a novel approach to targeting <100 nm compositional and isotopic variations that can be used for targeting regions of interest for subsequent lift-out and APT analysis. We present a new method for high-spatial resolution targeting of small features that involves using FIB-SEM-based electron deposition of platinum “buttons” prior to standard lift-out and sharpening procedures for atom probe specimen manufacture. In combination, FIB-ToF-SIMS analysis and application of the “button” method ensure that even the smallest APT targets can be successfully captured in extracted needles.
The way social scientists think that others think about revolutions has been shaped primarily by Jack Goldstone. In his influential review essays, Goldstone (1982, 2001) presents the twentieth-century study of revolution as occurring in generations – from natural historians of the 1930s to general theorists of the mid-twentieth century, from state-centered scholars in the 1980s to a contemporary fourth generation basket of approaches. Because it is so familiar, his reading animates nearly all contemporary literature reviews in revolution studies.
This paper provides an up-to-date review of the problems related to the generation, detection and mitigation of strong electromagnetic pulses created in the interaction of high-power, high-energy laser pulses with different types of solid targets. It includes new experimental data obtained independently at several international laboratories. The mechanisms of electromagnetic field generation are analyzed and considered as a function of the intensity and the spectral range of emissions they produce. The major emphasis is put on the GHz frequency domain, which is the most damaging for electronics and may have important applications. The physics of electromagnetic emissions in other spectral domains, in particular THz and MHz, is also discussed. The theoretical models and numerical simulations are compared with the results of experimental measurements, with special attention to the methodology of measurements and complementary diagnostics. Understanding the underlying physical processes is the basis for developing techniques to mitigate the electromagnetic threat and to harness electromagnetic emissions, which may have promising applications.
To assess the outcomes of congenital tracheal stenosis among children.
Materials and methods:
A retrospective review of all children who underwent surgical repair of congenital tracheal stenosis reviewing charts, operative notes, echocardiograms, CT and MRI data from January 2002 to February 2019.
Twenty-six children underwent surgical treatment for tracheal stenosis. The median age was 3 months (range 0.3–35 months) and the median weight was 4.7 kg (range 2.5–13 kg) at the time of surgical intervention. Stridor was the most common presenting symptom in 17 patients (65% of patients). Twenty-one patients (81%) had concurrent cardiac anomalies, with pulmonary arterial sling being the most common, present in nine patients (34%). Extracorporeal life support was utilised in seven patients (27%) pre-operatively. Laryngeal release was required in 16 patients. In 7 patients an end-to-end anastomosis was performed, in 18 patients slide tracheoplasty, and 1 patient had a double slide tracheoplasty. The median cardiopulmonary bypass time was 106 minutes (range 25–255 minutes). The median cross-clamp time was 30 minutes (range 5–67 minutes). The median post-operative duration of ventilation was 5 days (range 0.5–16 days). The median ICU length of stay was 12.5 days (range 2–60 days). There were three hospital mortalities with 88% survival. One patient only required reintervention with balloon dilation. Twenty-two patients (85%) remained symptom-free on median follow-up at 7.6 years (range 0.2–17 years). Two patients since 2017 had 3D printed tracheas produced from CT imaging to assist surgical planning.
Congenital tracheal stenosis can be managed effectively with excellent outcomes and 3D printed models assist in planning the optimal surgical intervention.
be a non-Archimedean locally compact field of residual characteristic
with Weil group
be an irreducible smooth complex representation of
, realized as the Langlands parameter of an irreducible cuspidal representation
of a general linear group over
. In an earlier paper we showed that the ramification structure of
is determined by the fine structure of the endo-class
of the simple character contained in
, in the sense of Bushnell and Kutzko. The connection is made via the Herbrand function
. In this paper we concentrate on the fundamental Carayol case in which
is totally wildly ramified with Swan exponent not divisible by
. We show that, for such
, the associated Herbrand function satisfies a certain functional equation, and that this property essentially characterizes this class of representations. We calculate
explicitly, in terms of a classical Herbrand function arising naturally from the classification of simple characters. We describe exactly the class of functions arising as Herbrand functions
varies over the set of totally wild endo-classes of Carayol type. In a separate argument, we derive a complete description of the restriction of
to any ramification subgroup and hence a detailed interpretation of the Herbrand function. This gives concrete information concerning the Langlands correspondence.