We report a 20-year-old female patient (76 Kg/164 cm) with an extra-cardiac Fontan circulation who was referred to our institution for exertional dyspnoea and desaturation. The patient was diagnosed with a large calcified thrombus at the level of the Fontan fenestration, protruding inside the lumen of the conduit and reducing the diameter by half with a 3 mmHg pressure gradient. Transcatheter stent expansion of the obstructed extra-cardiac conduit was done with a 48 mm long XXL PTFE-covered Optimus-CVS® under temporary cerebral embolic protection with a TriGUARD-3™ deflection filter device (Keystone Heart). There was no procedural complication and the 3 months clinical outcomes are good.

The present study focuses on two-dimensional direct numerical simulations of shallow-water breaking waves, specifically those generated by a wave plate at constant water depths. The primary objective is to quantitatively analyse the dynamics, kinematics and energy dissipation associated with wave breaking. The numerical results exhibit good agreement with experimental data in terms of free-surface profiles during wave breaking. A parametric study was conducted to examine the influence of various wave properties and initial conditions on breaking characteristics. According to research on the Bond number ($Bo$, the ratio of gravitational to surface tension forces), an increased surface tension leads to the formation of more prominent parasitic capillaries at the forwards face of the wave profile and a thicker plunging jet, which causes a delayed breaking time and is tightly correlated with the main cavity size. A close relationship between wave statistics and the initial conditions of the wave plate is discovered, allowing for the classification of breaker types based on the ratio of wave height to water depth, $H/d$. Moreover, an analysis based on inertial scaling arguments reveals that the energy dissipation rate due to breaking can be linked to the local geometry of the breaking crest $H_b/d$, and exhibits a threshold behaviour, where the energy dissipation approaches zero at a critical value of $H_b/d$. An empirical scaling of the breaking parameter is proposed as $b = a(H_b/d - \chi _0)^n$, where $\chi _0 = 0.65$ represents the breaking threshold and $n = 1.5$ is a power law determined through the best fit to the numerical results.

We present the investigation and control of an extensively drug-resistant Serratia marcescens outbreak in a 30-bed intensive care unit (ICU). Within 6 weeks, 4 critically ill trauma patients were infected by the same strain. Intensive containment measures limited the spread of this strain while sustaining the capacity of the trauma ICU.

Given a graph $H$, let us denote by $f_\chi (H)$ and $f_\ell (H)$, respectively, the maximum chromatic number and the maximum list chromatic number of $H$-minor-free graphs. Hadwiger’s famous colouring conjecture from 1943 states that $f_\chi (K_t)=t-1$ for every $t \ge 2$. A closely related problem that has received significant attention in the past concerns $f_\ell (K_t)$, for which it is known that $2t-o(t) \le f_\ell (K_t) \le O(t (\!\log \log t)^6)$. Thus, $f_\ell (K_t)$ is bounded away from the conjectured value $t-1$ for $f_\chi (K_t)$ by at least a constant factor. The so-called $H$-Hadwiger’s conjecture, proposed by Seymour, asks to prove that $f_\chi (H)={\textrm{v}}(H)-1$ for a given graph $H$ (which would be implied by Hadwiger’s conjecture).

In this paper, we prove several new lower bounds on $f_\ell (H)$, thus exploring the limits of a list colouring extension of $H$-Hadwiger’s conjecture. Our main results are:

• For every $\varepsilon \gt 0$ and all sufficiently large graphs $H$ we have $f_\ell (H)\ge (1-\varepsilon )({\textrm{v}}(H)+\kappa (H))$, where $\kappa (H)$ denotes the vertex-connectivity of $H$.

• For every $\varepsilon \gt 0$ there exists $C=C(\varepsilon )\gt 0$ such that asymptotically almost every $n$-vertex graph $H$ with $\left \lceil C n\log n\right \rceil$ edges satisfies $f_\ell (H)\ge (2-\varepsilon )n$.

The first result generalizes recent results on complete and complete bipartite graphs and shows that the list chromatic number of $H$-minor-free graphs is separated from the desired value of $({\textrm{v}}(H)-1)$ by a constant factor for all large graphs $H$ of linear connectivity. The second result tells us that for almost all graphs $H$ with superlogarithmic average degree $f_\ell (H)$ is separated from $({\textrm{v}}(H)-1)$ by a constant factor arbitrarily close to $2$. Conceptually these results indicate that the graphs $H$ for which $f_\ell (H)$ is close to the conjectured value $({\textrm{v}}(H)-1)$ for $f_\chi (H)$ are typically rather sparse.

Musculoskeletal disorders have the highest prevalence of work-related health problems. Due to the aging population, the prevalence of shoulder pain in workers in physically demanding occupations is increasing, thereby causing rising costs to society and underlining the need for preventive technologies. Wearable support structures are designed to reduce the physical work load during physically demanding tasks. Here, we evaluate the physiological benefit of the DeltaSuit, a novel passive shoulder exoskeleton, using an assessment framework that conforms to the approach proposed in the literature.

In this study, 32 healthy volunteers performed isometric, quasi-isometric, and dynamic tasks that represent typical overhead work to evaluate the DeltaSuit performance. Muscle activity of the arm, neck, shoulder, and back muscles, as well as cardiac cost, perceived exertion, and task-related discomfort during task execution with and without the exoskeleton were compared.

When working with the DeltaSuit, muscle activity was reduced up to 56% (p < 0.001) in the Trapezius Descendens and up to 64% (p < 0.001) in the Deltoideusmedius. Furthermore, we observed no additional loading on the abdomen and back muscles. The use of the exoskeleton resulted in statistically significant reductions in cardiac cost (15%, p < 0.05), perceived exertion (21.5%, p < 0.001), and task-related discomfort in the shoulder (57%, p < 0.001).

These results suggest that passive exoskeletons, such as the DeltaSuit, have the potential to meaningfully support users when performing tasks in overhead postures and offer a valuable solution to relieve the critical body parts of biomechanical strains for workers at high risk of musculoskeletal disorders.

High mortality of juvenile Holothuria scabra in seagrass nursery areas has been attributed to predation. In this study, laboratory and field experiments were conducted to determine the effect of the size of two seagrass–associated crabs, Thalamita crenata and Dardanus megistos, on the survival of juvenile sandfish at different sizes (1–10 g). Small juvenile sandfish (1–2 g) offered in field trials were more preferred by small Thalamita and large Dardanus. Non-lethal damage caused by both crabs were also evident, indicating differences in the mode of attack and consumption. The incidence of non-lethal wounds in medium and large juveniles in the laboratory indicate higher incidences of unsuccessful attacks by the crabs. Differences in consumption rate may be related to cheliped morphology and handling techniques, and activity patterns affecting encounter rates. Mortality rates of juvenile sandfish due to T. crenata (CW: 4.30–7.05 cm) ranged from 10–43%, while those by D. megistos (SL: 0.90–2.3 cm) was even higher at 34–53% after 24 h trials. This is the first report that a hermit crab D. megistos is a significant predator of juvenile sandfish. Results provide new insights on crab–soft-bodied prey interactions in tropical seagrass areas. These are also important considerations in stock restoration and ocean-based culture. Given that juveniles (≤10 g) are very vulnerable to predation by these common crab species, growing sandfish to larger sizes is essential prior to release in the field.

The present work is devoted to the analysis of drop impact on a deep liquid pool, focusing on the high-energy splashing regimes caused by large raindrops at high velocities. Such cases are characterized by short time scales and complex mechanisms, thus they have received very little attention until now. The BASILISK open-source solver is used to perform three-dimensional direct numerical simulations. The capabilities of octree adaptive mesh refinement techniques enable capturing of the small-scale features of the flow, while the volume of fluid approach combined with a balanced-force surface-tension calculation is applied to advect the volume fraction of the liquids and reconstruct the interfaces. The numerical results compare well with experimental visualizations: both the evolution of crown and cavity, the emanation of ligaments, the formation of bubble canopy and the growth of a downward-moving spiral jet that pierces through the cavity bottom, are correctly reproduced. Reliable quantitative agreements are also obtained regarding the time evolution of rim positions, cavity dimensions and droplet distributions through an observation window. Furthermore, simulation gives access to various aspects of the internal flows, which allows us to better explain the observed physical phenomena. Details of the early-time dynamics of bubble ring entrapment and splashing performance, the formation/collapse of bubble canopy and the spreading of drop liquid are discussed. The statistics of droplet size show the bimodal distribution in time, corroborating distinct primary mechanisms of droplet production at different stages.

This response takes advantage of the diverse and wide-ranging series of commentaries to clarify some aspects of the target article, and flesh out other aspects. My central point is a plea to take graphic codes seriously as codes, rather than as a kind of visual art or as a byproduct of spoken language; only in this way can the puzzle of ideography be identified and solved. In this perspective, I argue that graphic codes do not derive their expressive power from iconicity alone (unlike visual arts), and I clarify the peculiar relationship that ties writing to spoken language. I then discuss three possible solutions to the puzzle of ideography. I argue that a learning account still cannot explain why ideographies fail to evolve, even if we emancipate the learning account from the version that Liberman put forward; I develop my preferred solution, the “standardization account,” and contrast it with a third solution suggested by some commentaries, which says that ideographies do not evolve because they would make communication too costly. I consider, by way of conclusion, the consequences of these views for the future evolution of ideography.

The Early to Middle Pleistocene Transition (EMPT) is characterised by major environmental changes and evolutionary innovations within the genus Homo but the scarcity of the African EMPT fossil and archaeological records obscures its palaeoecological context. Here, we present archaeological and faunal evidence from a newly excavated West-Turkana EMPT site—Kanyimangin.

Virtual reality (VR) sketching has many advantages for product design and tends to be more and more used among designers and non-designers (end-users). Nevertheless, few studies have focused on the skills needed to use VR sketching for non-designers especially VR novices in VR software. This study focuses on identifying the cognitive impact of VR sketching compared to traditional sketching on VR expert and VR novice in an experimental setting. Thirty-one participants composed of VR experts (N = 15) and VR novices (N = 16) completed a mental rotation test and then performed one traditional paper and pencil sketching task and two VR sketching tasks. We also measured the participants’ movements when using the VR sketching. Results show that VR experts perform better than VR novices in VR sketching because training is an essential element for the quality of traditional and VR sketching. Nevertheless, VR novices with previous training in traditional drawing and/or high mental rotation skills will be able to produce good-quality sketches. In addition, the results show that users moving more in the immersive environment performed better quality sketches if the drawing requires more complex shapes. Our results suggest that VR sketching can be complex to use for a part of the population that may be end-users, especially for those with little experience in traditional and VR sketching and with poor visuospatial abilities. We, therefore, advise to check the non-designers’ prior skills, otherwise, it will be necessary to train these users in VR sketching.

This quality improvement project aimed to reduce institutional incidence of Clostridioides difficile infection (CDI) following autologous stem cell transplantation. CDI incidence per transplant was .17 in a baseline period and .09 following the implementation of postdischarge ultraviolet room cleaning (χ2 = 2.11, p = .15).

We observe that, in the eta-periodic motivic stable homotopy category, odd rank vector bundles behave to some extent as if they had a nowhere vanishing section. We discuss some consequences concerning $\operatorname {\mathrm {SL}}^c$-orientations of motivic ring spectra and the étale classifying spaces of certain algebraic groups. In particular, we compute the classifying spaces of diagonalisable groups in the eta-periodic motivic stable homotopy category.

Scientists may sometimes generalize from their samples to broader populations when they have not yet sufficiently supported this generalization. Do such hasty generalizations also occur in experimental philosophy? To check, we analyzed 171 experimental philosophy studies published between 2017 and 2023. We found that most studies tested only Western populations but generalized beyond them without justification. There was also no evidence that studies with broader conclusions had larger, more diverse samples, but they nonetheless had higher citation impact. Our analyses reveal important methodological limitations of many experimental philosophy studies and suggest that philosophical training may not protect against hasty generalizations.

Experiments are conducted in an open-channel flow where half of the section is smooth and the other half consists of an array of cubes, which are either submerged or emergent. A shear layer featuring large-scale Kelvin–Helmholtz structures develops between the two subsections. The flows are first analysed in the framework of the double-averaging method (averaging of the flow both in time and space). Double averaging could be performed thanks to an experimental set-up (three-dimensional, two-component telecentric scanning particle image velocimetry) that allows to measure the velocity field in a large volume, including the interstices between the cubes. A momentum balance performed on the smooth subsection indicates that the loss of momentum towards the rough subsection has the same order of magnitude than the momentum loss through bed friction. This lateral momentum flux occurs nearly exclusively through turbulent shear stress, whereas secondary currents plays a minor role and dispersive shear stress is negligible. A pattern recognition technique is then applied to investigate statistically the large-scale Kelvin–Helmholtz structures that develop in the shear layer. The structures appear to be coherent over the water depth and to be strongly inclined in the vertical, the top part being ahead. The educed coherent structure is responsible by itself for the shape of the velocity profile across the shear layer and for a large part of the turbulence (up to 60 % for the turbulent shear stress). Finally, a coupling is identified between the passage of the Kelvin–Helmholtz structures and the instantaneous wake flow around the cubes at the interface.

Aromatic B-series were introduced as an extension of standard Butcher-series for the study of volume-preserving integrators. It was proven with their help that the only volume-preserving B-series method is the exact flow of the differential equation. The question was raised whether there exists a volume-preserving integrator that can be expanded as an aromatic B-series. In this work, we introduce a new algebraic tool, called the aromatic bicomplex, similar to the variational bicomplex in variational calculus. We prove the exactness of this bicomplex and use it to describe explicitly the key object in the study of volume-preserving integrators: the aromatic forms of vanishing divergence. The analysis provides us with a handful of new tools to study aromatic B-series, gives insights on the process of integration by parts of trees, and allows to describe explicitly the aromatic B-series of a volume-preserving integrator. In particular, we conclude that an aromatic Runge–Kutta method cannot preserve volume.

This paper uses data from the 2021 Swiss edition of the Gault&Millau food guide to analyze the probability with which restaurant owners decide to share their wine list with the public. This is an important question relating to the amount of information circulating in markets characterized by information asymmetry in the context of experience and credence goods. We find that restaurant owners are more willing to share wine lists with others if competition is limited or their wine list does not contain idiosyncratic information that competitors may use strategically. Interviews indicate the challenge for restaurants to balance the risk of sharing information with competitors and the opportunity to attract wine lovers by revealing an appealing wine list. We also show that this decision depends on cultural considerations.