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Aims: To evaluate the prevalence of subclinical cardiomyopathy and cardiac mortality in a research colony of non-purebred cats, established as a model of the wider cat population in New Zealand. Methods: All apparently healthy, compliant, non-pregnant, non-neonatal cats in the colony at the Centre for Feline Nutrition (Massey University, Palmerston North, NZ) underwent physical examination and echocardiography using a 4.4–6.2-MHz probe by a board-certified veterinary cardiologist. Cardiac phenotype was classified following current guidelines. Hypertrophic cardiomyopathy (HCM) phenotype was defined as an end-diastolic left ventricular wall thickness ≥ 6 mm. Colony mortality data from February 2012 to February 2022 was reviewed to determine cardiac mortality. Results: Cats (n = 132; 65 females and 67 males) included in the study had a median age of 4.1 (IQR 3.0–8.0) years. Thirty-two (24%) cats had a heart murmur, and three (2%) cats had an arrhythmia. Echocardiography revealed heart disease in 24 (18.2%) cats, including 23 with an HCM phenotype and one with a restrictive cardiomyopathy phenotype. Of the cats with the HCM phenotype, 3/23 had systemic hypertension or hyperthyroidism or both, and these cats were excluded from the final diagnosis of HCM (20/132; 15.2 (95% CI = 9.5–22.4)%). Between 2012 and 2022, 168 colony cats died, with 132 undergoing post-mortem examination. Heart disease was considered the cause of death in 7/132 (5.3%; 95% CI = 2.2–10.6%) cats; five had HCM, one a congenital heart defect, and one myocarditis. The overall prevalence of death related to HCM in the colony during this period was 3.8% (95% CI = 1.2–8.6%). Three cats with HCM and the cat with a congenital heart defect died unexpectedly without prior clinical signs, while congestive heart failure was observed prior to death in two cats with HCM and the cat with myocarditis. Additionally, 30/132 (22.7%) cats had cardiac abnormalities but died for non-cardiac reasons. Conclusions: Subclinical cardiomyopathy, specifically HCM, was common in cats in the colony. Given that the colony originated as a convenience selection of non-purebred cats in New Zealand, the true prevalence of HCM in the wider New Zealand population is likely to fall within the 95% CI (9.5–22%). The proportion of deaths of colony cats due to HCM was lower (3.8%) supporting the conclusion that subclinical cardiomyopathy may not progress to clinical disease causing death. Clinical relevance: Veterinarians should be aware of the high prevalence of subclinical HCM when treating cats. Abbreviations: CAM: Systolic anterior motion of the chordae tendineae; CFN: Centre for Feline Nutrition; HCM: Hypertrophic cardiomyopathy; LA/Ao: Left atrial to aortic ratio; LV FS: Left ventricular fractional shortening; LVIDd: Left ventricular internal diameters in end-diastole; LVIDs: Left ventricular internal diameter in end-systole; LVWT: Max Maximum left ventricular wall thickness; SAM: Systolic anterior motion of the mitral valve; 2D: Two-dimensional [ABSTRACT FROM AUTHOR]

Case history: Over a period of 2 months in the spring and early summer of 2021, 13 cases of sudden death in cull ewes due to aortic rupture were diagnosed at a small number of New Zealand abattoirs. Clinical findings: In 12/13 (92%) cases, a large blood clot was present in the thorax, and in one case the blood clot was seen in the tissues dorsal to the heart. There were no obvious signs of external trauma. The pluck (heart and lungs) or fixed aorta was submitted for histological examination in seven cases and in all of these, a tear in the aorta was found. Comparing the microscopic appearance of the proximal aorta in these seven cases to three clinically normal ewes from unaffected farms, the aortic wall thickness appeared thinner in the case ewes than the unaffected ewes. Subjectively, there was increased collagen in the tunica media in 3/7 and decreased elastin fibres in 5/7 case ewes compared to the control ewes. Further investigations on the index farm (where the first cases originated), found that the mean liver and serum Cu concentrations in 10 similarly aged, clinically normal ewes were within the normal reference range for New Zealand sheep. Similarly, the liver Cu concentrations of the seven case ewes were within the normal reference range. Diagnosis: Aortic rupture due to an unknown aetiology. Clinical relevance: Clinicians should be aware of this condition as a differential diagnosis for sudden death in older sheep and to assist the Ministry for Primary Industries in establishing the extent of this problem in New Zealand. [ABSTRACT FROM AUTHOR]

Jean-Marin Charcot died unexpectedly on August 16, 1893, at the age of 67, while on a journey to the Morvan for a short holiday with colleagues and friends. This article reports in detail circumstances of Charcot’s journey, and his untimely death in a small and modest room in a secluded hotel in the French countryside. In Part 1, I describe the reasons for Charcot’s choice to go on the journey, with an emphasis on his role in the recent and controversial “Panama Affair.” Subsequently, I describe the first days of the vacation journey by train, horse-drawn carriage, and walking as he visited castles, churches, and an archeological museum. During this holiday, Charcot’s companions got to know his great versatility: He was interested in history, antiques, excavations from the prehistory, languages, literature, painting, architecture, nature, and horticulture. In Part 2, I narrate Charcot’s sudden death. Additionally, I pay attention to the different reports in the press, the difficult and long journey of the corpse back to Paris, and the religious funeral, followed by the walk to Charcot’s final resting place in the Montmartre Cemetery. [ABSTRACT FROM AUTHOR]

The unique voice of long-term bereaved siblings has been almost completely ignored in the literature. Using 14 semi-structured in-depth interviews, we examine the perspectives of Israeli siblings on their relationship with their bereaved parents. All informants experienced the sudden death of a brother during his army service and, as a result of the loss, became only children. The findings emphasise the complexity of these relationships, which were characterised by the participants’ experience of lack of recognition and subjective presence on the one hand and the heavy responsibility they feel for their parents on the other. These relational components are evident throughout the bereavement years – regardless of the gender or age of the sibling at the time of death – and were echoed in the social messages bereaved siblings received following the loss. [ABSTRACT FROM AUTHOR]

Western white pine (Pinus monticola) with genetic tolerance to white pine blister rust disease caused by Cronartium ribicola constitutes an invaluable resource for the mitigation of this disease as well as the restoration of the species and its utilization in managed forests. In the last several years, typical root-rot symptoms and sudden tree death have been observed in some western white pine plantations located in British Columbia (BC) in Canada, and a few Phytophthora species were found to be associated with symptomatic trees. Our objectives were to survey one of the plantations located in south-west BC on Vancouver Island to confirm the presence of these Phytophthora species and other oomycetes and test their pathogenicity on western white pine by completing Koch's postulates. We used direct plating of root samples on PARP(H)-CMA media and by baiting for oomycetes in soil and root samples. Ten oomycetes, including four Phytophthora species (Phytophthora cinnamomi, P. cactorum-like, P. cryptogea and P. pseudocryptogea) were isolated from roots and soil samples of diseased Pi. monticola trees. The Phytophthora species were identified using ITS, β-tubulin and TEF1 gene regions. Koch's postulates were validated with controlled inoculations of 1-year old seedlings; mortality occurred as early as 15 days after inoculation with P. cinnamomi when the seedlings were maintained in warm temperature conditions (25°C). Molecular typing of two P. cinnamomi cultures using Oxford Nanopore MinIONTM sequencing indicated that they belong to one of the two main clonal clusters of mating type A2 that have been recognized as the main drivers of the global P. cinnamomi epidemic. [ABSTRACT FROM AUTHOR]

Introduction: Although sudden death (SD) is a recognized complication of cardiac amyloidosis, there is scarce data about its incidence, mechanisms, and predictors. The aim of this study was to describe incidence of SD and to analyze possible risk factors. Methods: Consecutive patients with ATTR or AL cardiac amyloidosis evaluated at two European centers were identified. SD was defined as unexpected death in clinically stable patients. Cox proportional hazard regression was performed to assess risk factors in univariate analysis. Those statistically significant were then assessed through age-adjusted multivariate analysis. Results: Analysis included 784 patients, 569 with ATTR amyloidosis (mean age 74.1 ± 12.1 years) and 215 with AL amyloidosis (mean age 64.5 ± 10.8 years). After a median follow-up of 1.9 years, SD rate at 2 years was 1.8% in ATTR. Previous pacemaker implantation (PPM) was associated with increased risk after age-adjusted analysis (HR 4.97; 95%CI: 1.39–17.7; p = 0.01). SD rate in AL amyloidosis patients at 2 years was 8.0% after a median follow-up of 1.2 years. Betablockers and NYHA III-IV were independently associated with an increased risk after age-adjusted multivariate analysis (HR 7.06 95%CI (2.31–21.5) p = 0.001) and (HR 4.56 95%CI (1.51–13.8) p = 0.007) respectively. Conclusions: SD is more frequent in AL than in ATTR cardiac amyloidosis. SD is associated with different risk factors in both entities. [ABSTRACT FROM AUTHOR]

This paper proposes a discourse-oriented approach to genetic literacy. The increased availability of genetic testing requires a certain level of genetic literacy among the public. This is important to understand the benefits and the risks of genetic testing. In this paper, we suggest that genetic literacy is not just a set of knowledge and skills that people have, but something that they do. It is discursively accomplished, and socially and culturally constitutive. We illustrate our approach using a genetic counseling consultation for Sudden Arrhythmic Death Syndrome (SADS). We examine how in this consultation, through careful orientation to the clients' understanding of genetic information, extended explanation-giving and education on genetics, the geneticist supports the clients in their decision about genetic testing. We discuss our findings in relation to clinical and non-clinical genetic contexts and highlight the importance of genetic literacy and professional support in diverse situations where genetic testing is considered. [ABSTRACT FROM AUTHOR]

Background and aims: Overweight and obesity have been found to exhibit a statistically significant increase in corrected QT interval (QTc), a major contributing factor to sudden death. However, the influence of widely used weight loss strategies including diet, exercise, anti-obesity drugs, and bariatric surgery on QTc remains inconsistent. Therefore, the present systematic review and meta-analysis aim to quantitatively analyse and evaluate the effect of weight loss on QTc in obese patients after diet control with exercise intervention and anti-obesity drugs, as well as bariatric surgery. Methods: Twenty randomised controlled trials (RCT) and observational studies were included in the meta-analysis on the effects of weight loss on QTc. The fixed-effects model was employed in the RCTs, and the random-effects model was employed due to the presence of statistical heterogeneity among observational studies. Subgroup analysis was conducted to understand the differences in distinct weight loss methods and follow-up time. Results: Overall, the QTc of people with obesity after weight loss was shorter than that before (mean difference (MD) = 21.97 ms, 95% confidence interval (CI) = 12.42, 31.52, p <.0001). Subgroup analysis restricted to seven included studies whose intervention was diet control with exercise showed a decrease of QTc with statistical significance (MD = 9.35 ms, 95%CI = 2.56, 37.54, p =.007). In the remaining 11 studies, bariatric surgery was the weight loss method. The results also showed a shortening of QTc after surgery, and the difference was statistically significant (MD = 29.04 ms, 95%CI = −16.46, 41.62, p <.00001). A statistically significant difference in QTc shortening at 6 months compared to pre-operation values was further observed (MD = −31.01 ms, 95%CI = −2.89, −59.12, p =.03). The shortening of QTc at 12 months of follow-up was also significantly different from that before surgery (MD = 36.47 ms, 95%CI = 14.17, 58.78, p <.00001). Moreover, the differences became more pronounced as the follow-up time extended. Conclusions: We demonstrate that weight loss links to a shortened QTc, without considering the means of weight loss. Bariatric surgery has been found to result in a greater reduction in QTc. [ABSTRACT FROM AUTHOR]

AbstractSystematic collection of outcome measures within suicide bereavement support is vital in building the sector’s evidence base. However, there is currently limited understanding around the appropriate and sensitive use of outcome measures. Following the scoping review methodology, a literature review was undertaken to map how programs and interventions that assist individuals bereaved by suicide or other sudden, traumatic deaths gather outcome measures. The search strategy identified 1145 papers, of which 49 met the inclusion criteria. The review identified many ways that outcomes are captured, with custom tools being commonplace. Among standardized tools, the Grief Experience Questionnaire (GEQ) and Beck Depression Inventory (BDI-II) emerged as frequently used. Most articles provided some form of justification for their chosen outcome measure methodology, often citing psychometric robustness over consideration of the impact on service users. The review underscores the need for careful consideration when selecting outcome measure tools or approaches in sudden death bereavement interventions. [ABSTRACT FROM AUTHOR]

AbstractThis study examined the experiences of loss among bereaved adults, and the association between loss-related factors and mental health outcomes. Participants were 2023 bereaved adults from the United Kingdom and Ireland who completed measures of their bereavement experiences and symptoms of depression, anxiety, and somatization. The highest proportion of participants and those at greatest risk of meeting criteria for all disorders were those with less time since loss, who were in contact with the deceased every day or not at all in the year prior to their death, experienced sudden unnatural death, and those who lost a partner/spouse or a child. Age of the deceased was negatively correlated with meeting criteria for depression, anxiety, and somatization. Overall, depression, anxiety, and somatization were common in the bereaved population. Identifying key loss-related variables—such as time since bereavement and nature of death—will help target those needing urgent psychological support. [ABSTRACT FROM AUTHOR]

Summary: Winning the coin toss at the end of a tied soccer game gives a team the right to choose whether to kick either first or second on all five rounds of penalty kicks, where each team is allowed one kick per round. There is considerable evidence that the right to make this choice, which is usually to kick first, gives a team a significant advantage. To make the outcome of a tied game fairer, we suggest a rule that handicaps the team that kicks first (A), requiring it to succeed on one more penalty kick than the team that kicks second (B). We call this the m − n rule and, more specifically, propose (m , n) = (5 , 4) : For A to win, they must successfully kick 5 goals before the end of the round in which B kicks its 4th; for B to win, it must succeed on 4 penalty kicks before A succeeds on 5. If both teams reach (5 , 4) on the same round—when they both kick successfully at (4 , 3) —then the game is decided by round-by-round "sudden death," in which the winner is the first team to score in a subsequent round when the other team does not. We show that this rule is fair in tending to equalize the ability of each team to win a tied game in a penalty shootout. We also discuss a sequential rule that precludes the teams from reaching (5 , 4) at the same time, obviating the need for sudden death and extra rounds. [ABSTRACT FROM AUTHOR]

Families bereaved by sudden work-related death are underrepresented in the literature therefore little is known about their engagement with the justice system. This qualitative study explored families' experiences and expectations of authorities in the legal system following sudden workplace death. We analyzed emergent meaning from transcript data of four focus groups. Six broad themes were identified: just outcome, delivery of workplace safety, family liaison, access to information, assistance for affected people, and representation and voice. The findings provide insights into broad expectations participants had of authorities, contextualized within their experience, which can inform practical response. [ABSTRACT FROM AUTHOR]

Jean-Martin Charcot is perhaps best remembered for his contributions to organic neurology. However, his pursuit of hysteria, the most prevalent diagnosis in his hospital clinic, yielded no anatomical lesion to account for hysteria’s plethora of somatic disorders assumed due to a purely functional or dynamic lesion in the cerebral cortex. This led Charcot to turn his attention to the psychology of hysteria. Taking advantage of institutional reforms at the Salpêtrière—notably, the establishment of his professorship in nervous diseases—Charcot from the early 1880s focused his teaching increasingly on case histories of hysteria in male as well as female patients. Already renown for his earlier dramatic public lessons on female hysteria, his lessons of the 1880s, of which two volumes were published at the end of the decade, elaborated the issue of psychology in terms of altered states of patient’s suggestibility. By the decade’s end, Charcot’s worldwide reputation rested on the prospects of this work as acknowledged by numerous students, notably medical psychologists Pierre Janet and Sigmund Freud. Yet Charcot’s views remained sketchy. They were discussed at length in his unpublished notes for a lesson intended for May 1893, just a few months before his sudden death. His unpublished notes reveal a detailed case for dreams as illustrating a psychological mechanism underlying hysteria in a 17-year-old Paris artisan. I conclude by considering why this significant climactic case of Charcot’s might have been overlooked by his entourage. [ABSTRACT FROM AUTHOR]

This article explores the challenges of studying history in anthropology, using Eric Hirsch's research on the Fuyuge people in Papua New Guinea as a case study. It discusses the difficulties of capturing a society's continuous change and the limitations of ethnographic research. The article also examines the translation of foreign concepts and the complex nature of history itself. It emphasizes the differences in perspectives and experiences of historical events between Oceania and the Western Indian Ocean. The text explores the concepts of myth, history, and historicity in relation to the Fuyuge people, suggesting that their understanding of history is complex and cannot be easily categorized. It highlights the importance of considering diverse perspectives and historicities in anthropological research. [Extracted from the article]

Digital technologies offer a quick and convenient method of communicating across distance, but there are unique benefits to engaging in forms of delayed communication. Long-distance letter writing in the early nineteenth century was often a slow business, and one that Romantic poet, John Keats, capitalised on. In particular, the letter provided Keats with a means of managing the reality of his circumstances when he was faced with inexorable loss and tragedy. In the period of time leading up to the death of his brother, Tom, in 1818, Keats exploited the specific cultures and forms of letter writing to generate a unique consolation for himself and his family members; as he confronted the reality of his own death two years later, the letter played a similarly crucial role in managing his feelings of loss and grief. Letter writing, during these difficult periods, presented Keats with a unique dichotomy: the letter kept him grounded in the cruel reality of his situation while often functioning as a singularly effective means of managing it. How the specific cultures of letter writing and disease intersect, and how Keats's imaginative epistolary narratives coalesce with the increasingly urgent facts of consumption and death, will be examined here. [ABSTRACT FROM AUTHOR]

Chronic coronary syndrome (CCS) remains the leading cause of death worldwide with high admission/re-admission rates. Medical databases were searched on CCS & its management. This review discusses phenotypes per stress-echocardiography, noninvasive/invasive testing (coronary computed-tomography angiography-CCTA; coronary artery calcium – CAC score; echocardiography assessing wall-motion, LV function, valvular disease; biomarkers), multidisciplinary management (risk factors/anti-inflammatory/anti-ischemic/antithrombotic therapies and revascularization), newer treatments (colchicine/ivabradine/ranolazine/melatonin), cardiac rehabilitation/exercise improving physical activity and quality-of-life, use of the implantable-defibrillator, and treatment with extracorporeal shockwave-revascularization for refractory symptoms. CCS is age-dependent, leading cause of death worldwide with high hospitalization rates. Stress-echocardiography defines phenotypes and guides prophylaxis and management. CAC is a surrogate for atherosclerosis burden, best for patients of intermediate/borderline risk. Higher CAC-scores indicate more severe coronary abnormalities. CCTA is preferred for noninvasive detection of CAC and atherosclerosis burden, determining stenosis' functional significance, and guiding management. Combining CAC score with CCTA improves diagnostic yield and assists prognosis. Echocardiography assesses LV wall-motion and function and valvular disease. Biomarkers guide diagnosis/prognosis. CCS management is multidisciplinary: risk-factor management, anti-inflammatory/anti-ischemic/antithrombotic therapies, and revascularization. Newer therapies comprise colchicine, ivabradine, ranolazine, melatonin, glucagon-like peptide-1-receptor antagonists. Cardiac rehabilitation/exercise improves physical activity and quality-of-life. An ICD protects from sudden death. Extracorporeal shockwave-revascularization treats refractory symptoms. [ABSTRACT FROM AUTHOR]

Acute myocardial infarction(AMI) is one of the most common causes of sudden cardiac death, but the accurate AMI identification biomarkers are still lacking. Recently, lipidomics shed new light on the exploration of AMI biomarkers. In this study, lipid molecules were examined in rat myocardial tissue based on Liquid chromatography-tandem mass spectrometry (LC-MS/MS) lipidomics to screen for metabolic markers for the identification of AMI. Results showed that 70 lipid molecules with different expressions identified by distinguishing between the sham group and the AMI 5 min group, 275 differentially expressed lipid molecules identified by distinguishing between the sham group and the AMI 4 hour group. And 257 differentially expressed lipid molecules identified by distinguishing between the AMI 5 min group and the AMI 4 hour group. Comprehensive analysis shows that PC (18:0_18:1)+HCOO and PC (16:0_18:2)+HCOO exhibited more significant changes. Two lipid molecules were applied to build AMI-identification models, the accuracy rate reached 77.8% and R2 = 0.539. [ABSTRACT FROM AUTHOR]

Epilepsies are a group of heterogeneous brain disorder, and antiseizure medications (ASMs) are the mainstay of treatment. Despite the availability of more than 30 drugs, at least one third of individuals with epilepsy are drug-resistant. This emphasizes the need for novel compounds that combine efficacy with improved tolerability. A literature review on the pharmacology, efficacy, tolerability, and safety of azetukalner (XEN1101), a second-generation opener of neuronal potassium channels currently in Phase 3 development as ASM. Results from the phase 2b clinical trial strongly support the ongoing clinical development of azetukalner as a new ASM. Its pharmacokinetic properties support convenient once-daily dosing, eliminating the need for titration at initiation or tapering at the conclusion of treatment. CYP3A4 is the main enzyme involved in its metabolism and drug-drug interactions can affect the drug exposure. Preliminary analysis of an ongoing open-label study reveals no reported pigmentary abnormalities. The upcoming Phase 3 clinical trials are expected to provide further insight into the efficacy, tolerability, and safety of azetukalner in treating focal-onset and primary generalized tonic-clonic seizures. Structurally distinct from currently marketed ASMs, azetukalner has the potential to be the only-in-class Kv7.2/7.3 opener on the market upon regulatory approval. [ABSTRACT FROM AUTHOR]

This paper explains how a turn in EU governance which was unthinkable only a few months prior became possible in 2020. Rather than a sudden paradigm shift brought about by the pandemic, we argue that it occurred through successive episodes of reinterpreting the rules and layering on new instruments while fostering investment and fiscal sharing on top of the pre-existing ordoliberal regime. Through a discursive institutionalist lens, the paper supports these claims by studying the frames and narratives of French, German and EU leaders during three rounds of reforms, namely the flexibilization of the European Semester (2014–2016), the adoption of the Budgetary Instrument for Convergence and Competitiveness (BICC) (2017–2019), and the adoption of the Recovery and Resilience Facility (2020–2021). The analysis shows that an increased awareness of a responsiveness imperative, going beyond national constituencies, transformed European elites' conceptions of 'responsible' government thus at least momentarily closing the gap between responsibility and responsiveness. [ABSTRACT FROM AUTHOR]

The use of drains, including suction drains in neurosurgery is individual preference-based, rather than scientific evidence-based. Furthermore, the use of suction drains has been associated with significant risks to patients, including sudden death. We present 2 cases of unfortunate sudden deaths following uneventful cranioplasty procedures, both of which were associated with the use of a suction drain. We also review the literature focusing on the benefits and risks in the use of suction drains, and discuss pathophysiological mechanisms underlying sudden death associated with their use. There is no substantial evidence to support the use of suction drains in neurosurgery. Furthermore, they have been associated with significant complications, including risk to life. Our experience and literature review suggest that the risk of sudden death is disproportionately higher following cranioplasty. We do not recommend the use of suction drains in cranial neurosurgery, and we strongly recommend against their use in cranioplasty procedures. [ABSTRACT FROM AUTHOR]

What does it mean to mourn the sudden death of a mother who abandoned you at the age of 5? In this narrative paper, the writer explores the many ways in which old wounds were reopened for him, more than fifty years later, when he was faced with the actual death of his mother in the summer of 2022. With her death the writer comes to realize that with death there is no ending. Mourning a mother that abandoned you does not lead to closure. There is always the question of Why? Themes of abandonment, grief and parental loss, centering around the writer's experiences of growing up in the foster care system will be examined. [ABSTRACT FROM AUTHOR]

Divisive politicisation of inequalities among the member states in the EU is the lowest in member states where one would expect the highest level of domestic demand for it, and it is highest in member states in which one would expect much lower demand. In this paper, we argue that the territorially fragmented structure of political representation in the EU creates the incentives for politicians to engage in blaming the other states and adopting us-vs.-them positions in the national, as well as in the EU arena. Regulatory and monetary integration among economies at different levels of development provides fertile ground for such politicisation. Yet, the ability to engage in such politicisation while ruling a peripheral country is crucially shaped by that country's form and level of economic dependency on the economies of the European core. The consumption-led and credit-based growth model of the South is much more exposed to crises and suddenly increasing levels of dependency, whereas the FDI-based growth models in the Eastern peripheries provide for much larger room for politicising dependency and cntesting the alleged dictate of 'foreign powers' and EU institutions. [ABSTRACT FROM AUTHOR]

Though it is a core function of a sovereign state, governments do not navigate defense policy free from outside influences and constraints. The provision of external security requires armed forces to be adequately equipped but the distribution of material resources - defense-industrial capacity – for such equipment is not even but rather concentrated in the international system. How do alliance politics and defense-industrial policy connect? Our contribution highlights the material resources for military alliance effectiveness and emphasizes a strategic view of the relationship between these material factors and alliance burden-sharing. The sudden surge in demand for materiel resulting from Russia's invasion of Ukraine revealed the defense-industrial fault lines within the transatlantic alliance. We outline existing dependencies and interdependencies, identify trade-offs and connections between industrial policy and defense spending, and formulate policy recommendations based on our findings. Taking a political economy of security perspective, these recommendations are aimed at a better understanding of how industrial politics and alliance stability are intertwined. They suggest pathways to a new and more stable transatlantic defense-industrial bargain in an era of increased great power conflict. [ABSTRACT FROM AUTHOR]

Terror management theory argues that mortality salience can engender greater prosocial behaviour. We extend this theory to corporate environmental practice. Using a sample of Chinese listed firms in heavily polluting industries, the results of difference-in-differences model show that firms significantly increase their environmental investment after the top executives experience mortality salience triggered by their colleague death. Moreover, we further show that the core relationship is amplified in situations where the death is sudden and firm is located in areas with strong public environmental awareness. [ABSTRACT FROM AUTHOR]

Worldwide around 70 million people have epilepsy, and every year, more than 1 out of 1000 cases of epilepsy result in Sudden Unexpected Death in Epilepsy (SUDEP). Video – EEG is the standard clinical method for monitoring epilepsy and seizures. However, wearable systems are required to monitor epileptic activity in daily living due to the complexity of using EEG outside the laboratory. Also, to prevent SUDEP, early prediction of seizure onset is required. In this work, we propose a machine learning model to detect ictal and preictal conditions using an Empatica E4 smartwatch. The Empatica E4 records real-time photoplethysmography, electrodermal activity, accelerometry, and temperature. Clinical data were recorded from 11 patients with epilepsy (PWE) for 19 seizure onsets. Features from all the modalities were extracted by taking segments of the signal during the seizure (ictal), pre-seizure, and inter-ictal (non-seizure) conditions. These features were used on support vector machine (SVM-RBF), decision tree (DTC), and logistic regression (LRC)-based supervised training for ictal vs. non-ictal and pre-ictal vs. inter-ictal conditions. The highest accuracy of 99.40% was recorded for DTC-based seizure detection classifier during 10-fold cross-validation. Also, the highest accuracy of 95.42% was recorded for DTC-based pre-seizure onset detection classifier during 10-fold cross-validation. [ABSTRACT FROM AUTHOR]

To what extent is military technology innovation emergent? This study answers this question by applying an emergence detection algorithm to roughly 300,000 technical terms extracted from military technology patents granted from 1980 to 2019. Emergence – instances of sudden and rapid growth of a technical term within the military patent corpus – is found to vary greatly over time. Military technology innovation during the period of 1996-2008 is found to be highly emergent. This period was found to be characterized by high organization-type diversity; non-traditional vendors, traditional defense contractors, large civilian-facing firms, and individuals generated military patents containing many novel emergent technical terms. However, in recent years, military technology innovation has exhibited markedly less emergence. The period of low emergence is characterized by reduced contributions by non-traditional vendors, defense prime contractors, and individual inventors to military patents containing emergent terms. These observations suggest that policies attempting to ensure a healthy defense innovation ecosystem should seek organization-type diversity and may benefit from employing promotion strategies targeted at distinct organization types. [ABSTRACT FROM AUTHOR]

Jean-Louis Cohen, a respected architectural historian, has passed away suddenly. He was known for his extensive research, writings, and exhibitions that challenged traditional views of architecture and urban planning. Cohen's work went beyond France, thanks to his fluency in multiple languages. He made significant contributions to the field and influenced a new generation of scholars. Despite facing opposition, he continued his scholarly work and received numerous honors and appointments throughout his career. [Extracted from the article]

In recent history, the sudden visibility of food delivery services has alerted global publics to the labor asymmetries and the transformative potential of food transport in societies upended by change. Responding to these developments, this essay offers an ethnographic account of the gendered political economy of food distribution at the Green Coop Consumers Cooperative. A forerunner of the Japanese food movement, Green Coop and its delivery routes have become a platform for women workers to witness and respond to the societal effects of the country's neoliberal restructuring. While similar organizations in other cultural contexts have struggled to move beyond exclusionary practices, women and mothers at this Fukuoka-based co-op foster social connection, accountability, and watchfulness in ways that surpass the capabilities of kin and state. Where scholarship has taken interest in the connective tissues between the spheres of production and consumption, this essay highlights and politicizes the node of distribution. Often cast as purely technical, the work of delivery is a prism through which to understand how demographic reforms bear on the food system, and how it has in turn become a site for citizens' response. [ABSTRACT FROM AUTHOR]

Pathological cardiac hypertrophy (referred to as cardiac hypertrophy) is a maladaptive response of the heart to a variety of pathological stimuli, and cardiac hypertrophy is an independent risk factor for heart failure and sudden death. Currently, the treatments for cardiac hypertrophy are limited to improving symptoms and have little effect. Elucidation of the developmental process of cardiac hypertrophy at the molecular level and the identification of new targets for the treatment of cardiac hypertrophy are crucial. In this review, we summarize the research on multiple active substances related to the pathogenesis of cardiac hypertrophy and the signaling pathways involved and focus on the role of transforming growth factor-β (TGF-β) and bone morphogenetic protein (BMP) signaling in the development of cardiac hypertrophy and the identification of potential targets for molecular intervention. We aim to identify important signaling molecules with clinical value and hope to help promote the precise treatment of cardiac hypertrophy and thus improve patient outcomes. [ABSTRACT FROM AUTHOR]

Ireland's emergence as a European hub for ICT and pharmaceutical multinationals highlights the growing tension between spatially dispersed economic activity and the nation-centered measures used to monitor it. While 'big tech' and 'big pharma' are often praised as powerful growth engines, their real contribution to the Irish economy remains unclear, as corporate tax avoidance artificially inflates statistics. By moving around intellectual property assets or engaging in factoryless manufacturing, firms go out of their way to book their profits in low-tax jurisdictions. Their products show up in Irish GDP and export figures, often without employing any Irish labour or capital in the production process. This article uses a novel empirical approach to distinguish job-sustaining economic activity from accounting fiction. By contrasting traditional measures of economic growth on a sectoral level with the growth of employment and earnings, it identifies sectors with sudden discrepancies that are indicative signs of fictitious activity. Discrepancies cluster in the industries dominated by US-based multinationals. [ABSTRACT FROM AUTHOR]

The deliberate inhalation of volatile substances for their psychotropic properties is a recognised public health issue that can precipitate sudden death. This study aimed to describe the epidemiological characteristics and survival outcomes of patients with out-of-hospital cardiac arrests following volatile substance use. We conducted a retrospective cohort analysis of all out-of-hospital cardiac arrest attended by the Queensland Ambulance Service over a ten-year period (2012-2021). Incidents were extracted from the Queensland Ambulance Service cardiac arrest registry, which collects clinical information using the Utstein-style guidelines and linked hospital data. During the study period, 52,102 out-of-hospital cardiac arrests were attended, with 22 (0.04%) occurring following volatile substance use. The incidence rate was 0.04 per 100,000 population, with no temporal trends identified. The most commonly used product was deodorant cans (19/22), followed by butane canisters (2/22), and nitrous oxide canisters (1/22). The median age of patients was 15 years (interquartile range 13–23), with 14/22 male and 8/22 Indigenous Australians. Overall, 16/22 patients received a resuscitation attempt by paramedics. Of these, 12/16 were bystander witnessed, 10/16 presented in an initial shockable rhythm, and 9/16 received bystander chest compressions. The rates of event survival, survival to hospital discharge, and survival with good neurological outcome (Cerebral Performance Category 1–2) were 69% (11/16, 95% CI 41–89%), 38% (6/16, 95% CI 15–65%) and 31% (5/16, 11–59%), respectively. Eight patients in the paramedic-treated cohort that used hydrocarbon-based products were administered epinephrine during resuscitation. Of these, none subsequently survived to hospital discharge. In contrast, all six patients that did not receive epinephrine survived to hospital discharge, with 5/6 having a good neurological outcome. Out-of-hospital cardiac arrest following volatile substance use is rare and associated with relatively favourable survival rates. Patients were predominately aged in their adolescence with Indigenous Australians disproportionately represented. [ABSTRACT FROM AUTHOR]

ObjectivesThe objective of this research was to determine the unique contributions of sudden death bereavement to the mental health of university students compared to non-sudden death bereaved university students. Methods: We surveyed 1047 bereaved university students (retention rate 92%) and compared the non-sudden death bereaved university student population to the sudden death bereaved university population on outcomes including mental health symptomatology, and complicated grief using logistic regressions. Results: Sixty two percent of the sample reported sudden death bereavement. There were no differences on measures of PTSD, generalized anxiety disorder, depression, suicidal ideation, and at-risk drinking behavior across types of bereavement. However, sudden death bereavement compared to general bereavement was associated with increased likelihood of complicated grief. Conclusions: Sudden death bereavement in university students is associated with elevated risk of complicated grief. These findings confirm previous research and provide more insight into the unique needs of university student coping with sudden loss. [ABSTRACT FROM AUTHOR]

Between 1882 and 2016, the medical literature offered a variety of etiologic hypotheses to explain Joan of Arc's voices, visions, and unwavering belief that she was the instrument of God. Although Joan lived from 1412 to 1431, there is extensive primary documentation of her life, including transcripts of her testimony during the Trial of Condemnation. Once this source material was compiled and made available, physician-authors began to theorize about Joan's neuropsychiatric symptoms in the context of her remarkable achievements. This article summarizes all papers written by physician-authors about Joan of Arc. The historical flow of diagnostic speculation in the medical literature reflects the cultural context in which it was produced as well as the emergence of novel ideas and new technologies in psychiatry, neurology, and neuropsychiatry. The early literature offered psychological theories and addressed the question of whether Joan was sane. The later literature focused on the possibility that Joan might have had epilepsy, with discussions of seizure etiology and possible cerebral focus, and also reflections on the purview of science as well as spirituality and the brain. This article offers the first comprehensive review of the medical literature about Joan of Arc, making this scholarship more accessible. [ABSTRACT FROM AUTHOR]

Natural disasters often pose sudden and drastic organizational environmental shocks for local governments, leading to administrative disruptions and public finance risks. In the short term, disasters may disrupt debt financing. The disaster shocks may increase the costs of debt if they hurt revenue bases or decrease the costs of debt if generating "constructive destruction" to the local economy. Using a panel of U.S. County governments between 1999 and 2019, we find that weather-related disasters decrease the likelihood of issuing general obligation bonds and increase the probability of issuing revenue bonds and short-term bonds in the subsequent 6 months. Conditional on borrowing, disasters increase the bond yields for short-term bonds. Thus, natural disasters may disrupt the timing of local government long-term borrowing but do not necessarily destroy public finances. [ABSTRACT FROM AUTHOR]

Stephen Fry has described the typical American comic hero as a freewheeling "wisecracker" compared to the English type, who is apt to be an aspirational lower-middle-class failure. With Fry as a prompt, we consider humour and class in the evolution—or devolution—of that representative local hero, the larrikin, during Australian television's first three decades. This was a period that saw a realignment of the nation's political, economic and cultural affiliations away from Britain towards the US, and in which the ocker came into sudden prominence as a less benign version of rowdy male identity. If media larrikins such as Graham Kennedy and Paul Hogan excelled at the kind of sketch-based humour that had its origins in vaudeville and were unsuited to sitcoms, ocker characters such as Wally Stiller from My Name's McGooley and Ted Bullpitt from Kingswood Country found a home there. Our analysis of larrikin and ocker humour is triangulated with that of Norman Gunston, as played by Garry McDonald: a desperately aspirational failure with his own mock variety show who emerged from the dialogue between these two comic types. We conclude with some thoughts on post-ockerism and the emergence of the bogan. [ABSTRACT FROM AUTHOR]

This essay addresses the rise and fall of the Swedish women's club Umeå IK. The question is how a team from a city almost devoid of any football culture suddenly could become one of the most successful clubs in the world during the early 2000s? The theoretical basis consists of the concepts of local identity, glocalization and Manuel Castell's analysis of the network society. The source material is a study of Umeå's largest daily newspaper and eleven interviews. Umeå IK worked energetically to create a strong local network for a women's club (consisting of good contacts with the municipality, high income from sponsors, good media coverage and high attendances). The university city of Umeå was dynamic and progressive, with a strong middle-class character. The population could identify with the team. However, the city's volatility meant that the team did not get long-lasting significance in terms of the city's identity. [ABSTRACT FROM AUTHOR]

Volatile solvent misuse-related death is associated with neuropsychiatric, cardiovascular, respiratory and renal pathology, as well as sudden death. The study aimed to determine: (1) the circumstances of death and case characteristics of volatile solvent misuse-related death in Australia, 2000–2021; (2) the toxicological profile of cases; and (3) the major autopsy findings. Retrospective study of volatile solvent misuse-related death in Australia, 2000–2021 retrieved from the National Coronial Information System. One hundred and sixty-four cases were identified, 79.9% male, mean age 26.5 years (8.5% aged 40 years or older). Circumstances of death were unintentional toxicity (61.0%), unintentional asphyxia (20.1%), intentional self-harm (12.2%) and traumatic accident (6.7%). The most commonly reported acute presentation prior to death was sudden collapse (22 of 47 witnessed events). The most frequently used solvents at the fatal incident were gas fuels (35.4%), gasoline (petrol) (19.5%) adhesives/paints (19.5%), aerosol propellants (12.8%), and volatile anaesthetics (12.8%). The most commonly detected volatile substances were butane (40.7%), toluene (29.6%), and propane (25.9%). Cannabis was present in 27.6% and alcohol in 24.6%. The prevalence of acute pneumonia amongst autopsied cases was low (5.8%) which, together with reports of sudden collapse, suggests that in many cases, death was extremely rapid. There were low levels of major organ pathology. While the average age of volatile solvent misuse-related death was in the mid-twenties, a substantial proportion occurred amongst people aged 40 years or older. Reflecting availability, gas fuels predominated. In many cases, death appeared to have been rapid. [ABSTRACT FROM AUTHOR]

In this cross-sectional study, regressions and multivariate analyses of covariance were used to assess group differences regarding family resilience, family coherence, and social support among 184 widows from three cultural groups in Israel: Druze (n = 66), Jewish (n = 59), and Muslim (n = 59). Druze widows had the lowest social support, but no differences were found between groups regarding family resilience or family coherence. Social support was positively associated with education and living in a city, beyond group. Social support and family coherence were positively associated with family resilience, beyond group. The discussion addresses cultural changes among the three groups. [ABSTRACT FROM AUTHOR]

In the present study, the authors aimed to investigate the experiences of families bereaved by the death of their loved ones at workplaces in Kashmir. 17 families were selected through purposive sampling. Data were collected by using an unstructured interview guide. Thematic analysis of the data revealed that the families had to face severe social, mental, physical, and financial problems, including difficulties in claiming and receiving compensation, immediate and long-term financial difficulties due to the death of the breadwinner, mental and physical health problems, unmet support needs, family disruption, and social, educational and behavioural impact on children. Recommendations for policy development and interventions are suggested to prevent workplace accidents and fatalities at workplaces, reduce the disturbance and sufferings experienced by surviving families and alleviate the multi-dimensional consequences. [ABSTRACT FROM AUTHOR]

Hypertrophic cardiomyopathy (HCM) is the most common inherited heart disease. However, a detailed DNA methylation (DNAme) landscape has not yet been elucidated. Our study combined DNAme and transcriptome profiles for HCM myocardium and identify aberrant DNAme associated with altered myocardial function in HCM. The transcription of methylation-related genes did not significantly differ between HCM and normal myocardium. Nevertheless, the former had an altered DNAme profile compared with the latter. The hypermethylated and hypomethylated sites in HCM tissues had chromosomal distributions and functional enrichment of correlated genes differing from those of their normal tissue counterparts. The GO analysis of network underlying the genes correlated with DNAme alteration and differentially expressed genes (DEGs) shows functional clusters centred on immune cell function and muscle system processes. In KEGG analysis, only the calcium signalling pathway was enriched either by the genes correlated with changes in DNAme or DEGs. The protein-protein interactions (PPI) underlying the genes altered at both the DNAme and transcriptional highlighted two important functional clusters. One of these was related to the immune response and had the estrogen receptor-encoding ESR1 gene as its node. The other cluster comprised cardiac electrophysiology-related genes. Intelliectin-1 (ITLN1), a component of the innate immune system, was transcriptionally downregulated in HCM and had a hypermethylated site within 1500 bp upstream of the ITLN1 transcription start site. Estimates of immune infiltration demonstrated a relative decline in immune cell population diversity in HCM. A combination of DNAme and transcriptome profiles may help identify and develop new therapeutic targets for HCM. [ABSTRACT FROM AUTHOR]

The death notification is regarded as one of the most defining events for families of sudden and unexpected death. Little is known how the death notification process impacts families who have lost a loved one to homicide. Using the focus group methodology, this study depicts the death notification process through the eyes of homicide co-victims and examines the patterned aspects of the notifiers' association with co-victims as their relationships and contacts unfold across three critical phases of death notification: initiating contact with co-victims, delivering the notice, and providing assistance and referral to co-victims. Of particular interest is retelling personal accounts of secondary victimization that homicide co-victims experience during the death notification process and how they responded to such experiences. The paper concludes by discussing ways to improve death notification protocols and training guidelines and providing direction for future policy and practice. [ABSTRACT FROM AUTHOR]

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The post-mortem diagnosis for acute myocardial infarction is one of the most challenging because acute myocardial infarction in the first 4 hours does not provide specific changes. Hence, this research evaluated the effectiveness of immunohistochemistry staining for detecting early myocardial infarction. Immunohistochemical staining for myoglobin and C5b9 were conducted on myocardial tissue from four groups with the following criteria: 1. Acute myocardial infarction cases (18 cases, positive control), 2. Severe coronary atherosclerosis cases (19 cases), 3. Natural deaths with unknown cause of death (12 cases), 4. Negative control. The results were that myoglobin staining was found positive in 17 cases of group 1 (94.4%), 13 cases of group 2 (68.4%), 3 cases of group 3 (25%), and 6 cases of group 4 (60%). C5b9 staining was found positive in 18 cases of group 1(100%), 10 cases of group 2 (52.6%), 4 cases of group 3 (33.3%), and 7 cases of group 4 (70%). The results showed that no statistical significance was found in a comparative analysis between group 4 and group 2. Hence, the results of staining for C5b9 and myoglobin conflict with the findings of prior research because the specificity in identifying acute myocardial infarction was low. [ABSTRACT FROM AUTHOR]

Loss of complexity and chaos of heart rate variability (HRV) of an individual increases the risk of mortality from cardiovascular diseases. Abnormalities in HRV associated with intractable epilepsy may even lead to "sudden death in epilepsy" (SUDEP). By activating the parasympathetic division of the autonomic nervous system, Vagus Nerve Stimulation (VNS) has the potential to restore the natural chaotic behavior of the heart which can be measured by the increase in complexity of HRV as indicated by complexity measures such as Effort-To-Compress (ETC) and Lempel-Ziv Complexity (LZC). In this study, we formulate and test two hypothesis – (A) chaotic time series exhibit lower temporal correlation of complexity measures such as LZ and ETC than uniformly random time series, and (B) Vagus Nerve Stimulation (VNS ON) results in chaotic cardiovascular dynamics. Hypothesis-A is verified by a simulated study on chaotic time series from the Logistic map where we see a clear decrease in temporal correlation between ETC and LZC values as the degree of chaos increases. Hypothesis-B is supported by an experimental study on a VNS implanted patient and not implanted controls. A temporal correlation analysis between complexity measures (ETC and LZC) on HRV data samples shows that VNS during sleep increases chaotic behavior in contrast to lack of VNS and in control subjects. Surrogate analysis further confirmed that VNS activation led to deterministic chaos and not stochastic randomness. Our approach proposes a clear methodology to determine the efficacy of VNS intervention in restoring the chaoticity of cardiovascular dynamics. [ABSTRACT FROM AUTHOR]

Survivors of sudden death losses frequently experience vivid imagery associated with the events surrounding their loved one's death. This paper describes the development and psychometric validation of the Dying Imagery Scale-Revised (DIS-R), a 15-item measure assessing three forms of death imagery, including Reenactment, Remorse, and Revenge imagery. The first study details the development of the DIS-R in a sample of suddenly bereaved college students. The second study examines the validity and reliability of the DIS-R among suddenly bereaved adults. Results suggest that the measure is psychometrically sound and may provide clinically useful information for bereavement counselors. [ABSTRACT FROM AUTHOR]

The three main cardiac amyloidosis (CA) types have different progression and prognosis. Little is known about the mode of death (MOD) which is commonly attributed to cardiovascular causes in CA. Improving MOD's knowledge could allow to adapt patient care. This retrospective study describes the MOD that occurred during long-term follow-up in CA patients in light-chain (AL), transthyretin hereditary (ATTRv) or wild-type (ATTRwt). Patients referred to and cared for, at the French referral centre for CA, Henri Mondor Hospital, Créteil between 2010 and 2016 were included. Clinical information surrounding patient deaths were investigated and centrally evaluated by two blinded clinical committees which classified MOD as cardiovascular, non-cardiovascular or unknown and sub-classified it depending on its subtype. From the 566 patients included, 187 had AL, 206 ATTRv and 173 ATTRwt. During the 864 patient-year follow-up, 160 (28%) deaths occurred, with median survival time of 17.3 months (interquartile range 5.1–35.4). The most frequent MOD was cardiovascular (64%) of which worsening heart failure occurred most frequently and for which, 69% were of AL subtype, 79% ATTRv and 76% ATTRwt. Sudden death also occurred more frequently in AL subtype accounting for 29% of AL deaths. Non-cardiovascular MOD occurred in 26% of patients overall. Among these, infection was the most common non-cardiovascular MOD in any type of CA (80%). Mortality is high during natural course of CA and differs between subtypes. The main MOD were worsening heart failure, sudden death and infection, opening room to optimise management. [ABSTRACT FROM AUTHOR]

The occurrence of a sustained monomorphic ventricular tachycardia in patients with structural heart disease is a class 1 indication for ICD because of the expected relevant risk of sudden death. However, if this concerns selected patients with preserved left ventricular function and well-tolerated arrhythmias is still poorly known. In this article, we review the available data about the natural history of nonimplanted patients with structural heart disease and sustained ventricular tachycardia and the possible role of catheter ablation alone in this population. In structural heart disease patients with well-tolerated sustained ventricular tachycardia and preserved LVEF, catheter ablation alone, without ICD implantation, does not seem to carry an important risk of sudden death and the prognosis of these patients is mainly nonarrhythmic. Randomized prospective trials are urgently needed for evaluating the place of first choice ablation without ICD implantation in these populations. [ABSTRACT FROM AUTHOR]

Intracranial germinomas are uncommon and constitute less than 1% of all intracranial tumors. They usually arise in the midline of the brain, most commonly in the pineal region. Pineal germinomas tend to spread through the cerebrospinal fluid (CSF). However, pineal germinomas with fast-developing diffuse subarachnoid/leptomeningeal dissemination are extremely rare, especially in young children. The case of a 4-year-old boy with a pineal germinoma who died of diffuse subarachnoid/leptomeningeal dissemination 1 month after radiotherapy is reported. A PubMed search with specific key terms was used to review cases of pineal germinomas with metastasis. The patient presented with a two-week history of worsening headache, visual disturbances and nonprojectile vomiting. Parinaud's sign was positive on physical examination. Head computed tomography (CT)/magnetic resonance imaging (MRI) revealed a lesion in the pineal region with eccentric calcification and obvious supratentorial hydrocephalus. Pineal germinoma was suspected. A ventriculoperitoneal (VP) shunt followed by focal radiotherapy ameliorated the headaches and visual disturbances. The patient was discharged home without further treatment due to financial difficulties. One month after discharge, he was readmitted due to worsening headache, vomiting and lethargy. MRI showed a decrease in the size of the pineal lesion but revealed a diffuse leptomeningeal enhancement including the sulcus, basal cistern, prepontine cistern, and supravermian cistern. The patient's condition deteriorated rapidly, and he died 26 hours after readmission. The characteristics of pineal germinomas with metastasis are reported based on a review of the literature. Metastases in pineal germinomas predominately occur in adolescents or young adults, most commonly as spinal "drop metastases." Dissemination usually develops several years after the initial tumor diagnosis and has a relatively good clinical prognosis. However, fast widespread subarachnoid/leptomeningeal dissemination and sudden death may occur in a young child before salvage treatment, as in the presented case. [ABSTRACT FROM AUTHOR]

Cardiac tamponade is a potential complication in neonates with central venous catheters (CVC). Cardiac tamponade may be due to infection, a CVC related complication, or parental nutrition (PN) effusion. This is a preterm (30 weeks gestational age), very low birth weight male, admitted to the Neonatal Intensive Care Unit, requiring nasal continuous positive airway pressure. PN was provided via an umbilical venous catheter. An unexpected cardiac arrest occurred on the third day of life with an unsuccessful resuscitation. Autopsy revealed pericardial effusion composed of PN fluid with cardiac tamponade as the cause of death. Cardiac tamponade due to total PN effusion in the premature neonate may be fatal. The mechanism of the epicardial/pericardial effusion is not known. [ABSTRACT FROM AUTHOR]

Commotio cordis is a sudden death mechanism that occurs when the heart is impacted during the repolarization phase of the cardiac cycle. This study aimed to investigate commotio cordis injury metrics by correlating chest force and rib deformation to left ventricle strain and pressure. We simulated 128 chest impacts using a simulation matrix which included two initial velocities, 16 impact locations spread across the transverse and sagittal plane, and four baseball stiffness levels. Results showed that an initial velocity of 17.88 m/s and an impact location over the left ventricle was the most damaging setting across all possible settings, causing the most considerable left ventricle strain and pressure increases. The impact force metric did not correlate with left ventricle strain and pressure, while rib deformations located over the left ventricle were strongly correlated to left ventricle strain and pressure. These results lead us to the recommendation of exploring new injury metrics such as the rib deformations we have highlighted for future commotio cordis safety regulations. [ABSTRACT FROM AUTHOR]