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Provides a detailed comparative analysis of the multiple mechanisms by which French and English monarchs exercised their power in the final centuries of the Middle Ages.

Potential benefits of precision medicine in cardiovascular disease (CVD) include more accurate phenotyping of individual patients with the same condition or presentation, using multiple clinical, imaging, molecular and other variables to guide diagnosis and treatment. An approach to realising this potential is the digital twin concept, whereby a virtual representation of a patient is constructed and receives real-time updates of a range of data variables in order to predict disease and optimise treatment selection for the real-life patient. We explored the term digital twin, its defining concepts, the challenges as an emerging field, and potentially important applications in CVD. A mapping review was undertaken using a systematic search of peer-reviewed literature. Industry-based participants and patent applications were identified through web-based sources. Searches of Compendex, EMBASE, Medline, ProQuest and Scopus databases yielded 88 papers related to cardiovascular conditions (28%, n  = 25), non-cardiovascular conditions (41%, n  = 36), and general aspects of the health digital twin (31%, n  = 27). Fifteen companies with a commercial interest in health digital twin or simulation modelling had products focused on CVD. The patent search identified 18 applications from 11 applicants, of which 73% were companies and 27% were universities. Three applicants had cardiac-related inventions. For CVD, digital twin research within industry and academia is recent, interdisciplinary, and established globally. Overall, the applications were numerical simulation models, although precursor models exist for the real-time cyber-physical system characteristic of a true digital twin. Implementation challenges include ethical constraints and clinical barriers to the adoption of decision tools derived from artificial intelligence systems.

\"The greatest of the under-18 set returns for another round of major-league mayhem against the forces of chaos and destruction. Join Robin, Beast Boy, Raven, Cyborg, and Starfire as they fight for right in six titanic tales\"--Page 4 of cover.

Precision medicine envisages a changed paradigm for health care through better understanding of individual disease susceptibility and prognosis, enabling more personalized treatment. Enabling technologies such as the health digital twin are rapidly evolving, presenting important challenges and opportunities to be tackled within local contexts.

\"A covert mission in Shanghai reunites Kusanagi with a wartime rival and shifting loyalties. Togusa and Saito set out to infiltrate a bio-supremacist gang, without the use of their cybernetics. A data thief living in the broken remnants of the United States is reuinted with an old flame and gets dragged into a tragedy that neither of them can stop. And a deep dive into the mind of a criminal forces Major Kusanagi to question the nature of imagination, and her own identity.\"--Page 4 of cover.

Purpose Nasal saline irrigation is highly recommended in patients following functional endoscopic sinus surgery (FESS) to aid the postoperative recovery. Post-FESS patients have significantly altered anatomy leading to markedly different flow dynamics from those found in pre-op or non-diseased airways, resulting in unknown flow dynamics. Methods This work investigated how the liquid stream disperses through altered nasal cavities following surgery using Computational Fluid Dynamics (CFD). A realistic squeeze profile was determined from physical experiments with a 27-year-old male using a squeeze bottle with load sensors. The administration technique involved a head tilt of 45-degrees forward to represent a head position over a sink. After the irrigation event that lasted 4.5 s, the simulation continued for an additional 1.5 s, with the head orientation returning to an upright position. Results The results demonstrated that a large maxillary sinus ostium on the right side allows saline penetration into this sinus. The increased volume of saline entering the maxillary sinus limits the saline volume available to the rest of the sinonasal cavity and reduces the surface coverage of the other paranasal sinuses. The average wall shear stress was higher on the right side than on the other side for two patients. The results also revealed that head position alters the sinuses’ saline residual, especially the frontal sinuses. Conclusion While greater access to sinuses is achieved through FESS surgery, patients without a nasal septum limits posterior sinus penetration due to the liquid crossing over to the contralateral cavity and exiting the nasal cavity early.

How cerebrospinal fluid (CSF) circulates around the brain and spine is important to understand solute transport and the mechanisms of CSF flow disorders. It has recently been shown that respiratory-associated spinal CSF flows are influenced by intrathoracic and abdominal pressures, as well as by cranial blood volume. The mechanism of this remains unclear, and we hypothesise that differences in thoracic and lumbar pressures during respiration drive spinal epidural blood volume changes, which in turn drive CSF movement. We tested this hypothesis using a simple model of the whole spinal subarachnoid space (SSAS) and deformed the boundaries of the SSAS to simulate the effect of changes in epidural venous blood volumes. The model showed that the direction of cervical CSF flow depended on the relative difference in the volumes of the thoracic and lumbar SSAS. When the volume increase of the thoracic SSAS was the same or larger than the reduction of the lumbar SSAS, cervical CSF was drawn caudally, but when the change in thoracic SSAS was smaller, cervical CSF was displaced cranially. These models showed that the direction of cervical CSF flow was sensitive to small differences in the thoracic and lumbar SSAS. Since the SSAS volume change depends on the intrathoracic and abdominal pressures that drive venous blood through the epidural veins, these models suggest that respiratory manoeuvres that produce a large pressure gradient across the diaphragm are more likely to draw CSF caudally from the cranium into the SSAS.

\"One of the greatest storytellers of his generation, Grant Morrison's arrival onto the Dark Knight was one of the most hyped debuts in industry history. This collection includes time-spanning epic graphic novels featuring the cataclysmic events of FINAL CRISIS and the introduction of Batman's son, Damian Wayne! These blockbuster stories featured a deconstruction of super hero comics like never before, with challenging, thought-provoking takes on the modern, four-color icons.\"-- Provided by publisher.

Background Urban air pollution is the second highest risk factor for non-communicable diseases. Socioeconomically deprived populations are at greater risk from related adverse health outcomes and often bear the additional burden of living in areas with higher pollution exposure. To reduce this inequality policy makers need to understand the relationship between the location of interventions and improvements in air quality. The 3–30-300 greening rule outlines guidance to improve residents’ access to trees and greenspace. No studies have yet evaluated its implications for reductions in inequalities or co-benefits beyond greenspace access. This paper explores the relationship between exposure to PM 2.5 and socioeconomic status in Paris and Aarhus, and the potential impact of the 3–30-300 rule on health inequalities. Method We use air quality models and socioeconomic data to calculate disparities in access to greenspace and exposure to fine particulate air pollution across subgroups using two land cover scenarios: existing greenspace conditions and potential enhancements following the 3–30 rule. The following socioeconomic data were disaggregated to residential buildings: households in poverty, age group, citizenship, employment, and education. Exposure to air pollution was calculated as the population-weighted average of PM 2.5 concentration (µg m −3 ). Results The relationship between socioeconomic characteristics and exposure to poor air quality differed in each city: In Paris, populations often considered more vulnerable to adverse health outcomes (unemployed, non-citizens, lower education level, lowest income) were exposed to higher concentrations of PM 2.5 , (although the relationship with income was nonlinear), whilst both older and younger populations had slightly lower particulate exposure than working age populations. By contrast, in Aarhus, populations with higher socioeconomic status (and by association, lower vulnerability) in terms of income, education, citizenship and employment status, were exposed to higher concentrations of PM 2.5 , whilst children were the age group least exposed to fine particulates. Increasing greenspace under the 3–30 had contrasting effects on inequities in each city: mitigations improved air quality for all populations in both but, in Paris, the greatest benefit was experienced by those with lower baseline exposure as well as lower vulnerability. In Aarhus larger air quality improvements were experienced by populations with the highest baseline exposure except for the income characteristic. These were not groups expected to be at greater risk of adverse health outcomes. Conclusions Reductions in PM 2.5 concentration can be produced via targeted increases in trees. The impact on public health outcomes depends in part, on the spatial distribution of socioeconomic groups. Somewhat counter-intuitively, the 3–30 rule in both cities gave greater benefit to those with lower vulnerability.