Southern Pomo (Pomoan, California) displays a process of rhythmic vowel deletion (syncope) reflecting two mutually incompatible metrical structures. This phenomenon, called metrical incoherence, can be derived by an ordered sequence of independent subgrammars, that is, strata. Metrical incoherence is under-attested crosslinguistically, and the stratal models of phonology necessary to generate it have been criticised for predicting counter-typological phenomena. Nevertheless, the Southern Pomo data cannot be generated in more restrictive frameworks. This article argues that overgeneration is a necessary property of the phonological component, and that metrical incoherence is rare because it is difficult to learn. In Southern Pomo, this difficulty appears to have caused grammatical competition and restructuring: a second pattern of syncope, occurring in only a limited context, suggests that learners have reanalysed the grammar as having consistent metrical structure across the derivation. This work thus supports the proposal that diachronic change – and therefore typology – is constrained by extragrammatical factors.

Stunning prior to slaughter is commonly used to render the animal insensible to pain. However, for certain markets, stunning is disallowed, unless the animal can fully recover if not slaughtered. There are very few available methods of inducing a fully recoverable stun. This preliminary study investigates the potential for microwave energy application to be used to induce a recoverable stun in sheep. Cadaver heads were used to demonstrate that brain temperature could be raised to a point at which insensibility would be expected to occur (44°C). Trials on four anaesthetised sheep confirmed this finding in a live animal model where brain temperatures between 43 and 48°C were achieved with 20 s of microwave energy application. Although the applicator and process variables require some further development, this technology seems eminently suitable for use as an alternative method of inducing a recoverable stun.

A young child presented with syncope attacks. Late-onset post-operative complete atrioventricular block and Torsades de Pointes were diagnosed. She was treated with surgical epicardial pacemaker implantation. This report is the description of Torsades de Pointes due to late-onset post-operative complete atrioventricular block followed by R on T phenomenon in a child.

In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients.

This study addresses a controversial aspect of the change traditionally known as Middle English Open Syllable Lengthening (MEOSL): the variable results of lengthening in disyllabic (C)V.CVC stems, the heaven–haven conundrum. It presents a full philological survey of the recoverable monomorphemic input items and their reflexes in Present-day English (PDE). A re-examination of the empirical data reveals a previously unnoticed correlation between lengthening and the sonority of the medial consonant in forms such as paper, rocket, gannet and baron, as well as interplay between that consonant and the σ2 coda. The alignment of disyllabic stems with a medial alveolar stop and a sonorant weak syllable coda (Latin, better, otter) with (C)V.RVR stems (baron, felon, moral) opens up a new perspective on the reconstruction of tapping in English. The results of lengthening in disyllabic forms, including those previously thought of as ‘exceptions’ to the change, are modeled in Classical OT and Maxent OT, prompting an account which reframes MEOSL as a stem-level compensatory process (MECL) for all inputs. We show that OT grammars with conventional constraints can correctly predict variation in the (C)V.TəR stems and categorical lengthening or non-lengthening in other disyllabic stems. Broadening the phonological factors beyond the open-syllable condition for potential stressed σ1 inputs in (C)V.CV(C) stems allows us to apply the same constraints to stems whose input structure does not involve an open syllable and to propose a uniform account of stressed vowel quantity in all late Middle English mono- and di-syllabic stems.

We present the case of a 12-year-old boy with type 2 long QT syndrome in whom torsades de pointes was induced by an acute face immersion test. This test is feasible to predict cardiac events in adolescents with long QT syndrome.

Short QT syndrome is a malignant repolarisation disorder characterised by short QT intervals. We present a previously asymptomatic 14-year-old male patient with negative family history, who suffered a sudden cardiac arrest while playing basketball and diagnosed with short QT syndrome to make emphasis on the fact that although very rare patients with this syndrome may experience cardiac arrest during exercise.

Introduction: Selecting appropriate patients for hospitalization following emergency department (ED) evaluation of syncope is critical for serious adverse event (SAE) identification. The primary objective of this study is to determine the association of hospitalization and SAE detection using propensity score (PS) matching. The secondary objective was to determine if SAE identification with hospitalization varied by the Canadian Syncope Risk Score (CSRS) risk-category. Methods: This was a secondary analysis of two large prospective cohort studies that enrolled adults (age ≥ 16 years) with syncope at 11 Canadian EDs. Patients with a serious condition identified during index ED evaluation were excluded. Outcome was a 30-day SAE identified either in-hospital for hospitalized patients or after ED disposition for discharged patients and included death, ventricular arrhythmia, non-lethal arrhythmia and non-arrhythmic SAE (myocardial infarction, structural heart disease, pulmonary embolism, hemorrhage). Patients were propensity matched using age, sex, blood pressure, prodrome, presumed ED diagnosis, ECG abnormalities, troponin, heart disease, hypertension, diabetes, arrival by ambulance and hospital site. Multivariable logistic regression assessed the interaction between CSRS and SAE detection and we report odds ratios (OR). Results: Of the 8183 patients enrolled, 743 (9.0%) patients were hospitalized and 658 (88.6%) were PS matched. The OR for SAE detection for hospitalized patients in comparison to those discharged from the ED was 5.0 (95%CI 3.3, 7.4), non-lethal arrhythmia 5.4 (95%CI 3.1, 9.6) and non-arrhythmic SAE 6.3 (95%CI 2.9, 13.5). Overall, the odds of any SAE identification, and specifically non-lethal arrhythmia and non-arrhythmia was significantly higher in-hospital among hospitalized patients than those discharged from the ED (p < 0.001). There were no significant differences in 30-day mortality (p = 1.00) or ventricular arrhythmia detection (p = 0.21). The interaction between ED disposition and CSRS was significant (p = 0.04) and the probability of 30-day SAEs while in-hospital was greater for medium and high risk CSRS patients. Conclusion: In this multicenter prospective cohort, 30-day SAE detection was greater for hospitalized compared with discharged patients. CSRS low-risk patients are least likely to have SAEs identified in-hospital; out-patient monitoring for moderate risk patients requires further study.