Ventricular septation is a complex process which involves the major genes of cardiac development, acting on myocardial cells from first and second heart fields, and on mesenchymal cells from endocardial cushions. These genes, coding for transcription factors, interact with each other, and their differential expression conditions the severity of the phenotype. In this chapter, we will describe the formation of the ventricular septum in the normal heart, as well as the molecular mechanisms leading to the four main anatomic types of ventricular septal defects: outlet, inlet, muscular, and central perimembranous, resulting from failure of development of the different parts of the ventricular septum. Experiments on animal models, particularly transgenic mouse lines, have helped us to decipher the molecular determinants of ventricular septation. However, a precise description of the anatomic phenotypes found in these models is mandatory to achieve a better comprehension of the complex mechanisms responsible for the various types of VSDs.

Venous thoracic outlet syndrome commonly results in arm swelling and pain as the subclavian vein is obstructed within the thoracic inlet. We report the use of ferumoxytol-enhanced contrast MRI in the diagnosis of venous thoracic outlet syndrome in a male adolescent. In this patient who presented with right upper extremity thrombosis, ferumoxytol-enhanced MRI of the chest was able to show both chronic subclavian vein thromboses and dynamic occlusion of the subclavian veins with arm abduction consistent with Paget-Schroetter syndrome.

Indoor particles and carbon dioxide concentration are major indices to evaluate indoor air quality. Based on the two-dimensional filler sieving model of the direct evaporative cooling segment, the porous media model was used for the simulation of the water filler section, the filtering efficiency of particle was simulated by adjusting the water drenching density and airflow velocity in different operating conditions. The three-dimensional classroom model used to change the exhaust outlet position and control the use of air conditioners simulated the indoor thermal environment and the changes in pollutant concentration. The Euler method and Lagrangian method were used to analyze the indoor flow field and particle sieving in the direct evaporation section, respectively. Conclusions show that in the application of evaporative cooling and stratum ventilation air conditioning system in classroom, the position of the exhaust port affects the concentration of carbon dioxide in the student\'s breathing area. The water filler section can effectively reduce the concentration of particle and carbon dioxide supplied indoors. The filtration efficiency of particle in outdoor air passing through the direct evaporative cooling section based on diffusion, inertial collision, and interception is affected by the combined effect of particle size, onward wind speed, and water spray density. The filtration efficiency of particle increases as the density of the spray water increases. With the increase of head-on wind speed, the filtration efficiency of coarse particulate matter is higher than that of fine particulate matter. The research results help policy makers decide whether to install evaporative cooling air conditioning in schools and determine which exhaust outlet positions are most effective in improving indoor air quality.

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Canada legalized nonmedical cannabis in October 2018, but significant variations in municipal regulations exist. This study explored the variations that exist and pondered their potential public health consequences. A comparative analysis was completed on the regulations and guidelines that addressed retailers\' location and public consumption in the municipalities of Alberta, Ontario, and Québec. Municipal regulations that addressed the location of retailers were more numerous and extensive in Alberta and Ontario (in the context of provincial private retail models) than in Québec (government-based model). Municipalities in Alberta added more restrictions to public consumption laws as compared to municipalities in Ontario and in Québec. These additions were made to Alberta\'s and Ontario\'s provincial-level smoking and vaping bans which used tobacco-inspired frameworks, and to Québec\'s ban on smoking and vaping in all public spaces. The comparative analysis showed the importance of considering municipal cannabis regulations when studying the impact of legalization, given the significant variations that exist. Policy makers should be made aware of these variations in the regulation of cannabis in order to limit health harms and further social inequalities.

Reducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth.
We reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours.
Thirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths\' home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth.
The existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths\' home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth.

UNASSIGNED: Electrical socket outlets are used continuously until a failure occurs because they have no indication of manufacturing date or exchange specifications. For this reason, 659 electrical fires related to electrical socket outlets broke out in the Republic of Korea at 2018 only, an increase year on year. To reduce electrical fires from electrical socket outlets, it is necessary to perform an accelerated test and analyze the thermal, insulation resistance, and material properties of electrical socket outlets by installation years.
UNASSIGNED: Thermal characteristics were investigated by measured the temperature increase of electrical socket outlets classified according to year with variation of the current level. Insulation resistance characteristics was measured according to temperature for an electrical socket outlets by their years of use. Finally, to investigate the thermal and insulation resistance characteristics in relation to outlet aging, this study analyzed electrical socket outlets\' conductor surface and content, insulator weight, and thermal deformation temperature.
UNASSIGNED: Analysis showed, regarding the thermal characteristics, that electrical socket outlet temperature rose when the current value increased. Moreover, the longer the time that had elapsed since an accelerated test and installation, the higher the electrical socket outlet temperature was. With respect to the insulation resistance properties, the accelerated test (30 years) showed that insulation resistance decreased from 110 °C. In relation to the installation year (30 years), insulation resistance decreased from 70 °C, which is as much as 40 °C lower than the result found by the accelerated test. Regarding the material properties, the longer the elapsed time since installation, the rougher the surface of conductor contact point was, and cracks increased.
UNASSIGNED: The 30-year-old electrical socket outlet exceeded the allowable temperature which is 65 °C of the electrical contacts at 10 A, and the insulation resistance began to decrease at 70 °C. It is necessary to manage electrical socket outlets that have been installed for a long time.

Local governments have integral roles in contributing to public health. One recent focus has been on how local governments can impact community nutrition by engaging food service outlets to improve their food offer. The Healthier Catering Commitment (HCC) is an initiative where London local governments support takeaways and restaurants to meet centrally defined nutrition criteria on their food options. Using the case of HCC, the current study aims to provide (1) practical learnings of how local governments could facilitate and overcome barriers associated with implementing healthy food service initiatives in general, and (2) specific recommendations for enhancements for HCC.
Key informant, semi-structured interviews were conducted with local government staff involved in HCC, exploring barriers and facilitators to HCC implementation in food businesses. A thematic analysis approach was used, with results presented according to a logic pathway of ideal implementation in order to provide practical, focused insights.
Local governments implementing HCC.
Twenty-two individuals supporting HCC implementation.
Facilitators to implementation included flexible approaches, shared resourcing and strategically engaging businesses with practical demonstrations. Barriers were limited resources, businesses fearing negative customer responses and low uptake in disadvantaged areas. Key suggestions to enhance implementation and impact included offering additional incentives, increasing HCC awareness and encouraging recruited businesses to make healthy changes beyond initiative requirements.
In order to facilitate the implementation of healthy food initiatives in food outlets, local governments would benefit from involving their environmental health team, employing community-tailored approaches and focusing on supporting businesses in disadvantaged areas.

BACKGROUND: Venous thoracic outlet syndrome (VTOS) results from compression and thrombosis of the axillosubclavian vein. In primary effort thrombosis, a subtype of VTOS, chronic repetitive compression injury of the axillosubclavian vein leads to scarring, stenosis, and eventually, thrombosis. This is a rare manifestation of an upper extremity deep vein thrombosis.
METHODS: A 23-year-old male student without significant past medical history presented to our Emergency Department with a complaint of intermittent swelling and discoloration of his upper right arm. His symptoms had been present for the past year and had worsened over the past few weeks. Swelling was associated with overhead use of the arm. There is no family history of clotting disorders. A computed tomography angiogram of the chest with upper extremity runoff showed findings consistent with VTOS. The patient was discharged with an urgent referral to Vascular Surgery. Within 2 weeks, he underwent multiple surgical procedures and was initiated on anticoagulation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: VTOS usually presents in patients who do not have commonly recognized prothrombotic risk factors. Emergency physicians should include this diagnosis in their differential because good functional outcomes rely on early diagnosis and prompt initiation of treatment. In addition, emergency physicians must refer these patients to vascular surgeons, as most will require surgical management.

Neighborhood-level socioeconomic variables, such as the proportion of minority and low-income residents, have been associated with a greater density of tobacco retail outlets (TROs), though less is known about the degree to which these neighborhood indicators are related to vape shop outlet (VSO) density. Many studies of TROs and neighborhood characteristics include only a small set of variables and also fail to take into account the correlation among these variables. Using a carefully curated database of all TROs and VSOs in Virginia (2016-2018), we developed a Bayesian model to estimate a neighborhood disadvantage index and examine its association with rates of outlets across census tracts while also accounting for correlations among variables. Models included 12 census tract variables from the American Community Survey. Results showed that increasing neighborhood disadvantage was associated with a 63% and 64% increase in TRO and VSO risk, respectively. Important variables associated with TRO rates included % renter occupied housing, inverse median gross rent, inverse median monthly housing costs, inverse median monthly housing costs, and % vacant housing units. Important variables associated with VSO rates were % renter occupied housing and % Hispanic population. There were several spatial clusters of significantly elevated risk for TROs and VSOs in western and eastern Virginia.