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Dynamic equilibrium models based on present value computation not only imply that returns are predictable but also generate particular short-term patterns of predictability in asset returns. I take advantage of this to construct a set of tests of equilibrium generated predictability (EGP). I apply the tests to document two puzzles: First, option-implied or realized measures of volatility ought to predict returns but do not; and second, the variance risk premium (VRP) predicts returns but only at long horizons. VRP fails the tests of EGP as the term structure of predictable variation is inconsistent with an equilibrium interpretation.
Disparities in CHD outcomes exist across the lifespan. However, less is known about disparities for patients with CHD admitted to neonatal ICU. We sought to identify sociodemographic disparities in neonatal ICU admissions among neonates born with cyanotic CHD.
Materials & Methods:
Annual natality files from the US National Center for Health Statistics for years 2009–2018 were obtained. For each neonate, we identified sex, birthweight, pre-term birth, presence of cyanotic CHD, and neonatal ICU admission at time of birth, as well as maternal age, race, ethnicity, comorbidities/risk factors, trimester at start of prenatal care, educational attainment, and two measures of socio-economic status (Special Supplemental Nutrition Program for Women, Infants, and Children [WIC] status and insurance type). Multivariable logistic regression models were fit to determine the association of maternal socio-economic status with neonatal ICU admission. A covariate for race/ethnicity was then added to each model to determine if race/ethnicity attenuate the relationship between socio-economic status and neonatal ICU admission.
Results:
Of 22,373 neonates born with cyanotic CHD, 77.2% had a neonatal ICU admission. Receipt of WIC benefits was associated with higher odds of neonatal ICU admission (adjusted odds ratio [aOR] 1.20, 95% CI 1.1–1.29, p < 0.01). Neonates born to non-Hispanic Black mothers had increased odds of neonatal ICU admission (aOR 1.20, 95% CI 1.07–1.35, p < 0.01), whereas neonates born to Hispanic mothers were at lower odds of neonatal ICU admission (aOR 0.84, 95% CI 0.76–0.93, p < 0.01).
Conclusion:
Maternal Black race and low socio-economic status are associated with increased risk of neonatal ICU admission for neonates born with cyanotic CHD. Further work is needed to identify the underlying causes of these disparities.
Natural sepiolite has great potential for application in wound healing, haemostasis and medicines. This paper introduces a versatile solid-state sintering technique for preparing sepiolite-based nanocomposites with enhanced antibacterial properties, and the physical, structural, rheological and antibacterial properties of which were determined to be enhanced. The incorporation of nanosized Ag and metal oxides into sepiolite composites results in a notable improvement in their antibacterial efficacy against Escherichia coli and Staphylococcus aureus in comparison to the unmodified sepiolite. With a low silver content of just 5%, the sepiolite–Ag composite achieves an antibacterial rate of ~100%. Furthermore, the rheological properties exhibited by the sepiolite composites are noteworthy, suggesting their suitability for use in wound-dressing applications due to their exceptional workability. The methodology employed in this research has the potential to offer a viable substitute for the production of economical and effective natural antibacterial nanocomposites.
We previously showed in rats that pre- and postnatal deficiencies in iron and omega-3 (n-3) fatty acids can impair bone development, with additive and potentially irreversible effects when combined. This study aimed to investigate, in female rats consuming a combined iron and n-3 fatty acid deficient (ID + n-3 FAD) diet preconception, whether supplementation with iron and docosahexaenoic/eicosapentaenoic acid (DHA/EPA), alone and in combination, can prevent bone impairments in offspring. Using a 2 × 2 factorial design, female Wistar rats consuming an ID + n-3 FAD diet preconception were randomised to receive an: 1) iron supplemented (Fe + n-3 FAD), 2) DHA/EPA supplemented (ID + DHA/EPA), 3) Fe + DHA/EPA, or 4) ID + n-3 FAD diet from gestational day 10 throughout pregnancy and lactation. Post-weaning, offspring (n = 24/group; male:female = 1:1) remained on the respective experimental diets for three weeks until postnatal day 42–45. Offspring born to female rats consuming a control diet preconception and an Fe+DHA/EPA diet throughout pregnancy and lactation served as non-deficient reference group (Control+Fe+DHA/EPA). Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry and bone strength using three-point bending tests. Only offspring in the Fe+DHA/EPA group had significantly higher spine and femur BMD, and higher femur stiffness than offspring in the ID + n-3 FAD group, and had similar spine BMD and femur stiffness as the Control + Fe + DHA/EPA group. Offspring in the Fe + DHA/EPA group further had significantly higher femur strength (ultimate load) than the other experimental groups, and a similar femur strength as the Control + Fe + DHA/EPA group. This study shows that only combined iron and DHA/EPA supplementation can prevent bone impairments in offspring of female rats consuming an iron and n-3 FA deficient diet preconception.
Prinzmetal angina is a rare condition more likely to be reported in adults. Vasospasm is by far notable for causing this condition. We present a case of Prinzmetal angina in a 17-year-old male who experienced unexplained resting chest pain for 2 days.
Prebiotic fibre represents a promising and efficacious treatment to manage pre-diabetes, acting via complementary pathways involving the gut microbiome and viscosity-related properties. In this study, we evaluated the effect of using a diverse prebiotic fibre supplement on glycaemic, lipid and inflammatory biomarkers in patients with pre-diabetes. Sixty-six patients diagnosed with pre-diabetes (yet not receiving glucose-lowering medications) were randomised into treatment (thirty-three) and placebo (thirty-three) interventions. Participants in the treatment arm consumed 20 g/d of a diverse prebiotic fibre supplement, and participants in the placebo arm consumed 2 g/d of cellulose for 24 weeks. A total of fifty-one and forty-eight participants completed the week 16 and week 24 visits, respectively. The intervention was well tolerated, with a high average adherence rate across groups. Our results extend upon previous work, showing a significant change in glycated haemoglobin (HbA1c) in the treatment group but only in participants with lower baseline HbA1c levels (< 6 % HbA1c) (P = 0·05; treatment –0·17 ± 0·27 v. placebo 0·07 ± 0·29, mean ± sd). Within the whole cohort, we showed significant improvements in insulin sensitivity (P = 0·03; treatment 1·62 ± 5·79 v. placebo –0·77 ± 2·11) and C-reactive protein (PFWE = 0·03; treatment –2·02 ± 6·42 v. placebo 0·94 ± 2·28) in the treatment group compared with the placebo. Together, our results support the use of a diverse prebiotic fibre supplement for physiologically relevant biomarkers in pre-diabetes.
Catcalls have been said to insult, intimidate, and silence their targets. The harms that catcalls inflict on individuals are reason enough to condemn them. This paper argues that they also inflict a type of structural harm by subordinating their targets. Catcalling initiates an unwanted conversation where none should exist. This brings the rules and norms governing conversations to bear in such a way that the catcall assigns their target a “subordinate discourse role.” This not only constrains the behavior of the target here and now, but also influences the norms governing future conversations. Catcalls are then not only bad because of the effects on their target, but also because of their pernicious contribution to the wider normative landscape.
Air-blast atomizers are extensively used for a variety of purposes. Due to its complexity, the atomization mechanism has not been elucidated. In this study, a mechanistic model is proposed to predict the droplet diameter distribution based on the atomization process of a planar liquid film with co-current gas flows, and its validity is examined by comparing the estimated and measured droplet diameters using high-speed image analysis and laser measurement. As a result, using high-speed imaging, we clarified that the bag film rupture is caused not by the turbulence of the gas flow but by the impact of floating droplets on the liquid film of the expanding bag when the film is thin enough. The average thickness of the liquid film at the bag breakup is of the order of micrometres and varies greatly, resulting in a dispersed distribution of droplet diameters. After the film ruptures, the bag film shrinks towards its transversal and vertical rims due to surface tension, forming large-diameter ligaments. During the contraction process of the bag film, tiny droplets of the order of micrometers are formed at the edge of the perforation. Finally, the remaining ligaments with large diameters fragment into large droplets with submillimetre diameters. The good agreement between the measured and predicted droplet diameter distributions validated the mechanistic model.
Despite its low prevalence, the potential diagnosis of catecholaminergic polymorphic ventricular tachycardia (CPVT) should be at the forefront of a paediatric cardiologists mind in children with syncope during exercise or emotions. Over the years, the number of children with a genetic diagnosis of CPVT due to a (likely) pathogenic RYR2 variant early in life and prior to the onset of symptoms has increased due to cascade screening programmes. Limited guidance for this group of patients is currently available. Therefore, we aimed to summarise currently available literature for asymptomatic patients with a (likely) pathogenic RYR2 variant, particularly the history of CPVT and its genetic architecture, the currently available diagnostic tests and their limitations, and the development of a CPVT phenotype – both electrocardiographically and symptomatic – of affected family members. Their risk of arrhythmic events is presumably low and a phenotype seems to develop in the first two decades of life. Future research should focus on this group in particular, to better understand the development of a phenotype over time, and therefore, to be able to better guide clinical management – including the frequency of diagnostic tests, the timing of the initiation of drug therapy, and lifestyle recommendations.
To determine prevalence of technical and behavioral interventions aimed at preventing central line-associated bloodstream infection (CLABSI) following the COVID19 pandemic.
Design:
Cross-sectional survey.
Setting:
US acute care hospitals.
Participants:
Infection preventionists at participating hospitals.
Methods:
Surveys were sent to infection preventionists from a national random sample of 881 US acute care hospitals. Questions covered use of technical interventions to prevent CLABSI (eg, alcohol-containing chlorhexidine gluconate [CHG] for skin antisepsis, use of coated catheters), socio-adaptive interventions (eg, feedback of CLABSI rates, use of appropriateness criteria), and leadership support for CLABSI prevention.
Results:
Survey response rate was 47% (415/881). Technical interventions such as maximal sterile barriers (99%) or CHG-impregnated dressings (92%) were highly prevalent, but routine use of CHG bathing was less common (68% indicated regular use in intensive care unit [ICU] vs 18% in non-ICU settings). Although 97% of respondents indicated use of systems to monitor CLABSI, feedback to providers on CLABSI events was reported by 89%. Only 53% of respondents indicated regular use of tools to determine appropriateness of central venous catheters (CVC). Three-quarters of respondents indicated their hospital assessed CVC necessity daily, but only 23% reported strategies to reduce routine blood cultures. CLABSI prevention was extremely important to hospital leadership at 82% of responding hospitals.
Conclusions:
Most US hospitals continue to use evidence-based methods to prevent CLABSI as recommended by leading organizations. Opportunities to focus on socio-adaptive interventions such as feedback of infection rates, use of appropriateness criteria for CVC placement, and improving the “culture of pan-culturing” remain.
While the Europe-wide cultural impact of the fall of Constantinople to Sultan Mehmed II is well known, its political reverberations in the Holy Roman Empire have received comparatively little attention. This article argues that the events of 1453 inaugurated a new dynamic in the empire that facilitated the polity's consolidation and the creation of new collective institutions within it long before Maximilian I (1486–1519), whose reign is often presented as a constitutional turning point. Some prince-electors had been calling for more effective peace-keeping and judicial institutions for decades before 1453 but lacked the leverage to compel kings and emperors of the Romans to accept political change on their terms. The fall of Constantinople provided a focal point for these negotiations: in return for promising to support an anti-Ottoman crusade, the reformists were able to force a compromise on new peace-keeping legislation at the diets of the 1450s and 1460s. This compromise was catalyzed by public pressure. There was a widely held expectation that leading imperial protagonists should fulfill this mission to defend Christendom, manifested in orations, diplomatic missives, poetry and songs, plays, and early printed pamphlets produced within and for a range of German-speaking public spheres.
A rapid nonlinear aeroelastic framework for the analysis of the highly flexible wing with distributed propellers is presented, validated and applied to investigate the propeller effects on the wing dynamic response and aeroelastic stability. In the framework, nonlinear beam elements based on the co-rotational method are applied for the large-deformation wing structure, and an efficient cylinder coordinate generation method is proposed for attached propellers at different position. By taking advantage of the relatively slow dynamics of the high-aspect-ratio wing, propeller wake is modeled as a quasi-steady skewed vortex cylinder with no updating process to reduce the high computational cost. Axial and tangential induced velocities are derived and included in the unsteady vortex lattice method. For the numerical cases explored, results indicate that large deformation causes thrust to produce wing negative torsion which limits the displacement oscillation, and slipstream mainly increases the response values. In addition, an improvement of flutter boundary is found with the increase of propeller thrust while slipstream brings a destabilising effect as a result of the increment of dynamic pressure and local lift. The great potential of distributed propellers in gust alleviation and flutter suppression of such aircraft is pointed out and the method as well as conclusions in this paper can provide further guidance.
Early-life adversity as neglect or low socioeconomic status is associated with negative physical/mental health outcomes and plays an important role in health trajectories through life. The early-life environment has been shown to be encoded as changes in epigenetic markers that are retained for many years.
We investigated the effect of maternal major financial problems (MFP) and material deprivation (MD) on their children’s epigenome in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Epigenetic aging, measured with epigenetic clocks, was weakly accelerated with increased MFP. In subsequent EWAS, MFP, and MD showed strong, independent programing effects on children’s genomes. MFP in the period from birth to age seven was associated with genome-wide epigenetic modifications on children’s genome visible at age 7 and partially remaining at age 15.
These results support the hypothesis that physiological processes at least partially explain associations between early-life adversity and health problems later in life. Both maternal stressors (MFP/MD) had similar effects on biological pathways, providing preliminary evidence for the mechanisms underlying the effects of low socioeconomic status in early life and disease outcomes later in life. Understanding these associations is essential to explain disease susceptibility, overall life trajectories and the transition from health to disease.
In the present study, a comparison of the thermal-insulation and mechanical performances of cement and heat-stabilized compressed earthen blocks (CEBs) was carried out to determine the factors which influence those properties. The raw clays used consist mainly of kaolinite, orthoclase and quartz. The mechanical strength increased with increase in both the amount of cement added and the firing temperature. However, the responses are better for cement-stabilized CEBs. The thermal insulation of fired bricks is greater than that of cement-stabilized bricks. This difference was related to the decrease in porosity and the formation of continuous-surface. The decrease in thermal insulation is mainly related to the formation of continuous-surface in cement-stabilized CEBs, whereas in the fired CEBs, it is due to the modification of pore volume. The mineralogy of the raw clays is statistically correlated to porosity and continuous-surface development that were confirmed as the main factors in the modification of both the mechanical strength and the thermal insulation. In cement-stabilization, the decrease in insulation is due to the development of continuous surface, while for heat-stabilization, mineral transformations during the sintering reduced continuous-surface formation and the insulation was controlled by both radiation and reduced surface conduction. The influence of the mineralogy of the raw material shows that clay content favours the insulation in fired bricks obtained at T ≤ 1000°C, while sand contents favour densification. In contrast, clay contents reduce the mechanical response of cement-stabilized material due to limited cement–clay interactions. In general, the mechanical response is more favourable in cement stabilization, while thermal insulation is better in fired bricks.