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While it is known that vitamin D deficiency is associated with adverse bone outcomes, it remains unclear whether low vitamin D status may increase the risk of a wider range of health outcomes. We had the opportunity to explore the association between common genetic variants associated with both 25 hydroxyvitamin D (25OHD) and the vitamin D binding protein (DBP, encoded by the GC gene) with a comprehensive range of health disorders and laboratory tests in a large academic medical center. We used summary statistics for 25OHD and DBP to generate polygenic scores (PGS) for 66,482 participants with primarily European ancestry and 13,285 participants with primarily African ancestry from the Vanderbilt University Medical Center Biobank (BioVU). We examined the predictive properties of PGS25OHD, and two scores related to DBP concentration with respect to 1322 health-related phenotypes and 315 laboratory-measured phenotypes from electronic health records. In those with European ancestry: (a) the PGS25OHD and PGSDBP scores, and individual SNPs rs4588 and rs7041 were associated with both 25OHD concentration and 1,25 dihydroxyvitamin D concentrations; (b) higher PGS25OHD was associated with decreased concentrations of triglycerides and cholesterol, and reduced risks of vitamin D deficiency, disorders of lipid metabolism, and diabetes. In general, the findings for the African ancestry group were consistent with findings from the European ancestry analyses. Our study confirms the utility of PGS and two key variants within the GC gene (rs4588 and rs7041) to predict the risk of vitamin D deficiency in clinical settings and highlights the shared biology between vitamin D-related genetic pathways a range of health outcomes.
Through a combination of laboratory experiments and theoretical models, we investigate the interaction of a mean upwelling through a closed basin with a vertical buoyancy flux. The fluid is mixed by a horizontally oscillating rake, which either traverses the whole basin or which oscillates just near one vertical boundary. We first review the steady state and demonstrate that, in both mixing regimes, the vertical density profile across the basin is controlled by the steady-state balance between the upward advective and diffusive fluxes of salinity as described by the classical model introduced by Munk (Deep-Sea Res., vol. 13, issue 4, 1966, pp. 707–730). However, with boundary mixing, we show that both the upwelling and the buoyancy transport are localised to the mixing zone near the boundary, and the interior fluid is stagnant. We then develop a model to describe the transient evolution of the system if there is either a discrete increase or gradual decrease to the buoyancy flux. In the boundary mixing case, the change in the buoyancy flux at the lower boundary leads to a change in the buoyancy of the fluid in the boundary mixing region, and this induces a transient, buoyancy-driven flow in the boundary region in addition to the steady upwelling. In turn, an equal and opposite vertical flow develops in the interior, and this leads to a change in the density stratification of the interior fluid as the system adjusts to a new equilibrium. However, in our experiments, there is no vertical mixing in the interior and interior fluid may upwell or downwell dependent on the change to the buoyancy forcing. We discuss the implications of our results for the transport and mixing in the deep ocean, and the associated interpretation of field experiments.
This article traces a speculative and critical engagement with histories of health care disparity and medical exploitation shared across fictions by Ralph Ellison and Toni Morrison, and the artwork of Ellen Gallagher. It argues that insistent returns to racialized experimentation and scientific modes of looking form a significant interrogation of a wider set of US promises and attritions. Specifically, it asks how postwar African American culture takes up scopic questions to address dominant accounts of progress and the modern, both via reference to visual orders and technologies, and via formal choices regarding iteration, perspective and scale.
Sustainability of DBT programmes and the factors which potentially influence this has received little attention from researchers. In this article, we review the literature reporting on sustainability of DBT programmes in outpatient settings. We also seek to advance the limited knowledge on this topic by reporting on the sustainability of DBT programmes delivered by teams that trained via a coordinated implementation approach in Ireland. As part of this perspective piece we conducted a systematic literature search which identified four studies reporting on DBT programme sustainability. All four reported on programmes delivered by teams that had received training as per the DBT Intensive Training Model. The findings of these studies are summarised and we consider the effect on DBT programme sustainability of introducing a coordinated implementation approach in Ireland.
Evidence for necrotising otitis externa (NOE) diagnosis and management is limited, and outcome reporting is heterogeneous. International best practice guidelines were used to develop consensus diagnostic criteria and a core outcome set (COS).
Methods
The study was pre-registered on the Core Outcome Measures in Effectiveness Trials (COMET) database. Systematic literature review identified candidate items. Patient-centred items were identified via a qualitative study. Items and their definitions were refined by multidisciplinary stakeholders in a two-round Delphi exercise and subsequent consensus meeting.
Results
The final COS incorporates 36 items within 12 themes: Signs and symptoms; Pain; Advanced Disease Indicators; Complications; Survival; Antibiotic regimes and side effects; Patient comorbidities; Non-antibiotic treatments; Patient compliance; Duration and cessation of treatment; Relapse and readmission; Multidisciplinary team management.
Consensus diagnostic criteria include 12 items within 6 themes: Signs and symptoms (oedema, otorrhoea, granulation); Pain (otalgia, nocturnal otalgia); Investigations (microbiology [does not have to be positive], histology [malignancy excluded], positive CT and MRI); Persistent symptoms despite local and/or systemic treatment for at least two weeks; At least one risk factor for impaired immune response; Indicators of advanced disease (not obligatory but mut be reported when present at diagnosis). Stakeholders were unanimous that there is no role for secondary, graded, or optional diagnostic items. The consensus meeting identified themes for future research.
Conclusion
The adoption of consensus-defined diagnostic criteria and COS facilitates standardised research reporting and robust data synthesis. Inclusion of patient and professional perspectives ensures best practice stakeholder engagement.
The Minnesota Longitudinal Study of Risk and Adaptation (MLSRA) is a landmark prospective, longitudinal study of human development focused on a sample of mothers experiencing poverty and their firstborn children. Although the MLSRA pioneered a number of important topics in the area of social and emotional development, it began with the more specific goal of examining the antecedents of child maltreatment. From that foundation and for more than 40 years, the study has produced a significant body of research on the origins, sequelae, and measurement of childhood abuse and neglect. The principal objectives of this report are to document the early history of the MLSRA and its contributions to the study of child maltreatment and to review and summarize results from the recently updated childhood abuse and neglect coding of the cohort, with particular emphasis on findings related to adult adjustment. While doing so, we highlight key themes and contributions from Dr Dante Cicchetti’s body of research and developmental psychopathology perspective to the MLSRA, a project launched during his tenure as a graduate student at the University of Minnesota.
Lehmer [‘On certain character matrices’, Pacific J. Math.6 (1956), 491–499, and ‘Power character matrices’, Pacific J. Math.10 (1960), 895–907] defines four classes of matrices constructed from roots of unity for which the characteristic polynomials and the kth powers can be determined explicitly. We study a class of matrices which arise naturally in transformation formulae of finite field hypergeometric functions and whose entries are roots of unity and zeroes. We determine the characteristic polynomial, eigenvalues, eigenvectors and kth powers of these matrices. The eigenvalues are natural families of products of Jacobi sums.
The objective of this study is to evaluate the association between the consumption of ultra-processed foods (UPF) and the mental health of pregnant women from the South of Brazil. This is a cross-sectional study carried out in Criciúma, Brazil, through face-to-face interviews, from April to December 2022. Pregnant women aged 18 or older who underwent prenatal care in the forty-eight basic health care units of the municipality and who were in their third trimester of pregnancy were included. High consumption of UPF was considered as six or more items or subgroups of UPF consumed on the day before the interview, using the Nova-UPF screener. The mental health variables were depressive symptoms, stress, sadness and anxiety. Crude and adjusted analyses were conducted using the Fisher’s exact test and the Poisson regression with robust variance. In total, 428 pregnant women were studied; most of them were aged between 20 and 25 years and were white. Pregnant women who presented high consumption of UPF were 1·42-fold (95 % CI 1·06, 1·92) more likely to experience anxiety and presented a prevalence 56 % (95 % CI 1·18, 2·07) higher of stress when compared with those who did not present high consumption of UPF. The prevalence of depressive symptoms and feelings of sadness was 1·31-fold (95 % CI 1·08, 1·60) and 3·41-fold (95 % CI 1·77, 6·58) higher among those with high consumption of UPF, respectively. The results suggest that diet quality is associated with the mental health of pregnant women. Promoting joint actions focused on food and nutritional education, and mental health, for pregnant women, is necessary.
We show a result on propagation of the anisotropic Gabor wave front set for linear operators with a tempered distribution Schwartz kernel. The anisotropic Gabor wave front set is parametrized by a positive parameter relating the space and frequency variables. The anisotropic Gabor wave front set of the Schwartz kernel is assumed to satisfy a graph type criterion. The result is applied to a class of evolution equations that generalizes the Schrödinger equation for the free particle. The Laplacian is replaced by any partial differential operator with constant coefficients, real symbol and order at least two.
“All or none” approaches to the use of contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) both fail to recognize that transmission risk varies. This qualitative study assessed healthcare personnel perspectives regarding the feasibility of a risk-tailored approach to use contact precautions for MRSA more strategically in the acute care setting.
The influence of the boundary layer (BL) thickness on the tonal noise generated by subsonic impinging jets is investigated. For that, initially laminar jets at Mach numbers $0.6$ and $0.9$ with BL thicknesses $0.05r_0$, $0.1r_0$ and $0.2r_0$, where $r_0$ is the pipe-nozzle radius, impinging on a plate at $6r_0$ from the nozzle, are simulated. For Mach number $0.9$, acoustic tones due to feedback loops of axisymmetric nature between the nozzle and the plate are generated at frequencies that do not vary with the BL thickness. The two dominant tones are, however, $17$ and $26\ \mathrm {dB}$ stronger for the thickest BL compared with the thinnest one. For Mach number $0.6$, for the thinnest BL no acoustic peaks appear, as observed in the experiments of the literature, but narrow peaks resulting from axisymmetric feedback loops emerge for thicker BLs. Therefore, low subsonic impinging jets can be resonant for specific nozzle-exit conditions. The increase in tone amplitude for Mach number $0.9$, and the establishment of feedback loops for Mach number $0.6$ with increasing BL thickness, are found to result from two changes in the jet flow. The first change is that the shear-layer laminar–turbulent transition occurs farther downstream for a thicker BL, leading to a greater predominance of the axisymmetric aerodynamic fluctuations near the plate. The second change is that the amplification of the flow fluctuations between the nozzle and the plate at the tone frequencies is stronger for thicker BLs.
In line with recent research that regards the Second World War as a “defining moment” rather than a temporary disruption to the development of consumer societies, this paper explores how consumers were imagined in nonbelligerent Sweden. The main empirical source material consists of business-to-business advertisements from newspaper and magazine publishers aimed at potential advertisers. There, publishers portrayed their readers as suitable consumers, and, given that the division of the press constituted the main infrastructure for reaching different consumer groups, this is interpreted as a key to understanding market segmentation processes. The findings show how geographical, demographic, and psychological factors were considered in optimizing advertising influence and reaching classed and gendered target audiences. Although the segmentation process consolidated during the war, focusing on stable, large consumer groups, the imagined consumer also underwent fundamental changes, combating anxiety and despair through dreams of both future and present patriotic consumption.
The coherent dynamics of bubble clusters are of fundamental and industrial importance, and are elusive due to the complex interactions of disordered bubble oscillations. Here we introduce and demonstrate a method for decomposition of the Lagrangian time series of bubble dynamics data by combining theory and principal component analysis. The decomposition extracts coherent features of bubble oscillations based on their energy, in a way similar to proper orthogonal decomposition of Eulerian flow field data. This method is applied to a dataset of spherical clusters under harmonic excitation at different amplitudes, with various nuclei density and polydispersity parameters. Results indicate that the underlying correlated mode of oscillations is isolated in a single dominant feature in cavitating regimes, independent of the nuclei's parameters. A systematic data analysis procedure further suggests that this feature is globally controlled by the dynamic cloud interaction parameter of Maeda and Colonius (J. Fluid Mech., vol. 862, 2019, pp. 1105–1134) that quantifies the mean-field interactions, regardless of initial polydispersity or nonlinearity. The method provides a simplified and comprehensive representation of complex bubble dynamics as well as a new path to reduced-order modelling of cavitation and nucleation.
The mid-fourth-century c.e.Cento Vergilianus de laudibus Christi retells the biblical story using cento technique (recombining excerpted lines and partial lines from Virgil into a new poem). Its author, the Christian poet Faltonia Betitia Proba, states that her aim in writing the Cento is to demonstrate that Virgil ‘sang the pious deeds of Christ’ (Vergilium cecinisse … pia munera Christi). Her compositional strategy reflects the exegetical method of typology, as explored in detail by Cullhed: by reusing particular Virgilian verses for biblical characters, Proba creates an implicit typological relationship whereby a Virgilian type both prefigures and is fulfilled by a biblical antitype. This paper first presents an extended model of typology, whereby the type not only prefigures the antitype but also enfigures it, providing the reader with a novel conceptual paradigm through which to understand a particular supernatural reality. The paper then turns to a case study: the baptism scene (380–414), the only passage in the Cento depicting all three members of the Trinity. For each, Proba reuses passages which in the Aeneid describe female characters, hinting at a feminine typological Trinity, one which highlights often-overlooked aspects of the three Christian antitypes. In so doing, she convincingly advances her thesis that Virgil's poetic works reflect typological correspondences to the Christian narrative in a similar way to Old Testament prophecy.
Bivalve molluscs are a diverse group of animals with particular economic and ecological importance. Their morphological characteristics frequently confuse their identification leading to mislabelling of edible species. Genetic diversity is critical to the resilience of marine bivalve populations in the face of environmental stressors such as ocean acidification and warming. In this study, we characterized the phylogeny and defined the first DNA barcodes of six marine bivalves [Ostrea edulis (Linnaeus, 1758) Arca noae (Linnaeus, 1758), Pinctada radiata (Leach, 1814), Venus verrucosa (Linnaeus, 1758), Calllista chione (Linnaeus, 1758) and Ruditapes decussatus (Linnaeus, 1758)] sampled from different coastal areas of Aegean and Ionian Seas using the molecular markers cytochrome c oxidase subunit I (COI) and 18S ribosomal RNA (18S rRNA). Further, COI gene was employed to investigate the population genetic diversity since 18S rRNA exhibited no conspecific differences. The sequence of 18S rRNA successfully discriminated the bivalves at family or superfamily level but occasionally proved insufficient for species identification. Contrariwise, COI was highly informative and could reliably distinguish all species. Population haplotype diversity was moderate to high and was always accompanied by generally low nucleotide diversity, indicating genetically closely related haplotypes. The invasive Pinctada radiata was found to be panmictic even among distant sampling areas, while Ostrea edulis was the only species that exhibited moderate levels of population subdivision. Finally, here we report for the first time the presence of Ostrea stentina in Thermaikos Gulf sampled among Ostrea edulis specimens, demonstrating a new invasive bivalve species in Eastern Mediterranean.
In contrast to a view of secrecy as a tool of statecraft, where the game of ‘covering/uncovering’ dominates as the central way of interpreting secrecy’s power, we set out ‘secrecy games’ as an approach for understanding secrecy’s power and influence. To do so, we offer a set of three games to illustrate the more varied ways that secrecy operates and draw attention to the ways in which non-state actors use secrecy and shape its effects. In particular, we offer an analysis of: (1) the secrecy games of tunnelling in the Israeli–Palestinian conflict and the role of mobility as part of secrecy; (2) the secrecy game of camouflage and how stowaways blend in to facilitate access to global shipping routes; and (3) the secrecy game of maze-running and maze-making within urban warfare. Drawing these together, we show how secrecy involves a wider set of actors, practices, and associated knowledge-(un)making strategies than currently understood within International Relations. In turn, this expanded understanding of secrecy helps to make sense of the more complex ways in which secrecy is presented, used, resisted, and transformed – including and especially as a force that limits sovereign power – and, therefore, as central to what shapes global politics.
A central function of the Black Lives Matter (BLM) movement in the United States has been to center and express the lived experiences of Black people within the social and political framework of white supremacy. Regarding reproductive justice, BLM, as well as organizations like the Black Mamas Matter Alliance and Sistersong, have drawn political attention to the oppressive parameters existing for pregnant people “birthing while Black.” Attention to disparities in health and birth outcomes for Black persons has necessary positive effects, such as the ability to produce data on the deleterious effects of anti-Blackness. However, discourses surrounding Black birthing persons can function to obfuscate the collective action undertaken by Black women and non-Black women of color. In this paper, I argue the hyper-focus on the problems Black pregnant/birthing persons face has at least four issues: (1) it encourages an ontological collapse wherein Black birthers are positioned as problems, rather than human beings facing problems; (2) obscures the collective action and care Black women undertake to support one another; (3) results in state solutions that rely on underpaid and volunteer labor of Black and non-Black women of color; and (4) focuses myopically on the time period of pregnancy and birthing for Black persons.