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Aortic coarctation can occur isolated or associated with ventricular septal defect. This study evaluated aortic stiffness in normotensive patients surgically treated for aortic coarctation and ventricular septal defect and in those who underwent simple aortic coarctation repair. Both groups were compared with healthy controls. Again, the two pathological groups were compared with each other regarding aortic stiffness and left ventricular diastolic function. A possible relationship between aortic stiffness and left ventricular diastolic function was investigated.
Methods:
Twenty-two isolated aortic coarctation patients and 17 aortic coarctation and ventricular septal defect patients were enrolled. Aortic root distensibility and aortic stiffness index were calculated from echocardiography and blood pressure. E wave to A wave (E/A) ratio was measured from mitral valve inflow profile.
Results:
Aortic root distensibility and aortic stiffness index in simple aortic coarctation vs healthy controls: both p < 0.0001. Aortic root distensibility and aortic stiffness index in aortic coarctation/ventricular septal defect vs healthy controls: both p < 0.0001. Aortic root distensibility and aortic stiffness index were similar in the two pathological groups (both p = ns). No statistically significant difference was detected in relation to left ventricular diastolic function (p = ns). No correlation was detected between aortic stiffness and diastolic function in simple aortic coarctation and aortic coarctation/ventricular septal defect groups (both p = ns).
Conclusions:
In both normotensive isolated aortic coarctation and aortic coarctation/ventricular septal defects subgroups, aortic stiffness is increased in a similar way in comparison with controls. Diastolic function was normal and similar in both groups. Aortic stiffness was not related to left ventricular diastolic function in this specific setting.
Although ample research links social factors and suicidality, there remains a gap in understanding how distinct processes within social communication relate to suicidality. We demonstrate how reciprocity of eye-gaze and facial expressions of happiness differ during parent-adolescent conflict based on adolescents’ future suicidal ideation (SI). Facial affect analyses were based on 103 girls (ages 11–13; M = 12.28; 75% White) and their parents. Eye-gaze analyses were conducted in subset of these dyads (N = 70). Participants completed a conflict discussion during which gaze to their partners’ eyes was assessed using mobile eye-tracking glasses and facial affect was coded using FaceReader Observer XT. Adolescents’ SI was assessed 12-months later. Actor-partner interdependence models tested whether participants’ gaze and affect predicted their own and their partners’ gaze and affect one second later and if these intra and interpersonal dynamics differed based on adolescents’ future levels of SI. Girls from dyads with less parental reciprocity of eye-gaze and happiness reported higher levels of SI 12-months later. During early adolescence, girls whose parents reciprocate their eye-contact or positive affect less during conflict may be at heightened risk for SI. If replicated, social communication could provide a promising intervention target to reduce suicidality prospectively.
This article uses the literature on subnational undemocratic regimes (SURs) and regime juxtaposition in Latin America to gain analytical leverage on the recent process of subnational democratic erosion in the United States. Based on a review of five key dimensions of federalism, we argue that the institutional landscape for the emergence and continuity of SURs is, comparatively speaking, more favorable in the US than in any of Latin America’s three federations (Argentina, Brazil, and Mexico). In addition to showing how federal structures are more detrimental for subnational democracy in the US, we assess how the two main theoretical approaches that have been developed to understand SURs in Latin America and elsewhere can be applied to the US.
Antenatal steroids (ANS) are one of the most widely prescribed medications in pregnancy, being administered to women at risk of preterm delivery. In the setting of preterm delivery at or below 35 weeks’ gestation, systematic review data show ANS reduce perinatal morbidity and mortality, primarily by promoting fetal lung maturation. However, with the expanding use of this intervention has come a growing appreciation for the potential off-target, adverse effects of ANS therapy on wider fetal development. We undertook a narrative literature review of the animal and clinical literature to assess current evidence for adverse effects of ANS exposure and fetal development. This review presents a summary of the evidence relating to the potential for wide-ranging, off-target, adverse effects of ANS therapy on fetal development and programming. We highlight an urgent need for further animal and clinical studies investigating the effects of ANS on the fetal immune, cardiovascular, renal and hepatic systems given a current sparsity of evidence. We also strongly suggest an emphasis on open disclosure, discussion and education of clinicians and patients with regard to the potential benefits and risks of ANS therapy, particularly in late preterm and term gestations where infants derive relatively few benefits from these drugs. We also propose further studies on the optimisation of ANS therapy through improved patient selection and improved dosing regimens based on a pharmacokinetic-pharmacodynamic informed understanding of ANS action on the fetal lung.
The murder of George Floyd in May 2020 sparked a wave of Black Lives Matter protests in many cities throughout the United States. Protesters’ demands ranged from constraints on police use of force to defunding and disbanding the police altogether. These have led some to worry about the possibility of a “Ferguson Effect,” where police withdraw from policing, and in particular discretionary stops and searches, with deleterious consequences for crime. Drawing on data from four cities, we evaluate whether the 2020 BLM protests impacted police behavior, and whether changes in policing negatively impacted public safety. Regression discontinuity-in-time estimates suggest that although depolicing followed the BLM protests, in some respects the quality of policing improved, and public safety was not clearly impacted. Our findings have important implications for research on policing, social movements, and structural inequality in cities.
The four Piano Sonatas by W. A. Mozart with freely composed additional accompaniment for a Second Piano by Edvard Grieg (EG 113) were first published in 1879–80 but were not heard by English concertgoers until 5 March 1890, when both Agathe Backer-Grøndahl and Anton Hartvigson opened separate recitals in London with Grieg's version of the Fantasy in C minor K475, the latter following it with the Sonata in F major K533/494. This coincidence is noteworthy not only because Grieg's additions appeared to flaunt the prevailing expectation of fidelity to classical works, but also because Mozart's solo keyboard music was rarely included in professional recitals. Focusing on Backer-Grøndahl and Hartvigson's concerts, this article considers Grieg's additions not merely as ‘arrangements’ but also as a performance practice subject to a range of interpretations by recitalists and different sections of the audience. The article begins by placing the transformation of the additions from teaching aids into concert repertoire in the context of similar supplements to classic works and concurrent attitudes to Mozart's piano music. The next section examines the mixed reception of Backer-Grøndahl and Hartvigson's recitals, situating this within contemporary debates about the role of fidelity in modern performances of historic works and its relationship with dominant conceptions of musical taste. While critics condemned the use of Grieg's additions, several disdainfully noted that they were well received by the rest of the audience. The final section attempts to account for this discrepancy by considering the widespread perception of Grieg's additions as Norwegian ‘national music’, a popular genre of exoticist parlour music that critics disparagingly associated with a mass audience of young, female players and considered inferior to ‘international’ classics. The article concludes by reflecting on how these factors might have informed Backer-Grøndahl's decision to perform Mozart's music with Grieg's additions.
To assess the association between social vulnerability index (SVI) and surgical site infections (SSIs) using National Healthcare Safety Network (NHSN) criteria.
Design:
Retrospective cohort study between August 1, 2022, and August 31, 2023.
Setting:
In total, 20 acute care hospitals in the Southeast United States.
Patients:
Totally, 23,768 total hip arthroplasty, total knee arthroplasty, abdominal hysterectomy, colon, and spinal fusion surgeries in 22,239 patients were included. Procedures with infection present at the time of surgery or incomplete geographic tracking data were excluded.
Methods:
Patient addresses as noted in the electronic health record were geocoded to determine census tract of residence and determine SVI. Demographic and clinical data were linked with SVI scores. SSIs were identified according to NHSN criteria. SVI was categorized into quartiles, and logistic regression was used to evaluate the association between SVI quartile (overall and for each SVI theme) and SSI risk. Subgroup analyses by procedure type and race were performed. Multivariable models of the association between overall SVI and SSI were adjusted for demographic and clinical factors.
Results:
Patients in the top SVI quartiles had significantly higher odds of developing SSIs after adjusting for other clinical and demographic factors. Increased risk was found for socioeconomic status and household characteristics themes, but not for the racial/ethnic minority theme. Association between SVI and SSI risk varied by type of surgery.
Conclusions:
Living in an area with a higher SVI is associated with increased SSI risk. Targeted interventions are needed to mitigate these disparities and improve outcomes.
We rely heavily on cut-off points of brief measures of psychological distress in research and clinical practice to identify those at risk of mental health conditions; however, few studies have compared the performance of different scales.
Aim
To determine the extent to which the child- and parent-report Strength and Difficulty Questionnaire (SDQ), Revised Children’s Anxiety and Depression Scale (RCADS), short Mood and Feeling Questionnaire (sMFQ) and child-report KIDSCREEN correlated and identified the same respondents above cut-off points and at risk of mental health conditions.
Method
A cross-sectional survey was conducted among 231 children aged 11–16 years and 289 parents who completed all the above measures administered via a mobile app, MyJournE, including the SDQ, RCADS and sMFQ.
Results
The psychopathology measures identified similar proportions of young people as above the cut-off point and at risk of depression (child report 14.7% RCADS, 19.9% sMFQ, parent report 8.7% RCADS, 12.1% sMFQ), anxiety (child report 24.7% RCADS, 26.0% SDQ-Emotional subscale, parent report 20.1% RCADS, 26% SDQ-Emotional subscale) and child-report internalising problems (26.8% RCADS, 29.9% SDQ). Despite strong correlations between measures (child report 0.77–0.84 and parent report 0.70–0.80 between the SDQ, sMFQ and RCADS) and expected directions of correlation with KIDSCREEN and SDQ subscales, kappa values indicate moderate to substantial agreement between measures. Measures did not consistently identify the same children; half (n = 36, 46%) of those on child report and a third (n = 30, 37%) on parent report, scoring above the cut-off point for the SDQ-Emotional subscale, RCADS total or sMFQ, scored above the cut-off point on all of them. Only half (n = 46, 54%) of the children scored above the cut-off point on child report by the SDQ-Internalising and RCADS total scales.
Conclusion
This study highlights the risk of using a screening test to ‘rule out’ potential psychopathology. Screening tests should not be used diagnostically and are best used together with broad assessment.
Russia’s 2014 seizure of parts of Ukraine, notably the Crimean Peninsula, set in motion a flurry of legal activity. Ukraine’s “lawfare” strategy, which aims to fight Russia via international legal means, included explicit encouragement of Ukrainian investors to file disputes under the Ukraine-Russia Bilateral Investment Treaty. We consider the resulting Investor-State Dispute Settlement (ISDS) arbitrations, the first instances of ISDS in which state parties to the treaty are actively engaged in armed conflict. Although Ukrainian actors have consistently won at ISDS arbitrations, Ukraine moved to formally withdraw from the treaty a year after the full-scale Russian invasion of 2022. Developments before and since the invasion point to the diverging interests between commercial actors and their home states, the weakness of ISDS as a tool during wartime, and a reconsideration of treaty-based commitments to international investor protections. We highlight the implications of these events for several literatures in international relations.
The topic of impersonalization has received a lot of attention in the literature, but the focus has mostly been on a limited number of strategies, such as the use of personal and indefinite pronouns and passive constructions. Impersonal strategies have thus far been examined using: (i) grammars, (ii) corpora, and (iii) language-based questionnaires. These methods suffer from several shortcomings if one wants to study the range of impersonal strategies. The present article aims to argue for a new way of investigating impersonal strategies that complements the other approaches, by reporting on the results of a visual questionnaire. More precisely, it discusses a visual questionnaire completed by speakers of Dutch and Afrikaans to determine whether this method is a satisfactory way of studying impersonal strategies and to also examine and compare the impersonal strategies of the two languages.*
The crystal structure of sparsentan has been solved and refined using synchrotron X-ray powder diffraction data and optimized using density functional theory techniques. Sparsentan crystallizes in space group P-1 (#2) with a = 11.4214(8), b = 12.0045(9), c = 14.1245(12) Å, α = 97.6230(22), β = 112.4353(16), γ = 110.2502(11)°, V = 1599.20(6) Å3, and Z = 2 at 298 K. The crystal structure consists of an isotropic packing of dimers of sparsentan molecules, linked by N–H···O=S hydrogen bonds. Several intra- and intermolecular C–H···O and C–H···N hydrogen bonds also link the molecules. The powder pattern has been submitted to the International Centre for Diffraction Data for inclusion in the Powder Diffraction File™ (PDF®).
Hymenopteran parasitoids are an understudied group of insects despite being important in biological control programs globally. Little is known about the ability of parasitoids to control the passionvine hopper (Scolypopa australis (Walker); PVH), which was introduced to New Zealand (NZ) in the 1800s and has since become a major economic pest of kiwifruit. However, in their native Australia, this species has not reached pest status, likely due to the presence of associated parasitoids. Understanding the ecology of parasitoids associated with PVH in their native range is a critical step in identifying potential biological control agents that could be used in NZ. In this study, PVH presence and occupancy on different plant species was determined and the PVH parasitoid fauna of NZ compared with the Australian fauna. Collections were undertaken in and around Melbourne, Australia, between December 2021 and May 2023 in public and private gardens, roadside verges and parklands. Parasitoids were reared from the nymphs and eggs of PVH and identified. Ten species of parasitoid were discovered to parasitise PVH, eight of which were new host records. Three parasitoids, Dryinus koebelei, Neodryinus nelsoni, and Neodryinus koebelei, were reared from PVH nymphs and seven parasitoids were reared from PVH eggs: Ablerus sp., Anastatus sp., Centrodora sp., Cheilonoeurus sp., Ooencyrtus sp., and unknown species belonging to the families Figitidae and Platygastridae. These new data have made a significant contribution to understanding the ecology of PVH in their native range.
We provide a complete classification of Teichmüller curves occurring in hyperelliptic components of the meromorphic strata of differentials. Using a non-existence criterion based on how Teichmüller curves intersect the boundary of the moduli space we derive a contradiction to the algebraicity of any candidate outside of Hurwitz covers of strata with projective dimension one, and Hurwitz covers of zero residue loci in strata with projective dimension two.
Edible goods are not usually considered suitable for archiving. This short article introduces an unconventional archive of images relating to design, book, costume, and performance history. Each image in this archive depicts an intricately decorated biscuit (cookie) set inspired by historical artifacts or styles. I began making these biscuits during the pandemic as a way of engaging with material culture while traditional archives and museums were closed, and I now perform this work as a form of close reading. I also collaborate with heritage organizations to make biscuit sets that share collection items with online audiences. This work has contributed to my own research process while celebrating the collections of a broad range of British archives.
While cognitive impairment is a core feature of psychosis, significant heterogeneity in cognitive and clinical outcomes is observed.
Aims
The aim of this study was to identify cognitive and clinical subgroups in first-episode psychosis (FEP) and determine if these profiles were linked to functional outcomes over time.
Method
A total of 323 individuals with FEP were included. Two-step hierarchical and k-means cluster analyses were performed using baseline cognitive and clinical variables. General linear mixed models were used to investigate whether baseline cognitive and clinical clusters were associated with functioning at follow-up time points (6–9, 12 and 15 months).
Results
Three distinct cognitive clusters were identified: a cognitively intact group (N = 59), a moderately impaired group (N= 77) and a more severely impaired group (N= 122). Three distinct clinical clusters were identified: a subgroup characterised by predominant mood symptoms (N = 76), a subgroup characterised by predominant negative symptoms (N= 19) and a subgroup characterised by overall mild symptom severity (N = 94). The subgroup with more severely impaired cognition also had more severe negative symptoms at baseline. Cognitive clusters were significantly associated with later social and occupational function, and associated with changes over time. Clinical clusters were associated with later social functioning but not occupational functioning, and were not associated with changes over time.
Conclusions
Baseline cognitive impairments are predictive of both later social and occupational function and change over time. This suggests that cognitive profiles offer valuable information in terms of prognosis and treatment needs.
Medical and surgical advancements have enabled a 95% survival rate for children with CHD. However, these survivors are disproportionately affected by neurodevelopmental disabilities. In particular, they have behavioural problems in toddlerhood. Because there is a known relationship between behavioural problems and early language delay, we hypothesise that children with critical CHD have early detectable language deficits. To test our hypothesis, we performed a retrospective study on a cohort of children with critical CHD to visualise their early language developmental trajectories.
Methods:
We identified a cohort of 27 children with two diagnoses: single ventricle physiology (19) and transposition of the great arteries (8). As part of their routine clinical care, all of these children had serial developmental evaluations with the language subsection of the Capute Scales. We visualised their developmental language trajectories as a function of chronologic age, and we used a univariate linear regression model to calculate diagnosis-specific expected developmental age equivalents.
Results:
In each group, language development is age-appropriate in infancy. Deviation from age-appropriate development is apparent by 18 months. This results in borderline-mild language delay by 30 months.
Discussion:
Using the Capute Scales, our team quantified early language development in infants and toddlers with critical CHD. Our identification of deceleration in skill acquisition reinforces the call for ongoing neurodevelopmental surveillance in these children. Understanding early language development will help clinicians provide informed anticipatory guidance to families of children with critical CHD.
Social Media Synopsis:
Children with single ventricle physiology and transposition of the great arteries have measurable early language delays.