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Heart failure is the most common complication of congenital heart disease (CHD), characterized by high morbidity and mortality. Early recognition and intervention are crucial for improving outcomes in pediatric patients with CHD and heart failure. This study aimed to analyze the clinical value of N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I in pediatric patients with CHD and heart failure.
Methods:
Ninety-eight pediatric patients with CHD complicated by heart failure were included in the Case Group, and 61 pediatric patients with CHD were included in the Control Group. The Case Group was categorized into subgroups based on the cardiac function of patients: grade I (n = 35), grade II (n = 40), and grade III (n = 23). Left ventricular ejection fraction was collected from pediatric patients in the case group. The correlation of the cardiac functional indicators with N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I levels was assessed using Pearson correlation analysis.
Results:
The serum levels of N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I in pediatric patients at grade III of cardiac function were significantly elevated compared to those at grade II, and these levels in patients at grade II were higher than those at grade I (P < 0.05). The left ventricular ejection fraction of pediatric patients in the Case Group were markedly negatively correlated with N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I (r = − 0.6807, r = −0.3013, r = −0.5412, P < 0.0001).
Conclusions:
N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I have a certain diagnostic value in determining concurrent heart failure in pediatric patients with CHD.
This study aimed to compare red meat, white meat and vegetable consumption before, during and after COVID-19 pandemic among older adults in regional China. Data were collected from individuals aged 60+ years in urban areas of Nanjing, China, in 2018, 2021 and 2023. Differences in food intake frequencies between participants and survey years were examined. Multivariate logistic regression models were employed to identify influencing factors of red plus white meat, and vegetable consumption. Totally, 13792 participants were analyzed, with 4355, 4622 and 4815 from 2018, 2021 and 2023 survey, respectively. The mean weekly intake frequency (± standard deviation) among participants in 2018, 2021 and 2023 was, separately, 3.85±2.83, 3.21±2.90 and 4.71±3.94 for red meat, 1.38±1.21, 2.08±1.90 and 2.73±2.55 for white meat, and 10.98±4.84, 10.00±5.04 and 10.34±5.04 for vegetable. Moreover, 23.2%, 32.6% and 52.3% of participants met recommendation for red plus white meat intake, while 53.7%, 46.8% and 49.6% reached recommendation for vegetable consumption before, during and after COVID-19 pandemic, respectively. Red plus white meat intake was positively associated with education, marital status and drinking, but negatively associated with age. Additionally, education and marital status were in negative relation to vegetable consumption, while smoking and drinking were positively associated with vegetable intake. The older residents consumed less red meat and vegetable but more white meat during COVID-19 pandemic, and their consumption levels of red plus white meat and vegetable went up after the pandemic. These findings highlight the need for targeted interventions to support older adults’ dietary habits during emergency events.
Assess the feasibility and effect of Enhanced Barrier Precautions (EBP) on the transmission of Staphylococcus aureus (SA) and carbapenem-resistant organisms (CRO) among residents in nursing home chronic ventilator units (NH-CVU).
Design:
Pre-post interventional study.
Setting:
Two community-based nursing homes with CVUs in Maryland. A total of 56 residents were enrolled in the baseline period and 64 residents were enrolled in the intervention period.
Methods:
During a 3-month baseline and intervention period, residents were swabbed monthly to estimate SA and CRO acquisition. During a 2-month training period, EBP was implemented for residents with chronic wounds, medical devices, or history of multidrug-resistant organism (MDRO) colonization. During the subsequent 3-month intervention period, healthcare personnel (HCP) wore gowns and gloves for high-contact care activities when residents were on EBP. Whole genome sequencing assessed resident-to-resident transmission.
Results:
At baseline, NH-CVU1 used gowns and gloves for all direct contact, while NH-CVU2 used EBP only for residents with a history of MDRO colonization. After training, the proportion of NH-CVU2 residents on EBP increased from 65% in the baseline period to 87% in the intervention period. Glove use was high (93–98%) in both NH-CVUs. Gown use increased from 39% to 77% in NH-CVU1 and from 26% to 72% in NH-CVU2. Resident-to-resident transmission of SA or CRO decreased by 25% in NH-CVU1 (p = 0.60) and by 67% in NH-CVU2 (p = 0.05). CRO transmission decreased by 33% in NH-CVU1 (p = 0.54) and by 83% in NH-CVU2 (p = 0.02).
Conclusions:
EBP is feasible and potentially decreases overall and CRO transmission in nursing home CVUs.
The Stages of Objective Memory Impairment (SOMI) system, based on the Free and Cued Selective Reminding Test (FCSRT), is a potential marker of subtle cognitive impairment in cognitively normal persons defined by a Clinical Dementia Rating (CDR) = 0. We investigated SOMI’s ability to predict incident cognitive impairment (CDR >0) in combination with demographic features and neuroimaging biomarkers.
Methods:
Cognitively unimpaired participants (CDR = 0) from the Harvard Aging Brain Study had baseline FCSRT scores, MRI, FDG-PET, and PiB-PET as well as follow-up CDRs for 5 years. Cox proportional hazards models with correction for multiple testing assessed the predictive validity of SOMI and neuroimaging biomarkers for progression (CDR >0). Comprehensive sensitivity analyses examined alternative outcomes and stricter screening criteria.
Results:
Participants (N = 231) were 73.7 years (SD = 6.0), 60.2% were female, 29.0% were APOE4 positive, and 54 (23.4%) progressed to CDR >0. At baseline, 67% were SOMI-0, 22% were SOMI-1, 4% were SOMI-2, and 7% were SOMI-3/4. After multiple testing correction, hazard ratios (HRs) using SOMI-0 as reference were: SOMI-1 = 2.06 (CI: 1.09 – 3.88), SOMI-2 = 2.85 (CI: 1.08 – 7.54), and SOMI-3/4 = 3.73 (CI: 1.58 – 8.79, p = 0.016). SOMI-3/4 remained significant across most biomarker models. Entorhinal thickness emerged as the most robust biomarker predictor (HR = 0.57 – 0.65, p ≤ 0.015). Sensitivity analyses confirmed robustness across alternative outcomes and stricter screening criteria.
Conclusions:
SOMI stages predict progression to incident cognitive impairment with SOMI-3/4 maintaining significance after rigorous multiple testing correction. Entorhinal thickness provides the strongest biomarker enhancement to prediction models. SOMI demonstrates substantial incremental predictive value beyond standard demographic and biomarker predictors.
The history of sugar is that of a commodity that has played a central and contested role in the development of global agro-industrial capitalism. In my introduction to this “Suggestions and Debates” collection, the theoretical underpinnings of The World of Sugar will be explained. Reference is made to the agenda of the Commodity Frontiers Initiative, which was published in the Journal of Global History in 2021, and of which I was a co-author. Inspired by the work of Friedmann and McMichael, a key element of this agenda is the notion of successive commodity regimes, separated by systemic frictions and phases of intense innovation to overcome them. Moreover, the argument is made that The World of Sugar can be read as an invitation to explore new directions in global labour history. My introduction concludes with an exhortation to overcome the limitations of single-commodity histories and to give more attention to the agency of workers in shaping the trajectories of global capitalism.
We study the moduli stacks of slope-semistable torsion-free coherent sheaves that admit reflexive, respectively, locally free, Seshadri graduations on a smooth projective variety. We show that they are open in the stack of coherent sheaves and that they admit good moduli spaces when the field characteristic is zero. In addition, in the locally free case we prove that the resulting moduli space is a quasi-projective scheme.
This study aims to analyze the effect of internal pay attributions on employees’ perceived organizational support (POS). Furthermore, it examines the pathway through which these pay attributions influence POS by analyzing the mediating effect of pay level satisfaction. Based on survey data from 695 employees, the results show that commitment-focused pay attributions are positively and directly related to POS, and also indirectly related to it through the mediated effect of pay level satisfaction. Regarding control-focused pay attributions, while getting the most out of employees’ pay attribution is only directly and negatively related to POS, the cost-reduction HR strategy pay attribution is only indirectly and negatively related to POS through pay level satisfaction. This study is relevant because it provides a more in-depth understanding of how employees’ perceptions of the intentions behind pay decisions can influence how they assess both the organization and the outcomes they receive.
Flame–flame interactions in continuous combustion systems can induce a range of nonlinear dynamical behaviours, particularly in the thermoacoustic context. This study examines the mutual coupling and synchronisation dynamics of two thermoacoustic oscillators in a model gas-turbine combustor operating within a stochastic environment and subjected to external sinusoidal forcing. Experimental observations from two flames in an annular combustor reveal the emergence of dissimilar limit cycles, indicating localised lock-in of thermoacoustic oscillators. To interpret these dynamics, we introduce a coupled stochastic oscillator model with sinusoidal forcing terms, which highlights the critical role of individual synchronisation in enabling local lock-in. Furthermore, through stochastic system identification using this phenomenological low-order model, we mathematically demonstrate that a transition towards self-sustained oscillations can be driven solely by enhanced mutual coupling under external forcing. This combined experimental and modelling effort offers a novel framework for characterising complex coupled flame dynamics in practical combustion systems.
Previous studies demonstrated that ultra-processed foods (UPF) affect overall diet quality. However, none have yet examined this relation across different age groups in Brazil. This study assessed the relationship between diet quality and the consumption of UPF in a Brazilian population according to age groups. This was a cross-sectional study that analysed food consumption data from 46,164 Brazilians aged ≥10 years who participated in the 2017–2018 National Dietary Survey. Food and beverages consumed were recorded by two 24-hour recalls. All food items were classified as UPF or non-UPF according to the Nova system. Diet quality was evaluated using nutritional density and the prevalence of inadequate nutrient consumption, according to the quintiles of energy contribution of UPF. The association between diet quality and UPF consumption was evaluated by linear and Poisson regressions, with adjustment for sociodemographic variables, stratified by age groups (adolescents, adults and older adults). The consumption of UPF increased the densities of carbohydrates, free sugar, saturated fat, and sodium and decreased the densities of proteins, fibres, and potassium in three age groups. Higher prevalence ratios (PR) of inadequate consumption of free sugar and fibre among the lower and higher quintiles of energy contribution of UPF among adolescents (PR=2.02, 95% CI=1.82–2.25; PR=1.88, 95% CI=1.68–2.10), adults (PR= 1.86, 95% CI=1.75–1.98; PR=1.70, 95% CI=1.60–1.80), and older adults (PR=1.48, 95% CI =1.30–1.69; PR=1.24, 95% CI=1.09–1.40). UPF consumption was negatively associated with diet quality across different age groups. Thus, interventions targeting UPF consumption should be implemented across life stages to improve overall diet quality.
In Greek literature, the barber is always portrayed as a garrulous chatterbox and his shop as a central place for gossip and rumours. Apart from these numerous anecdotes, however, few scholars have investigated the concrete realities of the profession and the actual status of barbers in the Greek East (including Egypt). This paper seeks to fill this gap. It is based on a careful social and economic analysis of the profession, including barbers’ workspaces, their social recognition as skilled craftsmen, their funerary and religious practices, their relationships with their clients, as well as their income, wages and expenses. It attempts to re-place ancient barbers in their socio-professional and socio-economic environment, and to reconstruct some aspects of their daily lives that go beyond the statements of ancient authors and their elite discourse. By systematically cross-referencing all available historical data (literary texts, inscriptions, papyri, ostraca, iconographic and archaeological sources), the paper shows how their lives and status differ from their representation in the literary sources in order to bring these everyday workers out of the shadows and rehabilitate them as historical actors in Greek and Hellenized societies.
In Colorado census tracts from 2021 to 2022, there was a 15% increase in the rate of candidemia for every 0.1 unit increase in social vulnerability index (SVI) (RR 1.15, 95% CI, 1.10, 1.20). Geographic social determinants of health included in SVI may be risk factors for candidemia.
Having a modern cooking stove at the household level provides an incomplete measure of cooking energy access. This limitation has necessitated the introduction of a multi-tier framework (MTF) to provide a more nuanced assessment. Thus, this study examines the overall, gendered, and rural-urban effects of cooking energy access under the MTF on health and time allocation to various household activities. Using the 2018 World Bank/ESMAP MTF dataset on Zambia, the study applies inverse probability regression adjustment with generalized propensity score to estimate pairwise average treatment effect on treated, by categorising households to tiers (0–5) based on six primary cooking energy attributes. The findings reveal that as households move up the MTF tiers, improvements in outcomes – such as reduced respiratory illness and better time allocation – are generally observed, though the magnitude of benefits tends to taper at higher tiers. Furthermore, women experience greater improvements relative to men, particularly in lower-tier transitions.
Parent attributions about their child significantly impact parenting behavior. The present study investigates parent attributions in the context of Parent–Child Interaction Therapy (PCIT) in child-welfare involved families. PCIT has two treatment phases, the first of which focuses on fostering a warm parent–child relationship and the second of which provides parents a positive discipline framework. This study characterizes individual differences in stability and change in parent attributions over the course of the intervention. It explores the impact of family treatment dosage on parent attributions as well as the impact of parent attributions on positive parenting skills outcomes. In a sample of 149 families involved with the child-welfare system (children aged 3–7, 59% nonwhite, 11% Hispanic, 50% female), multinomial logistic regression analyses and ANCOVAs were used. Results showed that engaging in additional treatment sessions increased the odds of parent attributions about their child increasing in warmth. Additionally, parents whose positive attributions of their child increased over time used more positive parenting behaviors in a cleanup task at posttreatment. These findings demonstrate that parent attributions about their child play an important role in behavioral parent training interventions. Future research should investigate how to leverage parent attributions to improve family treatment outcomes.
The study aimed to translate the Eating-Related Eco-Concern Questionnaire (EREC) into Turkish, ensure its cross-cultural adaptation, and evaluate its reliability, validity, and psychometric properties. EREC is a 10-item scale assessing the extent to which adults consider ecological impact when making food choices due to concerns about climate change. The study was conducted between November 2023 and February 2024 in Mersin with 442 adults aged 18 to 65 years, using face-to-face interviews. The Turkish version was adapted using the Translation–Back Translation method, and language validity was ensured. Face validity was evaluated through a pilot study with 40 participants. Construct validity was initially assessed using exploratory factor analysis (EFA) with data from 200 participants, followed by confirmatory factor analysis (CFA) conducted on an independent sample of 242 participants to verify the factor structure. The reliability of the scale was assessed by test-retest analysis with 106 participants from the main sample (n=442) and consistency was measured by intraclass correlation coefficient (ICC). The factor structure and model fit were evaluated using indices such as CFI, GFI, and RMSEA. 68.3% of the participants were female; whereas, 31.7% were male. The group’s median BMI value was 24.3 (21.6-27.1), with 52.9% classified as “normal” according to the BMI classification. Factor 2 had a low score, but it was found to be adequate for other factors and the total scale score. The Turkish adaptation of the Eating-Related Eco-Concern Questionnaire has been found to be a valid and reliable scale, as confirmed by comprehensive evaluations.
The article looks at instances of specialisation for specific linguistic contexts in ‘command’ and ‘inference’ uses of will and must. It tests the feasibility of different motivations for this specialisation, such as statistical and construal pre-emption. It also proposes a new motivation for specialisation, polysemous pre-emption, i.e. whether a strongly entrenched polyseme of a given expression might pre-empt the use of an expression with a less strongly entrenched polyseme. The investigation uses corpus analysis and distinctive collexeme analysis to test the three motivations (statistical, construal, and polysemous pre-emption). The results show that all instances of specialisation with will and must could be explained through construal pre-emption and/or polysemous pre-emption, thus making recourse to statistical pre-emption unnecessary.
The rise of U.S. inflation in 2021 and 2022 and its partial subsiding have sparked debates about the relative role of supply and demand factors. The initial surge surprised many macroeconomists despite the unprecedented jump in money growth in 2020–21. We find that the relationship between consumption and the theoretically based Divisia M3 measure of money (velocity) can be well modeled both in the short- and long-runs. We use the estimated long-run relationship to calculate the deviation of actual velocity from its long-run equilibrium and incorporate it into a P-Star framework. Our model of velocity significantly improves the performance of the P-Star model relative to using a one-sided HP filter to calculate trend velocity as used by other researchers. We also include a global supply pressures index in the model and find that recent movements in U.S. inflation largely owed to aggregate demand driven macroeconomic factors that are tracked by Divisia money with a smaller role played by supply factors.