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The alternation between wet and dry seasons in tropical regions can dramatically affect parasite infection dynamics by influencing larval survival, intermediate-host density, definitive-host foraging behaviour, and host immune function. Freshwater chelonians are excellent models for studying parasite-host ecology. Their longevity, site fidelity, and dietary breadth make them valuable sentinel species for aquatic ecosystem health. Here, we identified the gastrointestinal helminth fauna of scorpion mud turtle (Kinosternon scorpioides) from Marajó Island and evaluated seasonal effects on parasite community dynamics. We observed a 71% reduction in parasite load during the dry season and substantial compositional shifts, in addition to species-specific responses: Spiroxys figueiredoi exclusively during floods and Nematophila grandis peaking during dry periods. Parasite species with flexible transmission pathways may thrive while specialists decline. Kinosternon scorpioides and its parasites function as sentinels, and monitoring helminth community composition could more accurately track ecosystem health than measuring host abundance alone.
This study aimed to identify echocardiographic predictors of successful weaning from extracorporeal membrane oxygenation in paediatric and congenital heart disease patients.
Methods:
We retrospectively analyzed pediatric patients who underwent venoarterial extracorporeal membrane oxygenation for cardiogenic shock or postoperative support between March 2018 and September 2023. Clinical and echocardiographic variables assessed at the time of weaning evaluation were compared between patients who were successfully weaned and those who were not.
Results:
Among the 46 enrolled patients, 31 were successfully weaned from extracorporeal membrane oxygenation. The mean age at extracorporeal membrane oxygenation initiation was 9.6 ± 13.9 years, and the mean duration of support was 12.3 ± 12.1 days. Patients in the successfully weaned group had significantly higher left ventricular ejection fraction (50.9 ± 16.4% vs. 27.3 ± 18.7%, p < 0.001) and higher velocity time integral at the left ventricular outflow tract (12.3 ± 8.0 cm vs. 4.1 ± 3.6 cm, p = 0.001) compared with the unsuccessfully weaned group. The cutoff values for predicting successful weaning were a left ventricular ejection fraction of 43.03% (sensitivity, 74.2%; specificity, 86.7%) and a velocity time integral of 4.45 cm (sensitivity, 92.0%; specificity, 66.7%).
Conclusions:
Left ventricular ejection fraction and velocity time integral provide valuable echocardiographic information for predicting successful weaning from extracorporeal membrane oxygenation in pediatric patients and may support clinical decision-making during weaning assessments.
We prove that the average size of a mixed character sum
\begin{equation*}\sum_{1\leqslant n \leqslant x} \chi(n) e(n\theta) w(n/x)\end{equation*}
(for a suitable smooth function $w$) is on the order of $\sqrt{x}$ for all irrational real $\theta$ satisfying a weak Diophantine condition, where $\chi$ is drawn from the family of Dirichlet characters modulo a large prime $r$ and where $x\leqslant r$. In contrast, it was proved by Harper that the average size is $o(\sqrt{x})$ for rational $\theta$. Certain quadratic Diophantine equations play a key role in the present paper.
If A is in the p-Schatten class on ${\mathbb {R}}^n$, $1\leq p \leq {4n}/{(2n-1)}$, then the quantum translates of A are linearly independent. Moreover, there exists a nonzero operator in the p-Schatten class on ${\mathbb {R}}^n$, $p>{4n}/{(2n-1)}$, whose quantum translates are linearly dependent.
Generative artificial intelligence (GenAI) shows promise for mental healthcare by increasing access to treatment. In this article, we analyse recent evidence on the use of GenAI chatbots as a treatment for common mental disorders. We examine key ethical and methodological considerations and discuss the specific risks for delusions. Adopting a precision psychiatry perspective, we propose that the therapeutic alliance can be improved by tailoring GenAI to mimic a user’s psychological traits, a version of socioaffective alignment.
Treatment-resistant schizophrenia (TRS) is a clinically challenging subtype of schizophrenia affecting up to 30% of patients, defined by persistent symptoms despite adequate trials of at least two antipsychotics. This review explores the complex neurobiology of TRS, highlighting the limitations of the dopamine hypothesis and emphasising the roles of glutamatergic, cholinergic and neurodevelopmental mechanisms. It outlines neuroimaging techniques (e.g. positron emission tomography, functional and structural magnetic resonance imaging, and proton magnetic resonance spectroscopy) used to explore neurotransmitter activity and structural brain changes in psychosis, and in TRS in particular, and gives an overview of their findings and utility. It also discusses frameworks like TRRIP and the INTEGRATE algorithm, which aim to facilitate earlier diagnosis and treatment. Integrating neuroimaging into practice may improve diagnosis and clinical outcomes and advance precision medicine approaches; emerging non-dopaminergic treatment options, such as xanomeline–trospium, may offer promising alternatives to standard clozapine treatment for TRS. Future research should prioritise biomarker discovery and the development of novel therapies beyond dopaminergic targets.
Solomon Islands’ plural legal system, in which customary law operates in parallel with common law, and its practice and effects on society have drawn scholarly attention in spaces of legal studies, policy, economics, and state governance. An area that remains understudied is the dynamic nature in which landowners use Indigenous cultural heritage such as ancestral sites or genealogies as kastom evidence in courts. We explore this intersection through a critical review of the literature, Solomon Islands court judgments, and the nation’s lacking cultural heritage legislation. Two major infrastructure development projects in Solomon Islands, the Tina Hydro Project located on Guadalcanal and the Bina-Talifu Project on Malaita, are also examined to explore the nuances of state-led compulsory versus negotiated land acquisition. Fueling the perception that the customary land system is more of a hinderence than a strength to its peoples, these case studies demonstrate the fluid and unpredictable nature with which kastom evidence has been implemented in legal forums to substantiate or dispute claims. Ultimately, we argue that this largely reflects an incongruence between the British legal framework and traditional land tenure systems. Furthermore, we highlight how greater integration of archaeological expertise into legal processes of land surveying in Solomon Islands has the potential to mitigate some of these challenges.
Syncope in children is commonly benign, yet rare cardiovascular anomalies may be causative. We present a child with recurrent syncope, ultimately diagnosed with an aorto-right atrial connection. Transcatheter closure was successfully performed with an Amplatzer Duct Occluder II. This case emphasizes considering aorto-atrial connections in pediatric syncope with continuous murmurs and highlights the efficacy of percutaneous closure.
Critical CHD often requires surgical intervention or results in infant mortality. We aimed to determine the association between critical CHD categories and exposure levels to pollutants.
Methods:
A retrospective study of n = 1484 infants who underwent complex cardiac surgery in early infancy from 1996 to 2021. The association between critical CHD categories (compared to a reference category with chromosomal abnormality) and exposure levels during early pregnancy to nitrogen dioxide, ozone, fine particulate matter (<2.5 micrometers diameter), and air quality from smoke was determined. Spatial heterogeneity was accounted for using geographically weighted multinomial logistic regression.
Results:
For fine particulate matter exposure, 0.34% of locations displayed statistically significant negative associations with critical CHD categories, clustered in Saskatchewan and Manitoba. These regions exhibited small spatial extents. For ozone exposure, 15.1% of locations exhibited statistically significant negative associations with critical CHD categories, with the majority originating from Alberta and a smaller fraction in Saskatchewan. Differences in significant associations with locations were observed before and after spatial adjustment. Air quality from smoke and nitrogen dioxide exposure demonstrated no statistically significant associations with critical CHD categories.
Conclusion:
Differences before and after geographic spatial adjustment underscored the importance of accounting for spatial heterogeneity to uncover patterns of association between environmental pollutants and critical CHD categories. The negative associations likely reflected pollution acting as a second hit to markedly increase the risk for critical CHD in those with genetic predisposition.
This article explores the complex cultural processes that engineered the production and circulation of British evangelical periodicals in the late eighteenth and early nineteenth centuries. It draws on a vast collection of missionary archival material from Tahiti to show the patched-together character of evangelical periodicals, constituted by highly mobile texts that connected readers across vast geographic distances. Furthermore, it illustrates how readers responded to periodicals: how they represented the intellectual worlds of the early missionaries and complicated their conceptualizations of home and mission, in particular. The article avoids characterizing periodicals as purely propaganda, instead examining how they worked to extend evangelical networks and how they fit into wider systems of knowledge production. The article makes contributions to the study of religion, media, and the materiality of knowledge, bringing the evangelical knowledge industry into a globalized context that intersected with the mission field.