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Cardiomyopathy is the leading cause of death in patients with Duchenne muscular dystrophy. The relationship between cardiac and skeletal muscle progression is unclear. The objective of this study was to evaluate the correlation between muscle activity and cardiomyopathy. We hypothesised that cardiomyopathy and skeletal muscle activity are directly related.
Methods:
Physical activity was assessed with accelerometers worn for 7 days. Average activity (vector magnitude/min) and percentage of time in different activities were reported. Cardiac MRI was used to assess left ventricular ejection fraction, global circumferential strain (Ecc), late gadolinium enhancement, and cardiac index. Associations were assessed between physical activity and cardiac variables using a Spearman correlation.
Results:
Duchenne muscular dystrophy subjects (n = 46) with an average age of 13 ± 4 years had a mean left ventricular ejection fraction of 57 ± 8%. All physical activity measures showed significant correlations with left ventricular ejection fraction (rho = 0.38, p = 0.01) and left ventricular cardiac index (rho = 0.51, p < 0.001). Less active subjects had lower left ventricular ejection fraction (p = 0.10) and left ventricular cardiac index (p < 0.01). Non-ambulatory patients (n = 29) demonstrated a stronger association between physical activity and left ventricular ejection fraction (rho = 0.40, p = 0.03) while ambulatory patients demonstrated a stronger association between physical activity and left ventricular cardiac index (rho = 0.53, p = 0.03). Ecc did not associate with physical activity in either cohort.
Conclusion:
Physical activity correlates with left ventricular ejection fraction and left ventricular cardiac index and is modified by ambulation. Future analysis should assess the temporal relationship between physical activity and cardiomyopathy.
The incidence of congenital malformations (CM) among non-Hispanic White American (NHWA) mothers was reviewed to identify and evaluate the geographic differences in the most frequent CM subtypes associated with smoking and other risk factors. Data on CM were obtained from 150,775 children (2000-2004) from the Centers for Disease Control and Prevention. Risk factors associated with CM development were the mother’s age < 21 and > 35 years, body weight gain during pregnancy, anemia, diabetes mellitus, eclampsia (cases of preeclampsia were omitted), smoking, and alcohol use during pregnancy. Among smoking mothers, the most common CM was omphalocele, club foot, cleft lip, and polydactyly. The highest incidences (CM/10,000 births/year) of observed CM in children of smoking mothers were clubfoot, 25.51 cases (Utah), cleft lip, 22.47 (South Dakota), polydactyly, 21.23 (North Dakota), and omphalocele, 13.14 (Montana). The presence of maternal comorbidities, tobacco and alcohol consumption, and their association with other environmental factors can affect the incidence of CM in NHWA mothers. Further comparisons among the American states regarding the overall changes in CM over the last two decades should uncover crucial outcomes in terms of CM and smoking.
Vascular rings cause highly variable clinical presentations. This study assesses the impact of prenatal versus postnatal diagnosis on clinical outcomes.
Methods:
We conducted a single centre retrospective review of isolated vascular ring patients (without significant CHD) from 2011 to 2022 and compared clinical and operative data between patients with prenatal and postnatal diagnoses.
Results:
Of 177 patients, 45% (N = 80) had prenatal diagnosis. Between 2018 and 2022, 78% had prenatal diagnosis compared to 41% from 2013 to 2018 and 4% before 2013 (p < 0.001). 76.3% (N = 135) had a right aortic arch with left ligamentum arteriosum, 22.6% (N = 40) had a double aortic arch, and 1.1% (N = 2) had a left aortic arch with right ligamentum arteriosum. Postnatal diagnosis patients were more likely to have preoperative respiratory symptoms (55.7%), medications (34.0%), or admissions (24.7%) (versus 32.5%, 10.0%, and 11.3% of the prenatal diagnosis patients, p < 0.05) and require surgical repair (68.0% versus 38.8% of prenatal diagnosis patients, p < 0.0001). 54.8% of patients had surgical repair; prenatal diagnosis patients were younger at surgery, 7.5 (3-11) months compared to 16.0 (5-18) months in the postnatal diagnosis patients (p = .0014). Double aortic arch patients were more likely to require surgical repair (90.0%, compared to 44.5% with right aortic arch, p < 1e−4). Postnatal diagnosis patients had more residual postoperative symptoms (40.9% versus 16.1% in prenatal diagnosis patients, p = 0.01).
Conclusion:
Prenatal diagnosis of vascular rings improves clinical surveillance, resulting in earlier surgical repair in symptomatic patients and diminished morbidity. Higher risk double aortic arch patients should have a tailored evaluation pathway.
This study investigated the helminths of the mixed invasive population of Darevskia armeniaca and D. dahli, collected during two field trips in Denyshy, Zhytomyr region, Ukraine, in 2023. In total, 67 adult lizards (35 D. armeniaca and 32 D. dahli) were examined. Molecular and morphological approaches were used to identify the parasites. The analyses revealed six helminth species, including four nematodes (Toxocara cati, Strongyloides darevskyi, Oswaldocruzia sp., and Spirurida gen. sp.), one trematode (Pleurogenes claviger), and one cestode (Mesocestoides litteratus). Toxocara cati had the highest prevalence, found in cysts located primarily on the liver and in the body cavity of the hosts. The qualitative and quantitative comparative assessment of the helminth community suggests that, due to the introduction of these lizards, most helminth species from their native range have been lost. Additionally, most local helminth species have not yet adapted to parasitising these lizards as normal hosts of their life cycle.
The crystal structure of etrasimod has been solved and refined using synchrotron X-ray powder diffraction data and optimized using density functional theory techniques. Etrasimod crystallizes in space group P1 (#1) with a = 10.6131(5), b = 10.7003(5), c = 11.1219(8) Å, α = 72.756(2), β = 76.947(2), γ = 77.340(1)°, V = 1159.28(6) Å3, and Z = 2 at 298 K. The crystal structure contains O▬H⋯O hydrogen-bonded etrasimod dimers, which lie in layers approximately parallel to the (2,0,−1) plane. The amino group of each molecule forms an intramolecular N▬H⋯O hydrogen bond to the carbonyl group of the adjacent carboxylic acid group. The powder pattern has been submitted to ICDD for inclusion in the Powder Diffraction File™ (PDF®).
We examine the maximum dimension of a linear system of plane cubic curves whose $\mathbb {F}_q$-members are all geometrically irreducible. Computational evidence suggests that such a system has a maximum (projective) dimension of $3$. As a step towards the conjecture, we prove that there exists a three-dimensional linear system $\mathcal {L}$ with at most one geometrically reducible $\mathbb {F}_q$-member.
Grazing is a crucial component of dairy farms across many regions of the world. This review explores challenges related to grazing infrastructure and opportunities for future improvement. Farmers who aim to increase pasture utilisation face heightened inter-animal competition necessitated by pasture restriction to achieve target post-grazing sward heights. Increasing the frequency of fresh pasture allocation beyond once per day has been observed to reduce milk production in primiparous animals, due to intensified competition for limited feed resources. Implementing grazing paddocks tailored for 24- to 36-hour allocations helps to mitigate inter-animal competition while concurrently preventing the grazing of fresh regrowth. Crucial to this approach is establishing farm roadway infrastructure that allows access to all sections of the grazing platform. However, the development of these roadway networks has often occurred without a comprehensive assessment of their impact on the efficiency of the dairy herd’s movement between grazing paddocks and the milking parlour. The efficiency of the dairy herd’s movement is most significantly influenced by the location of the milking parlour within the grazing platform. Extreme walking distances or challenging terrain on farm roadways may have an impact on milk production per cow. Factors such as farm roadway surface quality and width significantly influence cow throughput on farm roadways. Recent studies have highlighted inadequate roadway widths on many farms relative to their herd size, while surface condition may also be limiting cow throughput on these farms. Enhancing roadway width and surface condition of farm roadways may improve labour efficiency on commercial farms.
Despite being almost 4000m above sea level, cereal crops have been grown in the Ngari Prefecture on the Tibetan Plateau for thousands of years. Where and when domestic crop species adapted to high-altitude growing conditions is a matter of ongoing debate. Here, the authors present a new radiocarbon date from the Gepa serul cemetery, providing the earliest evidence of naked six-rowed barley in Tibet (c. 3500 BP). Evaluating the available evidence for barley cultivation and interregional connections in central Asia at this time, two hypotheses are considered—a generational advance with farmers migrating up river valleys or rapid, long-distance trade through mountain corridors.
According to the ‘rigorist’ interpretation, the imperfect duty of (e.g.) beneficence does not permit agents to fail to perform any beneficent act that is available to the agent in order to pursue some nonmoral interest, whereas on the latitudinal interpretation, agents are permitted to fail to do so. I defend the latitudinal interpretation by criticising recent defences of rigorism offered by Jens Timmermann and Pauline Kleingeld, arguing that they conflict with important features of Kant’s moral theory, and that the latitudinal interpretation better coheres with Kant’s overall view.
The concept of interaction classes (iClasses) for multi-environment trial data was introduced to address the problem of summarising variety performance across environments in the presence of variety by environment interaction (VEI). The approach involves the fitting of a factor analytic linear mixed model (FALMM), with the resultant estimates of factor loadings being used to form groups of environments (iClasses) that discriminate varieties with different patterns of VEI. It is then meaningful to summarise variety performance across environments within iClasses. The iClass methodology was developed with respect to a FALMM in which the genetic effects for different varieties were assumed independent. This was done for pedagogical reasons but it was pointed out that the accuracy of variety selection is greatly enhanced by considering the genetic relatedness of varieties, either via ancestral or genomic information. The focus of the current paper is therefore to extend the iClass approach for FALMMs which incorporate such information. In addition, a measure of stability of variety performance across iClasses is defined. The utility of the approach for variety selection is illustrated using a multi-environment trial dataset from the lentil breeding programme operated by Agriculture Victoria.
The effect of the supplementation of γ-aminobutyric acid (GABA), a component of the neuroendocrine cascade involved in stress alleviation, was studied in broiler chickens in a heat stress model. In a 42-day feeding trial, 300 male and 300 female broiler chickens were equally distributed in an environmentally controlled and an open house (OH) according to a 2 × 2 × 3 factorial design. The diet was either devoid of GABA (0 mg/kg) or was supplemented with 60 or 120 mg/kg GABA. Zootechnical performances (1–42 days), expression of mRNA for genes coding for inflammatory cytokines (IL-1β, IL-8, TNF-α) in the spleen (24 days), oxidative regulators (Nrf-2, superoxide dismutase) in the liver (24 days) and arterial blood gas concentrations (24 days) were assessed. Whole genome sequencing of the caecal microbiome was performed for the male birds (42 days). Supplementation of GABA improved (P < 0.01) body weight and feed conversion ratio irrespective of sex and housing conditions, expression of IL-1β and IL-8 and Nrf-2 gene. GABA decreased (P < 0.05) malondialdehyde and increased (P < 0.05) glutathione peroxidase activities in serum. GABA decreased circulatory corticosterone concertation (P < 0.05). While both housing conditions benefitted from GABA, its effects were more pronounced in OH (house effect P < 0.05). GABA supplementation modulated caecal microbiota composition by increasing the relative abundance of beneficial bacteria such as Alistipes and Bacteroides, particularly in the OH environment. Overall, this study concludes that 60 mg/kg GABA supplementation improves growth performance, stress resilience and microbial composition in broiler chickens, with variable effects depending on housing conditions.
We argue that the controversial Barrett appointment and President Trump’s norm-violating rhetoric posed risks to the Supreme Court’s ability to generate acceptance of a 2020 election intervention. We fielded four nationally-representative survey experiments to measure the Court’s ability to generate public acceptance of an election intervention across key events during the election period. Results show that public acceptance changed substantially across events. The Court lacked the ability to induce acceptance, particularly among Democrats, after the election. Only after the Court dismisses the Republican-led election challenge does acceptance rebound. The Court’s ability to generate public acceptance regarding election disputes appears tenuous.
A new explicit solution representation is provided for ARMA recursions with drift and either deterministically or stochastically varying coefficients. It is expressed in terms of the determinants of banded Hessenberg matrices and, as such, is an explicit function of the coefficients. In addition to computational efficiency, the proposed solution provides a more explicit analysis of the fundamental properties of such processes, including their Wold–Cramér decomposition, their covariance structure, and their asymptotic stability and efficiency. Explicit formulae for optimal linear forecasts based either on finite or infinite sequences of past observations are provided. The practical significance of the theoretical results in this work is illustrated with an application to U.S. inflation data. The main finding is that inflation persistence increased after 1976, whereas from 1986 onward, the persistence declines and stabilizes to even lower levels than the pre-1976 period.
Right anterolateral thoracotomy or left anterolateral thoracotomy applied to partial anomalous pulmonary venous connection correction have been reported to obtain cosmetic and less invasive outcomes as alternative approaches to median sternotomy. However, the application of different approaches is still confusing. We compared the perioperative and mid-term outcomes to seek indications of different approaches and guide surgical treatment of partial anomalous pulmonary venous connection.
Methods:
From July 2019 to August 2023, 44 patients who underwent surgical correction of partial anomalous pulmonary venous connection were recruited. Of these, 13 (29.6%) patients who underwent median sternotomy were separated into M group, 28 (63.6%) patients who underwent right anterolateral thoracotomy were separated into R group, and three (6.8%) patients who underwent left anterolateral thoracotomy were separated into L group. Clinical data were reviewed and compared between each group.
Results:
In M group, direct anastomosis accounted for the most (7, 53.8%), in R group, intra-atrial rerouting accounted for the most (22, 78.6%), and in L group, direct anastomosis accounted for the most (3, 100%). R group had shorter cardiopulmonary bypass time (70.0 ± 32.4 vs113.1 ± 83.3, p = 0.029), shorter ICU stay (1.0 ± 0.2 vs 1.9 ± 1.7, p = 0.01), shorter postoperative stay (6.0 ± 1.2 vs 8.3 ± 5.0, p = 0.021), and fewer chest tube drainage (8.4 ± 4.3 vs 13.9 ± 10.2, p = 0.026) compared with M group. Three left-sided partial anomalous pulmonary venous connection in L group adopted off-pump approach.
Conclusions:
Median sternotomy S.V.C. can be applicable to all anatomic types of partial anomalous pulmonary venous connection especially for complex types. Considering the minimally invasive advantages, we prefer applying right anterolateral thoracotomy for pulmonary vein connected to right atrium or proximal end of off-pump. Applying left anterolateral thoracotomy for left-sided partial anomalous pulmonary venous connection without atrial septal defect by off-pump.
Nonsuicidal self-injury (NSSI) is one of the strongest predictors of suicidal behavior. Despite this, the field still has a limited understanding of the mechanisms by which this relationship is conferred.
Method:
We conducted a systematic review of the empirical research examining potential factors driving (i.e., moderators, mediators) the relationship between NSSI and suicidal behavior to address this gap in the literature.
Results:
We identified only 15 studies examining moderators or mediators of this relationship, examining 40 unique mediators and 22 unique moderators. Three prominent weaknesses were identified in the reviewed literature: (1) limited intersection with existing theoretical models of the NSSI – suicidal behavior relationship, (2) little replication of findings across studies (i.e., only four mediators and four moderators assessed in multiple studies), and (3) only one of the included studies utilized a prospective design. Research to date does little to improve our understanding of the theoretical or prospective relationship between NSSI and suicidal behavior, highlighting a foundational gap in the literature.
Discussion:
We propose the Nonsuicidal to Suicidal Self-Injury Pathway Model, a new conceptual model of the relationship between NSSI and suicidal behavior, drawing on extant theory and empirical research; we discuss future directions for work in this area.
To retrospectively assess the suitability of pulmonary artery banding as a treatment strategy for dilated cardiomyopathy and left ventricular non-compaction cardiomyopathy with depressed left ventricular ejection fraction.
Methods:
The study was retrospective and included consecutive patients who met the inclusion criteria: diagnosed with dilated cardiomyopathy or left ventricular non-compaction cardiomyopathy and left ventricular ejection fraction less than 35%. Cardiac indices were documented, and clinical outcomes were followed for 5 years.
Results:
This study included 21 patients with depressed left ventricular ejection fraction due to dilated cardiomyopathy (n = 11) or left ventricular non-compaction cardiomyopathy (n = 10), treated either with anti-congestion medication alone or in combination with pulmonary artery banding. The groups treated with pulmonary artery banding showed significant improvement in left ventricular ejection fraction compared to controls (ANOVA, p = 0.0002), with no major adverse events. In the subgroup with left ventricular non-compaction, pulmonary artery banding led to significant improvement of the left ventricular ejection fraction (p = 0.00002) and significant reductions in the Z scores of left ventricular end-diastolic diameter (p = 0.0002) and of end-diastolic volume (p = 0.004).
Conclusions:
Pulmonary artery banding appears to be a viable strategy for improving heart function in patients with non-compaction and dilated cardiomyopathy and depressed left ventricular ejection fraction. While pulmonary artery banding demonstrated more pronounced benefits in the subgroup with non-compaction cardiomyopathy, significantly enhancing cardiac restoration indices throughout the follow-up period, warranting further investigation in larger studies.
In the 1870s, Heinrich Schliemann's excavations in Mycenae brought to light an unknown civilization. His intellectual network exploited the impact of these fascinating discoveries by implementing a double appropriation process. Many foreign intellectuals and members of the upper class sought to engage with the impressive findings. Meanwhile, a Greek intellectual elite played a pivotal role by Hellenizing Mycenaean antiquities to integrate them within a vision of a glorious national past. These processes were brought together with the inauguration of the branch of Mycenaean Archaeology by the Greek king and the establishment of the National Museum.
The crystal structure of cummingtonite-(P21/m) was characterised by single-crystal structure-refinement, infrared spectroscopy and 57Fe Mössbauer spectroscopy. Previous cummingtonite-(P21/m) specimens characterised have Mn2+ as the dominant constituent at M(4) but this amphibole has Fe2+ dominant at M(4). The formula of the amphibole was corrected for minor exsolved calcium-amphibole and is (Mg5.66Fe2+1.28Mn0.06)Σ7.00Si8.00O22(OH)2. The crystal structure (a = 9.4885(19), b = 18.040(4), c = 5.2891(11) Å, β = 102.06(3)°, V = 885.4(3) Å3, space group P21/m and Z = 2), was refined to an R1-index of 3.34% for 2338 observed reflections. Site-occupancy refinement gave the following site-populations: M(1) = 1.972(8) Mg + 0.028 Fe2+, M(2) = 2.000 Mg, M(3) = 0.989(6) Mg + 0.011 Fe2+, M(4) = 0.815(8) Mg + 1.125 Fe2+ + 0.060 Mn2+ apfu. Infrared spectroscopy in the principal (OH)-stretching region shows two peaks, at 3367 and 3652 cm–1, that were assigned to the local arrangements M(1)MgM(1)MgM(3)Mg–OH and M(1)MgM(1)Fe2+M(3)Mg–OH (≈ M(1)MgM(1)MgM(3)Fe2+–OH) with relative intensities in accord with the refined site-populations. 57Fe Mössbauer spectrum shows three quadrupole-split doublets with parameters indicative of octahedrally coordinated Fe2+ at M(4) and M(1,2,3), and octahedrally coordinated Fe3+ that occurs in exsolved calcium amphibole. All three techniques indicate a small amount of Fe2+ at M(1,2,3) despite the fact that there is more than sufficient CMg to completely fill the M(1,2,3) sites: 5.66 Mg pfu. Issues involving the current and possible future nomenclature and classification of the magnesium-iron-manganese amphiboles are discussed in detail.
Cumulative exposure to anticholinergic and sedative medications has been associated with worsening physical function in older adults. We evaluated the feasibility of measuring physical function using wearable devices and explored the impact of reducing the anticholinergic and sedative medication burden in a pilot study of community-dwelling adults aged 60 years and older. Evaluations included the 10-meter walk test (10MWT), the Short Physical Performance Battery (SPPB), and the mini-BESTest. Two participants/month were recruited in one clinic in 2022. The five participants had a median age of 67, a median DBI of 1.7, and four were female. The feasibility analysis showed that the 10MWT and SPPB tests were completed on 12/12, and the mini-BESTest on 11/12. An exploratory analysis showed clinically meaningful improvements in gait speed (mean +0.18 m/s) and SPPB (mean +2.2 points). We showed the feasibility of measuring physical function by wearable devices during deprescribing of anticholinergic and sedative medications.
The diet proposed by the EAT-Lancet Commission has faced criticism concerning its affordability. This study aimed to investigate the cost associated with a greater alignment to the EAT-Lancet reference diet in the province of Québec, Canada. The dietary habits of 1147 French-speaking adults were assessed using repeated web-based 24-h recall data collected between 2015 and 2017 in the cross-sectional PRÉDicteurs Individuels, Sociaux et Environnementaux (PREDISE) study. Diet costs were calculated using a Nielsen food price database. Usual dietary intakes and diet costs were estimated using the National Cancer Institute’s multivariate Markov Chain Monte Carlo method. Adherence to the EAT-Lancet diet was assessed using the EAT-Lancet dietary index (EAT-I). Associations between diet costs and EAT-I scores were evaluated using linear regression models with restricted cubic splines. After adjustment for energy intake, a higher EAT-I score (75th v. 25th percentiles) was associated with a 1·0 $CAD increase in daily diet costs (95 % CI, 0·7, 1·3). This increase in diet costs was mostly driven by the following component scores of the EAT-I (75th v. 25th percentiles, higher scores reflecting greater adherence): vegetables (1·6 $CAD/d, 95 % CI: 1·2, 2·1), free sugars (1·6 $CAD/d, 95 % CI: 1·3, 1·9), fish and plant-based proteins (1·4 $CAD/d, 95 % CI: 1·0, 1·8), fruits (0·9 $CAD/d, 95 % CI: 0·4, 1·3) and whole grains (0·4 $CAD/d, 95 % CI: 0·0, 0·8). Inversely, a greater score for the poultry and eggs component was associated with reduced diet costs (–1·2 $CAD/d, 95 % CI: −1·7, −0·7). This study suggests that adhering to the EAT-Lancet diet may be associated with an increase in diet costs in the province of Québec.