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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.
This article, the third in a series, focuses on the “living” preverbs used in the verbal system of contemporary Pashto. The verbs treated here belong to the “compound verbs with preverb” class or to the “mixed verbs with preverb” class: verbs that replace the wə́- of the simple verbs with another preverb. This class of verbs represents a closed set, and a complete list of these verbs can be investigated systematically and exhaustively. This subject is as yet unexamined and its implications for the interpretation of contemporary Pashto verbal morphology are particularly stimulating.
The objective of the trial was to evaluate the effects of arginine supplementation in the feed of gestating sows on the variability of piglet birth weight. The weight of the piglets was evaluated using descriptive analysis, correlation analysis and analysis of variance with a 2 × 3 factorial arrangement. This arrangement included no supplementation or supplementation with 1.0 % L-arginine, combined in three periods. Period 1: from days 25 to 53 of gestation, providing 23 g/day from days 25 to 28 and 18 g/day from days 29 to 53 of gestation; period 2: from days 30 to 60 of gestation and from day 80 of gestation to farrowing, providing 18 g/day in the first period and 45 g/day in the second period and period 3: from day 85 of gestation to delivery, with 24 g/day was provided from day 85 until farrowing and 28 g/day from days 85 to 107, increasing to 56 g/day from day 108 until farrowing. Supplementation with 1.0 % of L-arginine reduced the percentage of total piglets born and piglets born alive with less than 800 g by 2.26 and 2.05 percentage points, respectively; and increased the percentage of total piglets born and piglets born alive between 1601 and 1800g by 5.89 and 6.08 percentage points, respectively. Supplementing with 1.0 % of L-arginine improves litter uniformity, with an average reduction of 4.06 percentage points in the piglet population of less than 1180 g and an increase in the piglet population of 1180 to 1890 g by 4.70 percentage points.
Cation exchange competition (CEC) is driven by water uptake during saturation of bentonite barriers surrounding canisters releasing heat from radioactive waste. CEC differences may be used to follow smectite degradation. The unanswered question is whether processes can be understood in more detail by studying a full set of 30 bentonite blocks of the Alternative Buffer Material (ABM) test series (ABM-5) after reaction in an underground laboratory operated in crystalline rock at temperatures of ~250°C, the highest reported temperature so far. In contrast to expectations, only a minor CEC decrease of, on average, 1.8 meq 100 g–1 was detected, although processes depending on high temperature were expected to alter the swelling properties of smectites that can be followed analytically by reducing bentonite CEC values. A critical role of initial water saturation and initially ~25% Na+/CEC on exchangers was identified by comparison with the first ABM-1 package where CEC decreased by on, average, 5.5 meq 100 g–1. ABM-1 was heated from the start whereas the packages ABM-2 and ABM-5 in this study were heated after water saturation. Exchangeable cations (EC) were distributed within the whole barrier in ABM-5 with (1) more pronounced horizontal EC gradients and (2) the absence of an exchangeable Na+ decrease. In all tests, a cation equilibration with the Äspö groundwater averaged over the whole packages of many different buffer materials was observed, showing, overall, a significant range in final composition after retrieval: Na+ (27–46%/CEC), Mg2+ (7–15%/CEC), and Ca2+ (45–100%/CEC). The groundwater for saturation, however, was locally variable in composition. Although excluded from the smectite interlayer (below or equal to 2 water layers), Cl– entered the barrier from groundwater, increased significantly in nearly all ABM-5 bentonite blocks, and was found to be mobile also in the less heated ABM-1 and ABM-2 test packages.
Duchenne muscular dystrophy is a devastating neuromuscular disorder characterized by the loss of dystrophin, inevitably leading to cardiomyopathy. Despite publications on prophylaxis and treatment with cardiac medications to mitigate cardiomyopathy progression, gaps remain in the specifics of medication initiation and optimization.
Method:
This document is an expert opinion statement, addressing a critical gap in cardiac care for Duchenne muscular dystrophy. It provides thorough recommendations for the initiation and titration of cardiac medications based on disease progression and patient response. Recommendations are derived from the expertise of the Advance Cardiac Therapies Improving Outcomes Network and are informed by established guidelines from the American Heart Association, American College of Cardiology, and Duchenne Muscular Dystrophy Care Considerations. These expert-derived recommendations aim to navigate the complexities of Duchenne muscular dystrophy-related cardiac care.
Results:
Comprehensive recommendations for initiation, titration, and optimization of critical cardiac medications are provided to address Duchenne muscular dystrophy-associated cardiomyopathy.
Discussion:
The management of Duchenne muscular dystrophy requires a multidisciplinary approach. However, the diversity of healthcare providers involved in Duchenne muscular dystrophy can result in variations in cardiac care, complicating treatment standardization and patient outcomes. The aim of this report is to provide a roadmap for managing Duchenne muscular dystrophy-associated cardiomyopathy, by elucidating timing and dosage nuances crucial for optimal therapeutic efficacy, ultimately improving cardiac outcomes, and improving the quality of life for individuals with Duchenne muscular dystrophy.
Conclusion:
This document seeks to establish a standardized framework for cardiac care in Duchenne muscular dystrophy, aiming to improve cardiac prognosis.
Although real wages have long been a cornerstone of our understanding of the premodern economy, in recent years historians have become sceptical about their usefulness as a proxy for living standards. One of the main concerns is that, before industrialization, most households did not depend on wages but were self-employed. This article therefore proposes a new methodology to test the representativeness of real wage series for the general population by comparing changes in the purchasing power of builders’ wages with the relative position of building labourers in tax lists. Not surprisingly, it confirms their exceptional position, which evolved according to remuneration. Instead of disregarding the unreal wages, the methodology shows a promising path forward. The relationship between changes in wage income and the relative position in fiscal sources can be exploited to identify other groups who were or became dependent on this type of labour. Accordingly, it holds the potential to retrace shifts in the functional distribution of income and the wage systems for different groups in the premodern economy.
This paper presents for the first time the implementation of an Si/SiGe heterojunction bipolar phototransistor (HPT) into an STMicroelectronics BiCMOS technology together with the development of hydrodynamical model that fits in a trustable manner the measured opto-microwave performance. The developed hydrodynamical model relies on a precise topology analysis of the HPT and an efficient optical absorption coefficient model. It is key to predict the optimization required for the HPT. Simulation results with responsivities of 0.92 A/W and bandwidth of 1.55 GHz are obtained at low $V_{\scriptsize{\text{CE}}}=2$ V and for small devices with $2 \times 2\,\unicode{x00B5} \text{m}^{2}$ optical window. Simulation results are used to identify the best horizontal geometry that maximizes the gain–bandwidth product of the HPT. The behavior of the photo-generated carriers in the active region of the device is investigated.
Gymnophallidae is one of the digenean families featuring bivalves as first intermediate hosts. However, the exact bivalve host species remain unknown for most members of this family. Gymnophallids have been one of the targets in our continuous efforts to reveal the diversity of digeneans in the higher north. Here, we focus on Gymnophallus minor, which we found in eiders from various locations in the Arctic and sub-Arctic. Sexual adults (maritae) of G. minor can be easily identified because they have a distinctive character: the roughly equal size of the pharynx and the ventral sucker. We also matched them, using DNA markers, with the intramolluscan stages (sporocysts, cercariae, and metacercariae) from the bivalve Liocyma fluctuosa collected on Spitsbergen. Taken together, we compile the first data on the life cycle of G. minor and discuss them in the context of other gymnophallids.
We aimed to evaluate the clinical and laboratory characteristics and aetiological factors of patients who underwent pericardiocentesis for moderate to large pericardial effusion.
Method:
A total of 38 patients who underwent pericardiocentesis due to moderate-severe pericardial effusion and not related to cardiac surgery were included in the study.
Results:
The male-to-female ratio was 2.16, and found to be 7.5 in patients over 3 years of age. Mean age and body weight of the patients were 69.4 ± 74.9 months and 22.5 ± 22.4 kg. Dyspnoea (51.7%) was the most common complaint, followed by chest pain (37.9%). Tamponade was present in 23.7% of the patients. The largest diameter of effusion was 24.4 ± 10.4 mm. The amount of fluid drained was 279.24 ± 279 ml. Macroscopic appearance was serous in 12 (34.3%), and haemorrhagic in 18 (51.4%). No complication related to procedure was seen. Aetiology for efusion was infectious in 26%, idiopathic in 18%, iatrogenic in 11%, rheumatological in 11%, malignancy in 8%, cardiomyopathy in 8%, and other factors related in 18%. Of the 38 patients, 16 received nonsteroidal anti-inflammatory drugs (NSAID), and colchicine and corticostreoid were added in nine and two patients, respectively. A total of eight (21%) patients died during follow-up.
Conclusion:
In conclusion, percutaneous pericardiocentesis can be applied safely and the underlying aetiology is decisive in the prognosis of the patient. Although pericardial effusion in children is often due to inflammation of the pericardium, it can develop as a finding of many local or systemic diseases that should be kept in mind.
Modern data analysis depends increasingly on estimating models via flexible high-dimensional or nonparametric machine learning methods, where the identification of structural parameters is often challenging and untestable. In linear settings, this identification hinges on the completeness condition, which requires the nonsingularity of a high-dimensional matrix or operator and may fail for finite samples or even at the population level. Regularized estimators provide a solution by enabling consistent estimation of structural or average structural functions, sometimes even under identification failure. We show that the asymptotic distribution in these cases can be nonstandard. We develop a comprehensive theory of regularized estimators, which include methods such as high-dimensional ridge regularization, gradient descent, and principal component analysis (PCA). The results are illustrated for high-dimensional and nonparametric instrumental variable regressions and are supported through simulation experiments.
The presence of excessive arsenic (As) in paddy fields poses a significant risk to human health due to its accumulation in rice grains. However, the current level of As in Sri Lankan paddy fields remains unclear. Therefore, this research aims to assess the distribution of exchangeable As concentration and investigate the effects of agro-climatic zones (ACZs), soil orders and water sources on exchangeable As concentration in Sri Lankan paddy fields. For this purpose, 7,154 soil samples were collected from paddy fields using a stratified random sampling method representing six ACZs, six soil orders and three water sources. Arsenic extraction was made using 0.01 M CaCl2 followed by the detection with inductive coupled plasma mass spectrophotometry. The concentration of exchangeable As ranged from 0.01 to 392.9 µg/kg with an average of 24.6 µg/kg. Samples from the Low-country Wet zone exhibited higher exchangeable As levels compared to those from the Low country Dry zone (P < 0.05). Among soil orders, Histosols, Inceptisols and Ultisols showed higher exchangeable As concentrations than Alfisols and Vertisols (P < 0.05). Rainfed paddy fields had higher exchangeable As compared to the fields with access to supplementary irrigation. Additionally, exchangeable As concentration was inversely correlated with soil pH and paddy grain yield (P < 0.05). The observed variations in soil-As concentration across ACZs, soil orders and water sources highlight the need for climate, soil order and water source-specific strategies to mitigate further accumulation of As in paddy fields.
We study minimax regret treatment rules under matched treatment assignment in a setup where a policymaker, informed by a sample of size N, needs to decide between T different treatments for a $T\geq 2$. Randomized rules are allowed for. We show that the generalization of the minimax regret rule derived in Schlag (2006, ELEVEN—Tests needed for a recommendation, EUI working paper) and Stoye (2009, Journal of Econometrics 151, 70–81) for the case $T=2$ is minimax regret for general finite $T>2$ and also that the proof structure via the Nash equilibrium and the “coarsening” approaches generalizes as well. We also show by example, that in the case of random assignment the generalization of the minimax rule in Stoye (2009, Journal of Econometrics 151, 70–81) to the case $T>2$ is not necessarily minimax regret and derive minimax regret rules for a few small sample cases, e.g., for $N=2$ when $T=3.$
In the case where a covariate x is included, it is shown that a minimax regret rule is obtained by using minimax regret rules in the “conditional-on-x” problem if the latter are obtained as Nash equilibria.
Fear of cardiac arrest among parents of infants with heart disease can cause stress and anxiety. Literature is scarce on the effects of cardiopulmonary resuscitation training (CPRt) on anxiety and stress of parents. We analysed the impact of CPRt on anxiety, stress, and comfort levels on parents of infants with heart disease.
Methods:
Cardiopulmonary resuscitation (CPR) and choking relief manoeuvre (CRM) comfort level, Parental State-Trait Anxiety Inventory (STAI), and Parenting Stress Index (PSI) scores were prospectively collected pre-, immediately post-, and 3 months post-CPRt.
Results:
There were 97 participants: 80% (n = 78) mothers/grandmothers and 20% (n = 19) fathers. The mean (SD) age of participants was 28.7 (5.6) years old. There was a significant decrease in STAI across the three time points collected; STAI decreased by 12% from baseline to immediately post-CPRt and 19% from baseline to 3 months post-CPRt (p < .0001). There were no significant changes in PSI across the time points. Baseline to immediately post-teaching, we found that CPRt significantly increased comfort performing CPR, CRM, and comfort in knowing what to do (p=< .001, p=< .001, p=< .001, respectively). Comfort levels persisted elevated when comparing pre- to 3 months post-CPRt (p=< .001, p= .002, p= .001, respectively), maintaining at least a 177% average increase up to 3 months post-CPRt for all aspects.
Conclusion:
CPRt can aid in improving anxiety and comfort levels of parents of infants with heart disease around hospital discharge. Parental preparedness and reassurance to know what to do in emergency situations can be enhanced by a simple intervention such as CPRt.
Agricultural monoculture negatively impacts soil quality, particularly in fragile soils that yield limited crop production and are highly susceptible to degradation. Increasing plant diversity in production systems can be an alternative for maintaining soil ecosystem services and increasing crop yields. This study investigated the influence of increased plant diversity on soil health and its impact on soybean and cotton yield in an Ultisol in the Brazilian savanna in Mato Grosso State, Brazil. Tested five rates of plant diversity after soybean harvest: (1) very low (VL), (2) low, (3) average, (4) long-term average and (5) high (integrated crop–livestock systems (ICLS)) were tested. Plant diversity improves the health of sandy loam soil, increases C and N fractions in particulate organic matter (POM-C and POM-N) and leads to differences in C utilization by the soil microbial community. High ICLS diversity raises total organic carbon content, being POM-C and POM-N, the labile fractions, more efficient to show changes in sandy loam soil, in the short term, over a period of three years. High diversity promoted yield gains of up to 251 % for cotton and 82 % for soybean in relation to VL plant diversity. Changes in soil microbial composition are able to partially explain crop yield in diversified production systems (R2 ranging from 0.51 to 0.80). Diversifying production components is a sustainable way to maintain biological functions and agricultural quality of loam sandy soil in the Brazilian Cerrado in Mato Grosso.
This study investigated the prevalence of malnutrition, time to achieve caloric goals, and nutritional risk factors after surgery for CHD in a cardiac ICU.
Method:
This retrospective study included patients with CHD (1 month-18 years old) undergoing open-heart surgery (2021–2022). We recorded nutritional status, body mass index-for-age z-score, weight-for-length/height z-score, cardiopulmonary bypass and aortic cross-clamp time, Paediatric Risk of Mortality-3 score, Paediatric Logistic Organ Dysfunction-2 score, vasoactive inotropic score, total duration of mechanical ventilation, length of stay in the cardiac ICU, mortality, and time to achieve caloric goals.
Results:
Of the 75 included patients, malnutrition was detected in 17% (n= 8) based on the body mass index-for-age z-score and in 35% (n= 10) based on the weight-for-length/height z-score. Sex, mortality, cardiopulmonary bypass and aortic cross-clamp time, Paediatric Risk of Mortality-3, Paediatric Logistic Organ Dysfunction-2, and vasoactive inotropic score, duration of mechanical ventilation, and length of cardiac ICU stay were similar between patients with and without malnutrition. Patients who achieved caloric goals on the fourth day and those who achieved them beyond the fourth day showed statistical differences in mortality, maximum vasoactive inotropic score, duration of mechanical ventilation, cardiopulmonary bypass and aortic cross-clamp time, Paediatric Risk of Mortality-3, Paediatric Logistic Organ Dysfunction-2, and length of cardiac ICU and hospital stay (p< 0.05). Logit regression analysis indicated that the duration of mechanical ventilation, Paediatric Logistic Organ Dysfunction-2 and Paediatric Risk of Mortality-3 score was a risk factor for achieving caloric goals (p< 0.05).
Conclusions:
Malnutrition is prevalent in patients with CHD, and concomitant organ failure and duration of mechanical ventilation play important roles in achieving postoperative caloric goals.