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Experts recommend standing orders for hospital-administered vaccines to improve adult immunization rates. We implemented an admission assessment tool to offer pneumococcal vaccine to eligible hospitalized patients. We retrospectively reviewed vaccines for guideline concordance and found that immunization rates increased but less than half of study patients received the correct vaccine.
For a proper, Gromov-hyperbolic metric space and a discrete, non-elementary, group of isometries, we define a natural subset of the limit set at infinity of the group called the ergodic limit set. The name is motivated by the fact that every ergodic measure which is invariant for the geodesic flow on the quotient metric space is concentrated on geodesics with endpoints belonging to the ergodic limit set. We refine the classical Bishop–Jones theorem proving that the packing dimension of the ergodic limit set coincides with the critical exponent of the group.
We report the discovery of an ancient forest bed near Stanley, on the Falkland Islands, the second such ancient deposit identified on the South Atlantic island archipelago that is today marked by the absence of native tree species. Fossil pollen, spores and wood fragments preserved in this buried deposit at Tussac House show that the source vegetation was characterized by a floristically diverse rainforest dominated by Nothofagus-Podocarpaceae communities, similar to cool temperate Nothofagus forests/woodlands and Magellanic evergreen Nothofagus rainforests. The age limit of the deposit is inferred from the stratigraphic distribution of fossil pollen species transported by wind, birds or ocean currents from southern Patagonia, as well as similar vegetation types observed across the broader region. The deposit is suggested to be between Late Oligocene and Early Miocene, making it slightly older than the previously analysed Neogene West Point Island forest bed (200 km west of Tussac House). The combined evidence adds to our current knowledge of the role of climate change and transoceanic dispersal of plant propagules in shaping high-latitude ecosystems in the Southern Hemisphere during the late Palaeogene and Neogene.
Although there is evidence that social status has a genetic basis, it is less known whether the genetic predisposition differs between men and women as well as among different status indicators and whether there are any intercorrelations among predispositions of status indicators. We therefore investigated the genetic predisposition for different indicators of social status separately for men and women, using polygenic scores obtained from the Wisconsin Longitudinal Study. We used multivariate polygenic regression of 7 different social status indicators on a total of 24 different polygenic scores. We find that in both men and women, wages and education show more associations with polygenic scores than the other status indicators. Also, the genetic predispositions for education and wages are correlated in both men and women, whereas in men more than in women, the genetic predispositions seem to cluster into wages and education on the one hand, and status indicators of position in the hierarchy, on the other hand, with being in a management position somewhere in between. These findings are consistent with an assumption of two different forms of selection pressure associated with either cognitive skill or dominance, which holds true particularly in men. We conclude that the genetic predisposition to higher social status may have changed even though the importance of the cultural trait of social status may have been very constant. Social status may thus be an example of a social trait of constant importance, but with a changing genetic predisposition.
The definition of subshifts of finite symbolic rank is motivated by the finite rank measure-preserving transformations which have been extensively studied in ergodic theory. In this paper, we study subshifts of finite symbolic rank as essentially minimal Cantor systems. We show that minimal subshifts of finite symbolic rank have finite topological rank, and conversely, every minimal Cantor system of finite topological rank is either an odometer or conjugate to a minimal subshift of finite symbolic rank. We characterize the class of all minimal Cantor systems conjugate to a rank-$1$ subshift and show that it is dense but not generic in the Polish space of all minimal Cantor systems. Within some different Polish coding spaces of subshifts, we also show that the rank-1 subshifts are dense but not generic. Finally, we study topological factors of minimal subshifts of finite symbolic rank. We show that every infinite odometer and every irrational rotation is the maximal equicontinuous factor of a minimal subshift of symbolic rank $2$, and that a subshift factor of a minimal subshift of finite symbolic rank has finite symbolic rank.
Suicide prevention strategies have shifted in many countries, from a national approach to one that is regionally tailored and responsive to local community needs. Previous Australian studies support this approach. However, most studies have focused on suicide deaths which may not fully capture a complete understanding of prevention needs, and few have focused on the priority population of youth. This was the first nationwide study to examine regional variability of self-harm prevalence and related factors in Australian young people.
Methods
A random sample of Australian adolescents (12–17-year-olds) were recruited as part of the Young Minds Matter (YMM) survey. Participants completed self-report questions on self-harm (i.e., non-suicidal self-harm and suicide attempts) in the previous 12 months. Using mixed effects regressions, an area-level model was built with YMM and Census data to produce out-of-sample small area predictions for self-harm prevalence. Spatial unit of analysis was Statistical Area Level 1 (average population 400 people), and all prevalence estimates were updated to 2019.
Results
Across Australia, there was large variability in youth self-harm prevalence estimates. Northern Territory, Western Australia, and South Australia had the highest estimated state prevalence. Psychological distress and depression were factors which best predicted self-harm at an individual level. At an area-level, the strongest predictor was a high percentage of single unemployed parents, while being in an area where ≥30% of parents were born overseas was associated with reduced odds of self-harm.
Conclusions
This study identified characteristics of regions with lower and higher youth self-harm risk. These findings should assist governments and communities with developing and implementing regionally appropriate youth suicide prevention interventions and initiatives.
This article examines the ways in which the language of legal rights is invoked by those seeking to improve the treatment of animals. Drawing from a range of analytical, realist, and critical legal and social theorists, it argues that certain argumentative techniques commonly employed to justify the extension of legal rights to animals may serve to strengthen and reproduce the very forms of exploitation they seek to challenge. The article begins by identifying and critiquing the binary characterisation of rights/welfare and property/personality in liberal animal law scholarship. It then employs the insights of Theodor Adorno and Walter Benjamin to expose and critique various appeals to an ‘exterior’ or ‘extra-legal’ domain which functions to stabilise the meaning of these doctrinal categories. In doing so, it explores the strategic viability of rights discourse in the animal advocacy movement with a view to highlighting the limitations of liberal constructions of animal rights.
Sharing ideas through communication with peers is the primary mode of human interaction. Consequently, extensive research has been conducted in the area of conversational AI, leading to an increase in the availability and diversity of conversational tasks, datasets, and methods. However, with numerous tasks being explored simultaneously, the current landscape of conversational AI has become fragmented. Consequently, initiating a well-thought-out model for a dialogue agent can pose significant challenges for a practitioner. Toward highlighting the critical ingredients needed for a practitioner to design a dialogue agent from scratch, the current study provides a comprehensive overview of the primary characteristics of a dialogue agent, the supporting tasks, their corresponding open-domain datasets, and the methods used to benchmark these datasets. We observe that different methods have been used to tackle distinct dialogue tasks. However, building separate models for each task is costly and does not leverage the correlation among the several tasks of a dialogue agent. As a result, recent trends suggest a shift toward building unified foundation models. To this end, we propose Unit, a Unified dialogue dataset constructed from conversations of varying datasets for different dialogue tasks capturing the nuances for each of them. We then train a Unified dialogue foundation model, GPT-2$^{\textrm{U}}$ and present a concise comparative performance of GPT-2$^{\textrm{U}}$ against existing large language models. We also examine the evaluation strategies used to measure the performance of dialogue agents and highlight the scope for future research in the area of conversational AI with a thorough discussion of popular models such as ChatGPT.
Altered affective state recognition is assumed to be a root cause of aggressive behavior, a hallmark of psychopathologies such as psychopathy and antisocial personality disorder. However, the two most influential models make markedly different predictions regarding the underlying mechanism. According to the integrated emotion system theory (IES), aggression reflects impaired processing of social distress cues such as fearful faces. In contrast, the hostile attribution bias (HAB) model explains aggression with a bias to interpret ambiguous expressions as angry.
Methods
In a set of four experiments, we measured processing of fearful and angry facial expressions (compared to neutral and other expressions) in a sample of 65 male imprisoned violent offenders rated using the Hare Psychopathy Checklist-Revised (PCL-R, Hare, R. D. (1991). The psychopathy checklist–revised. Toronto, ON: Multi-Health Systems) and in 60 age-matched control participants.
Results
There was no evidence for a fear deficit in violent offenders or for an association of psychopathy or aggression with impaired processing of fearful faces. Similarly, there was no evidence for a perceptual bias for angry faces linked to psychopathy or aggression. However, using highly ambiguous stimuli and requiring explicit labeling of emotions, violent offenders showed a categorization bias for anger and this anger bias correlated with self-reported trait aggression (but not with psychopathy).
Conclusions
These results add to a growing literature casting doubt on the notion that fear processing is impaired in aggressive individuals and in psychopathy and provide support for the idea that aggression is related to a hostile attribution bias that emerges from later cognitive, post-perceptual processing stages.
This article explores sumptuary legislation and its enforcement in early modern Genoa. Whereas the sumptuary laws from other early modern Italian city-states partitioned society by social rank, profession, or citizenship, the laws in effect in late sixteenth-century Genoa divided the population only into men and women. Genoa therefore represents a key site for exploring gender difference through dress and adornment. Adopting a gendered, sociological, and material culture framework, this article demonstrates how sumptuary laws informed understandings of gender and gendered practices of dressing. It takes as its point of departure a ledger of sumptuary denouncements for the year 1594, and examines how Genoa’s citizens adhered to, or transgressed the gendered expectations set out by the city’s legislative structures. It argues that while prescriptions for idealized masculine and feminine comportment coloured the content and wording of the law, in daily life a spectrum of gendered identities could be enacted through clothing. This article thus advances discourse on the impact of sumptuary laws on understandings of gender in early modern Italy, and the ways in which masculine and feminine identifications were negotiated through and in dialogue with clothing.
In this article, I reconceptualise the League of Nations as an Imperial Assemblage that embeds and is embedded by coloniality. Relying on the return to the League’s historisisation by Third World Approaches to International Law, I argue that we can understand the League as a governance body that works across scales of international, transnational and local actors, processes and structures to reiterate coloniality within the mandated territories. I utilise Deleuzian notions of assemblage alongside the concept of ‘coloniality’ within the literature of decolonial theory within International Relations and Sociology to show how the work of the League’s various actors, processes and structures across different scales made, actualised and evolved the laws on Forced Labour and Slavery from 1925 to 1932 in the inter-war era with a particular focus on Mandate Territories B and C.
Whether by reevaluating previously underappreciated factors or by uncovering new source material, historical scholarship occasionally makes immediate and simultaneous interventions in both academic and public-facing conversations.1 Andrew Kahrl's The Black Tax is one such work, and actually accomplishes these two tasks admirably. In the last two decades, scholars have investigated African American ownership of real property in land and homes, as well as the ways that governmental and private actors, policies, and practices have impaired Black people's ability to acquire and accumulate wealth in this country.2 This body of scholarship, alongside the work of public intellectuals, has served to jumpstart discussion around the issue of reparations.3 Prior to the release of Kahrl's illustrious book, however, no one had identified property taxes as lying at the very center of race-based structural inequality.4
Adolescence is a critical period for brain development, consolidation of self-understanding, and onset of non-suicidal self-injury (NSSI). This study evaluated the RDoC (Research Domain Criteria) sub-construct of Self-Knowledge in relation to adolescent NSSI using multiple units of analysis.
Methods
One hundred and sixty-four adolescents assigned female at birth (AFAB), ages 12–16 years with and without a history of NSSI entered a study involving clinical assessment and magnetic resonance imaging (MRI), including structural, resting-state functional MRI (fMRI), and fMRI during a self-evaluation task. For imaging analyses, we used an a priori defined Self Network (anterior cingulate, orbitofrontal, and posterior cingulate cortices; precuneus). We first examined interrelationships among multi-level Self variables. We then evaluated the individual relationships between NSSI severity and multi-level Self variables (self-report, behavior, multi-modal brain Self Network measures), then conducted model testing and multiple regression to test how Self variables (together) predicted NSSI severity.
Results
Cross-correlations revealed key links between self-reported global self-worth and self-evaluation task behavior. Individually, greater NSSI severity correlated with lower global self-worth, more frequent and faster negative self-evaluations, lower anterior Self Network activation during self-evaluation, and lower anterior and posterior Self Network resting-state connectivity. Multiple regression analysis revealed the model including multi-level Self variables explained NSSI better than a covariate-only model; the strongest predictive variables included self-worth, self-evaluation task behavior, and resting-state connectivity.
Conclusions
Disruptions in Self-Knowledge across multiple levels of analysis relate to NSSI in adolescents. Findings suggest potential neurobiological treatment targets, potentially enhancing neuroplasticity in Self systems to facilitate greater flexibility (more frequently positive) of self-views in AFAB adolescents.
We consider a dilute fully spin-polarized Fermi gas at positive temperature in dimensions $d\in \{1,2,3\}$. We show that the pressure of the interacting gas is bounded from below by that of the free gas plus, to leading order, an explicit term of order $a^d\rho ^{2+2/d}$, where a is the p-wave scattering length of the repulsive interaction and $\rho $ is the particle density. The results are valid for a wide range of repulsive interactions, including that of a hard core, and uniform in temperatures at most of the order of the Fermi temperature. A central ingredient in the proof is a rigorous implementation of the fermionic cluster expansion of Gaudin, Gillespie and Ripka (Nucl. Phys. A, 176.2 (1971), pp. 237–260).
This article explores the links between anti-Catholicism in the United Kingdom and the acceleration of settler colonialism in British North America, and it does so by considering two group migrations from Catholic districts in the North West Highlands and Islands of Scotland. Occurring over 30 years apart, the Glenaladale settlement (1772) in Prince Edward Island and the Glengarry settlement (1803) in Upper Canada offer instructive insight into how anti-Catholicism activated Highland Catholic colonial agency. Not only did significant numbers of Highland Catholics choose to quit Scotland forever, but their settlement in places like Prince Edward Island and Upper Canada accelerated the process of settler colonialism and the establishment of the Catholic Church. The colonies at Glengarry and Glenaladale were peopled by settlers who were doubly motivated to settle in the empire. They stood to prosper economically—certainly—and they also stood to gain the freedom to practice their faith free of obvious interference. To the Indigenous peoples whose ancestral lands they settled, the consequences were not softened by this pretext for settler colonization, and too often the history of anti-Catholic discrimination in the four nations elide the fact that Catholics were enthusiastic colonizers elsewhere, and that the two processes were often related.
The COVID-19 pandemic is associated with increases in child mental health problems, but the persistence of these changes in the post-pandemic era remains uncertain. Additionally, it is unclear whether changes in mental health problems during the pandemic exceed the anticipated increases as children age. This study controls for the linear effect of age in 1399 children, investigating the course of child-reported anxiety, depression, hyperactivity, and inattention symptoms during and after the pandemic, and identifies risk and protective factors that predict these mental health trajectories.
Methods
Children (51% male; ages 9–11 at the first timepoint) provided mental health ratings at three pandemic timepoints (July–August 2020; March–April 2021; November 2021–January 2022) and one post-pandemic timepoint (January–July 2023). Mothers reported pre-pandemic mental health (2017–2019) and socio-demographic factors. Children reported socio-demographic factors, risk (e.g. screen time, sleep), and resilience (e.g. optimism) factors during the first timepoint.
Results
Average mental health symptoms increased over time, with more children exceeding clinical cut-offs for poor mental health at each subsequent pandemic timepoint. Growth curve modeling, adjusting for age-related effects, revealed a curvilinear course of mental health symptoms across all domains. Examination of risk and protective factors revealed that pre-existing mental health symptoms and optimism were associated with the course of symptoms.
Conclusions
After considering age effects, children's mental health follows a curvilinear pattern over time, suggesting an initial decline followed by a rising trend in symptoms post-COVID. These findings underscore the continued need for additional resources and timely, evidence-based mental health prevention and intervention for children.
Bacterial resistance is known to diminish the effectiveness of antibiotics for treatment of urinary tract infections. Review of recent healthcare and antibiotic exposures, as well as prior culture results is recommended to aid in selection of empirical treatment. However, the optimal approach for assessing these data is unclear. We utilized data from the Veterans Health Administration to evaluate relationships between culture and treatment history and the subsequent probability of antibiotic-resistant bacteria identified in urine cultures to further guide clinicians in understanding these risk factors.
Methods:
Using the XGBoost algorithm, a retrospective cohort of outpatients with urine culture results and antibiotic prescriptions from 2017 to 2022 was used to develop models for predicting antibiotic resistance for three classes of antibiotics: cephalosporins, fluoroquinolones, and trimethoprim/sulfamethoxazole (TMP/SMX) obtained from urine cultures. Model performance was assessed using Area Under the Receiver Operating Characteristic curve (AUC) and Precision-Recall AUC (PRAUC)
Results:
There were 392,647 prior urine cultures identified in 214,656 patients. A history of bacterial resistance to the specific treatment was the most important predictor of subsequent resistance for positive cultures, followed by a history of specific antibiotic exposure. The models performed better than previously established risk factors alone, especially for fluoroquinolone resistance, with an AUC of .84 and PRAUC of .70. Notably, the models’ performance improved markedly (AUC = .90, PRAUC = .87) when applied to cultures from patients with a known history of resistance to any of the antibiotic classes.
Conclusion:
These predictive models demonstrate potential in guiding antibiotic prescription and improving infection management.
This article posits that team sports can provide fresh insights into the place of leisure pursuits in the lives, networks and outlooks of historical literary figures. The social and literary role of the Authors Eleven, a cricket side of London-based writers active between 1899 and 1912, is explored through three case studies. George Ives was a pioneering campaigner for gay rights, who used cricket to bolster his homosexual identity. E. W. Hornung, creator of the famous cricketer-thief Raffles, saw cricket as the ideal training – and analogy – for imperialism. And P. G. Wodehouse, author of the Jeeves and Wooster stories, first made his name writing cricket-filled magazine pieces. All three writers saw their involvement in cricket, particularly the Authors Eleven in-group, as an essential component of their social status. The Authors Eleven thus presents a potent example of embodied sociability, whereby the specific nature of what these individuals were doing together (in this case, playing cricket) has a bearing on their friendships and their intellectual outlooks. As ways of understanding the lives and cultural significance of historical figures, shared physical activity and embodied sociability need to be accorded much more importance than they have been hitherto.
Antimicrobial resistance (AMR) is one of the greatest global health problems for humans, animals, and the environment. Although the association between various factors and AMR is being increasingly researched, the need to understand the contribution of social and ecological determinants, especially in developing nations, remains. This review fills these knowledge gaps by synthesizing existing evidence on the social and ecological determinants of AMR in Africa.
Results:
Twenty-four studies were selected based on predefined criteria from PubMed. 58.33% (n = 14) and 29.17% (n = 7) of the studies reported on ecological and social determinants of AMR, respectively, and 3 (12.5%) studies documented both social and environmental determinants of AMR. Sociodemographic factors include increased household size, poor knowledge, attitudes toward AMR, low educational levels, and rural residences. Indicators of poor water sanitation and hygiene, framing practices, and consumption of farm products were among the common ecological determinants of AMR and AM misuse in Africa.
Conclusion:
Our review demonstrates the importance of social and ecological determinants of AMR among African populations. The findings may be valuable to researchers, policymakers, clinicians, and those working in lower-income countries to implement AMR prevention programs utilizing a holistic approach.
Diagnosis of amyotrophic lateral sclerosis (ALS) takes more than 1year from detection of first symptoms. The paper seeks to understand the ALS diagnostic process and adjustment from the perspective of informal caregivers.
Methods
The data stems from an interview study with 9 current and 13 bereaved informal caregivers of people with ALS in Switzerland. The interviews were analyzed using thematic analysis.
Results
We identified 3 key themes pertaining to ALS diagnosis. In the first theme, we present the close involvement of informal caregivers in the “diagnosis journey.” Highlighted within this theme is the important role they play, which ultimately leads to diagnosis of ALS avoiding further delays. Second, we relay their perceptions on “diagnosis communication pitfalls” where they underlined empathy and planning from the part of medical professional, while communicating the terminal diagnosis of ALS. Participants’ reactions and adjustments post-ALS diagnosis are described in “the aftermath of diagnosis.” In this third theme, we highlight participants’ shock and their need to rethink overall life plans and roles in their family.
Significance of the results
Diagnosis communication that is clear, empathetic, and adjusted to the needs of the patients as well as their caregivers is critical. More work is needed to improve diagnosis communication for ALS patients. Receiving the diagnosis of ALS leads to complete changes in life of caregivers. It is therefore necessary that medical professionals provide adequate support that allows them to plan for their future.