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This study aimed to assess the impact of hypertensive disorders of pregnancy on infant neurodevelopment by comparing 6-month and 2-year psychomotor development outcomes of infants exposed to gestational hypertension (GH) or preeclampsia (PE) versus normotensive pregnancy (NTP). Participating infants were children of women enrolled in the Postpartum Physiology, Psychology and Paediatric (P4) cohort study who had NTPs, GH or PE. 6-month and 2-year Ages and Stages Questionnaires (ASQ-3) scores were categorised as passes or fails according to domain-specific values. For the 2-year Bayley Scales of Infant and Toddler Development (BSID-III) assessment, scores > 2 standard deviations below the mean in a domain were defined as developmental delay. Infants (n = 369, male = 190) exposed to PE (n = 75) versus GH (n = 20) and NTP (n = 274) were more likely to be born small for gestational age and premature. After adjustment, at 2 years, prematurity status was significantly associated with failing any domain of the ASQ-3 (p = 0.015), and maternal tertiary education with increased cognitive scores on the BSID-III (p = 0.013). However, PE and GH exposure were not associated with clinically significant risks of delayed infant neurodevelopment in this study. Larger, multicentre studies are required to further clarify early childhood neurodevelopmental outcomes following hypertensive pregnancies.
Antisocial behavior (ASB) is relatively common in childhood and adolescence. While it harms victims, perpetrators are at increased risk of disadvantageous adult outcomes. Developmental heterogeneity is well documented; distinctions have been drawn between early-onset persistent, adolescent-onset, and childhood-limited pathways. We examine whether individuals in some pathways face worse mid-life outcomes than others and whether the pattern differs across sexes.
Methods
The 1970 British Cohort Study assessed parent-reported ASB measures at ages 5, 10, and 16. We classified developmental pathways using the Rutter A scale conduct questions. We categorized children scoring in the top 10% of the distribution as showing high ASB, separately at each assessment. Approximately 6000 individuals were classified into low (73%), childhood-limited (11%), adolescent-onset (9%), and early-onset persistent (7%) groups. We tested associations of ASB grouping with age 46 social, economic, and health outcomes, controlling for a range of covariates.
Results
The childhood-limited group showed little mid-life difficulty. The early-onset persistent and adolescent-onset groups both showed a pattern of worse midlife outcomes for boys and girls.
Conclusions
The results highlight that ASB in young people is not transient and that prevention and treatment during early childhood and adolescence are warranted.
In 2022, uptake of all seven Core Elements of Antibiotic Stewardship were reported by 83% of US long-term care facilities. Though 98% of facilities reported access to an electronic health record, less than one-third utilized it for tracking antibiotic use, suggesting opportunities to leverage electronic data for automated reporting.
This study is the first to attempt to isolate a relationship between cognitive activity and equilibration to a Nash Equilibrium. Subjects, while undergoing fMRI scans of brain activity, participated in second price auctions against a single competitor following predetermined strategy that was unknown to the subject. For this auction there is a unique strategy that will maximize the subjects’ earnings, which is also a Nash equilibrium of the associated game theoretic model of the auction. As is the case with all games, the bidding strategies of subjects participating in second price auctions most often do not reflect the equilibrium bidding strategy at first but with experience, typically exhibit a process of equilibration, or convergence toward the equilibrium. This research is focused on the process of convergence.
In the data reported here subjects participated in sixteen auctions, after which all subjects were told the strategy that will maximize their revenues, the theoretical equilibrium. Following that announcement, sixteen more auctions were performed. The question posed by the research concerns the mental activity that might accompany equilibration as it is observed in the bidding behavior. Does brain activation differ between being equilibrated and non-equilibrated in the sense of a bidding strategy? If so, are their differences in the location of activation during and after equilibration? We found significant activation in the frontal pole especially in Brodmann's area 10, the anterior cingulate cortex, the amygdala and the basal forebrain. There was significantly more activation in the basal forebrain and the anterior cingulate cortex during the first sixteen auctions than in the second sixteen. The activity in the amygdala shifted from the right side to the left after the solution was given.
Generative AI tools, such as ChatGPT, have demonstrated impressive capabilities in summarisation and content generation. However, they are infamously prone to hallucination, fabricating plausible information and presenting it as fact. In the context of legal research, this poses significant risk. This paper, written by Sally McLaren and Lily Rowe, examines how widely available AI applications respond to fabricated case citations and assesses their ability to identify false cases, the nature of their summaries, and any commonalities in their outputs. Using a non-existent citation, we analysed responses from multiple AI models, evaluating accuracy, detail, structure and the inclusion of references. Results revealed that while some models flagged our case as fictitious, others generated convincing but erroneous legal content, occasionally citing real cases or legislation. The experiment underscores concern about AI’s credibility in legal research and highlights the role of legal information professionals in mitigating risks through user education and AI literacy training. Practical engagement with these tools is crucial to understanding the user experience. Our findings serve as a foundation for improving AI literacy in legal research.
This article reassesses the contribution of the late Renaissance scholar and teacher Petrus Victorius (Pier Vettori) to the reconstruction of the text of Aristotle's Eudemian Ethics, which has come down to us in what is often a highly corrupt form. It proposes an interpretation of certain abbreviations in the marginalia in one of Victorius's copies of the Aldine Eudemian Ethics which reveals them as recommending readings rather than recording them; it proposes that many more of those readings constitute his own conjectures than previously thought. The article goes on to suggest why Victorius never produced an edition of the Eudemian Ethics as he did of other Aristotelian works, despite returning repeatedly, over much of his life, to the task of improving this particular text. Victorius is revealed nonetheless as a highly creative—but also highly disciplined—textual critic, at least the equal of his nineteenth- and twentieth-century successors.
One hundred percent pasture-fed beef production has been suggested as a promising approach for sustainable ruminant farming, due to the potential benefits that can accrue across a range of sustainability domains. This study aimed to investigate the impacts across the four domains of sustainability of a wholesale switch from conventional to 100% pasture-fed beef production in the UK. We used fuzzy cognitive mapping (FCM) as a method for extracting knowledge from multiple stakeholders to create representative systems models of both conventional and pasture-based beef production systems. We then conducted a scenario analysis to assess how a switch to a pasture-fed system could affect components of sustainability in the UK beef sector. The FCMs indicated that vegetation quality, grass use efficiency, and soil health were central components of the pasture-fed approach, while economic and regulatory aspects, and climate change targets were more central to mainstream production approaches. The most marked changes under the 100% conversion scenario were an increase in income from subsidies (27.3%) in line with ‘public money for public goods’, a decrease in ability to export beef (unless advice to reduce consumption of animal protein is followed) (23.5%), a decrease in land used for farming vs other uses (e.g., natural capital) (11.23%), and a decrease in the use of feed from agricultural co/byproducts (7.5%), freeing up these feed sources for more sustainable monogastric production. Therefore, the mapping and scenario analysis suggests that while upscaling the pasture-fed approach may reduce productivity, it would likely increase public goods provision and reduce feed–food competition in the UK.
Burial 10 is a unique Manteño (AD 650–1532) burial from Buen Suceso, Ecuador, dating between AD 771 and 953. This burial included the remains of a young female, pregnant at the time of death and buried with an elaborate array of goods, including anachronistic spondylus ornaments, green stones, and shell eye coverings. Perimortem trauma, including a cranial fracture and cutmarks on hand bones, perimortem removal of the hands and left leg, and other body manipulation suggest she was sacrificed, a rare event for coastal Ecuadorian peoples.
Over the last couple of decades, there has been a growing awareness of the value of community-engaged research (CEnR). Simultaneously, many academic institutions have established centralized support for CEnR. For example, dozens of academic medical centers in the United States receive National Institutes of Health (NIH)-funded Clinical and Translational Science Awards (CTSAs) and have embedded community engagement programs (CE) whose primary expertise and mission is to advance CEnR at their institutions.
Methods:
As part of a larger interview study aiming to learn more about how institutional CE programs and HRPPs work together, we analyzed interviews with CE program leaders at academic medical centers that receive funding from the NIH CTSA program to identify barriers and strategies to conducting CEnR at their institutions, primarily focusing on the relationships with Institutional Review Boards (IRBs).
Results:
We identified three categories in the interviews: barriers and strategies vis-à-vis IRBs to address 1) CE/IRB relationships; 2) Understanding issues; and 3) Structural and resource issues.
Conclusions:
CTSA CE program leaders have experience implementing solutions to common barriers to IRB review faced by CEnR researchers. The barriers they face in these three categories and the strategies they use to overcome them can provide helpful insights to others who hope to facilitate CEnR research at their institutions.
Jesus of Nazareth’s future engages Christian hope and the fulfillment of creation’s purpose. Jesus’s earthly life and divine identity are inseparable. This union both constitutes and challenges perceptions of linear time and functions creatively to intertwine past, present, and future. Jesus’s transformative impact on humanity and history signifies the final reconciliation and realization of God’s kingdom, which is manifest both in his historical presence and in his eternal nature.
While the number of international students attending UK universities has been increasing in recent years, the 2021/22 and 2022/23 academic years saw a decline in applications from EU-domiciled students. However, the extent and varying impact of this decline remain to be estimated and disentangled from the impacts of the COVID-19 pandemic. Using difference-in-differences (DID) in a hierarchical regression framework and Universities and Colleges Admissions Service (UCAS) data, we aim to quantify the decline in the number of student applications post-Brexit. We find evidence of an overall decline of 65% in the 2021 academic year in successful applications from EU students as a result of Brexit. This decline is more pronounced for non-Russell Group institutions, as well as for Health and Life Sciences and Arts and Languages. Furthermore, we explore the spatial heterogeneity of the impact of Brexit across EU countries of origin, observing the greatest effects for Poland and Germany, though this varies depending on institution type and subject. We also show that higher rates of COVID-19 stringency in the country of origin led to greater applications for UK higher education institutions. Our results are important for government and institutional policymakers seeking to understand where losses occur and how international students respond to external shocks and policy changes. Our study quantifies the distinct impacts of Brexit and COVID-19 and offers valuable insights to guide strategic interventions to sustain the UK’s attractiveness as a destination for international students.
Our aim was to explore the experiences of individuals receiving emergency department (ED) care for acute headaches.
Background:
Patients with headache exacerbations commonly present to EDs. This study explored the experiences of adult patients during the exacerbation period, specifically using photovoice.
Methods:
Recruited from two urban EDs in Alberta, Canada, participants with primary headaches took photographs over 3–4 weeks and subsequently completed a 60–90 minute, one-on-one, in-person photo-elicitation interview. Interviews were audio recorded, transcribed and thematically analyzed alongside photographs.
Results:
Eight participants (six women) completed the study. The average age was 42 years (standard deviation: 16). Five themes emerged: (1) the struggle for legitimacy in light of the invisibility of their condition; (2) the importance of hope, hopelessness and fear in the day-to-day life of participants; (3) the importance of agency and becoming “your own advocate”; (4) the struggle to be and be seen as themselves despite the encroachment of their headaches; and (5) the realities of “good” and “bad” care in the ED. Participants highlighted examples of good care, specifically when they felt seen and believed. Additionally, some expressed the acute care space itself being a beacon of hope in the midst of their crisis. Others felt dismissed because providers “know it’s not life or death.”
Conclusions:
This study highlighted the substantial emotional impact that primary headaches have on the lives of participants, particularly during times of exacerbation and while seeking acute care. This provides insight for acute care settings and practitioners on how to effectively engage with this population.
Manufacturing of mycelium-based composites is an emerging biorefinery technology toward the development of environmentally positive materials within the circular economy: it benefits from waste and industrial by-products upcycling while excelling in biodegradability. This study investigates the compressive behavior of materials repurposed from local agricultural wastes (tree nuts and crop wastes in California’s Central Valley), using the fungal mycelium of Pleurotus ostreatus and Ganoderma lucidum, well-known edible and medicinal species. We also explore the hybridization of these mycelium-based composites with local textile waste fibers as reinforcements. Following guidelines from several ASTM standards, the compressive behavior of these composites is analyzed to determine the impact of biomass processing, composition, fungal species used, and post-processing strategy. We propose a post-processing strategy based on a short exposure to sodium chloride solutions in ambient conditions, to de-activate mycelium and prevent its fruiting, replacing the established energy-intensive heat-based post-processing. This work aims at contributing to the decarbonization of the built environment and the construction industry in particular, through materials designed with upcycled waste (agricultural and textile), fungal mycelium and low-carbon footprint processes.
Childhood adversities have been linked to psychosocial outcomes, but it remains uncertain whether subtypes of adversity exert different effects on outcomes. Research is also needed to explore the dynamic interplay between adversity and psychosocial outcomes from childhood to mid-adolescence. This study aimed to investigate these relationships and their role in shaping adolescent wellbeing. Data were extracted from three timepoints of the UK Household Longitudinal Survey when participants (n = 646) were aged 10–15. Cross-lagged panel models were used to explore the relationship between cumulative adversities, and separately non-household (i.e., bullying victimization and adverse neighborhood) and household (i.e., sibling victimization, quarrelsome relationship with parents, financial struggles, and maternal psychological distress) adversities, and psychosocial outcomes (i.e., internalizing and externalizing problems, delinquency, and life satisfaction). Our results revealed that heightened cumulative adversity predicted psychosocial outcomes from childhood to mid-adolescence. Increased levels of household adversity predicted psychosocial outcomes throughout early to mid-adolescence, while non-household adversity only predicted psychosocial outcomes in early adolescence. Furthermore, worse psychosocial outcomes predicted higher levels of adversities during adolescence, highlighting bidirectionality between adversity and psychosocial outcomes. These findings underscore the varying impacts of adversity subtypes and the mutually reinforcing effects of adversities and psychosocial functioning from childhood to mid-adolescence.
What I propose to do in this short paper is to outline two different approaches to needs in Greek philosophy. The first is the reasonably familiar approach used by Aristotle, and, in some moods, by Plato; the second is a rather less well-known approach which can with some justice be associated with Socrates, and/or Plato when he is not in an Aristotelian mood (if I may so put it)—and also the Stoics, who seem to have picked up some distinctly Socratic ways of thinking. The Aristotelian line, if not necessarily familiar as Aristotle’s, will be familiar just insofar as it gives some degree of that recognition to needs that most moderns would suppose the idea should be given. What I am calling the Socratic line, by contrast, appears to leave no room for the idea of needs at all (or at least, that will be my way of putting it for now; I shall need a rather different formulation later on). It is this second, ‘Socratic’, approach that primarily interests me, not least because it is non-standard.
This study aimed to report on the UK rate of surgical voice restoration usage and investigate the factors that influence its uptake.
Method
A national multicentre audit of people with total laryngectomy was completed over a six-month period (March to September 2020) in response to the coronavirus disease 2019 pandemic. This study is a secondary analysis of the data collected, focusing on the primary communication methods used by people with total laryngectomy.
Results
Data on surgical voice restoration were available for 1196 people with total laryngectomy; a total of 852 people with total laryngectomy (71 per cent) used surgical voice restoration. Another type of communication method was used by 344 people. The factors associated with surgical voice restoration in the multiple regression analysis were sex (p = 0.003), employment (employed vs not employed, p < 0.001) and time post-laryngectomy (p < 0.001).
Conclusion
This study provides an important benchmark for the current status of surgical voice restoration usage across the UK. It found that 71 per cent of people with total laryngectomy used surgical voice restoration as their primary communication method.
Management of primary headache (PHA) varies across emergency departments (ED), yet there is widespread agreement that computed tomography (CT) scans are overused. This study assessed emergency physicians’ (EPs) PHA management and their attitudes towards head CT ordering.
Methods:
A cross-sectional study was undertaken with EPs from one Canadian center. Drivers of physicians’ perceptions regarding the appropriateness of CT ordering for patients with PHA were explored.
Results:
A total of 73 EPs (70% males; 48% with <10 years of practice) participated in the study. Most EPs (88%) did not order investigations for moderate-severe primary headaches; however, CT was the common investigation (47%) for headaches that did not improve. Computed tomography ordering was frequently motivated by the need for specialist consultation (64%) or admission (64%). A small proportion (27%) believed patients usually/frequently expected a scan. Nearly half of EPs (48%) identified patient imaging expectations/requests as a barrier to reducing CT ordering. Emergency physicians with CCFP (EM) certification were less likely to perceive CT ordering for patients with PHA as appropriate. Conversely, those who identified the possibility of missing a condition as a major barrier to limiting their CT use were more likely to perceive CT ordering for patients with PHA as appropriate.
Conclusions:
Emergency physicians reported consistency and evidence-based medical management. They highlighted the complexities of limiting CT ordering and both their level of training and their perceived barriers for limiting CT ordering seem to be influencing their attitudes. Further studies could elucidate these and other factors influencing their practice.
Natromelansonite, Na3Zr[Si7AlO19]⋅4–5H2O, was found at the Poudrette (Demix) quarry, Mont Saint-Hilaire, Quebec, Canada in a highly altered pegmatite together with a clay mineral, steacyite, polylithionite and rhodochrosite. It occurs as an outer zone of tabular crystals to 0.1 × 0.3 × 1 mm in size flattened on (001). The inner zone is made of melansonite. The mineral is grey with white powder colour and vitreous lustre. The cleavage is parallel to {010}, perfect. The Mohs hardness is 3.5. The mineral has green fluorescence under short-wave ultraviolet light. The Dcalc is 2.31 g/cm3. The infrared spectrum is reported. The composition (wt.%, average of 8 analyses) is Na2O 10.08, K2O 1.72, CaO 0.24, BaO 0.32, MnO 0.10, Al2O3 6.86, Y2O3 0.35, Yb2O3 0.55, SiO2 56.23, ZrO2 14.78, H2O 9.52, total 100.75. The empirical formula calculated on the basis of O = 23 apfu and H = 8 apfu is Na(□Na0.38Ca0.02Mn0.01)2(Na0.70K0.28Ba0.02)Σ1.00(Zr0.91Y0.02Yb0.02)Σ0.95(Si7.08Al1.02)Σ8.10O19⋅4H2O. The mineral is monoclinic, P21/m, a = 6.5156(3) Å, b = 24.061(1) Å, c = 6.9759(6) Å, β = 90.453(5)° and V = 1093.61(9) Å3 and Z = 2. The strongest reflections of the powder X-ray diffraction pattern [d,Å(I)(hkl)] are: 12.02(100)(020), 6.97(89)(001), 6.51(39)(100), 3.416(37)(160), 3.062(42)($\bar{1}$61, 102, 161 and $\bar{1}$12), 3.018(38)(230 and 042), 2.864(40)(240 and 132). The crystal structure, solved and refined from single-crystal X-ray diffraction data (R1 = 0.042), is based on a double sheet of tetrahedra (T) and a sheet of octahedra (O) that alternate along the [010] direction forming a TOT structure typical for members of the rhodesite mero-plesiotype series.