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The goal of this study was to unpack processes that may lead to child emotional insecurity. Guided by the emotional security theory (EST/EST-R), we examined the mediational role of parental depressive symptomology between interparental conflict (IPC), both constructive and destructive, and child emotional insecurity at age 36-months. We partitioned unique variance of IPC from shared using an extension of the common fate model. We used two-wave data from the Building Strong Families project, which consisted of racially diverse couples/parents (N = 4,424) who were low income and unmarried at the conception of their child. We found gendered differences for how mothers and fathers experience IPC, with mothers more influenced by their relational circumstances. We also found that fathers were vulnerable to experiencing depressive symptoms following aspects of destructive IPC. Consistent with EST-R, constructive IPC did not promote emotional security in children. Rather, both destructive and constructive IPC related to greater levels of emotional insecurity, with destructive IPC showing stronger effects. Proposed mediation was found for fathers only. Our findings may appeal to scholars who focus on untangling the complexity of IPC and intervention specialists and clinicians interested in a process-oriented approaches to the development of child psychopathology.
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.
Unconsolidated soils typically develop a physical surface crust after wetting and drying. We reproduced this process in the laboratory by wetting with fog and simulated rain on fallow agricultural soils from 26 locations, representing 15 soil types from Pinal County, Arizona. Through correlative analyses, we found that carbonate content was a strong predictor of physical crust strength with fog (p < 0.0001, R2 = 0.48) and rain (p = 0.004, R2 = 0.30). Clay content increased crust strength (p = 0.04) but was not a useful predictor. Our results extend the current understanding of the soil crusting process by highlighting the preeminence of carbonate cementation in desert agricultural soils. Consequently, we identify carbonate as a pragmatic tool for estimating crust strength, a surrogate measure of a soil’s potential to produce fugitive dust, which can help prioritize interventions to curb airborne dust in arid lands.
Efficient evidence generation to assess the clinical and economic impact of medical therapies is critical amid rising healthcare costs and aging populations. However, drug development and clinical trials remain far too expensive and inefficient for all stakeholders. On October 25–26, 2023, the Duke Clinical Research Institute brought together leaders from academia, industry, government agencies, patient advocacy, and nonprofit organizations to explore how different entities and influencers in drug development and healthcare can realign incentive structures to efficiently accelerate evidence generation that addresses the highest public health needs. Prominent themes surfaced, including competing research priorities and incentives, inadequate representation of patient population in clinical trials, opportunities to better leverage existing technology and infrastructure in trial design, and a need for heightened transparency and accountability in research practices. The group determined that together these elements contribute to an inefficient and costly clinical research enterprise, amplifying disparities in population health and sustaining gaps in evidence that impede advancements in equitable healthcare delivery and outcomes. The goal of addressing the identified challenges is to ultimately make clinical trials faster, more inclusive, and more efficient across diverse communities and settings.
Coastal wetlands are hotspots of carbon sequestration, and their conservation and restoration can help to mitigate climate change. However, there remains uncertainty on when and where coastal wetland restoration can most effectively act as natural climate solutions (NCS). Here, we synthesize current understanding to illustrate the requirements for coastal wetland restoration to benefit climate, and discuss potential paths forward that address key uncertainties impeding implementation. To be effective as NCS, coastal wetland restoration projects will accrue climate cooling benefits that would not occur without management action (additionality), will be implementable (feasibility) and will persist over management-relevant timeframes (permanence). Several issues add uncertainty to understanding if these minimum requirements are met. First, coastal wetlands serve as both a landscape source and sink of carbon for other habitats, increasing uncertainty in additionality. Second, coastal wetlands can potentially migrate outside of project footprints as they respond to sea-level rise, increasing uncertainty in permanence. To address these first two issues, a system-wide approach may be necessary, rather than basing cooling benefits only on changes that occur within project boundaries. Third, the need for NCS to function over management-relevant decadal timescales means methane responses may be necessary to include in coastal wetland restoration planning and monitoring. Finally, there is uncertainty on how much data are required to justify restoration action. We summarize the minimum data required to make a binary decision on whether there is a net cooling benefit from a management action, noting that these data are more readily available than the data required to quantify the magnitude of cooling benefits for carbon crediting purposes. By reducing uncertainty, coastal wetland restoration can be implemented at the scale required to significantly contribute to addressing the current climate crisis.
Art libraries play a vital role in building, managing and sustaining collections to support art scholarship. Ensuring that these valuable collections remain available long into the future requires innovative thinking about collection development, resource sharing and stewardship. The specialized and decentralized nature of the art research collective collection suggests that multi-institutional collaboration is an important option for art libraries as they seek sustainable pathways for their collections. Findings and recommendations from the Operationalizing the Art Research Collective Collection (OpArt) project show that data-driven analysis, as well as the practical experiences and lessons learned from real-world partnerships, are important sources of intelligence for art libraries as they address their sustainability challenges through collaborative approaches.
Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD.
Methods
As part of the longitudinal AURORA study, 2924 patients seeking emergency department (ED) treatment in the acute aftermath of trauma provided self-report assessments of pre- peri- and post-traumatic risk factors, as well as 3-month PTSD severity. We systematically examined sex-dependent effects of 16 risk factors that have previously been hypothesized to show different associations with PTSD severity in women and men.
Results
Women reported higher PTSD severity at 3-months post-trauma. Z-score comparisons indicated that for five of the 16 examined risk factors the association with 3-month PTSD severity was stronger in men than in women. In multivariable models, interaction effects with sex were observed for pre-traumatic anxiety symptoms, and acute dissociative symptoms; both showed stronger associations with PTSD in men than in women. Subgroup analyses suggested trauma type-conditional effects.
Conclusions
Our findings indicate mechanisms to which men might be particularly vulnerable, demonstrating that known PTSD risk factors might behave differently in women and men. Analyses did not identify any risk factors to which women were more vulnerable than men, pointing toward further mechanisms to explain women's higher PTSD risk. Our study illustrates the need for a more systematic examination of sex differences in contributors to PTSD severity after trauma, which may inform refined preventive interventions.
Stress and diabetes coexist in a vicious cycle. Different types of stress lead to diabetes, while diabetes itself is a major life stressor. This was the focus of the Chicago Biomedical Consortium’s 19th annual symposium, “Stress and Human Health: Diabetes,” in November 2022. There, researchers primarily from the Chicago area met to explore how different sources of stress – from the cells to the community – impact diabetes outcomes. Presenters discussed the consequences of stress arising from mutant proteins, obesity, sleep disturbances, environmental pollutants, COVID-19, and racial and socioeconomic disparities. This symposium showcased the latest diabetes research and highlighted promising new treatment approaches for mitigating stress in diabetes.
The ongoing COVID-19 pandemic has impacted the world to devastating effect, yielding profound societal disruption around the globe. However, its impact throughout the world has not been equal among nations. In the United States, the impact of COVID-19 is influenced and exacerbated by an embedded social issue: structural racism and its attendant systemic inequities. This paper first addresses how structural racism, broadly construed as the deeply rooted discriminatory policies and systems that produce the chronic systemic inequities faced by BIPOC (Black, Indigenous, and People of Color) people in American society, have influenced, with notable detriment, COVID-19’s impact in the United States. This detrimental impact is most keenly demonstrated by the extreme disparate medical impact of COVID-19 itself, collectively in terms of the disease’s rate of infection, morbidity, and mortality on the BIPOC population versus that of the white population. As the United States crossed the threshold of 275,000 total deaths from COVID-19, it continued to see the significant inequities that were revealed in the early weeks of the pandemic. The latest data (as of November 2020) show that age-adjusted mortality rates for Indigenous people are 3.2 times higher than for white people; rates for Black and Latinx are 3.0 times higher than for whites. This translates into an unprecedented level of excess deaths across the country. If the COVID-19 mortality rate experienced in the white population applied universally to BIPOC communities, approximately 21,000 Black, 10,000 Latinx and 1,000 Indigenous people would still be alive today. The disparate impact is also evident regarding problems ancillary to the pandemic, such as the economic recession, which take a greater malignant toll on BIPOC communities, as well. Job and wage losses due to COVID-19 have hit marginalized and minoritized communities hardest; more than half of Hispanic (58 percent) and Black (53 percent) households in the US Census Bureau’s Household Pulse Survey reported a decline in employment income since mid-March. Black workers have experienced the highest rates of unemployment and the weakest recoveries since the March–April unemployment peak.
Infection prevention and control (IPC) measures are critical in preventing the risk of acquiring and transmitting nosocomial infections. In Zambia, there is little information concerning IPC practices among pharmacy students who are exposed to potentially infectious areas both in public and private healthcare settings. Therefore, this study assessed the knowledge, attitude, and practices of undergraduate pharmacy students toward infection prevention and control at the University of Zambia.
Materials and methods:
This cross-sectional study was conducted among 290 undergraduate pharmacy students at the University of Zambia using a structured questionnaire from August 2022 to October 2022. Data analysis was performed using SPSS version 25.0, and statistical significance was set at a 95% confidence level.
Results:
Of the 290 participants, 166(57.2%) were female and the majority were aged between 18 and 23 years. Overall, 252(86.9%) had good knowledge, 167(57.6%) had positive attitudes, and 248(85.5%) had good practices toward IPC measures. These results indicate lower attitude scores compared to knowledge and practices. Having good knowledge of IPC was associated with being a Christian by religion compared to other religions (OR = 5.314, 95% CI: 1.141–24.745). There was no association between sociodemographics and attitude and practice concerning IPC.
Conclusion:
This study found that pharmacy students had good knowledge, positive attitudes, and good practices toward IPC measures. Consequently, more emphasis is needed to improve the student’s knowledge, attitudes, and practices toward IPC, especially in areas where gaps were identified. Additionally, there is a need to improve curricula on IPC measures in the training of pharmacy programs.
The U.S. Department of Agriculture–Agricultural Research Service (USDA-ARS) has been a leader in weed science research covering topics ranging from the development and use of integrated weed management (IWM) tactics to basic mechanistic studies, including biotic resistance of desirable plant communities and herbicide resistance. ARS weed scientists have worked in agricultural and natural ecosystems, including agronomic and horticultural crops, pastures, forests, wild lands, aquatic habitats, wetlands, and riparian areas. Through strong partnerships with academia, state agencies, private industry, and numerous federal programs, ARS weed scientists have made contributions to discoveries in the newest fields of robotics and genetics, as well as the traditional and fundamental subjects of weed–crop competition and physiology and integration of weed control tactics and practices. Weed science at ARS is often overshadowed by other research topics; thus, few are aware of the long history of ARS weed science and its important contributions. This review is the result of a symposium held at the Weed Science Society of America’s 62nd Annual Meeting in 2022 that included 10 separate presentations in a virtual Weed Science Webinar Series. The overarching themes of management tactics (IWM, biological control, and automation), basic mechanisms (competition, invasive plant genetics, and herbicide resistance), and ecosystem impacts (invasive plant spread, climate change, conservation, and restoration) represent core ARS weed science research that is dynamic and efficacious and has been a significant component of the agency’s national and international efforts. This review highlights current studies and future directions that exemplify the science and collaborative relationships both within and outside ARS. Given the constraints of weeds and invasive plants on all aspects of food, feed, and fiber systems, there is an acknowledged need to face new challenges, including agriculture and natural resources sustainability, economic resilience and reliability, and societal health and well-being.
Conspiracy theories and misinformation have become increasingly prominent in politics, and these beliefs have pernicious effects on political behavior. A prominent line of research suggests that these beliefs are promoted by repeated exposure. Yet, as scholars have rushed to understand these beliefs, they have exposed countless respondents to conspiratorial claims, raising the question of whether researchers are contributing to their spread. We investigate this possibility using a pre-registered within-subjects experiment embedded in a panel survey. The results suggest that exposure to a standard conspiracy question causes a significant increase in the likelihood of endorsing that conspiracy a week later. However, this exposure effect does not occur with a question format that offers an alternative, non-conspiratorial explanation for the target event. Thus, we recommend that researchers reduce the likelihood of spreading conspiracy beliefs by adopting a question format that asks respondents to choose between alternative explanations for an event.
The book discusses the 'state trial' as a legal process, a public spectacle, and a point of political conflict - a key part of how constitutional monarchy became constitutional.
The trilobite Needmorella new genus, with type species N. simoni new genus new species from the late Emsian to mid-Eifelian Needmore Shale of West Virginia, is a distinctive member of the subfamily Synphoriinae. It also occurs in the same formation in Pennsylvania and Virginia. It is not very similar to other Devonian representatives of the subfamily and is considered to have its origins in a morphologically less-derived ancestor because it shares certain similarities with Silurian genera, including the very short anterior cephalic border unmodified by crenulations or spines, S2 that is not largely reduced to a deep pit adaxially, the relatively low inflation of L3, and the well-defined interpleural furrows on the pygidium. Other particularly distinctive characters of the genus include the very long genal spines and the abaxially inflated and expanded posterior pleural bands on the thorax and pygidium that project slightly distally. The conventional concept of the Devonian synphoriine Anchiopsis Delo, 1935 appears to be incompatible with the holotype of the type species, judging from the early illustrations of the specimen, and the genus could be a synonym of Synphoria Clarke, 1894.
From 2014 to 2020, we compiled radiocarbon ages from the lower 48 states, creating a database of more than 100,000 archaeological, geological, and paleontological ages that will be freely available to researchers through the Canadian Archaeological Radiocarbon Database. Here, we discuss the process used to compile ages, general characteristics of the database, and lessons learned from this exercise in “big data” compilation.
The goal of disaster triage at both the prehospital and in-hospital level is to maximize resources and optimize patient outcomes. Of the disaster-specific triage methods developed to guide health care providers, the Simple Triage and Rapid Treatment (START) algorithm has become the most popular system world-wide. Despite its appeal and global application, the accuracy and effectiveness of the START protocol is not well-known.
Objectives:
The purpose of this meta-analysis was two-fold: (1) to estimate overall accuracy, under-triage, and over-triage of the START method when used by providers across a variety of backgrounds; and (2) to obtain specific accuracy for each of the four START categories: red, yellow, green, and black.
Methods:
A systematic review and meta-analysis was conducted that searched Medline (OVID), Embase (OVID), Global Health (OVID), CINAHL (EBSCO), Compendex (Engineering Village), SCOPUS, ProQuest Dissertations and Theses Global, Cochrane Library, and PROSPERO. The results were expanded by hand searching of journals, reference lists, and the grey literature. The search was executed in March 2020. The review considered the participants, interventions, context, and outcome (PICO) framework and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Accuracy outcomes are presented as means with 95% confidence intervals (CI) as calculated using the binomial method. Pooled meta-analyses of accuracy outcomes using fixed and random effects models were calculated and the heterogeneity was assessed using the Q statistic.
Results:
Thirty-two studies were included in the review, most of which utilized a non-randomized study design (84%). Proportion of victims correctly triaged using START ranged from 0.27 to 0.99 with an overall triage accuracy of 0.73 (95% CI, 0.67 to 0.78). Proportion of over-triage was 0.14 (95% CI, 0.11 to 0.17) while the proportion of under-triage was 0.10 (95% CI, 0.072 to 0.14). There was significant heterogeneity of the studies for all outcomes (P < .0001).
Conclusion:
This meta-analysis suggests that START is not accurate enough to serve as a reliable disaster triage tool. Although the accuracy of START may be similar to other models of disaster triage, development of a more accurate triage method should be urgently pursued.
To describe the cumulative seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies during the coronavirus disease 2019 (COVID-19) pandemic among employees of a large pediatric healthcare system.
Design, setting, and participants:
Prospective observational cohort study open to adult employees at the Children’s Hospital of Philadelphia, conducted April 20–December 17, 2020.
Methods:
Employees were recruited starting with high-risk exposure groups, utilizing e-mails, flyers, and announcements at virtual town hall meetings. At baseline, 1 month, 2 months, and 6 months, participants reported occupational and community exposures and gave a blood sample for SARS-CoV-2 antibody measurement by enzyme-linked immunosorbent assays (ELISAs). A post hoc Cox proportional hazards regression model was performed to identify factors associated with increased risk for seropositivity.
Results:
In total, 1,740 employees were enrolled. At 6 months, the cumulative seroprevalence was 5.3%, which was below estimated community point seroprevalence. Seroprevalence was 5.8% among employees who provided direct care and was 3.4% among employees who did not perform direct patient care. Most participants who were seropositive at baseline remained positive at follow-up assessments. In a post hoc analysis, direct patient care (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.03–3.68), Black race (HR, 2.70; 95% CI, 1.24–5.87), and exposure to a confirmed case in a nonhealthcare setting (HR, 4.32; 95% CI, 2.71–6.88) were associated with statistically significant increased risk for seropositivity.
Conclusions:
Employee SARS-CoV-2 seroprevalence rates remained below the point-prevalence rates of the surrounding community. Provision of direct patient care, Black race, and exposure to a confirmed case in a nonhealthcare setting conferred increased risk. These data can inform occupational protection measures to maximize protection of employees within the workplace during future COVID-19 waves or other epidemics.
Recent well-powered genome-wide association studies have enhanced prediction of substance use outcomes via polygenic scores (PGSs). Here, we test (1) whether these scores contribute to prediction over-and-above family history, (2) the extent to which PGS prediction reflects inherited genetic variation v. demography (population stratification and assortative mating) and indirect genetic effects of parents (genetic nurture), and (3) whether PGS prediction is mediated by behavioral disinhibition prior to substance use onset.
Methods
PGSs for alcohol, cannabis, and nicotine use/use disorder were calculated for Minnesota Twin Family Study participants (N = 2483, 1565 monozygotic/918 dizygotic). Twins' parents were assessed for histories of substance use disorder. Twins were assessed for behavioral disinhibition at age 11 and substance use from ages 14 to 24. PGS prediction of substance use was examined using linear mixed-effects, within-twin pair, and structural equation models.
Results
Nearly all PGS measures were associated with multiple types of substance use independently of family history. However, most within-pair PGS prediction estimates were substantially smaller than the corresponding between-pair estimates, suggesting that prediction is driven in part by demography and indirect genetic effects of parents. Path analyses indicated the effects of both PGSs and family history on substance use were mediated via disinhibition in preadolescence.
Conclusions
PGSs capturing risk of substance use and use disorder can be combined with family history measures to augment prediction of substance use outcomes. Results highlight indirect sources of genetic associations and preadolescent elevations in behavioral disinhibition as two routes through which these scores may relate to substance use.
The ‘state trials’ of early modern England have long been known, and often cited, due to the prominence of the mighty 34-volume collection of trial proceedings compiled by William Cobbett, Thomas Bayly Howell, and Thomas Jones Howell under the title A Complete Collection of State Trials and published over the course of nearly two decades from 1809 to 1828. While these trials have found their way into the footnotes of many volumes of scholarship, there have been precious few extended studies of the concept of a ‘state trial’ as it came to be known in the eighteenth and nineteenth centuries. This book seeks to investigate that concept in greater detail.
When this project was conceived, the editors of this volume were independently engaged in studies of politically charged trials during the later Stuart period. We quickly realized that the concept of a ‘state trial’ was worth studying at length, and that the legal proceedings that came to be understood as state trials were diverse and complicated enough that it would take more than just two historians to tackle the subject properly. We have deliberately taken an expansive view of the state trials. Rather than focusing solely on the formal legal proceedings that constituted a trial, we have looked at these trials as part of a longer process that began well before the defendants were taken to court and continued well after the formal proceedings had concluded. As such, the case studies collected in this book contribute to a social and cultural history of the politics of law in the later seventeenth and early eighteenth centuries.
The book is divided into three sections. The chapters in the first, ‘What Were the State Trials?’, address the genealogy of the concept of state trials as well as the history of politically charged trials in a period when English men and women struggled to come to terms with the experience of the great regicidal revolution of 1649 and experienced another, soi disant ‘glorious’ revolution in 1688–89. The second section is devoted to the state trials of the Restoration, an era that struggled and ultimately failed to restore either a sense of political normalcy or a uniformly accepted rule of law.