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Some of us recently discussed the problems existing in describing the channels that permit interventricular shunting. We offered suggestions for improvement, particularly when assessing the channel that is found when both arterial trunks arise from the morphologically right ventricle. Our proposals engendered significant debate, with several criticisms appearing in an editorial commentary. The commentator now accepts that not all of the criticisms were justified. In an attempt to seek further consensus, we have now joined with additional colleagues so as to clarify the aspects of our initial work that created potential confusion. Having reviewed the aspects producing the misconceptions, we again provide an overview of the evidence relevant to deficient ventricular septation now provided by knowledge of cardiac development. We show how remodelling of the primary interventricular communication involves the provision of an inlet for the developing right ventricle and an outlet for the developing right ventricle. During this process, the secondary interventricular foramen, which is a subaortic-left ventricular communication when the outflow tract remains supported exclusively by the right ventricle, becomes the outflow tract for the left ventricle, with a subaortic-right ventricular communication then being closed to complete ventricular septation. We show how knowledge of these processes, coupled with an appreciation of the mechanism of formation of the muscular ventricular septum and the separate formation of an embryonic muscular outlet septum, which with normal development becomes the subpulmonary infundibulum, provides the basis for understanding the various phenotypic lesions that permit interventricular shunting in the postnatal heart.
The macro-social and environmental conditions in which people live, such as the level of a country’s development or inequality, are associated with brain-related disorders. However, the relationship between these systemic environmental factors and the brain remains unclear. We aimed to determine the association between the level of development and inequality of a country and the brain structure of healthy adults.
Methods
We conducted a cross-sectional study pooling brain imaging (T1-based) data from 145 magnetic resonance imaging (MRI) studies in 7,962 healthy adults (4,110 women) in 29 different countries. We used a meta-regression approach to relate the brain structure to the country’s level of development and inequality.
Results
Higher human development was consistently associated with larger hippocampi and more expanded global cortical surface area, particularly in frontal areas. Increased inequality was most consistently associated with smaller hippocampal volume and thinner cortical thickness across the brain.
Conclusions
Our results suggest that the macro-economic conditions of a country are reflected in its inhabitants’ brains and may explain the different incidence of brain disorders across the world. The observed variability of brain structure in health across countries should be considered when developing tools in the field of personalized or precision medicine that are intended to be used across the world.
Haemolysis is developing prominence in the setting of supporting increasingly complex children with heart failure with a ventricular assist device. The goal of this study is to better characterise haemolysis and its implications in children supported with pulsatile ventricular assist devices.
Methods:
This is a single-centre retrospective review of 44 children who were supported by Berlin Heart EXCOR between January 2006 and June 2020. Patients were divided into major haemolysers and non-major haemolysers. Major haemolysers were defined as patients with lactate dehydrogenase > 500U/L (2.5x the upper limits of normal) with either total bilirubin > 2mg/dL (with predominantly indirect hyperbilirubinemia) or anaemia out of proportion to the clinical scenario more than three days following implantation of the ventricular assist device(s). Patient demographics, ventricular assist device factors, and outcomes, including end-organ function and mortality, were compared between major haemolysers and non-major haemolysers.
Main results:
Forty-four patients supported by the Berlin EXCOR were included in the analytic cohort of the study: 27 major haemolysers and 17 non-major haemolysers. Major haemolysis was more common in those supported with single-ventricle ventricular assist device (i.e., VAD in the context of functionally univentricular anatomy) compared to those with biventricular hearts, p = 0.01. There were no patients with an isolated left ventricular assist device or isolated right ventricular assist device in our analytic cohort of 44 patients. Of the 19 patients with single-ventricle ventricular assist device, 84% (16/19) were major haemolysers. Of the 25 patients with a biventricular assist device, 44% (11/25) were major haemolysers. Major haemolysers and non-major haemolysers had a body surface area of 0.28 and 0.40, respectively (p = 0.01). Overall, survival to discharge from the hospital was 66% (n = 29/44). Survival to discharge from the hospital was 52% (14/27) in major haemolysers versus 88% (15/17) in non-major haemolysers, p = 0.02. Only 3 of the 27 with major haemolysis had severe haemolysis, that is, lactate dehydrogenase > 2000 and bilirubin above 10. Non-major haemolysers had a better improvement in creatinine clearance during ventricular assist device support, p < 0.0001. (During the same era of this study, 22 patients who were supported with Berlin Heart were excluded from the analytic cohort because they did not have any recorded measurement of lactate dehydrogenase. Seventeen of these 22 patients had no clinical evidence of haemolysis. Survival to discharge from the hospital in this excluded cohort was 86% [19/22].)
Conclusions:
Major haemolysis in patients with pulsatile ventricular assist device is more likely with single-ventricle ventricular assist device support and smaller body surface area.
Integrating trees and shrubs into agroecosystems increases soil nutrients and organic matter, which helps in the recovery of degraded tropical soils. However, selecting the most appropriate tree and shrub species as sources of nutrients and organic matter requires knowledge of their productive potential. The study aimed to evaluate litter productivity and nutrient input to the soil of three tropical silvopastoral fodder bank species. Litter input from Tithonia diversifolia, Leucaena leucocephala, and Moringa oleifera was quantified monthly for one year. We found that the litterfall amount was greatest (p < 0.05) from T. diversifolia (1.81 t ha–1 yr–1) compared to L. leucocephala (1.26 t ha–1 yr–1) and M. oleifera (118 t ha–1 yr–1). Indeed, T. diversifolia had a greater (p < 0.05) input of biomass from leaves (1.36 t ha–1 yr–1) compared to L. leucocephala (0.901 t ha–1 yr–1) and M. oleifera (0.869 t ha–1 yr–1). The highest biomass input (p < 0.05) occurred in September to the three species, T. diversifolia (0.516 t ha–1), L. leucocephala (0.243 t ha–1), and M. oleifera (0.233 t ha–1), and the lowest biomass input occurred in March. Furthermore, the greatest annual input of carbon (0.687 t ha–1 yr–1), nitrogen (0.030 t ha–1 yr–1), and phosphorus (0.006 t ha–1 yr–1) to the soil originated from T. diversifolia. Our study showed that T. diversifolia had the greatest capacity to produce biomass that potentially can reintroduce nutrients and contribute to the recovery process of degraded soil due to its high litter productivity, besides, a combination of these three species also improves soil nutrients in fodder banks when do not hauling forage for livestock, contributing to sustainability of system.
Female genital schistosomiasis (FGS) is a chronic disease manifestation of the waterborne parasitic infection Schistosoma haematobium that affects up to 56 million women and girls, predominantly in sub-Saharan Africa. Starting from early childhood, this stigmatizing gynaecological condition is caused by the presence of Schistosoma eggs and associated toxins within the genital tract. Schistosoma haematobium typically causes debilitating urogenital symptoms, mostly as a consequence of inflammation, which includes bleeding, discharge and lower abdominal pelvic pain. Chronic complications of FGS include adverse sexual and reproductive health and rights outcomes such as infertility, ectopic pregnancy and miscarriage. FGS is associated with prevalent human immunodeficiency virus and may increase the susceptibility of women to high-risk human papillomavirus infection. Across SSA, and even in clinics outside endemic areas, the lack of awareness and available resources among both healthcare professionals and the public means FGS is underreported, misdiagnosed and inadequately treated. Several studies have highlighted research needs and priorities in FGS, including better training, accessible and accurate diagnostic tools, and treatment guidelines. On 6 September, 2024, LifeArc, the Global Schistosomiasis Alliance and partners from the BILGENSA Research Network (Genital Bilharzia in Southern Africa) convened a consultative, collaborative and translational workshop: ‘Female Genital Schistosomiasis: Translational Challenges and Opportunities’. Its ambition was to identify practical solutions that could address these research needs and drive appropriate actions towards progress in tackling FGS. Here, we present the outcomes of that workshop – a series of discrete translational actions to better galvanize the community and research funders.
The Australian SKA Pathfinder (ASKAP) offers powerful new capabilities for studying the polarised and magnetised Universe at radio wavelengths. In this paper, we introduce the Polarisation Sky Survey of the Universe’s Magnetism (POSSUM), a groundbreaking survey with three primary objectives: (1) to create a comprehensive Faraday rotation measure (RM) grid of up to one million compact extragalactic sources across the southern $\sim50$% of the sky (20,630 deg$^2$); (2) to map the intrinsic polarisation and RM properties of a wide range of discrete extragalactic and Galactic objects over the same area; and (3) to contribute interferometric data with excellent surface brightness sensitivity, which can be combined with single-dish data to study the diffuse Galactic interstellar medium. Observations for the full POSSUM survey commenced in May 2023 and are expected to conclude by mid-2028. POSSUM will achieve an RM grid density of around 30–50 RMs per square degree with a median measurement uncertainty of $\sim$1 rad m$^{-2}$. The survey operates primarily over a frequency range of 800–1088 MHz, with an angular resolution of 20” and a typical RMS sensitivity in Stokes Q or U of 18 $\mu$Jy beam$^{-1}$. Additionally, the survey will be supplemented by similar observations covering 1296–1440 MHz over 38% of the sky. POSSUM will enable the discovery and detailed investigation of magnetised phenomena in a wide range of cosmic environments, including the intergalactic medium and cosmic web, galaxy clusters and groups, active galactic nuclei and radio galaxies, the Magellanic System and other nearby galaxies, galaxy halos and the circumgalactic medium, and the magnetic structure of the Milky Way across a very wide range of scales, as well as the interplay between these components. This paper reviews the current science case developed by the POSSUM Collaboration and provides an overview of POSSUM’s observations, data processing, outputs, and its complementarity with other radio and multi-wavelength surveys, including future work with the SKA.
This article examines the evolution of the role played by the number and gender of siblings in the survival and biological well-being of individuals in rural Spain during the twentieth century. Our aim is to test how two fundamental theories – the cooperative breeding hypotheis and the resource dilution hypothesis – about how the number of siblings affect the individual come together in this area of study during a period of economic, health, and social transformation. We used a sample of 19,331 individuals born between 1900 and 1979 from 14 rural villages, for whom data on sibling count and various family and environmental variables are available. Using these data, we ran several statistical models to discover the effects of siblings on survival. In addition, we studied the long-term effect of siblings on height using height data from 2,783 male conscripts. Our results show that the number of siblings positively influenced survival, either through the cooperation of older siblings in the care of their younger brothers and sisters or through parents exhibiting higher offspring survival abilities. However, increased reproductive success may come with a disadvantage. The biological well-being, as measured by height, of male conscripts was significantly lower among individuals with more siblings in the early decades of the study. Conversely, in the later decades, the negative relationship between sibship size and height was not statistically significant when the number of living siblings was fewer than five.
The phenomenon of focusing of microwave beams in a plasma near a turning-point caustic is discussed by exploiting the analytical solution to the Gaussian beam-tracing equations in the two-dimensional (2-D) linear-layer problem. The location of maximum beam focusing and the beam width at that location are studied in terms of the beam initial conditions. This focusing must be taken into account to interpret Doppler backscattering (DBS) measurements. We find that the filter function that characterises the scattering intensity contribution along the beam path through the plasma is inversely proportional to the beam width, predicting enhanced scattering from the beam focusing region. We show that the DBS signal enhancement for decreasing incident angles between the beam path and the density gradient is due to beam focusing and not due to forward scattering, as was originally proposed by (Gusakov et al., (Plasma Phys. Contr. Fusion, vol. 56, 2014, p. 0250092014, 2017); Plasma Phys. Rep. vol. 43(6), 2017, pp. 605–613). The analytic beam model is used to predict the measurement of the $k_y$ density-fluctuation wavenumber power spectrum via DBS, showing that, in an NSTX-inspired example, the spectral exponent of the turbulent, intermediate-to-high $k_y$ density-fluctuation spectrum might be quantitatively measurable via DBS, but not the spectral peak corresponding to the driving scale of the turbulent cascade.
Adverse childhood experiences (ACEs) are prevalent in people with substance use disorder (SUD). The aims of this study were to determine the prevalence of ACEs in a specific sample of people with SUD and to analyze the specific characteristics of these patients according to gender. The studied sample consisted of 215 people seeking treatment for SUD in two clinical centers in Spain. Descriptive and comparison analyses were carried out, and a logistic regression analysis was conducted to identify the main variables related to ACEs. The prevalence of at least one ACE was 82.3%. Women reported a higher prevalence of family mental health problems (p = .045; d = 0.14) and sexual abuse (p < .001; d = 0.43) than men. The group with ≥3 ACEs showed a higher severity profile for the addiction severity and psychopathological variables than the groups with 0 ACEs and 1–2 ACEs. Logistic regression showed that problems related to the group with ≥3 ACEs in the total sample were psychiatric and legal problems and lifetime suicidal ideation (in men, family/social problems and lifetime suicidal ideation; in women, employment/support problems). This study supports the high prevalence of ACEs in people with SUD and the cumulative effect of ACEs. In addition, gender is a relevant factor. The implementation of assessments and treatment for ACEs is necessary in SUD treatment programs.
Recent observations have shown a fast decrease in thickness and area of Pyrenean glaciers in some cases leading to a stagnation of ice flow. However, their transition to a new paraglacial stage is not well understood. Through the combination of uncrewed aerial vehicles imagery, airborne LiDAR, ground-penetrating radar and ground temperature observations, we characterized the recent evolution of Infiernos Glacier. In 2021, this glacier had small sectors thicker than 25 m, but most of area did not exceed 10 m. The thickness losses from 2011 to 2023 reached 9 m in average, of which 5 m occurring during the period 2020–23. This trend demonstrates the significant ice melt under current climatic conditions. In the last years, the glacier has also shown a remarkable increase of debris cover extent. In these areas, the ice loss was reduced by half when compared to the thickness decrease in the entire glacier. Sub-freezing ground temperatures evidence the highly probable presence of permafrost or buried ice in the surroundings of the glacier. The clear signs of ice stagnation and the magnitude of area and thickness decrease support the main hypothesis of this work: After 2023, the Infiernos Glacier can no longer be considered a glacier and has become an ice patch.
The recommended first-line treatment for insomnia is cognitive behavioral therapy for insomnia (CBTi), but access is limited. Telehealth- or internet-delivered CBTi are alternative ways to increase access. To date, these intervention modalities have never been compared within a single study. Further, few studies have examined (a) predictors of response to the different modalities, (b) whether successfully treating insomnia can result in improvement of health-related biomarkers, and (c) mechanisms of change in CBTi. This protocol was designed to compare the three CBTi modalities to each other and a waitlist control for adults aged 50–65 years (N = 100). Participants are randomly assigned to one of four study arms: in-person- (n = 30), telehealth- (n = 30) internet-delivered (n = 30) CBTi, or 12-week waitlist control (n = 10). Outcomes include self-reported insomnia symptom severity, polysomnography, circadian rhythms of activity and core body temperature, blood- and sweat-based biomarkers, cognitive functioning and magnetic resonance imaging.
Achieving sustainability on the ground poses a challenge in decoding globally defined goals, such as sustainable development goals, and aligning them with local perspectives and realities. This decoding necessitates the understanding of the multifaceted dimensions of the sustainability challenges in a given context, including their underlying causes. In case studies from Brazilian drylands, we illustrate how an enhanced multiscale participatory method, combined with systems thinking tools, can shed light on systemic structures that currently entrench unsustainable development trajectories. This method offers insights into co-designing potential pathways toward sustainable futures and unlocking transformative capacities of the local population.
Technical summary
Translating United Nations global sustainable development goals (SDGs) into actions that address local realities and aspirations is an urgent challenge. It requires new thinking and approaches that foster the discussion about the main challenges to implementing the SDGs at multiple levels. This paper presents a novel multiscale participatory approach that combines the popular Three Horizons diagram with the formalism of causal loop diagrams in systems thinking. We present results from six multi-stakeholder dialogues held across drylands in Brazil with a focus on desired futures aligned with SDGs. Focusing on identifying the root causes and systemic structures of unsustainability, participants identified lock-ins, leverage points, and interventions for how these could be changed. The core lock-ins are the discontinuity of public policies, and the historical land and power concentration reinforced by the current expansion of large-scale agricultural, mining, and energy projects. The proposed interventions are structural and – if implemented – would contribute to achieving SDGs in an integrated manner. The unique approach developed in this study can provide leverage as it bridges the inclusivity of participatory visioning with the change potential of systems thinking tools to tackle root causes and unleash societal transformations.
Social media summary
We are not achieving SDGs. Understanding root causes of unsustainability is critical to move toward sustainable and just futures.
Illiberal actors in Western democracies increasingly exploit the superficial defence of liberal values like gender equality and LGBTQ+ rights to demonize ethnic out-groups, portraying Muslims as inherently opposed to Western values. This paper investigates whether this stereotype reflects widespread public beliefs and asks: is the stereotypical view of the Muslim community as an illiberal ‘bogeyman’ endorsed by citizens? Leveraging an original double-list experiment design that minimizes sensitivity bias, we identify population-level estimates of this stereotype in Britain, Germany, the Netherlands, and the USA. Our cross-national results reveal a pervasive and ubiquitous stereotype of Muslims as a threat to LGBTQ+ communities across Western democracies. The implications of these findings are concerning as they signal that societal tolerance of ethnic out-groups across liberal democracies remains tainted by prejudicial stereotypes. The results also underscore the alarming electoral potential of far-right parties that exploit homonationalist and femonationalist stereotype-based threat perceptions to their political advantage.
Young people with childhood adversity (CA) were at increased risk to experience mental health problems during the COVID-19 pandemic. Pre-pandemic research identified high-quality friendship support as a protective factor that can buffer against the emergence of mental health problems in young people with CA. This longitudinal study investigated friendship buffering effects on mental health symptoms before and at three timepoints during the pandemic in 102 young people (aged 16–26) with low to moderate CA. Multilevel analyses revealed a continuous increase in depression symptoms following the outbreak. Friendship quality was perceived as elevated during lockdowns and returned to pre-pandemic baseline levels during reopening. A stress-sensitizing effect of CA on social functioning was evident, as social thinning occurred following the outbreak. Bivariate latent change score modeling revealed that before and during the pandemic, young people with greater friendship quality self-reported lower depression symptoms and vice versa. Furthermore, sequential mediation analysis showed that high-quality friendships before the pandemic buffered depression symptoms during the pandemic through reducing perceived stress. These findings highlight the importance of fostering stable and supportive friendships in young people with CA and suggest that through reducing stress perceptions high-quality friendships can mitigate mental health problems during times of multidimensional stress.
In this work, we develop a method for robust single-cycle measurement velocity vector estimation for automotive radar. Building upon our previous work, we introduce a methodology that leverages spatial diversity for accurate estimation of the velocity vector of targets in the medium to close ranges. We extend our initial conceptual framework, addressing limitations from our first approach and proposing necessary enhancements for real-world applicability. Our improved process excels in target separation, identification, and velocity vector estimation, proving effective across various scenarios and minimizing errors. The system, tested on pedestrians and metal targets, presents a promising avenue for exploring its performance with varying target sizes. Simultaneously, our in-depth study on Doppler-multiplex modulation reveals new relevant constraints, prompting a modulation change for improved response separation. Despite the necessity of increasing module numbers for enhanced performance, our structured approach to target itemization and classification positions our methodology as a valuable framework for future systems, offering a comprehensive solution to diverse challenges in target estimation and classification within the automotive landscape.
Hypertensive heart disease and hypertrophic cardiomyopathy both lead to left ventricular hypertrophy despite differing in aetiology. Elucidating the correct aetiology of the presenting hypertrophy can be a challenge for clinicians, especially in patients with overlapping risk factors. Furthermore, drugs typically used to combat hypertensive heart disease may be contraindicated for the treatment of hypertrophic cardiomyopathy, making the correct diagnosis imperative. In this review, we discuss characteristics of both hypertensive heart disease and hypertrophic cardiomyopathy that may enable clinicians to discriminate the two as causes of left ventricular hypertrophy. We summarise the current literature, which is primarily focused on adult populations, containing discriminative techniques available via diagnostic modalities such as electrocardiography, echocardiography, and cardiac MRI, noting strategies yet to be applied in paediatric populations. Finally, we review pharmacotherapy strategies for each disease with regard to pathophysiology.
Understanding the physics of electromagnetic pulse (EMP) emission and nozzle damage is critical for the long-term operation of laser experiments with gas targets, particularly at facilities looking to produce stable sources of radiation at high repetition rates. We present a theoretical model of plasma formation and electrostatic charging when high-power lasers are focused inside gases. The model can be used to estimate the amplitude of gigahertz EMPs produced by the laser and the extent of damage to the gas jet nozzle. Looking at a range of laser and target properties relevant to existing high-power laser systems, we find that EMP fields of tens to hundreds of kV/m can be generated several metres from the gas jet. Model predictions are compared with measurements of EMPs, plasma formation and nozzle damage from two experiments on the VEGA-3 laser and one experiment on the Vulcan Petawatt laser.