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We present the serendipitous radio-continuum discovery of a likely Galactic supernova remnant (SNR) G305.4–2.2. This object displays a remarkable circular symmetry in shape, making it one of the most circular Galactic SNRs known. Nicknamed Teleios due to its symmetry, it was detected in the new Australian Square Kilometre Array Pathfinder (ASKAP) Evolutionary Map of the Universe (EMU) radio–continuum images with an angular size of 1 320$^{\prime\prime}$$\times$1 260$^{\prime\prime}$ and PA = 0$^\circ$. While there is a hint of possible H$\alpha$ and gamma-ray emission, Teleios is exclusively seen at radio–continuum frequencies. Interestingly, Teleios is not only almost perfectly symmetric, but it also has one of the lowest surface brightnesses discovered among Galactic SNRs and a steep spectral index of $\alpha$=–0.6$\pm$0.3. Our best estimates from Hi studies and the $\Sigma$–D relation place Teleios as a type Ia SNR at a distance of either $\sim$2.2 kpc (near-side) or $\sim$7.7 kpc (far-side). This indicates two possible scenarios, either a young (under 1 000 yr) or a somewhat older SNR (over 10 000 yr). With a corresponding diameter of 14/48 pc, our evolutionary studies place Teleios at the either early or late Sedov phase, depending on the distance/diameter estimate. However, our modelling also predicts X-ray emission, which we do not see in the present generation of eROSITA images. We also explored a type Iax explosion scenario that would point to a much closer distance of $\lt$1 kpc and Teleios size of only $\sim$3.3 pc, which would be similar to the only known type Iax remnant SN1181. Unfortunately, all examined scenarios have their challenges, and no definitive Supernova (SN) origin type can be established at this stage. Remarkably, Teleios has retained its symmetrical shape as it aged even to such a diameter, suggesting expansion into a rarefied and isotropic ambient medium. The low radio surface brightness and the lack of pronounced polarisation can be explained by a high level of ambient rotation measure (RM), with the largest RM being observed at Teleios’s centre.
The Lyman alpha (Ly$\alpha$) forest in the spectra of $z\gt5$ quasars provides a powerful probe of the late stages of the epoch of reionisation (EoR). With the recent advent of exquisite datasets such as XQR-30, many models have struggled to reproduce the observed large-scale fluctuations in the Ly$\alpha$ opacity. Here we introduce a Bayesian analysis framework that forward-models large-scale lightcones of intergalactic medium (IGM) properties and accounts for unresolved sub-structure in the Ly$\alpha$ opacity by calibrating to higher-resolution hydrodynamic simulations. Our models directly connect physically intuitive galaxy properties with the corresponding IGM evolution, without having to tune ‘effective’ parameters or calibrate out the mean transmission. The forest data, in combination with UV luminosity functions and the CMB optical depth, are able to constrain global IGM properties at percent level precision in our fiducial model. Unlike many other works, we recover the forest observations without invoking a rapid drop in the ionising emissivity from $z\sim7$ to 5.5, which we attribute to our sub-grid model for recombinations. In this fiducial model, reionisation ends at $z=5.44\pm0.02$ and the EoR mid-point is at $z=7.7\pm0.1$. The ionising escape fraction increases towards faint galaxies, showing a mild redshift evolution at fixed UV magnitude, $M_\textrm{UV}$. Half of the ionising photons are provided by galaxies fainter than $M_\textrm{UV} \sim -12$, well below direct detection limits of optical/NIR instruments including $\textit{ JWST}$. We also show results from an alternative galaxy model that does not allow for a redshift evolution in the ionising escape fraction. Despite being decisively disfavoured by the Bayesian evidence, the posterior of this model is in qualitative agreement with that from our fiducial model. We caution, however, that our conclusions regarding the early stages of the EoR and which sources reionised the Universe are more model-dependent.
This paper focuses on the developmental tendencies and mechanisms underlying the unfolding of mood systems in Romance complement clauses. In view of the fact that the subsequent dynamics of change can be better understood and motivated against the backdrop of the Latin system, we take the basic structure of the Latin mood system as the reference and necessary starting point of our analysis. After briefly discussing the basic approaches to the mechanisms of mood change in the relevant research literature that puts forward notions like ‘modal harmony’, ‘regrammation’, ‘lexicalization’, and ‘conventionalization’, the article develops a modal–semantic perspective that casts a different light on the convergent and divergent developments of mood in the complement clause domain of Romance languages. The modal–semantic approach allows, apart from a coherent description and analysis of the developments, recasting the question of whether mood, especially the subjunctive, also comes with its own semantic value(s) in complement clauses. This modal–semantic approach not only provides a coherent description and analysis of the developments but also allows for a re-examination of the abstract semantics of the subjunctive mood (in complement clauses), spelling out its basic semantic features.
The economic burden of migraine is substantial; determining the cost that migraine imposes on the Canadian healthcare system is needed.
Methods:
Administrative data were used to identify adults living with migraine, including chronic migraine (CM) and episodic migraine (EM), and matched controls in Alberta, Canada. One- and two-part generalized linear models with gamma distribution were used to estimate direct healthcare costs (hospitalization, emergency department, ambulatory care, physician visit, prescription medication; reported in 2022 Canadian dollars) of migraine during a 1-year observation period (2017/2018).
Results:
The fully adjusted total mean healthcare cost of migraine (n = 100,502) was 1.5 times (cost ratio: 1.53 [95% CI: 1.50, 1.55]) higher versus matched controls (n = 301,506), with a predicted annual incremental cost of $2,806 (95% CI: $2,664, $2,948) per person. The predicted annual incremental cost of CM and EM was $5,059 (95% CI: $4,836, $5,283) and $669 (95% CI: $512, $827) per person, respectively, compared with matched controls. All healthcare cost categories were greater for migraine (overall, CM and EM) compared with matched controls, with prescription medication the primary cost driver (incremental cost – overall: $1,381 [95% CI: $1,234, $1,529]; CM: $2,057 [95% CI: %1,891, $2,223]; EM: $414 [95% CI: $245, $583] per person per year).
Conclusion:
Persons living with migraine had greater direct healthcare costs than those without. With an estimated migraine prevalence of 8.3%–10.2%, this condition may account for an additional $1.05–1.29 billion in healthcare costs per year in Alberta. Strategies to prevent and effectively manage migraine and associated healthcare costs are needed.
Rates of psychiatric illness among the child and adolescent population have increased over the past several decades. As social and government agencies work to expand access to mental health treatment, more and more children and adolescents are receiving medications for their symptoms. However, many drugs used in this population are not approved for people under the age of 18, and have not been studied in terms of long-term impact on the developing brain. A significant proportion of these patients receive psychiatric polypharmacy, or the prescription of 2 or more psychotropic agents. This rate has increased from about 8% in 1996 to over 40% in 2005. Factors correlated with polypharmacy include older age, male gender, White race, and low socioeconomic status. Polypharmacy can increase the risk of drug-drug interactions, increase morbidity/mortality through cumulative toxicity, and cause decreased medication adherence.
Study Aims: This study aimed to examine psychiatric polypharmacy specifically among psychiatrically hospitalized patients in a New York City hospital, and to determine the impact of the COVID-19 pandemic.
Methods
This IRB-approved study reviewed the medical records of 1101 child and adolescent patients that were psychiatrically hospitalized between June 1 2018 and November 30 2021 at Mount Sinai Morningside. Sociodemographic and clinical information was collected and analyzed using SPSS.
Results
In this sample, 29.4% of patients received psychotropic polypharmacy. The polypharmacy group contained a higher percentage of males, White patients, and fewer Asian/South Asian patients. They had on average more hospitalizations, a longer hospitalization period, and were more likely to be diagnosed with an impulsive/behavioral disorder, developmental disorder, or bipolar spectrum disorder. The polypharmacy group were twice as likely to receive medication for agitation while hospitalized. A regression model identified positive predictors of polypharmacy as having a history of violence and a higher number of psychiatric hospitalizations. Negative predictors included non-White race. White patients had the highest average number of medications and Asian/South Asian patients had the lowest. No impact of the COVID-19 pandemic was found.
Conclusion
Psychiatric polypharmacy is extremely common in the child and adolescent population that requires psychiatric hospitalization. Increased behavioral needs, such as episodes of violence, as well as greater illness severity, as indicated by greater number of hospitalizations, may be the driving factors behind polypharmacy. Further investigation is indicated to determine other contributing causal factors and to track long-term consequences of psychiatric polypharmacy.
Dropout from healthcare interventions can negatively affect patients and healthcare providers through impaired trust in the healthcare system and ineffective use of resources. Research on this topic is still largely missing on refugees and asylum seekers. The current study aimed to characterize predictors for dropout in the Mental Health in Refugees and Asylum Seekers (MEHIRA) study, one of the largest multicentered controlled trials investigating the effectiveness and cost-effectiveness of a nationwide stepped and collaborative care model.
Methods
Predictors were multiply imputed and selected for descriptive modelling using backward elimination. The final variable set was entered into logistic regression.
Results
The overall dropout rate was 41,7%. Dropout was higher in participants in group therapy (p = 0.001; OR = 10.7), with larger satisfaction with social relationships (p = 0.017; OR = 1.87), with difficulties in maintaining personal relationships (p = 0.005; OR = 4.27), and with higher depressive symptoms (p = 0.029; OR = 1.05). Participants living in refugee accommodation (p = 0.040; OR = 0.45), with a change in social status (p = 0.008; OR = 0.67) and with conduct (p = 0.020; OR = 0.24) and emotional problems (p = 0.013; OR = 0.31) were significantly less likely to drop out of treatment.
Conclusion
Overall, the outcomes of this study suggest that predictors assessing social relationships, social status, and living conditions should be considered as topics of psychological treatment to increase adherence and as predictors for future research studies (including treatment type).
In temporal extensions of answer set programming (ASP) based on linear time, the behavior of dynamic systems is captured by sequences of states. While this representation reflects their relative order, it abstracts away the specific times associated with each state. However, timing constraints are important in many applications like, for instance, when planning and scheduling go hand in hand. We address this by developing a metric extension of linear-time temporal equilibrium logic, in which temporal operators are constrained by intervals over natural numbers. The resulting Metric Equilibrium Logic (MEL) provides the foundation of an ASP-based approach for specifying qualitative and quantitative dynamic constraints. To this end, we define a translation of metric formulas into monadic first-order formulas and give a correspondence between their models in MEL and Monadic Quantified Equilibrium Logic, respectively. Interestingly, our translation provides a blue print for implementation in terms of ASP modulo difference constraints.
Migraine, including episodic migraine (EM) and chronic migraine (CM), is a common neurological disorder that imparts a substantial health burden.
Objective:
Understand the characteristics and treatment of EM and CM from a population-based perspective.
Methods:
This retrospective population-based cross-sectional study utilized administrative data from Alberta. Among those with a migraine diagnostic code, CM and EM were identified by an algorithm and through exclusion, respectively; characteristics and migraine medication use were examined with descriptive statistics.
Results:
From 79,076 adults with a migraine diagnostic code, 12,700 met the criteria for CM and 54,686 were considered to have EM. The majority of migraineurs were female, the most common comorbidity was depression, and individuals with CM had more comorbidities than EM. A larger proportion of individuals with CM versus EM were dispensed acute (80.6%: CM; 63.4%: EM) and preventative (58.0%: CM; 28.9%: EM) migraine medications over 1 year. Among those with a dispensation, individuals with CM had more acute (13.6 ± 32.2 vs. 4.6 ± 10.9 [mean ± standard deviation], 95% confidence interval [CI] 7.7-8.3), and preventative (12.6 ± 43.5 vs. 5.0 ± 12.6, 95% CI 6.9-8.4) migraine medication dispensations than EM, over 1-year. Opioids were commonly used in both groups (proportion of individuals dispensed an opioid over 1-year: 53.1%: CM; 25.7%: EM).
Conclusions:
Individuals with EM and CM displayed characteristics and medication use patterns consistent with other reports. Application of this algorithm for CM may be a useful and efficient means of identifying subgroups of migraine using routinely collected health data in Canada.
Alterations of the gut microbiome have been associated with obesity and metabolic disorders. The gut microbiota can be influenced by the intake of dietary fibres with prebiotic properties, such as inulin-type fructans. The present study tested the hypothesis that obese individuals subjected for 12 weeks to an inulin-enriched v. inulin-poor diet have differential faecal fermentation patterns. The fermentation of cellulose and inulin hydrolysates of six different inulin-rich and inulin-poor vegetables of both groups was analysed in vitro on faecal inocula. The results showed that the microbiota from obese patients who received a fructan-rich diet for 3 weeks produces more gas and total SCFA compared with the microbiota taken from the same individuals before the treatment. Obese individuals fed with a low-fructan diet produce less gas and less SCFA compared with the treated group. The present study highlighted profound changes in microbiota fermentation capacity obtained by prebiotic intervention in obese individuals, which favours the production of specific bioactive metabolites.
The aetiology of dementia is not yet fully understood. Stress can have a damaging effect on brain health. The prognostic effect of anxiety is still unclear regarding Alzheimer's disease as well as vascular dementia.
Aims
To explore the association between anxiety and future dementia.
Method
Medline, PsycINFO, CINAHL, Web of Science and ALOIS were searched for publications up to 12 January 2018. Longitudinal studies with a follow-up of at least 2 years were included, if the trait or state anxiety had been assessed at baseline. Studies with cognitive impairment at baseline were not included. We used a random effects model to calculate the pooled time to Alzheimer's disease and incidence of vascular dementia.
Results
Anxiety predicts risk of Alzheimer's disease (n = 26 193 out of seven studies, hazard ratio1.53, 95% CI 1.16–2.01, P < 0.01) and vascular dementia (n = 4916 out of two studies, odds ratio1.88, 95% CI 1.05–3.36, P < 0.01). The pooled hazard ratio regarding risk of Alzheimer's disease was still significant when excluding studies with critical risk of bias (n = 14 110 out of six studies, hazard ratio 1.35, 95% CI 1.08–1.70, P < 0.01).
Conclusions
Anxiety is a risk factor for both types of dementia. The temporal and functional relation between anxiety and dementia needs investigation in future studies. The protective value of treating anxiety should be explored further.
Erosion of the upper Arkadelphia Formation by the Ouachita River in Hot Spring County, Arkansas, has revealed a diverse and abundant, late Maastrichtian chondrichthyan fauna representing at least 17 species: Squatina hassei, Ginglymostoma lehneri, Plicatoscyllium derameei, Ondontaspis aculeatus, Carcharias cf. C. holmdelensis, Serratolamna serrata, Squalicorax kaupi, Galeorhinus girardoti, Rhinobatos casieri, Ischyrhiza avonicola, Ischyrhiza mira, Sclerorhynchus sp., Ptychotrygon cf. P. vermiculata, Raja farishi, Rhombodus binkhorsti, and Dasyatis sp. All of these species are widely known from the Upper Cretaceous of North America. An extremely rare species, Schizorhiza cf. S. stromeri, currently known only from Mexico and Africa, is also present. The chondrichthyan remains occur almost entirely as teeth scattered by river activity across the surface of the marl and marly clay of the Arkadelphia Formation and can be collected from within localized accumulations of river sediments. Also present with the chondrichthyan remains are teeth from actinopterygians and reptiles as well as molluscan steinkerns, echinoid spines, and fragments of branching corals. This fauna expands the known geographic distribution of late Maastrichtian chondrichthyans in North America, and provides an important biostratigraphic connection between fauna of the Gulf Coastal Plain and Western Interior Seaway. It also supports the idea of a significant chondrichthyan turnover across the Cretaceous–Tertiary boundary.
Atrazine has been the most widely used herbicide in North Americanprocessing sweet corn for decades; however, increased restrictions in recentyears have reduced or eliminated atrazine use in certain production areas.The objective of this study was to identify the best stakeholder-derivedweed management alternatives to atrazine in processing sweet corn. In fieldtrials throughout the major production areas of processing sweet corn,including three states over 4 yr, 12 atrazine-free weed managementtreatments were compared to three standard atrazine-containing treatmentsand a weed-free check. Treatments varied with respect to herbicide mode ofaction, herbicide application timing, and interrow cultivation. Alltreatments included a PRE application of dimethenamid. No single weedspecies occurred across all sites; however, weeds observed in two or moresites included common lambsquarters, giant ragweed, morningglory species,velvetleaf, and wild-proso millet. Standard treatments containing bothatrazine and mesotrione POST provided the most efficacious weed controlamong treatments and resulted in crop yields comparable to the weed-freecheck, thus demonstrating the value of atrazine in sweet corn productionsystems. Timely interrow cultivation in atrazine-free treatments did notconsistently improve weed control. Only two atrazine-free treatmentsconsistently resulted in weed control and crop yield comparable to standardtreatments with atrazine POST: treatments with tembotrione POST either withor without interrow cultivation. Additional atrazine-free treatments withtopramezone applied POST worked well in Oregon where small-seeded weedspecies were prevalent. This work demonstrates that certain atrazine-freeweed management systems, based on input from the sweet corn growers andprocessors who would adopt this technology, are comparable in performance tostandard atrazine-containing weed management systems.
To determine the prevalence of multidrug-resistant organisms (MDROs) colonizing in pediatric refugees admitted to a University Children Hospital in Germany.
DESIGN
Retrospective observational study.
SETTING
General pediatric and pediatric surgery units.
PATIENTS
In Germany, recommendations for MDRO screening of pediatric refugees were recently published. According to these and institutional recommendations, all hospitalized pediatric refugees were screened for MDROs between October 2015 and March 2016.
METHODS
Using electronic surveillance data, we performed a chart review to identify the prevalence of MDROs among and the clinical diagnoses of pediatric refugees.
RESULTS
Among 325 patients hospitalized for various causes, most frequently gastroenteritis (30.9%), MDROs were detected in 33.8%. Most of these patients were colonized with multidrug-resistant Gram-negative (MRGN) bacteria (113 isolates), mostly 2MRGN/ESBL (87 isolates); some patients were colonized with methicillin-resistant Staphylococcus aureus (MRSA, 22 isolates); and 1 patient was colonized with vancomycin-resistant enterococci (VRE). Among 110 refugee patients, we detected single colonization with an MDRO in 84 patients (76.4%), co-colonization with 2 pathogens in 23 patients (20.9%), and triple colonization in 3 patients (2.7%). However, infections with MDROs occurred in only 3.6% of pediatric refugees. The peak of positive MDRO screening results in 2015 correlated with an increased hospitalization rate.
CONCLUSION
Implementation of infection control measures among pediatric refugees is challenging. Due to the high frequency of MDROs in these patients, current screening, isolation, and treatment strategies may have to be adapted.
Edited by
Swen Hutter, European University Institute, Florence,Edgar Grande, Ludwig-Maximilians-Universität Munchen,Hanspeter Kriesi, European University Institute, Florence
The previous chapters have traced the politicisation of Europe by looking at contestation both around key integration steps and national elections. Generally speaking, the results support the claim that the European integration process has become politicised since the 1990s. At the same time, they suggest that public conflicts over Europe are still very much an elite affair. While the study of election campaigns focused exclusively on political parties, the integration debates turned out to be dominated by public authority actors. Less powerful actors, such as civil society or social movement organisations (SMOs), were hardly present in these public debates (see also Koopmans 2007, 2010; Helbling et al. 2012: 216–220 and Statham and Trenz 2013a: 85–93). While this finding casts doubt on the idea that social movements and other civil society actors are key to the politicisation of Europe, as suggested by Beck and Grande (2007) and Habermas (2012), we still lack a systematic assessment of this claim.
This chapter provides such an assessment by testing our ‘mass politics hypothesis’ (see Chapter 1). In other words, the chapter answers the question of whether European integration has become part and parcel of mass politics, i.e., whether non-party challengers and ordinary citizens are becoming more involved in conflicts over Europe. To do this, the chapter shifts attention to the protest arena. More specifically, we ask whether and to what extent European integration has become politicised in the protest arenas of the six countries. The protest arena's centre and pivotal point is the direct participation of people in protest events. Mobilising this active participation is a core competence and resource of the collective actors involved in protest politics (Hutter 2014a: 26–29). Taking up Schattschneider's (1975 [1960]: 1) words again, the protest arena is the channel where the ‘crowd’ can enter the fight without institutional, thematic or territorial boundaries. Thus, we change our research strategy and focus on protest events that are thematically related to European integration – either directly in terms of the issues articulated by the protesters or indirectly by means of the justification frames used or the addressee of the event (for the data collection strategy, see Chapter 2).
The focus on protest events reflects our general definition of politicisation as involving three dimensions: salience, polarisation and actor expansion.
The Lower Ferron Sandstone Member of the Mancos Shale in southeastern Utah preserves a chondrichthyan assemblage of at least 13 taxa that include: Hybodus sp., Ptychodus cf. P. mammillaris Agassiz, 1843, Ptychodus whipplei Marcou, 1858, cf. Chiloscyllium sp., Scapanorhynchus raphiodon (Agassiz, 1843), Cretodus crassidens (Dixon, 1850), cf. Leptostyrax sp., cf. Cretalamna appendiculata (Agassiz, 1835), Squalicorax sp., Pseudohypolophus mcnultyi (Thurmond, 1971), Protoplatyrhina hopii Williamson, Kirkland and Lucas, 1993, Ischyrhiza schneideri (Slaughter and Steiner, 1968), and Ptychotrygon triangularis (Reuss, 1844). Although this assemblage is typical of other Turonian chondrichthyan faunas in North America, fossil teeth are preserved in two unique facies associations that consist of arenitic sandstones with mud interclasts and rounded chert, feldspar, and quartz pebbles. the coarser beds within these facies associations are previously interpreted to represent storm events and turbidity flows associated with a sea level lowstand. Chondrichthyan teeth occurring within these coarser beds are indicative of extensive transport and reworking and attest to the durable nature of chondrichthyan teeth for biostratigraphic and paleoecological interpretations. Similar studies of chondrichthyan teeth in shelf marine settings may also provide new insights for facies interpretations related to sequence stratigraphy and regional stratigraphic correlations.