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Neurological disorders in children encompass a heterogeneous group of conditions, congenital or acquired, that are often associated with significant respiratory morbidity. In considering the impact on the respiratory system that are relevant in children with neurological disorders, the phenotypes can be broadly classified into (1) impaired respiratory drive; (2) loss of airway protection/patency; (3) neuromuscular weakness; and (4) reduced or elevated muscle tone. These are not mutually exclusive. In this chapter, the authors review the pathophysiology of respiratory impairment in children with neurological disorders, in the context of childhood development, and discuss the principles behind long-term management of respiratory issues, including monitoring and therapies available to optimize respiratory function. Acute management strategies, including in the pediatric intensive care unit are discussed, alongside the ethical dilemmas faced by clinicians treating this patient population. The lack of high-quality evidence makes management of respiratory issues in children with severe neurological impairments challenging.
Will voters punish incumbents for psychological distress associated with public policy during external shocks? This study examines this question in the empirical context of the first wave of the COVID-19 pandemic in India, utilizing three novel cross-sectional surveys conducted in the first three weeks of June 2020, immediately after the national lockdown policy was officially revoked. We find that propensity to vote for the nationally incumbent Bharatiya Janata Party (if hypothetical elections were held on the day of the survey) was negatively correlated with mental stress from routine disruptions in mobility (Week 1); worsening mental health (Week 2); and emotion-focused coping (Week 3). We show that these effects are strongest in BJP-ruled states. We argue that psychological distress shaped political attitudes in the midst of the pandemic and this effect was conditional on the source of distress and moderated by governmental clarity of responsibility.
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 ∼ 50 per cent of the sky (20,630 deg2); (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 ∼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 μJy beam−1. Additionally, the survey will be supplemented by similar observations covering 1296–1440 MHz over 38 per cent of the sky. POSSUM will enable the discovery and detailed investigation of magnetized 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.
Waterlogging (WL) stress drastically impacts sesame crops, making them highly susceptible by hindering growth and development. Hence, identifying and characterizing the promising trait is necessary to conserve germplasm exploitation during WL stress conditions. The current study emphasized comprehensively screening 148 accessions by treating 48 hours of WL stress in sesame crops. In addition, the trait association and morphological characteristics were attributed to identify tolerant and susceptible germplasm, which can be further utilized in crop improvement and breeding programmes. Therefore, the present study screened the genotypes by assessing morphological traits, including shoot height (SH), root length (RL), SPAD measurements and branches per plant. The observation reveals that RL, SH and SPAD significantly varied in sesame accessions. Hence, accession EC377024 and IC129289 showed highly tolerant and susceptible behaviour. The statistical analysis, including G × E interactions, Pearson’s correlation, and principal component analysis (PCA), supports the selected trait that can be used to screen the WL susceptible crops. The genotypes identified in this study have the potential to aid in sesame crop improvement.
To identify risk factors for catheter-related bloodstream infections (CRBSI) in cancer patients, we compared 200 CRBSI cases to 400 controls. Neutropenia, transplants, multiple catheters, blood products, and basilic/cephalic PICCs increased CRBSI risk, while jugular insertion was protective. Catheter site selection can reduce risk. Other targeted strategies are warranted.
Edited by
Richard Pinder, Imperial College of Science, Technology and Medicine, London,Christopher-James Harvey, Imperial College of Science, Technology and Medicine, London,Ellen Fallows, British Society of Lifestyle Medicine
Suboptimal diet is a major risk factor for health issues and early mortality globally. Diets like the Mediterranean, DASH, and whole-food plant-based are associated with improved health and disease prevention. It’s crucial to assess dietary quality and nutritional status during clinical consultations using brief validated tools. Dietary habit improvements can be achieved through medical consultations with time and follow-up. The most effective way to promote healthy eating at a population level is through Public Health policies. Nutrition research has advanced from focusing on calories to understanding food quality, processing, and the role of phytoactive substances. Large-scale studies have established associations between diet and health outcomes, despite challenges in proving causality. High-quality trials such as DASH and Lyon Diet Heart Study have shown the benefits of specific dietary patterns on health. Tailoring dietary advice to individual characteristics can motivate healthier eating habits. Discussing dietary habits in clinical consultations should be sensitive to cultural, social, and financial determinants.
The dispersion behaviour of solutes in flow is crucial to the design of chemical separation systems and microfluidics devices. These systems often rely on coupled electroosmotic and pressure-driven flows to transport and separate chemical species, making the transient dispersive behaviour of solutes highly relevant. However, previous studies of Taylor dispersion in coupled electroosmotic and pressure-driven flows focused on the long-term dispersive behaviour and the associated analyses cannot capture the transient behaviour of solute. Further, the radial distribution of solute has not been analysed. In the current study, we analyse the Taylor dispersion for coupled electroosmotic and pressure-driven flows across all time regimes, assuming a low zeta potential (electric potential at the shear plane), the Debye–Hückel approximation and a finite electric double layer thickness. We first derive analytical expressions for the effective dispersion coefficient in the long-time regime. We also derive an unsteady, two-dimensional (radial and axial) solute concentration field applicable in the latter regime. We next apply Aris’ method of moments to characterise the unsteady propagation of the mean axial position and the unsteady growth of the variance of the solute zone in all time regimes. We benchmark our predictions with Brownian dynamics simulations across a wide and relevant dynamical regime, including various time scales. Lastly, we derive expressions for the optimal relative magnitudes of electroosmotic versus pressure-driven flow and the optimum Péclet number to minimise dispersion across all time scales. These findings offer valuable insights for the design of chemical separation systems, including the optimisation of capillary electrophoresis devices and electrokinetic microchannels and nanochannels.
People with severe mental illness (SMI) have a higher risk of premature mortality than the general population.
Aims
To investigate whether the life expectancy gap for people with SMI is widening, by determining time trends in excess life-years lost.
Method
This population-based study included people with SMI (schizophrenia, bipolar disorder and major depression) alive on 1 January 2000. We ascertained SMI from psychiatric hospital admission records (1981–2019), and deaths via linkage to the national death register (2000–2019). We used the Life Years Lost (LYL) method to estimate LYL by SMI and sex, compared LYL to the Scottish population and assessed trends over 18 3-year rolling periods.
Results
We included 28 797 people with schizophrenia, 16 657 with bipolar disorder and 72 504 with major depression. Between 2000 and 2019, life expectancy increased in the Scottish population but the gap widened for people with schizophrenia. For 2000–2002, men and women with schizophrenia lost an excess 9.4 (95% CI 8.5–10.3) and 8.2 (95% CI 7.4–9.0) life-years, respectively, compared with the general population. In 2017–2019, this increased to 11.8 (95% CI 10.9–12.7) and 11.1 (95% CI 10.0–12.1). The life expectancy gap was lower for bipolar disorder and depression and unchanged over time.
Conclusions
The life expectancy gap in people with SMI persisted or widened from 2000 to 2019. Addressing this entrenched disparity requires equitable social, economic and health policies, healthcare re-structure and improved resourcing, and investment in interventions for primary and secondary prevention of SMI and associated comorbidities.
We perform direct numerical simulations of sub-Kolmogorov, inertial spheroids settling under gravity in homogeneous, isotropic turbulence, and find that small-scale clustering, measured via the correlation dimension, depends sensitively on the spheroid aspect ratio. In particular, such spheroids are shown to cluster more as their anisotropy increases. Further, the approach rate for pairs of spheroids is calculated and found to deviate significantly from the spherical-particle limit. Our study, spanning a range of Stokes numbers and aspect ratios, provides critical inputs for developing collision models to understand the dynamics of sedimenting, anisotropic particles in general, and ice crystals in clouds in particular.
Transthoracic intracardiac lines provide a unique access point for postoperative monitoring and management in paediatric cardiothoracic surgeries, particularly within the single ventricle population where preserving vasculature is crucial for future interventions. This retrospective review examined paediatric single ventricle patients undergoing cardiothoracic surgeries at a tertiary children’s hospital between 2011 and 2018, focusing on the use of and factors associated with transthoracic line complications (infection, thrombosis, malfunction, and migration). A total of 338 lines were placed during the study period, with the majority occurring during palliative surgeries (86.5%). Lines remained in place for a median of 14 days postoperatively. Complications occurred in 21 lines (6.2%), comprising 8 migrations (2.4%), 7 thrombosis (2.1%), 4 malfunctions (1.2%), and 2 infections (0.6%). The presence of a surgical shunt was significantly associated with line complications (odds ratio 2.58, confidence interval 1.05 – 6.31; P 0.03). The use of transthoracic intracardiac lines seems to be safe and should be considered as a primary alternative to other central lines in the single ventricle population. A prospective assessment of transthoracic line complications, along with delineation of unit protocols, may further enhance outcomes in this complex population.
This Element seeks to provide an in-depth survey of the papers written on the optimal taxation of the incomes of the members of family households, as opposed to households with just a single individual, over the period beginning with the early 1980s and ending in the late 2010s.This literature, solidly within the public finance tradition, is not large, and so the Element gives quite a full exposition and discussion of the main contributions. The papers are grouped according to the type of tax system they have dealt with: linear, piecewise linear and non-linear taxation.
HOPE (National Institute for Health and Care Research Global Health Research Group on Homelessness and Mental Health in Africa) aims to develop and evaluate interventions that address the unmet needs of people who are homeless and have severe mental illness (SMI) living in three African countries in ways that are rights-based, contextually grounded, scalable and sustainable.
Methods
We will work in the capital city (Addis Ababa) in Ethiopia, a regional city (Tamale) in Ghana, and the capital city (Nairobi) and a rural county (Makueni) in Kenya to understand different approaches to intervention needed across varied settings.
We will be guided by the MRC/NIHR framework on complex interventions and implementation frameworks and emphasise co-production. Formative work will include synthesis of global evidence (systematic review, including grey literature, and a Delphi consensus exercise) on interventions and approaches to homelessness and SMI. We will map contexts; conduct focused ethnography to understand lived experiences of homelessness and SMI; carry out a cross-sectional survey of people who are homeless (n = 750 Ghana/Ethiopia; n = 350 Kenya) to estimate prevalence of SMI and identify prioritised needs; and conduct in-depth interviews and focus group discussions with key stakeholders to understand experiences, challenges and opportunities for intervention. This global and local evidence will feed into Theory of Change (ToC) workshops with stakeholders to establish agreement about valued primary outcomes, map pathways to impact and inform selection and implementation of interventions. Intervention packages to address prioritised needs will be co-produced, piloted and optimised for feasibility and acceptability using participatory action research. We will use rights-based approaches and focus on community-based care to ensure sustainability. Realist approaches will be employed to analyse how contextual variation affects mechanisms and outcomes to inform methods for a subsequent evaluation of larger scale implementation. Extensive capacity-strengthening activities will focus on equipping early career researchers and peer researchers. People with lived experience of SMI and policymakers are an integral part of the research team. Community engagement is supported by working closely with multisectoral Community Advisory Groups.
Conclusions
HOPE will develop evidence to support action to respond to the needs and preferences of people experiencing homelessness and SMI in diverse settings in Africa. We are creating a new partnership of researchers, policymakers, community members and people with lived experience of SMI and homelessness to enable African-led solutions. Key outputs will include contextually relevant practice and policy guidance that supports achievement of inclusive development.
Improved understanding of the cognitive and behavioural processes underpinning panic disorder (PD) in adolescents could improve identification and treatment.
Aims:
We investigated whether the processes outlined in Clark’s (1986) cognitive model of PD are observed in adolescents with PD, are specific to PD, and predict symptom severity.
Method:
We recruited three groups of adolescents (12–17 years): 34 with a PD diagnosis, 33 with another anxiety disorder excluding PD (‘clinical control’), and 34 scoring below the clinical cut-off on a measure of anxiety symptoms (‘community control’). Participants self-reported on measures of PD symptom severity, catastrophic cognitions, bodily sensation fear, and safety-seeking behaviours.
Results:
The PD group reported significantly higher levels of catastrophic cognitions and safety-seeking behaviours than both control groups. They reported significantly higher levels of bodily sensation fear compared with the community but not the clinical control group. All process measures positively predicted PD symptom severity across all groups.
Conclusions:
We found evidence of catastrophic cognitions and safety-seeking behaviours as PD-specific processes in adolescents which predict symptom severity. Bodily sensation fear also predicted symptom severity. Findings support Clark’s cognitive model of PD in adolescents and suggest that catastrophic cognitions and safety behaviours may be targets for adolescent PD treatment.
Granular surface flows are frequently encountered in nature as well as during handling of powders in different industries. An experimental study of granular surface flow on a heap is carried out. The heap is formed by pouring nearly monodisperse spherical particles from the rectangular slit orifice of a hopper on a rough rectangular plate. A flow of particles is developed on the heap surface, which is planar in the central region, with particles flowing over the edge of the plate into a collection chamber. The geometry considered in this study is an example of a fully three-dimensional heap without side walls. The surface velocities of the particles are measured using high-speed videography and particle tracking velocimetry for different mass flow rates with steel balls and glass beads of two different sizes, for heaps of different aspect ratios. The flow is uni-directional and fully developed in a central zone on the heap surface. The flowing layer thickness is measured in this zone by immersing a soot-coated blade into the flow. The angle of inclination of the free surface of the heap is found to be nearly constant for a ten-fold increase of the mass flow rate. The scaled flowing layer thickness is found to vary linearly with the scaled flow rate and the data for all the particles collapse to a single line over a ten-fold increase in the scaled flow rate and an increase in the aspect ratio of the heap by a factor of 1.75. The predicted scaled surface velocity and scaled shear rate using this correlation match the measured values.
Polar ring galaxies (PRGs) are a unique class of galaxies characterised by a ring of gas and stars orbiting nearly orthogonal to the main body. This study delves into the evolutionary trajectory of PRGs using the exemplary trio of NGC 3718, NGC 2685, and NGC 4262. We investigate the distinct features of PRGs by analysing their ring and host components to reveal their unique characteristics through spectral energy distribution (SED) fitting. Using CIGALE, we performed SED fitting to independently analyse the ring and host spatially resolved regions, marking the first decomposed SED analysis for PRGs, which examines stellar populations using high-resolution observations from AstroSat UVIT at a resolved scale. The UV-optical surface profiles provide an initial idea that distinct patterns in the galaxies, with differences in FUV and NUV, suggest three distinct stages of ring evolution in the selected galaxies. The study of resolved-scale stellar regions reveals that the ring regions are generally younger than their host galaxies, with the age disparity progressively decreasing along the evolutionary sequence from NGC 3718 to NGC 4262. Star formation rates (SFR) also exhibit a consistent pattern, with higher SFR in the ring of NGC 3718 compared to the others, and a progressive decrease through NGC 2685 and NGC 4262. Finally, the representation of the galaxies in the HI gas fraction versus the NUV–$\text r$ plane supports the idea that they are in three different evolutionary stages of PRG evolution, with NGC 3718 in the initial stage, NGC 2685 in the intermediate stage, and NGC 4262 representing the final stage. This study concludes that PRGs undergo various evolutionary stages, as evidenced by the observed features in the ring and host components. NGC 3718, NGC 2685, and NGC 4262 represent different stages of this evolution, highlighting the dynamic nature of PRGs and emphasising the importance of studying their evolutionary processes to gain insights into galactic formation and evolution.
Despite current and predicted ongoing primary health care (PHC) nursing workforce shortages, the undergraduate nursing curricula in Australasia and internationally remain largely directed towards acute care. Additionally, the efforts of schools of nursing in supporting the career development of new graduate nurses and their transition to practice also remain largely focused on employment in acute care tertiary settings. Registered nurses are integral members of the multidisciplinary PHC team and fulfil various roles. These roles include managing acute presentations, coordinating care for people with complex chronic conditions, providing preventive care, promoting the health of individuals and communities, and supporting end-of-life care.
We run a laboratory experiment to test the concept of coarse correlated equilibrium (Moulin and Vial in Int J Game Theory 7:201–221, 1978), with a two-person game with unique pure Nash equilibrium which is also the solution of iterative elimination of strictly dominated strategies. The subjects are asked to commit to a device that randomly picks one of three symmetric outcomes (including the Nash point) with higher ex-ante expected payoff than the Nash equilibrium payoff. We find that the subjects do not accept this lottery (which is a coarse correlated equilibrium); instead, they choose to play the game and coordinate on the Nash equilibrium. However, given an individual choice between a lottery with equal probabilities of the same outcomes and the sure payoff as in the Nash point, the lottery is chosen by the subjects. This result is robust against a few variations. We explain our result as selecting risk-dominance over payoff dominance in equilibrium.
This article uncovers the journey of a Nepal educator, poet, and writer who found inspiration in a Japanese philosopher's search for the self through love, care, happiness, and the “golden” moments of life. Nandu Uprety opened Kenji's International School to follow Miyazawa Kenji's philosophy of humanity, working for people experiencing poverty, developing society, and nurturing nature. This is not to say that Nandu Uprety did not face challenges, as he sold all his property for this school and never sought donations. Yet he adored the blooming flowers in the gardens, the echoes of Sirbuba, and the happiness in the children's smiles.
How did literature and politics blend in nineteenth-century oratory? This chapter argues that the admixture was always particular. Thus it begins by explicating three moments of ordinary oratorical practice in Philadelphia in 1855: a gubernatorial inaugural by James Pollock, an oration by the student Jacob C. White Jr. at the Institute for Colored Youth, and a speech by delegate Mary Ann Shadd at the Colored National Convention. Themes germane to nineteenth-century oratory emerge from these examples: its ubiquity and variety, the interactions of oratorical and print cultures, the critical role of audiences in producing meanings of oratorical events, and the ephemeral characteristics of embodied performance. Further, the emphasis in these examples on freedom, citizenship, learning, leadership, and democratic life highlights political debates on racial justice, slavery, colonization, and emigration, demonstrating the myriad ways in which oratory in the nineteenth-century United States can supply an avenue into culture, voice, and lived experience that helps explain trajectories to our own time.