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This article analyses the struggle for possession of the House of Baha’u’llah in Baghdad during the 1920s and 1930s. One of the Bahai religion’s most sacred sites, the House of Baha’u’llah was the subject of protracted legal and political-diplomatic disputes following efforts by anti-Bahai activists to appropriate it from its Bahai custodians in 1921. The ensuing case touched almost every facet of the Iraqi judicial system, galvanised the international Bahai community and captured the attention of the British colonial state, the Iraqi government and the League of Nations. This article explores the causes and implications of the dispute, which can be considered one of the first incidents of religious persecution in modern Iraq. Rather than explaining the incident with reference to the intolerant attitudes of the Shi`i majority, the article argues for the role of the institutions of colonial modernity – the Mandates system, the new minorities regime, the praxis and discourse of colonial expansion, and the internationalism of the interwar period – for the unravelling of the case itself and for affecting modern, secular articulations of anti-Bahai prejudice.
In RISE, TV46000 once monthly (q1m) or once every 2 months (q2m) significantly extended time to impending schizophrenia relapse. The current study (SHINE, NCT03893825) evaluated the long-term safety, tolerability, and effect of TV46000.
Methods
Patients completing RISE without relapse (rollover) or newly recruited (de novo) were eligible. The de novo and placebo rollover cohorts were randomized 1:1 to q1m or q2m for ≤56 weeks; the TV46000 rollover cohort continued assigned regimen. Exploratory efficacy endpoints included time to impending relapse and patient centered outcomes (PCOs) including Schizophrenia Quality of Life Scale (SQLS).
Results
334 patients were randomized and received TV46000 q1m (n=172) or q2m (n=162), for 202.3 patient-years [PY] of TV-46000 treatment. Treatment-emergent adverse events (AEs) reported for ≥5% of patients were: overall–injection site pain (event rate/100 PY, n [%]; 23.23, 16 [5%]); de novo (n=109)–injection site pain (56.10, 11 [10%]), injection site nodule (16.03, 6 [6%]), blood creatine phosphokinase increased (16.03, 8 [7%]), urinary tract infection (10.69, 7 [6%]); placebo rollover (n=53)–tremor (18.50, 5 [9%]); TV46000 rollover (n=172)–headache (7.97, n=8 [5%]). Serious AEs reported for ≥2 patients were worsening schizophrenia and hyperglycemia. Kaplan– Meier estimates for remaining relapse-free at week 56 were 0.98 (2% risk; q1m) and 0.88 (12%; q2m). SQLS improved for q1m (least-squares mean change [SE], − 2.16 [0.98]) and q2m (− 0.43 [0.98]); other PCOs (5Level EuroQoL 5Dimensions Questionnaire, Personal and Social Performance Scale, Drug Attitudes Inventory 10-item version) remained stable.
Conclusions
TV-46000 had a favorable long-term benefit–risk profile in patients with schizophrenia.
There is growing interest in lifestyle interventions as stand-alone and add-on therapies in mental health care due to their potential benefits for both physical and mental health outcomes. We evaluated lifestyle interventions focusing on physical activity, diet, and sleep in adults with severe mental illness (SMI) and the evidence for their effectiveness. To this end, we conducted a meta-review and searched major electronic databases for articles published prior to 09/2022 and updated our search in 03/2024. We identified 89 relevant systematic reviews and assessed their quality using the SIGN checklist. Based on the findings of our meta-review and on clinical expertise of the authors, we formulated seven recommendations. In brief, evidence supports the application of lifestyle interventions that combine behavioural change techniques, dietary modification, and physical activity to reduce weight and improve cardiovascular health parameters in adults with SMI. Furthermore, physical activity should be used as an adjunct treatment to improve mental health in adults with SMI, including psychotic symptoms and cognition in adults with schizophrenia or depressive symptoms in adults with major depression. To ameliorate sleep quality, cognitive behavioural informed interventions can be considered. Additionally, we provide an overview of key gaps in the current literature. Future studies should integrate both mental and physical health outcomes to reflect the multi-faceted benefits of lifestyle interventions. Moreover, our meta-review highlighted a relative dearth of evidence relating to interventions in adults with bipolar disorder and to nutritional and sleep interventions. Future research could help establish lifestyle interventions as a core component of mental health care.
Understanding characteristics of healthcare personnel (HCP) with SARS-CoV-2 infection supports the development and prioritization of interventions to protect this important workforce. We report detailed characteristics of HCP who tested positive for SARS-CoV-2 from April 20, 2020 through December 31, 2021.
Methods:
CDC collaborated with Emerging Infections Program sites in 10 states to interview HCP with SARS-CoV-2 infection (case-HCP) about their demographics, underlying medical conditions, healthcare roles, exposures, personal protective equipment (PPE) use, and COVID-19 vaccination status. We grouped case-HCP by healthcare role. To describe residential social vulnerability, we merged geocoded HCP residential addresses with CDC/ATSDR Social Vulnerability Index (SVI) values at the census tract level. We defined highest and lowest SVI quartiles as high and low social vulnerability, respectively.
Results:
Our analysis included 7,531 case-HCP. Most case-HCP with roles as certified nursing assistant (CNA) (444, 61.3%), medical assistant (252, 65.3%), or home healthcare worker (HHW) (225, 59.5%) reported their race and ethnicity as either non-Hispanic Black or Hispanic. More than one third of HHWs (166, 45.2%), CNAs (283, 41.7%), and medical assistants (138, 37.9%) reported a residential address in the high social vulnerability category. The proportion of case-HCP who reported using recommended PPE at all times when caring for patients with COVID-19 was lowest among HHWs compared with other roles.
Conclusions:
To mitigate SARS-CoV-2 infection risk in healthcare settings, infection prevention, and control interventions should be specific to HCP roles and educational backgrounds. Additional interventions are needed to address high social vulnerability among HHWs, CNAs, and medical assistants.
The present study examined the longitudinal associations between three dimensions of temperament – activity, affect-extraversion, and task orientation – and childhood aggression. Using 131 monozygotic and 173 dizygotic (86 same-sex) twin pairs from the Louisville Twin Study, we elucidated the ages, from 6 to 36 months, at which each temperament dimension began to correlate with aggression at age 7. We employed latent growth modeling to show that developmental increases (i.e., slopes) in activity were positively associated with aggression, whereas increases in affect-extraversion and task orientation were negatively associated with aggression. Genetically informed models revealed that correlations between temperament and aggression were primarily explained by common genetic variance, with nonshared environmental variance accounting for a small proportion of each correlation by 36 months. Genetic variance explained the correlations of the slopes of activity and task orientation with aggression. Nonshared environmental variance accounted for almost half of the correlation between the slopes of affect-extraversion and aggression. Exploratory analyses revealed quantitative sex differences in each temperament-aggression association. By establishing which dimensions of temperament correlate with aggression, as well as when and how they do so, our work informs the development of future child and family interventions for children at highest risk of aggression.
We develop and analyse a continuum model of two-phase slurry dynamics for planetary cores. Mixed solid–liquid slurry regions may be ubiquitous in the upper cores of small terrestrial bodies and have also been invoked to explain anomalous seismic structure in the F-layer at the base of Earth's liquid iron core. These layers are expected to influence the dynamics and evolution of planetary cores, including their capacity to generate global magnetic fields; however, to date, models of two-phase regions in planetary cores have largely ignored the complex fluid dynamics that arises from interactions between phases. As an initial application of our model, and to focus on fundamental fluid dynamical processes, we consider a non-rotating and non-magnetic slurry comprised of a single chemical component with a temperature that is tied to the liquidus. We study one-dimensional solutions in a configuration set up to mimic Earth's F-layer, varying gravitational strength $R$, the solid/liquid viscosity ratio $\lambda _{\mu }$ and the interaction parameter $K$, which measures friction between the phases. We develop scalings describing behaviour in the limit $R \gg 1$ and $\lambda _{\mu } \gg 1$, which are in excellent agreement with our numerical results. Application to Earth's core, where $R \sim 10^{28}$ and $\lambda _{\mu } \sim 10^{22}$, suggests that a pure iron slurry F-layer would contain a mean solid fraction of at most 5 %.
Skin-based samples (leather, skin, and parchment) in archaeological, historic and museum settings are among the most challenging materials to radiocarbon (14C) date in terms of removing exogenous carbon sources—comparable to bone collagen in many respects but with much less empirical study to guide pretreatment approaches. In the case of leather, the 14C content of materials used in manufacturing the leather can vary greatly. The presence of leather manufacturing chemicals before pretreatment and their absence afterward is difficult to demonstrate, and the accuracy of dates depends upon isolating the original animal proteins and removing exogenous carbon. Parchments differ in production technique from leather but include similar unknowns. It is not clear that lessons learned in the treatment of one are always salient for treating the other. We measured the 14C content of variously pretreated leather, parchment, skin samples, and extracts, producing apparent ages that varied by hundreds or occasionally thousands of years depending upon sample pretreatment. Fourier Transform Infrared Spectroscopy (FTIR) and C:N ratios provided insight into the chemical composition of carbon reservoirs contributing to age differences. The results of these analyses demonstrated that XAD column chromatography resulted in the most accurate 14C dates for leather and samples of unknown tannage, and FTIR allowed for the detection of contamination that might have otherwise been overlooked.
Daily rhythms are primarily synchronized by the suprachiasmatic nucleus (SCN) in the hypothalamus, the body’s central circadian clock. The SCN aligns whole-body cellular, behavioral and phenomenological processes with the Earth’s 24-hour day/night rhythm. When disruptions to the SCN’s perceptual system occur (e.g., “jet-lag,” prolonged waking, chronic exposure to light at night or habit change as the result of becoming a parent), disrupted melatonin and glucocorticoid secretion can lead to widespread dysregulation of sleep and circadian cycling. The effects of circadian disruptions are often compounded by the homeostatic sleep drive, wherein sleep pressure accumulates with protracted wakefulness to affect mood, cognition, health and well-being.
Background: The NHSN Antimicrobial Resistance (AR) Option is an important avenue for acute-care hospitals to electronically report facilitywide antibiogram data. The NEDSS Base System (NBS) is the statewide surveillance system for mandatory reporting of all carbapenem-resistant Enterobacteriaceae (CRE) cases. The state health department (SHD) validated CRE case data reported through the AR Option to assess completeness and accuracy. Methods: NHSN AR Option data from July 2020–December 2021 for 24 facilities were validated by comparing reported CRE and susceptibility results to CRE isolates reported via the NBS. Isolates were matched based on specimen date, sex, birth month and day, pathogen, and specimen source. NHSN susceptibility results were dichotomized as “not resistant” and “resistant” to match the NBS results. Susceptibility discordance (differing proportions of resistant isolates) of matched pairs were evaluated using the McNemar exact test in SAS version 9.4 software. Results: The SHD identified 270 CRE cases from the NHSN and 1,254 unique CRE isolates from the NBS. Of the NHSN events, 72 (26.67%) were matched to the NBS. Among matched isolates, discordance was significant for doripenem (0 resistant isolates in the NHSN vs 13 in the NBS; P < .001) and imipenem (5 resistant isolates in the NHSN vs 23 in the NBS; P < .0001). Discordance was not significant for ertapenem nor meropenem. Sensitivity analyses maximized the match rate at 30.74% (83 matches) when NBS isolates from unknown sources were included and matching factors were specimen date and date of birth ± 1 day, and pathogen. Among all 6,325 CRE isolates in NBS, 290 (4.58%) did not have a specimen source provided. Of all 47,348 NHSN events, 7,624 (16.10%) had impossible patient birthdays. Conclusions: Many NHSN isolates could not be matched to NBS due to either isolates being missing from NBS or to data differences across the systems. This mismatch highlights the need for data validation and standardization at the point of entry for both systems. Discordant susceptibility outcomes raise concerns about using the NHSN as a method for facility and regional antibiogram data.
The NIH National Center for Advancing Translational Science (NCATS) was established to support translational research that spans the entire TS Continuum, with the goal of bridging the gap between preclinical biomedical research and real-world applications to advance treatments to patients more quickly. In 2018, the Translational Science Training (TST) TL1 Program at the University of Texas Health Science Center at San Antonio implemented new strategies to better include and encourage research more broadly across the TS Continuum, including the addition of postdoctoral scientists and a clinically trained Program Co-Director, expansion of team science and community engagement programming, and targeted trainee recruitment from schools of nursing, dentistry, and allied health, in addition to medicine. The objective of this bibliometric analysis was to determine if the program exhibited a more diverse mix of T-types after the adjustments made in 2018. The TST/TL1 Program experienced a shift in T-type, from mostly T0 (preclinical) to more T3/T4 (clinical implementation/public health) research, after new strategies were implemented. This supports the conclusion that strategic programmatic adjustments by an NCATS-funded predoctoral training program resulted in outcomes that better align with NCATS priorities to develop Trainees who contribute across the entire TS Continuum.
To characterize residential social vulnerability among healthcare personnel (HCP) and evaluate its association with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection.
Design:
Case–control study.
Setting:
This study analyzed data collected in May–December 2020 through sentinel and population-based surveillance in healthcare facilities in Colorado, Minnesota, New Mexico, New York, and Oregon.
Participants:
Data from 2,168 HCP (1,571 cases and 597 controls from the same facilities) were analyzed.
Methods:
HCP residential addresses were linked to the social vulnerability index (SVI) at the census tract level, which represents a ranking of community vulnerability to emergencies based on 15 US Census variables. The primary outcome was SARS-CoV-2 infection, confirmed by positive antigen or real-time reverse-transcriptase– polymerase chain reaction (RT-PCR) test on nasopharyngeal swab. Significant differences by SVI in participant characteristics were assessed using the Fisher exact test. Adjusted odds ratios (aOR) with 95% confidence intervals (CIs) for associations between case status and SVI, controlling for HCP role and patient care activities, were estimated using logistic regression.
Results:
Significantly higher proportions of certified nursing assistants (48.0%) and medical assistants (44.1%) resided in high SVI census tracts, compared to registered nurses (15.9%) and physicians (11.6%). HCP cases were more likely than controls to live in high SVI census tracts (aOR, 1.76; 95% CI, 1.37–2.26).
Conclusions:
These findings suggest that residing in more socially vulnerable census tracts may be associated with SARS-CoV-2 infection risk among HCP and that residential vulnerability differs by HCP role. Efforts to safeguard the US healthcare workforce and advance health equity should address the social determinants that drive racial, ethnic, and socioeconomic health disparities.
Mosquito surveillance programmes are essential to assess the risks of local vector-borne disease outbreaks as well as for early detection of mosquito invasion events. Surveys are usually performed with traditional sampling tools (i.e., ovitraps and dipping method for immature stages or light or decoy traps for adults). Over the past decade, numerous studies have highlighted that environmental DNA (eDNA) sampling can enhance invertebrate species detection and provide community composition metrics. However, the usefulness of eDNA for detection of mosquito species has, to date, been largely neglected. Here, we sampled water from potential larval breeding sites along a gradient of anthropogenic perturbations, from the core of an oil palm plantation to the rainforest on São Tomé Island (Gulf of Guinea, Africa). We showed that (i) species of mosquitoes could be detected via metabarcoding mostly when larvae were visible, (ii) larvae species richness was greater using eDNA than visual identification and (iii) new mosquito species were also detected by the eDNA approach. We provide a critical discussion of the pros and cons of eDNA metabarcoding for monitoring mosquito species diversity and recommendations for future research directions that could facilitate the adoption of eDNA as a tool for assessing insect vector communities.
We provide an overview of diagnostic stewardship with key concepts that include the diagnostic pathway and the multiple points where interventions can be implemented, strategies for interventions, the importance of multidisciplinary collaboration, and key microbiologic diagnostic tests that should be considered for diagnostic stewardship. The document focuses on microbiologic laboratory testing for adult and pediatric patients and is intended for a target audience of healthcare workers involved in diagnostic stewardship interventions and all workers affected by any step of the diagnostic pathway (ie, ordering, collecting, processing, reporting, and interpreting results of a diagnostic test). This document was developed by the Society for Healthcare Epidemiology of America Diagnostic Stewardship Taskforce.
The impact of Indigenous populations on historical fire regimes has been controversial and beset by mismatches in the geographic scale of paleofire reconstructions and the scale of land-use behaviors. It is often assumed that anthropogenic burning is linearly related to population density and not different cultural practices. Here we take an off-site geoarchaeology strategy to reconstruct variability in historical fire regimes (<1000 years ago) at geographic scales that match the archaeological, ethnohistorical, and oral tradition evidence for variability in the intensity of Indigenous land use by two different cultural groups (Ancestral Pueblo and Western Apache). We use multiple, independent proxies from three localities in ponderosa pine (Pinus ponderosa) forests in east-Central Arizona to reconstruct fire regime variability during four phases of cultural use of different intensities. Elevated charcoal with domesticate pollen (Zea spp.) but otherwise unchanged forest pollen assemblages characterized intensive land use by Ancestral Pueblo people during an early phase, suggesting fire use to support agricultural activities. By contrast, a phase of intensive pre-reservation Western Apache land use corresponded to little change in charcoal, but had elevated ash-derived phosphorus and elevated grass and ruderal pollen suggestive of enhanced burning in fine fuels to promote economically important wild plants.
There is substantial variation in patient symptoms following psychological therapy for depression and anxiety. However, reliance on endpoint outcomes ignores additional interindividual variation during therapy. Knowing a patient's likely symptom trajectories could guide clinical decisions. We aimed to identify latent classes of patients with similar symptom trajectories over the course of psychological therapy and explore associations between baseline variables and trajectory class.
Methods
Patients received high-intensity psychological treatment for common mental health problems at National Health Service Improving Access to Psychological Therapies services in South London (N = 16 258). To identify trajectories, we performed growth mixture modelling of depression and anxiety symptoms over 11 sessions. We then ran multinomial regressions to identify baseline variables associated with trajectory class membership.
Results
Trajectories of depression and anxiety symptoms were highly similar and best modelled by four classes. Three classes started with moderate-severe symptoms and showed (1) no change, (2) gradual improvement, and (3) fast improvement. A final class (4) showed initially mild symptoms and minimal improvement. Within the moderate-severe baseline symptom classes, patients in the two showing improvement as opposed to no change tended not to be prescribed psychotropic medication or report a disability and were in employment. Patients showing fast improvement additionally reported lower baseline functional impairment on average.
Conclusions
Multiple trajectory classes of depression and anxiety symptoms were associated with baseline characteristics. Identifying the most likely trajectory for a patient at the start of treatment could inform decisions about the suitability and continuation of therapy, ultimately improving patient outcomes.
A numerical investigation is undertaken on the development of linear disturbances in the rotating disk boundary layer, in which a time-periodic modulation is applied to the disk rotation rate. The model gives a prototypical example of a three-dimensional oscillatory boundary layer, by adding a Stokes layer to the von Kármán flow that develops on a steady disk. The study extends the Floquet analysis of Morgan et al. (J. Fluid Mech., vol. 925, 2021, A20), who showed that disk modulation stabilises the stationary convective instabilities found on the steady rotating disk. Using a radial homogeneous flow approximation, whereby the radial dependence of the basic state is ignored, disturbance development is simulated for several modulation settings, with flow conditions matched to both convective and absolute forms of linear instability. Disturbances excited via a stationary periodic wall forcing display behaviour consistent with that found using Floquet theory; time-periodic modulation stabilises the cross-flow instability by reducing the radial growth rate. In addition, convective and absolute instabilities, generated by an impulsive wall forcing, are both stabilised by the introduction of modulation to the disk rotation rate. Modulation establishes a significant reduction in both the temporal growth rate and the disturbance amplitude as it propagates away from the impulse origin. Moreover, greater stabilising control benefits are realised as the modulation amplitude increases.
Heart attacks (HAs) present clinically with varying symptoms, which are not always described by patients as chest pain (CP) or chest discomfort (CD). Emergency Medical Dispatchers (EMDs) select the CP/CD dispatch protocol for non-chest pain HA symptoms or classic HA complaint of CP/CD. Nevertheless, it is still unknown how often callers report HA symptoms other than CP/CD.
Objectives:
The objective of this study was to characterize the caller’s descriptions of the primary HA symptoms, descriptions of the other HA symptoms, and the use of a case entry (CE) question clarifier.
Methods:
A retrospective descriptive study analyzed randomly selected EMD audios (where CD/CD protocol was used) from five accredited emergency communication centers in the United States. Several Quality Performance Review (QPR) experts reviewed the audios and recorded callers’ initial problem descriptions, the use of and responses to the CE question clarifier, including the EMD-assigned final determinant code.
Results:
A total of 1,261 audios were reviewed. The clarifier was used only 8.5% of the time. The CP/CD symptoms were mentioned alone or with other problems 87.0% of the time. Overall, CP symptom was mentioned alone 70.8%, HA alone 4.0%, and CD symptom alone 1.4% of the time.
Conclusion:
9-1-1 callers report potential HA cases using a variety of terms and descriptions—most commonly CP. Other less-common symptoms associated with a HA may be mentioned. Therefore, EMDs must be well-trained to be prepared to probe the caller with a clarifying query to elicit more specific information when “having a heart attack” is the only complaint initially mentioned.
Anxiety and depressive disorders can be chronic and disabling. Although there are effective treatments, only a fraction of those impaired receive treatment. Predictors of treatment-seeking and treatment receipt could be informative for initiatives aiming to tackle the burden of untreated anxiety and depression.
Aims
To investigate sociodemographic characteristics associated with treatment-seeking and treatment receipt.
Method
Two binary retrospective reports of lifetime treatment-seeking (n = 44 810) and treatment receipt (n = 37 346) were regressed on sociodemographic factors (age, gender, UK ethnic minority background, educational attainment, household income, neighbourhood deprivation and social isolation) and alternative coping strategies (self-medication with alcohol/drugs and self-help) in UK Biobank participants with lifetime generalised anxiety or major depressive disorder. Analyses were also stratified by gender.
Results
Treatment access was more likely in those who reported use of self-help strategies, with university-level education and those from less economically advantaged circumstances (household income <£30 000 and greater neighbourhood deprivation). Treatment access was less likely in those who were male, from a UK ethnic minority background and with high household incomes (>£100 000). Men who self-medicated and/or had a vocational qualification were also less likely to seek treatment.
Conclusions
This work on retrospective reports of treatment-seeking and treatment receipt at any time of life replicates known associations with treatment-seeking and treatment receipt during time of treatment need. More work is required to understand whether improving rates of treatment-seeking improves prognostic outcomes for individuals with anxiety or depression.