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Posttraumatic stress disorder (PTSD) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset PTSD diagnosis and changes in PTSD symptom severity over time were associated with changes in two metrics of epigenetic aging over two time points.
Methods
We conducted meta-analyses of the association between change in PTSD diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (total N = 1,367).
Results
Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset PTSD over time was significantly associated with Horvath age residuals at T2 (meta β = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in PTSD symptom severity over time was significantly related to Horvath age residuals at T2 (meta β = 0.24, meta p = 0.05). No associations were observed for GrimAge residuals.
Conclusions
Results indicated that individuals who developed new-onset PTSD or showed increased PTSD symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that PTSD may accelerate biological aging over time and highlights the need for intervention studies to determine if PTSD treatment has a beneficial effect on the aging methylome.
Objectives/Goals: Depression is common among people living with HIV (PLWH). This study explored the link between reduced metacognitive awareness and depression in PLWH. It utilized a positive emotion regulation task to compare brain activation during viewing versus upregulating positive emotions. Methods/Study Population: Depressed PLWH (N = 24; mean age = 53; HAM-D mean = 19) participated in an emotion regulation task while blood oxygen-level-dependent (BOLD) responses were recorded. In the emotional regulation task, participants were shown the International Affective Picture System (IAPS) a series of positive, negative, and neutral images. Participants were asked to view these images and given instructions to either negatively reappraise (RN) or positively reappraise (RP). In the RP condition, participants were no longer shown the image and asked to upregulate their positive emotional responses associated with it. Ten onset times were included for each trial. Results/Anticipated Results: A one-sample t-test was conducted to analyze contrasts between reappraisal of positive images and viewing positive images (RP > VP). Results showed significantly greater activation in the posterior cingulate and angular gyrus during the RP condition (peak MNI: 18, -52, 34; p < 0.001, uncorrected, k > 10 voxels). In comparing the reappraisal of negative images to viewing negative images (RN > VN), there was increased activation in the right supramarginal gyrus (peak MNI: 50, -28, 22; p < 0.001, uncorrected, k > 10 voxels). When contrasting the reappraisal of positive to negative images (RP > RN), BOLD signals were higher in the left dorsolateral prefrontal cortex (peak MNI: 40, -38, 32; p < 0.001, uncorrected, k > 10 voxels). Discussion/Significance of Impact: Findings underscore that depressed PLWH demonstrates BOLD responses in brain regions linked to appetitive motivation and meta-cognitive awareness during the RP condition which demands more executive resources among those with depression, highlighting the complexity of emotional regulation in this population.
War, captives, and human sacrifice were parts of Late Postclassic (AD 1250–1524) Maya culture in highland Guatemala. Las Casas (1958:152) wrote that the supreme lord “put the heads of the sacrificed on some poles on a certain altar dedicated only to this, where they had these for some time, after which they buried them.” These cultural aspects show up in human remains excavated at Iximche’, the Kaqchikel Maya capital. Here, we integrate previously published and unpublished results of stable isotope analyses and explore their implications for diets and the geographic origins of individuals who were buried at the site on the eve of the Spanish conquest. Data from Iximche’ are compared with available results from other ancient Maya sites.
To quantify the impact of patient- and unit-level risk adjustment on infant hospital-onset bacteremia (HOB) standardized infection ratio (SIR) ranking.
Design:
A retrospective, multicenter cohort study.
Setting and participants:
Infants admitted to 284 neonatal intensive care units (NICUs) in the United States between 2016 and 2021.
Methods:
Expected HOB rates and SIRs were calculated using four adjustment strategies: birthweight (model 1), birthweight and postnatal age (model 2), birthweight and NICU complexity (model 3), and birthweight, postnatal age, and NICU complexity (model 4). Sites were ranked according to the unadjusted HOB rate, and these rankings were compared to rankings based on the four adjusted SIR models.
Results:
Compared to unadjusted HOB rate ranking (smallest to largest), the number and proportion of NICUs that left the fourth quartile (worst-performing) following adjustments were as follows: adjusted for birthweight (16, 22.5%), birthweight and postnatal age (19, 26.8%), birthweight and NICU complexity (22, 31.0%), birthweight, postnatal age and NICU complexity (23, 32.4%). Comparing NICUs that moved into the better-performing quartiles after birthweight adjustment to those that remained in the better-performing quartiles regardless of adjustment, the median percentage of low birthweight infants was 17.1% (Interquartile Range (IQR): 15.8, 19.2) vs 8.7% (IQR: 4.8, 12.6); and the median percentage of infants who died was 2.2% (IQR: 1.8, 3.1) vs 0.5% (IQR: 0.01, 12.0), respectively.
Conclusion:
Adjusting for patient and unit-level complexity moved one-third of NICUs in the worst-performing quartile into a better-performing quartile. Risk adjustment may allow for a more accurate comparison across units with varying levels of patient acuity and complexity.
The new software package OpenMx 2.0 for structural equation and other statistical modeling is introduced and its features are described. OpenMx is evolving in a modular direction and now allows a mix-and-match computational approach that separates model expectations from fit functions and optimizers. Major backend architectural improvements include a move to swappable open-source optimizers such as the newly written CSOLNP. Entire new methodologies such as item factor analysis and state space modeling have been implemented. New model expectation functions including support for the expression of models in LISREL syntax and a simplified multigroup expectation function are available. Ease-of-use improvements include helper functions to standardize model parameters and compute their Jacobian-based standard errors, access to model components through standard R $ mechanisms, and improved tab completion from within the R Graphical User Interface.
A method is presented for marginal maximum likelihood estimation of the nonlinear random coefficient model when the response function has some linear parameters. This is done by writing the marginal distribution of the repeated measures as a conditional distribution of the response given the nonlinear random effects. The resulting distribution then requires an integral equation that is of dimension equal to the number of nonlinear terms. For nonlinear functions that have linear coefficients, the improvement in computational speed and accuracy using the new algorithm can be dramatic. An illustration of the method with repeated measures data from a learning experiment is presented.
This paper provides a generalization of the Procrustes problem in which the errors are weighted from the right, or the left, or both. The solution is achieved by having the orthogonality constraint on the transformation be in agreement with the norm of the least squares criterion. This general principle is discussed and illustrated by the mathematics of the weighted orthogonal Procrustes problem.
Ridit analysis is statistical method for comparing ordinal-scale responses. In this paper, the extact variance and asymptotic distribution of the average ridit is developed, including the cases in which the reference group is sampled or the comparison group is finite. The appropriate use and interpretation of ridit analysis is also discussed.
Giant coronary artery aneurysms and myocardial fibrosis after Kawasaki disease may lead to devastating cardiovascular outcomes. We characterised the vascular and myocardial outcomes in five selected Kawasaki disease patients with a history of giant coronary artery aneurysms that completely regressed.
Methods:
Five patients were selected who had giant coronary artery aneurysm in early childhood that regressed when studied 12–33 years after Kawasaki disease onset. Coronary arteries were imaged by coronary CT angiography, and coronary artery calcium volume scores were determined. We used endocardial strain measurements from CT imaging to assess myocardial regional wall function. Calprotectin and galectin-3 (gal-3) as biomarkers of inflammation and myocardial fibrosis were measured by enzyme-linked immunosorbent assay.
Results:
The five selected patients with regressed giant coronary artery aneurysms had calcium scores of zero, normal levels of calprotectin and gal-3, and normal appearance of the coronary arteries by coronary computed tomography angiography. CT strain demonstrated normal peak systolic and diastolic strain patterns in four of five patients. In one patient with a myocardial infarction at the time of Kawasaki disease diagnosis at the age of 10 months, CT strain showed altered global longitudinal strain, reduced segmental peak strain, and reduced diastolic relaxation patterns in multiple left ventricle segments.
Conclusions:
These patients illustrate that regression of giant aneurysms after Kawasaki disease is possible with no detectable calcium, normal biomarkers of inflammation and fibrosis, and normal myocardial function. Individuals with regressed giant coronary artery aneurysm still require longitudinal surveillance to assess the durability of this favourable outcome.
With Palmer amaranth and waterhemp evolving resistance to nine and six different sites of action (SOAs) globally, soybean producers continue to search for new options to control these problematic weeds. Bayer CropScience has announced its intentions to launch a Convintro™ brand of herbicides, one being a three-way premixture for preemergence use in soybean. The premixture will contain diflufenican (WSSA Group 12), metribuzin (WSSA Group 5), and flufenacet (WSSA Group 15), adding a new SOA for soybean producers throughout the United States. With the anticipated launch of the premixture, research is needed to evaluate the length of residual control provided by the new herbicide. Research trials were conducted in Fayetteville and Keiser, AR, and Morrice, MI, in 2022 and 2023. A 0.17:0.35:0.48 ratio of a diflufenican:metribuzin:flufenacet (DFF)-containing premixture was applied alone and in combination with additional metribuzin and dicamba. Also, metribuzin, acetochlor, a S-metolachlor:metribuzin premixture, and a flumioxazin:pyroxasulfone:metribuzin premixture were applied preemergence. The DFF-containing premixture was more effective in reducing Palmer amaranth/waterhemp emergence than acetochlor in four of six trials at 28 d after treatment (DAT). Palmer amaranth and waterhemp densities in plots treated with the DFF-containing premixture exhibited similar results to plots treated with the S-metolachlor:metribuzin premixture and the flumioxazin:pyroxasulfone:metribuzin premixture at 28 DAT. By 56 DAT, Palmer amaranth and waterhemp densities were comparable or superior in plots with the DFF-containing premixture than in those treated with acetochlor and metribuzin, and the S-metolachlor:metribuzin premixture at five of six sites. The addition of dicamba or metribuzin to the DFF-containing premixture did not reduce Palmer amaranth or waterhemp density compared to the DFF-containing premixture at 28 or 56 DAT. Overall, the DFF-containing premixture generally provided greater or comparable control over several standard herbicides, providing growers a new product for preemergence control of Amaranthus species in soybean fields.
Italian ryegrass control is one of the most significant limitations in wheat production in the United States today. Resistance to Herbicide Resistance Action Committee (HRAC)/Weed Science Society of America (WSSA) Groups 1, 2, and 9 in Arkansas have further complicated postemergence control, whereas residual herbicides still show effective weed control. One problem is the potential of HRAC/WSSA Group 15 herbicides to injure wheat when applied preemergence, indicating the need for a herbicide safener. A series of experiments were conducted in Fayetteville, AR, to evaluate crop tolerance and Italian ryegrass control using a capsule suspension (CS) formulation of S-metolachlor in conjunction with fenclorim-treated wheat. Experiments were conducted as a two-factor factorial with S-metolachlor applied at three rates (0.37, 0.74, and 1.12 kg ai ha–1) and a microencapsulated formulation of acetochlor at 1.05 kg ai ha–1, and three rates of a fenclorim seed treatment at 0, 0.5, and 2.0 g ai kg–1 of seed. Separate experiments utilized either a preemergence (PRE) or a delayed-preemergence (DPRE) application timing. In both experiments, S-metolachlor at 0.74 and 1.12 kg ai ha–1 provided 77% to 96% control of Italian ryegrass by preharvest, whereas acetochlor only provided 49% to 72% control. Visible wheat injury from PRE applications ranged from 7% to 49% for all treatments 21 d after treatment (DAT), with a reduction in injury when fenclorim-treated wheat was used for both the 0.74 and 1.12 kg ai ha–1 rate of S-metolachlor. In the DPRE experiments, wheat injury ranged from 5% to 16% 21 DAT with no noticeable safening from the presence of fenclorim at any herbicide rate. The results of these experiments indicate that a DPRE application using a CS formulation of S-metolachlor would be more favorable for producers to mitigate the potential for injury to wheat while providing Italian ryegrass control. Additionally, at the DPRE application timing, fenclorim is unnecessary for S-metolachlor to be safely applied at the rates evaluated.
Traditional approaches for evaluating the impact of scientific research – mainly scholarship (i.e., publications, presentations) and grant funding – fail to capture the full extent of contributions that come from larger scientific initiatives. The Translational Science Benefits Model (TSBM) was developed to support more comprehensive evaluations of scientific endeavors, especially research designed to translate scientific discoveries into innovations in clinical or public health practice and policy-level changes. Here, we present the domains of the TSBM, including how it was expanded by researchers within the Implementation Science Centers in Cancer Control (ISC3) program supported by the National Cancer Institute. Next, we describe five studies supported by the Penn ISC3, each focused on testing implementation strategies informed by behavioral economics to reduce key practice gaps in the context of cancer care and identify how each study yields broader impacts consistent with TSBM domains. These indicators include Capacity Building, Methods Development (within the Implementation Field) and Rapid Cycle Approaches, implementing Software Technologies, and improving Health Care Delivery and Health Care Accessibility. The examples highlighted here can help guide other similar scientific initiatives to conceive and measure broader scientific impact to fully articulate the translation and effects of their work at the population level.
Accurately quantifying all the components of the surface energy balance (SEB) is a prerequisite for the reliable estimation of surface melt and the surface mass balance over ice and snow. This study quantifies the SEB closure by comparing the energy available for surface melt, determined from continuous measurements of radiative fluxes and turbulent heat fluxes, to the surface ablation measured on the Greenland ice sheet between 2003 and 2023. We find that the measured daily energy available for surface melt exceeds the observed surface melt by on average 18 ± 30 W m−2 for snow and 12 ± 54 W m−2 for ice conditions (mean ± SD), which corresponds to 46 and 10% of the average energy available for surface melt, respectively. When the surface is not melting, the daily SEB is on average closed within 5 W m−2. Based on the inter-comparison of different ablation sensors and radiometers installed on different stations, and on the evaluation of modelled turbulent heat fluxes, we conclude that measurement uncertainties prevent a better daily to sub-daily SEB closure. These results highlight the need and challenges in obtaining accurate long-term in situ SEB observations for the proper evaluation of climate models and for the validation of remote sensing products.
Clay samples from shales and bentonites in the Mancos Shale (Cretaceous) and its stratigraphic equivalents in the southern Rocky Mountain and Colorado Plateau have been analyzed by X-ray powder diffraction methods. The major clay in the shales is mixed layered illite/smectite, with 20–60% illite layers. The regional distribution of ordered vs. random interstratification in the illite/smectite is consistent with the concept of burial metamorphism in which smectite interlayers are converted to illite, resulting finally in ordered interstratification. The interstratification data correlate with other geologic information, including rank of coal and Laramide tectonic activity. In addition, contact metamorphism of the shale by Tertiary igneous intrusions produced a similar clay suite. Chemical variation within these shales (particularly the presence or absence of carbonate) affected the clay conversion reactions in the interbedded bentonites and the shale itself during the early stages of transformation. In extreme cases, shales and bentonites from a single outcrop may contain clays that range from pure smectite (calcareous shales) to ordered illite/smectite containing ⩾50% illite layers (noncalcareous shales). The use of mixed-layered illite/smectite compositions to infer thermal regimes, therefore, may be misleading unless allowance is made for local chemical controls.
The ongoing Russian–Ukrainian war has been linked to mental health problems in the Ukrainian general population. To date, however, scarce research has examined the mental health of psychosocial support workers (PSWs) in Ukraine who have a burdensome workload in the context of ongoing conflict. This study aimed to examine the prevalence and correlates of burnout, posttraumatic stress disorder (PTSD), and suicidal ideation (SI) in PSWs in Ukraine during the Russian–Ukrainian war.
Methods:
One hundred seventy-eight PSWs in Ukraine completed a survey assessing war exposure, mental health, and psychosocial characteristics.
Results:
A total 59.6% of PSWs screened positive for burnout, 38.2% for PTSD, and 10.7% for current SI. Lower optimism was associated with greater odds of burnout. Greater distress from witnessing war-related destruction, lower optimism, lower presence of meaning in life, and lower levels of close social relationships were associated with greater odds of burnout. Lower presence of meaning in life was associated with greater odds of SI.
Conclusions:
Results of this study highlight the mental health challenges faced by PSWs in Ukraine during the ongoing Russian–Ukrainian war. They further suggest that interventions to foster meaning in life and promote social connectedness may “help the helpers” during this ongoing conflict.
The U.S. Department of Veterans Affairs is actively transitioning away from a disease-centric model of healthcare to one that prioritizes disease prevention and the promotion of overall health and well-being. Described as Whole Health, this initiative aims to provide personalized, values-centered care that optimizes physical, behavioral, spiritual, and socioeconomic well-being. To inform this initiative, we analyzed cross-sectional data from a nationally representative sample of primarily older U.S. military veterans to estimate levels of well-being across these domains, and identify sociodemographic, military, and potentially modifiable health and psychosocial correlates of them. Results revealed that, overall, veterans reported high domain-specific well-being (average scores ranging from 6.7 to 8.3 out of 10), with the highest levels in the socioeconomic domain and lowest in the physical domain. Several modifiable factors, including purpose in life, resilience, and social support, were strongly associated with the examined well-being domains. Interventions targeting these constructs may help promote well-being among U.S. veterans.
Over the years, so-called univentricular hearts represented one of the greatest challenges for surgical correction. All this changed with the advent of the Fontan procedure,1 along with the realization that it could become the final stage of the sequence of procedures used to correct lesions such as those included in the hypoplastic left heart syndrome,2 which previously had been beyond surgical repair. The overall group of lesions also posed significant problems in adequate description and categorization. Even these days, many continue to describe patients with a double inlet left ventricle as having a single ventricle, despite the fact that, with the availability of clinical diagnostic techniques producing three-dimensional datasets, patients with this lesion can be seen to have two chambers within their ventricular mass, one being large and the other small (Figure 9.1.1). The semantic problems with description can now be resolved by the simple expedient of describing the patients as having functionally univentricular hearts.3
Understanding the anatomy of septal defects is greatly facilitated if the heart is thought of as having three distinct septal structures: the atrial septum, the atrioventricular septum, and the ventricular septum (Figure 8.1.1). The normal atrial septum is relatively small. It is made up, for the most part, by the floor of the oval fossa. When viewed from the right atrial aspect, the fossa has a floor, surrounded by rims. As we have shown in Chapter 2, the floor is derived from the primary atrial septum, or septum primum. Although often considered to represent a secondary septum, or septum secundum, the larger parts of the rims, specifically the superior, antero-superior, and posterior components, are formed by infoldings of the adjacent right and left atrial walls.1 Infero-anteriorly, in contrast, the rim of the fossa is a true muscular septum (Figure 8.1.2).
It is axiomatic that a thorough knowledge of valvar anatomy is a prerequisite for successful surgery, be it valvar replacement or reconstruction. The surgeon will also require a firm understanding of the arrangement of other aspects of cardiac anatomy to ensure safe access to a diseased valve or valves. These features were described in the previous chapter. Knowledge of the surgical anatomy of the valves themselves, however, must be founded on appreciation of their component parts, the relationships of the individual valves to each other, and their relationships to the chambers and arterial trunks within which they reside. This requires understanding of, first, the basic orientation of the cardiac valves, emphasizing the intrinsic features that make each valve distinct from the others. Such information must then be supplemented by attention to their relationships with other structures that the surgeon must avoid, notably the conduction tissues and the major channels of the coronary circulation.