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To compare the risk and exposure-adjusted central line-associated bloodstream infection (CLABSI) rates between racial and ethnic groups.
Design:
Retrospective cohort study.
Setting:
15 network hospitals in Illinois and Michigan (Part of OSF HealthCare).
Patients:
Patients of all age groups who had a central line inserted and removed during the same hospitalization between 01/2018 and 06/2023.
Methods:
CLABSI rates/1000 Central line days of the four major racial and ethnic categories (Hispanic, non-Hispanic White [NHW], non-Hispanic Black [NHB], and non-Hispanic others) were analyzed by generalized Poisson regression. Confounding variables included in the regression model based on a directed acyclic graph and included age group, insurance class, language, ICU admission, diagnostic cohorts (obesity, diabetes, dialysis, cancer, neutropenia), and line usage (blood products, chemotherapy, total parenteral nutrition).
Results:
27,674 central lines (244,889 catheter days) on 23,133 unique patients (median age 64 years, 8% pediatric patients) were included in the analysis. Overall, the CLABSI rate was 1.070/1000 Central line days. 76% of the study population was NHW, 17% NHB, and 4% Hispanic. After adjusting for confounding variables, Hispanic patients had higher CLABSI rates than NHW (IRR 1.89, 95% CI 1.15–3.10, P = .013). No significant difference was observed in the CLABSI rates between NHW and NHB patients.
Conclusion:
Disparities in hospital-associated conditions persist even after controlling for patient-level risk factors and exposures, with Hispanic patients at the highest risk.
Geometric Langlands predicts an isomorphism between Whittaker coefficients of Eisenstein series and functions on the moduli space of $\check {N}$-local systems. We prove this formula by interpreting Whittaker coefficients of Eisenstein series as factorization homology and then invoking Beilinson and Drinfeld’s formula for chiral homology of a chiral enveloping algebra.
The survey indicates marked continuity in rural settlement around Tuscania from Etruscan times into Roman Early Republican period (c.300-170 BC: 212 sites), implying that there was minimal disruption to pre-existing systems of ownership following the subjugation of the area by the Roman army. There was a dramatic expansion in rural settlement, a filling-up of the countryside particularly in formerly under-developed areas away from the town. This growth was encouraged by a better communications network, especially by the upgrading of the Via Clodia.There were increased levels of investment both in the town and in the surrounding countryside. Maximum site numbers developed in the Later Republican period (170-30 BC: 230 sites), and on the evidence of intensive grid collection of surface remains at selected sites, and geophysical survey at others, the core buildings of agrarian units first reached their maximum extent at this time. However, there is little evidence for large slave-run villas producing goods geared primarily for export and displacing the free peasantry, despite the written sources emphasizing this process throughout Italy at this time: the countryside around Tuscania was dominated by small farms and villages, and high-ranking sites did not bring significant changes to long-established farming regimes.
With advances in care, an increasing number of individuals with single-ventricle CHD are surviving into adulthood. Partners of individuals with chronic illness have unique experiences and challenges. The goal of this pilot qualitative research study was to explore the lived experiences of partners of individuals with single-ventricle CHD.
Methods:
Partners of patients ≥18 years with single-ventricle CHD were recruited and participated in Experience Group sessions and 1:1 interviews. Experience Group sessions are lightly moderated groups that bring together individuals with similar circumstances to discuss their lived experiences, centreing them as the experts. Formal inductive qualitative coding was performed to identify salient themes.
Results:
Six partners of patients participated. Of these, four were males and four were married; all were partners of someone of the opposite sex. Themes identified included uncertainty about their partners’ future health and mortality, becoming a lay CHD specialist, balancing multiple roles, and providing positivity and optimism. Over time, they took on a role as advocates for their partners and as repositories of medical history to help navigate the health system. Despite the uncertainties, participants described championing positivity and optimism for the future.
Conclusions:
In this first-of-its-kind pilot study, partners of individuals with single-ventricle CHD expressed unique challenges and experiences in their lives. There is a tacit need to design strategies to help partners cope with those challenges. Further larger-scale research is required to better understand the experiences of this unique population.
Psychosocial interventions that mitigate psychosocial distress in cancer patients are important. The primary aim of this study was to examine the feasibility and acceptability of an adaptation of the Mindful Self-Compassion (MSC) program among adult cancer patients. A secondary aim was to examine pre–post-program changes in psychosocial wellbeing.
Method
The research design was a feasibility and acceptability study, with an examination of pre- to post-intervention changes in psychosocial measures. A study information pack was posted to 173 adult cancer patients 6 months–5 years post-diagnosis, with an invitation to attend an eight-week group-based adaptation of the MSC program.
Results
Thirty-two (19%) consented to the program, with 30 commencing. Twenty-seven completed the program (mean age: 62.93 years, SD 14.04; 17 [63%] female), attending a mean 6.93 (SD 1.11) group sessions. There were no significant differences in medico-demographic factors between program-completers and those who did not consent. However, there was a trend toward shorter time since diagnosis in the program-completers group. Program-completers rated the program highly regarding content, relevance to the concerns of cancer patients, and the likelihood of recommending the program to other cancer patients. Sixty-three percent perceived that their mental wellbeing had improved from pre- to post-program; none perceived a deterioration in mental wellbeing. Small-to-medium effects were observed for depressive symptoms, fear of cancer recurrence, stress, loneliness, body image satisfaction, mindfulness, and self-compassion.
Significance of results
The MSC program appears feasible and acceptable to adults diagnosed with non-advanced cancer. The preliminary estimates of effect sizes in this sample suggest that participation in the program was associated with improvements in psychosocial wellbeing. Collectively, these findings suggest that there may be value in conducting an adequately powered randomized controlled trial to determine the efficacy of the MSC program in enhancing the psychosocial wellbeing of cancer patients.
Drawing on archival sources in Britain, Singapore, Malaysia, and the United States, this article explores late-colonial anxieties about the influence of Chinese nationalism in Malaya (and especially among students in Chinese-medium schools) in the lead up to self-government in 1957. It demonstrates that the colonial fear of communism in Malaya was not always synonymous with the fear of cultural influence from “new China” and that the “rise of China” in the mid-1950s was viewed as a challenge to colonially sanctioned programs for “Malayanization.” More importantly, in exploring some of the ways in which the colonial state mobilized anti-communist cultural workers from Hong Kong to help counter the perceived threat from China, the article argues that more focus should be placed on the role of colonial agency in shaping “Sinophone” cultural expression in Southeast Asia during this period.
THE SHANGHAI BUND – that celebrated stretch of waterfront in China's most populous of cities – looms large in the western imagination. As a site of nostalgic partings and arrivals, the subject of fiction and the backdrop to film (Hollywood and Hong Kong alike), it is the stuff of urban legend. In fictional and quasi-historical depictions of ‘old Shanghai’, the bund is everywhere, and is written as a romantic setting around which the intrigues of the treaty port world are woven. Likewise the literature of finance and business, in which Shanghai has been described as the specific location of a littoral Chinese identity grounded in market capitalism and entrepreneurialism. For such histories, the towering buildings of the Shanghai Bund and its flashing neon streetscapes have become the classic symbols of Chinese economic strength and vigour.
The Shanghai Bund is perhaps one of the world's most recognizable skylines. Hugging the banks of the Whampoa river, it is one of China's most photographed and written-about urban localities (see Figure 1). Yet the bund is more than just a streetscape – it is the single most important spatial reminder of an entire social system and lifestyle that came to East Asia in the wake of British success over China in the first Opium War, and the arrival of Admiral Perry's gunboats in Japanese waters shortly afterwards. The treaty port system meant far more than import/export statistics and diplomatic manoeuvres. Above all it meant a social system of exclusion and exploitation that was unique in the imperialist movement of the western powers during the mid- to late- nineteenth century, and into the early years of the twentieth century. This system brought with it specific concepts regarding space and power, and transferred such concepts onto the environments of Asia's riverine and coastal ports. The most distinctive of these was the bund – a spatial form that emerged not only in Shanghai, but in many other ports open to foreign trade throughout mainland China, Taiwan and Japan.
Predictably, most work on bunds in the Anglophone Academy has tended to focus exclusively on Shanghai, and little has been written outside the regional confines of ‘China Studies’.
Fertility is one of the most economically important traits in both beef and dairy cattle production; however, only female fertility is typically subjected to selection. Male and female fertility have only a small positive genetic correlation which is likely due to the existence of a relatively small number of genetic variants within each breed that cause embryonic and developmental losses. Genomic tools have been developed that allow the identification of lethal recessive loci based upon marker haplotypes. Selection against haplotypes harbouring lethal alleles in conjunction with selection to improve female fertility will result in an improvement in male fertility. Genomic selection has resulted in a two to fourfold increase in the rate of genetic improvement of most dairy traits in US Holstein cattle, including female fertility. Considering the rapidly increasing rate of adoption of high-throughput single nucleotide polymorphism genotyping in both the US dairy and beef industries, genomic selection should be the most effective of all currently available approaches to improve male fertility. However, male fertility phenotypes are not routinely recorded in natural service mating systems and when artificial insemination is used, semen doses may be titrated to lower post-thaw progressively motile sperm numbers for high-merit and high-demand bulls. Standardization of sperm dosages across bull studs for semen distributed from young bulls would allow the capture of sire conception rate phenotypes for young bulls that could be used to generate predictions of genetic merit for male fertility in both males and females. These data would allow genomic selection to be implemented for male fertility in addition to female fertility within the US dairy industry. While the rate of use of artificial insemination is much lower within the US beef industry, the adoption of sexed semen in the dairy industry has allowed dairy herds to select cows from which heifer replacements are produced and cows that are used to produce terminal crossbred bull calves sired by beef breed bulls. Capture of sire conception rate phenotypes in dairy herds utilizing sexed semen will contribute data enabling genomic selection for male fertility in beef cattle breeds. As the commercial sector of the beef industry increasingly adopts fixed-time artificial insemination, sire conception rate phenotypes can be captured to facilitate the development of estimates of genetic merit for male fertility within US beef breeds.
Based on recently reopened files and publications in Nanjing, as well as published and newsreel accounts from the 1940s, this paper represents the first scholarly analysis of the rituals surrounding the death and burial of Wang Jingwei in Japanese-occupied China. Rather than locating this analysis purely in the literature on the history of the Second Sino-Japanese War (1937–45), however, this paper asks what Wang Jingwei's Re-organized National Government might tell us about personality cults in the political culture of modern China. While Wang's burial drew heavily on the precedent of Sun Yat-sen's funerals of the 1920s, it also presaged later spectacles of public mourning and posthumous commemoration, such as Chiang Kai-shek's funeral in 1975 in Taipei. In focusing on this one specific event in the life of a “puppet government,” this paper hopes to reignite scholarly interest in the study of “dead leaders” and their posthumous lives in modern Chinese history more generally.
The Taipan galaxy survey (hereafter simply ‘Taipan’) is a multi-object spectroscopic survey starting in 2017 that will cover 2π steradians over the southern sky (δ ≲ 10°, |b| ≳ 10°), and obtain optical spectra for about two million galaxies out to z < 0.4. Taipan will use the newly refurbished 1.2-m UK Schmidt Telescope at Siding Spring Observatory with the new TAIPAN instrument, which includes an innovative ‘Starbugs’ positioning system capable of rapidly and simultaneously deploying up to 150 spectroscopic fibres (and up to 300 with a proposed upgrade) over the 6° diameter focal plane, and a purpose-built spectrograph operating in the range from 370 to 870 nm with resolving power R ≳ 2000. The main scientific goals of Taipan are (i) to measure the distance scale of the Universe (primarily governed by the local expansion rate, H0) to 1% precision, and the growth rate of structure to 5%; (ii) to make the most extensive map yet constructed of the total mass distribution and motions in the local Universe, using peculiar velocities based on improved Fundamental Plane distances, which will enable sensitive tests of gravitational physics; and (iii) to deliver a legacy sample of low-redshift galaxies as a unique laboratory for studying galaxy evolution as a function of dark matter halo and stellar mass and environment. The final survey, which will be completed within 5 yrs, will consist of a complete magnitude-limited sample (i ⩽ 17) of about 1.2 × 106 galaxies supplemented by an extension to higher redshifts and fainter magnitudes (i ⩽ 18.1) of a luminous red galaxy sample of about 0.8 × 106 galaxies. Observations and data processing will be carried out remotely and in a fully automated way, using a purpose-built automated ‘virtual observer’ software and an automated data reduction pipeline. The Taipan survey is deliberately designed to maximise its legacy value by complementing and enhancing current and planned surveys of the southern sky at wavelengths from the optical to the radio; it will become the primary redshift and optical spectroscopic reference catalogue for the local extragalactic Universe in the southern sky for the coming decade.
Recent molecular phylogenetic and molecular clock data both suggest a pre-Mesozoic age for the divergence of the angiosperm lineage from other seed plants, greatly predating the confirmed fossil record of the angiosperm crown group. In addition, molecular phylogenetic studies have not supported the morphologically based conclusion that gnetophytes are the extant sister group to angiosperms. We examine these relationships and divergence ages by using a novel approach of examining the presence of oleanane. This includes the development of methods using zeolites to preferentially reduce hopanes that can co-elute with oleanane. The presence of this molecular fossil strongly correlates with angiosperm diversification; in its functionalized form, along with its triterpenoid precursors, it is found in many living angiosperms. Our data show that among non-angiosperm seed plants examined thus far, oleanane is found only in fossil Cretaceous Bennettitales and Permian Gigantopteridales, both of which share characteristics with angiosperms. Previous morphological phylogenetic results indicate Bennettitales could be a sister group to or member of the angiosperm stem lineage, and results of our preliminary phylogenetic analysis including the Gigantopteridales suggests the same. Our data, based on a new pyrolysis method to treat living species, support previous research indicating that oleanane and its precursors are absent in living gnetophytes. If oleanane originated once in seed plants then the angiosperm stem lineage would have diverged from other seed plant lineages by the late Paleozoic.
This paper explores the development of the Wang Jingwei personality cult during the Japanese occupation of China (1937–1945). It examines how the collaborationist Chinese state led by Wang sought to distinguish its figurehead from the person he had replaced, Nationalist leader Chiang Kai-shek. Drawing on visual, archival, and published sources, it traces the development of the Wang cult from the early years of the war, and argues that the unusual context in which the cult evolved ultimately undermined its coherence. The case of Wang Jingwei illustrates how the Chinese case more broadly can enhance our understandings of personality cults that develop under occupation. To this end, I compare the Wang regime with various European “collaborationist” governments that sought to promote their leaders in similar ways.
The Bovine Respiratory Disease Coordinated Agricultural Project (BRD CAP) is a 5-year project funded by the United States Department of Agriculture (USDA), with an overriding objective to use the tools of modern genomics to identify cattle that are less susceptible to BRD. To do this, two large genome wide association studies (GWAS) were conducted using a case:control design on preweaned Holstein dairy heifers and beef feedlot cattle. A health scoring system was used to identify BRD cases and controls. Heritability estimates for BRD susceptibility ranged from 19 to 21% in dairy calves to 29.2% in beef cattle when using numerical scores as a semi-quantitative definition of BRD. A GWAS analysis conducted on the dairy calf data showed that single nucleotide polymorphism (SNP) effects explained 20% of the variation in BRD incidence and 17–20% of the variation in clinical signs. These results represent a preliminary analysis of ongoing work to identify loci associated with BRD. Future work includes validation of the chromosomal regions and SNPs that have been identified as important for BRD susceptibility, fine mapping of chromosomes to identify causal SNPs, and integration of predictive markers for BRD susceptibility into genetic tests and national cattle genetic evaluations.
There has been a hesitancy in academic discussion of Roman Britain to address the potential significance of the identity and agency of rural communities in shaping the provincial landscape. This article seeks to address the reasons for this before delineating some avenues by which we might better investigate this issue. Through two case studies the importance of kinship, agricultural peers and occupational identity (being farmers) are recognised as potential drivers for the course of rural life in Roman Britain. In so doing the extent to which ‘being Roman’ was really a central concern of many agricultural communities is questioned.
This paper explores the nature of film exhibition amongst the Chinese community in Manila during the Japanese Occupation of that city. Based on advertisements and film listings published in the Chinese-language press of the day (as well as on pre-war records concerning commercial Chinese entertainment in the Philippines), it explores the continuities in film exhibition practice undertaken by various theatre operators within the Binondo area of Manila both before, during, and after the war. The paper suggests not only that such practices represented a quite different trajectory from that experienced in other parts of Occupied Manila, but also that a more thorough exploration of the Manila Chinese during wartime—one which goes beyond questions of mere collaboration and/or resistance—will encourage us to question some of the assumptions that underpin recent scholarship about this community.
Imputation of moderate-density genotypes from low-density panels is of increasing interest in genomic selection, because it can dramatically reduce genotyping costs. Several imputation software packages have been developed, but they vary in imputation accuracy, and imputed genotypes may be inconsistent among methods. An AdaBoost-like approach is proposed to combine imputation results from several independent software packages, i.e. Beagle(v3.3), IMPUTE(v2.0), fastPHASE(v1.4), AlphaImpute, findhap(v2) and Fimpute(v2), with each package serving as a basic classifier in an ensemble-based system. The ensemble-based method computes weights sequentially for all classifiers, and combines results from component methods via weighted majority ‘voting’ to determine unknown genotypes. The data included 3078 registered Angus cattle, each genotyped with the Illumina BovineSNP50 BeadChip. SNP genotypes on three chromosomes (BTA1, BTA16 and BTA28) were used to compare imputation accuracy among methods, and the application involved the imputation of 50K genotypes covering 29 chromosomes based on a set of 5K genotypes. Beagle and Fimpute had the greatest accuracy among the six imputation packages, which ranged from 0·8677 to 0·9858. The proposed ensemble method was better than any of these packages, but the sequence of independent classifiers in the voting scheme affected imputation accuracy. The ensemble systems yielding the best imputation accuracies were those that had Beagle as first classifier, followed by one or two methods that utilized pedigree information. A salient feature of the proposed ensemble method is that it can solve imputation inconsistencies among different imputation methods, hence leading to a more reliable system for imputing genotypes relative to independent methods.