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Though their experience was in no way typical of American service in the Vietnam War, American prisoners of war have dominated American perceptions of the conflict. A small, strikingly homogenous group, the POWs were important because of, not despite, their unusual character. As most were pilots captured while waging air war against North Vietnam, they were subjected to harsh treatment by Vietnamese authorities, who sought to make them confess and repent their aggression against the Vietnamese people. But because aviators tended to be older, well-educated, white, career officers who identified deeply with the United States and its mission in Vietnam, American POWs were determined to resist Vietnamese coercion. In enduring torture rather than admit guilt, they inverted the wars moral framework, representing themselves as victims of Vietnamese aggression. Because they so neatly embodied the nation as its white majority wished to imagine it, their suffering and sacrifice worked to redeem the American cause in Vietnam and restore national honor. This chapter explains this phenomenon through close attention to the POW experience in North Vietnams prisons.
This chapter will examine some aspects of Marsilio Ficino’s complex engagement with the many-sided but interrelated notions of temperance and music, and with the technical notion of participation (methexis) in the Platonic Ideas, a key, it would appear, both to Platonic metaphysics, epistemology, and ethics (see Cornford 1962 [1935]; see too Spruit 1994–1995),1 and to Christian theology, given that redeemed souls will participate in the glory of the risen Christ on the Day of Judgment having already participated in the gift of divine grace.
In his maturity, Ficino was the undisputed voice of Renaissance Platonism on at least three counts. First, as a devout Christian, an ordained priest, and eventually a canon of Florence’s cathedral, he was wedded to the dream, in part a Patristic dream, of reconciling Christianity with Platonic and pre-Platonic philosophy, and of inaugurating a new Platonic age of gold.
Geoarchaeological research as part of the AHRC funded Living with Monuments (LwM) project investigated the upper Kennet river system across the Avebury World Heritage landscape. The results demonstrate that in the early–mid-Holocene (c. 9500–1000 bc) there was very low erosion of disturbed soils into the floodplain, with floodplain deposits confined to a naturally forming bedload fluvial deposit aggrading in a shallow channel of inter-linked deeper pools. At the time of the Neolithic monument building in the 4th–early 3rd millennium bc, the river was wide and shallow with areas of presumed braid plain. Between c. 4000 and 1000 bc, a human induced signature of soil erosion became a minor component of fluvial sedimentation in the Kennet palaeo-channel but it was small scale and localised. This strongly suggests that there is little evidence of widespread woodland removal associated with Neolithic farming and monument building, despite the evidently large timber requirements for Neolithic sites like the West Kennet palisade enclosures. Consequently, there was relatively light human disturbance of the hinterland and valley slopes over the longue durée until the later Bronze Age/Early Iron Age, with a predominance of pasture over arable land. Rather than large Neolithic monument complexes being constructed within woodland clearings, representing ancestral and sacred spaces, the substantially much more open landscape provided a suitable landscape with areas of sarsen spreads potentially easily visible. During the period c. 3000–1000 bc, the sediment load within the channel slowly increased with alluvial deposition of increasingly humic silty clays across the valley floor. However, this only represents small-scale landscape disturbance. It is from the Late Bronze Age–Early Iron Age when the anthropogenic signal of human driven alluviation becomes dominant and overtakes the bedload fluvial signal across the floodplain, with localised colluvial deposits on the floodplain margins. Subsequently, the alluvial archive describes more extensive human impact across this landscape, including the disturbance of loessic-rich soils in the catchment. The deposition of floodplain wide alluvium continues throughout the Roman, medieval, and post-medieval periods, correlating with the development of a low-flow, single channel, with alluvial sediments describing a decreasing energy in the depositional environment.
We explored the utility of the standardized infection ratio (SIR) for surgical site infection (SSI) reporting in an Australian jurisdiction.
Design:
Retrospective chart review.
Setting:
Statewide SSI surveillance data from 2013 to 2019.
Patients:
Individuals who had cardiac bypass surgery (CABG), colorectal surgery (COLO), cesarean section (CSEC), hip prosthesis (HPRO), or knee prosthesis (KPRO) procedures.
Methods:
The SIR was calculated by dividing the number of observed infections by the number of predicted infections as determined using the National Healthcare Safety Network procedure-specific risk models. In line with a minimum precision criterion, an SIR was not calculated if the number of predicted infections was <1.
Results:
A SIR >0 (≥1 observed SSI, predicted number of SSI ≥1, no missing covariates) could be calculated for a median of 89.3% of reporting quarters for CABG, 75.0% for COLO, 69.0% for CSEC, 0% for HPRO, and 7.1% for KPRO. In total, 80.6% of the reporting quarters, when the SIR was not calculated, were due to no observed infections or predicted infections <1, and 19.4% were due to missing covariates alone. Within hospitals, the median percentage of quarters during which zero infections were observed was 8.9% for CABG, 20.0% for COLO, 25.4% for CSEC, 67.3% for HPRO, and 71.4% for KPRO.
Conclusions:
Calculating an SIR for SSIs is challenging for hospitals in our regional network, primarily because of low event numbers and many facilities with predicted infections <1. Our SSI reporting will continue to use risk-indexed rates, in tandem with SIR values when predicted number of SSI ≥1.
The U.S. Department of Agriculture–Agricultural Research Service (USDA-ARS) has been a leader in weed science research covering topics ranging from the development and use of integrated weed management (IWM) tactics to basic mechanistic studies, including biotic resistance of desirable plant communities and herbicide resistance. ARS weed scientists have worked in agricultural and natural ecosystems, including agronomic and horticultural crops, pastures, forests, wild lands, aquatic habitats, wetlands, and riparian areas. Through strong partnerships with academia, state agencies, private industry, and numerous federal programs, ARS weed scientists have made contributions to discoveries in the newest fields of robotics and genetics, as well as the traditional and fundamental subjects of weed–crop competition and physiology and integration of weed control tactics and practices. Weed science at ARS is often overshadowed by other research topics; thus, few are aware of the long history of ARS weed science and its important contributions. This review is the result of a symposium held at the Weed Science Society of America’s 62nd Annual Meeting in 2022 that included 10 separate presentations in a virtual Weed Science Webinar Series. The overarching themes of management tactics (IWM, biological control, and automation), basic mechanisms (competition, invasive plant genetics, and herbicide resistance), and ecosystem impacts (invasive plant spread, climate change, conservation, and restoration) represent core ARS weed science research that is dynamic and efficacious and has been a significant component of the agency’s national and international efforts. This review highlights current studies and future directions that exemplify the science and collaborative relationships both within and outside ARS. Given the constraints of weeds and invasive plants on all aspects of food, feed, and fiber systems, there is an acknowledged need to face new challenges, including agriculture and natural resources sustainability, economic resilience and reliability, and societal health and well-being.
To explore the role environment plays in influencing galaxy evolution at high redshifts, we study $2.0\leq z<4.2$ environments using the FourStar Galaxy Evolution (ZFOURGE) survey. Using galaxies from the COSMOS legacy field with ${\rm log(M_{*}/M_{\odot})}\geq9.5$, we use a seventh nearest neighbour density estimator to quantify galaxy environment, dividing this into bins of low-, intermediate-, and high-density. We discover new high-density environment candidates across $2.0\leq z<2.4$ and $3.1\leq z<4.2$. We analyse the quiescent fraction, stellar mass and specific star formation rate (sSFR) of our galaxies to understand how these vary with redshift and environment. Our results reveal that, across $2.0\leq z<2.4$, the high-density environments are the most significant regions, which consist of elevated quiescent fractions, ${\rm log(M_{*}/M_{\odot})}\geq10.2$ massive galaxies and suppressed star formation activity. At $3.1\leq z<4.2$, we find that high-density regions consist of elevated stellar masses but require more complete samples of quiescent and sSFR data to study the effects of environment in more detail at these higher redshifts. Overall, our results suggest that well-evolved, passive galaxies are already in place in high-density environments at $z\sim2.4$, and that the Butcher–Oemler effect and SFR-density relation may not reverse towards higher redshifts as previously thought.
Studies of early fourth-millennium BC Britain have typically focused on the Early Neolithic sites of Wessex and Orkney; what can the investigation of sites located in areas beyond these core regions add? The authors report on excavations (2011–2019) at Dorstone Hill in Herefordshire, which have revealed a remarkable complex of Early Neolithic monuments: three long barrows constructed on the footprints of three timber buildings that had been deliberately burned, plus a nearby causewayed enclosure. A Bayesian chronological model demonstrates the precocious character of many of the site's elements and strengthens the evidence for the role of tombs and houses/halls in the creation and commemoration of foundational social groups in Neolithic Britain.
Sea-level rise threatens both human communities and vulnerable species within coastal areas. Joint spatial planning can allow conservation and social resiliency goals to work in synergy. We present a case study integrating distribution information of a threatened saltmarsh bird, the eastern black rail (Laterallus jamaicensis jamaicensis), with social information to facilitate such joint planning. We constructed a distribution model for the species within an urbanizing coastal region (New Jersey, USA) and integrated this with publicly available parcel and protected area data to summarize ownership patterns. We estimated that c. 0.3–2.8% (c. 260–2200 ha) of available saltmarsh is occupied by eastern black rail, most of which is publicly owned (79%). Privately owned saltmarsh was spread across nearly 5000 individual parcels, 10% of which contained areas with the highest likelihood of rail presence according to our model (top quartile of predicted occupancy probabilities). Compared with all privately owned saltmarsh, parcels with probable rail habitat were larger (median: 5 versus 2 ha), contained more marsh (87% versus 59%) and were less economically valuable (US$11 200 versus US$36 100). Our approach of integrating species distributions with landownership data helps clarify trade-offs and synergies in species conservation and coastal resiliency planning.
Since its founding in 1971, the United Arab Emirates (UAE) has advanced rapidly and emerged as a global leader in innovation. One of the best examples of this progress is the development of a comprehensive federal university system and a well-articulated vision and framework for building a highly educated workforce who possess twenty-first-century skills and who will be key players in a knowledge-based economy. This chapter explores the role of undergraduate research within the UAE’s federal university system, and the role for these programmes in national capacity development. Model programmes at each of the UAE’s three federal higher education institutions are explored, and recommendations for policy and practice related to undergraduate research are discussed.
More than 80% of the people of Papua New Guinea (PNG) live in rural areas and produce most of the calories they consume. The rest comes from imported food, mainly rice and wheat. An estimated 83% of all food energy consumed in PNG in 2006 was derived from locally grown food. Rapid population change, an HIV/AIDS epidemic, and global climate change are the main threats to the sustainable production of this food into the future. Rapid population change threatens to bring about land degradation in shifting cultivation systems; also, HIV/AIDS will slow population growth but will selectively remove working-age people from the population, while the outcomes of global warming are less certain. Global warming is apparent in rises in temperatures and some observable changes in plant distributions. If global climate change increases the frequency of El Niño-Southern Oscillation (ENSO) events, then food production will be adversely affected. On the other hand, global warming may have some positive effects. Governance in PNG is poor, so rural people will have to face the outcomes of these three threats largely using their own resources of resilience, innovativeness, and hard work.
Introduction. While many individuals quit smoking during pregnancy, most relapse within one year postpartum. Research into methods to decrease smoking relapse postpartum has been hampered by difficulties with recruitment. Method. We conducted individual interviews with pregnant women (N = 22) who were interested in quitting smoking while pregnant about their attitudes regarding smoking and quitting during pregnancy, clinical trial participation, and smoking cessation medication use. Results. Participants were aware of the risks of smoking while pregnant. Many wanted to quit smoking before delivery. Few used empirically supported treatments to quit. While research was viewed positively, interest in taking on new commitments postpartum and taking a medication to prevent relapse was low. Medication concerns were evident among most participants, especially among those planning to breastfeed. Further, several women noted medication was unnecessary, as they did not believe they would relapse postpartum. Financial incentives, childcare, and fewer and/or remote visits were identified as facilitators to participating in research. However, these factors did not outweigh women’s concerns about medication use and time commitments. Conclusions. Women are aware that quitting smoking during pregnancy and remaining smoke-free postpartum are important. However, beliefs that personal relapse risk is low and that medications are dangerous reduced enthusiasm for taking medication for postpartum relapse prevention. Future medication trials should educate women about the high likelihood of relapse, prepare to answer detailed questions about risks of cessation medications, and connect with participants’ clinicians. For new mothers, studies conducted remotely with few scheduled appointments would reduce barriers to participation.
Barrows are a prominent feature of Britain's Bronze Age landscape. While they originated as burial monuments, they also appear to have acquired other roles in prehistory. British prehistorians, however, have been hampered in their interpretations of these monuments, as they are wary of speculating about how Bronze Age people might have conceptualised their dead. Here, the authors suggest that a recurring pattern of inversion is significant. They use Conceptual Metaphor Theory to argue that Bronze Age people in Britain saw their dead inhabiting an inverted underworld directly beneath the surface of the earth. This interpretation would explain not only burial practices, but also some of the barrows’ other apparent functions, such as guarding boundaries and controlling routeways.
Colleges and universities around the world engaged diverse strategies during the COVID-19 pandemic. Baylor University, a community of ˜22,700 individuals, was 1 of the institutions which resumed and sustained operations. The key strategy was establishment of multidisciplinary teams to develop mitigation strategies and priority areas for action. This population-based team approach along with implementation of a “Swiss Cheese” risk mitigation model allowed small clusters to be rapidly addressed through testing, surveillance, tracing, isolation, and quarantine. These efforts were supported by health protocols including face coverings, social distancing, and compliance monitoring. As a result, activities were sustained from August 1 to December 8, 2020. There were 62,970 COVID-19 tests conducted with 1435 people testing positive for a positivity rate of 2.28%. A total of 1670 COVID-19 cases were identified with 235 self-reports. The mean number of tests per week was 3500 with approximately 80 of these positive (11/d). More than 60 student tracers were trained with over 120 personnel available to contact trace, at a ratio of 1 per 400 university members. The successes and lessons learned provide a framework and pathway for similar institutions to mitigate the ongoing impacts of COVID-19 and sustain operations during a global pandemic.
Non-invasive prenatal testing (NIPT) for the detection of foetal aneuploidy through analysis of cell-free DNA (cfDNA) in maternal blood is offered routinely by many healthcare providers across the developed world. This testing has recently been recommended for evaluative implementation in the UK National Health Service (NHS) foetal anomaly screening pathway as a contingent screen following an increased risk of trisomy 21, 18 or 13. In preparation for delivering a national service, we have implemented cfDNA-based NIPT in our Regional Genetics Laboratory. Here, we describe our validation and verification processes and initial experiences of the technology prior to rollout of a national screening service.
Methods
Data are presented from more than 1000 patients (215 retrospective and 840 prospective) from ‘high- and low-risk pregnancies’ with outcome data following birth or confirmatory invasive prenatal sampling. NIPT was by the Illumina Verifi® test.
Results
Our data confirm a high-fidelity service with a failure rate of ~0.24% and a high sensitivity and specificity for the detection of foetal trisomy 13, 18 and 21. Secondly, the data show that a significant proportion of patients continue their pregnancies without prenatal invasive testing or intervention after receiving a high-risk cfDNA-based result. A total of 46.5% of patients referred to date were referred for reasons other than high screen risk. Ten percent (76/840 clinical service referrals) of patients were referred with ultrasonographic finding of a foetal structural anomaly, and data analysis indicates high- and low-risk scan indications for NIPT.
Conclusions
NIPT can be successfully implemented into NHS regional genetics laboratories to provide high-quality services. NHS provision of NIPT in patients with high-risk screen results will allow for a reduction of invasive testing and partially improve equality of access to cfDNA-based NIPT in the pregnant population. Patients at low risk for a classic trisomy or with other clinical indications are likely to continue to access cfDNA-based NIPT as a private test.
To define optimal thromboprophylaxis strategy after stent implantation in superior or total cavopulmonary connections.
Background:
Stent thrombosis is a rare complication of intravascular stenting, with a perceived higher risk in single-ventricle patients.
Methods:
All patients who underwent stent implantation within superior or total cavopulmonary connections (caval vein, innominate vein, Fontan, or branch pulmonary arteries) were included. Cohort was divided into aspirin therapy alone versus advanced anticoagulation, including warfarin, enoxaparin, heparin, or clopidogrel. Primary endpoint was in-stent or downstream thrombus, and secondary endpoints included bleeding complications.
Results:
A total of 58 patients with single-ventricle circulation underwent 72 stent implantations. Of them 14 stents (19%) were implanted post-superior cavopulmonary connection and 58 (81%) post-total cavopulmonary connection. Indications for stenting included vessel/conduit stenosis (67%), external compression (18%), and thrombotic occlusion (15%). Advanced anticoagulation was prescribed for 32 (44%) patients and aspirin for 40 (56%) patients. Median follow up was 1.1 (25th–75th percentile, 0.5–2.6) years. Echocardiograms were available in 71 patients (99%), and advanced imaging in 44 patients (61%). Thrombosis was present in two patients on advanced anticoagulation (6.3%) and none noted in patients on aspirin (p = 0.187). Both patients with in-stent thrombus underwent initial stenting due to occlusive left pulmonary artery thrombus acutely post-superior cavopulmonary connection. There were seven (22%) significant bleeding complications for advanced anticoagulation and none for aspirin (p < 0.001).
Conclusions:
Antithrombotic strategy does not appear to affect rates of in-stent thrombus in single-ventricle circulations. Aspirin alone may be sufficient for most patients undergoing stent implantation, while pre-existing thrombus may warrant advanced anticoagulation.
Transcatheter right ventricle decompression in neonates with pulmonary atresia and intact ventricular septum is technically challenging, with risk of cardiac perforation and death. Further, despite successful right ventricle decompression, re-intervention on the pulmonary valve is common. The association between technical factors during right ventricle decompression and the risks of complications and re-intervention are not well described.
Methods
This is a multicentre retrospective study among the participating centres of the Congenital Catheterization Research Collaborative. Between 2005 and 2015, all neonates with pulmonary atresia and intact ventricular septum and attempted transcatheter right ventricle decompression were included. Technical factors evaluated included the use and characteristics of radiofrequency energy, maximal balloon-to-pulmonary valve annulus ratio, infundibular diameter, and right ventricle systolic pressure pre- and post-valvuloplasty (BPV). The primary end point was cardiac perforation or death; the secondary end point was re-intervention.
Results
A total of 99 neonates underwent transcatheter right ventricle decompression at a median of 3 days (IQR 2–5) of age, including 63 patients by radiofrequency and 32 by wire perforation of the pulmonary valve. There were 32 complications including 10 (10.5%) cardiac perforations, of which two resulted in death. Cardiac perforation was associated with the use of radiofrequency (p=0.047), longer radiofrequency duration (3.5 versus 2.0 seconds, p=0.02), and higher maximal radiofrequency energy (7.5 versus 5.0 J, p<0.01) but not with patient weight (p=0.09), pulmonary valve diameter (p=0.23), or infundibular diameter (p=0.57). Re-intervention was performed in 36 patients and was associated with higher post-intervention right ventricle pressure (median 60 versus 50 mmHg, p=0.041) and residual valve gradient (median 15 versus 10 mmHg, p=0.046), but not with balloon-to-pulmonary valve annulus ratio, atmospheric pressure used during BPV, or the presence of a residual balloon waist during BPV. Re-intervention was not associated with any right ventricle anatomic characteristics, including pulmonary valve diameter.
Conclusion
Technical factors surrounding transcatheter right ventricle decompression in pulmonary atresia and intact ventricular septum influence the risk of procedural complications but not the risk of future re-intervention. Cardiac perforation is associated with the use of radiofrequency energy, as well as radiofrequency application characteristics. Re-intervention after right ventricle decompression for pulmonary atresia and intact ventricular septum is common and relates to haemodynamic measures surrounding initial BPV.
To evaluate differences in interstage growth of pulmonary arteries between use of polytetrafluoroethylene and femoral vein homograft as Sano shunt during stage-I Norwood palliation.
Methods
A retrospective review of all patients who survived to the second stage following Norwood–Sano operation at two institutions was performed. Either polytetrafluoroethylene or the valved segment of femoral vein homograft was used for construction of the Sano shunt. The size of pulmonary arteries was compared at pre-Glenn catheterisation.
Results
A total of 48 neonates with the diagnosis of hypoplastic left heart syndrome or its variants comprised the study population. Femoral vein homograft of 5–6 mm diameter was used in 14 and polytetrafluoroethylene graft of 5 mm was used in 34 patients. The two groups were comparable in terms of preoperative demographics and age at time of pre-Glenn catheterisation (3.9±0.7 versus 3.4±0.8 months, p=0.06). Patients who received femoral vein homograft demonstrated a significantly higher pre-Glenn Nakata index [264 (130–460) versus 165 (108–234) mm2/m2, p=0.004]. The individual branch pulmonary arteries were significantly larger in the femoral vein group (right, 7.8±3.6 versus 5.0±1.2, p=0.014; left, 7.2±2.1 versus 5.6±1.9, p=0.02). There were no differences in cardiac index, Qp:Qs, ventricular end-diastolic pressure or systemic oxygen saturations.
Conclusions
Utilisation of a valved segment of femoral vein homograft as right ventricle to pulmonary artery conduit during Norwood–Sano operation confers better interstage growth of the pulmonary arteries. Further studies are needed to evaluate the impact of femoral vein homograft on single ventricle function.
After the Portuguese discovered the Cape Verde Islands in AD 1456 they divided its main island, Santiago, into two governing captaincies. The founding settlement in the south-west, Cidade Velha, soon became the Islands’ capital and a thriving trade centre; in contrast, that in the east, Alcatrazes, only lasted as an official seat from 1484–1516 and is held to have ‘failed’ (see Richter 2015).
Stonehenge is a site that continues to yield surprises. Excavation in 2009 added a new and unexpected feature: a smaller, dismantled stone circle on the banks of the River Avon, connected to Stonehenge itself by the Avenue. This new structure has been labelled ‘Bluestonehenge’ from the evidence that it once held a circle of bluestones that were later removed to Stonehenge. Investigation of the Avenue closer to Stonehenge revealed deep periglacial fissures within it. Their alignment on Stonehenge's solstitial axis (midwinter sunset–midsummer sunrise) raises questions about the early origins of this ritual landscape.