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Society of Thoracic Surgeons Congenital Heart Surgery Database is the largest congenital heart surgery database worldwide but does not provide information beyond primary episode of care. Linkage to hospital electronic health records would capture complications and comorbidities along with long-term outcomes for patients with CHD surgeries. The current study explores linkage success between Society of Thoracic Surgeons Congenital Heart Surgery Database and electronic health record data in North Carolina and Georgia.
Methods:
The Society of Thoracic Surgeons Congenital Heart Surgery Database was linked to hospital electronic health records from four North Carolina congenital heart surgery using indirect identifiers like date of birth, sex, admission, and discharge dates, from 2008 to 2013. Indirect linkage was performed at the admissions level and compared to two other linkages using a “direct identifier,” medical record number: (1) linkage between Society of Thoracic Surgeons Congenital Heart Surgery Database and electronic health records from a subset of patients from one North Carolina institution and (2) linkage between Society of Thoracic Surgeons data from two Georgia facilities and Georgia’s CHD repository, which also uses direct identifiers for linkage.
Results:
Indirect identifiers successfully linked 79% (3692/4685) of Society of Thoracic Surgeons Congenital Heart Surgery Database admissions across four North Carolina hospitals. Direct linkage techniques successfully matched Society of Thoracic Surgeons Congenital Heart Surgery Database to 90.2% of electronic health records from the North Carolina subsample. Linkage between Society of Thoracic Surgeons and Georgia’s CHD repository was 99.5% (7,544/7,585).
Conclusions:
Linkage methodology was successfully demonstrated between surgical data and hospital-based electronic health records in North Carolina and Georgia, uniting granular procedural details with clinical, developmental, and economic data. Indirect identifiers linked most patients, consistent with similar linkages in adult populations. Future directions include applying these linkage techniques with other data sources and exploring long-term outcomes in linked populations.
This commentary analyzes the extent to which the incommensurability problem can be resolved through the proposed alternative method of integrative experiment design. We suggest that, although one aspect of incommensurability is successfully addressed (dimensional incommensurability), the proposed design space method does not yet alleviate another major source of discontinuity, which we call conceptual incommensurability.
We report new, fossiliferous Paleogene Naran Bulak Formation localities from the central-eastern part of the Nemegt Basin of the Gobi Desert, Mongolia. Early Paleogene localities have been identified previously only in the western half of the Nemegt Basin. The new localities, near the town of Daus, are also noteworthy for their geographical proximity to Ukhaa Tolgod, a Late Cretaceous Djadokhta Formation locality known for its numerous dinosaur, mammal, and lizard fossils. The Daus section consists of the Zhigden, Naran, and Bumban members of the Naran Bulak Formation at three localities, and mammal and ostracode fossils were discovered in the Naran Member. Noteworthy discoveries are a dentary of the pantodont Archaeolambda cf. A. planicanina, postcrania of Pantolambdodon, a skull of the gliroid Gomphos, and a partial skull with a worn and damaged dentition provisionally identified as an arctostylopid. Biostratigraphy has been the primary means of dating Paleogene Asian faunas, however, the local fauna from the new localities does not fit easily with established patterns. The Naran Member and Archaeolambda planicanina and the arctostylopid Palaeostylops typically have been allied with the Gashatan Asian Land Mammal Age (ALMA) and attributed to the latest Paleocene. By contrast, Gomphos repeatedly has been found in the Bumban Member and assigned a Bumbanian ALMA, which has been considered as the earliest Eocene. Pantolambdodon has been reported from middle Eocene Arshatan and Irdinmanhan ALMA beds. The co-occurrence of these taxa in Naran Member beds complicates the temporal interpretation of the new localities and the reliability of broader biostratigraphic patterns.
Some symptoms are recognised as red flags for cancer, causing the General Practitioner (GP) to refer the patient for investigation without delay. However, many early symptoms of cancer are vague and unspecific, and in these cases, a delay in referral risks a diagnosis of cancer that is too late. Empowering GPs in their management of patients that may have cancer is likely to lead to more timely cancer diagnoses.
Aim:
To identify the factors that affect European GPs’ empowerment in making an early diagnosis of cancer.
Methods:
This was a Delphi study involving GPs in 20 European countries. We presented GPs with 52 statements representing factors that could empower GPs to increase the number of early cancer diagnoses. Over three Delphi rounds, we asked GPs to indicate the clinical relevance of each statement on a Likert scale.
The final list of statements indicated those that were considered by consensus to be the most relevant.
Results:
In total, 53 GPs from 20 European countries completed the Delphi process, out of the 68 GPs who completed round one. Twelve statements satisfied the pre-defined criteria for relevance. Five of the statements related to screening and four to the primary/secondary care interface. The other selected statements concerned information technology (IT) and GPs’ working conditions. Statements relating to training, skills and working efficiency were not considered priority areas.
Conclusion:
GPs consider that system factors relating to screening, the primary-secondary care interface, IT and their working conditions are key to enhancing their empowerment in patients that could have cancer. These findings provide the basis for seeking actions and policies that will support GPs in their efforts to achieve timely cancer diagnosis.
Does attending communal religious services heighten the tendency to express exclusionary attitudes? Drawing on responses from thousands of Muslims, we identify how the ritual Friday Prayer systematically influences congregants' political and social attitudes. To isolate the independent role of this religious behavior, we exploit day-of-the-week variation in survey enumeration, which we assume to be plausibly uncorrelated with likely confounders, including self-reported religiosity. In our primary analysis, six variables charting various modes of intolerance each indicate that frequent attenders interviewed on Fridays (that is, proximate to the weekly communal prayer) were significantly more likely to express sectarian and antisecular attitudes than their counterparts. To test the potential mechanism behind this tendency, we rely on a controlled comparison between Egyptian and Algerian subgroups, as well as an original survey experiment in Lebanon. Evidence from both analyses is consistent with arguments that elite political messaging embedded in religious rituals spurs much of the observed variation.
The acquisition, maintenance, and attrition of morphological properties of heritage languages (HLs) has been a central research focus since the inception of the systematic study of these linguistic varieties. Both child and adult heritage language speakers (HSs) experience difficulty in producing target-like inflectional morphology, and in some instances, the errors in their production are similar to those found in the speech of L2 learners. This chapter offers a broad survey of developmental trends of derivational and inflectional morphology in the nominal (e.g., gender and case) and verbal (e.g., agreement, tense, aspect, mood) domains. Different morphological types (e.g., inflectional, agglutinative, fusion, isolating) are discussed, focusing on whether certain properties of heritage morphology are specific to each type and whether certain properties cut across all of them. Claims regarding the effects of maturational constraints and continued activation on the ultimate attainment of heritage morphology are reviewed. This chapter also considers the issue of age effects in connection with heritage morphology and concludes with a brief discussion of the implications that these findings have on linguistic theory as well as highlighting future directions for the study of heritage morphology.
This paper describes a collaborative approach to professional learning that has provided an opportunity for refreshed practices and growth in capacity in schools supporting students with various learning needs in several schools that are part of the Association of Independent Schools in the Australian Capital Territory. An action research approach to professional learning for school staff was facilitated with the participating schools in 2018/2019, centred on the Nationally Consistent Collection of Data on School Students with Disability.
Diverse identities coexisting within the same society are often viewed as problematic for economic and political development. This article argues that different types of social diversity have differential effects on regime type. Specifically, ethno-linguistic diversity increases prospects for democracy while religious diversity decreases prospects for democracy. The article presents a variety of reasons why diversity might have divergent causal effects on regime type. Cross-national regressions in a variety of econometric formats – including instrumental variables – provide corroborating evidence for the argument.
Recent developments in the Arab world have shattered the feeble equilibrium that once existed. Uprisings in Egypt, Libya, Syria, and elsewhere have undermined long-established dictators and created an ever-present threat of violence in many parts of the region. In many cases, religious minorities are particularly endangered. The conflict in Syria has taken an increasingly sectarian tone in lockstep with its increasing level of violence. Conditions have become so severe that some Arab Christian observers outside Syria believe that this conflict “will likely be the final blow for Syria's embattled Christians.” Electoral victories for Islamist parties in Tunisia and Egypt (albeit a short-lived victory in the latter case) have certainly not comforted Christians and other non-Muslims in the Arab world. It seems that the birthplace of several of the world's largest faith traditions is still a hotbed of conflict between religious groups, and the outcome remains as uncertain as ever.
The growing uncertainty in the region – particularly for religious minorities – creates a vital need for understanding the social forces that shape relations between the faiths in these countries. If the Arab Spring revolutions were to bring about a more “popular” form of government, in contrast to the dictatorships that preceded them, then it is crucial to examine what popular demands might be. Popular rule does not necessarily mean tolerance. As Tocqueville famously warned, rule by the majority can result in highly unequal treatment of minority groups. There is thus no logical necessity that elections, however free and fair, will lead to improved conditions for non-Muslims in the Arab world; in fact, many observers have predicted just the opposite.
This chapter remedies some of the uncertainty regarding Arab attitudes toward religious minorities and religious freedom. Using recent original data from the Arab Barometer, it examines the attitudes of Arab citizens toward religious minorities through a number of different religious and political lenses. Furthermore, it considers the origins of these attitudes. Views about non-Muslims (and political policies relevant to them) were collected in ten Arab societies, providing valuable insight into the minds of everyday citizens in this important part of the world. In order to understand the plight of Christians and other religious minorities in the Arab world, we must consider the beliefs and attitudes of the Muslim citizens who make up the majority of the population in these countries.
Ediacara-type fossils are found in a diverse array of preservational styles, implying that multiple taphonomic mechanisms might have been responsible for their preservational expression. For many Ediacara fossils, the “death mask” model has been invoked as the primary taphonomic pathway. The key to this preservational regime is the replication or sealing of sediments around the degrading organisms by microbially induced precipitation of authigenic pyrite, leading toward fossil preservation along bedding planes. Nama-style preservation, on the other hand, captures Ediacaran organisms as molds and three-dimensional casts within coarse-grained mass flow beds, and has been previously regarded as showing little or no evidence of a microbial preservational influence. To further understand these two seemingly distinct taphonomic pathways, we investigated the three-dimensionally preserved Ediacaran fossil Pteridinium simplex from mass flow deposits of the upper Kliphoek Member, Dabis Formation, Kuibis Subgroup, southern Namibia. Our analysis, using a combination of petrographic and micro-analytical methods, shows that Pteridinium simplex vanes are replicated with minor pyrite, but are most often represented by open voids that can be filled with secondary carbonate material; clay minerals are also found in association with the vanes, but their origin remains unresolved. The scarcity of pyrite and the development of voids are likely related to oxidative weathering and it is possible that microbial activities and authigenic pyrite may have contributed to the preservation of Pteridinium simplex; however, any microbes growing on P. simplex vanes within mass flow deposits were unlikely to have formed thick mats as envisioned in the death mask model. Differential weathering of replicating minerals and precipitation of secondary minerals greatly facilitate fossil collection and morphological characterization by allowing Pteridinium simplex vanes to be parted from the massive hosting sandstone.
Voters and political candidates increasingly use social networking sites (SNSs) such as Facebook. This study uses data from an online posttest-only experiment (N = 183) in analyzing how exposure to supportive or challenging user comments on a fictional candidate's Facebook page influenced participants’ perceptions of and willingness to vote for the candidate, as well as whether candidate replies to each type of user comments affected these outcomes. Participants who viewed a page with supportive comments and “likes” reported more favorable perceptions of and greater support for the candidate, relative to participants who viewed a page with challenging comments. Thus, the appearance of interactivity between a candidate and other users on the candidate's Facebook page can shape the responses of those viewing the page. However, exposure to candidate replies to either supportive or challenging comments did not lead to significantly more favorable perceptions or a greater likelihood of voting for the candidate.