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This paper reports the methods and preliminary findings of Germina, an ongoing cohort study to identify biomarkers and trajectories of executive functions and language development in the first 3 years of life. 557 mother-infant dyads (mean age of mothers 33.7 years, 65.2% white, 48.7% male infants) have undergone baseline and are currently collecting data for other timepoints. A linear regression was used to predict baseline Bayley-III using scores derived from data-driven sparse partial least squares utilizing a multiple holdout framework of 15 domains. Significant associations were found between socioeconomic/demographic characteristics (B = 0.29), epigenetics (B = 0.11), EEG theta (B = 0.14) and beta activity (B = 0.11), and microbiome functional pathways (B = 0.08) domains, and infant development measured by the Bayley-III at T1, suggesting potential interventions to prevent impairments.
The development of inhibitory control (IC) and working memory (WM) in preschool is linked to a multitude of cognitive, emotional, and social outcomes, including elementary school adjustment. Furthermore, there are both cognitive and socioemotional domains of IC and it is unclear if both are related to these outcomes in the same manner. Using a family study design, the present investigation examined preschoolers’ IC, WM and externalizing behavior problems, maternal depression and anxiety measured when the children were in preschool, and elementary school externalizing behaviors and child and family functioning. Families with two children between 2.5 and 5.5 years of age (n = 198; mean age = 3.88, SD = 1.04) completed online surveys and laboratory visits, as well as another online survey after the children entered elementary school. Both cognitive and emotional domains of preschool IC significantly predicted the externalizing and functioning aspects of adjustment in elementary school (but WM did not predict either). In addition, child age predicted functioning in elementary school, and maternal depression predicted externalizing in elementary school. These longitudinal results indicate that supporting both cognitive and emotional aspects of preschool IC can benefit adjustment in elementary school.
Links between personality disorders and antisocial outcomes has not examined individual personality disorders, and the contribution of comorbidities remain uncertain. Previous systematic reviews are dated.
Aims
To synthesise evidence from observational studies on the risk of antisocial outcomes and recidivism associated with personality disorders.
Method
We searched six bibliographic databases (up to March 2024) for observational studies examining the risk of antisocial behaviour, interpersonal violence and recidivism in individuals diagnosed with personality disorders, compared to controls. We explored sources of heterogeneity using subgroup analyses and meta-regression.
Results
We identified 21 studies involving 83 418 individuals with personality disorders from 10 countries examining antisocial and violent outcomes (Aim 1), and 39 studies of 14 131 individuals from 13 countries with recidivism (or repeat offending) as the outcome (Aim 2). We found increased risks of violence among individuals with any personality disorder (odds ratio 4.5, 95% CI 3.0–6.7), particularly antisocial personality disorder (odds ratio 7.6, 95% CI 5.1–11.5) and borderline personality disorder (odds ratio 2.6, 95% CI 1.8–3.9). Individuals with any personality disorder (odds ratio 2.3, 95% CI 2.0–2.6) and antisocial personality disorder (odds ratio 2.8, 95% CI 1.6–4.9) also demonstrated an elevated risk of recidivism. Personality disorder types and comorbid substance use disorder were associated with between-study heterogeneity.
Conclusions
The assessment and management of personality disorders should be considered as part of violence prevention strategies. Improving identification and treatment of comorbid substance misuse may reduce adverse outcomes in individuals with personality disorders.
This paper presents the results of reverse-engineering (RE) strategies, surface roughness and computational fluid dynamics (CFD) modelling for a Wren100 micro gas turbine (MGT). Utilising silicone moulds and resin tooling, precise blade geometry capture was achieved for 3D reconstruction allowing for discrete and parametric geometric models to be created. Using these geometries, CFD simulations employing both Reynolds-averaged Navier–Stokes (RANS) and large eddy simulation (LES) models, alongside experimental wind tunnel cascade tests, were used to evaluate these reverse engineering strategies. The results show that while the parametric model captures overall MGT performance with fewer parameters, the discrete model provides enhanced accuracy, highlighting its suitability for detailed aerodynamic analyses. Contrary to initial expectations, surface roughness exhibited a noticeable impact on performance despite the lower Reynolds numbers (40,000), as demonstrated by the CFD model and wind tunnel experiments. The results indicate that surface roughness can reduce laminar separation bubbles on the blade leading edge, delay the onset of transition, and mitigate secondary flow losses. Overall, this study contributes to knowledge advancement in turbine blade reverse engineering and aerodynamics by detailing the impact of surface roughness on performance.
To examine feasibility, acceptability, and preliminary effectiveness of a novel group-based telemedicine psychoeducation programme aimed at supporting psychological well-being among adolescents with Fontan-palliated CHD.
Study design:
A 5-week telemedicine psychoeducation group-based programme (WE BEAT) was developed for adolescents (N = 20; 13–18 years) with Fontan-palliated CHD aimed at improving resiliency and psychological well-being. Outcome measures included surveys of resilience (Connor–Davidson Resilience Scale), benefit finding (Benefit/Burden Scale for Children), depression, anxiety, peer relationships, and life satisfaction (National Institutes of Health Patient-Reported Outcomes Measurement Information System scales). Within-subject changes in these outcomes were compared pre- to post-intervention using Cohen’s d effect size. In addition, acceptability in the form of satisfaction measures and qualitative feedback was assessed.
Results:
Among eligible patients reached, 68% expressed interest in study participation. Of those consented, 77% have been scheduled for a group programme to date with 87% programme completion. Twenty adolescents (mean age 16.1 ± SD 1.6 years) participated across five WE BEAT group cohorts (range: 3–6 participants per group). The majority (80%) attended 4–5 sessions in the 5-session programme, and the median programme rating was a 9 out of 10 (10 = most favourable rating). Following WE BEAT participation, resiliency (d = 0.44) and perceptions of purpose in life increased (d = 0.26), while depressive symptoms reduced (d = 0.36). No other changes in assessed outcome measures were noted.
Conclusions:
These findings provide preliminary support that a group-based, telemedicine delivered psychoeducation programme to support psychological well-being among adolescents with CHD is feasible, acceptable, and effective. Future directions include examining intervention effects across diverse centres, populations, and implementation methods.
We present the Pilot Survey Phase 2 data release for the Wide-field ASKAP L-band Legacy All-sky Blind surveY (WALLABY), carried-out using the Australian SKA Pathfinder (ASKAP). We present 1760 H i detections (with a default spatial resolution of 30′′) from three pilot fields including the NGC 5044 and NGC 4808 groups as well as the Vela field, covering a total of $\sim 180$ deg$^2$ of the sky and spanning a redshift up to $z \simeq 0.09$. This release also includes kinematic models for over 126 spatially resolved galaxies. The observed median rms noise in the image cubes is 1.7 mJy per 30′′ beam and 18.5 kHz channel. This corresponds to a 5$\sigma$ H i column density sensitivity of $\sim 9.1\times10^{19}(1 + z)^4$ cm$^{-2}$ per 30′′ beam and $\sim 20$ km s$^{-1}$ channel and a 5$\sigma$ H i mass sensitivity of $\sim 5.5\times10^8 (D/100$ Mpc)$^{2}$ M$_{\odot}$ for point sources. Furthermore, we also present for the first time 12′′ high-resolution images (“cut-outs”) and catalogues for a sub-sample of 80 sources from the Pilot Survey Phase 2 fields. While we are able to recover sources with lower signal-to-noise ratio compared to sources in the Public Data Release 1, we do note that some data quality issues still persist, notably, flux discrepancies that are linked to the impact of side lobes associated with the dirty beams due to inadequate deconvolution. However, in spite of these limitations, the WALLABY Pilot Survey Phase 2 has already produced roughly a third of the number of HIPASS sources, making this the largest spatially resolved H i sample from a single survey to date.
Emerging evidence suggests that routine physical activity may improve exercise capacity, long-term outcomes, and quality of life in individuals with Fontan circulation. Despite this, it is unclear how active these individuals are and what guidance they receive from medical providers regarding physical activity. The aim of this study was to survey Fontan patients on personal physical activity behaviours and their cardiologist-directed physical activity recommendations to set a baseline for future targeted efforts to improve this.
Methods:
An electronic survey assessing physical activity habits and cardiologist-directed guidance was developed in concert with content experts and patients/parents and shared via a social media campaign with Fontan patients and their families.
Results:
A total of 168 individuals completed the survey. The median age of respondents was 10 years, 51% identifying as male. Overall, 21% of respondents spend > 5 hours per week engaged in low-exertion activity and only 7% spend > 5 hours per week engaged in high-exertion activity. In all domains questioned, pre-adolescents reported higher participation rates than adolescents. Nearly half (43%) of respondents reported that they do not discuss activity recommendations with their cardiologist.
Conclusions:
Despite increasing evidence over the last two decades demonstrating the benefit of exercise for individuals living with Fontan circulation, only a minority of patients report engaging in significant amounts of physical activity or discussing activity goals with their cardiologist. Specific, individualized, and actionable education needs to be provided to patients, families, and providers to promote and support regular physical activity in this patient population.
Animal models of retinal degeneration are critical for understanding disease and testing potential therapies. Inducing degeneration commonly involves the administration of chemicals that kill photoreceptors by disrupting metabolic pathways, signaling pathways, or protein synthesis. While chemically induced degeneration has been demonstrated in a variety of animals (mice, rats, rabbits, felines, 13-lined ground squirrels (13-LGS), pigs, chicks), few studies have used noninvasive high-resolution retinal imaging to monitor the in vivo cellular effects. Here, we used longitudinal scanning light ophthalmoscopy (SLO), optical coherence tomography, and adaptive optics SLO imaging in the euthermic, cone-dominant 13-LGS (46 animals, 52 eyes) to examine retinal structure following intravitreal injections of chemicals, which were previously shown to induce photoreceptor degeneration, throughout the active season of 2019 and 2020. We found that iodoacetic acid induced severe pan-retinal damage in all but one eye, which received the lowest concentration. While sodium nitroprusside successfully induced degeneration of the outer retinal layers, the results were variable, and damage was also observed in 50% of contralateral control eyes. Adenosine triphosphate and tunicamycin induced outer retinal specific damage with varying results, while eyes injected with thapsigargin did not show signs of degeneration. Given the variability of damage we observed, follow-up studies examining the possible physiological origins of this variability are critical. These additional studies should further advance the utility of chemically induced photoreceptor degeneration models in the cone-dominant 13-LGS.
Although behavioral mechanisms in the association among depression, anxiety, and cancer are plausible, few studies have empirically studied mediation by health behaviors. We aimed to examine the mediating role of several health behaviors in the associations among depression, anxiety, and the incidence of various cancer types (overall, breast, prostate, lung, colorectal, smoking-related, and alcohol-related cancers).
Methods
Two-stage individual participant data meta-analyses were performed based on 18 cohorts within the Psychosocial Factors and Cancer Incidence consortium that had a measure of depression or anxiety (N = 319 613, cancer incidence = 25 803). Health behaviors included smoking, physical inactivity, alcohol use, body mass index (BMI), sedentary behavior, and sleep duration and quality. In stage one, path-specific regression estimates were obtained in each cohort. In stage two, cohort-specific estimates were pooled using random-effects multivariate meta-analysis, and natural indirect effects (i.e. mediating effects) were calculated as hazard ratios (HRs).
Results
Smoking (HRs range 1.04–1.10) and physical inactivity (HRs range 1.01–1.02) significantly mediated the associations among depression, anxiety, and lung cancer. Smoking was also a mediator for smoking-related cancers (HRs range 1.03–1.06). There was mediation by health behaviors, especially smoking, physical inactivity, alcohol use, and a higher BMI, in the associations among depression, anxiety, and overall cancer or other types of cancer, but effects were small (HRs generally below 1.01).
Conclusions
Smoking constitutes a mediating pathway linking depression and anxiety to lung cancer and smoking-related cancers. Our findings underline the importance of smoking cessation interventions for persons with depression or anxiety.
Scanning, transmission, and analytical electron microscopy studies of shales from the Salton Sea geothermal field revealed that phyllosilicates progress through zones of illite-muscovite (115°−220°C), chlorite (220°−310°C), and biotite (310°C). These phyllosilicates occur principally as discrete, euhedral to subhedral crystals which partly fill pore space. The structural and chemical heterogeneity, which is typical of phyllosilicates in shales subject to diagenesis, is generally absent. Textures and microstructures indicate that the mineral progression involves dissolution of detrital phases, mass transport through interconnecting pore space, and direct crystallization of phyllosilicates from solution.
Phyllosilicate stability relations indicate that either increase in temperature or changing ion concentrations in solutions with depth are capable of explaining the observed mineral zoning. Textural and compositional data suggest that the observed mineral assemblages and the interstitial fluids approach equilibrium relative to the original detrital suites. The alteration process may have occurred in a single, short-lived, episodic hydrothermal event in which the original detrital phases (smectite, etc.) reacted directly to precipitate illite, chlorite, or biotite at different temperatures (depths) without producing intermediate phases.
Wyoming bentonite, Fithian illite, and basalt from the Umtanum Formation, Washington, were treated hydrothermally at 200° to 460°C and 260 to 500 bars for 71 to 584 days. No change was detected for the bentonite and basalt, except for the loss of calcite and exchange of Ca for K in the smectite and the growth of a small amount of smectite (presumably from a glass phase) in the basalt. Calcite in the initial bentonite may have stabilized the smectite by Ca/K exchange; thus, if the latter is used as a packing material in a nuclear waste repository, limestone should be added. No change was detected in the illite samples treated <300°C; however, at 360°C, euhedral crystals of berthierine and illite grew at the expense of original illite/smectite, apparently by a solution-crystallization process. Significant changes involving the dissolution of starting phases and the formation of illite and chlorite were also detected in mixtures of basalt and bentonite at 400°C; at temperatures <400°C, no changes were observed.
The newly formed mineral phases (berthierine, illite, and chlorite) observed by transmission electron microscopy showed euhedral to subhedral shapes. These shapes are the same as those observed in hydrothermally altered sediments from the Salton Sea field and different from those from burial metamorphic environments, such as Gulf Coast sediments. The reaction mechanism is apparently the dissolution of reactants followed by the crystallization of products from solution, without conservation of structural elements of the reactants. Reactions apparently required temperatures greater than those for analogous changes in nature, suggesting that the degree of reaction was controlled by kinetics. The lack of dissolution in experimental runs at low temperatures, however, does not necessarily imply long-term stabilities of these clay minerals.
Using a life tables approach with 2011–2017 claims data, we calculated lifetime risks of Clostridioides difficile infection (CDI) beginning at age 18 years. The lifetime CDI risk rates were 32% in female patients insured by Medicaid, 10% in commercially insured male patients, and almost 40% in females with end-stage renal disease.
Due to the environmental problems derived from the use of common surfactants as modifiers for clay mineral adsorbents to mitigate mycotoxin contamination of animal feeds, finding non-toxic modifiers to prepare safe and efficient adsorbents is necessary. The objective of the present study was, therefore, to modify acidified palygorskite with polyhexamethylene biguanide (PHMB) to obtain antibacterial polyhexamethylene biguanide/palygorskite (PHMB/Plg) composites for the removal of zearalenone, a common mycotoxin. The PHMB/Plg composites were characterized and analyzed by X-ray diffraction, Fourier-transform infrared spectroscopy, field-emission scanning electron microscopy, and isothermal nitrogen adsorption analysis. The adsorption properties of the composites with respect to zearalenone and their antibacterial activity with respect to Escherichia coli and Staphylococcus aureus were studied. The results indicated that the hydrophobicity of palygorskite was enhanced after modification with PHMB, which could effectively improve the adsorption property of palygorskite toward the nonpolar zearalenone molecules. The adsorption capacity of PHMB/Plg increased with increasing amounts of polyhexamethylene biguanide and increasing pH. The adsorption data were described well by pseudo-second order kinetics and by the Langmuir adsorption model. The maximum adsorption capacity was 2777 μg/g. When the amount of PHMB added increased to 15 wt.%, the composites obtained exhibited good antibacterial performance, and the minimum inhibitory concentrations for Escherichia coli and Staphylococcus aureus were both at 2.5 mg/mL.
Major depressive disorder (MDD) contributes to suicide risk. Treating MDD effectively is considered a key suicide prevention intervention. Yet many patients with MDD do not respond to their initial medication and require a ‘next-step’. The relationship between next-step treatments and suicidal thoughts and behaviors is uncharted.
Method
The VA Augmentation and Switching Treatments for Depression trial randomized 1522 participants to one of three next-step treatments: Switching to Bupropion, combining with Bupropion, and augmenting with Aripiprazole. In this secondary analysis, features associated with lifetime suicidal ideation (SI) and attempts (SA) at baseline and current SI during treatment were explored.
Results
Compared to those with SI only, those with lifetime SI + SA were more likely to be female, divorced, or separated, unemployed; and to have experienced more childhood adversity. They had a more severe depressive episode and were more likely to respond to ‘next-step’ treatment. The prevalence of SI decreased from 46.5% (694/1492) at baseline to 21.1% (315/1492) at end-of-treatment. SI during treatment was associated with baseline SI; low positive mental health, more anxiety, greater severity and longer duration of current MDD episode; being male and White; and treatment with S-BUP or C-BUP as compared to A-ARI.
Conclusion
SI declines for most patients during next-step medication treatments. But about 1 in 5 experienced emergent or worsening SI during treatment, so vigilance for suicide risk through the entire 12-week acute treatment period is necessary. Treatment selection may affect the risk of SI.
This article presents a theoretical modelling framework for the previously unconsidered case of turbulent wall plumes that detrain continually with height in stably stratified environments. Built upon the classic turbulent plume model, our approach incorporates turbulent detrainment with a variable coefficient of detrainment. Based on a linear constitutive relationship between the ratio of the detrainment to entrainment coefficients and the ambient buoyancy gradient, it is found that for linear ambient stratifications, a dynamic quasi-equilibrium region, characterised by a near invariant local plume Richardson number, is achieved, downstream of which this equilibrium rapidly breaks down. With increasing ambient buoyancy gradient, while the plume becomes increasingly slender with weaker vertical motions, the level at which the plume breaks down to form a horizontal intrusion first decreases and then increases. Moreover, distinct from classic purely entraining plumes, a detraining wall plume can swell within the pre-equilibrium adjustment stage provided the local Richardson number is sufficiently low $({Ri\ll 6})$, behaviour which is in accordance with observations made in filling-box experiments.
The linear temporal and absolute/convective stability characteristics of a thermal plume generated along a heated vertical cylinder are investigated theoretically under the Boussinesq approximation. Special focus is given to the uniform-wall-buoyancy-flux case whereby the cylinder surface sustains the same linear temperature gradient as the environment. A competition between the axisymmetric and helical modes is a remarkable feature of the instability, distinguishing these ‘annular plumes’ from free plumes/jets for which the helical mode is generally dominant. It is found that higher surface curvature stabilises the temporal axisymmetric mode significantly, but only has moderate effects on the helical mode. The most temporally unstable perturbation mode switches from a helical into an axisymmetric mode when the Prandtl number increases beyond a critical value. Both the roles of shear and buoyancy during the destabilisation are identified through an energy analysis which indicates that, while the shear work is usually a major source of perturbation energy, the buoyancy work manifests for long-wave axisymmetric perturbation modes, and for thin cylinders and high Prandtl numbers. For the specific temperature configuration considered herein, an annular plume is always convectively unstable whereas decreasing the cylinder radius from the planar limiting case first decreases and then increases the tendency of the flow towards being absolutely unstable. The helical mode is especially susceptible to being absolutely unstable on very thin cylinders. Several conditions for the onset of cellular thermal convection and plume detrainment are proposed based on our results and a hypothesis which connects the absolute instability to the detrainment phenomenon.
To evaluate the incidence of a candidate definition of healthcare facility-onset, treated Clostridioides difficile (CD) infection (cHT-CDI) and to identify variables and best model fit of a risk-adjusted cHT-CDI metric using extractable electronic heath data.
Methods:
We analyzed 9,134,276 admissions from 265 hospitals during 2015–2020. The cHT-CDI events were defined based on the first positive laboratory final identification of CD after day 3 of hospitalization, accompanied by use of a CD drug. The generalized linear model method via negative binomial regression was used to identify predictors. Standardized infection ratios (SIRs) were calculated based on 2 risk-adjusted models: a simple model using descriptive variables and a complex model using descriptive variables and CD testing practices. The performance of each model was compared against cHT-CDI unadjusted rates.
Results:
The median rate of cHT-CDI events per 100 admissions was 0.134 (interquartile range, 0.023–0.243). Hospital variables associated with cHT-CDI included the following: higher community-onset CDI (CO-CDI) prevalence; highest-quartile length of stay; bed size; percentage of male patients; teaching hospitals; increased CD testing intensity; and CD testing prevalence. The complex model demonstrated better model performance and identified the most influential predictors: hospital-onset testing intensity and prevalence, CO-CDI rate, and community-onset testing intensity (negative correlation). Moreover, 78% of the hospitals ranked in the highest quartile based on raw rate shifted to lower percentiles when we applied the SIR from the complex model.
Conclusions:
Hospital descriptors, aggregate patient characteristics, CO-CDI burden, and clinical testing practices significantly influence incidence of cHT-CDI. Benchmarking a cHT-CDI metric is feasible and should include facility and clinical variables.
The post-compression technique based on self-phase modulation of high-energy pulses leads to an increase in achievable peak power and intensity. Typically, the pulses considered in experiments have been less than 100 fs in duration. Here, the method is applied to the ELFIE laser system at the LULI facility, for a pulse of 7 J energy and an initial measured duration of 350 fs. A 5-mm-thick fused silica window and a 2 mm cyclic-olefin polymer were used as optical nonlinear materials. The 9 cm diameter beam was spectrally broadened to a bandwidth corresponding to 124 fs Fourier-limited pulse duration, and then it was partly post-compressed to 200 fs. After measuring the spatial spectra of the beam fluence, a uniform gain factor of 4 increase in the fluctuations over the studied range of frequencies is observed, due to small-scale self-focusing.
Burnout is well characterised in physicians and residents but not in paediatric cardiology fellows, and few studies follow burnout longitudinally. Training-specific fears have been described in paediatric cardiology fellows but also have not been studied at multiple time points. This study aimed to measure burnout, training-specific fears, and professional fulfilment in paediatric cardiology fellows with the attention to time of year and year-of-training.
Methods:
This survey-based study included the Professional Fulfillment Index and the Impact of Events Scale as well as an investigator-designed Fellow Fears Questionnaire. Surveys were distributed at three-time points during the academic year to paediatric cardiology fellows at a large Midwestern training programme. Fellow self-reported gender and year-of-training were collected. Descriptive analyses were performed.
Results:
10/17 (59%) of fellows completed all surveys; 60% were female, 40% in the first-year class, 40% in the second-year class, and 20% in the third-year class. At least half of the fellows reported burnout at each survey time point, with lower mean professional fulfilment scores. The second-year class, who rotate primarily in the cardiac ICU, had higher proportions of burnout than the other two classes. At least half of fellows reported that they “often” or “always” worried about not having enough clinical knowledge or skills and about work–life balance.
Conclusions:
Paediatric cardiology fellows exhibit high proportions of burnout and training-specific fears. Interventions to mitigate burnout should be targeted specifically to training needs, including during high-acuity rotations.
To evaluate the prevalence of hospital-onset bacteremia and fungemia (HOB), identify hospital-level predictors, and to evaluate the feasibility of an HOB metric.
Methods:
We analyzed 9,202,650 admissions from 267 hospitals during 2015–2020. An HOB event was defined as the first positive blood-culture pathogen on day 3 of admission or later. We used the generalized linear model method via negative binomial regression to identify variables and risk markers for HOB. Standardized infection ratios (SIRs) were calculated based on 2 risk-adjusted models: a simple model using descriptive variables and a complex model using descriptive variables plus additional measures of blood-culture testing practices. Performance of each model was compared against the unadjusted rate of HOB.
Results:
Overall median rate of HOB per 100 admissions was 0.124 (interquartile range, 0.00–0.22). Facility-level predictors included bed size, sex, ICU admissions, community-onset (CO) blood culture testing intensity, and hospital-onset (HO) testing intensity, and prevalence (all P < .001). In the complex model, CO bacteremia prevalence, HO testing intensity, and HO testing prevalence were the predictors most associated with HOB. The complex model demonstrated better model performance; 55% of hospitals that ranked in the highest quartile based on their raw rate shifted to a lower quartile when the SIR from the complex model was applied.
Conclusions:
Hospital descriptors, aggregate patient characteristics, community bacteremia and/or fungemia burden, and clinical blood-culture testing practices influence rates of HOB. Benchmarking an HOB metric is feasible and should endeavor to include both facility and clinical variables.