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Coronary artery complications are the main reason for early mortality after an arterial switch operation. Late complications are relatively rare, and there is no consensus regarding the need or indications for routine follow-up coronary artery evaluations or the best first-line assessment modality. The aim of this study was to present the long-term post-operative frequency of coronary abnormalities in asymptomatic patients with transposition of the great arteries discovered by coronary CT angiography and potential “red flags” revealed by other examinations.
Patients and methods:
A group of 50 consecutive asymptomatic patients who underwent routine long-term coronary artery evaluation after an arterial switch operation according to our institutional protocol were qualified for this study. This routine in-hospital visit included a detailed medical interview, electrocardiography, echocardiography, Holter electrocardiography examinations, and laboratory and cardiopulmonary exercise tests. Patients who showed significant abnormalities were qualified for perfusion scintigraphy.
Unfavourable coronary abnormalities were detected in 30 patients (60%) and included ostial stenosis, muscular bridge, coronary fistula, interarterial course, proximal kinking, high ellipticity index, proximal acute angulation (<30 degree) of the left coronary artery, and proximal acute angulation of the right coronary artery. These features could not be predicted based on the medical interviews, surgical reports, or non-invasive screening test results.
Complex coronary configurations with potentially dangerous coronary features are common in patients with transposition after an arterial switch operation. Such high-risk patients cannot be identified indirectly, and coronary CT angiography provides accurate information that is useful for post-operative management.
The ability of “comfort-food” (CF) diet to revert long-term effects of early-life stress (ELS) is less well known. The objective of this study was to verify if the chronic exposure to CF diet in animals submitted to ELS could relief the stress response at behavioral, neuroendocrine, and neurobiochemical levels, via differences in glucocorticoid receptors expression in brain areas involved in the stress response. From the second day of life, litters of Wistar rats and their mothers were submitted to the reduced nesting material protocol (ELS). In adult life, ELS and a control group were exposed chronically to two diet schemes: standard rat chow only or both “CF” diet, containing fat (34%) and sugar (20%) and a diet similar to the standard diet. Anxiety-like behavior, neuroendocrine response stress, leptin, GR, SOCS-3, pSTAT3, and the abdominal fat were evaluated. The anxiety-like behavior results showed that ELS group when exposed to comfort food were not different from the others groups. Chronic exposure to CF diet induced an anxiety-like behavior in the control group. Groups chronically exposed to CF diet had lower levels of corticosterone over time independent of the neonatal group. The ELS group exposed to the “CF” diet had higher levels of hippocampal GR, lower levels of hypothalamic SOCS-3 and greater accumulation of abdominal fat. Chronic CF diet consumption is able to reduce corticosterone levels independent of the neonatal history, but is associated with anxiety-like behavior in animals without previous history of trauma. Metabolic disturbances like increased adiposity and altered SOCS-3 seem to be a result of multiple insults (neonatal trauma followed by chronic CF diet). We highlight that the Control-chow and ELS-chow data were previously published, and are included in this study for comparative analysis.
A new deep level transient spectroscopy (DLTS) technique is described, called half-width at variable intensity analysis. This method utilizes the width and normalized intensity of a DLTS signal to determine the activation energy and capture cross section of the trap that generated the signal via a variable, kO. This constant relates the carrier emission rates giving rise to the differential capacitance signal associated with a given trap at two different temperatures: the temperature at which the maximum differential capacitance is detected, and an arbitrary temperature at which some nonzero differential capacitance signal is detected. The extracted activation energy of the detected trap center is used along with the position of the peak maximum to extract the capture cross section of the trap center.
Recent studies have indicated only limited agreement between theoretically calculated X-ray absorption, fluorescence, and electron penetration correction factors and calibration curves obtained from alloy standards in binary systems. For some practical metallurgical problems, including diffusion gradient studies, intermediate phase identifications, etc., where analytical precision is required, alloy standards must be employed.
Most metallurgical investigations, however, are concerned with alloys containing a variety of elements. The use of theoretical calculations in these analyses is severely limited. At present, the precision of analyzed chemistries in such systems is somewhat poorer than the precision of the measured X-ray intensity values. Methods for applying combinations of theoretically calculated corrections, extrapolations from nominal alloy chemistries, etc. have been employed which yield reasonable analytical precisions but at best are first-order approximations. Approximate calculations for use in determining the chemistries of fine precipitates or inclusions where matrix excitation is unavoidable are also discussed.
Studies on the association between depression and dementia risk mostly use sum scores on depression questionnaires to model symptomatology severity. Since individual items may contribute differently to this association, this approach has limited validity.
We used network analysis to investigate the functioning of individual Geriatric Depression Scale (GDS-15) items, of which, based on studies that used factor analysis, 3 are generally considered to measure apathy (GDS-3A) and 12 depression (GDS-12D). Functional disability and future dementia were also included in our analysis. Data were extracted from 3229 participants of the Prevention of Dementia by Intensive Vascular care trial (preDIVA), analyzed as a single cohort, yielding 20,542 person-years of observation. We estimated a sparse network by only including connections between variables that could not be accounted for by variance in other variables. For this, we used a repeated L1 regularized regression procedure.
This procedure resulted in a selection of 59/136 possible connections. GDS-3A items were strongly connected to each other and with varying strength to several GDS-12D items. Functional disability was connected to all three GDS-3A items and the GDS-12D items “helplessness” and “worthlessness”. Future dementia was only connected to the GDS-12D item “memory problems”, which was in turn connected to the GDS-12D items “unhappiness” and “helplessness” and all three GDS-3A items.
Network analysis reveals interesting relationships between GDS items, functional disability and dementia risk. We discuss what implications our results may have for (future) research on the associations between depression and/or apathy with dementia.
In this paper we provide a novel and unified formal analysis of the stress microvariation found in verb–enclitic groupings in Barcelona Catalan, with stress stability, in Formentera Catalan, with stress shift to the penultimate and the last syllable of the whole sequence, and in Mallorca and Menorca Catalan, with stress shift to the last syllable. We argue that stress shift in Formentera Catalan conforms directly to the unmarked pattern of nominal stress in Catalan, that is, a right-aligned moraic trochee, with the constraint All-Feet-Right undominated, leading to final and penultimate stress. In Barcelona Catalan, the effects of this constraint are inhibited by an anti-alignment constraint prohibiting the right edge of a foot from coinciding with the right edge of a clitic. In Mallorca and Menorca Catalan, stress shift is also understood as a strategy to meet the unmarked nominal stress pattern of Catalan, although in these dialects the anti-alignment constraint is also undominated, leading to catalexis, in this case a melodically empty mora, and thus to final stress.
Desperate to find a weapon so that his older brother can participate in a tournament, the young Arthur secretly pulls a sword from a stone and is thus recognised as the King of Britain. This story is ubiquitous today, but in medieval England it was only one of several narratives of how the young king came to the throne. The story is first told around 1200 in the French prose Merlin and this romance, along with the other parts of the Vulgate Cycle, was popular throughout late-medieval Britain. It is perhaps best known through its inclusion in Thomas Malory's late fifteenth-century Morte Darthur, but it is also found in other texts which translate the French Merlin, including Of Arthour and of Merlin (late thirteenth century), Henry Lovelich's verse Merlin (1420s or 1430s) and the Middle English prose Merlin (mid-fifteenth century).
One other translation of this scene merits attention. It is found in London, College of Arms MS Arundel 58, a mid-fifteenth-century copy of Robert of Gloucester's Metrical Chronicle. Inserted as an interpolation in its Arthurian narrative, the Arundel Coronacio Arthuri amounts to 398 lines of original Middle English verse and it reveals the complex relationship between the chronicle tradition of King Arthur's reign and the French romance tradition which complemented and, at times, contradicted the historical narrative. The poem also shares features with its fellow English versions of the story, and thus gives us some insight into the circulation of the French prose Merlin in England and the reading habits of the scribe of Arundel 58.
Not used extensively by either of the two editors of Robert of Gloucester's Metrical Chronicle, Arundel 58 begins with ‘The tabile offe cronycil offe Engelonde’ and the claim that ‘Thys boke with hys antecedens and consequens was ful ended the vj day offe Auguste the ʒere of oure lorde a Ml CCC. xlviij’ (i.e. 1448). This date may refer to when the text of Robert's Chronicle was brought together with a summarising prologue (i.e. ‘hys antecedens’) and a concluding pedigree of Henry VI (i.e. the ‘consequens’), but the Chronicle could not have been copied much earlier. The text of Robert's verse has been extensively expanded with prose excerpts from a variety of sources including the Middle English Brut, and translations of Geoffrey of Monmouth, William of Malmesbury, John of Glastonbury and others.
Evidence suggests that both high and low birth weight children have increased the risk for obesity and the metabolic syndrome in adulthood. Previously we have found altered feeding behaviour and food preferences in pre-school children and adults born with low birth weight. In this study, we investigated if birth weight was associated with different intake of fat, carbohydrate and/or protein at 6–12 years of age. This is a cross-sectional study where 255 guardians answered online and telephone questions including anthropometrics and demographic data, parental family food rules (food control, encouragement and restriction) and a complete web-based FFQ for their children (130 boys and 125 girls). Baseline demographic and parental food rules characteristics did not differ accordingly to sex. Linear regression models were conducted separately for each sex, adjusted for income, age and maternal age. There were no differences in total energy intake, but energy density (ED, energy content/g) was negatively associated with birth weight in boys. Macronutrient analysis showed that ED intake was from a greater intake of fat. Birth weight was not a significant predictor of protein and carbohydrate intake in boys. In girls, we saw a positive correlation between fat intake and cholesterol intake v. birth weight, but no association with ED intake (results did not remain after adjustment). The study shows that low birth weight is associated with altered fat intake in childhood in a sex-specific manner. It is likely that biological factors such as fetal programming of homoeostatic and/or hedonic pathways influencing food preferences are involved in this process.
To elucidate the mechanisms of how snack foods may induce non-homeostatic food intake, we used resting state functional magnetic resonance imaging (fMRI), as resting state networks can individually adapt to experience after short time exposures. In addition, we used graph theoretical analysis together with machine learning techniques (support vector machine) to identifying biomarkers that can categorize between high-caloric (potato chips) vs. low-caloric (zucchini) food stimulation.
Seventeen healthy human subjects with body mass index (BMI) 19 to 27 underwent 2 different fMRI sessions where an initial resting state scan was acquired, followed by visual presentation of different images of potato chips and zucchini. There was then a 5-minute pause to ingest food (day 1=potato chips, day 3=zucchini), followed by a second resting state scan. fMRI data were further analyzed using graph theory analysis and support vector machine techniques.
Potato chips vs. zucchini stimulation led to significant connectivity changes. The support vector machine was able to accurately categorize the 2 types of food stimuli with 100% accuracy. Visual, auditory, and somatosensory structures, as well as thalamus, insula, and basal ganglia were found to be important for food classification. After potato chips consumption, the BMI was associated with the path length and degree in nucleus accumbens, middle temporal gyrus, and thalamus.
The results suggest that high vs. low caloric food stimulation in healthy individuals can induce significant changes in resting state networks. These changes can be detected using graph theory measures in conjunction with support vector machine. Additionally, we found that the BMI affects the response of the nucleus accumbens when high caloric food is consumed.
Epigenetic DNA modifications in genes related to the hypothalamic–pituitary–adrenal (HPA) axis are discussed as a mechanism underlying the association between prenatal depression and altered child HPA activity. In a longitudinal study, DNA methylation changes related to prenatal depressive symptoms were investigated in 167 children aged 6 to 9 years. At six candidate genes, 126 cytosine–guanine dinucleotides were considered without correcting for multiple testing due to the exploratory nature of the study. Further associations with the basal child HPA activity were examined. Children exposed to prenatal depressive symptoms exhibited lower bedtime cortisol (p = .003, ηp2 = 0.07) and a steeper diurnal slope (p = .023, ηp2 = 0.06). For total cortisol release, prenatal exposure was related to lower cortisol release in boys, and higher release in girls. Furthermore, prenatal depressive symptoms were associated with altered methylation in the glucocorticoid receptor gene (NR3C1), the mineralocorticoid receptor gene (NR3C2), and the serotonin receptor gene (SLC6A4), with some sex-specific effects (p = .012–.040, ηp2 = 0.03–0.04). In boys, prenatal depressive symptoms predicted bedtime cortisol mediated by NR3C2 methylation, indirect effect = –0.07, 95% confidence interval [–0.16, –0.02]. Results indicate relations of prenatal depressive symptoms to both child basal HPA activity and DNA methylation, partially fitting a mediation model, with exposed boys and girls being affected differently.
The present study used a sheep model of intrauterine growth restriction, combining maternal undernutrition and twinning, to determine possible markers of early damage to the fetal kidney. The occurrence of early deviations in fetal hemodynamics which may be indicative of changes in blood perfusion was assessed by Doppler ultrasonography. A total of 24 sheep divided in two groups were fed with the same standard grain-based diet but fulfilling either their daily maintenance requirements for pregnancy (control group; n=12, six singleton and six twin pregnancies) or only the 50% of such quantity (food-restricted group; n=12; four singleton and eight twin pregnancies). All the fetuses were assessed by both B-mode and Doppler ultrasonography at Day 115 of pregnancy. Fetal blood supply was affected by maternal undernutrition, although there were still no evidences of brain-sparing excepting in fetuses at greatest challenge (twins in underfed pregnancies). However, there were early changes in the blood supply to the kidneys of underfed fetuses and underfed twins evidenced decreases in kidney size.
The prolonged interval from calving to first ovulation in beef cows is primarily due to the suckling-mediated inhibition of pulsatile LH release. Undernutrition both before and after calving also suppresses LH release, reduces ovarian follicular growth and delays ovulation. The interactive effects of these factors on the interval from calving to first ovulation in beef cows were quantified by studying the incidence of ovulation, following acute calf isolation and once-a-day suckling (restricted access), after emergence of the fourth follicular wave post partum in cows in differing body condition at calving and offered low or high planes of nutrition after calving.
The experiment was a 2 x 2 x 2 factorial design, in which the factors were body condition score at calving (Low v. Moderate), feeding level after calving (0.6 v. 1.0 MJ ME/d/kg M0.75), and restricted (once-a-day) v. ad libitum access and suckling. The experiment, duplicated at each of the four participating sites, involved 16 Simmental, 16 Sarda, 16 Brown Swiss and 16 Hereford x Friesian multi-parous cows. Follicle growth was monitored daily from day 21 post partum until the earlier of second ovulation or Day 90 post partum using transrectal ovarian ultrasonography.
Aberrant reward mechanisms with regard to slim body shapes are discussed in patients with anorexia nervosa (AN). The aim of the present study was to examine of cue reactivity toward body shapes in AN via the late positive potential (LPP), an event-related electroencephalography (EEG) component. By including adolescents and adults, aspects of development and chronification could be studied (2 × 2 design).
Thirty-two female AN patients (19 adolescents and 13 adults) and 37 control participants (16 adolescents and 21 adults) were included. Standardized photographic stimuli showing women's bodies in underwear from five body mass index (BMI) categories (extremely underweight to extremely overweight) were presented. During picture evaluation, EEG activity was recorded (10–20 system). The LPP was measured in two time windows characterized by different topographies (450–700 ms: posterior; 1000–1300 ms: central).
Regarding the posterior component, LPP amplitudes were clearly reduced in adult but not in adolescent patients; for both time windows the LPP showed differential patterns over BMI categories for patients and controls. Regarding the central component, a highly significant linear decrease from extremely underweight to extremely overweight body shapes was revealed in patients and no significant modulation in control participants.
Adolescent and adult patients show increased sustained attention toward extremely underweight bodies. In chronically ill patients, this bias appears to be accompanied by generally reduced automatic attention. The LPP findings provide a differentiated picture of aberrant cue reactivity which could be interpreted as motivated attention toward body shapes in AN.
Over the period 1995–2012, the incidence of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup Y (NmY) increased significantly in Sweden. This is mainly due to the emergence of a predominant cluster named strain type YI subtype 1, belonging to the ST-23 clonal complex (cc). The aim of this study was to examine the clinical picture of patients with invasive disease caused by NmY and to analyse whether the predominant cluster exhibits certain clinical characteristics that might explain the increased incidence. In this retrospective observational study, the medical records available from patients with IMD caused by Nm serogroup Y in Sweden between 1995 and 2012 were systematically reviewed. Patient characteristics, in-hospital findings and outcome were studied and differences between the dominating cluster and other isolates were analysed. Medical records from 175 of 191 patients were retrieved. The median age was 62 years. The all-cause mortality within 30 days of admission was 9% (15/175) in the whole material; 4% (2/54) in the cohort with strain type YI subtype 1 and 11% (12/121) among patients with other isolates. Thirty-three per cent of the patients were diagnosed with meningitis, 19% with pneumonia, 10% with arthritis and 35% were found to have bacteraemia but no apparent organ manifestation. This survey included cases with an aggressive clinical course as well as cases with a relatively mild clinical presentation. There was a trend towards lower mortality and less-severe disease in the cohort with strain type YI subtype 1 compared with the group with other isolates.
In our reply to Elise van Nederveen Meerkerk’s “Big Questions and Big Data: The Role of Labour and Labour Relations in Recent Global Economic History”, we focus on her observations on the Global Collaboratory on the History of Labour Relations. We endorse many of her suggestions to connect global labour and economic history and to regard labour relations not only as a dependent variable. In fact, as the examples from various Collab workshops and publications show, some of these ideas are already being put into practice. These examples also show that if we seriously want to combine global labour and economic history data and join the debate on the growth (or decrease) in social inequality, workers’ individual and collective agency must be taken on board. Finally, we argue that global labour and economic historians can benefit most from each other’s disciplines by truly working together in collaborative projects, developing new theories, perhaps less grand than those with which economic historians attract so much attention, but more profound.
The introductory article to this volume offers an analytical framework for the capacities in which states have historically affected labour relations. The framework captures the full range of possible manifestations of state power, including early states, empires, regional authorities, and city states. It distinguishes between the state as a direct actor or participant, carrying out tasks deemed essential for its functioning, and the state as an arbiter, redistributor, or regulator. As conquerors or employers, states are confronted with a basic dilemma: how to extract and allocate the labour resources required to accomplish state tasks. Borrowing from Charles Tilly, the two broad categories of capital and coercion are used as a heuristic device to bring order to the ways in which states have solved this dilemma. Contrary to Tilly’s trajectories of state formation, states’ reliance on capital or coercion is subject to a great degree of flexibility, both over time and across space. In their capacities as mediators and regulators, modern states came to have an even more profound impact on labour relations, as state building moved away from the single focus on organizing the extraction of resources to a wider mission of fostering welfare, economic development, and human capital formation.
This study analyses the shifts in labour relations due to state intervention, first during the conquest of the Ming empire between 1600 and 1644 by its Manchurian contenders, and thereafter until about 1780, as the Manchurian Qing dynasty established itself and drove the Chinese empire to its greatest expansion. The main focus lies on the socio-military formation of the Eight Banners, the institution that, for about 200 years, epitomized the domination of the Chinese empire by a small elite group of about two per cent of the population. These findings will be contextualized in the larger setting of labour relations of the early and mid-Qing, when state intervention occurred in the form of arbitration in labour conflicts, but also, in a much more aggressive manner, in the decimation of the Qing rulers’ Dzungharian rivals. In the framework of Charles Tilly’s paradigm of capital versus coercion, while both are present in the Chinese case, the capital-oriented path seems more distinct.
A high proportion of patients with remitted major depressive disorder (MDD) will experience recurring episodes, whilst some develop resilience and remain in recovery. The neural basis of resilience to recurrence is elusive. Abnormal resting-state connectivity of the subgenual cingulate cortex (sgACC) was previously found in cross-sectional studies of MDD, suggesting its potential pathophysiological importance. The current study aimed to investigate whether resting-state connectivity to a left sgACC seed region distinguishes resilient patients from those developing recurring episodes.
A total of 47 medication-free remitted MDD patients and 38 healthy controls underwent resting-state functional magnetic resonance imaging (fMRI) at baseline. Over 14 months, 30 patients remained resilient whilst 17 experienced a recurring episode.
Attenuated interhemispheric left-to-right sgACC connectivity distinguished the resilient from the recurring-episode and control groups and was not correlated with residual depressive symptoms.
The current study revealed a neural signature of resilience to recurrence in MDD and thereby elucidates the role of compensatory adaptation in sgACC networks.
In the last five years, more monographs about Marcion have been published than during the hundred years before. What is it about this man that make scholars worldwide feel the need to interact with him so intensively? And why now, of all times?