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Physiological, political, and poetic studies of the relationship between the human body and voice saw increased attention and took on new significance in British literature of the politically turbulent period between the 1770s and the 1820s. Focusing on Erasmus Darwin, John Thelwall, and Percy Bysshe Shelley, three writers whose works draw together the fields of science, politics, language, and literature, and who were subject to charges of political radicalism and materialist philosophy, Alice Rhodes draws attention to a developing theory of spoken and poetic utterance which, for its subscribers, suggested a fundamental, material, and reciprocal connection between the speaking body and the physical, social, and political worlds around it. By investigating the Romantic-era fascination with the mechanics and physiology of speech production, she explores how Darwin, Thelwall, and Shelley came to present the voice as a form of physical, autonomous, and effective political action.
The Han Dynasty, which ruled from 202 BCE to 212 CE, is often taken as a reference point and model for Chinese identity and tradition. Covering a geographical expanse comparable to that of the People's Republic of China, it is foundational to understanding Chinese culture and politics, past and present. This volume offers an up-to-date overview of the archaeology of the Han Empire. Alice Yao and Wengcheong Lam study the period via an interdisciplinary approach that combines textual and archaeological evidence. Exploring the dynamics of empire building in East Asia, Yao and Lam draw on recent archaeological discoveries to recast Western Han imperialism as a series of contingent material projects, including the organization of spatial orders, foodways, and the expansion of communication and ritual activities. They also demonstrate how the archaeology of everyday life offers insights into the impact of social change, and how people negotiated their identities and cultural affiliations as individuals and imperial subordinates.
Objectives: There is a lack of research on differences between decision-making capacity and awareness according to age at onset of dementia. We investigated the relationship between decision-making capacity and awareness domains in people with young-(YOAD) and late-onset Alzheimer´s Disease (LOAD).
Methods: A cross-sectional study included 169 consecutively selected people with AD and their caregivers (124 people with LOAD and 45 people with YOAD). Decision-making capacity was assessed with the MacCAT-T and awareness with the ASPIDD scale.
Results: People with YOAD were more cognitively impaired, but more aware of their cognitive deficits and health condition, with moderate effect sizes. We did not find any other significant differences between the groups in the other domains of awareness. In addition, there were no significant differences in the domains of decision-making capacity between groups. All PwAD presented deficits in the domains of decision-making capacity with a greater impairment in the understanding domain (YOAD = mean 3.67, SD 1.57; LOAD = mean 3.80, SD 1.22). Understanding was the domain of MacCAT-T most significantly associated with awareness domains: ASPIDD Total (p < 0.001), awareness of cognitive deficits and health condition (p < 0.001), awareness of emotional state (p < 0.008), awareness of social functioning and relationships (p < 0.001), and awareness of impaired functional activity (p < 0.001). However, age at onset only impacted total ASPIDD (p < 0.013) and awareness of cognitive deficits and health condition (p < 0.001).
Conclusions: Better awareness involved better understanding in the YOAD group. Clinically, our findings shed light on the need to consider the differences in the domains of awareness and their relationship with other clinical aspects such as decision-making capacity according to age at onset of AD.
Introduction: The progression of dementia may be followed by decreased sexual activity for People with Alzheimer’s Disease (PwAD) and their spouse-carers. The aim of this study was to investigate the perception of change in sexual activity and sexual satisfaction among couples whose spouses were diagnosed with Alzheimer’s Disease (AD).
Methods: Using a cross-sectional design, we compared 74 dyads of people with Alzheimer´s disease (PwAD) and their spouse-carers, and 21 elderly dyads control. We assessed sexual satisfaction with Questionnaire on Sexual Experience and Satisfaction (QSES), cognition using a Mini-Mental State Examination (MMSE), disease severity using a Clinical Dementia Rating scale (CDR), awareness of disease with Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), functionality with Pfeffer Functional Activities Questionnaire (FAQ), depressive symptoms with Cornell Scale for Depression in Dementia (CSDD), quality of life using a Quality of Life in Alzheimer’s Disease Scale (QoL-AD), and burden using a Zarit Burden Interview (ZBI). Univariate and multivariate regression analyses were conducted to identify the factors that influenced couples’ sexual satisfaction.
Results: We found a significant difference between the perception and no perception of change in sexual activity of PwAD (p < 0.001), spouse-carers (p < 0.01), and controls (p < 0.05). Moderate to severe sexual dissatisfaction was observed in 36.5% of PwAD, 65% of spouse- carers, and 31% of controls. The linear regression indicated that PwAD sexual satisfaction was related to cognitive impairment (p < 0.05). Spouse-caregivers sexual satisfaction was related to gender of spouse-caregivers (p < 0.05) and the presence of sexual activity (p < 0.001).
Conclusions: The perception of change and consequent interruption of sexual activity, with higher sexual dissatisfaction, were higher in PwAD and their spouse-carers, in comparison with control group. We also found that spouse-carers experienced lower levels of sexual satisfaction than PwAD and healthy elderly couples. Moreover, PwAD sexual satisfaction was related to the level of cognitive impairment and spouse-carers’ sexual satisfaction was related to gender and the presence of sexual activity.
Introduction: People with young-onset Alzheimer’s disease (YOAD) are diagnosed when the neurocognitive process begins before the age of 65 and often present with more global impairments and a more rapid course of the disease. In contrast, in late-onset Alzheimer’s disease (LOAD), the loss of short-term memory is most pronounced. Therefore, the age of onset may affect global functioning in different ways.
Objectives: This study examines the relationship between Social Cognition, global cognition, and other clinical variables in young and late-onset people with Alzheimer’s disease and their caregivers.
Methods: Using a cross-sectional design, we included 48 people with YOAD and 118 with LOAD and their carers. We assessed social cognition, global cognition, quality of life, dementia severity, mood, functionality, neuropsychiatric symptoms, and caregiver burden.
Results: Our results showed that the YOAD group had more global cognitive impairment, lower MMSE scores (P = 0.018, d = 0.41), higher Adas cog (P = 0.002, d = 0.06), poorer quality of life (QoL- AD) (P = 0.036, d = 0.36), and more neuropsychiatric symptoms (NPI) (P = 0.044, d = 0.35). However, social cognition showed a stable pattern of impairments in YOAD that did not follow the global deficits. The multifactorial regression analyses further showed that in both groups functionality was significantly related to Social Cognition, YOAD (P = 0.035), and LOAD (P = 0.001).
Conclusions: The significant findings of our study underscore that in YOAD, despite more pronounced global impairment compared to LOAD, social cognition remains stable. This finding is crucial for understanding the patterns of social cognition in YOAD and may potentially guide future interventions and care strategies.
The Atlantic Forest is one of the most threatened biomes globally. Data from monitoring programs are necessary to evaluate the conservation status of species, prioritise conservation actions and to evaluate the effectiveness of these actions. Birds are particularly well represented in citizen-collected datasets that are used worldwide in ecological and conservation studies. Here, we analyse presence-only data from three online citizen science datasets of Atlantic Forest endemic bird species to evaluate whether the representation of these species was correlated with their global threat status, range and estimated abundance. We conclude that even though species are over- and under-represented with regard to their presumed abundance, data collected by citizen scientists can be used to infer species distribution and, to a lesser degree, species abundance. This pattern holds true for species across global threat status.
In the context of the ongoing biodiversity crisis, understanding forest ecosystems, their tree species composition, and especially the successional stages of their development is crucial. They collectively shape the biodiversity within forests and thereby influence the ecosystem services that forests provide, yet this information is not readily available on a large scale. Remote sensing techniques offer promising solutions for obtaining area-wide information on tree species composition and their successional stages. While optical data are often freely available in appropriate quality over large scales, obtaining light detection and ranging (LiDAR) data, which provide valuable information about forest structure, is more challenging. LiDAR data are mostly acquired by public authorities across several years and therefore heterogeneous in quality. This study aims to assess if heterogeneous LiDAR data can support area-wide modeling of forest successional stages at the tree species group level. Different combinations of spectral satellite data (Sentinel-2) and heterogeneous airborne LiDAR data, collected by the federal government of Rhineland-Palatinate, Germany, were utilized to model up to three different successional stages of seven tree species groups. When incorporating heterogeneous LiDAR data into random forest models with spatial variable selection and spatial cross-validation, significant accuracy improvements of up to 0.23 were observed. This study shows the potential of not dismissing initially seemingly unusable heterogeneous LiDAR data for ecological studies. We advocate for a thorough examination to determine its usefulness for model enhancement. A practical application of this approach is demonstrated, in the context of mapping successional stages of tree species groups at a regional level.
This article was written before Andrea Robin Skinner, daughter of Alice Munro, wrote an essay in the Toronto Star on July 7, 2024, describing her mother's silence in the face of her abuse at the hands of Munro's husband/Skinner's stepfather, Gerald Fremlin. I wish to honour Skinner's story and her courage in coming forward, as well as her wish that “… this story, my story, to become part of the stories people tell about my mother.” I, like so many others, will continue to grapple with Munro's writing and her reflections on intimate human relationships — as well as her literary legacy — following these revelations.
Simultaneous ultra-intense pulses at petawatt laser facilities enable a broad range of experiments in nuclear photonics and strong field quantum electrodynamics. These experiments often require very precise control of the time delays between pulses. We report measurements of the time delay between the two 1 PW outputs of the Extreme Light Infrastructure - Nuclear Physics (ELI-NP) facility in Romania. The short-term standard deviation of the time delay was approximately half of the pulse duration of 23 fs, and the average delay drifted with up to 100 fs/h. The drift and sporadic delay jumps were corrected using a feedback loop, which reduced the long-term standard deviation of the delay close to its short-term value. These results imply that in ELI-NP experiments using two simultaneous pulses, a temporal overlap of better than half of the pulse duration can be achieved for more than two thirds of the shots, which would enable high data rate experiments using simultaneous petawatt pulses.
Theoretical and empirical contributions have identified insula as key in addiction. However, anatomical modifications of the insula in addictive states, and their variations across substance use disorders (SUDs), remain to be specifically explored. We therefore explored the specificities and commonalities of insula gray matter (GM) alterations in severe alcohol use disorder (sAUD) and severe cocaine use disorder (sCUD).
Methods
We explored insula GM volume through a refined parcellation in 12 subregions (six bilateral): anterior inferior cortex (AIC), anterior short gyrus, middle short gyrus, posterior short gyrus, anterior long gyrus (ALG), and posterior long gyrus (PLG). Using a linear mixed model analysis, we explored the insula volume profiles of 50 patients with sAUD, 61 patients with sCUD, and 36 healthy controls (HCs).
Results
In both sAUD and sCUD, we showed overall insular lower volume with a right-sided lateralization effect, and a major volume deficit in bilateral ALG. Moreover, differences emerged across groups, with higher left AIC and PLG volume deficits in sCUD compared to sAUD and HC.
Conclusions
We offered the first joint exploration of GM insular volumes in two SUD through refined parcellation, thus unveiling the similarities and dissimilarities in volume deficit profiles. Our results bring evidence complementing prior ones suggesting the core role of the right and posterior insula in craving and interoception, two crucial processes in addiction. Left AIC and PLG group differences also show that, while insula is a region of interest in SUD, sCUD and sAUD generate distinct insular profiles, which might parallel clinical differences across SUD.
The taxonomy of the subfamily Scolytinae has traditionally been based on external morphological attributes corresponding to the elytral declivity, head, and pronotum. Some traits from the general morphology of the aedeagus and spermatheca have been proposed in scarce genera. In this study, we explore and improve a technique of endophallus inflation to apply it in Scolytinae members and to describe its morphology for the first time in 16 species from Dendroctonus Erichson, Ips DeGeer, and Phloeosinus Chapuis. These taxa display differences in the attachment types of endophallus and two distinct inflation and retraction mechanisms. Our results support the use of the internal sac as a taxonomic feature in Scolytinae because each tribe, genus, and species display a particular morphological pattern. The results also indicate use of the internal sac for Dendroctonus taxonomy supports phylogenetic inferences.
In confined systems, the entrapment of a gas volume with an equivalent spherical diameter greater than the dimension of the channel can form extended bubbles that obstruct fluid circuits and compromise performance. Notably, in sealed vertical tubes, buoyant long bubbles cannot rise if the inner tube radius is below a critical value near the capillary length. This critical threshold for steady ascent is determined by geometric constraints related to the matching of the upper cap shape with the lubricating film surrounding the elongated part of the bubble. Developing strategies to overcome this threshold and release stuck bubbles is essential for applications involving narrow liquid channels. Effective strategies involve modifying the matching conditions with an external force field to facilitate bubble ascent. However, it is unclear how changes in acceleration conditions affect the motion onset of buoyancy-driven long bubbles. This study investigates the mobility of elongated bubbles in sealed tubes with an inner radius near the critical value inhibiting bubble motion in a vertical setting. Two strategies are explored to tune bubble motion, leveraging variations in axial and transversal accelerations: tube rotation around its axis and tube inclination relative to gravity. By revising the geometrical constraints of the simple vertical setting, the study predicts new thresholds based on rotational speed and tilt angle, respectively, providing forecasts for the bubble rising velocity under modified apparent gravity. Experimental measurements of motion threshold and rising velocity compare well with theoretical developments, thus suggesting practical approaches to control and tune bubble motion in confined environments.
Social determinants of health (SDOH) are an important contributor to health status and health outcomes. In this analysis, we compare SDOH measured both at the individual and population levels in patients with high comorbidity who receive primary care at Federally Qualified Health Centers in New York and Chicago and enrolled in the Tipping Points trial.
Methods:
We analyzed individual- and population-level measures of SDOH in 1,488 patients with high comorbidity (Charlson Comorbidity Index ≥ 4) enrolled in Tipping Points. At the individual level, we used a standardized patient-reported questionnaire. At the population level, we employed patient addresses to calculate the Social Deprivation Index (SDI) and Area Deprivation Index. Multivariable regressions were conducted in addition to qualitative feedback from stakeholders.
Results:
Individual-level SDOH are distinct from population-level measures. Significant component predictors of population SDI are being unhoused, unable to pay for utilities, and difficulty accessing medical transportation. Qualitative findings mirrored these results. High comorbidity patients report significant SDOH challenges at the individual level. Fitting a binomial generalized linear model, the comorbidity score is significantly predicted by the composite individual SDOH index (p < 0.0001) controlling for age and race/ethnicity.
Conclusions:
Individual- and population-level SDOH measures provide different risk assessments. The use of community-level SDI data is informative in the aggregate but should not be used to identify patients with individual unmet social needs. Health systems should implement a standardized individualized assessment of unmet SDOH needs and build strong, enduring partnerships with community-based organizations that can provide those services.
The spreading of large viscous drops of density-matched suspensions of non-Brownian spheres on a smooth solid surface is investigated experimentally at the global drop scale. The focus is on dense suspensions with a solid volume fraction equal to or greater than $40\,\%$, and for drops larger than the capillary length, i.e. for which the spreading is governed by the balance of gravitational and viscous forces. Our findings indicate that all liquids exhibit a power-law behaviour typical of gravity-driven dynamics, albeit with an effective suspension viscosity that is smaller than the bulk value. When the height of the drop is of the order of the particle size, the power law breaks down as the particles freeze while the contact line continues to advance.
Clostridioides difficile infection (CDI) may be misdiagnosed if testing is performed in the absence of signs or symptoms of disease. This study sought to support appropriate testing by estimating the impact of signs, symptoms, and healthcare exposures on pre-test likelihood of CDI.
Methods:
A panel of fifteen experts in infectious diseases participated in a modified UCLA/RAND Delphi study to estimate likelihood of CDI. Consensus, defined as agreement by >70% of panelists, was assessed via a REDCap survey. Items without consensus were discussed in a virtual meeting followed by a second survey.
Results:
All fifteen panelists completed both surveys (100% response rate). In the initial survey, consensus was present on 6 of 15 (40%) items related to risk of CDI. After panel discussion and clarification of questions, consensus (>70% agreement) was reached on all remaining items in the second survey. Antibiotics were identified as the primary risk factor for CDI and grouped into three categories: high-risk (likelihood ratio [LR] 7, 93% agreement among panelists in first survey), low-risk (LR 3, 87% agreement in first survey), and minimal-risk (LR 1, 71% agreement in first survey). Other major factors included new or unexplained severe diarrhea (e.g., ≥ 10 liquid bowel movements per day; LR 5, 100% agreement in second survey) and severe immunosuppression (LR 5, 87% agreement in second survey).
Conclusion:
Infectious disease experts concurred on the importance of signs, symptoms, and healthcare exposures for diagnosing CDI. The resulting risk estimates can be used by clinicians to optimize CDI testing and treatment.
To evaluate postoperative outcomes among patients undergoing colon surgery who receive perioperative prophylaxis with ertapenem compared to other antibiotic regimens.
Design and setting:
Multicenter retrospective cohort study among adults undergoing colon surgery in seven hospitals across three health systems from 1/1/2010 to 9/1/2015.
Methods:
Generalized linear mixed logistic regression models were applied to assess differential odds of select outcomes among patients who received perioperative prophylaxis with ertapenem compared to other regimens. Postoperative outcomes of interest included surgical site infection (SSI), Clostridioides difficile infection (CDI) and clinical culture positivity for carbapenem-resistant Enterobacteraciae (CRE). Inverse probability weights were applied to account for differing covariate distributions across ertapenem and non-ertapenem groups.
Results:
A total of 2,109 patients were included for analysis. The odds of postoperative SSI was 1.56 times higher among individuals who received ertapenem than among those receiving other perioperative antimicrobial prophylaxis regimens in our cohort (46 [3.5%] vs 20 [2.5%]; IPW-weighted OR 1.56, [95% CI, 1.08–2.26], P = .02). No statistically significant differences in odds of postoperative CDI (24 [1.8%] vs 16 [2.0%]; IPW-weighted OR 1.07 [95% CI, .68–1.68], P = .78) were observed between patients who received ertapenem prophylaxis compared to other regimens. Clinical CRE culture positivity was rare in both groups (.2%–.5%) and did not differ statistically.
Conclusions:
Ertapenem use for perioperative prophylaxis was associated with increased odds of SSI among patients undergoing colon surgery in our study population, though no differences in CDI or clinical CRE culture positivity were identified. Further study and replication of these findings are needed.