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What's the word that describes the process of making supportive noises when you're listening to someone? What is syntax and how does it differ from grammar? Do you know what a morpheme is? And did you know that it's not only an atom that has a nucleus? The Babel Lexicon of Language is an entertaining and accessible introduction to the key terminology involved in the study of language. It defines over 500 terms and uses contemporary language examples, explaining complex issues in an easy-to-understand way. Written by the expert editorial team behind Babel, the popular language magazine, and assuming no prior knowledge of linguistics, The Babel Lexicon of Language is an invaluable resource for students, teachers and anyone with an interest in language.
In this volume, Charles Taliaferro and Jil Evans promote aesthetic personalism by examining three domains of aesthetics - the philosophy of beauty, aesthetic experience, and philosophy of art - through the lens of Judaism, Christianity, Islam, theistic Hinduism, and the all-seeing Compassionate Buddha. These religious traditions assume an inclusive, overarching God's eye, or ideal point of view, that can create an emancipatory appreciation of beauty and goodness. This appreciation also recognizes the reality and value of the aesthetic experience of persons and deepens the experience of art works. The authors also explore and contrast the invisibility of persons and God. The belief that God or the sacred is invisible does not mean God or the sacred cannot be experienced through visual and other sensory or unique modes. Conversely, the assumption that human persons are thoroughly visible, or observable in all respects, ignores how racism and other forms of bias render persons invisible to others.
This comprehensive textbook provides a modern, self-contained treatment for upper undergraduate and graduate level students. It emphasizes the links between structure, defects, bonding, and properties throughout, and provides an integrated treatment of a wide range of materials, including crystalline, amorphous, organic and nano- materials. Boxes on synthesis methods, characterization tools, and technological applications distil specific examples and support student understanding of materials and their design. The first six chapters cover the fundamentals of extended solids, while later chapters explore a specific property or class of material, building a coherent framework for students to master core concepts with confidence, and for instructors to easily tailor the coverage to fit their own single semester course. With mathematical details given only where they strengthen understanding, 400 original figures and over 330 problems for hands-on learning, this accessible textbook is ideal for courses in chemistry and materials science.
Garlic mustard [Alliaria petiolata (M. Bieb.) Cavara & Grande] is a biennial invasive plant commonly found in the northeastern and midwestern United States. Although it is not recommended to apply herbicides after flowering, land managers frequently desire to conduct management during this timing. We applied glyphosate and triclopyr (3% v/v and 1% v/v using 31.8% and 39.8% acid equivalent formulations, respectively) postemergence to established, second-year A. petiolata populations at three locations when petals were dehiscing, and evaluated control, seed production and seed viability. Postemergence glyphosate applications at this timing provided 100% control of A. petiolata by 4 weeks after treatment at all locations whereas triclopyr efficacy was variable, providing 38-62% control. Seed production was only reduced at one location, with similar results regardless of treatment. Percent seed viability was also reduced, and when combined with reductions in seed production, we found a 71-99% reduction in number of viable seed produced plant-1 regardless of treatment. While applications did not eliminate viable seed production, our findings indicate that glyphosate and triclopyr applied while petals were dehiscing is a viable alternative to cutting or hand-pulling at this timing as it substantially decreased viable A. petiolata seed production.
Postemergence glyphosate and triclopyr applications in the early spring to rosettes are standard treatments used to manage A. petiolata. However, weather and other priorities limit the window for management, forcing field practitioners to utilize more labor-intensive methods such as hand-pulling. It is not known how late in the development of A. petiolata these herbicides can be applied to prevent viable seed production. Since prevention of soil seedbank replenishment is a key management factor for effective long-term control of biennial invasive species, we hypothesized late spring foliar herbicide applications to second year A. petiolata plants when flower petals were dehiscing could be an effective management tool if seed production or viability is eliminated. Our study indicated that glyphosate applications at this timing provided 100% control of A. petiolata plants by 4 weeks after treatment at all locations, whereas triclopyr efficacy was inconsistent. Although both glyphosate and triclopyr decreased viable seed production to nearly zero at one of our three study locations, the same treatments produced significant amounts of viable seed at the other two locations. Our findings suggest late spring glyphosate and triclopyr applications should not be recommended over early spring applications to rosettes for A. petiolata management, as our late spring application timing did not prevent viable seed production, and may require multiple years of implementation to eradicate populations. Nonetheless, this application timing holds value in areas devoid of desirable understory vegetation compared to no management practices or mechanical management options including hand-pulling when fruit are present, as overall viable seed production was reduced to similar levels as these treatments.
United States dentists prescribe 10% of all outpatient antibiotics. Assessing appropriateness of antibiotic prescribing has been challenging due to a lack of guidelines for oral infections. In 2019, the American Dental Association (ADA) published clinical practice guidelines (CPG) on the management of acute oral infections. Our objective was to describe baseline national antibiotic prescribing for acute oral infections prior to the release of the ADA CPG and to identify patient-level variables associated with an antibiotic prescription.
We performed an analysis of national VA data from January 1, 2017, to December 31, 2017. We identified cases of acute oral infections using International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Antibiotics prescribed by a dentist within ±7 days of a visit were included. Multivariable logistic regression identified patient-level variables associated with an antibiotic prescription.
Of the 470,039 VA dental visits with oral infections coded, 12% of patient visits with irreversible pulpitis, 17% with apical periodontitis, and 28% with acute apical abscess received antibiotics. Although the median days’ supply was 7, prolonged use of antibiotics was frequent (≥8 days, 42%–49%). Patients with high-risk cardiac conditions, prosthetic joints, and endodontic, implant, and oral and maxillofacial surgery dental procedures were more likely to receive antibiotics.
Most treatments of irreversible pulpitis and apical periodontitis cases were concordant with new ADA guidelines. However, in cases where antibiotics were prescribed, prolonged antibiotic courses >7 days were frequent. These findings demonstrate opportunities for the new ADA guidelines to standardize and improve dental prescribing practices.
To characterize postextraction antibiotic prescribing patterns, predictors for antibiotic prescribing and the incidence of and risk factors for postextraction oral infection.
Retrospective analysis of a random sample of veterans who received tooth extractions from January 1, 2017 through December 31, 2017.
VA dental clinics.
Overall, 69,610 patients met inclusion criteria, of whom 404 were randomly selected for inclusion. Adjunctive antibiotics were prescribed to 154 patients (38.1%).
Patients who received or did not receive an antibiotic were compared for the occurrence of postextraction infection as documented in the electronic health record. Multivariable logistic regression was performed to identify factors associated with antibiotic receipt.
There was no difference in the frequency of postextraction oral infection identified among patients who did and did not receive antibiotics (4.5% vs 3.2%; P = .59). Risk factors for postextraction infection could not be identified due to the low frequency of this outcome. Patients who received antibiotics were more likely to have a greater number of teeth extracted (aOR, 1.10; 95% CI, 1.03–1.18), documentation of acute infection at time of extraction (aOR, 3.02; 95% CI, 1.57–5.82), molar extraction (aOR, 1.78; 95% CI, 1.10–2.86) and extraction performed by an oral maxillofacial surgeon (aOR, 2.29; 95% CI, 1.44–3.58) or specialty dentist (aOR, 5.77; 95% CI, 2.05–16.19).
Infectious complications occurred at a low incidence among veterans undergoing tooth extraction who did and did not receive postextraction antibiotics. These results suggest that antibiotics have a limited role in preventing postprocedural infection; however, future studies are necessary to more clearly define the role of antibiotics for this indication.
The aim of this umbrella review was to summarize the evidence from existing systematic reviews on the association between different dietary patterns and overweight or obesity outcomes in adults.
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and searched the MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science for systematic reviews reporting on dietary patterns and weight gain or overweight/obesity outcomes.
We identified 16 systematic reviews with 143 unique studies published between 2001 and 2019. Overall quality scores ranged from four to 10. Six reviews in 2/11 cohort and 6/19 cross-sectional studies reported (statistically significant) decreased odds ratios (ORs) for obesity (range: 0.53 to 0.73 and 0.35 to 0.88, respectively) associated with the Mediterranean diet. Five reviews in 5/15 cohort and 10/45 cross-sectional studies reported an inverse association between diet quality and weight gain or body mass index (β range: -1.3 to -0.09). Two reviews in 1/3 cohort and 1/2 cross-sectional studies reported a decreased risk of obesity (OR=0.76) and weight gain (OR=0.26), respectively, with fruit and vegetable intake. Five reviews of mixed dietary patterns in 3/40 cross-sectional studies reported an increased prevalence of obesity (OR=1.19) or abdominal obesity (OR range: 1.07 to 1.27) with the Korean diet pattern.
Our umbrella review confirms the hypothesis that Mediterranean-type dietary patterns reduce the risk of obesity in adults. Although population-specific evidence of effective interventions is needed, characteristics of Mediterranean-type dietary patterns are important considerations for national obesity prevention strategies.
This research communication reports the results from questionnaires used to identify the impact of recent research into the disinfection of cattle foot-trimming equipment to prevent bovine digital dermatitis (BDD) transmission on (a) biosecurity knowledge and (b) hygiene practice of foot health professionals. An initial questionnaire found that more than half of participating farmers, veterinary surgeons and commercial foot-trimmers were not considering hand or hoof-knife hygiene in their working practices. The following year, after the release of a foot-trimming hygiene protocol and a comprehensive knowledge exchange programme by the University of Liverpool, a second survey showed 35/80 (43.8%) farmers, veterinary surgeons and commercial foot-trimmers sampled considered they were now more aware of the risk of spreading BDD during foot- trimming. Furthermore, 36/80 (45.0%) had enhanced their hygiene practice in the last year, impacting an estimated 1383 farms and 5130 cows trimmed each week. Participants who reported having seen both the foot-trimming hygiene protocol we developed with AHDB Dairy and other articles about foot-trimming hygiene in the farming and veterinary press, were significantly more likely to have changed their working practices. Difficulties accessing water and cleaning facilities on farms were identified as the greatest barrier to improving biosecurity practices. Participants' preferred priority for future research was continued collection of evidence for the importance and efficacy of good foot-trimming hygiene practices.
Yield gaps in milk production are here defined as the differentials between the actual yield obtained by the dairy farmer and the potential farm yield (production achieved by the top 10% of farmers: Gap 2) as well as the differential between this potential farm yield and the yield registered in the research stations (Gap 1). Assessment of yield gaps provides valuable information on potential production enhancement and drivers behind yield gaps. Milk production can be increased by narrowing the predominant large yield gaps in resource-poor smallholder farming system. Hence, this study assessed the milk yield gap and factors affecting the yield gap in Ri-Bhoi district of Meghalaya, a state located in the north-eastern Himalayan region of India. This research paper provides a scope for exploring the possibilities for improving dairy production in the state as well as contributing to literature through incorporating crucial determinants responsible for milk yield gap. A sample of 81 respondents was drawn purposely from two blocks of the district. The results indicated that the average number of cattle per household was 9.38 in standard animal units. The total yield gap was estimated at 6.20 l (91.06%) per day, composed of 0.80 l (11.76%) per day of yield gap I and 5.40 l (79.30%) per day of yield gap II. This demonstrates that the top performing farms were achieving a production level not dissimilar to that obtained on the research stations, but many were doing far less well. The size of cattle shed, dairy farming experience, concentrate price and human labour were the important determinants of the yield gap. Hence, encouraging the right stocking density of cattle, training on the preparations of home-made concentrates, access to cheap and quality concentrates, incorporating training and experience sharing on proper dairy management practices and use of technology could benefit the dairy farmers of the region.
One strategy for the containment of a pandemic is mass testing. Magen David Adom (MDA), the Israeli National Emergency Medical Services (EMS) Organization undertook this mission by operating a nationwide series of drive-through testing complexes. The objective of this study is to learn lessons from an analysis of these centers. Data from 198 stationary and mobile drive-through complexes from March 20, 2020, through October 17, 2020, were analyzed for temporal and geographic factors, and cost. Also, an operational improvement program was implemented and analyzed. A total of 931,074 patients were sampled in the MDA drive-through system: 46.9% in stationary complexes, and 53.1% in mobile complexes. The optimized cost per patient of home testing was estimated at 74.5 USD compared to 6.55 USD in the drive-through centers. An operational improvement program lowered the total sampling time from 128 seconds per patient to 98 seconds and decreased the total cost per patient from 6.55 USD to 6.27 USD. The EMS led drive-through complexes were cost-effective and efficient in performing large numbers of viral tests, especially when compared to home testing. Established concepts in clinical operations should be implemented to increase the number of persons that can be tested and decrease cost.
In response to the 2013–2016 Ebola virus disease outbreak, the US government designated certain healthcare institutions as Ebola treatment centers (ETCs) to better prepare for future emerging infectious disease outbreaks. This study investigated ETC experiences and critical care policies for patients with viral hemorrhagic fever (VHF).
A 58-item questionnaire elicited information on policies for 9 critical care interventions, factors that limited care provision, and innovations developed to deliver care.
Setting and participants:
The questionnaire was sent to 82 ETCs.
We analyzed ordinal and categorical data pertaining to the ETC characteristics and descriptive data about their policies and perceived challenges. Statistical analyses assessed whether ETCs with experience caring for VHF patients were more likely to have critical care policies than those that did not.
Of the 27 ETCs who responded, 17 (63%) were included. Among them, 8 (47%) reported experience caring for persons under investigation or confirmed cases of VHF. Most felt ready to provide intubation, chest compressions, and renal replacement therapy to these patients. The factors most cited for limiting care were staff safety and clinical futility. Innovations developed to better provide care included increased simulation training and alternative technologies for procedures and communication.
There were broad similarities in critical care policies and limitations among institutions. There were several interventions, namely ECMO and cricothyrotomy, which few institutions felt ready to provide. Future studies could identify obstacles to providing these interventions and explore policy changes after increased experience with novel infectious diseases, such as COVID-19.
The current study assessed whether the proportion of childhood (age 0–9 years) in poverty altered the developmental trajectories (ages 9–24) of multimethodological indicators of psychological well-being. In addition, we tested whether exposure to cumulative risk over time mediated the association between poverty exposure and psychological well-being. Measures of psychological well-being included internalizing and externalizing symptoms, a behavioral index of learned helplessness (task persistence), and chronic physiological stress (allostatic load). Exposure to poverty during childhood predicted the trajectory of each development outcome: individuals with more poverty exposure during childhood showed (a) relatively high levels of internalizing symptoms that diminished more slowly with maturation, (b) relatively high levels of externalizing symptoms that increased faster over time, (c) less task persistence indicative of greater learned helplessness, and (d) higher levels of chronic physiological stress which increased faster over time relative to persons with less childhood poverty exposure. Trajectories of cumulative risk exposure from physical and psychosocial surroundings from 9–24 years accounted for the association between childhood poverty and the growth curves of internalizing and externalizing symptoms but not for learned helplessness or chronic physiological stress. Additional sensitivity analyses indicate that early childhood disadvantage is particularly problematic for each outcome, except for internalizing symptoms which seem sensitive to the combination of early and lifetime poverty exposure. We also explored whether domains of cumulative risk as well as two alternatives, maternal sensitivity or family cohesion, functioned as mediators. Little evidence emerged for any of these alternative mediating constructs.
Recent studies of efforts to increase citizen engagement in local governance through information campaigns report mixed results. We consider whether low levels of self-efficacy beliefs limit engagement, especially among poor citizens in poor countries. Citizens may be caught in an “efficacy trap” which limits their realization of better public goods provision. We describe results from a series of experimental studies conducted with over 2,200 citizens in rural Tanzania, in which we compare the effects of standard information campaigns with Validated Participation (VP), an intervention designed to socially validate citizens’ participation. We implement a staged approach to experimental research, seeking to balance ethical and cost concerns about field experimentation. In our main analyses, we find that VP did not lead to increased levels of self-efficacy or more active citizen behaviors relative to standard informational treatments. Nonetheless, we find some promising evidence for VP in a follow-up qualitative study with teachers. We conclude by discussing lessons from this research and directions for future investigation of the possible role of self-efficacy traps in development.
Simulation training has become a core component in the training of ENT surgeons. It provides the opportunity for the repetitive practice of a surgical technique. Simulators are broadly categorised into low- and high-fidelity simulators. A method using a home microprocessor to enhance a low-fidelity surgical simulator is introduced.
The Yorick tonsil tie trainer was enhanced using an Arduino microcontroller attached to the simulated inferior pole of the tonsil. The Arduino was coded to give a visual stimulus when linear motion exceeded parameters. The prototype simulator was tested to gain information on whether the enhancement could identify differences between novice and expert users.
An enhanced low-fidelity tonsil trainer was produced using a low-cost, simple home microprocessing board. The enhanced simulator gives objective feedback allowing for self-directed learning. Further research is required to evaluate the benefits of these enhancements above non-enhanced simulation training.
Past findings on the connection between class position and political preferences are overwhelmingly derived from cross-sectional studies, which provided a limited basis for inferring causality. This study uses long-term panel data on thousands of British respondents to measure the impact of intra-generational class mobility across a range of political identities and preferences. Upward class mobility leads to small increases in economic conservatism, but party choice, class identity and attitudes to non-economic issues do not change. This updating of economic values is much smaller than cross-sectional differences between classes. These results are consistent with the short-run effects of class mobility operating primarily through a limited economic self-interest mechanism. Beliefs that are plausibly unconnected to economics are unaffected. The overall association between class and a range of identities, opinions and preferences is therefore more likely to be caused by early life experiences and longer-term socialization than by the immediate material interests associated with jobs.
A transformative approach to language education calls for an expanded understanding of curriculum and program design that leverages potential learning environments both in and outside the classroom - in academic, residential, and social settings - to support language and culture learning. This chapter provides an overview of curricular and co-curricular learning environments designed by the University of Wisconsin-Madison Russian Flagship that offer affordances for transformative language and culture learning for its students. Elements of the program's design that facilitate transformative learning include: (1) positioning students as independent language learners striving to meet programmatic and personal goals; (2) providing a continuum of opportunities for language and culture learning in formal instructional environments, individual and small-group tutorials, and residential and social contexts in which students engage in meaningful interactions in Russian with various interlocutors, reflecting the concept of open architecture design for learning; and (3) offering spaces for reflection in supportive, low-stakes environments, potentially leading to transformative change.
This study compared the level of education and tests from multiple cognitive domains as proxies for cognitive reserve.
The participants were educationally, ethnically, and cognitively diverse older adults enrolled in a longitudinal aging study. We examined independent and interactive effects of education, baseline cognitive scores, and MRI measures of cortical gray matter change on longitudinal cognitive change.
Baseline episodic memory was related to cognitive decline independent of brain and demographic variables and moderated (weakened) the impact of gray matter change. Education moderated (strengthened) the gray matter change effect. Non-memory cognitive measures did not incrementally explain cognitive decline or moderate gray matter change effects.
Episodic memory showed strong construct validity as a measure of cognitive reserve. Education effects on cognitive decline were dependent upon the rate of atrophy, indicating education effectively measures cognitive reserve only when atrophy rate is low. Results indicate that episodic memory has clinical utility as a predictor of future cognitive decline and better represents the neural basis of cognitive reserve than other cognitive abilities or static proxies like education.