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We investigate how early exposure to parental externalizing behaviors (EB) may contribute to development of alcohol use disorders (AUD) in young adulthood, testing a developmental cascade model focused on competencies in three domains (academic, conduct, and work) in adolescence and emerging adulthood, and examining whether high parental education can buffer negative effects of parental EB and other early risk factors. We use data from 451,054 Swedish-born men included in the national conscript register. Structural equation models showed parental EB was associated with academic and behavioral problems during adolescence, as well as with lower resilience, more criminal behavior, and reduced social integration during emerging adulthood. These pathways led to elevated rates of AUD in emerging and young adulthood. Multiple groups analysis showed most of the indirect pathways from parental EB to AUD were present but buffered by higher parental education, suggesting early life experiences and competencies matter more for young men from lower socioeconomic status (SES) families than from higher SES families. Developmental competencies in school, conduct, and work are important precursors to the development of AUD by young adulthood that are predicted by parental EB. Occupational success may be an overlooked source of resilience for young men from low-SES families.
Yukon Territory (YT) is a remote region in northern Canada with ongoing spread of tuberculosis (TB). To explore the utility of whole genome sequencing (WGS) for TB surveillance and monitoring in a setting with detailed contact tracing and interview data, we used a mixed-methods approach. Our analysis included all culture-confirmed cases in YT (2005–2014) and incorporated data from 24-locus Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats (MIRU-VNTR) genotyping, WGS and contact tracing. We compared field-based (contact investigation (CI) data + MIRU-VNTR) and genomic-based (WGS + MIRU-VNTR + basic case data) investigations to identify the most likely source of each person's TB and assessed the knowledge, attitudes and practices of programme personnel around genotyping and genomics using online, multiple-choice surveys (n = 4) and an in-person group interview (n = 5). Field- and genomics-based approaches agreed for 26 of 32 (81%) cases on likely location of TB acquisition. There was less agreement in the identification of specific source cases (13/22 or 59% of cases). Single-locus MIRU-VNTR variants and limited genetic diversity complicated the analysis. Qualitative data indicated that participants viewed genomic epidemiology as a useful tool to streamline investigations, particularly in differentiating latent TB reactivation from the recent transmission. Based on this, genomic data could be used to enhance CIs, focus resources, target interventions and aid in TB programme evaluation.
Ground-penetrating radar data acquired in the 2016/17 austral summer on Sørsdal Glacier, East Antarctica, provide evidence for meltwater lenses within porous surface ice that are conceptually similar to firn aquifers observed on the Greenland Ice Sheet and the Arctic and Alpine glaciers. These englacial water bodies are associated with a dry relict surface basin and consistent with perennial drainage into an interconnected englacial drainage system, which may explain a large englacial outburst flood observed in satellite imagery in the early 2016/17 melt season. Our observations indicate the rarely-documented presence of an englacial hydrological system in Antarctica, with implications for the storage and routing of surface meltwater. Future work should ascertain the spatial prevalence of such systems around the Antarctic coastline, and identify the degree of surface runoff redistribution and storage in the near surface, to quantify their impact on surface mass balance.
This article, the first detailed scholarly assessment of northern responses to the death of former Confederate President Jefferson Davis in December 1889, contributes to ongoing academic debates over the troubled process of sectional reconciliation after the Civil War. Southern whites used their leader's funeral obsequies to assert not only their affection for the deceased but also their devotion to the Lost Cause that he had championed and embodied. Based on an analysis of northern newspapers and mass-circulation magazines in the two weeks after Davis's death, the essay demonstrates that many northerners, principally Republican politicians and editors, Union veterans, and African Americans, were outraged by southerners’ flagrant willingness to laud a man whom they regarded as the arch-traitor and that they remained opposed to reconciliation on southern terms. However, despite continuing concerns about public displays of affection for the Confederacy evident at the time of Davis's reinterment in Richmond in May 1893, northern opposition to the Lost Cause waned rapidly in the last decade of the nineteenth century. Full-blown sectional reconciliation occurred after the Republicans gave up on their efforts to enforce black voting rights in the South and President William McKinley's imperialist foreign policy necessitated, and to some degree garnered, support from southern whites. The death of Jefferson Davis, therefore, can be seen as an important event in the difficult transition from a heavily sectionalized postwar polity to a North-South rapprochement based heavily on political pragmatism, sentiment, nationalism, and white supremacism.
Tree-ring reconstructions of temperature often target trees at altitudinal or latitudinal tree line where annual growth is broadly expected to be limited by and respond to temperature variability. Based on this principal, regions with sparse tree line would seem to be restricted in their potential to reconstruct past temperatures. In the northeastern United States, there are only two published temperature reconstructions. Previous work in the region reconstructing moisture availability, however, has shown that using a greater diversity of species can improve reconstruction model skill. Here, we use a network of 228 tree-ring records composed of 29 species to test the hypothesis that an increase in species diversity among the pool of predictors improves reconstructions of past temperatures. Chamaecyparis thyoides alone explained 31% of the variability in observed cool-season minimum temperatures, but a multispecies model increased the explained variance to 44%. Liriodendron tulipifera, a species not previously used for temperature reconstructions, explained a similar amount of variance as Chamaecyparis thyoides (12.9% and 20.8%, respectively). Increasing the species diversity of tree proxies has the potential for improving reconstruction of paleotemperatures in regions lacking latitudinal or elevational tree lines provided that long-lived hardwood records can be located.
Few studies have used genomic epidemiology to understand tuberculosis (TB) transmission in rural and remote settings – regions often unique in history, geography and demographics. To improve our understanding of TB transmission dynamics in Yukon Territory (YT), a circumpolar Canadian territory, we conducted a retrospective analysis in which we combined epidemiological data collected through routine contact investigations with clinical and laboratory results. Mycobacterium tuberculosis isolates from all culture-confirmed TB cases in YT (2005–2014) were genotyped using 24-locus Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats (MIRU-VNTR) and compared to each other and to those from the neighbouring province of British Columbia (BC). Whole genome sequencing (WGS) of genotypically clustered isolates revealed three sustained transmission networks within YT, two of which also involved BC isolates. While each network had distinct characteristics, all had at least one individual acting as the probable source of three or more culture-positive cases. Overall, WGS revealed that TB transmission dynamics in YT are distinct from patterns of spread in other, more remote Northern Canadian regions, and that the combination of WGS and epidemiological data can provide actionable information to local public health teams.
Expression of estrus (EST) near the time of fixed-time artificial insemination (FTAI) increases pregnancy success in beef females. This outcome has been associated with improved pregnancy establishment and maintenance, although research is still warranted to validate this theory. Hence, this experiment compared ovarian, uterine and conceptus factors associated with pregnancy establishment in Bos indicus beef cows according to estrous expression during a FTAI protocol. One hundred lactating multiparous Nelore cows received a 2 mg injection of estradiol benzoate and an intravaginal progesterone (P4) releasing device on day −11, a 12.5 mg injection of prostaglandin F2α on day −4, P4 device removal in addition to 0.6 mg injection of estradiol cypionate and 300 IU injection of equine chorionic gonadotropin on day −2, and FTAI on day 0. An estrous detection patch was attached to the tailhead of each cow on day −2, and estrous expression was defined as removal of >50% of the rub-off coating from the patch at FTAI. Overall, 39 cows expressed EST, 55 did not express EST (NOEST), and six cows lost their patch and were discarded from the experiment. Ovarian ultrasonography was performed at FTAI, and on days 7 and 15 of the experiment. Blood samples were also collected on days 7 and 15. Only cows without a corpus luteum (CL) on day 0, and with a CL on days 7 and 15 remained in the experiment (EST, n=36; NOEST, n=48). On day 15, cows were randomly selected within each group (EST, n=29; NOEST, n=30) for conceptus collection via transcervical flushing, followed by endometrial biopsy in the uterine horn ipsilateral to the CL. Within cows not assigned to conceptus collection, blood samples were collected for whole blood RNA extraction (day 20) and pregnancy status was verified by transrectal ultrasonography (day 30). Diameter of dominant follicle on day 0 and plasma P4 concentrations on day 7 were greater (P⩽0.02) in EST v. NOEST cows. Conceptus length and messenger RNA (mRNA) expression of prostaglandin E synthase and interferon-tau were greater (P⩽0.04) in EST v. NOEST cows. Moreover, EST cows diagnosed as pregnant on day 30 had greater (P<0.01) blood mRNA expression of myxovirus resistance 2 on day 20 compared with NOEST. In summary, estrous expression near the time of FTAI enhanced pregnancy establishment factors in B. indicus cows, including conceptus development and mRNA expression of interferon-tau.
Patulous Eustachian tube is a benign but notoriously difficult condition to treat successfully. Symptoms include autophony of voice and breathing, and aural fullness.
This paper presents a series of 8 patients (12 ears) for whom a novel computed tomography guided injection of silicone elastomer suspension implant (Vox) was used to treat patulous Eustachian tube. This is the largest and only series in the current literature using this technique.
The combined complete and partial symptom resolution rate was 91 per cent. Complications related to the procedure are described. The pros and cons of this novel approach are also discussed in relation to traditional endoscopic transnasal techniques.
Computed tomography guided injection of Vox for the treatment of patulous Eustachian tube is suggested to be a feasible alternative to endoscopic transnasal approaches, particularly for refractory cases.
Instrumental variable (IV) methods are widely used to address endogeneity concerns. Yet, a specific kind of endogeneity – spatial interdependence – is regularly ignored. We show that ignoring spatial interdependence in the outcome results in asymptotically biased estimates even when instruments are randomly assigned. The extent of this bias increases when the instrument is also spatially clustered, as is the case for many widely used instruments: rainfall, natural disasters, economic shocks, and regionally- or globally-weighted averages. Because the biases due to spatial interdependence and predictor endogeneity can offset, addressing only one can increase the bias relative to ordinary least squares. We demonstrate the extent of these biases both analytically and via Monte Carlo simulation. Finally, we discuss a general estimation strategy – S-2SLS – that accounts for both outcome interdependence and predictor endogeneity, thereby recovering consistent estimates of predictor effects.
Solvency II came into force on 1 January 2016 and included a transitional measure on technical provisions (“TMTP”) designed to help smooth in the capital impact of Solvency II over a 16-year period. The working party’s view is that the main intention of the TMTP is to mitigate the impact of the introduction of the risk margin, which significantly increases the technical provisions of firms, relative to their Solvency I Pillar 2 liabilities.
The majority of firms who hold a TMTP have now had at least one recalculation approved by the Prudential Regulation Authority (PRA); or are in the process of applying for a recalculation. Despite this large number of approved recalculations, there remains significant uncertainty in the industry around the approach and triggers for recalculation.
This paper considers aspects of TMTP recalculation for regulated UK life firms, for example practicalities of the calculation, asset and liability considerations, and communications/announcements.
In this paper, we outline the need for pragmatism when considering the approach to recalculation of a measure originally intended to serve as the bridge between two regimes. We call for an allowance for doing what is sensible in a principles-based regime balancing what might be more theoretically correct with what is practical and possible to support effective management of the business.
Previous qualitative research analyzing social media and online community discussions highlighted the symptomatic burden of cough and mucus (sputum), alongside shortness of breath, in patients with chronic obstructive pulmonary disease (COPD). The objective of this study was to determine the relative importance of these symptoms and their consequences (for example, disturbed sleep) to COPD patients, compared with conventional COPD endpoints (lung function and exacerbations).
A total of 1,050 patients (at least 40 years of age) with moderate to severe COPD or chronic bronchitis, and regular symptoms of cough and excess mucus production, are to be recruited through patient advocacy groups (PAGs) from five countries (Australia, France, Japan, the United Kingdom, and the United States; 150 to 400 patients per country). A discrete choice experiment was designed with input from clinical experts and the PAGs, plus scientific advice from the National Institute for Health and Care Excellence (NICE) in the United Kingdom. Patients’ preferences for the conditional relative importance of symptoms and impact of COPD will be quantified based on trade-offs they are willing to make among hypothetical COPD disease state profiles, described by differing attributes and levels. Hierarchical Bayesian analysis with effect-coding parameterization will be undertaken on the choice data to estimate (using Gibbs sampling) the relative value each respondent places on an attribute level.
The feedback from NICE informed the selection of screening criteria and the statistical analysis plan, as well as the inclusion of a health status measure, the EQ-5D-3L. Qualitative patient interviews and pilot testing of the attributes and levels grid have been completed, informing finalization of the online survey design.
Patient preference studies evaluating the relative importance of symptom burden through assessment of disease state preference values are an important new form of patient-based evidence for informing value-based decision making in HTA. The present study should facilitate a more patient-centered approach to developing new treatments for and improving the care of patients with COPD.
A variety of paediatric tracheostomy tubes are available. This article reviews the tubes in current use at Great Ormond Street Hospital for Children and Evelina London Children's Hospital.
This paper outlines our current preferences, and the particular indications for different tracheostomy tubes, speaking valves and other attachments.
Our preferred types of tubes have undergone significant design changes. This paper also reports further experience with certain tubes that may be useful in particular circumstances. An updated sizing chart is included for reference purposes.
The choice of a paediatric tracheostomy tube remains largely determined by individual clinical requirements. Although we still favour a small range of tubes for use in the majority of our patients, there are circumstances in which other varieties are indicated.
Excitable temperament disrupts physiological events required for reproductive development in cattle, but no research has investigated the impacts of temperament on growth and puberty attainment in Bos indicus females. Hence, this experiment evaluated the effects of temperament on growth, plasma cortisol concentrations and puberty attainment in B. indicus heifers. A total of 170 Nelore heifers, weaned 4 months before the beginning of this experiment (days 0 to 91), were managed in two groups of 82 and 88 heifers each (mean ± SE; initial BW=238±2 kg, initial age=369±1 days across groups). Heifer temperament was evaluated via exit velocity on day 0. Individual exit score was calculated within each group by dividing exit velocity into quintiles and assigning heifers with a score from 1 to 5 (1=slowest; 5=fastest heifer). Heifers were classified according to exit score as adequate (ADQ, n=96; exit score⩽3) or excitable temperament (EXC, n=74; exit score>3). Heifer BW, body condition score (BCS) and blood samples were obtained on days 0, 31, 60 and 91. Heifer exit velocity and score were recorded again on days 31, 60 and 91. Ovarian transrectal ultrasonography was performed on days 0 and 10, 31 and 41, 60 and 70, 81 and 91 for puberty evaluation. Heifer was declared pubertal at the first 10-day interval in which a corpus luteum was detected. Exit velocity and exit score obtained on day 0 were correlated (r⩾0.64, P<0.01) with evaluations on days 31, 60 and 91. During the experiment, ADQ had greater (P<0.01) mean BCS and BW gain, and less (P<0.01) mean plasma cortisol concentration compared with EXC heifers. Temperament × time interactions were detected (P<0.01) for exit velocity and exit score, which were always greater (P<0.01) in EXC v. ADQ heifers. A temperament × time interaction was also detected (P=0.03) for puberty attainment, which was delayed in EXC v. ADQ heifers. At the end of the experiment, a greater (P<0.01) proportion of ADQ were pubertal compared with EXC heifers. In summary, B. indicus heifers classified as EXC had reduced growth, increased plasma cortisol concentrations and hindered puberty attainment compared to ADQ heifers. Moreover, exit velocity may serve as temperament selection criteria to optimize development of B. indicus replacement heifers.
Most agree that models of binary time-series-cross-sectional data in political science often possess unobserved unit-level heterogeneity. Despite this, there is no clear consensus on how best to account for these potential unit effects, with many of the issues confronted seemingly misunderstood. For example, one oft-discussed concern with rare events data is the elimination of no-event units from the sample when estimating fixed effects models. Many argue that this is a reason to eschew fixed effects in favor of pooled or random effects models. We revisit this issue and clarify that the main concern with fixed effects models of rare events data is not inaccurate or inefficient coefficient estimation, but instead biased marginal effects. In short, only evaluating event-experiencing units gives an inaccurate estimate of the baseline risk, yielding inaccurate (often inflated) estimates of predictor effects. As a solution, we propose a penalized maximum likelihood fixed effects (PML-FE) estimator, which retains the complete sample by providing finite estimates of the fixed effects for each unit. We explore the small sample performance of PML-FE versus common alternatives via Monte Carlo simulations, evaluating the accuracy of both parameter and effects estimates. Finally, we illustrate our method with a model of civil war onset.
Unusual mafic rock fragments deposited in Plio-Pleistocene-aged marine sediments were recorded at Integrated Ocean Drilling Program (IODP) Site U1359, in Wilkes Land, East Antarctica. These fragments were identified from sediment layers deposited between c. 3 and 1.2 Ma, indicating a sustained supply during this time interval. Clinopyroxenes in these basalts are Al–Ti diopside–hedenbergite, uncommon in terrestrial magmatic rocks. A single strong peak in the Raman spectra of a phosphate-bearing mineral at 963 cm-1 supports the presence of merrillite. Although not conclusive, petrological traits and oxygen isotopic compositions also suggest that the fragments may be extra-terrestrial fragments affected by shock metamorphism. Nevertheless, it is concluded that the basaltic fragments incorporated in marine sediments at Site U1359 represent ice-rafted material supplied to the continental rise of East Antarctica, probably from the bedrocks near the proximal Ninnis Glacier. Further studies on Plio-Pleistocene sediments near Site U1359 are required to characterize the unusual mafic rocks described.
We propose here a generalization of the problem addressed by the SHGH conjecture. The SHGH conjecture posits a solution to the question of how many conditions a general union
of fat points imposes on the complete linear system of curves in
of fixed degree
, in terms of the occurrence of certain rational curves in the base locus of the linear subsystem defined by
. As a first step towards a new theory, we show that rational curves play a similar role in a special case of a generalized problem, which asks how many conditions are imposed by a general union of fat points on linear subsystems defined by imposed base points. Moreover, motivated by work of Di Gennaro, Ilardi and Vallès and of Faenzi and Vallès, we relate our results to the failure of a strong Lefschetz property, and we give a Lefschetz-like criterion for Terao’s conjecture on the freeness of line arrangements.