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While echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.
Data from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman’s test.
Median age at echocardiogram was 4.6 (range 2.5–7.4) months. Median ventricular end-diastolic pressure was 7 (range 3–19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range −35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = −0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.
In this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.
Sintered tape-cast yttria-stabilized zirconia (YSZ) was evaluated for its elemental composition, crystal structure, and imaged with atomic force microscopy (AFM) and scanning electron microscopy (SEM). Human bone marrow stem cells (hBMSC) were cultured on the ceramic and differentiated into the osteoblast lineage; alkaline phosphatase (ALP) activity was tracked as a differentiation marker. The YSZ was composed of purely tetragonal grains with a median equivalent circular diameter of 283 nm. Zirconium, yttrium, oxygen, and adventitious carbon was detected on the substrate with no other elements in significant quantities detected. YSZ samples had an RMS roughness value of 27 nm, elastic modulus of 206 ± 14 GPa, and hardness of 14 ± 2 GPa. hBMSC were observed to attach and proliferate on the YSZ surfaces and had significantly increased ALP versus the undifferentiated control cultured on glass. This method for producing a YSZ ceramic yields a typical material of this type and supports attachment and differentiation of hBMSC; thus, making it useful as a bone implant material.
Cybermentoring refers to virtual peer support in which young people themselves are trained as cybermentors and interact with those needing help and advice (cybermentees) online. This article describes the training in, and implementation of, a cross-national cybermentoring scheme, Beatbullying Europe, developed in the United Kingdom. It involved train-the-trainer workshops for partners and life mentors in six European countries (Italy, Spain, Portugal, Romania, Poland and the Czech Republic) in 2013–2014, followed by training sessions for pupil cybermentors aged 11–16 years. Although BeatBullying went into liquidation in November 2014, the project was largely completed. We (1) report an evaluation of the training of the life mentors and mentors, via questionnaire survey; and (2) discuss findings about the implementation of the scheme and its potential at a cross-national level, via partner interviews during and at the end of the project. The training was found to be highly rated in all respects, and in all six countries involved. The overall consensus from the data available is that there was a positive impact for the schools and professionals involved; some challenges encountered are discussed. The BeatBullying Europe project, despite being unfinished, was promising, and a similar approach deserves further support and evaluation in the future.
Peter K Steinberg shows us how Plath used scrapbooks as an early means of honing her story telling techniques and narrative skills, combining the linguistic and visual aptitudes that were present throughout her life and developing the art of self-performance and selection that are vital to any artist. Moreover, these relatively overlooked documents are a valuable source of key biographical data that amplify our understanding of the context out of which the work emerged.
In his expert analysis of Plath’s correspondence with the editors to whom she submitted her poems at The New Yorker, Peter K. Steinberg provides a unique and critical new context for understanding Plath’s compositional practices. Steinberg makes clear just how responsive those practices were to her professional aspirations for publishing her work, with The New Yorker being the pinnacle for those aspirations.
Organismal metabolic rates reflect the interaction of environmental and physiological factors. Thus, calcifying organisms that record growth history can provide insight into both the ancient environments in which they lived and their own physiology and life history. However, interpreting them requires understanding which environmental factors have the greatest influence on growth rate and the extent to which evolutionary history constrains growth rates across lineages. We integrated satellite measurements of sea-surface temperature and chlorophyll-a concentration with a database of growth coefficients, body sizes, and life spans for 692 populations of living marine bivalves in 195 species, set within the context of a new maximum-likelihood phylogeny of bivalves. We find that environmental predictors overall explain only a small proportion of variation in growth coefficient across all species; temperature is a better predictor of growth coefficient than food supply, and growth coefficient is somewhat more variable at higher summer temperatures. Growth coefficients exhibit moderate phylogenetic signal, and taxonomic membership is a stronger predictor of growth coefficient than any environmental predictor, but phylogenetic inertia cannot fully explain the disjunction between our findings and the extensive body of work demonstrating strong environmental control on growth rates within taxa. Accounting for evolutionary history is critical when considering shells as historical archives. The weak relationship between variation in food supply and variation in growth coefficient in our data set is inconsistent with the hypothesis that the increase in mean body size through the Phanerozoic was driven by increasing productivity enabling faster growth rates.
In the process of researching this chapter, the first author spent a crisp December day touring London’s major bookshops in an attempt to discover what recent books on health might have to say about leadership and what those on leadership might have to say about health. It was a pleasant way to spend a day, but, as a research exercise, it was something of a failure. Of the books on health, not a single one had an index entry for leadership and most restricted their coverage of the topic to general discussions of team and patient management as aspects of effective healthcare. Conversely, very few of the books on leadership had much to say about health, although the biographies of influential leaders (e.g. Obama, Gillard, Thatcher) typically included significant sections devoted to the biographee’s policy on health (e.g. democratisation, rationalisation, privatisation).
Powerful synergies between phosphonate, zinc oxide, and acrylamido-tert-butyl-sulfonate (ATBS) copolymer chemical additives render superior performance in a high-temperature retarder system for oil well grade Portland cement. The phosphonate retarder and ATBS-based retarders establish a two-tiered strength development where amorphous C-S-H converts to crystalline dicalcium silicate hydrate (C2SH) in the first (low compressive strength) tier prior to the reaction of Portlandite with quartz. The three additive retarder system can be tuned with nanosilica to eliminate the two-tiered strength development effect leading to a smooth transition from the cement in the slurry form directly to its highest compressive strength.
The late Miocene is a time of strong environmental change in SW Asia. Himalayan foreland stable isotope data show a shift in the dominant vegetation of the flood plains away from trees and shrubs towards more C4 grasslands at a time when oceanic upwelling increased along the Oman margin. We present integrated geochemical and colour spectral records from International Ocean Discovery Program Site U1456 in the eastern Arabian Sea to reconstruct changing chemical weathering and erosion, as well as relative humidity during this climatic transition. Increasing hematite/goethite ratios derived from spectral data are consistent with long-term drying after c. 7.7 Ma. Times of dry conditions are largely associated with weaker chemical alteration measured by K/Rb and reduced coarse clastic flux, constrained by Si/Al and Zr/Al. A temporary phase of increased humidity from 6.3 to 5.95 Ma shows a reversal to stronger weathering and erosion. Wetter conditions can result in both more and less alteration due to the nonlinear relationship between weathering rates, precipitation and sediment transport times. Trends in relative aridity do not follow existing palaeoceanographic records and are not apparently linked to changes in Tibetan or Himalayan elevation, but more closely correlate with global cooling. An apparent opposing trend in the humidity evolution in the Indus compared to southern China, as tracked by spectrally estimated hematite/goethite, likely reflects differences in the topography in the Indus compared to the Pearl River drainage basins, as well as the generally wetter climate in southern China.
For a large part of the past century, the cold war between the Soviet Union and the United States and Russia’s continued refusal to join the Berne Convention for the Protection of Literary and Artistic Works (Berne Convention), the predominant international copyright agreement, have raised complicated questions concerning the protection of Russian authors in the United States.1 The case that has received considerable attention in intellectual property literature is Itar-Tass Russian News Agency v. Russian Kurier, Inc (Itar-Tass).2 Filed in the mid-1990s, shortly after Russia’s accession to the Berne Convention but before its admission to the World Trade Organization (WTO), this case covered not only choice-of-law questions in the intellectual property field but also the interrelationship between domestic law and international treaties. Less frequently explored, however, are the rich comparative lessons that the case has provided on the development of intellectual property law and policy in Central and Eastern Europe.
The intensity of turbidite sedimentation over long timescales is driven by sea-level change, tectonically driven rock uplift and climatically modulated sediment delivery rates. This study focuses on understanding the effect of sea-level fluctuations and climatic variability on grain-size variations. The grain size and environmental magnetic parameters of Arabian Sea sediments have been documented using 203 samples, spanning the last 200 ka, obtained from International Ocean Discovery Program (IODP) Site U1457. Grain-size end-member modelling suggests that between ~200 and 130 ka there was an increase in the coarse silt fraction caused by sediment transport following reworking of the Indus Fan and development of deep-sea canyons. The sediment size and enhanced magnetic susceptibility indicate a dominant flux of terrestrial sediments. Sedimentation in the distal Indus Fan at c. 200–130 ka was driven by a drop in sea level that lowered the base level in the Indus and Narmada river systems. The low sea-stand caused incision in the Indus delta, canyons and fan area, which resulted in the transportation of coarser sediment at the drilling site. Magnetic susceptibility and other associated magnetic parameters suggest a large fraction of the sediment was supplied by the Narmada River during ~200–130 ka. Since ~130 ka, clay-dominated sedimentation is attributed to the rise in sea level due to warm and wet climate.
Micronutrient supplementation is recommended in Ebola Virus Disease (EVD). However, there is limited data on its therapeutic impacts. This study evaluated the association between vitamin A supplementation and mortality outcomes in EVD patients.
This retrospective cohort study accrued patients with EVD admitted to five International Medical Corps run Ebola Treatment Units (ETU) in two countries from 2014-2015. Protocolized treatments with antimicrobials and micronutrients were used at all ETUs. However, due to resource limitations and care variations, only a subset of patients received vitamin A. Standardized data on demographics, clinical characteristics, malaria status, and Ebola virus RT-PCR cycle threshold (CT) values were collected. The outcome of interest was mortality compared between cases treated with 200,000 International Units of vitamin A on care days one and two and those not. Propensity scores (PS) based on the first 48-hours of care were derived using the covariates of age, duration of ETU function, malaria status, CT values, symptoms of confusion, hemorrhage, diarrhea, dysphagia, and dyspnea. Treated and non-treated cases were matched 1:1 based on nearest neighbors with replacement. Covariate balance met predefined thresholds. Mortality proportions between cases treated and untreated with vitamin A were compared using generalized estimating equations to calculate relative risks (RR) with associated 95% confidence intervals (CI).
There were 424 cases analyzed, with 330 (77.8%) being vitamin A-treated cases. The mean age was 30.5 years and 57.0% were female. The most common symptoms were diarrhea (86%), anorexia (81%), and vomiting (77%). Mortality proportions among cases untreated and treated with vitamin A were 71.9% and 55.0%, respectively. In a propensity-matched analysis, mortality was significantly lower among cases receiving vitamin A (RR = 0.77 95%; CI:0.59-0.99; p = 0.041).
Early vitamin A supplementation was associated with reduced mortality in EVD patients and should be provided routinely during future epidemics.
The aim of the study was to examine racism and the Pinkerton syndrome in Singapore. Specifically, the study examined the effects of race on hiring decisions in a simulated hiring decision task. Participants were 171 (61% males) Singaporean Chinese undergraduates from a private university in Singapore. They were randomly assigned into one of nine groups and asked to review a resume of a job applicant. The study used a 3 (Academic qualifications: strong, moderate, or weak) × 3 (Race: White, Chinese, or Malay) between-subjects design with perceived warmth, competence, applicant suitability and recommended salary as the dependent variables. The results showed that while Chinese participants discriminated against Malay applicants (racism), they discriminated in favor of White applicants (the Pinkerton syndrome). The results provided a potential explanation to the economic disparities between Malays and the other races, and first experimental evidence for racism and the Pinkerton syndrome in Singapore.
We analyse the vorticity production of lake-scale circulation in wind-induced shallow flows using a linear elliptic partial differential equation. The linear equation is derived from the vorticity form of the shallow-water equation using a linear bed friction formula. The features of the wind-induced steady-state flow are analysed in a circular basin with topography as a concave paraboloid, having a quadratic pile in the middle of the basin. In our study, the size of the pile varies by a size parameter. The vorticity production due to the gradient in the topography (and the distance of the boundary) makes the streamlines parallel to topographical contours, and beyond a critical size parameter, it results in a secondary vortex pair. We compare qualitatively and quantitatively the steady-state circulation patterns and vortex evolution of the flow fields calculated by our linear vorticity model and the full, nonlinear shallow-water equations. From these results, we hypothesize that the steady-state topographical vorticity production in lake-scale wind-induced circulations can be described by the equilibrium of the wind friction field and the bed friction field. Moreover, the latter can also be considered as a linear function of the velocity vector field, and hence the problem can be described by a linear equation.
In the current manuscript we discuss the response of dynamic metallogels that display reversion to the liquid state when exposed to phosphines. The metallogels are formed through the condensation of formaldehyde and poly(alkyloxide)amines in polar aprotic solvents. The gel formation can be catalyzed with trivalent metals (Al(III and Fe(III)) with concomitant enhanced dynamism (gelation/degelation). When various phosphines are introduced, the metallogel is irreversibly liquefied. This process adds a new vector for controlling the bulk properties of this class of materials. Here, we explore the mechanism in detail for the reaction of tris(carboxyethyl)phosphine with N,N,N-triethoxylethyl-1,3,5-hexahydro-1,3,5-triazine (HEHT, 1) a stable derivative of the active hexahydrotriazine (HT) core in dimethylformamide in the presence or absence of Al(III). Additionally, density functional theory is used on the model N,N,N-trimethyl system (MHT, 2) to estimate reaction parameters and predict nuclear magnetic resonance spectra.