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Less is known about the relationship between conduct disorder (CD), callous–unemotional (CU) traits, and positive and negative parenting in youth compared to early childhood. We combined traditional univariate analyses with a novel machine learning classifier (Angle-based Generalized Matrix Learning Vector Quantization) to classify youth (N = 756; 9–18 years) into typically developing (TD) or CD groups with or without elevated CU traits (CD/HCU, CD/LCU, respectively) using youth- and parent-reports of parenting behavior. At the group level, both CD/HCU and CD/LCU were associated with high negative and low positive parenting relative to TD. However, only positive parenting differed between the CD/HCU and CD/LCU groups. In classification analyses, performance was best when distinguishing CD/HCU from TD groups and poorest when distinguishing CD/HCU from CD/LCU groups. Positive and negative parenting were both relevant when distinguishing CD/HCU from TD, negative parenting was most relevant when distinguishing between CD/LCU and TD, and positive parenting was most relevant when distinguishing CD/HCU from CD/LCU groups. These findings suggest that while positive parenting distinguishes between CD/HCU and CD/LCU, negative parenting is associated with both CD subtypes. These results highlight the importance of considering multiple parenting behaviors in CD with varying levels of CU traits in late childhood/adolescence.
In 2018 Pearson et al. published a new sequence of annual radiocarbon (14C) data derived from oak (Quercus sp.) trees from Northern Ireland and bristlecone pine (Pinus longaeva) from North America across the period 1700–1500 BC. The study indicated that the more highly resolved shape of an annually based calibration dataset could improve the accuracy of 14C calibration during this period. This finding had implications for the controversial dating of the eruption of Thera in the Eastern Mediterranean. To test for interlaboratory variation and improve the robustness of the annual dataset for calibration purposes, we have generated a replicate sequence from the same Irish oaks at ETH Zürich. These data are compatible with the Irish oak 14C dataset previously produced at the University of Arizona and are used (along with additional data) to examine inter-tree and interlaboratory variation in multiyear annual 14C time-series. The results raise questions about regional 14C offsets at different scales and demonstrate the potential of annually resolved 14C for refining subdecadal and larger scale features for calibration, solar reconstruction, and multiproxy synchronization.
Six experiments were conducted in 2018 on field sites located in Arkansas, Indiana, Michigan, Nebraska, Ontario, and Wisconsin to evaluate the off-target movement (OTM) of dicamba under field-scale conditions. The highest estimated percentages of dicamba injury in non–dicamba-resistant (DR) soybean were 55%, 44%, 39%, 67%, 15%, and 44% injury for noncovered areas and 55%, 5%, 13%, 42%, 0%, and 41% injury for covered areas during dicamba application in Arkansas, Indiana, Michigan, Nebraska, Ontario, and Wisconsin, respectively. The level of injury generally decreased as the downwind distance increased under covered and noncovered areas at all sites. There was an estimated 10% injury in non-DR soybean at 113, 8, 11, 8, and 8 m; and estimated 1% injury at 293, 28, 71, 15, and 19 m from the edge of treated fields downwind when plants were not covered during dicamba application in Arkansas, Indiana, Michigan, Ontario, and Wisconsin, respectively. Assessment of filter-paper collectors placed from 4 to 137 m downwind from the edge of the sprayed area suggested the dicamba deposition reduced exponentially with distance. The greatest injury to non-DR soybean from dicamba OTM occurred at Nebraska and Arkansas (as far as 250 m). Non-DR soybean injury was greatest adjacent to the dicamba sprayed area, but injury decreased with no injury beyond 20 m downwind or in any other direction from the dicamba sprayed area in Indiana, Michigan, Ontario, and Wisconsin. The presence of soybean injury under covered and noncovered areas during the spray period for primary drift suggests that secondary movement of dicamba was evident at five sites. Additional research is needed to determine the exact forms of secondary movement of dicamba under different environmental conditions.
The purpose of this paper is to examine the evidence commonly claimed to show the presence of slaves in the audience of Plautus’ comedies (above all the evidence of his prologue to Poenulus) and to argue that it more probably shows the opposite, that slaves were not present, or at least were expected not to be. The question is given some urgency by the appearance of Amy Richlin's new book, which takes the presence of slaves in the audience for granted and builds on it to develop a view of Plautine comedy as addressing the experiences, hopes and fears of those slaves. Richlin cites the Poenulus prologue at pages 89–90, accepting it without detailed discussion as indicating the presence of slaves in the audience; and it has been cited similarly in standard handbooks from which I quote a representative sample of remarks below. Some scholars have said things in passing which suggest a different conclusion, but they too have not discussed the question in detail or examined the other evidence that has been thought relevant to the issue. I think that the time is ripe for closer scrutiny of all this evidence.
First aid, particularly bystander cardiopulmonary resuscitation (CPR), is an important element in the chain of survival. However, little is known about what influences populations to undertake first aid/CPR training, update their training, and use of the training.
The aim of this study was to explore the characteristics of people who have first aid/CPR training, those who have updated their training, and use of these skills.
As part of the 2011 state-wide, computer-assisted telephone interviewing (CATI) survey of people over 18 years of age living in Queensland, Australia, stratified by gender and age group, three questions about first aid training, re-training, and skill uses were explored.
Of the 1,277 respondents, 73.2% reported having undertaken some first aid/CPR training and 39.5% of those respondents had used their first aid/CPR skills. The majority of respondents (56.7%) had not updated their first aid/CPR skills in the past three years, and an additional 2.5% had never updated their skills. People who did not progress beyond year 10 in school and those in lower income groups were less likely to have undertaken first aid/CPR training. Males and people in lower income groups were less likely to have recently updated their first aid/CPR training. People with chronic health problems were in a unique demographic sub-group; they were less likely to have undertaken first aid/CPR training but more likely to have administered first aid/CPR.
Training initiatives that target people on the basis of education level, income group, and the existence of chronic health problems might be one strategy for improving bystander CPR rates when cardiac arrest occurs in the home.
Franklin RC, Watt K, Aitken P, Brown LH, Leggat PA. Characteristics associated with first aid and cardiopulmonary resuscitation training and use in Queensland, Australia. Prehosp Disaster Med. 2019;34(2):155–160
Optimising short- and long-term outcomes for children and patients with CHD depends on continued scientific discovery and translation to clinical improvements in a coordinated effort by multiple stakeholders. Several challenges remain for clinicians, researchers, administrators, patients, and families seeking continuous scientific and clinical advancements in the field. We describe a new integrated research and improvement network – Cardiac Networks United – that seeks to build upon the experience and success achieved to-date to create a new infrastructure for research and quality improvement that will serve the needs of the paediatric and congenital heart community in the future. Existing gaps in data integration and barriers to improvement are described, along with the mission and vision, organisational structure, and early objectives of Cardiac Networks United. Finally, representatives of key stakeholder groups – heart centre executives, research leaders, learning health system experts, and parent advocates – offer their perspectives on the need for this new collaborative effort.
Analogy is a core cognition process used to produce inferences as well as new ideas using previous knowledge and experience. Ontology is a formal representation of a set of domain concepts and their relationships. The use of analogy and ontology in design activities to support design creativity have previously been explored. This paper explores an approach to construct ontologies with sufficient richness and coverage to support reasoning over real-world datasets for prompting creative idea generation. This approach has been implemented into a computational tool for assisting designers in generating creative ideas during the early stages of design. The tool, called “the Retriever”, has been developed based on ontology by embracing the aspects of analogical reasoning. A case study has indicated that the tool can be effective and useful for idea generation. The results have indicated that the tool, in its current formulation, can significantly improve the fluency and flexibility of idea generation and the usefulness of ideas, as well as slightly increase the originality of ideas, for the case study concerned.
Each year, Emergency Medical Services (EMS) personnel respond to over 30 million calls for assistance in the United States alone. These EMS personnel have a rate of occupational fatality comparable to firefighters and police, and a rate of non-fatal injuries that is higher than the rates for police and firefighters and much higher than the national average for all workers. In Australia, no occupational group has a higher injury or fatality rate than EMS personnel. Emergency Medical Services personnel in the US have a rate of occupational violence injuries that is about 22-times higher than the average for all workers. On average, more than one EMS provider in the US is killed every year in an act of violence.
The objective of this epidemiological study was to identify the risks and factors associated with work-related physical violence against EMS personnel internationally.
An online survey, based on a tool developed by the World Health Organization (WHO; Geneva, Switzerland), collected responses from April through November 2016.
There were 1,778 EMS personnel respondents from 13 countries; 69% were male and 54% were married. Around 55% described their primary EMS work location as “urban.” Approximately 68% described their employer as a “public provider.” The majority of respondents were from the US.
When asked “Have you ever been physically attacked while on-duty?” 761 (65%) of the 1,172 who answered the question answered “Yes.” In almost 10% (67) of those incidents, the perpetrator used a weapon. Approximately 90% of the perpetrators were patients and around five percent were patient family members. The influence of alcohol and drugs was prevalent. Overall, men experienced more assaults than women, and younger workers experienced more assaults than older workers.
In order to develop and implement measures to increase safety, EMS personnel must be involved with the research and implementation process. Furthermore, EMS agencies must work with university researchers to quantify agency-level risks and to develop, test, and implement interventions in such a way that they can be reliably evaluated and the results published in peer-reviewed journals.
MaguireBJ, BrowneM, O’NeillBJ, DealyMT, ClareD, O’MearaP. International Survey of Violence Against EMS Personnel: Physical Violence Report. Prehosp Disaster Med. 2018;33(5):526–531.
This article presents detailed illustrations of two rock-reliefs from the neighbouring sites Rabana and Merquly, located on the flanks of Mt. Piramagrun in Iraqi Kurdistan. Both matching sculptures are aligned with perimeter fortifications that enclose substantial architectural remains. Based on numismatic parallels, supported by archaeological evidence, it is proposed that these depictions of near life-size figures represent an anonymous Arsacid King of Kings from the early first millennium (c. a.d. 50-150), who was credited with construction of the mountain fortresses. Rabana and Merquly together form an important landscape of settlement on the north-western frontier of the Parthian Empire.
The Virtual Personalities Model is a motive-based neural network model that provides both a psychological model and a computational implementation that explicates the dynamics and often large within-person variability in behavior that arises over time. At the same time the same model can produce—across many virtual personalities—between-subject variability in behavior that when factor analyzed yields familiar personality structure (e.g., the Big Five). First, we describe our personality model and its implementation as a neural network model. Second, we focus on detailing the neurobiological underpinnings of this model. Third, we examine the learning mechanisms, and their biological substrates, as ways that the model gets “wired up,” discussing Pavlovian and Instrumental conditioning, Pavlovian to Instrumental transfer, and habits. Finally, we describe the dynamics of how initial differences in propensities (e.g., dopamine functioning), wiring differences due to experience, and other factors could operate together to develop and change personality over time, and how this might be empirically examined. Thus, our goal is to contribute to the rising chorus of voices seeking a more precise neurobiologically based science of the complex dynamics underlying personality.
Although interstage mortality for infants with hypoplastic left heart syndrome has declined within the National Pediatric Cardiology Quality Improvement Collaborative, variation across centres persists. It remains unclear whether centres with lower interstage mortality have lower-risk patients or whether differences in care may explain this variation. We examined previously established risk factors across National Pediatric Cardiology Quality Improvement Collaborative centres with lower and higher interstage mortality rates.
Lower-mortality centres were defined as those with >25 consecutive interstage survivors. Higher-mortality centres were defined as those with cumulative interstage mortality rates >10%, which is a collaborative historic baseline rate. Baseline risk factors and perioperative characteristics were compared.
Seven lower-mortality centres were identified (n=331 patients) and had an interstage mortality rate of 2.7%, as compared with 13.3% in the four higher-mortality centres (n=173 patients, p<0.0001). Of all baseline risk factors examined, the only factor that differed between the lower- and higher-mortality centres was postnatal diagnosis (18.4 versus 31.8%, p=0.001). In multivariable analysis, there remained a significant mortality difference between the two groups of centres after adjusting for this variable: adjusted mortality rate was 2.8% in lower-mortality centres compared with 12.6% in higher-mortality centres, p=0.003. Secondary analyses identified multiple differences between groups in perioperative practices and other variables.
Variation in interstage mortality rates between these two groups of centres does not appear to be explained by differences in baseline risk factors. Further study is necessary to evaluate variation in care practices to identify targets for improvement efforts.
Children with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.
Materials and methods
We sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation.
A total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease.
The overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.
To develop and pilot a clinician-rated outcome scale to evaluate symptomatic outcomes in liaison psychiatry services. Three hundred and sixty patient contacts with 207 separate individuals were rated using six subscales (mood, psychosis, cognition, substance misuse, mind–body problems and behavioural disturbance) plus two additional items (side-effects of medication and capacity to consent for medical treatment). Each item was rated on a five-point scale from 0 to 5 (nil, mild, moderate, severe and very severe).
The liaison outcome measure was acceptable and easy to use. All subscales showed acceptable interrater reliability, with the exception of the mind–body subscale. Overall, the measure appears to show stability and sensitivity to change.
The measure provides a useful and robust way to determine symptomatic change in a liaison mental health setting, although the mind–body subscale requires modification.
The lower Mississippian Ballagan Formation of northern Britain is one of only two successions worldwide to yield the earliest known tetrapods with terrestrial capability following the end-Devonian mass extinction event. Studies of the sedimentary environments and habitats in which these beasts lived have been an integral part of a major research project into how, why and under what circumstances this profound step in the evolution of life on Earth occurred. Here, a new palaeogeographic map is constructed from outcrop data integrated with new and archived borehole material. The map shows the extent of a very low-relief coastal wetland developed along the tropical southern continental margin of Laurussia. Coastal floodplains in the Midland Valley and Tweed basins were separated from the marginal marine seaway of the Northumberland–Solway Basin to the south by an archipelago of more elevated areas. A complex mosaic of sedimentary environments was juxtaposed, and included fresh and brackish to saline and hypersaline lakes, a diverse suite of floodplain palaeosols and a persistent fluvial system in the east of the region. The strongly seasonal climate led to the formation of evaporite deposits alternating with flooding events, both meteoric and marine. Storm surges drove marine floods from the SW into both the western Midland Valley and Northumberland–Solway Basin; marine water also flooded into the Tweed Basin and Tayside in the east. The Ballagan Formation is a rare example in the geological record of a tropical, seasonal coastal wetland that contains abundant, small-scale evaporite deposits. The diverse sedimentary environments and palaeosol types indicate a network of different terrestrial and aquatic habitats in which the tetrapods lived.
In 481 BC, as Xerxes was approaching Sardis with his enormous expeditionary force, he was one day south of Sardis when, according to Herodotus VII. 31, he ‘came across a plane tree of such beauty that he was moved to decorate it with golden ornaments and to appoint a guardian for it in perpetuity’. Meanwhile at Abydos, on the south shore of the Hellespont, north-west of Sardis, his engineers had been constructing two bridges across the Hellespont, which Herodotus tells us about almost immediately afterwards (chapters 33–6). At one stage, he says,
the work was successfully completed, but a storm of great violence smashed it up and carried everything away. Xerxes was very angry when he learned of the disaster, and he gave orders that the Hellespont should receive three hundred lashes and have a pair of fetters thrown into it. I have heard before now that he also sent people to brand it with hot irons. … In addition to punishing the Hellespont, he gave orders that the men responsible for building the bridges should have their heads cut off.
His orders were of course carried out, the bridges were rebuilt, and after wintering in Sardis he and his force set off for Abydos in the spring of 480; it took them seven days and seven nights without a break to cross over to Europe on the bridges, and the rest is history – or, if you are Minato or Stampiglia, Cavalli or Bononcini or Handel, the rest is fiction. In the Minato–Stampiglia libretto of Handel's Serse, the plane tree is evidently at Abydos (it has been transplanted some 150 miles), Xerxes is already there when the storm comes, and apart from those slight distortions of approximately one page of Herodotus’ monumental work there is precious little in the opera that has anything to do with any ancient evidence for Xerxes or his famous expedition to Greece. The plane tree is given far more prominence at the beginning of the opera than it receives in Herodotus, who deals with it in thirteen words of Greek, and the storm comes over as rather a tame affair, focalised through the comic character Elviro: we are not shown Xerxes reacting to it in any way, and there is nothing about his angry treatment of the Hellespont and the engineers.