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We describe the case of a newborn infant with transposition of the great vessels and a retroaortic innominate vein. This is a previously undescribed association. The decision was made to incorporate the retroaortic innominate vein into the Lecompte procedure at the time of surgery to avoid the risk of superior caval vein syndrome.
Scholars have recently investigated the efficacy of applying globalisation models to ancient cultures such as the fourth-millennium BC Mesopotamian Uruk system. Embedded within globalisation models is the ‘complex connectivity‘ that brings disparate regions together into a singular world. In the fourth millennium BC, the site of Çadır Höyük on the north-central Anatolian plateau experienced dramatic changes in its material culture and architectural assemblages, which in turn reflect new socio-economic, sociopolitical and ritual patterns at this rural agro-pastoral settlement. This study examines the complex connectivities of the ancient Uruk system, encompassing settlements in more consistent contact with the Uruk system such as Arslantepe in southeastern Anatolia, and how these may have fostered exchange networks that reached far beyond the Uruk ‘global world‘ and onto the Anatolian plateau.
To date, Ireland has been a leading light in the provision of youth mental health services. However, cognisant of the efforts of governmental and non-governmental agencies working in youth mental health, there is much to be done. Barriers into care as well as discontinuity of care across the spectrum of services remain key challenges. This editorial provides guidance for the next stage of development in youth mental care and support that will require significant national engagement and resource investment.
The unique phenotypic and genetic aspects of obsessive-compulsive (OCD) and attention-deficit/hyperactivity disorder (ADHD) among individuals with Tourette syndrome (TS) are not well characterized. Here, we examine symptom patterns and heritability of OCD and ADHD in TS families.
OCD and ADHD symptom patterns were examined in TS patients and their family members (N = 3494) using exploratory factor analyses (EFA) for OCD and ADHD symptoms separately, followed by latent class analyses (LCA) of the resulting OCD and ADHD factor sum scores jointly; heritability and clinical relevance of the resulting factors and classes were assessed.
EFA yielded a 2-factor model for ADHD and an 8-factor model for OCD. Both ADHD factors (inattentive and hyperactive/impulsive symptoms) were genetically related to TS, ADHD, and OCD. The doubts, contamination, need for sameness, and superstitions factors were genetically related to OCD, but not ADHD or TS; symmetry/exactness and fear-of-harm were associated with TS and OCD while hoarding was associated with ADHD and OCD. In contrast, aggressive urges were genetically associated with TS, OCD, and ADHD. LCA revealed a three-class solution: few OCD/ADHD symptoms (LC1), OCD & ADHD symptoms (LC2), and symmetry/exactness, hoarding, and ADHD symptoms (LC3). LC2 had the highest psychiatric comorbidity rates (⩾50% for all disorders).
Symmetry/exactness, aggressive urges, fear-of-harm, and hoarding show complex genetic relationships with TS, OCD, and ADHD, and, rather than being specific subtypes of OCD, transcend traditional diagnostic boundaries, perhaps representing an underlying vulnerability (e.g. failure of top-down cognitive control) common to all three disorders.
Aberrant emotional biases have been reported in bipolar disorder (BD), but results are inconsistent. Despite the clinical relevance of chronic mood variability in BD, there is no previous research investigating how the extent of symptom fluctuations in bipolar disorder might relate to emotional biases. This exploratory study investigated, in a large cohort of bipolar patients, whether instability in weekly mood episode symptoms and other clinical and demographic factors were related to emotional bias as measured in a simple laboratory task.
Participants (N = 271, BDI = 206, BDII = 121) completed an ‘emotional categorization and memory’ task. Weekly self-reported symptoms of depression and mania were collected prospectively. In linear regression analyses, associations between cognitive bias and mood variability were explored together with the influence of demographic and clinical factors, including current medication.
Greater accuracy in the classification of negative words relative to positive words was associated with greater instability in depressive symptoms. Furthermore, greater negative bias in free recall was associated with higher instability in manic symptoms. Participants diagnosed with BDII, compared with BDI, showed overall better word recognition and recall. Current antipsychotic use was associated with reduced instability in manic symptoms but this did not impact on emotional processing performance.
Emotional processing biases in bipolar disorder are related to instability in mood. These findings prompt further investigation into the underpinnings as well as clinical significance of mood instability.
The multi-object spectroscopic facility FOCAP at the Anglo-Australian Telescope has been used to obtain spectra centred at the Ca II IR triplet of 14 stars in the field of the Sextans dwarf spheroidal (dSph) galaxy. This satellite of our own Galaxy was recently discovered by Irwin et al. (1990) from APM measures of UK Schmidt Telescope photographic plates.
The first QSO with a redshift z > 4 was found using a combination of UK Schmidt Telescope (UKST) plates and the APM automatic plate measuring machine (Warren et al. 1987a). By continuing to make use of UKST survey plates plus the APM facility we have added substantially to the number of known QSOs with z > 4. A brief description of the general survey technique is presented together with a preliminary discussion of some of the results obtained so far.
Twin and family studies using Western samples have established that child and adolescent anxiety and depression are under substantial genetic, modest shared environmental, and substantial non-shared environmental influences. Generalizability of these findings to non-Western societies remains largely unknown, particularly regarding the changes of genetic and environmental influences with age. The current study examined changes in genetic and environmental influences on self-reported anxiety and depression from late childhood to mid-adolescence among a Chinese twin sample. Sex differences were also examined.
Self-reported anxiety and depression were collected from 712 10- to 12-year-old Chinese twins (mean = 10.88 years, 49% males) and again 3 years later. Quantitative genetic modeling was used to examine developmental changes in genetic and environmental influences on anxiety and depression, and sex differences.
Heritability of anxiety and depression in late childhood (23 and 20%) decreased to negligible in mid-adolescence, while shared environmental influences increased (20 and 27% to 57 and 60%). Shared environmental factors explained most of the continuity of anxiety and depression (75 and 77%). Non-shared environmental factors were largely time-specific. No sex differences were observed.
Shared environmental influences might be more pronounced during the transition period of adolescence in non-Western societies such as China. Future research should examine similarities and differences in the genetic and environmental etiologies of child and adolescent internalizing and other psychopathology in development between Western and non-Western societies.
Owing to an editorial oversight, the citation and reference for Piplani and Talmadge (2015) was deleted twice on page 307 of the May 2015 issue of American Political Science Review. The citations should read as follows:
In this context, it is useful to consider the empirical results of two studies that find that the probability of coups is lower if the country is involved in a war (Piplani and Talmadge, 2015) and even in a crisis (Arbatli and Arbatli, 2014). The explanatory mechanisms these studies offer are different (although not necessarily incompatible): Piplani and Talmadge (2015) argue that when the military is engaged in a war there are fewer opportunities for a coup and more uncertainty about who will join it, whereas Arbatli and Arbatli (2014) argue that crises allow rulers to commit credibly to transfers to the military and to generate rally-around-the-flag effects.
Also, owing to a printer's error on page 305, Qaddafi is misspelled as Qaddaf.
Armed forces strong enough to protect the state also pose a threat to the state. We develop a model that distills this “Guardianship Dilemma” to its barest essentials, and show that the seemingly ironclad logic underlying our existing understanding of civil-military relations is flawed. Militaries contemplating disloyalty must worry about both successfully overthrowing the government and defeating the state’s opponent. This twin challenge induces loyalty as the state faces increasingly strong external threats, and can be managed effectively by rulers using a number of policy levers. Disloyalty can still occur when political and military elites hold divergent beliefs about the threat environment facing the state, since militaries will sometimes have less incentive to remain loyal than the ruler suspects. Consequently, it is not the need to respond to external threats that raises the risk of disloyalty—as conventional wisdom suggests—but rather uncertainty about the severity of these threats.
Peer review mechanisms, such as the Universal Periodic Review, rely upon traditional sovereign state diplomacy for contemporary human rights implementation. This article argues that this is a positive development for several reasons. First, at a theoretical level, it reveals an evolving maturity of the human rights regime through its capacity to detach from exclusively legalistic approaches to human rights implementation. Second, at a policy level, there is enough evidence of measured positive outcomes of peer review mechanisms to suggest a preference for more co-operative approaches to ensuring human rights compliance as a first and complementary step to other more controversial legal/adversarial means of implementation (such as the third pillar of the R2P concept). Finally, peer review mechanisms offer a theoretical and pragmatic framework conciliating between universalist and relativist conceptual approaches to human rights, accommodating and integrating views that call for compliance with international human rights law as well as those emphasizing respect for sovereignty.
The aim of this work was to determine if volumetric modulated arc therapy (VMAT) plans, created for constant dose-rate (cdrVMAT) delivery are a viable alternative to step and shoot five-field intensity modulated radiation therapy (IMRT).
Materials and methods
The cdrVMAT plans, inverse planned on a treatment planning system with no solution to account for couch top or rails, were created for delivery on a linear accelerator with no variable dose rate control system. A series of five-field IMRT and cdrVMAT plans were created using dual partial arcs (gantry rotating between 260° and 100°) with 4° control points for ten prostate patients with the average rectal constraint incrementally increased. Pareto fronts were compared for the planning target volume homogeneity and average rectal dose between the two techniques for each patient. Also investigated were tumour control probability and normal tissue complication probability values for each technique. The delivery parameters [monitor units (MU) and time] and delivery accuracy of the IMRT and VMAT plans were also compared.
Pareto fronts showed that the dual partial arc plans were superior to the five-field IMRT plans, particularly for the clinically acceptable plans where average rectal doses were less for rotational plans (p = 0·009) with no statistical difference in target homogeneity. The cdrVMAT plans had significantly more MU (p = 0·005) but the average delivery time was significantly less than the IMRT plans by 42%. All clinically acceptable cdrVMAT plans were accurate in their delivery (gamma 99·2 ± 1·1%, 3%3 mm criteria).
Accurate delivery of dual partial arc cdrVMAT avoiding the couch top and rails has been demonstrated.
Widely-held, untested assumptions in many prairies are that high-intensity fires conducted during droughts will decrease native herbaceous species richness and lead to rapid invasions by alien species. We compared native and exotic herbaceous species richness and aboveground herbaceous biomass one year following the application of high-intensity growing-season fires in Texas coastal prairie. Fires were conducted in June 2008, when precipitation was 96% below the long-term monthly average, at the end of a severe 5-mo drought, resulting in high fire intensities within treatment units. Native forb species richness was greater in burned than unburned areas. In contrast, species richness of native grasses, exotic forbs, and the frequency of King Ranch (KR) bluestem [Bothriochloa ischaemum (L.) Keng.] did not significantly differ between burned and unburned treatments. The potential to use prescribed extreme fire to maintain native herbaceous species richness while not increasing KR bluestem provides preliminary evidence that growing season fires conducted during droughts can be a viable management strategy in coastal prairies.