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Alveolar capillary dysplasia with misalignment of the pulmonary veins is an uncommon disorder that affects the lung vasculature development in the neonatal period and leads to pulmonary hypertension. We describe two patients with alveolar capillary dysplasia associated with left-sided obstructive heart defects with two different genetic variants. Our cases highlight the importance of early recognition of this disease in the setting of persistent and supra-systemic pulmonary hypertension despite surgical correction of the associated lesions. Identification of these cases will facilitate the development of a multidisciplinary approach and provide guidance to the affected families.
The UK Biobank contains data with varying degrees of reliability and completeness for assessing depression. A third of participants completed a Mental Health Questionnaire (MHQ) containing the gold-standard Composite International Diagnostic Interview (CIDI) criteria for assessing mental health disorders.
To investigate whether multiple observations of depression from sources other than the MHQ can enhance the validity of major depressive disorder (MDD).
In participants who did not complete the MHQ, we calculated the number of other depression measures endorsed, for example from hospital episode statistics and interview data. We compared cases defined this way with CIDI-defined cases for several estimates: the variance explained by polygenic risk scores (PRS), area under the curve attributable to PRS, single nucleotide polymorphisms (SNPs)-based heritability and genetic correlations with summary statistics from the Psychiatric Genomics Consortium MDD genome-wide association study.
The strength of the genetic contribution increased with the number of measures endorsed. For example, SNP-based heritability increased from 7% in participants who endorsed only one measure of depression, to 21% in those who endorsed four or five measures of depression. The strength of the genetic contribution to cases defined by at least two measures approximated that for CIDI-defined cases. Most genetic correlations between UK Biobank and the Psychiatric Genomics Consortium MDD study exceeded 0.7, but there was variability between pairwise comparisons.
Multiple measures of depression can serve as a reliable approximation for case status where the CIDI measure is not available, indicating sample size can be optimised using the entire suite of UK Biobank data.
The effects of background turbulence on the entrainment process, as well as the nature of the interfacial region between two bodies of turbulent fluid, were examined through an investigation of the far wake of a circular cylinder that is subjected to free-stream turbulence. Simultaneous particle image velocimetry and planar laser induced fluorescence measurements were conducted 40 diameters downstream of the cylinder. Despite the availability of turbulent, rotational fluid in the background, the outer interface between the wake and the ambient fluid exhibits an enstrophy jump akin to the classical result of a turbulent/non-turbulent interface. This jump at the wake boundary persists even when the intensity of the background turbulence is greater than the turbulence intensity of the wake itself. Analysis on the structure of the wake boundary reveals that an increase in background turbulence intensity results in an increased interfacial surface area relative to the non-turbulent case. However, instead of the intuitive result of increased entrainment as a result of increased surface area, a reduction in mean entrainment mass flux is observed with increased background turbulence intensity. Through the analysis of the flux probability density functions, the reduction in mean entrainment can be attributed to a tip in balance of extreme entrainment and detrainment events to the detrainment side in the presence of background turbulence. Lastly, a scale by scale analysis of entrainment behaviour revealed that free-stream turbulence affects entrainment behaviour across all length scales and is not just limited to the energy containing scales.
Approximately, 1.7 million individuals in the United States have been infected with SARS-CoV-2, the virus responsible for the novel coronavirus disease-2019 (COVID-19). This has disproportionately impacted adults, but many children have been infected and hospitalised as well. To date, there is not much information published addressing the cardiac workup and monitoring of children with COVID-19. Here, we share the approach to the cardiac workup and monitoring utilised at a large congenital heart centre in New York City, the epicentre of the COVID-19 pandemic in the United States.
High levels of alexithymia as well as low scores on assertiveness have been described in patients with chronic pain and headache.
To determine alexithymia and assertiveness scores and to explore their association with headache impact, in primary chronic headache patients.
This study aims to advance knowledge of the emotional expressiveness in headache impact.
In a sample of 62 outpatients, we used the Toronto Alexithymia Scale (TAS-20), the Rathus Assertiveness Scale and the Headache Impact Test (HIT-6) and applied the Pearson correlation index.
77.4% of women, 36.3 years mean age. The most prevalent diagnoses are migraine combined with tension type headache (33.9%), migraine alone (32.3%) and tension-type headache alone (22.6%). Most of the patients have not any psychiatric comorbidity (77.8%). We observe a direct linear relationship and statistically significant difference, between the total impact of headache and the total score of alexithymia (r = 0.27 p = 0.03) and there is an inverse correlation between the impact of headache and the total score of the scale of assertiveness, not statistically significant (r = −0.004 p = 0.97).
Discriminated by diagnostic groups, we found that the association between assertiveness and headache impact remains only in patients with migraine alone, while that between alexithymia and headache impact is preserved in all subgroups.
Two indirect measures of the difficulties in emotional expressiveness such as alexithymia and assertiveness, show the expected association with headache impact. The sample size can influence some of the correlations not statistically significant.
In 2015, beverages were removed from display at a self-service café within a major health service, resulting in fewer purchases of unhealthy beverages. This initiative was continued following initial evaluation of the results. The current study aimed to determine customer acceptability of the initiative, and whether healthier purchases had continued, at 18 months following implementation.
Drinks were categorised as ‘green’ (best choices), ‘amber’ (choose carefully) and ‘red’ (limit), based on the state government nutrient profiling system, for intervention and analysis purposes. In 2015, unhealthy ‘red’ drinks were removed from display. In 2017, weekly beverage sales were counted, through stock-taking, for 6 weeks, and customer surveys were conducted over 2 days.
A café located within a major Victorian health service.
Café customers (hospital staff, patients and visitors).
Eighteen months after the implementation of the initiative, the proportion of ‘red’ beverages sold was 7 % of total drink sales (compared with 33 % before the removal of unhealthy beverages from display in 2015 (P < 0·001), and 10 % immediately following the removal of unhealthy beverages from display). Customer surveys revealed high levels of acceptability for the initiative and low levels of awareness of the initiative.
The removal of unhealthy beverages from display can result in customers making healthier purchases, and this appears to continue over the long-term. Such interventions have the potential to contribute to the sustained shift in population purchases and consumption needed to make meaningful improvements to population health.
Considerable progress in explaining cultural evolutionary dynamics has been made by applying rigorous models from the natural sciences to historical and ethnographic information collected and accessed using novel digital platforms. Initial results have clarified several long-standing debates in cultural evolutionary studies, such as population origins, the role of religion in the evolution of complex societies and the factors that shape global patterns of language diversity. However, future progress requires recognition of the unique challenges posed by cultural data. To address these challenges, standards for data collection, organisation and analysis must be improved and widely adopted. Here, we describe some major challenges to progress in the construction of large comparative databases of cultural history, including recognising the critical role of theory, selecting appropriate units of analysis, data gathering and sampling strategies, winning expert buy-in, achieving reliability and reproducibility in coding, and ensuring interoperability and sustainability of the resulting databases. We conclude by proposing a set of practical guidelines to meet these challenges.
Recent comparisons between classical Wagner theory for the impact of two liquid droplets and direct numerical simulations in Cimpeanu & Moore (J. Fluid Mech., vol. 856, 2018, pp. 764–796) show that, in some regimes, the inviscid theory over-predicts the thickness of the root of the splash jet that forms in the impact, while also struggling to predict the angle at which the jet is emitted. The effect of capillary and viscous perturbations to Helmholtz flows was investigated in a previous study, see Moore et al. (J. Fluid Mech., vol. 742, 2014, R1). However, the paper in question ignored a term in the second-order perturbation analysis, which needs to be included in order to predict the displacement of the inviscid free boundary to lowest order. In this paper, we derive a singular integro-differential equation for the free-surface perturbations caused by viscosity in Helmholtz flows and discuss its application both in the context of Wagner theory and more generally. In particular, viscosity can induce non-monotonic behaviour in the free boundary profiles near points of maximum curvature.
Microcredit – joint-liability loans to the poorest of the poor – has been touted as a powerful approach for combatting global poverty, but sustainability varies dramatically across banks. Efforts to improve the sustainability of microcredit have assumed defaults are caused by free-riding. Here, we point out that the response of other group members to delinquent groupmates also plays an important role in defaults. Even in the absence of any free-rider problem, some people will be unable to make their payments due to bad luck. It is other group members’ unwillingness to pitch in extra – due to, among other things, not wanting to have less than other group members – that leads to default. To support this argument, we utilize the Ultimatum Game (UG), a standard paradigm from behavioral economics for measuring one's aversion to inequitable outcomes. First, we show that country-level variation in microloan default rates is strongly correlated (overall r = 0.81) with country-level UG rejection rates, but not free-riding measures. We then introduce a laboratory model ‘Microloan Game’ and present evidence that defaults arise from inequity-averse individuals refusing to make up the difference when others fail to pay their fair share. This perspective suggests a suite of new approaches for combatting defaults that leverage findings on reducing UG rejections.
The Children of the Twins Early Development Study (CoTEDS) is a new prospective children-of-twins study in the UK, designed to investigate intergenerational associations across child developmental stages. CoTEDS will enable research on genetic and environmental factors that underpin parent–child associations, with a focus on mental health and cognitive-related traits. Through CoTEDS, we will have a new lens to examine the roles that parents play in influencing child development, as well as the genetic and environmental factors that shape parenting behavior and experiences. Recruitment is ongoing from the sample of approximately 20,000 contactable adult twins who have been enrolled in the Twins Early Development Study (TEDS) since infancy. TEDS twins are invited to register all offspring to CoTEDS at birth, with 554 children registered as of May 2019. By recruiting the second generation of TEDS participants, CoTEDS will include information on adult twins and their offspring from infancy. Parent questionnaire-based data collection is now underway for 1- and 2-year-old CoTEDS infants, with further waves of data collection planned. Current data collection includes the following primary constructs: child mental health, temperament, language and cognitive development; parent mental health and social relationships; parenting behaviors and feelings; and other socioecological factors. Measurement tools have been selected with reference to existing genetically informative cohort studies to ensure overlap in phenotypes measured at corresponding stages of development. This built-in study overlap is intended to enable replication and triangulation of future analyses across samples and research designs. Here, we summarize study protocols and measurement procedures and describe future plans.
Over recent decades, biomass gains in remaining old-growth Amazonia forests have declined due to environmental change. Amazonia’s huge size and complexity makes understanding these changes, drivers, and consequences very challenging. Here, using a network of permanent monitoring plots at the Amazon–Cerrado transition, we quantify recent biomass carbon changes and explore their environmental drivers. Our study area covers 30 plots of upland and riparian forests sampled at least twice between 1996 and 2016 and subject to various levels of fire and drought. Using these plots, we aimed to: (1) estimate the long-term biomass change rate; (2) determine the extent to which forest changes are influenced by forest type; and (3) assess the threat to forests from ongoing environmental change. Overall, there was no net change in biomass, but there was clear variation among different forest types. Burning occurred at least once in 8 of the 12 riparian forests, while only 1 of the 18 upland forests burned, resulting in losses of carbon in burned riparian forests. Net biomass gains prevailed among other riparian and upland forests throughout Amazonia. Our results reveal an unanticipated vulnerability of riparian forests to fire, likely aggravated by drought, and threatening ecosystem conservation at the Amazon southern margins.
The terrestrialization of life has profoundly affected the biosphere, geosphere and atmosphere, and the Geological Magazine has published key works charting the development of our understanding of this process. Integral to this understanding – and featuring in one of the Geological Magazine publications – is the Devonian Rhynie chert Konservat-Lagerstätte located in Aberdeenshire, Scotland. Here we provide a review of the work on this important early terrestrial deposit to date. We begin by highlighting contributions of note in the Geological Magazine improving understanding of terrestrialization and Palaeozoic terrestrial ecosystems. We then introduce the Rhynie chert. The review highlights its geological setting: the Caledonian context of the Rhynie Basin and its nature at the time of deposition of the cherts which host its famous fossils. There follows an introduction to the development of the half-graben in which the cherts and host sediments were deposited, the palaeoenvironment this represented and the taphonomy of the fossils themselves. We subsequently provide an overview of the mineralization and geochemistry of the deposit, and then the fossils found within the Rhynie chert. These include: six plant genera, which continue to provide significant insights into the evolution of life on land; a range of different fungi, with recent work starting to probe plant–fungus interactions; lichens, amoebae and a range of unicellular eukaryotes and prokaryotes (algae and cyanobacteria); and finally a range of both aquatic and terrestrial arthropods. Through continued study coupled with methodological advances, Rhynie fossils will continue to provide unique insights into early life on land.
This narrative review aims to critically evaluate scientific evidence exploring the therapeutic role(s) of long-chain n-3 PUFA in the context of ageing, and specifically, sarcopenia. We highlight that beyond impairments in physical function and a lack of independence, the age-related decline in muscle mass has ramifications for cardio-metabolic health. Specifically, skeletal muscle is crucial in regulating blood glucose homeostasis (and by extension reducing type 2 diabetes mellitus risk) and providing gluconeogenic precursors that are critical for survival during muscle wasting conditions (i.e. AIDS). Recent interest in the potential anabolic action of n-3 PUFA is based on findings from experimental studies that measured acute changes in the stimulation of muscle protein synthesis (MPS) and/or chronic changes in muscle mass and strength in response to fish oil-derived n-3 PUFA supplementation. Key findings include a potentiated response of MPS to amino acid provision or resistance-based exercise with n-3 PUFA in healthy older adults that extrapolated to longer-term changes in muscle mass and strength. The key mechanism(s) underpinning this enhanced response of MPS remains to be fully elucidated, but is likely driven by the incorporation of exogenous n-3 PUFA into the muscle phospholipid membrane and subsequent up-regulation of cell signalling proteins known to control MPS. In conclusion, multiple lines of evidence suggest that dietary n-3 PUFA provide an essential link between musculoskeletal and cardio-metabolic health in older adults. Given that western diets are typically meagre in n-3 PUFA content, nutritional recommendations for maintaining muscle health with advancing age should place greater emphasis on dietary n-3 PUFA intake.
We read with interest the recent editorial, “The Hennepin Ketamine Study,” by Dr. Samuel Stratton commenting on the research ethics, methodology, and the current public controversy surrounding this study.1 As researchers and investigators of this study, we strongly agree that prospective clinical research in the prehospital environment is necessary to advance the science of Emergency Medical Services (EMS) and emergency medicine. We also agree that accomplishing this is challenging as the prehospital environment often encounters patient populations who cannot provide meaningful informed consent due to their emergent conditions. To ensure that fellow emergency medicine researchers understand the facts of our work so they may plan future studies, and to address some of the questions and concerns in Dr. Stratton’s editorial, the lay press, and in social media,2 we would like to call attention to some inaccuracies in Dr. Stratton’s editorial, and to the lay media stories on which it appears to be based.
Ho JD, Cole JB, Klein LR, Olives TD, Driver BE, Moore JC, Nystrom PC, Arens AM, Simpson NS, Hick JL, Chavez RA, Lynch WL, Miner JR. The Hennepin Ketamine Study investigators’ reply. Prehosp Disaster Med. 2019;34(2):111–113
This article summarizes the results of controlled experiments in which flaked-stone points that varied in impact strength by a factor of almost three were shot at media that were increasingly inelastic and therefore likely to break the points. Broken tips were reworked if possible, and used again under the same conditions. Our results show that all damage to low impact-strength materials, especially obsidian, was generally catastrophic, and, consequently, these points could only rarely be reworked. The fact that low-strength stones were commonly used to make small arrowpoints suggests that reworking was not a primary concern for their designers. Furthermore, in those instances when broken tips could be reworked, their performance declined. In addition, reworking broken points also resulted in shapes that are uncommon in many arrowpoint assemblages. Our results suggest that the original design attributes of arrowpoints may have been less affected by reworking, and, consequently, may more accurately suggest temporal and behavioral associations.
Ambient water condenses readily on metal oxides, which can lead to water film formation and water-mediated reactions at the oxide surface. Similar to bulk water, thin water films with thicknesses below 10 molecular layers can modify the oxide surface chemical reactivity and stability. However, due to the confinement of mass transport at the oxide surface, these processes do not proceed exactly as they do in bulk liquid water. In this review article, we will present selected examples from our group and others’ that illustrate the rich interaction of MgO and TiO2 nanostructures with thin water films. We will show that these condensed water films can induce significant chemical, structural, and microstructural transformations of metal oxide nanostructures such as dissolution/precipitation, morphological changes, crystallization, and self-assembly in the solid state.
The near wakes of flows past single- and multi-scale arrays of bars are studied by means of planar laser induced fluorescence (PLIF) and particle image velocimetry (PIV). The aim of this research is to better understand dispersion of passive scalar downstream of the multi-scale turbulence generator. In particular, the focus is on plausible manifestations of the space-scale unfolding (SSU) mechanism, which is often considered in the literature as the reason for the enhancement of the turbulent scalar flux in flows past fractal grids (i.e. specific multi-scale turbulence generators). The analysis of qualitative and quantitative PLIF results, as well as the simultaneously acquired PIV results, confirms the appearance of a physical scenario resembling the SSU mechanism. Unlike the anticipation of the literature, however, this scenario applies to some extent also to the flow past the single-scale obstacle. Application of a triple decomposition technique (which splits the acquired fields into their means, a number of coherent fluctuations and their stochastic parts) and a conditional-averaging technique reveals that the SSU mechanism is active in the vicinity of an intersection point between two adjacent wakes and is driven almost exclusively by coherent fluctuations associated with the larger of the intersecting wakes. This suggests that the SSU mechanism is related to the coherent fluctuations embedded in the flow rather than to the fine-scale turbulence and its underlying integral length scale, as proposed in previous works.
Optical parametric chirped-pulse amplification (OPCPA) [Dubietis et al., Opt. Commun. 88, 437 (1992)] implemented by multikilojoule Nd:glass pump lasers is a promising approach to produce ultraintense pulses (
). Technologies are being developed to upgrade the OMEGA EP Laser System with the goal to pump an optical parametric amplifier line (EP OPAL) with two of the OMEGA EP beamlines. The resulting ultraintense pulses (1.5 kJ, 20 fs,
) would be used jointly with picosecond and nanosecond pulses produced by the other two beamlines. A midscale OPAL pumped by the Multi-Terawatt (MTW) laser is being constructed to produce 7.5-J, 15-fs pulses and demonstrate scalable technologies suitable for the upgrade. MTW OPAL will share a target area with the MTW laser (50 J, 1 to 100 ps), enabling several joint-shot configurations. We report on the status of the MTW OPAL system, and the technology development required for this class of all-OPCPA laser system for ultraintense pulses.
This paper describes a model of electron energization and cyclotron-maser emission applicable to astrophysical magnetized collisionless shocks. It is motivated by the work of Begelman, Ergun and Rees [Astrophys. J. 625, 51 (2005)] who argued that the cyclotron-maser instability occurs in localized magnetized collisionless shocks such as those expected in blazar jets. We report on recent research carried out to investigate electron acceleration at collisionless shocks and maser radiation associated with the accelerated electrons. We describe how electrons accelerated by lower-hybrid waves at collisionless shocks generate cyclotron-maser radiation when the accelerated electrons move into regions of stronger magnetic fields. The electrons are accelerated along the magnetic field and magnetically compressed leading to the formation of an electron velocity distribution having a horseshoe shape due to conservation of the electron magnetic moment. Under certain conditions the horseshoe electron velocity distribution function is unstable to the cyclotron-maser instability [Bingham and Cairns, Phys. Plasmas 7, 3089 (2000); Melrose, Rev. Mod. Plasma Phys. 1, 5 (2017)].