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This book is a comprehensive manual for decision-makers and policy leaders addressing the issues around human caused climate change, which threatens communities with increasing extreme weather events, sea level rise, and declining habitability of some regions due to desertification or inundation. The book looks at both mitigation of greenhouse gas emissions and global warming and adaption to changing conditions as the climate changes. It encourages the early adoption of climate change measures, showing that rapid decarbonisation and improved resilience can be achieved while maintaining prosperity. The book takes a sector-by-sector approach, starting with energy and includes cities, industry, natural resources, and agriculture, enabling practitioners to focus on actions relevant to their field. It uses case studies across a range of countries, and various industries, to illustrate the opportunities available. Blending technological insights with economics and policy, the book presents the tools decision-makers need to achieve rapid decarbonisation, whilst unlocking and maintaining productivity, profit, and growth.
We present the case of a 13-year-old male with a complex congenital cardiac history who was supported with extracorporeal membrane oxygenation for 394 days while awaiting cardiac transplantation. The patient underwent successful cardiac transplantation after 394 days of support with veno-arterial extracorporeal membrane oxygenation and is currently alive 2 years after cardiac transplantation. We believe that this case represents the longest period of time that a patient has been supported with extracorporeal membrane oxygenation as a bridge to cardiac transplantation.
We also review the literature associated with prolonged support with extracorporeal membrane oxygenation. This case report documents many of the challenges associated with prolonged support with extracorporeal membrane oxygenation, including polymicrobial bacterial and fungal infections, as well as renal dysfunction. It is possible to successfully bridge a patient to cardiac transplantation with prolonged support with extracorporeal membrane oxygenation of over 1 year; however, multidisciplinary collaboration is critical.
Security is often a non-excludable public good. On the one hand, it benefits the people who buy it; on the other, it also benefits those who live near the people who buy it. It benefits those neighbors even if they refuse to share in the cost of the security themselves. Security also entails economies of scale. In part because of the positive externalities involved, people economize when they purchase security together. Rather than each pay to protect him- or herself, they save resources if they purchase their security together.
Statistical learning (SL) approaches to reading maintain that proficient reading requires assimilation of rich statistical regularities in the writing system. Reading skills in developing first-language readers are predicted by individual differences in sensitivity to regularities in mappings from orthography to phonology (O-P) and semantics (O-S), where good readers rely more on O-P consistency, and less on O-S associations. However, how these regularities are leveraged by second-language (L2) learners remains an open question. We utilize an individual-differences approach, measuring L2 English learners’ sensitivity to O-P, O-S, and frequency during word-naming, across two years of immersion. We show that reliance on O-P is leveraged by better readers, while reliance on O-S is slower to develop, characterizing less proficient readers. All factors explain substantial individual variance in L2 reading skills. These findings show how SL plays a key role in L2 reading development through its role in assimilating sublexical regularities between print and speech.
Diagnosis of sinus venosus defects, not infrequently associated with complex anomalous pulmonary venous drainage, may be delayed requiring multimodality imaging.
Retrospective review of all patients from February 2008 to January 2019.
Thirty-seven children were diagnosed at a median age of 4.2 years (range 0.5−15.5 years). In 32 of 37 (86%) patients, diagnosis was achieved on transthoracic echocardiography, but five patients (14%) had complex variants (four had high insertion of anomalous vein into the superior caval vein and three had multiple anomalous veins draining to different sites, two of whom had drainage of one vein into the high superior caval vein). In these five patients, the final diagnosis was achieved by multimodality imaging and intra-operative findings. The median age at surgery was 5.2 years (range 1.6−15.8 years). Thirty-one patients underwent double patch repair, four patients a Warden repair, and two patients a single-patch repair. Of the four Warden repairs, two patients had a high insertion of right-sided anomalous pulmonary vein into the superior caval vein, one patient had bilateral superior caval veins, and one patient had right lower pulmonary vein insertion into the right atrium/superior caval vein junction. There was no post-operative mortality, reoperation, residual shunt or pulmonary venous obstruction. One patient developed superior caval vein obstruction and one patient developed atrial flutter.
Complementary cardiac imaging modalities improve diagnosis of complex sinus venosus defects associated with a wide variation in the pattern of anomalous pulmonary venous connection. Nonetheless, surgical treatment is associated with excellent outcomes.
Yield losses due to weeds are a major threat to wheat production and economic well-being of farmers in the United States (US) and Canada. The objective of this Weed Science Society of America (WSSA) Weed Loss Committee report is to provide estimates of wheat yield and economic losses due to weeds. Weed scientists provided both weedy (best management practices but no weed control practices) and weed-free (best management practices providing >90% weed control) average yield from replicated research trials in both winter and spring wheat from 2007 to 2017. Winter wheat yield loss estimates ranged from 2.9 to 34.4%, with a weighted average (by production) of 25.6% for the US, 2.9% for Canada, and 23.4% combined. Based on these yield loss estimates and total production, the potential winter wheat loss due to weeds is 10.5, 0.09, and 10.5 billion kg with a potential loss in value of US$ 2.19, 0.19, and 2.19 billion for the US, Canada, and combined, respectively. Spring wheat yield loss estimates ranged from 7.9 to 47.0%, with a weighted average (by production) of 33.2% for the US, 8.0% for Canada, and 19.5% combined. Based on this yield loss estimate and total production, the potential spring wheat loss is 4.8, 1.6, and 6.6 billion kg with a potential loss in value of US$ 1.14, 0.37, and 1.39 billion for the US, Canada, and combined, respectively. Yield loss in this analysis is greater than some previous estimates, likely indicating an increasing threat from weeds. Climate impacts yield loss in winter wheat in the Pacific Northwest, with percent yield loss highest in wheat-fallow systems with less than 30 cm of annual precipitation. Continued investment in weed science research for wheat is critical for continued yield protection.
Nonsuicidal self-injury (NSSI) is a common but poorly understood phenomenon in adolescents. This study examined the Sustained Threat domain in female adolescents with a continuum of NSSI severity (N = 142). Across NSSI lifetime frequency and NSSI severity groups (No + Mild NSSI, Moderate NSSI, Severe NSSI), we examined physiological, self-reported and observed stress during the Trier Social Stress Test; amygdala volume; amygdala responses to threat stimuli; and resting-state functional connectivity (RSFC) between amygdala and medial prefrontal cortex (mPFC). Severe NSSI showed a blunted pattern of cortisol response, despite elevated reported and observed stress during TSST. Severe NSSI showed lower amygdala–mPFC RSFC; follow-up analyses suggested that this was more pronounced in those with a history of suicide attempt for both moderate and severe NSSI. Moderate NSSI showed elevated right amygdala activation to threat; multiple regressions showed that, when considered together with low amygdala–mPFC RSFC, higher right but lower left amygdala activation predicted NSSI severity. Patterns of interrelationships among Sustained Threat measures varied substantially across NSSI severity groups, and further by suicide attempt history. Study limitations include the cross-sectional design, missing data, and sampling biases. Our findings highlight the value of multilevel approaches in understanding the complexity of neurobiological mechanisms in adolescent NSSI.
Radiocarbon (14C) is an isotopic tracer used to address a wide range of scientific research questions. However, contamination by elevated levels of 14C is deleterious to natural-level laboratory workspaces and accelerator mass spectrometer facilities designed to precisely measure small amounts of 14C. The risk of contaminating materials and facilities intended for natural-level 14C with elevated-level 14C-labeled materials has dictated near complete separation of research groups practicing profoundly different measurements. Such separation can hinder transdisciplinary research initiatives, especially in remote and isolated field locations where both natural-level and elevated-level radiocarbon applications may be useful. This paper outlines the successful collaboration between researchers making natural-level 14C measurements and researchers using 14C-labeled materials during a subglacial drilling project in West Antarctica (SALSA 2018–2019). Our strict operating protocol allowed us to successfully carry out 14C labeling experiments within close quarters at our remote field camp without contaminating samples of sediment and water intended for natural level 14C measurements. Here we present our collaborative protocol for maintaining natural level 14C cleanliness as a framework for future transdisciplinary radiocarbon collaborations.
Antisociality across adolescence and young adulthood puts individuals at high risk of developing a variety of problems. Prior research has linked antisociality to autonomic nervous system and endocrinological functioning. However, there is large heterogeneity in antisocial behaviors, and these neurobiological measures are rarely studied conjointly, limited to small specific studies with narrow age ranges, and yield mixed findings due to the type of behavior examined.
We harmonized data from 1489 participants (9–27 years, 67% male), from six heterogeneous samples. In the resulting dataset, we tested relations between distinct dimensions of antisociality and heart rate, pre-ejection period (PEP), respiratory sinus arrhythmia, respiration rate, skin conductance levels, testosterone, basal cortisol, and the cortisol awakening response (CAR), and test the role of age throughout adolescence and young adulthood.
Three dimensions of antisociality were uncovered: ‘callous-unemotional (CU)/manipulative traits’, ‘intentional aggression/conduct’, and ‘reactivity/impulsivity/irritability’. Shorter PEPs and higher testosterone were related to CU/manipulative traits, and a higher CAR is related to both CU/manipulative traits and intentional aggression/conduct. These effects were stable across age.
Across a heterogeneous sample and consistent across development, the CAR may be a valuable measure to link to CU/manipulative traits and intentional aggression, while sympathetic arousal and testosterone are additionally valuable to understand CU/manipulative traits. Together, these findings deepen our understanding of the fundamental mechanisms underlying different components of antisociality. Finally, we illustrate the potential of using current statistical techniques for combining multiple datasets to draw robust conclusions about biobehavioral associations.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
A cartel is an association of independent businesses for the purpose of regulating trade in an industry. There are three important reasons for studying international cartels: they will become important in the future; they are of immense historical significance; and they are poorly understood. This paper reviews the economic, political, and historical literatures on international cartels and considers the lessons for international business theory and policy. If IB researchers are to retain their reputation for policy-relevance, they must engage with the issue of institutional responses to globalization, and this must include the analysis of cartels.
It remains unclear which mass-casualty incident (MCI) triage tool best predicts outcomes for child disaster victims.
The primary objective of this study was to compare triage outcomes of Simple Triage and Rapid Treatment (START), modified START, and CareFlight in pediatric patients to an outcomes-based gold standard using the Criteria Outcomes Tool (COT). The secondary outcomes were sensitivity, specificity, under-triage, over-triage, and overall accuracy at each level for each MCI triage algorithm.
Singleton trauma patients under 16 years of age with complete prehospital, emergency department (ED), and in-patient data were identified in the 2007-2009 National Trauma Data Bank (NTDB). The COT outcomes and procedures were translated into ICD-9 procedure codes with added timing criteria. Gold standard triage levels were assigned using the COT based on outcomes, including mortality, injury type, admission to the hospital, and surgical procedures. Comparison triage levels were determined based on algorithmic depictions of the three MCI triage tools.
A total of 31,093 patients with complete data were identified from the NTDB. The COT was applied to these patients, and the breakdown of gold standard triage levels, based on their actual clinical outcomes, was: 17,333 (55.7%) GREEN; 11,587 (37.3%) YELLOW; 1,572 (5.1%) RED; and 601 (1.9%) BLACK. CareFlight had the best sensitivity for predicting COT outcomes for BLACK (83% [95% confidence interval, 80%-86%]) and GREEN patients (79% [95% CI, 79%-80%]) and the best specificity for RED patients (89% [95% CI, 89%-90%]).
Among three prehospital MCI triage tools, CareFlight had the best performance for correlating with outcomes in the COT. Overall, none of three tools had good test characteristics for predicting pediatric patient needs for surgical procedures or hospital admission.
Substance use disorders are highly prevalent, affecting millions of Americans directly (social, occupational, and health problems) and indirectly (billions of dollars in health care costs and lost revenues due to disability). This section briefly introduces the chemical classification and neurobehavioral properties of the most commonly misused substances.
A field study was conducted in Mississippi to determine the effect of reduced dicamba rates on sweetpotato crop tolerance and storage root yield, simulating off-target movement or sprayer tank contamination. Treatments were a non-treated control and four rates of dicamba [70 g ae ha−1 (1/8X), 35 g ae ha−1 (1/16X), 8.65 g ae ha−1 (1/64X) and 1.09 g ae ha−1 (1/512X)] applied either 3 days before transplanting (DBP) or 1, 3, 5, or 7 weeks after transplanting (WAP). An additional treatment consisted of 560 g ae ha−1 (1X) dicamba applied 3 DBP. Crop injury ratings were taken 1, 2, 3, and 4 weeks after treatment (WAT). Across application timings, predicted sweetpotato plant injury 1, 2, 3, and 4 WAT increased from 3 to 22%, 3 to 32%, 2 to 58%, and 1 to 64% as dicamba rate increased from 0 to 70 g ha−1 (1/8X), respectively. As dicamba rate increased from 1/512X to 1/8X, predicted No. 1 yield decreased from 127 to 55%, 103 to 69%, 124 to 31%, and 124 to 41% of the non-treated control for applications made 1, 3, 5, and 7 WAP, respectively. Similarly, as dicamba rate increased from 1/512X to 1/8X, predicted marketable yield decreased from 123 to 57%, 107 to 77%, 121 to 44%, and 110 to 53% of the non-treated control for applications made 1, 3, 5, and 7 WAP, respectively. Dicamba residue (5.3 to 14.3 parts per billion) was detected in roots treated with 1/16X or 1/8X dicamba applied 5 or 7 WAP and 1/64X dicamba applied 7 WAP with the highest residue detected in roots harvested from sweetpotato plants treated at 7 WAP. Collectively, care should be taken to avoid sweetpotato exposure to dicamba especially at 1/8X and 1/16X rates during the growing season.
The aim of this retrospective cohort study was to determine the incidence, potential risk factors, characteristics, and outcomes of acute kidney injury in children following the arterial switch operation for transposition of the great arteries.
Retrospective review of children who underwent ASO between 2000 and 2020 in our tertiary children’s hospital in the Netherlands. Pre-and post-ASO serum creatinine levels were collected. Severe AKI was defined as 100% serum creatinine rise or estimated creatinine clearance <35 ml/min/1.73 m2 according to pRIFLE criteria. Logistic regression was used to adjust for confounders.
A total of 242 children were included. Fifty-seven (24%) children developed severe AKI after ASO. Four patients with severe AKI were treated with renal replacement therapy. Children with severe AKI had a longer duration of mechanical ventilation 4.5 (1.0–29) versus 3 (1.0–12) days (p = 0.001), longer PICU stay 7 (2–76) versus 5 (1–70) days, (p = 0.001), higher rate of myocardial infarction 5% versus 0.5% (p = 0.001), sepsis 24% versus 9% (p = 0.002), post-operative pulmonary hypertension 19% versus 6% (p = 0.002), post-operative bleeding 9% versus 3% (p = 0.044), longer time to sternal closure 3 (1–19) versus 2 (1–6) days, (p = 0.009), and a higher mortality rate 9.0% versus 0.5% (p = 0.001) compared to children without severe AKI. Sepsis was a risk factor for developing severe AKI.
In this single-centre cohort, 24% of our patients developed severe AKI after ASO, which is associated with increased morbidity, longer PICU stay, and higher mortality.
The growing unmet demand for suitable organ donors increases each year. Despite relative contraindications for thoracic organ donation after previous cardiac surgery, experienced programmes and surgeons can successfully utilise the lungs from select donors who have undergone prior cardiac surgery. This is the first reported case of double lung en bloc procurement from a donor who had a previous arterial switch operation as an infant.
While substantial evidence has identified low birth weight (LBW; <2500 g) as a risk factor for early life morbidity, mortality and poor childhood development, relatively little is known on the links between birth weight and economic outcomes in adulthood. The objective of this study was to systematically review the economics (EconLit) and biomedical literature (Medline) and estimate the pooled association between birth weight and adult earnings. A total of 15 studies from mostly high-income countries were included. On average, each standard deviation increase in birth weight was associated with a 2.75% increase in annual earnings [(95% CI: 1.44 to 4.07); 9 estimates]. A negative, but not statistically significant, association was found between being born LBW and earnings, compared to individuals not born LBW [mean difference: −3.41% (95% CI: −7.55 to 0.73); 7 estimates]. No studies from low-income countries were identified and all studies were observational. Overall, birth weight was consistently associated with adult earnings, and therefore, interventions that improve birth weight may provide beneficial effects on adult economic outcomes.
This retrospective case series study sought to describe the safety and clinical effectiveness of propafenone for the control of arrhythmias in children with and without CHD or cardiomyopathy.
We reviewed baseline characteristics and subsequent outcomes in a group of 63 children treated with propafenone at 2 sites over a 15-year period Therapy was considered effective if no clinically apparent breakthrough episodes of arrhythmias were noted on the medication.
Sixty-three patients (29 males) were initiated on propafenone at a median age of 2.3 years. CHD or cardiomyopathy was noted in 21/63 (33%). There were no significant differences between demographics, clinical backgrounds, antiarrhythmic details, side effect profiles, and outcomes between children with normal hearts and children with CHD or cardiomyopathy. Cardiac depression at the initiation of propafenone was more common amongst children with CHD or cardiomyopathy compared to children with normal hearts. Systemic ventricular function was diminished in 15/63 patients (24%) prior to starting propafenone and improved in 8/15 (53%) of patients once better rhythm control was achieved. Other than one child in whom medication was stopped due to gastroesophageal reflux, no other child experienced significant systemic or cardiac side effects during treatment with propafenone. Propafenone achieved nearly equal success in controlling arrhythmias in both children with normal hearts and children with congenital heart disease or cardiomyopathy (90% versus 86%, p = 0.88).
Propafenone is a safe and effective antiarrhythmic medication in children.