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Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code (IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC.
The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature.
The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.
When Hurricane Harvey struck the coastline of Texas in 2017, it caused 88 fatalities and over US $125 billion in damage, along with increased emergency department visits in Houston and in cities receiving hurricane evacuees, such as the Dallas-Fort Worth metroplex (DFW).
This study explored demographic indicators of vulnerability for patients from the Hurricane Harvey impact area who sought medical care in Houston and in DFW. The objectives were to characterize the vulnerability of affected populations presenting locally, as well as those presenting away from home, and to determine whether more vulnerable communities were more likely to seek medical care locally or elsewhere.
We used syndromic surveillance data alongside the Centers for Disease Control and Prevention Social Vulnerability Index to calculate the percentage of patients seeking care locally by zip code tabulation area. We used this variable to fit a spatial lag regression model, controlling for population density and flood extent.
Communities with more patients presenting for medical care locally were significantly clustered and tended to have greater socioeconomic vulnerability, lower household composition vulnerability, and more extensive flooding.
These findings suggest that populations remaining in place during a natural disaster event may have needs related to income, education, and employment, while evacuees may have more needs related to age, disability, and single-parent household status.
Ecosystem modeling, a pillar of the systems ecology paradigm (SEP), addresses questions such as, how much carbon and nitrogen are cycled within ecological sites, landscapes, or indeed the earth system? Or how are human activities modifying these flows? Modeling, when coupled with field and laboratory studies, represents the essence of the SEP in that they embody accumulated knowledge and generate hypotheses to test understanding of ecosystem processes and behavior. Initially, ecosystem models were primarily used to improve our understanding about how biophysical aspects of ecosystems operate. However, current ecosystem models are widely used to make accurate predictions about how large-scale phenomena such as climate change and management practices impact ecosystem dynamics and assess potential effects of these changes on economic activity and policy making. In sum, ecosystem models embedded in the SEP remain our best mechanism to integrate diverse types of knowledge regarding how the earth system functions and to make quantitative predictions that can be confronted with observations of reality. Modeling efforts discussed are the Century ecosystem model, DayCent ecosystem model, Grassland Ecosystem Model ELM, food web models, Savanna model, agent-based and coupled systems modeling, and Bayesian modeling.
Emerging from the warehouse of knowledge about terrestrial ecosystem functioning and the application of the systems ecology paradigm, exemplified by the power of simulation modeling, tremendous strides have been made linking the interactions of the land, atmosphere, and water locally to globally. Through integration of ecosystem, atmospheric, soil, and more recently social science interactions, plausible scenarios and even reasonable predictions are now possible about the outcomes of human activities. The applications of that knowledge to the effects of changing climates, human-caused nitrogen enrichment of ecosystems, and altered UV-B radiation represent challenges addressed in this chapter. The primary linkages addressed are through the C, N, S, and H2O cycles, and UV-B radiation. Carbon dioxide exchanges between land and the atmosphere, N additions and losses to and from lands and waters, early studies of SO2 in grassland ecosystem, and the effects of UV-B radiation on ecosystems have been mainstays of research described in this chapter. This research knowledge has been used in international and national climate assessments, for example the IPCC, US National Climate Assessment, and Paris Climate Accord. Likewise, the knowledge has been used to develop concepts and technologies related to sustainable agriculture, C sequestration, and food security.
Antarctica's ice shelves modulate the grounded ice flow, and weakening of ice shelves due to climate forcing will decrease their ‘buttressing’ effect, causing a response in the grounded ice. While the processes governing ice-shelf weakening are complex, uncertainties in the response of the grounded ice sheet are also difficult to assess. The Antarctic BUttressing Model Intercomparison Project (ABUMIP) compares ice-sheet model responses to decrease in buttressing by investigating the ‘end-member’ scenario of total and sustained loss of ice shelves. Although unrealistic, this scenario enables gauging the sensitivity of an ensemble of 15 ice-sheet models to a total loss of buttressing, hence exhibiting the full potential of marine ice-sheet instability. All models predict that this scenario leads to multi-metre (1–12 m) sea-level rise over 500 years from present day. West Antarctic ice sheet collapse alone leads to a 1.91–5.08 m sea-level rise due to the marine ice-sheet instability. Mass loss rates are a strong function of the sliding/friction law, with plastic laws cause a further destabilization of the Aurora and Wilkes Subglacial Basins, East Antarctica. Improvements to marine ice-sheet models have greatly reduced variability between modelled ice-sheet responses to extreme ice-shelf loss, e.g. compared to the SeaRISE assessments.
Reconstructions of prehistoric vegetation composition help establish natural baselines, variability, and trajectories of forest dynamics before and during the emergence of intensive anthropogenic land use. Pollen–vegetation models (PVMs) enable such reconstructions from fossil pollen assemblages using process-based representations of taxon-specific pollen production and dispersal. However, several PVMs and variants now exist, and the sensitivity of vegetation inferences to PVM selection, variant, and calibration domain is poorly understood. Here, we compare the reconstructions, parameter estimates, and structure of a Bayesian hierarchical PVM, STEPPS, both to observations and to REVEALS, a widely used PVM, for the pre–Euro-American settlement-era vegetation in the northeastern United States (NEUS). We also compare NEUS-based STEPPS parameter estimates to those for the upper midwestern United States (UMW). Both PVMs predict the observed macroscale patterns of vegetation composition in the NEUS; however, reconstructions of minor taxa are less accurate and predictions for some taxa differ between PVMs. These differences can be attributed to intermodel differences in structure and parameter estimates. Estimates of pollen productivity from STEPPS broadly agree with estimates produced for use in REVEALS, while comparison between pollen dispersal parameter estimates shows no significant relationship. STEPPS parameter estimates are similar between the UMW and NEUS, suggesting that STEPPS parameter estimates are transferable between floristically similar regions and scales.
The political atmosphere on US college campuses is overwhelmingly left-leaning and liberal, with the vast majority of faculty self-identifying as socially progressive. Considerable research on cognitive biases has demonstrated the pervasive role of people’s attitudes, which act as filters during thinking and reasoning – particularly about politically-valenced topics. The prevalence of faculty from one side of the political spectrum coupled with the omnipresence of cognitive biases means that college campuses and the research done by their faculty runs the risk of favoring one side during what should, scientifically-speaking, be a process of fair and open inquiry. We discuss these phenomena and document numerous examples in which lack of genuine viewpoint diversity has spelled trouble for sound science. We advocate a more ideologically-diverse scientific workforce to better enable true diversity of thinking on key issues of our time.
There are large between-country differences in measures of economic and noneconomic well-being. Many researchers view increasing the stock of human capital as the key to raising economic development, promoting democratization, and improving health, and hence improving overall societal well-being. The single most studied aspect of human capital concerns cognitive competence. Differences in population cognitive competence might explain these societal differences. Evidence suggests that education builds cognitive competence, and education and cognitive competence promote better social outcomes, in terms of both economic and noneconomic factors. However, measuring population cognitive competence for countries requires representative samples, culture-fair tests, equivalency in the relationship between test measures and other cognitive attributes, and comparability in testing situations. In most cases, none of this has been achieved.
The Minnesota Center for Twin and Family Research (MCTFR) comprises multiple longitudinal, community-representative investigations of twin and adoptive families that focus on psychological adjustment, personality, cognitive ability and brain function, with a special emphasis on substance use and related psychopathology. The MCTFR includes the Minnesota Twin Registry (MTR), a cohort of twins who have completed assessments in middle and older adulthood; the Minnesota Twin Family Study (MTFS) of twins assessed from childhood and adolescence into middle adulthood; the Enrichment Study (ES) of twins oversampled for high risk for substance-use disorders assessed from childhood into young adulthood; the Adolescent Brain (AdBrain) study, a neuroimaging study of adolescent twins; and the Siblings Interaction and Behavior Study (SIBS), a study of adoptive and nonadoptive families assessed from adolescence into young adulthood. Here we provide a brief overview of key features of these established studies and describe new MCTFR investigations that follow up and expand upon existing studies or recruit and assess new samples, including the MTR Study of Relationships, Personality, and Health (MTR-RPH); the Colorado-Minnesota (COMN) Marijuana Study; the Adolescent Brain Cognitive Development (ABCD) study; the Colorado Online Twins (CoTwins) study and the Children of Twins (CoT) study.
This volume has achieved a large coverage of the experimentally well-studied areas of the temperate and subtropical coasts of the world (see Figure 1.1) – venturing into the tropics in some regions (Chapter 14, South-East Asia) and including mangroves (Chapter 17). Coral reef systems have not been considered. Much of the emphasis has been on rocky habitats as this is where the majority of experimental work on interactions has been done (but see Chapter 6). As well as reviewing regions where there has been a long history of experimental research (e.g., Chapters 2–4, 6, 10, 11, 13, 15, 16), areas of emerging experimental research in the last twenty-five years (e.g., Chapter 8, western Mediterranean; Chapter 12, south-east Pacific) and understudied regions (e.g., Chapter 7, Argentina; Chapter 14, South-East Asia) have also been included, allowing more comprehensive insights into the processes important for shaping these communities. In this short synthesis chapter, we first consider the main processes determining patterns covered by the previous chapters. We then consider major human impacts in these regions. Finally, we identify gaps in knowledge and make some suggestions for the way forward. We make the case for combining phylogeographic studies with macro-ecology and biogeography, coupled with well-designed hypothesis testing experiments, to better understand processes generating patterns on micro-evolutionary (hundreds to thousands of years) and ecological (up to hundreds of years) time scales.
The synthesis of the Aquatic Biodiversity and Ecosystems Conference (ABEC) 2015, which was held to assess scientific progress over the past twnety-five years, this book provides a comprehensive and global review of work since the 1992 publication of Plant-Animal Interactions in the Marine Benthos. Taking a regional and, where appropriate, habitat perspective, it considers sites of coastal biodiversity from around the world to incorporate a global approach. The volume analyses abiotic and biotic interactions, and the factors determining distribution patterns, community structure and ecosystem functioning of coastal systems. It explores themes of how phylogeography and biogeographic process influence assemblage composition, and hence drive community structure and the respective roles of environmental factors and biological interactions, with the overall goal to establish how general are the processes in different regions and habitats. For researchers, graduate students and academics studying coastal ecosystems, with interest for conservation practitioners managing areas of high biodiversity.
At the end of the 2015 Aquatic Biodiversity and Ecosystems Conference, a day was set aside for a workshop following up on the 1990 Plant–Animal Interactions meeting and its associated Systematics Association book – Plant–Animal Interactions in the Marine Benthos (John et al., 1992). Talks given throughout the 2015 conference also informed the present volume and its chapters. The 2015 workshop took a comparative approach with a series of informal presentations and discussion sessions from selected participants from around the world. The general aim was to take a regionally based view of the role of interactions in setting distribution patterns, community structure and functioning of shallow-water marine ecosystems. The coverage was predominantly coastal, down to the limit of light penetration. Most contributions were from those working on rocky intertidal and subtidal habitats, reflecting the size (and willingness to contribute) of the research community coupled with the greater tradition of experimental approaches to examine interactions on more tractable hard substrata. In addition, mangroves, biofilms and the deep sea were also considered as special systems that are ubiquitous across several oceans where significant advances have been made and, therefore, warranted inclusion. Recent advances in remotely operated vehicles, for example, have increased the scope for observation and experiment in the deep sea (Johnson et al., 2013); whereas mangroves are important ecosystem engineers which provide important ecosystem services, but are declining globally (Polidoro et al., 2010; Chee et al., 2017). Biofilms were also included as a subject given their global distribution and importance as the site of first settlement of macrobenthic organisms and as a food source for grazers (Abreu et al., 2007). While this volume does not feature any chapters specifically on artificial structures, ocean sprawl or eco-engineering, a large number of talks and posters at the conference dealt with these emerging issues, reflecting their global importance (see Firth et al., 2016; Bishop et al., 2017 and Strain et al., 2018 for reviews). A notable omission is coral reefs, which were not covered because they already have a well-established community of research workers and deserve a volume in their own right. Inevitably, there are gaps in coverage reflecting difficulties in soliciting and delivering input, especially on soft shores as well as certain geographic locations. Coverage in 1992 and 2018 is shown on the maps in Figure 1.1.
Much of the peace agreement durability literature assumes that stronger peace agreements are more likely to survive the trials of the post-conflict environment. This work does an excellent job identifying which provisions indicate that agreements are more likely to endure. However, there is no widely accepted way to directly measure the strength of agreements, and existing measures suffer from a lack of nuance or reliance on subjective weighting. We use a Bayesian item response theory model to develop a principled measure of the latent strength of peace agreements in civil conflicts from 1975 to 2005. We illustrate the measure's utility by exploring how various international factors such as sanctions and mediation contribute to the strength or weakness of agreements.