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Mandibular and dental material of hyaenids from the Central Asian localities of Zasukhino-3 (Russia) and Nalaikha (Mongolia), dating to the late Early Pleistocene (0.9–0.78 Ma) was identified as giant hyena Pachycrocuta brevirostris based on morphological and size similarities. Comparative analysis of Eurasian P. brevirostris from different stratigraphic levels (from 2.1 to 0.5 Ma) revealed two evolutionary stages of the lower cheek teeth of the giant hyenas. The stages are determined as morphotypes A and B, directed toward the differentiation of the function of premolar and enhancing the cutting function of m1. We traced the microprocesses that occurred during the transition from the primitive structure of the m1 talonid to its more advanced state. This event occurred during the transition from the late Villafranchian to the Epivillafranchian (ca. 1.1–0.9 Ma). The stabilized advanced morphotype B was found in samples from Zasukhino-3, Nalaikha, and other close-in-age localities such as Lakhuti-2. The new finds from Asian Russia and Mongolia suggest that P. brevirostris from these regions represent a single giant hyena population occupying the northernmost part of their Asian range.
Fields of sandy paleodunes have been identified in Brazil, Colombia, Venezuela, and Guyana north of the South American continent. In this study, geochronological data obtained by optically stimulated luminescence (OSL) for paleodunes in the Middle Rio Negro region (Brazil) allowed the identification of two stages of dune deposition: the older from 169.74 ± 1.01 ka to 124.38 ± 0.91 ka and the younger from 18.89 ± 0.88 ka to 14.75 ± 0.77 ka. The older interval is the first reported in the Amazon; no correlated sediment has been documented. In contrast, the more recent depositional interval correlates to the interval of paleodune fields of the region called “dry corridor” in the Late Pleistocene–Holocene. In this study, we associated the genesis of paleodunes with the reworking of alluvial deposits from the Negro and Demini rivers, driven by river seasonality during the Pleistocene–Holocene, as evidenced by characteristic microtextural data.
Catheter-related bloodstream infections (CRBSI) or central line-associated bloodstream infections (CLABSI) occur frequently with long-term indwelling catheters. EDTA (Ethylenediaminetetraacetic acid) and other catheter lock solutions can prevent CRBSI/CLABSI. This study aimed to identify the role of EDTA lock solution in preventing CRBSI/CLABSI compared to the non-EDTA lock solutions.
Materials and Methods:
Eligible studies comparing the effectiveness of EDTA versus a control group on averting CRBSI or CLABSI were identified through searches across PubMed, Embase, Scopus, Cochrane CENTRAL, medRxiv, bioRxiv, and ClinicalTrials.gov. The secondary outcomes were catheter colonization, catheter survival, and catheter thrombosis. The relative risk for all the outcomes was calculated.
Results:
This meta-analysis included eight studies (403 EDTA vs 425 control patients) and demonstrated a significant reduction in CRBSI/CLABSI with EDTA (15 vs 71 events; RR: 0.18; 95% CI: 0.10–0.33; P < 0.00001). Catheter colonization also decreased significantly (8 vs 38 events; OR: 0.11; 95% CI: 0.05–0.29). EDTA improved catheter survival in hemodialysis patients (OR: 3.77; 95% CI: 1.23–11.61; P < 0.02) but showed no significant effect on thrombolytic treatment or all-cause mortality. Subgroup analyses supported these findings, with no publication bias detected.
Conclusion:
EDTA significantly reduces CRBSI/CLABSI and catheter colonization, improves catheter survival, but does not affect thrombolytic treatment or mortality. Evidence certainty varies across outcomes.
This article offers principles to be followed when editing οὔκουν and οὐκοῦν. The distinction between these words is supported by the ancient grammarians, but manuscript readings oscillate to such a degree that modern editors often do not trust them. The most common principles thus far available are those established by Kühner–Gerth and Denniston. Some are so subjective, however, that editors do not always agree on the accentuation of a non-negligible number of instances. This article takes into account the pragmatic contexts in which the particle is used in Attic drama to effect a distinction by applying a conversation analytic methodology to their interpretation. All instances appearing in the extant plays of Aeschylus, Sophocles, Euripides and Aristophanes have been analysed.
A mechanical heart valve is a durable device used to replace damaged ones inside a living heart, aiming for regulated blood flow to avoid the risks of cardiac failure or stroke. The modern bileaflet designs, featuring two semicircular leaflets, aim to improve blood flow control and minimise turbulence as compared to the older models. However, these valves require lifelong anticoagulation therapy to prevent blood clots, increasing bleeding risks and necessitating regular monitoring. Turbulence within the valve can lead to complications such as haemolysis (damage to red blood cells), thrombosis, platelet activation and valve dysfunction. It also contributes to energy loss, increased cardiac workload, and endothelial damage, potentially impairing the valve efficiency and increasing the risk of infective endocarditis. To address these challenges, a design-modified St Jude Medical (SJM) valve with streamlined edges was conceptualised and assessed using direct numerical simulations. Results show that the streamlined design minimises abrupt blood flow alterations and reduces turbulence-inducing vortices. Compared to existing SJM valves, the new design ensures smoother flow transitions, reduces flow disturbances, and reduces pressure drop. It significantly decreases shear stress, drag and downstream turbulence, enhancing haemodynamic efficiency. These improvements lower the risk of complications such as haemolysis and thrombosis, offering a safer and more efficient option for valve replacement, establishing the potential of edge streamlining in advancing mechanical heart valve technology, and favouring patient outcomes.
Unhealthy diets are a leading cause of preventable ill health. Healthy diets tend to be more expensive than less healthy diets and as such are more likely to be consumed by individuals with a higher income. This review paper discusses the development of the Eatwell Guide, evaluates the affordability of a diet consistent with the Eatwell Guide (“the Eatwell Guide diet”), and explores how food pricing can be leveraged to encourage and support healthier dietary choices.
The Eatwell Guide is the UK’s food-based dietary guidelines. It provides healthy eating advice that is intended to facilitate policy cohesion but is also used as a public facing health promotion tool.
The cost of food has increased and recent estimates suggest that the Eatwell Guide diet is now more expensive than the current average diet. There is strong evidence that subsidies would be effective at increasing the uptake of healthy diets. Monitoring the cost of a healthy diet is important for policy development; however, we should exercise caution when considering how to incorporate costs into food-based dietary guidelines and be mindful of the limitations of the data that could support this.
This study connected flow structure and morphological changes in and around a rectangular vegetation patch. The emergent patch was constructed in an 8 cm sand bed. Two patch densities were tested, using a regular configuration of rigid dowels. Near the leading edge of the patch, enhanced turbulence levels produced sediment erosion. Some of the eroded sediment was carried into the patch, forming an interior deposition dune. The denser patch resulted in a smaller dune due to stronger lateral flow diversion and weaker interior streamwise velocity. After the leading-edge dune, in the fully developed region of the patch, vortices formed in the shear layers along the patch lateral edges. Elevated turbulence at the patch edge produced local erosion. For the dense patch, material eroded from the edge was transported into the patch to form a flow-parallel ridge, and there was no net sediment loss/gain by the patch. For the sparse patch, material eroded from the edge was transported away from the patch, resulting in a net loss of sediment from the patch. In the wake of both patches, deposition occurred near the wake edges and not at the wake centreline, which was attributed to the weak lateral transport associated with the weakness of the von Kármán vortex street. Specifically, the lateral transport length scale was less than half the width of the patch. The increasing bedform height within the wake progressively weakened and narrowed the von Kármán vortex street, illustrating an important feedback from morphological evolution to the flow structure. Despite significant local sediment redistribution, the patch did not induce channel-scale sediment transport.
The crystal structure of a new form of racemic reboxetine mesylate has been solved and refined using synchrotron X-ray powder diffraction data and optimized using density functional theory techniques. Reboxetine mesylate crystallizes in space group P21/c (#14) with a = 14.3054(8), b = 18.0341(4), c = 16.7924(11) Å, β = 113.4470(17)°, V = 3,974.47(19) Å3, and Z = 8 at 298 K. The crystal structure consists of double columns of anions and cations along the a-axis. Strong N–H···O hydrogen bonds link the cations and anions into zig-zag chains along the a-axis. The powder pattern has been submitted to the International Centre for Diffraction Data (ICDD®) for inclusion in the Powder Diffraction File™ (PDF®).
Although fundamental arguments have been presented to support the value-laden nature of all scientific research, they appear to be difficult to apply to basic research in physics. To explain this, I argue that basic research in physics is, in a very specific respect, often value-laden to a lesser degree. To spell this out, I refer to the different signal-to-noise ratios that can be achieved in different fields of research. I also argue that having a very low degree of value-ladenness in the very specific respect that I identify does not mean that the research is not value-laden at all.
The Third Reich established a new financial order in Central Europe. This article examines one aspect of these changes, namely the evolution of banking law. After the seizure of power in 1933, Nazi officials weaponized financial and legal institutions to support the rearmament campaign. They initially worked through the Credit Supervisory Office, a regulatory agency created in 1934, to enforce a standardized model of regulation. Driven by more than a desire for self-sufficiency (autarky) and expropriative control, the authorities devised a system of economic governance that perpetuated the conflict and continually supported German financial interests. The politicization and dismantling of the regulatory office, officially dissolved in 1944, reflected the evolving priorities of the Nazi regime. By reinterpreting existing laws and working with a willing state bureaucracy, officials were able to use regulation as a tool for redesigning the banking systems of Germany and the annexed territories.
Although current prescribing guidelines suggest continuation of psychotropic drugs in pregnant women, population-based evidence supporting their safety is limited.
Aims
This study aims to clarify the plausible causal links between maternal psychotropic drug exposures and obstetric complications.
Method
This cohort study investigated all births by Hong Kong residents ≥18 years of age in public hospitals between 2004 and 2022. Birth episodes were classified according to whether they were unexposed to psychotropic drugs, exposed but discontinued before conception or exposed during pregnancy. Firth’s penalised logistic regression was employed in all analysis, and negative control analysis was conducted to assess causality. False discovery rate correction and sensitivity analyses were performed.
Results
Among 587 419 births, 7182 episodes involved psychotropic prescriptions (antipsychotics, antidepressants, anticonvulsants, benzodiazepines) during pregnancy. In broad drug class analysis, all significant associations observed in the exposed group were also observed in negative control analysis (psychotropics discontinued before conception), suggesting that elevated risks could be attributed to unmeasured confounders. Nevertheless, in subclass analyses, certain psychotropic drugs showed increased risks of obstetric complications, i.e. significant associations between atypical antipsychotics and genito-urinary infection (odds ratio 2.70, 95% CI 1.46–4.83), and between valproate and low birth weight (odds ratio 1.68, 95% CI 1.16–2.37). These associations became non-significant in negative control analysis, and the high E-values (atypical antipsychotics and genito-urinary infection, 4.84; valproate and low birth weight, 2.75) suggested that the results were unlikely to have been driven by unmeasured confounders. Maternal diagnoses of schizophrenia and depression were independently associated with increased risk of obstetric complications, after controlling for the effects of psychotropics.
Conclusions
The population-based data and meticulous analyses did not support any clear causal link between broad-class psychotropic exposure during pregnancy and increased risk of obstetric/neonatal complications. However, some psychotropic subclasses may increase obstetric/neonatal complications. The limited number of episodes involving discontinuation of some psychotropic subclasses may have resulted in false negative findings in the negative control analysis.
This study examines the political participation of undocumented Mexican immigrants residing in the United States in Mexican external voting. As international mobility of people has increased globally, scholarly attention has grown concerning how overseas citizens engage in electoral processes in their countries of origin. However, previous studies based on traditional survey methods may have yielded biased results due to the underrepresentation of undocumented immigrants, who are less likely to enroll in survey company panels due to concerns about the potential compromise of their identities. To include this hard-to-reach population and conduct representative sampling, our research employs a method called respondent-driven sampling (RDS), which permits the surveying of a population devoid of a sampling frame. Our analysis of the Mexican case demonstrates that a lack of electoral information, lower levels of education, and heightened distrust of the Mexican government are associated with diminished electoral participation.
Cognitive behavioural therapy (CBT) is a frontline treatment for a range of mental health problems and is increasingly offered as the psychological therapy of choice across the globe. Access to or benefit from this psychological therapy relies on proficiency in the dominant language of the area. However, to meet our clients’ needs in an increasingly mobile, multicultural, and diverse society, it may require adaptation through the use of spoken language interpreters. The benefits of interpreter-mediated CBT for mental health problems remains uncertain. The objective of this review is to systematically identify, evaluate, and integrate the existing empirical literature on interpreter-mediated CBT for mental health problems. A comprehensive search was conducted in July 2024 across CINAHL, MEDLINE, PsycINFO and Scopus. Studies meeting the inclusion criteria resulted in a total of eleven articles being included in the review. The included research shows promise in terms of feasibility and efficacy, but not conclusively. The narrative review enabled the synthesis of recommendations, which have been conceptualised as being at individual, service, and organisational levels. There is limited research and a need for further studies into the influence of other factors such as therapist proficiency, interpreter proficiency, complexity/co-morbidity and service context. Further evaluation should consider controlled trials of interpreter-mediated CBT, while also establishing its efficacy more robustly in regular practice. It should also further explore the experiences and perspectives of the client, interpreter, and therapist regarding the suggested recommendations.
Key learning aims
(1) Gain an understanding of the existing evidence on the effectiveness of interpreter-mediated CBT for various mental health problems across diverse populations.
(2) Learn about key recommendations emerging from empirical research on the implementation of interpreter-mediated CBT.
(3) Acquire clear, practical guidance that can inform the work of interpreters, practitioners, services, and healthcare systems to improve the delivery of interpreter-mediated CBT.
In the United Kingdom (UK), approximately one million people cannot speak English well enough to access therapy in English. If there is no shared language used by both the client and therapist, then individuals require access to an interpreter so that they receive an equitable service. Research highlights the anxiety and pressures that working with an interpreter can bring for professionals. In light of the Coronavirus pandemic and increased remote working, this research aimed to explore the experience and perspectives of cognitive behavioural therapists working with language interpreters remotely. Semi-structured interviews were conducted with 18 participants who were asked about their experience of working with interpreters remotely. Data were analysed using Braun and Clarke’s six phases of thematic analysis. The analysis resulted in four main themes being constructed: the system doesn’t make it easier; working in a culturally sensitive way; the powerful role of the interpreter; and remote therapy – different landscape, different journey. Findings offer an understanding of how working with an interpreter impacts ways of working in cognitive behavioural therapy. The findings draw attention to the impact of the organisational context where therapists work.
Key learning aims
After reading this paper, it is hoped that readers will be able to:
(1) Consider cognitive behavioural therapists’ experiences of challenges and barriers when working remotely with interpreters.
(2) Look at the experience and perspectives of cognitive behavioural therapists working with interpreters remotely (in light of the COVID-19 pandemic and increased remote working practices).
(3) Consider the support needed to enable therapists, healthcare services and broader healthcare structures to provide services to clients through working with interpreters and adapting therapy for diverse cultural groups.
While often described as a unified process imposed by external actors on weak, conflict-ridden countries, international state building increasingly comprises a variety of actors involved in different ways in (re)building a diverse set of institutions. Civilian preferences are often excluded from this fragmented environment. We identify and explicate three dimensions along which postconflict state building meaningfully varies: the actor involved, the type of institution targeted, and the form of involvement. We then examine how variation along each dimension impacts civilians’ state-building preferences with two rounds of original survey experiments fielded in Liberia. We find that Liberians largely prefer state-building processes overseen by a subset of international actors; that they prefer state building focused on security-oriented institutions over non-security-oriented institutions; and that different forms of involvement in the process meaningfully influence their preferences. We also find that these preferences depend on civilians’ characteristics. Ultimately, we provide an initial, conceptual mapping of the diversified landscape of international state building, as well as an empirical “unpacking” of the conditions that may shape civilians’ preferences toward the process.
This article maps out the challenges of public global health communication in the context of the COVID-19 pandemic by providing an overview of the shifting media of health communication from the post-Second World War era to the present. The article explores the communication of science in real-time or live media of film, television, video and digital social media during three emerging infectious-disease (EID) outbreaks to place COVID-19 health communication in historical perspective. Examination of the transition from centralized, top-down communications to distributed, many-to-many, mobile communication illuminates challenges to expertise, authority and control of health narratives and imagery. Through theories of intermediality, the article explores the central function of gaps in communication networks. The article considers three cases of crisis communications amid EIDs: the influenza outbreak of 1957, HIV/AIDS around 1990 and COVID-19 in the early 2020s, and the challenges posed by scientific uncertainty under these circumstances of live, intermedial health communication. The article concludes that ‘liveness’ in intermedial health communications may have an inherently destabilizing effect on scientific authority.