Prognostic value of echocardiographic parameters in congenital diaphragmatic hernia: a systematic review and meta-analysis.

BACKGROUND: Prognostication of mortality and decision to offer extracorporeal membrane oxygenation (ECMO) treatment in infants with congenital diaphragmatic hernia (CDH) can inform clinical management. OBJECTIVE: To summarise the prognostic value of echocardiography in infants with CDH. METHODS: Electronic databases Ovid MEDLINE, Embase, Scopus, CINAHL, the Cochrane Library and conference proceedings up to July 2022 were searched. Studies evaluating the prognostic performance of echocardiographic parameters in newborn infants were included. Risk of bias and applicability were assessed using the Quality Assessment of Prognostic Studies tool. We used a random-effect model for meta-analysis to compute mean differences (MDs) for continuous outcomes and relative risk (RR) for binary outcomes with 95% CIs. Our primary outcome was mortality; secondary outcomes were need for ECMO, duration of ventilation, length of stay, and need for oxygen and/or inhaled nitric oxide. RESULTS: Twenty-six studies were included that were of acceptable methodological quality. Increased diameters of the right and left pulmonary arteries at birth (mm), MD 0.95 (95% CI 0.45 and 1.46) and MD 0.79 (95% CI 0.58 to 0.99), respectively) were associated with survival. Left ventricular (LV) dysfunction, RR 2.40, (95% CI 1.98 to 2.91), right ventricular (RV) dysfunction, RR 1.83 (95% CI 1.29 to 2.60) and severe pulmonary hypertension (PH), RR 1.69, (95% CI 1.53 to 1.86) were associated with mortality. Left and RV dysfunctions, RR 3.30 (95% CI 2.19 to 4.98) and RR 2.16 (95% CI 1.85 to 2.52), respectively, significantly predicted decision to offer ECMO treatment. Limitations are lack of consensus on what parameter is optimal and standardisation of echo assessments. CONCLUSIONS: LV and RV dysfunctions, PH and pulmonary artery diameter are useful prognostic factors among patients with CDH

Do marine planktonic ciliates follow Bergmann's rule?

Body size is a fundamental trait determining individual fitness and ecological processes. Reduction in body size with increasing temperature has been widely observed in most ectotherms and endotherms, known as Bergmann's rule. However, we lack data to assess if ciliates, the major consumers of marine primary production, follow Bergmann's rule and what drives the distributions of their cell size. Here, we examined a data set (287 samples) collected across the global oceans to investigate biogeographic patterns in the mean cell-size of ciliate communities. By measuring the sizes of every ciliate cell ( 300 per sample), we found that community cell-size increased with increasing latitude, conforming to Bergmann's rule. We then addressed the cause. Temperature was a main driver of the trend. Ciliate community mean cell-size decreased 34% when temperature increased from 3.5 to 31°C, implying that temperature may be a direct physiological driver. In addition, prey (phytoplankton) size also influenced the trend, with ciliate size increasing by 35% across the gradient of phytoplankton size (0.6–15.5 μm). Generally, these findings emphasized the importance of how both biotic and abiotic factors affect size distribution of marine ciliates, a key component of pelagic ecosystems. Our novel, extensive dataset and the predictive trends arising from them contribute to understanding how climate change will influence pelagic ecosystem functions

How does reputation win trust? A customer-based mediation analysis

This study investigates the relationship between customer-based corporate reputation (CBR) and customer trust, in particular, the mediating role of customer perceived risk in this relationship. We propose and test a model comprising of four components: cognitive CBR, affective CBR, customer perceived risk, and customer trust using a sample of 156 customers from the fast-food services industry in Pakistan. The results suggest that the cognitive and affective dimensions of CBR behave differently in developing customer trust. Affective CBR has a direct positive relationship with customer trust; whereas, customer perceived risk and affective CBR mediate the relationship between cognitive CBR and customer trust. Implications for future researchers and practicetioners are proposed based on the study results

Purine synthesis promotes maintenance of brain tumor initiating cells in glioma

Brain tumor initiating cells (BTICs), also known as cancer stem cells, hijack high-affinity glucose uptake active normally in neurons to maintain energy demands. Here we link metabolic dysregulation in human BTICs to a nexus between MYC and de novo purine synthesis, mediating glucose-sustained anabolic metabolism. Inhibiting purine synthesis abrogated BTIC growth, self-renewal and in vivo tumor formation by depleting intracellular pools of purine nucleotides, supporting purine synthesis as a potential therapeutic point of fragility. In contrast, differentiated glioma cells were unaffected by the targeting of purine biosynthetic enzymes, suggesting selective dependence of BTICs. MYC coordinated the control of purine synthetic enzymes, supporting its role in metabolic reprogramming. Elevated expression of purine synthetic enzymes correlated with poor prognosis in glioblastoma patients. Collectively, our results suggest that stem-like glioma cells reprogram their metabolism to self-renew and fuel the tumor hierarchy, revealing potential BTIC cancer dependencies amenable to targeted therapy

Development of inclusive education in England: Impact on children with special educational needs and disabilities

This is an accepted manuscript of a book chapter published by Springer Routledge in the Handbook on Promoting Social Justice in Education, available online: https://doi.org/10.1007/978-3-319-74078-2_151-1 The accepted version of the publication may differ from the final published version. Please refer to the publisher's terms and conditions for re-use.This chapter considers a historical account of the development of inclusion in England and the changes made to the education of children with SEND since the 1940s. The chapter details the development of inclusive education, the complexity of defining inclusion, and what inclusion has come to mean in current practice. This historical account is considered alongside the development and dominance of the standards agenda. In considering inclusion in this manner, the original intentions of its agenda are questioned against the practical implementation of inclusive education in current practice. The chapter concludes by proposing that significant progress has not been made with inclusion because it has not been possible to accommodate it within the competing political agendas replete in England’s education system

Authorship, automation, authenticity

Thesis: M. Arch., Massachusetts Institute of Technology, Department of Architecture, February, 2021Cataloged from the official pdf of thesis. Page 124 blankIncludes bibliographical references (page 123).Walter Benjamin wrote in his seminal 1935 essay, "that which withers in the age of mechanical reproduction is the aura of the work of art"--an essay that narrowly defines art and the craft of art up until that moment as something that is rooted in site specificity, ritual, uniqueness and non-reproducibility. This conception of art and artistic production fails to acknowledge the networks of transmission, transfer, and transformation that have always existed in parallel with the migration of objects, people and tools circulating the world throughout history. Almost a century after Benjamin's essay on mechanical reproduction, we have entered the digital, the post-digital, the automated, while at times have been nostalgic for the mechanical and the hand-made. That being said, the anxiety surrounding the Aura has in many ways not faded. We still bid wildly at auctions, flock into galleries in pursuit of the new or go on pilgrimages to architectural sites and museums to see and experience the original "in person." We also employ armies of scholars or dealers to find or authenticate the "original". In After Art, David Joselit asks for an expansion of the definition of art to "embrace heterogeneous configurations of relationships or links," freeing art from belonging to any particular time, space or medium, but rather as Pierre Huyghe says, "a dynamic chain that passes through different formats." This thesis attempts to document and utilize these dynamic chains through acts of copying using contemporary tools and conditions such as outsourcing and open sourcing. In experiments in outsourcing, I decided to digitally reproduce ornate, luxurious, objects valued for their rarity in order to make them more easily reproducible. In experiments in tools for copying, I designed a machine by utilizing an open source, anonymous, catalog of parts to imitate expired mechanical copying devices.by Kailin J. Jones.M. Arch.M.Arch. Massachusetts Institute of Technology, Department of Architectur