Preschoolers, Parents, and Teachers (PPT): A Preventive Intervention with an At-Risk Population

The importance of early intervention with children who are at risk for mental health problems is widely recognized. Relationships with significant adults (parents, other caregivers, and teachers) are critically important in young children\u27s lives and can make a tremendous difference in the trajectory of a child\u27s future. This study utilized a waiting-control group design to examine the effects on student behavior and parent stress of play-based interventions designed to improve the relationships between parents and their children (i.e., Filial Therapy), and teachers and their students (i.e., Kinder Training). To incorporate the benefits of group work, the eight-week intervention was delivered to parents in a small-group format. Teachers participated in a one-day group training with weekly coaching and dyadic consultation for on-going support. Results at post-intervention indicated that teachers perceived children in the intervention group to exhibit significantly less problem behavior than students in the waiting-control group. Although results suggest that the intervention had no demonstrable effect on parent stress, qualitative results indicate otherwise. Implications for practice and research are discussed

Black, Brown, and Powerful: Freedom Dreams in Unequal Cities

In April 2018, the Institute on Inequality and Democracy convened scholars, activists, policy advocates, community residents, and nonprofit workers to share and discuss research and action pertaining to processes of inequality in Los Angeles. We sought to shed light on the entangled structures of oppression, including urban displacement, housing precarity, racialized policing, criminal justice debt, forced labor, and the mass supervision and control of youth. Through keynote talks, group dialogue, and workshops, we analyzed how in Los Angeles, and elsewhere, black and brown communities face multiple forms of banishment and exploitation ranging from the criminalization of poverty to institutionalized theft.The question of racial banishment has been an important one for the Institute since its inauguration two years ago. This year though, amidst the troubled times of Trumpism, we wanted to shift our focus from banishment to freedom. In the reports that follow, you will find many examples of what Robin D.G. Kelley, a key presence at the Institute, has famously called “freedom dreams.” Located in, and thinking from South Central Los Angeles, the event’s participants provide insight into organizing frameworks and resistance strategies that challenge exclusion and refuse subordination. From tenant organizing to debtors’ unions, from underground scholars to educational reparations, visions of freedom abound. The Institute on Inequality and Democracy is convinced that university-based research can, and must, support such freedom dreams. Such partnership – between the public university and social justice movements – requires careful attention to the difficult task of decolonizing the university. This mandate is evident throughout this collection of reports. There is no easy alliance between academic power and banished communities; there is no obvious solidarity between urban plans and freedom dreams. This event was intended to be a step towards building such alliances, especially by reconstructing the curriculum and canon of knowledge

Imagen urbana y contaminación visual en los parques del sector Tahuantinsuyo del distrito de Independencia, 2019. Caso de estudio: Parque frente a la estación Naranjal del Metropolitano en la Av. Túpac Amaru

La presente investigación hace referencia a la imagen urbana que se presenta en la actualidad en los parques del sector de Tahuantinsuyo afectada por la contaminación visual, ante este problema se tuvo como objetivo determinar la relación entre la imagen urbana y la contaminación visual en los parques del sector Tahuantinsuyo del distrito de Independencia. La metodología fue de diseño no experimental, correlacional, con enfoque cuantitativo de corte transversal. La población fue de 19 587 personas y se aplicó encuestas a 377 personas lo cual fue la muestra, usando la escala de Likert. Para la confiabilidad del instrumento se recurrió al Alpha de Cronbach, logrando un resultado de 0.827 respectivamente. Se determinó el grado de correlación entre ambas variables mediante Rho de Spearman obteniendo 0.512, este resultado afirmó que existe correlación positiva considerable; quiere decir que se demostró que la imagen urbana se relaciona con la contaminación visual en los parques del sector Tahuantinsuyo del distrito de Independencia, afectando la estética y la calidad visual del contexto provocado por la congestión, así como la publicidad exterior y las fachadas que afectan la calidad paisajística y el entorno de los parques. Sin embrago la contaminación visual tiene relación con la imagen urbana pero no es muy significativa, por ello, no es el único factor determinante del deterioro de la imagen urbana, así mismo esta investigación aportó a este problema con el desarrollo de acciones por parte de la ciudadanía y el municipio

Diversification in the South American Pampas: the genetic and morphological variation of the widespread Petunia axillaris complex (Solanaceae)

Understanding the spatiotemporal distribution of genetic variation and the ways in which this distribution is connected to the ecological context of natural populations is fundamental for understanding the nature and mode of intraspecific and, ultimately,interspecific differentiation. The Petunia axillaris complex is endemic to the grasslands of southern South America and includes three subspecies: P. a. axillaris, P. a. parodii and P. a. subandina. These subspecies are traditionally delimited based on both geography and floral morphology, although the latter is highly variable. Here, we determined the patterns of genetic (nuclear and cpDNA), morphological and ecological (bioclimatic) variation of a large number of P. axillaris populations and found that they are mostly coincident with subspecies delimitation. The nuclear data suggest that the subspecies are likely independent evolutionary units, and their morphological differences may be associated with local adaptations to diverse climatic and/or edaphic conditions and population isolation. The demographic dynamics over time estimated by skyline plot analyses showed different patterns for each subspecies in the last 100 000 years, which is compatible with a divergence time between 35 000 and 107 000 years ago between P. a. axillaris and P. a. parodii, as estimated with the IMa program. Coalescent simulation tests using Approximate Bayesian Computation do not support previous suggestions of extensive gene flow between P. a. axillaris and P. a. parodii in their contact zone.Fil: Turchetto, Caroline. Universidade Federal Do Rio Grande Do Sul; Brasil;Fil: Fagundes, Nelson J. R.. Universidade Federal Do Rio Grande Do Sul; Brasil;Fil: Segatto, Ana L. A.. Universidade Federal Do Rio Grande Do Sul; Brasil;Fil: Kuhlemeier, Cris. Institute of Plant Science; Suiza;Fil: Solis Neffa, Viviana Griselda. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Nordeste. Instituto de Botánica del Nordeste (i); ArgentinaFil: Speranza, Pablo R. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Nordeste. Instituto de Botánica del Nordeste (i); ArgentinaFil: Bonatto, Sandro L.. Pontificia Universidade Catolica Do Rio Grande Do Sul; Brasil;Fil: Freitas, Loreta B.. Universidade Federal Do Rio Grande Do Sul; Brasil

Predicting atrial fibrillation recurrence by combining population data and virtual cohorts of patient-specific left atrial models

Background: Current ablation therapy for atrial fibrillation is suboptimal, and long-term response is challenging to predict. Clinical trials identify bedside properties that provide only modest prediction of long-term response in populations, while patient-specific models in small cohorts primarily explain acute response to ablation. We aimed to predict long-term atrial fibrillation recurrence after ablation in large cohorts, by using machine learning to complement biophysical simulations by encoding more interindividual variability. Methods: Patient-specific models were constructed for 100 atrial fibrillation patients (43 paroxysmal, 41 persistent, and 16 long-standing persistent), undergoing first ablation. Patients were followed for 1 year using ambulatory ECG monitoring. Each patient-specific biophysical model combined differing fibrosis patterns, fiber orientation maps, electrical properties, and ablation patterns to capture uncertainty in atrial properties and to test the ability of the tissue to sustain fibrillation. These simulation stress tests of different model variants were postprocessed to calculate atrial fibrillation simulation metrics. Machine learning classifiers were trained to predict atrial fibrillation recurrence using features from the patient history, imaging, and atrial fibrillation simulation metrics. Results: We performed 1100 atrial fibrillation ablation simulations across 100 patient-specific models. Models based on simulation stress tests alone showed a maximum accuracy of 0.63 for predicting long-term fibrillation recurrence. Classifiers trained to history, imaging, and simulation stress tests (average 10-fold cross-validation area under the curve, 0.85±0.09; recall, 0.80±0.13; precision, 0.74±0.13) outperformed those trained to history and imaging (area under the curve, 0.66±0.17) or history alone (area under the curve, 0.61±0.14). Conclusion: A novel computational pipeline accurately predicted long-term atrial fibrillation recurrence in individual patients by combining outcome data with patient-specific acute simulation response. This technique could help to personalize selection for atrial fibrillation ablation

Atrial Fibrillation and In-Hospital Mortality in Covid-19 patients

BACKGROUND: There are conflicting data on whether new-onset atrial fibrillation (AF) is independently associated with poor outcomes in COVID-19 patients. This study represents the largest dataset curated by manual chart review comparing clinical outcomes between patients with sinus rhythm, pre-existing AF, and new-onset AF. OBJECTIVE: The primary aim of this study was to assess patient outcomes in COVID-19 patients with sinus rhythm, pre-existing AF, and new-onset AF. The secondary aim was to evaluate predictors of new-onset AF in patients with COVID-19 infection. METHODS: This was a single-center retrospective study of patients with a confirmed diagnosis of COVID-19 admitted between March and September 2020. Patient demographic data, medical history, and clinical outcome data were manually collected. Adjusted comparisons were performed following propensity score matching between those with pre-existing or new-onset AF and those without AF. RESULTS: The study population comprised of 1241 patients. A total of 94 (7.6%) patients had pre-existing AF and 42 (3.4%) patients developed new-onset AF. New-onset AF was associated with increased in-hospital mortality before (odds ratio [OR] 3.58, 95% confidence interval [CI] 1.78-7.06, P < .005) and after (OR 2.80, 95% CI 1.01-7.77, P < .005) propensity score matching compared with the no-AF group. However, pre-existing AF was not independently associated with in-hospital mortality compared with patients with no AF (postmatching OR: 1.13, 95% CI 0.57-2.21, P = .732). CONCLUSION: New-onset AF, but not pre-existing AF, was independently associated with elevated mortality in patients hospitalised with COVID-19. This observation highlights the need for careful monitoring of COVID-19 patients with new-onset AF. Further research is needed to explain the mechanistic relationship between new-onset AF and clinical outcomes in COVID-19 patients

Atrial CARdiac Magnetic resonance imaging in patients with embolic stroke of unknown source without documented Atrial Fibrillation (CARM-AF): Study design and clinical protocol

Background: Initiation of anticoagulation therapy in ischemic stroke patients is contingent on a clinical diagnosis of atrial fibrillation (AF). Results from previous studies suggest thromboembolic risk may predate clinical manifestations of AF. Early identification of this cohort of patients may allow early initiation of anticoagulation and reduce the risk of secondary stroke. Objective: This study aims to produce a substrate-based predictive model using cardiac magnetic resonance imaging (CMR) and baseline noninvasive electrocardiographic investigations to improve the identification of patients at risk of future thromboembolism. Methods: CARM-AF is a prospective, multicenter, observational cohort study. Ninety-two patients will be recruited following an embolic stroke of unknown source (ESUS) and undergo atrial CMR followed by insertion of an implantable loop recorder (ILR) as per routine clinical care within 3 months of index stroke. Remote ILR follow-up will be used to allocate patients to a study or control group determined by the presence or absence of AF as defined by ILR monitoring. Results: Baseline data collection, noninvasive electrocardiographic data analysis, and imaging postprocessing will be performed at the time of enrollment. Primary analysis will be performed following 12 months of continuous ILR monitoring, with interim and delayed analyses performed at 6 months and 2 and 3 years, respectively. Conclusion: The CARM-AF Study will use atrial structural and electrocardiographic metrics to identify patients with AF, or at high risk of developing AF, who may benefit from early initiation of anticoagulation

High prevalence of new clinically significant findings in patients with embolic stroke of unknown source evaluated by cardiac magnetic resonance imaging

Background: Embolic stroke of unknown source (ESUS) accounts for one in six ischaemic strokes. Current guidelines do not recommend routine cardiac magnetic resonance (CMR) imaging in ESUS and, beyond the identification of cardio-embolic sources, there are no data assessing new clinical findings from CMR in ESUS. This study aimed to assess the prevalence of new cardiac and non-cardiac findings and to determine their impact on clinical care in patients with ESUS.Methods and Results: In this prospective, multicentre, observational study, CMR was performed within 3-months of ESUS. All scans were reported according to standard clinical practice. A new clinical finding was defined as one not previously identified through prior clinical evaluation. A clinically significant finding was defined as one resulting in further investigation, follow-up or treatment. A change in patient care was defined as initiation of medical, interventional, surgical or palliative care. From 102 patients recruited, 96 underwent CMR. One or more new clinical findings were observed in 59 patients (61%). New findings were clinically significant in 48 (81%) of these patients. Of 40 patients with a new clinically significant cardiac finding, 21 (53%) experienced a change in care (medical therapy, n=15; interventional/surgical procedure, n=6). In 12 patients with a new clinically significant extra-cardiac finding, 6 (50%) experienced a change in care (medical therapy, n=4; palliative care, n=2). Conclusions: CMR imaging identifies new clinically significant cardiac and non-cardiac findings in half of patients with recent ESUS. Advanced cardiovascular screening should be considered in patients with ESUS.<br/

Transethnic meta-analysis of rare coding variants in PLCG2, ABI3, and TREM2 supports their general contribution to Alzheimer’s disease

Rare coding variants in TREM2, PLCG2, and ABI3 were recently associated with the susceptibility to Alzheimer’s disease (AD) in Caucasians. Frequencies and AD-associated effects of variants differ across ethnicities. To start filling the gap on AD genetics in South America and assess the impact of these variants across ethnicity, we studied these variants in Argentinian population in association with ancestry. TREM2 (rs143332484 and rs75932628), PLCG2 (rs72824905), and ABI3 (rs616338) were genotyped in 419 AD cases and 486 controls. Meta-analysis with European population was performed. Ancestry was estimated from genome-wide genotyping results. All variants show similar frequencies and odds ratios to those previously reported. Their association with AD reach statistical significance by meta-analysis. Although the Argentinian population is an admixture, variant carriers presented mainly Caucasian ancestry. Rare coding variants in TREM2, PLCG2, and ABI3 also modulate susceptibility to AD in populations from Argentina, and they may have a European heritage.International Society for Neurochemistry (ISN) and Alexander von Humboldt Foundation (to M.C.D.); Agencia Nacional de Promoción Científica y Tecnológica (PBIT/09 2013, PICT2015-0285 and PICT-2016-4647 to L.M.; PICT-2014-1537 to M.C.D.