Impact of social complexity on outcomes in cystic fibrosis after transfer to adult care

Objective This study evaluates the roles of medical and social complexity in health care use outcomes in cystic fibrosis (CF) after transfer from pediatric to adult care. Methods Retrospective cohort design included patients with CF who were transitioned into adult care at Indiana University from 2005 to 2015. Predictor variables included demographic and comorbidity data, age at transition, treatment complexity score (TCS), and an objective scoring measure of their social complexity (Bob's Level of Social Support, BLSS). Outcome variables included outpatient visit rates and hospitalization rates. Pearson's correlations and linear regression were used to analyze the data. Results The median age of the patients (N = 133) at the time of transition was 20 (IQR 19‐23) years. The mean FEV1 % predicted at transition was 69 ± 24%. TCS correlated with outpatient visit rates (r = 0.3, P = 0.003), as well as hospitalization rates (r = 0.4, P < 0.001); while the BLSS only correlated with hospitalization rates (r = 0.7, P < 0.001). After adjusting for covariates, the strongest predictors of post‐transfer hospitalizations are BLSS (P < 0.0001) and pre‐transfer hospitalization rate (P < 0.0001). Conclusion Greater treatment complexity is associated with greater healthcare utilization overall, while greater social complexity is associated with increased hospitalizations (but not outpatient visits). Screening young adults for social complexity may identify high‐risk subpopulations and allow for patient centered interventions to support them and prevent avoidable health care use

Little cost of injury to growth and development of damselflies

*_Background:_*&#xd;&#xa;Damaged or missing appendages are a common problem in numerous vertebrate and invertebrate taxa and can negatively affect many aspects of life: mobility, foraging, predator avoidance, growth, and development have all been shown to suffer. Many animals use autotomy to survive a predation attempt but suffer diminished performance until the missing appendage heals or regenerates. Animals that regenerate face an extra problem, as they must re-allocate resources away from growth and development in order to regrow their missing parts. We examined the effect of appendage loss on the growth and development of the damselfly Ischnura posita. Damselfly larvae have three caudal lamellae, external gills that can be autotomized and eventually regenerated and that are frequently missing from animals in natural populations (30-40% missing at least one in our collections). We collected animals from the field and raised them individually in the lab, removing lamellae at different times through ontogeny and predicting that growth rate and development rate would be most affected by earlier injuries. As larvae neared emergence to adulthood, we expected them to devote less resources to regeneration and therefore experience less of a decline in growth and development.&#xd;&#xa;&#xd;&#xa;*_Results &#x26; Conclusions:_*&#xd;&#xa;We found that injuries did not strongly affect larval growth rates or sizes, regardless of timing. Developmental rates, measured as time per instar, were not strongly affected by injury. Most larvae attempted to emerge, and injured individuals were non-significantly more likely to emerge successfully. In sum, injured damselflies fared as well or better than their uninjured counterparts in terms of growth and development. We hypothesize that the relative unimportance of injury in this species may be due to their &#x201c;slow&#x201d; life history, behavioral or physiological compensation, or lack of stressors in this experiment

Nonet for Percussion and Tape

Nonet for Percussion and Tape is a twenty-two minute through-composed work for eight percussionists and tape. The instrumentation includes: marimba, xylophone, glass wind chimes, slit drum, woodblock, vibraphone, crotales, metal wind chimes, snare drum, bass drum, tom-toms, temple blocks, bass marimba, log drum, cowbells, medium suspended cymbal, gongs, timbales, bongos, tambourine, roto-toms, timpani, and pre-recorded computer-generated/computer-sampled sound

Feigned Histories: Philip Sidney and the Poetics of Spanish Chivalric Romance

This study re-evaluates Sidney's method and purpose for inventing Arcadia, through analyzing his fiction in tandem with the Spanish genre of chivalric "feigned history." It introduces the new perspective that Arcadia exploits structural and thematic focus on clandestine marriage in Feliciano de Silva's feigned Chronicle of Florisel de Niquea, Part Three (1535), as rendered in translation by Jacques Gohory as "Book" Eleven in the French Amadis cycle (1554). Old Arcadia follows that chivalric paradigm in Books One through Three; then it employs motifs from ancient prose fiction by Apuleius and Heliodorus in Books Four and Five to amplify plot conflict tied to the protagonist lovers' secret marriages. Imitation of Spanish pastoral romances by Montemayor and Gil Polo in Old Arcadia's Eclogues supplements the work's primary narrative plane and also facilitates Protestant aesthetic impressions of marriage and affective individual piety. Shifts in literary source material occur as means to extend and enrich thematic focus and narrative poetics of those first three Books. Sidney's narrative establishes admiratio for its protagonist lovers and reader complicity with them, while imposing comic and tragic distance from other main characters. These observations revise dominant critical assumptions about Old Arcadia. Building upon its chivalric source material, Sidney's fiction increases verisimilitude and invents its own rhetorical focus on dynastic union through clandestine marriage. This study observes for the first time that political tension and legal debate in Old Arcadia's conclusion revolve around that issue. Sidney's fiction figures forth a succession crisis contingent upon legal complications with the issue of clandestine marriage in Arcadia, in a manner congruous with Genevan, French, and Tridentine legal reform on that matter, as well as with England's unique legal situation regarding secret marriage. The story's intellectual focus on justice and equity complements its author's concern with the case of his uncle Robert Dudley, Earl of Leicester. While Sidney composed Arcadia, his own political and economic prospects remained largely contingent upon Leicester's secret marriage. This study opens new avenues for research on continuity in Sidney's oeuvre and on New Arcadia's influence in English prose fiction and drama of the 1590s and the seventeenth century

Auge y declive de los gobiernos de guerrilla en América Latina

[ES] El artículo trata de explicar los procesos a través de los cuales un gobierno llega a suceder a otro en situaciones revolucionarias, haciendo especial hincapié en los movimientos guerrilleros en América Latina desde la Revolución cubana hasta finales de la década del sesenta, y que están experimentando un resurgimiento en la actualidad. El autor sugiere cinco proposiciones que vinculan a gobernantes y gobernados en un contrato social, ya sea implícito o explícito, que elabora basándose en estudios de este período más temprano y que es posible encontrar también en los movimientos revolucionarios/gobiernos guerrilleros de los años setenta y ochenta.[EN] The article tries to explain the processes of how one government comes to succeed another in revolutionaly situations, emphasizing the guerrilla movements in Latin America from the Cuban revolution until the late 1960's and which are currently experiencing a revival. The author suggests five propositions linking governors and governed in a social contract, implicit or explicit, which he ellaborates based upon studies of the earlier period and that is also possible to find them in the revolutionary movements/guerrilla governments in the 1970's and 1980's

Concurrent Primary Cardiac Tumors in a High-Risk Patient Presenting With Tamponade.

Primary cardiac tumors are rare, particularly in the elderly population. The patient described in this report presented with symptoms of dyspnea on exertion, leg swelling, and weight gain and was found to have two histologically distinct cardiac masses: atrial myxoma with concurrent aortic fibroelastoma. Given her history of cirrhosis and end-stage renal disease, the patient was a poor surgical candidate but opted for excision of both masses. The patient eventually succumbed to her cirrhosis six weeks after presentation. In this report, we advocate for further research into medical management for the unique presentation of concurrent primary cardiac tumors in high-operative-risk patients, particularly those whose symptoms are mostly due to tamponade

Gene-edited meat: Disentangling consumers’ attitudes and potential purchase behaviour

Novel gene-editing (GE) technologies provide promising opportunities to increase livestock productivity and to tackle several global livestock production sustainability and food security challenges. However, these technologies, as with previous genetic modification technologies in food production, are very likely to generate social controversy and opposition toward their use in the meat industry. Here, we explored public attitudes and consumption predisposition toward gene-edited meat products and their potential added benefits to livestock farming. Our results show that societal perception currently comes as a package, where the use of gene-editing technology acts as an extrinsic cue of meat products quality, and is used to make a range of inferences about all quality facets at once. Although consumers with anti-GE attitudinal positions generally were not sensitive to price discounts or added benefits, added benefits increased the consumption predisposition of most moderate and pro-GE consumers, where benefits related to animal welfare had larger effects than those relating to the environment or human health issues.Publishe

Lipid Exchange between Borrelia burgdorferi and Host Cells

Borrelia burgdorferi, the agent of Lyme disease, has cholesterol and cholesterol-glycolipids that are essential for bacterial fitness, are antigenic, and could be important in mediating interactions with cells of the eukaryotic host. We show that the spirochetes can acquire cholesterol from plasma membranes of epithelial cells. In addition, through fluorescent and confocal microscopy combined with biochemical approaches, we demonstrated that B. burgdorferi labeled with the fluorescent cholesterol analog BODIPY-cholesterol or 3H-labeled cholesterol transfer both cholesterol and cholesterol-glycolipids to HeLa cells. The transfer occurs through two different mechanisms, by direct contact between the bacteria and eukaryotic cell and/or through release of outer membrane vesicles. Thus, two-way lipid exchange between spirochetes and host cells can occur. This lipid exchange could be an important process that contributes to the pathogenesis of Lyme disease

Evaluated kinetic and photochemical data for atmospheric chemistry: Volume VII-Criegee intermediates

This article, the seventh in the series, presents kinetic and photochemical data sheets evaluated by the IUPAC Task Group on Atmospheric Chemical Kinetic Data Evaluation. It covers an extension of the gas-phase and photochemical reactions related to Criegee intermediates previously published in Atmospheric Chemistry and Physics (ACP) in 2006 and implemented on the IUPAC website up to 2020. The article consists of an introduction, description of laboratory measurements, a discussion of rate coefficients for reactions of O3 with alkenes producing Criegee intermediates, rate coefficients of unimolecular and bimolecular reactions and photochemical data for reactions of Criegee intermediates, and an overview of the atmospheric chemistry of Criegee intermediates. Summary tables of the recommended kinetic and mechanistic parameters for the evaluated reactions are provided. Data sheets summarizing information upon which the recommendations are based are given in two files, provided as a Supplement to this article. © Author(s) 2020