Risk factors associated with recurrent child maltreatment

The purpose of this study was to identify factors that contribute to the recurrence of child maltreatment within a variety of families. The following discussion addresses the safety and security of children, child protective services, cultural sensitivity, and perception of poverty

Institutional Rules and Mechanisms for Western Hemisphere Trade

In the third of three related papers, the authors discuss rules and mechanisms that could facilitate the expansion of the North American Free Trade Agreement (NAFTA) and promote freer trade and investment in the Americas. These mechanisms include macroeconomic policies that open trade and capital flows, and institutional policies that specify standards and requirements to protect investments and lower risks

Dipolar interactions and anisotropic magnetoresistance in metallic granular systems

We revisit the theory of magnetoresistance for a system of nanoscopic magnetic granules in metallic matrix. Using a simple model for the spin dependent perturbation potential of the granules, we solve Boltzmann equation for the spin dependent components of the non equilibrium electronic distribution function. For typical values of the geometric parameters in granular systems, we find a peculiar structure of the distribution function of conduction electrons, which is at variance with the two-current model of conduction in inhomogeneous systems. Our treatment explicitly includes the effects of dipolar correlations yielding a magnetoresistance ratio which contains, in addition to the term proportional to the square of uniform magnetization (), a weak anisotropic contribution depending on the angle between electric and magnetic fields, and arising from the anisotropic character of dipolar interactions.Comment: 9 pages, 2 figures, accepted in PR

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Institutional Rules and Mechanisms for Western Hemisphere Trade

In the third of three related papers, the authors discuss rules and mechanisms that could facilitate the expansion of the North American Free Trade Agreement (NAFTA) and promote freer trade and investment in the Americas. These mechanisms include macroeconomic policies that open trade and capital flows, and institutional policies that specify standards and requirements to protect investments and lower risks.