Background The “Primary Immunodeficiencies (PIDs) principles of care” were published in 2014 as the gold standard for care of patients with PIDs, setting a common goal for stakeholders to ensure that patients with PID have access to appropriate care and good quality of life. Since then, IPOPI (the International Patient Organisation for Primary Immunodeficiencies), has been working with national PID patient organisations as well as collaborating with scientific and medical institutions and experts to bring these principles closer to the day-to-day life of individuals with PIDs. Method The six PID Principles of Care were revised to consider advances in the field, as well as political developments that had occurred after their initial publication in 2014. Based on this revision the list was updated, and a new principle was added. The six established principles were: diagnosis, treatment, universal health coverage, specialised centres, national patient organisations and registries. Each principle was structured and measured through a series of criteria, and was given the same weight, as they have been considered to all be equally important. Specific weights were attributed to the criteria depending on their relevance and importance to quantify the principle. The index was translated into a survey for data collection: initially involving data from selected countries for a pilot, followed by integration of data from IPOPI’s national member organisations and key countries. Results The PID Life Index was developed in 2020 to assess the status of the PID environment and the implementation of the 6 principles worldwide. The Index allows for benchmarking countries either according to a set of principles and criteria or based on the user’s preferences. This can be displayed in an interactive map or through a data visualisation system. Conclusion The PID Life Index has been developed successfully and has potential to become an important source of information for PID stakeholders, to increase awareness and information as well as support advocacy initiatives on PIDs nationally, regionally or globally.
Artificial islands near Dubai were constructed with geomaterials of significant gravel content from other areas of the United Arab Emirates (UAE). The fills were dynamically compacted and their present geotechnical properties are unknown. Large development projects are being proposed on the islands that will require extensive field testing to characterize the fills because existing correlations developed for nearby natural soils are not representative. The main focus of this study is to develop correlations between Standard Penetration Test (SPT), Cone Penetration Tests (CPT), and shear wave velocity (Vs) measurements applicable to the compacted fills with high gravel content. More than fifty (50) SPT and similar number of CPT tests are performed on a large area of the island. A number of Multi-Channel Analysis of Surface Waves (MASW) and Downhole Seismic (DHS) tests are conducted to measure the distribution of Vs with depth and imaging. The data is analyzed to develop correlations between SPT and CPT and between SPT and Vs. The proposed correlation between SPT and CPT generally does not agree with existing correlations for coarse grained soils. This study predicts larger values of tip resistance (qc) with N60 values. The predicted Vs values as function of N60; however, are comparable with some prediction equations in the literature. The Vs values from MASW and DHS for the fill are comparable on average; however, reliability of DHS increases with depth. The results from all tests reveal the inadequacy of earlier dynamic compaction in achieving consistent and uniform densification.
The band offsets for the β-(Al0.21Ga0.79)2O3/β-Ga2O3 (010) heterojunction have been experimentally measured by X-ray photoelectron spectroscopy. High-quality β-(Al0.21Ga0.79)2O3 films were grown by metal-organic chemical vapor deposition for characterization. The indirect band gap of β-(Al0.21Ga0.79)2O3 was determined by optical transmission to be 4.69 ± 0.03 eV with a direct transition of 5.37 ± 0.03 eV, while β-Ga2O3 was confirmed to have an indirect band gap of 4.52 ± 0.03 eV with a direct transition of 4.94 ± 0.03 eV. The resulting band alignment at the heterojunction was determined to be of type II with the valence and conduction band edges of β-(Al0.21Ga0.79)2O3 being -0.26 ± 0.08 and 0.43 ± 0.08 eV, respectively, above those of β-Ga2O3 (010). These values can now be used to help better design and predict the performance of β-(AlxGa1-x)2O3 heterojunction-based devices.
This study compares two linguistic landscapes and the concurrent language policies of two scenarios where minority languages coexist with Spanish. On one hand, in the Archipelago of San Andres, Colombia, Spanish is in contact with an English-based Creole (Raizal Creole). Similarly, Valencian (Spain) coexists with Spanish as a national language. This work examines over 1200 pictures of public signs to reveal the extent to which these regional languages are represented in the public sphere by their main social actors in comparable domains: touristic sites and urban centres. Results showed that Raizal Creole is associated with signs authored by the community, while Spanish is the language of choice of the government and private sector. In contrast, Valencian is maintained in written signs in both settings. Despite having analogous language laws, only Valencian enjoys substantial governmental recognition. This situation sheds light on the de facto language policies and language maintenance in multilingual settings where Spanish is the national language.
The unique relationship humans have with rabbits has been coined the “21st century rabbit paradox” because there are few social boundaries surrounding how rabbits are interacted with and used by humans. Though this paradoxical relationship with rabbits has been observed, there is no clear empirical picture of what it looks like. This online survey of 1,006 US adults is the first to measure the prevalence and nature of human interactions with and attitudes toward rabbits across multiple industries. This study finds that experiences with rabbits are quite often nonexistent, the types of experiences respondents have had with rabbits vary widely, and many respondents lacked opinions regarding how rabbits are used by humans. The findings provide a clear picture of just how paradoxical the human relationship with rabbits is in US society and suggests areas for future research.
Background/Goal Caloric restriction—the most prevalent obesity treatment—has a 97% failure rate when spread over 5–7 years. Sarcopenic obesity is thought to be the consequence of chronic dieting and the cause of weight management problems. This pilot study’s goal was to develop a screening questionnaire that detects sarcopenic obesity in young and middle-aged female adults. Subjects/Method A total of 23 women (ages 19–59) completed a sarcopenic obesity questionnaire and were assessed for total body weight (TBWt), percent fat mass, and percent fat-free mass (%FFM) using the Bod Pod (air plethsmography), and bioelectrical impedance analysis (BIA). Appendicular skeletal mass (ASM) was calculated using BIA. Resting energy expenditure was determined using indirect calorimetry, and the basal metabolic rate (BMR) was calculated using BIA. Results The screening questionnaire score was negatively correlated with BMR (r² = 0.885), %FFM (r² = 0.86), ASM (r² = 0.79) relative to TBWt and to ASM/BMI (r² = 0.58). The screening questionnaire had an acceptable sensitivity (83%) and specificity (87%) in detecting sarcopenia measured using ASM/BMI. Conclusion This pilot intimates that subjects who frequently dieted suffered from a disproportionally lower FFM and BMR relative to the TBWt. The questionnaire can help clinicians recognize the presence of sarcopenic obesity in patients.
According to a 2018 report by the United States Department of Health and Human Services, more than 400,000 students live in foster care. Among other obstacles to success, involvement in the child welfare system is associated with negative school outcomes, including school instability, disproportionate placement in restrictive special education settings, and risk of school disengagement. Educational professionals, such as teachers, administrators, school psychologists, counselors, social workers, and paraprofessionals, are positioned to help reduce risks of school failure and promote educational resilience for students in foster care by providing safe and supportive school services. When engaging in the provision of school-based services, there are several legal obligations which educators must follow in order to uphold the rights of students in foster care and promote student resilience. The purpose of this paper is to review the extant literature regarding educational professionals’ legal obligations when serving students in foster care. Actionable recommendations that increase the likelihood of student success are highlighted.
Playa lakes have been promoted as potential point sources of recharge to the High Plains Aquifer, but information about recharge rates is only available for the Southern High Plains, where soils and substrate differ significantly from the Central High Plains. The goal of this study is to determine the degree to which functioning playas contribute to recharge of the aquifer in the Central High Plains. This is accomplished through a multifaceted study across a single 34-43 day-long playa hydroperiod, combining physical and geochemical evidence to measure fluid flux through the playa and geochemical evidence of fluid flux through the nearby interplaya. The hydroperiod resulted in increased matric potential and decreases in chloride and other anion concentrations in the vadose zone beneath the playa, and increases in groundwater levels downgradient, likely indicating recharge to the aquifer over the course of the short event. Anion concentrations are significantly higher in the interplaya compared with the playa, while fluid flux estimates are significantly higher beneath the playa. The fluid fluxes determined in this study are consistent with estimates from elsewhere in the High Plains region. The combination of physical and geochemical data decreased the uncertainty and improved the overall conclusion that recharge rates are higher beneath the playa than the interplaya, providing evidence that playas in the Central High Plains function similarly to those in the Southern High Plains.
We examine whether the protection of trade secrets by restricting the mobility of knowledgeable employees through the adoption of the legal Inevitable Disclosure Doctrine (IDD), an exogenous event, increases the marginal value of corporate cash holdings by reducing the uncertainty of future cash flows, and how that value differs across firms in IDD recognizing and non- recognizing states. We find that the marginal value of cash holdings increases (decreases) significantly in states in which the IDD has (not) been recognized through increases (decreases) in firm value and performance. A battery of robustness tests reveals that the effect of the IDD is more pronounced in firms with high R&D activities. Overall, the evidence shows that the IDD acts as a mechanism that inhibits the mobility of key employees and, thus, reduces the probability of the misappropriation of knowledge-based human capital assets. That is, the IDD creates an opportunity for firms to efficiently use cash to increase firm value - rather than using cash to protect trade secrets from rivals.
Background: Family engagement positively impacts patient and family members' experiences of care and health outcomes. While partnering with families denotes best practice in intensive care units (ICUs), its full adoption requires improvement. A better understanding of the factors that influence the implementation of family engagement practices is necessary. Aim: To investigate the factors that enable or hinder adult ICU nurse-family engagement and to explore potential international variations. Study design: Descriptive, cross-sectional survey. Nurses from 10 countries completed the 'Questionnaire on Factors that Influence Family Engagement' (QFIFE), including five open-ended questions. We performed descriptive statistics on quantitative data and content analysis for open-ended questions, and then integrated the findings according to influencing factors and geographical patterns. This was part of a larger qualitative study where 65 nurses participated from adult intensive care units. Results: Sixty-one nurses completed the questionnaire, making a response rate of 94%. Overall, patient acuity (Md = 5.0) and nurses' attitudes (Md = 4.6) seemed to be the most influential facilitator, followed by nurse workflow (Md = 4.0) and ICU environment (Md = 3.1) (score 1-6 most influential). The open-ended question data showed a more nuanced picture of the complexity of family engagement in care around these four determinants. Adding a fifth determinant, namely Families are complex structures that respond uniquely to the ICU and patient, revealed that difficult family dynamics, miscommunication and family having difficulty in understanding the situation or health literacy, hindered family engagement. Exploring geographical variations, Africa/Middle East consistently differed from others on three of the four QFIFE subscales, showing lower median levels. Conclusions: Some determinants are perceived to be more influential than others, becoming barriers or enablers to nurse-family engagement in adult ICU. Research that investigates contextual determinants and which compares implementation and improvement initiatives tailored to address family engagement practices barriers and enablers are needed. Relevance to clinical practice: Knowledge of this international study expands our understanding of enablers and barriers in family engagement that may inform family engagement practice improvement efforts around the world.
Affect regulation is associated with compulsive sexual behavior (CSB) despite ongoing debate about its inclusion in diagnostic criteria. Previous studies on two specific affect regulation constructs - boredom proneness and attachment styles - suggest that affect regulation is associated with CSB. We tested a moderation model of the effects of attachment anxiety and attachment avoidance on the relationship between boredom proneness and CSB. Results indicate that the relationship between boredom proneness and CSB is stronger at higher levels of attachment anxiety, with no interaction between boredom proneness and attachment avoidance. Overall findings support the importance of affect regulation in conceptualizing and treating CSB.
Sand stringers are subtle, aeolian landforms that reach 100’s to 1000’s of meters in length and lack a slipface. While 100’s of sand stringers exist beyond the last glacial maximum margin in the upper Midwest, USA, little is known about the timing and nature of their formation. This research characterizes the morphology and stratigraphy and provides geochronological data from two sand stringers in the upper Mississippi River basin in Minnesota and Wisconsin. The sand stringers investigated have similar west‐northwest to east‐southeast orientations and are located ~100 km from each other on uplands west and east of the Mississippi River valley. The sand stringer in Goodhue County, Minnesota (GC site), is ~870 m long and 50‐80 m wide. To the east, the sand stringer in Eau Claire County, Wisconsin (ECC site), is ~925 m long and 30‐50 m wide. The main body of GC sand stringer is characterized by a ~80‐270‐cm‐thick silt‐rich surface unit overlying a sandy unit that is underlain by a dark brown paleosol, while the main body of ECC sand stringer is sandier/coarser, stratified, and overlies outwash. 14C ages, interpreted as minimums, at GC indicate formation began prior to 25‐20 cal yr BP, while OSL and 14C ages indicate ECC formed ~11.25–8.9 ka. We interpret the main body of GC as equivalent to Peoria Loess, with minor inputs of reworked outwash. We interpret ECC as composed of reworked outwash and local bedrock‐derived sands. Pedogenesis at GC and ECC indicate stabilization with possible minor modification of near surface sediments through the Holocene. Differences in stratigraphy and chronology between the two sites highlight the complexity of aeolian systems in the upper Midwest, interpreted as indicative of the variety of sediment sources contributing to landform development via aeolian processes due to spatial and temporal variability in deglaciation and permafrost melting.
Macrophytes are an integral component of lake communities; therefore, understanding the factors that affect macrophyte community structure is important for conservation and management of lakes. In Sibley County, Minnesota, USA, five of the largest and most recreationally important lakes were surveyed using the point-intercept method. At each point the presence of macrophytes were recorded, water depth was measured, and a sediment sample was collected. Sediment samples were partitioned by determining sand, silt, clay, and organic matter fractions. The richness of macrophytes in all lakes were modeled via generalized linear regression with six explanatory variables: water depth, distance from shore, percent sand, percent silt, percent clay, and percent sediment organic matter. If model residuals were spatially autocorrelated, then a geographically weighted regression was used. Mean species richness (N point⁻¹) was negatively related to depth and distance from shore and either positively or negatively related to silt depending on the lake and which macrophytes were present. All species richness models had pseudo-R² values between 0.25 and 0.40. Curlyleaf pondweed (Potamogeton crispus) was found at 44% of all sampling points in one lake, and its presence was related to water depth, percent silt, and percent sediment organic matter during early season surveys. Results from this study exhibit the inhibitory relationship between water depth and macrophyte growth. The results from these models suggest interactions are complex between macrophytes, environmental factors, and sediment texture; and that these interactions are species and site specific. A single landscape scale model would not be appropriate to capture the in-lake processes driving macrophyte distribution and abundance; and management strategies will need to be developed on a lake-by-lake basis.
Nitrogen (N) is one of the decisive elements for plant growth, crop biomass accumulation, and yield formation of cereal crops. However, managing N in crop production and comparing N use efficiency are challenging without prior knowledge of in-season crop N status. The development of critical N (Nc) dilution curves based on allometry between plant metabolic and structural compartments allows the estimation of crop N nutrition status by determining the N nutrition index (NNI). The purpose of this article is to review the research progress on the development of Nc curves in three major cereal crops (wheat, maize, and rice). The focus of this review paper is to compare the Nc curves of major cereals developed worldwide and to explain the differences in these Nc curve parameters in light of genotype through the management of environmental interactions. Additionally, this review provides an update on the most relevant methods for non-destructive estimation of the NNI of major cereal crops using various remote sensing technologies for large-scale applications. This review also sheds light on the applicability of Nc curve-based NNI for in-season crop N diagnosis, crop N requirement, crop grain yield, and quality prediction. Moreover, this review outlines future research directions to expand the impact of this approach on crop production.
Through an Interpretative Phenomenological Analysis design, this study explored career experiences of eight self‐identified feminist women. This study contributes to existing literature through focusing on the intersection of feminist identity and career development. The findings indicated that having a community of support, particularly from other women, is influential in career progression. All participants noted adversity, however, they recognized when situations were either sexist or unfair and did not appear to internalize these experiences. Implications include making space to discuss the impact of social identities on life decisions, prioritizing inclusive environments that mitigate adversity, and fostering communities of support.
Background: This study examined the relations between students' expectancies for success and a physiological component of test anxiety, salivary cortisol, during an authentic testing setting. Aims: The aim of the study was to better understand the connection between shifts in students' control appraisals and changes in the physiological component of test anxiety. Sample: The study comprised 45 undergraduate engineering majors in the United States. Methods: Survey data concerning students' expectancy for success and saliva samples were taken before, during and after the practice midterm examination prior to their actual in-class examination. Results: Students' expectancy for success declined during the examination while cortisol levels declined from the beginning to middle of the examination and began to increase again as a function of time. Although students' initial levels of expectancy for success and cortisol were not correlated, there was a negative relation between change in cortisol and change in expectancy for success. Conclusions: Our study demonstrates a relation between salivary cortisol, a physiological component of test anxiety and students' expectancy for success in an authentic testing context. Most students saw a decrease in cortisol during the examination, suggesting anticipatory anxiety prior to the test and a return to homeostasis as the examination progressed. Some students, however, did not see a declination in cortisol, suggesting they may not have recovered from pre-examination anxiety. The negative relation between change in cortisol and expectancy for success suggests that students who had the greatest decrease in expectancy for success saw the smallest recovery in cortisol.
The capacitated degree constrained min-sum arborescence problem consists of finding a directed spanning tree in a network to connect a set of terminal nodes to a central node with minimal total cost where the links in the network are directed away from the central node. The number links incident on each terminal node is limited by the number of ports available on them (degree constraint). Additionally, the reliability and response time constraints limit the number of nodes in the sub-trees rooted at the central node (capacity constraint). This problem is formulated as an integer-programming problem and a branch exchange heuristic embedded in the Lagrangian relaxation method is used to find a good feasible solution. The lower bound found as a byproduct of this solution method is used to estimate the quality of the solution given by our heuristic. Experimental results over a wide range of problem structures show that our heuristic method gives good solutions to this problem.
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