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Purpose: This study aimed to evaluate the effect of intraoperative positioning and ocular immobility on the amount of cerebrospinal fluid around the optic nerve in patients undergoing prone spinal surgery by measuring the optic nerve sheath diameter (ONSD) using ultrasound., Methods: Consecutive participants ( n = 15 patients, 30 eyes) were scanned preoperatively, intraoperatively approximately 20 minutes before the end of the surgery, and postoperatively in the post-anesthesia care unit at least 10 min after the completion of the surgery at one academic hospital., Results: On average, patients who underwent prone spinal surgery had a 21% increase in ONSD intraoperatively, with a positive time-dependent relationship with the overall length of surgery ( P < 0.001). ONSDs postoperatively returned to baseline and were not significantly different from preoperative measurements., Conclusion: Our findings suggest pooling and inadequate clearance of perioptic cerebrospinal fluid during prone spinal surgery that improves following termination of the procedure and return of the patient to an upright position., Competing Interests: None., (Copyright © 2024 Rahangdale et al.)

Developing theoretical understanding of complex reactions and processes at interfaces requires using methods that go beyond semilocal density functional theory to accurately describe the interactions between solvent, reactants and substrates. Methods based on many-body perturbation theory, such as the random phase approximation (RPA), have previously been limited due to their computational complexity. However, this is now a surmountable barrier due to the advances in computational power available, in particular through modern GPU-based supercomputers. In this work, we describe the implementation of RPA calculations within BerkeleyGW and show its favorable computational performance on large complex systems relevant for catalysis and electrochemistry applications. Our implementation builds off of the static subspace approximation which, by employing a compressed representation of the frequency dependent polarizability, enables the evaluation of the RPA correlation energy with significant acceleration and systematically controllable accuracy. We find that the computational cost of calculating the RPA correlation energy scales only linearly with system size for systems containing up to 50 thousand bands, and is expected to scale quadratically thereafter. We also show excellent strong scaling results across several supercomputers, demonstrating the performance and portability of this implementation.

Studies to date have predominantly focused on countries' socioeconomic conditions (e.g., income inequality) to explain cross-national differences in socioeconomic inequalities in adolescent health (behaviours). However, the potential explanatory role of sociocultural contexts at country-level remains underexamined. This study examined whether the country-level sociocultural context and changes thereof were associated with adolescent socioeconomic inequalities in dietary behaviours. International comparative data of 344,352 adolescents living in 21 countries participating in 2002, 2006, 2010 and 2014 waves of the Health Behaviour in School-aged Children (HBSC) survey were combined with aggregated levels of openness-to-change from the European Social Survey (ESS). Four dietary behaviours (i.e., fruit, vegetable, sweets and soft drink consumption) and two measures of socioeconomic status (SES) on the individual level (i.e., family affluence scale [FAS] and occupational social class [OSC]) were studied. Multilevel logistic regression analyses returned contrasting results for the two SES measures used. In countries with higher levels of openness-to-change, smaller FAS inequalities in daily fruit, sweets and soft drink consumption were observed, but no such inequalities were found for vegetable consumption. Conversely, in these countries, larger OSC inequalities in soft drink consumption were found. Country-specific changes in openness-to-change over time were not associated with the magnitude of adolescent dietary inequalities. Findings underscore the importance of including country-level sociocultural contexts to improve the understanding of cross-national differences in socioeconomic inequalities in adolescents' diets. Future studies, spanning a longer timeframe, are required to examine whether such associations exist within countries over time since our timeframe might have been too small to capture these long-term trends., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: Characterize short-term outcomes of late preterm and term infants who received positive pressure ventilation in the delivery room and compare these with infants who did not receive resuscitation at birth., Study Design: Single center retrospective cohort study of infants born between 35 0/7 and 41 6/7 weeks' gestation in 2019. Baseline characteristics and outcomes of infants who received positive pressure ventilation were compared with controls who did not receive delivery room ventilation. The primary outcome was neonatal intensive care unit admission; secondary outcomes included multiple hospital morbidities and interventions., Results: Among 202 infants who received delivery room positive pressure ventilation, 77 (38.1%) received ≤1 min, and 125 (61.9%) received >1 min of positive pressure ventilation. Neonatal intensive care unit admission directly following resuscitation was more common in the ventilation cohort (33%) compared with controls (1.5%), p  ≤ 0.0001. After initial admission to the newborn nursery, intensive care unit transfer rates were similar in the positive pressure ventilation cohort (4%) and controls (5%). Antibiotic exposure, hypoxic ischemic encephalopathy, respiratory support in the neonatal intensive care unit, and pneumothorax were more common in the ventilation cohort. The composite outcome of any post-delivery complication occurred in 45% of positive pressure ventilation-exposed infants, compared to 15.8% of control infants (<0.0001); this was more common following >1 min (52.8%) than ≤1 min positive pressure ventilation (32.5%), p  = 0.002., Conclusion: Post-delivery complications are common following delivery room positive pressure ventilation, emphasizing the need for post-resuscitation monitoring in either the neonatal intensive care unitor newborn nursery setting., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘This work was supported by the Belgian French Community (Fund for Scientific Research) through a FRIA scholarship benefitting Maureen Peers de Nieuwburgh and the AHRQ career development award (K08HS029029) supporting Heidi Herrick. The funding sources had no involvement in study design, data collection, analysis and interpretation, writing of the report and in the decision to submit the article for publication. Additionally, we confirm there is no overlap with previous publications and that these findings are novel and have not been published or submitted elsewhere. There is no other conflict of interest to disclose’., (© 2024 The Authors.)

The social gradient in adolescent mental health is well established: adolescents' socioeconomic status is negatively associated with their mental health. However, despite changes in social cognition during adolescence, little is known about whether social cognitions mediate this gradient. Therefore, this study tested this proposed mediational path using three data waves, each 6 months apart, from a socioeconomically diverse sample of 1,429 adolescents ( M age = 17.9) in the Netherlands. Longitudinal modeling examined whether three social cognitions (self-esteem, sense of control, and optimism) mediated associations between perceived family wealth and four indicators of adolescent mental health problems (emotional symptoms, conduct problems, hyperactivity, and peer problems). There was evidence of a social gradient: adolescents with lower perceived family wealth reported more concurrent emotional symptoms and peer problems and an increase in peer problems 6 months later. Results also showed evidence of mediation through social cognitions, specifically sense of control: adolescents with lower perceived family wealth reported a decrease in sense of control (though not self-esteem nor optimism) 6 months later, and lower sense of control predicted increases in emotional symptoms and hyperactivity 6 months later. We found concurrent positive associations between perceived family wealth and all three social cognitions, and concurrent negative associations between social cognitions and mental health problems. The findings indicate that social cognitions, especially sense of control, may be an overlooked mediator of the social gradient in adolescent mental health.

Background National Basketball Association (NBA) and Women's National Basketball Association (WNBA) players with Achilles tendon ruptures have previously been noted to have a significant decline in performance post-injury. There has been recent anecdotal evidence that elite players with dominant Achilles tendon ruptures may be able to return at a higher level of play post-rupture. Objective This study aimed to evaluate for any differences in performance in higher-performing NBA and WNBA players with dominant versus non-dominant Achilles tendon ruptures pre- and post-injury. Methods This study was conducted at the University of Pennsylvania, Department of Physical Medicine and Rehabilitation. NBA and WNBA players with an Achilles tendon rupture from 1990 to 2020 were identified. Only elite players, indicated by an average player efficiency rating (PER) of >15 in either of the three seasons pre/post-injury, were included. The average PER, offensive rating, defensive rating, and usage percentage were compared in the three seasons pre- and post-injury. Results Eighteen players met the inclusion criteria, and nine each were classified as dominant and non-dominant Achilles tendon ruptures based on their primary shooting hand. There was no significant difference between the dominant and non-dominant rupture groups in any outcomes pre-injury, including age. The non-dominant cohort had a significant decline in PER (20.04 vs. 14.16; p < 0.001) and offensive rating (110.33 vs. 101.56; p = 0.004) post-injury. There was no significant difference observed post-injury in defensive rating or usage percentage. The dominant cohort had no significant difference in any outcomes post-injury, returning to the same level of play as pre-injury. Despite no difference existing between the groups at baseline, the dominant group performed significantly better post-rupture with regard to PER (19.56 vs. 14.16; p < 0.001) and offensive rating (114.00 vs. 101.56; p < 0.001) versus the non-dominant group. Conclusion Elite NBA and WNBA players with dominant Achilles tendon ruptures had no change in performance post-injury, returning to the same level of production as pre-injury. Post-rupture, they demonstrated notably superior outcomes versus the non-dominant group with regard to PER and offensive rating. The non-dominant rupture group experienced the same decline in PER and offensive rating post-injury observed in previous studies. The data indicate that elite NBA and WNBA players with a dominant Achilles tendon rupture have a much more favorable recovery post-injury and are able to return to the same level of performance., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Weinberg et al.)

Rather than confining the categories health and sickness to a biomedical conception of the biological organism, there is growing recognition of epistemological and ontological multiplicity in the realm of diagnosis and, indeed, in the very realm of disease itself. In short, the empirical manifestations of health and illness as well as the processes thought to cause them are now understood to assume a much wider variety of both biological and other forms. This essay considers the underlying epistemological and ontological opportunities and challenges of taking what we are calling this diffusion of diagnosis seriously. By diffusion we mean the movement from a concentrated understanding of diagnostic authority as confined to scientific biomedicine to a less concentrated appreciation of the diverse approaches to diagnosis throughout the world. We consider the extent to which, and the manner in which, we as sociologists of diagnosis might not only critique these various processes but perhaps also take them seriously in an ethnographic sense as locally produced, evaluated and legitimated forms of health care., (© 2023 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for the Sociology of Health & Illness.)

Background: Clinical trials of anti-inflammatories in schizophrenia do not show clear and replicable benefits, possibly because patients were not recruited based on elevated inflammation status. Interleukin 1-beta (IL-1β) mRNA and protein levels are increased in serum, plasma, cerebrospinal fluid, and brain of some chronically ill patients with schizophrenia, first episode psychosis, and clinical high-risk individuals. Canakinumab, an approved anti-IL-1β monoclonal antibody, interferes with the bioactivity of IL-1β and interrupts downstream signaling. However, the extent to which canakinumab reduces peripheral inflammation markers, such as, high sensitivity C-reactive protein (hsCRP) and symptom severity in schizophrenia patients with inflammation is unknown., Trial Design: We conducted a randomized, placebo-controlled, double-blind, parallel groups, 8-week trial of canakinumab in chronically ill patients with schizophrenia who had elevated peripheral inflammation., Methods: Twenty-seven patients with schizophrenia or schizoaffective disorder and elevated peripheral inflammation markers (IL-1β, IL-6, hsCRP and/or neutrophil to lymphocyte ratio: NLR) were randomized to a one-time, subcutaneous injection of canakinumab (150 mg) or placebo (normal saline) as an adjunctive antipsychotic treatment. Peripheral blood hsCRP, NLR, IL-1β, IL-6, IL-8 levels were measured at baseline (pre injection) and at 1-, 4- and 8-weeks post injection. Symptom severity was assessed at baseline and 4- and 8-weeks post injection., Results: Canakinumab significantly reduced peripheral hsCRP over time, F(3, 75) = 5.16, p = 0.003. Significant hsCRP reductions relative to baseline were detected only in the canakinumab group at weeks 1, 4 and 8 (p's = 0.0003, 0.000002, and 0.004, respectively). There were no significant hsCRP changes in the placebo group. Positive symptom severity scores were significantly reduced at week 8 (p = 0.02) in the canakinumab group and week 4 (p = 0.02) in the placebo group. The change in CRP between week 8 and baseline (b = 1.9, p = 0.0002) and between week 4 and baseline (b = 6.0, p = 0.001) were highly significant predictors of week 8 change in PANSS Positive Symptom severity scores. There were no significant changes in negative symptoms, general psychopathology or cognition in either group. Canakinumab was well tolerated and only 7 % discontinued., Conclusions: Canakinumab quickly reduces peripheral hsCRP serum levels in patients with schizophrenia and inflammation; after 8 weeks of canakinumab treatment, the reductions in hsCRP are related to reduced positive symptom severity. Future studies should consider increased doses or longer-term treatment to confirm the potential benefits of adjunctive canakinumab in schizophrenia. Australian and New Zealand Clinical Trials Registry number: ACTRN12615000635561., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.)

Energy funneling is a phenomenon that has been exploited in optoelectronic devices based on low-dimensional materials to improve their performance. Here, we introduce a new class of two-dimensional semiconductor, characterized by multiple regions of varying thickness in a single confined nanostructure with homogeneous composition. This "noninteger 2D semiconductor" was prepared via the structural transformation of two-octahedron-layer-thick ( n = 2) 2D cesium lead bromide perovskite nanosheets; it consisted of a central n = 2 region surrounded by edge-lying n = 3 regions, as imaged by electron microscopy. Thicker noninteger 2D CsPbBr 3 nanostructures were obtained as well. These noninteger 2D perovskites formed a laterally coupled quantum well band alignment with virtually no strain at the interface and no dielectric barrier, across which unprecedented intramaterial funneling of the photoexcitation energy was observed from the thin to the thick regions using time-resolved absorption and photoluminescence spectroscopy.

This study examined the relationship between family wealth and school dropout among vocational education students (n = 1,231; mean age=17.81). It investigated whether (1) family affluence and adolescents' own perceptions and experiences of their family wealth (i.e., perceived family wealth, financial scarcity) predict dropout, (2) adolescents' civic attitudes (i.e., system justification, institutional trust) explain the association between family wealth and school dropout, and (3) trust in teachers buffers against the risk of dropout among students with lower civic attitudes. Multivariate models revealed that financial scarcity predicted dropout. Financial scarcity showed an indirect only effect on dropout through lower institutional trust, but not through system justification. Trust in teachers was neither associated with dropout, nor a moderator. Controlling for mental health problems did not affect these results. This study helps explain how students' experienced and perceived family wealth can affect their educational attainment, by reducing their trust in social institutions., (© 2023. Springer Nature Limited.)

The order of bright and dark excitonic states in lead-halide perovskite nanocrystals is debated. It has been proposed that the Rashba effect, driven by lattice-induced symmetry breaking, causes a bright excitonic ground state. Direct measurements of excitonic spectra, however, show the signatures of a dark ground state, bringing the role of the Rashba effect into question. We use an atomistic theory to model the exciton fine structure of perovskite nanocrystals, accounting for realistic lattice distortions. We calculate optical gaps and excitonic features that compare favorably with experimental works. The exciton fine structure splittings show a nonmonotonic size dependence due to a structural transition between cubic and orthorhombic phases. Additionally, the excitonic ground state is found to be dark with spin triplet character, exhibiting a small Rashba coupling. We additionally explore the effects of nanocrystal shape on the fine structure, clarifying observations on polydisperse nanocrystals.

Background: Chagas Disease (ChD) is a Neglected Tropical Disease (NTD) affecting 6 to 7 million people worldwide, mostly from Latin America. In Argentina, a national control program has been implemented since 1962, yet there are still an estimated 1.6 million infected individuals. Control programs were based almost exclusively on entomological surveillance and chemical control of households and were not continuous given a lack of coordination and resources. Argentina´s ChD program was originally vertical and centralized; later, it was partially and, in general, unsuccessfully transferred to the provinces. Herein, we describe the implementation of a control program for ChD with an ecohealth approach in rural settlements around the city of Añatuya, Santiago del Estero., Methods: The program included yearly household visits for entomological surveillance and control, health promotion workshops, and structural house improvements. Improved structures included internal and external walls and roofs, as well as the construction of water wells and latrines, and the organization and improvement of peri-domestic structures. Activities were carried out by specifically trained personnel except for house improvements, which were performed by the community, under technical guidance and provision of materials. Data was collected using standardized questionnaires for household characterization, entomological infestation status and chemical control activities., Results: This program was continuously implemented since 2005 with high community participation and adherence, incorporating 13 settlements and 502 households. During the surveillance phase, 4,193 domiciliary inspections were performed, and both the intra- and peri-domestic infestation rate were reduced from 17.9% to 0.2% (P < 0.01) and from 20.4% to 3%, respectively. Additionally, 399 households were structurally improved., Conclusion: The program is still ongoing and, after 14 years of implementation, has built social networks and collaboration between implementers and beneficiaries with a reduction of T. infestans infestation in the intra- and peri-domicile. This reduction, especially inside the household, has enabled access to diagnosis and treatment of the population, with minimal risk of re-infection., Competing Interests: The authors declare no competing interests., (Copyright: © 2023 Weinberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Black phosphorus has emerged as a unique optoelectronic material, exhibiting tunable and high device performance from mid-infrared to visible wavelengths. Understanding the photophysics of this system is of interest to further advance device technologies based on it. Here we report the thickness dependence of the photoluminescence quantum yield at room temperature in black phosphorus while measuring the various radiative and non-radiative recombination rates. As the thickness decreases from bulk to ~4 nm, a drop in the photoluminescence quantum yield is initially observed due to enhanced surface carrier recombination, followed by an unexpectedly sharp increase in photoluminescence quantum yield with further thickness scaling, with an average value of ~30% for monolayers. This trend arises from the free-carrier to excitonic transition in black phosphorus thin films, and differs from the behaviour of conventional semiconductors, where photoluminescence quantum yield monotonically deteriorates with decreasing thickness. Furthermore, we find that the surface carrier recombination velocity of black phosphorus is two orders of magnitude lower than the lowest value reported in the literature for any semiconductor with or without passivation; this is due to the presence of self-terminated surface bonds in black phosphorus., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Purpose: A social gradient in adolescent mental health exists: adolescents with higher socioeconomic status (SES) have fewer mental health problems than their peers with lower SES. Little is known about whether adolescents' societal beliefs play a role in this social gradient. Belief in a just world (BJW) may be a mediator or moderator of the social gradient in adolescent mental health., Methods: Using data from 848 adolescents (M age  = 17) in the Netherlands, path analyses examined whether two indicators of BJW (general and personal) mediated or moderated the associations between two indicators of SES (family affluence and perceived family wealth), and four indicators of adolescent mental health problems (emotional symptoms, conduct problems, hyperactivity, and peer problems)., Results: Adolescents with lower family affluence and lower perceived family wealth reported more emotional symptoms, and the association between perceived family wealth and emotional symptoms was mediated by lower personal and general BJW. Furthermore, higher personal BJW amplified the negative association between SES and peer problems., Conclusion: This study suggests BJW may both mediate and amplify the social gradient in adolescent mental health. Adolescents' beliefs about society may be important to include in research aimed at understanding this social gradient., (© 2021. The Author(s).)

This study examined socioeconomic disparities in changes in adolescent mental health between fall 2019 (pre-COVID-19), spring 2020 (initial coronavirus disease 2019 (COVID-19) phase), and fall 2020 (prevailing COVID-19 phase). Using data from 1429 adolescents (M age  = 17.9) from tertiary vocational schools in the Netherlands with n = 386 participating in all three waves, linear and latent basis growth curve models were assessed and multigroup analyses conducted. Results showed a small but significant decrease in life satisfaction and small but significant increases in emotional problems, peer relationship problems, conduct problems, and hyperactivity-inattention problems. For emotional problems and peer relationship problems, increases between pre-COVID-19 and the initial COVID-19 phase were more pronounced than increases between the initial and prevailing COVID-19 phase. In contrast, linear decreases were found for life satisfaction and linear increases for conduct problems and hyperactivity-inattention problems over the course of the study. Mental health patterns were largely comparable for adolescents from families with varying socioeconomic status., (© 2022 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

Background: The submarine environment presents unique challenges in mitigating the spread of respiratory viruses because of the re-circulatory atmosphere and lack of ability to physically distance. The atmosphere of a submarine is periodically ventilated and continuously scrubbed. However, the air is recycled for months until the ship is able to ventilate. An outbreak of coronavirus disease 2019 (COVID-19) occurred on a U.S. Navy fast-attack nuclear submarine (SSN) with a crew of 128 personnel., Methods: Demographics, symptom data, and test results for all crew members on board during the outbreak were collected. Testing was completed by real-time reverse-transcriptase polymerase chain reaction, and symptom data were collected via a patient-reported online application. Symptom results were collected from August 4, 2020 to September 1, 2020., Results: The crew was 100% male, with a mean age of 27.0 years. All crew members met the stringent medical standards for submarine and sea duty. Fifty-five Sailors tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (43.0% of the crew) during the outbreak. Additionally, nine Sailors (7.0% of the crew) met the criteria for infection despite testing negative, resulting in an overall attack rate of 50.0%. Among the 64 crew members with suspected or confirmed COVID-19, 1 (1.6%) was hospitalized. There were no deaths. Out of the 55 positive tests, there were 6 (10.9%) asymptomatic positive cases., Conclusions: As expected, SARS-CoV-2 was able to spread rapidly among a submarine crew. In 11 days, the infection spread to 64 total crewmembers out of 128. Outbreaks such as these have played a role in future COVID-19 testing and mitigation protocols that have affected day-to-day operations., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Higher family affluence is associated with healthier behaviours in adolescents, but the strength of this association varies across countries. Differences in social mobility at the country-level, i.e. the extent to which adolescents develop a different socioeconomic status (SES) than their parents, may partially explain why the association between family affluence and adolescent health behaviours is stronger in some countries than in others. Using data from adolescents aged 11-15 years from 32 countries, participating in the 2017/2018 wave of the Health Behaviour in School-aged Children (HBSC) study (N = 185,086), we employed multilevel regression models with cross-level interactions to examine whether country-level social mobility moderates the association between family affluence and adolescent health behaviours (i.e. moderate-to-vigorous physical activity, vigorous physical activity, healthy and unhealthy foods consumption, having breakfast regularly, and weekly smoking). Higher family affluence was more strongly associated with higher levels of adolescent physical activity in countries characterized by high levels of social mobility. No cross-level interactions were found for any of the other health behaviours. Differences in social mobility at the country-level may contribute to cross-national variations in socioeconomic inequalities in adolescent physical activity. Further research can shed light on the mechanisms linking country-level social mobility to inequalities in adolescent physical activity to identify targets for policy and interventions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Addiction science is very often cast as an indispensable source of political justification and clinical resources for engaging addicts therapeutically rather than punitively. It is said to promote an image of overcoming addictions as projects of recovery from disease or mental disorder rather than merely a repudiation of one's formerly troubled ways. Thusly, it is said to inform more compassionate and effective approaches to fostering constructive personal change than merely blaming and punishing addicts for their difficulties. In this essay I argue that because mainstream addiction science seeks to generalise regarding the nature of addiction and recovery, it invariably fails to capture the practices of freedom through which particular people undertake to recover from their particular addictions. I show how theoretical resources drawn from Michel Foucault, Harry Frankfurt and Donald Davidson allow us to develop the insights of posthumanist scholarship to provide in detail for the specific practices of freedom through which people undertake to recover from their particular addictions under the diverse practical conditions in which they seek to do so. This attention to particularity keys addiction science much more closely to the actual exigencies people encounter in the work of therapeutically fostering recovery from addiction in practice., Competing Interests: Declarations of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

The description of carrier dynamics in spatially confined semiconductor nanocrystals (NCs), which have enhanced electron-hole and exciton-phonon interactions, is a great challenge for modern computational science. These NCs typically contain thousands of atoms and tens of thousands of valence electrons with discrete spectra at low excitation energies, similar to atoms and molecules, that converge to the continuum bulk limit at higher energies. Computational methods developed for molecules are limited to very small nanoclusters, and methods for bulk systems with periodic boundary conditions are not suitable due to the lack of translational symmetry in NCs. This perspective focuses on our recent efforts in developing a unified atomistic model based on the semiempirical pseudopotential approach, which is parameterized by first-principle calculations and validated against experimental measurements, to describe two of the main nonradiative relaxation processes of quantum confined excitons: exciton cooling and Auger recombination. We focus on the description of both electron-hole and exciton-phonon interactions in our approach and discuss the role of size, shape, and interfacing on the electronic properties and dynamics for II-VI and III-V semiconductor NCs.

The Pan American Health Organization (PAHO) has defined Chagas Disease hotspots in Central America associated with the vector Triatoma spp. Triatoma dimidiata is a native vector adapted to multiple environments, including intra-domestic and peri-domestic habitats. A multi-institutional project named "Alliances for the elimination of Chagas in Central America" was created to help reduce the incidence of the disease in the region. Activities performed in the field as part of the project included aspects of vector surveillance and control, improvement of houses, diagnosis and treatment of individuals, health promotion, training of human resources and identification of access barriers to diagnosis and treatment. As a base line study, eleven villages, comprised of 1,572 households, were entomologically evaluated (83.4% overall participation); five were found to have very high infestation rates (>20%), three had high infestation rates (8-20%) and three had low-infestation rates (<8%), coinciding with the category of infestation-risk of the houses within each village. Serological tests were carried out in 812 people (>80% participation) in two of the 11 villages and none of the 128 children tested, less than 5 years of age, were positive for Trypanosoma cruzi infection. Community participation in all the activities was high (>70%). The collaboration between several subnational, national, and international institutions, each with specific roles, promoted community participation in the activities of vector control and patient care, thus, establishing a baseline to continue implementing and monitoring project progress., (Copyright © 2021. Published by Elsevier B.V.)

Vasoplegic syndrome can occur after reperfusion in liver transplantation. Generally, vasopressor infusions along with volume resuscitation are used to combat this process. There are case reports of the use of hydroxocobalamin to improve vasoplegia in liver transplant and cardiac surgery. In this case report, we describe a patient who received hydroxocobalamin for a simultaneous liver-kidney transplant. Use of this medication facilitated a prompt decrease of very high-dose vasopressor infusions and allowed completion of the kidney transplantation portion of this case. To our knowledge, use in combined liver-kidney transplant has not been described. In light of the dearth of medications to improve vasoplegia outside of vasopressor infusions, the use of hydroxocobalamin as a therapeutic intervention may gain importance., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Purpose: Adolescents with higher socioeconomic status (SES) report better mental health. The strength of the association-the "social gradient in adolescent mental health"-varies across countries, with stronger associations in countries with greater income inequality. Country-level meritocratic beliefs (beliefs that people get what they deserve) may also strengthen the social gradient in adolescent mental health; higher SES may be more strongly linked to adolescent's perceptions of capability and respectful treatment., Methods: Using data from 11-15 year olds across 30 European countries participating in the 2013/2014 Health Behaviour in School-aged Children study (n = 131,101), multilevel regression models with cross-level interactions examined whether country-level meritocratic beliefs moderated the association between two individual-level indicators of SES, family affluence and perceived family wealth, and three indicators of adolescent mental health (life satisfaction, psychosomatic complaints, and aggressive behavior)., Results: For family affluence, in some countries, there was a social gradient in adolescent mental health, but in others the social gradient was absent or reversed. For perceived family wealth, there was a social gradient in adolescent life satisfaction and psychosomatic complaints in all countries. Country-level meritocratic beliefs moderated associations between SES and both life satisfaction and psychosomatic complaints: in countries with stronger meritocratic beliefs associations with family affluence strengthened, while associations with perceived family wealth weakened., Conclusions: Country-level meritocratic beliefs moderate the associations between SES and adolescent mental health, with contrasting results for two different SES measures. Further understanding of the mechanisms connecting meritocratic beliefs, SES, and adolescent mental health is warranted., (Copyright © 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Understanding electronic dynamics in multiexcitonic quantum dots (QDs) is important for designing efficient systems useful in high power scenarios, such as solar concentrators and multielectron charge transfer. The multiple charge carriers within a QD can undergo undesired Auger recombination events, which rapidly annihilate carriers on picosecond time scales and generate heat from absorbed photons instead of useful work. Compared to the transfer of multiple electrons, the transfer of multiple holes has proven to be more difficult due to slower hole transfer rates. To probe the competition between Auger recombination and hole transfer in CdSe, CdS, and CdSe/CdS QDs of varying sizes, we synthesized a phenothiazine derivative with optimized functionalities for binding to QDs as a hole accepting ligand and for spectroscopic observation of hole transfer. Transient absorption spectroscopy was used to monitor the photoinduced absorption features from both trapped holes and oxidized ligands under excitation fluences where the averaged initial number of excitons in a QD ranged from ∼1 to 19. We observed fluence-dependent hole transfer kinetics that last around 100 ps longer than the predicted Auger recombination lifetimes, and the transfer of up to 3 holes per QD. Theoretical modeling of the kinetics suggests that binding of hole acceptors introduces trapping states significantly different from those in native QDs passivated with oleate ligands. Holes in these modified trap states have prolonged lifetimes, which promotes the hole transfer efficiency. These results highlight the beneficial role of hole-trapping states in devising hole transfer pathways in QD-based systems under multiexcitonic conditions.

Refractory hypotension is a known entity in liver transplantation. Catecholamine and vasopressin infusions are first-line therapies. There has been recent interest in angiotensin II (Ang-2) as an alternative vasopressor; however, liver failure patients were excluded from the original trials. Ang-2 has potential in this patient population. This case discusses a patient who received an infusion of Ang-2 during a liver transplant for combined liver failure-induced distributive shock and septic shock. It is the first known successful use of intraoperative Ang-2 in this situation, and it shows that Ang-2 may be safe in liver transplantation when traditional therapies fail., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 International Anesthesia Research Society.)

Since the growth of research into neighbourhood effects on young people's health in the 1980s, there have been major societal changes and scientific methodological advancements. In this systematic review we will, therefore, discuss the recent (>2009) literature on the association between neighbourhood deprivation and young people's (0-19 years old) mental health and well-being. We focus on whether neighbourhood deprivation effects exist, and how and for whom the neighbourhood matters. Together, the thirty studies included in the review indicate that overall there are neighbourhood effects on young people's mental health and well-being. The comparison of results from these studies suggests that such associations were more commonly found for well-being and externalising problem behaviour rather than internalising problem behaviour. Also, mental health and well-being seemed to be more often associated with the neighbourhood social environment than neighbourhood socio-economic status and neighbourhood disorder. Studies investigating mediating processes between the linkage between neighbourhood deprivation and mental health and well-being were rare although there was some evidence that processes within the family and peer context are important mechanisms in this linkage. Inconsistent evidence was found regarding the moderating role of age, gender, and ethnicity. There are ongoing challenges of researching the how and for whom neighbourhoods are important. We should work towards rigorous theory and evidence on how different features of residential contexts matter and on differential exposure and vulnerability to these contexts., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: A respiratory function monitor (RFM) provides real-time positive pressure ventilation feedback. Whether providers use RFM during neonatal resuscitation is unknown., Methods: Ancillary study to the MONITOR(NCT03256578) randomised controlled trial. Neonatal resuscitation leaders at two centres wore eye-tracking glasses, and visual attention (VA) patterns were compared between RFM-visible and RFM-masked groups., Results: 14 resuscitations (6 RFM-visible, 8 RFM-masked) were analysed. The median total gaze duration on the RFM was significantly higher with a visible RFM (29% vs 1%, p<0.01), while median total gaze duration on other physical objects was significantly lower with a visible RFM (3% vs 8%, p=0.02). Median total gaze duration on the infant was lower with RFM visible, although not statistically significantly (29% vs 46%, p=0.05)., Conclusion: Providers' VA patterns differed during neonatal resuscitation when the RFM was visible, emphasising the importance of studying the impact of additional delivery room technology on providers' behaviour., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Triatoma infestans (Klug) (Hemiptera: Reduviidae) is the main vector of Chagas disease in the Southern Cone of America and resistance to pyrethroid insecticides has been detected in several areas from its geographical distribution. Pyrethroid resistance presents a complex geographical pattern at different spatial scales. However, it is still unknown if the toxicological variability is a common feature within villages of the Gran Chaco were high resistance was descripted. The objectives of this study were to determine: (a) the microgeographical distribution of the deltamethrin-resistance in insects from Pampa Argentina village, (b) the performance of the insecticide impregnated paper bioassay to evaluate deltamethrin-resistance in field collected insects and (c) the lethal activity of the fumigant canister containing DDVP against insects resistant to deltamethrin. High survival of T. infestans exposed to discriminant dose was observed in the samples of all the evaluated dwellings, suggesting that the resistance to deltamethrin is homogeneous at the microgeographical level. Resistance determination by impregnated paper bioassay was similar to traditional topical determination, highlighting the use of this rapid methodology in field large-scale monitoring. The fumigant canister was not effective against resistant insects, remarking the need to develop suitable formulations that ensure minimal toxicological risk and high effectivity.

We present here a reply on the observations and comments of Dr. David Gorla regarding our article "Evaluation and planning of Chagas control activities using geospatial tools" published in Geospatial Health 2019;14:229-238. (doi: 10.4081/gh.2019.786).

Purpose: Although previous research has established a positive association between national income inequality and socioeconomic inequalities in adolescent health, very little is known about the extent to which national-level wealth inequalities (i.e., accumulated financial resources) are associated with these inequalities in health. Therefore, this study examined the association between national wealth inequality and income inequality and socioeconomic inequality in adolescents' mental well-being at the aggregated level., Methods: Data were from 17 countries participating in three consecutive waves (2010, 2014, and 2018) of the cross-sectional Health Behaviour in School-aged Children study. We aggregated data on adolescents' life satisfaction, psychological and somatic symptoms, and socioeconomic status (SES) to produce a country-level slope index of inequality and combined it with country-level data on income inequality and wealth inequality (n = 244,771). Time series analyses were performed on a pooled sample of 48 country-year groups., Results: Higher levels of national wealth inequality were associated with fewer average psychological and somatic symptoms, while higher levels of national income inequality were associated with more psychological and somatic symptoms. No associations between either national wealth inequality or income inequality and life satisfaction were found. Smaller differences in somatic symptoms between higher and lower SES groups were found in countries with higher levels of national wealth inequality. In contrast, larger differences in psychological symptoms and life satisfaction (but not somatic symptoms) between higher and lower SES groups were found in countries with higher levels of national income inequality., Conclusions: Although both national wealth and income inequality are associated with socioeconomic inequalities in adolescent mental well-being at the aggregated level, associations are in opposite directions. Social policies aimed at a redistribution of income resources at the national level could decrease socioeconomic inequalities in adolescent mental well-being while further research is warranted to gain a better understanding of the role of national wealth inequality in socioeconomic inequalities in adolescent health., (Copyright © 2020. Published by Elsevier Inc.)

The threadworm, Strongyloides stercoralis , is endemic in tropical and subtropical areas. Data on the prevalence and distribution of infection with this parasite species is scarce in many critical regions. We conducted a seroprevalence study of S. stercoralis infection in 13 locations in the Gran Chaco and Yungas regions of Argentina and Bolivia during the period 2010-2016. A total of 2803 human serum samples were analyzed by ELISA-NIE which has a sensitivity of 75% and specificity of 95%. Results showed that 551 (19.6%) of those samples were positive. The adjusted prevalence was 20.9%, (95% confidence interval (CI) 19.4%-22.4%). The distribution of cases was similar between females and males with an increase of prevalence with age. The prevalence in the different locations ranged from 7.75% in Pampa del Indio to 44.55% in Santa Victoria Este in the triple border between Argentina, Bolivia, and Paraguay in the Chaco region. Our results show that S. stercoralis is highly prevalent in the Chaco and Yungas regions, which should prompt prospective surveys to confirm our findings and the design and deployment of control measures., Competing Interests: The authors declare no conflict of interest.

Childhood adversity, such as physical, sexual, and verbal abuse, as well as neglect and family conflict, is a risk factor for schizophrenia. Such adversity can lead to disruptions of cognitive function during development, undermining intellectual capabilities and academic achievement. Schizophrenia is a neurodevelopmental disorder that is associated with cognitive impairments that may become evident during childhood. The Australian Schizophrenia Research Bank database comprises a large community cohort (N = 1169) in which we previously identified 3 distinct cognitive groups among people with schizophrenia: (1) Compromised, current, and estimated premorbid cognitive impairment; (2) Deteriorated, substantial decline from estimated premorbid function; and (3) Preserved, performing in the normal cognitive range without decline. The compromised group displayed the worst functional and symptom outcomes. Here, we extend our previous work by assessing the relationship among these categories of cognitive abilities and reported childhood adversity in 836 patients and healthy controls. Exploratory factor analysis of the Childhood Adversity Questionnaire revealed 3 factors (lack of parental involvement; overt abuse; family breakdown and hardship). People with schizophrenia reported significantly more childhood adversity than healthy controls on all items and factors. People with schizophrenia in the compromised group reported significantly more lack of parental involvement and family breakdown and hardship and lower socioeconomic status than those in the deteriorated group. The cognitive groups were not related to family history of psychosis. These findings identify specific social and family factors that impact cognition, highlighting the important role of these factors in the development of cognitive and functional abilities in schizophrenia., (© Crown copyright 2019.)

Chagas continues to be a relevant public health problem in Latin America. In this work, we present a spatiotemporal analysis applied for the evaluation and planning of Chagas vector control strategies. We analysed the spatial distribution of the vector Triatoma infestans infestation related to ongoing control interventions cycles in rural communities near Añatuya, Santiago del Estero, Argentina. A geographical information system was developed for the spatial analysis obtaining, for each house, variables that describe the history of spraying and infestation at each time of interventions. Bi-dimensional histograms were used to describe the spatiotemporal pattern of these activities and peri-domestic infestation at the last intervention was modelled by a neural network model. We qualitatively evaluate control programmes considering the history of infestation and spraying from a spatiotemporal point of view, incorporating new ways of visualising this information. Predictions are based on novel, non-linear models and spatiotemporal indices, which should be useful for strategically allocating Chagas control resources in the future and thus help to better plan spraying strategies.

Even in wealthy countries there are substantial socioeconomic inequalities in adolescent mental health. Socioeconomic status (SES) indicators-parental SES, adolescent subjective SES and adolescent educational level-are negatively associated with adolescent mental health problems, but little is known about the interplay between these SES indicators and whether associations have changed over time. Using data from the Dutch Health Behaviour in School-Aged Children (HBSC) studies ( n = 27,020) between 2001 and 2017, we examined associations between three SES indicators and six indicators of adolescent mental health problems. Linear regressions revealed that adolescent subjective SES and adolescent educational level were independently negatively associated with adolescent mental health problems and positively associated with adolescent life satisfaction, but parental SES had negligible independent associations with adolescent mental health problems and life satisfaction. However, when interactions between SES indicators were considered, high adolescent subjective SES was shown to buffer the negative association between parental SES and adolescent mental health problems and the positive association between parental SES and life satisfaction. Despite societal changes between 2001 and 2017, socioeconomic inequalities in adolescent mental health were stable during this period. Findings suggest that all three SES indicators-parental SES, adolescent subjective SES and adolescent educational level-are important for studying socioeconomic inequalities in adolescent mental health.

Background: Blood-based methods using cell-free DNA (cfDNA) are under development as an alternative to existing screening tests. However, early-stage detection of cancer using tumor-derived cfDNA has proven challenging because of the small proportion of cfDNA derived from tumor tissue in early-stage disease. A machine learning approach to discover signatures in cfDNA, potentially reflective of both tumor and non-tumor contributions, may represent a promising direction for the early detection of cancer., Methods: Whole-genome sequencing was performed on cfDNA extracted from plasma samples (N = 546 colorectal cancer and 271 non-cancer controls). Reads aligning to protein-coding gene bodies were extracted, and read counts were normalized. cfDNA tumor fraction was estimated using IchorCNA. Machine learning models were trained using k-fold cross-validation and confounder-based cross-validations to assess generalization performance., Results: In a colorectal cancer cohort heavily weighted towards early-stage cancer (80% stage I/II), we achieved a mean AUC of 0.92 (95% CI 0.91-0.93) with a mean sensitivity of 85% (95% CI 83-86%) at 85% specificity. Sensitivity generally increased with tumor stage and increasing tumor fraction. Stratification by age, sequencing batch, and institution demonstrated the impact of these confounders and provided a more accurate assessment of generalization performance., Conclusions: A machine learning approach using cfDNA achieved high sensitivity and specificity in a large, predominantly early-stage, colorectal cancer cohort. The possibility of systematic technical and institution-specific biases warrants similar confounder analyses in other studies. Prospective validation of this machine learning method and evaluation of a multi-analyte approach are underway.

Background: Worldwide, roughly 80% of adolescents fail to meet World Health Organization (WHO) recommendations regarding physical activity, though there is substantial variation in adolescent physical activity prevalence across countries. This study explored whether country-level environmental differences explained cross-national variation in adolescent moderate- to vigorous-intensity physical activity (MVPA) and vigorous-intensity activity (VPA)., Method: Using the data of 138,014 11- to 15-year-olds from 29 European countries in the 2013/2014 Health Behaviour in School-aged Children (HBSC) study, multilevel regression models examined the influence of four types of country-level environmental factors (physical, socio-cultural, economic, and political) on self-reported individual-level physical activity (MVPA and VPA)., Results: The environmental variables explained 38% of country-level variance in MVPA and 81% of country-level variance in VPA. Lower annual average national temperature, higher community safety, lower average national household income and a weaker physical education policy were significantly associated with more MVPA. Greater urbanisation, lower annual average national temperature, higher adult physical activity and higher average national household income were significantly associated with more VPA., Conclusions: The findings showed that national differences in the physical, socio-cultural and economic environment were related to adolescent physical activity. They point to potential avenues for future research looking at interactions between individual and environmental factors.

Addiction science and public policy have for some time been articulated in conformity with a broader antinomy in Western thought between biological reductionism and liberal voluntarism. Hence, mainstream debates have concerned whether and how addiction might be understood as a disease in the biomedically orthodox sense of anatomical or physiological pathology or whether and how addiction might be understood as a voluntary choice of some kind. The fact that those who staff these debates have appeared either unable or unwilling to consider alternatives to this antinomy has resulted in a rather unhappy and intransigent set of intellectual anomalies both on the biomedical and the social scientific sides of this divide. Perhaps more importantly, it has also resulted in a striking isolation of scientific debates themselves from the vicissitudes of therapeutically caring for those putatively suffering from addictions both within and outside clinical settings. After briefly demonstrating the conformity of debates in addiction science with the broader antinomy between biological reductionism and liberal voluntarism and the anomalies that thereby result, this article considers the scientific and therapeutic benefits of a psychosomatic framework for the understanding of both self-governing subjects and the experience of a loss of self-control to agencies of addiction., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Adolescents with high educational attainment generally have better outcomes across the lifespan than adolescents with lower educational attainment. This study investigated how three measures of socioeconomic status (SES)-maternal education, paternal education, and neighbourhood SES-combined to predict adolescent educational attainment (track level at age 17). We proposed three mechanisms for this pathway: cognitive ability (at age 11), primary school teacher assessment (stating the secondary education level suitable for a child at age 11), and educational expectations (at age 14). Using the data of 2,814 Dutch adolescents from the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study, logistic regressions tested associations between SES and educational attainment. Structural equation modelling (SEM) tested mediational pathways between SES and educational attainment. In models with three SES measures, having a medium-educated mother was associated with higher educational attainment relative to having a low-educated mother (OR; 95% CI: 1.83; 1.41-2.38), and having a high-educated mother was associated with higher educational attainment relative to having a low-educated mother (OR; 95% CI: 3.44; 2.59-4.55). The odds ratios for paternal education showed a similar pattern. We found no association between neighbourhood SES and adolescent educational attainment, so neighbourhood SES was removed from further analyses. Mediational analyses revealed that cognitive ability (30.0%), teacher assessment (28.5%), and educational expectations (1.2%) explained 59.8% of the total association between parental SES and educational attainment. The results showed that mother education and father education were both important for understanding the strong association between parental SES and adolescent educational attainment. In the Netherlands, the association between parental SES and educational attainment can be largely explained by cognitive ability and teacher assessments., Competing Interests: The authors have declared that no competing interests exist.

Introduction and Hypothesis: Rectopexy and sacrocolpopexy can be performed concurrently to treat rectal and vaginal prolapse. We hypothesized that concurrent procedures might be associated with more complications than rectopexy and sacrocolpopexy alone., Methods: Patients undergoing laparoscopic sacrocolpopexy or rectopexy, or concurrent laparoscopic sacrocolpopexy and rectopexy were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database from 2013 to 2016. Preoperative characteristics, operative time, and 30-day post-operative complications were compared between groups. Complications were those defined by the ACS Risk Calculator. Descriptive tests and regression methods were utilized for group comparisons. Significance was set at p < 0.05., Results: We identified 7,232 laparoscopic sacrocolpopexy, 1,560 laparoscopic rectopexy, and 123 concurrent laparoscopic sacrocolpopexy and rectopexy cases. Patients undergoing concurrent procedures were more commonly white, non-Hispanic, non-diabetic, and smokers. Operative time was longest for concurrent procedures, followed by sacrocolpopexy and rectopexy (p < 0.0001). Patients undergoing isolated rectopexy were more commonly ≥ American Society of Anesthesiologists class 3 (p < 0.0001). Rates of any complication for colpopexy, rectopexy, and concurrent procedures did not differ (6.18%, 7.63%, 8.94%; p = 0.058). Serious complication rates for colpopexy, rectopexy, and concurrent procedures did not differ (5.52%, 6.35%, 8.13%; p = 0.222). Odds of experiencing any complication were higher comparing rectopexy with colpopexy alone (adjusted odds ratio = 1.252, 95% CI 1.002-1.565). Comparing all groups, rectopexy had the highest mortality, reoperation, and transfusion rates (all p < 0.05). Concurrent procedures had the highest surgical site and urinary tract infection rates (all p < 0.05)., Conclusions: Complications were low for all three procedures. Concurrent repair may be appropriate in well-selected patients.

This article reviews the epidemiology, diagnosis, and management of vulvar preinvasive lesions, squamous cell carcinoma, and melanoma. There is an emphasis on sentinel lymph node dissection for early stage disease and advances in chemoradiation for late-stage disease. A brief review of vulvar Paget disease is also included., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Metal-organic frameworks (MOFs) and metal nanoparticles are two classes of materials that have received considerable recent attention, each for controlling chemical reactivities, albeit in very different ways. Here, we report the growth of MOF shell layers surrounding aluminum nanocrystals (Al NCs), an Earth-abundant metal with energetic, plasmonic, and photocatalytic properties. The MOF shell growth proceeds by means of dissolution-and-growth chemistry that uses the intrinsic surface oxide of the NC to obtain the Al 3+ ions accommodated into the MOF nodes. Changes in the Al NC plasmon resonance provide an intrinsic optical probe of its dissolution and growth kinetics. This same chemistry enables a highly controlled oxidation of the Al NCs, providing a precise method for reducing NC size in a shape-preserving manner. The MOF shell encapsulation of the Al NCs results in increased efficiencies for plasmon-enhanced photocatalysis, which is observed for the hydrogen-deuterium exchange and reverse water-gas shift reactions.

Vector control of Chagas disease in the past decades has been mainly based on chemical control. Fundación Mundo Sano is implementing an Integral Chagas Program in a rural area of the Argentinean Gran Chaco Region since 2002. The objective of this study was to analyze both, temporal and spatial variation of infestation indices and their relation to the actions of the Program and environmental variables as land and vegetation cover changes, during a 5 year intervention period (2010-2014). Triatoma infestans infestation data from five rural localities from the Province of Santiago del Estero (Argentina) was analyzed in order to detect spatial aggregation. Differences in control effectiveness were observed between the peridomicile and intradomicile: infestation indices were higher in the peridomicile, recurrent infestation was present only in the peridomicile while low level infestation clusters were absent in the peridomicile. Cluster zones with low intradomestic infestation had larger proportions of bare soil and thin vegetation. In contrast, cluster zones with high intradomestic infestation had higher forest vegetation proportions and smaller cultivated area proportions. Spatial statistics analysis detected differences in cluster patterns between intra and peridomestic infestation suggesting that control actions should be based on geographical areas and not on political units. This work brings together different approaches to analyze infestation levels at the fine spatial scale, which could be used as a base for risk spatial stratification., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Nonsteroidal antiinflammatory drug use has been shown to increase blood pressure in nonpregnant adults. Because of this, the American College of Obstetricians and Gynecologists suggests avoiding their use in women with postpartum hypertension; however, evidence to support this recommendation is lacking., Objective: Our goal was to test the hypothesis that nonsteroidal antiinflammatory drugs, such as ibuprofen, adversely affect postpartum blood pressure control in women with preeclampsia with severe features., Study Design: At delivery, we randomized women with preeclampsia with severe features to receive around-the-clock oral dosing with either 600 mg of ibuprofen or 650 mg of acetaminophen every 6 hours. Dosing began within 6 hours after delivery and continued until discharge, with opioid analgesics available as needed for breakthrough pain. Study drugs were encapsulated in identical capsules such that patients, nurses, and physicians were masked to study allocation. Exclusion criteria were serum aspartate aminotransferase or alanine aminotransferase >200 mg/dL, serum creatinine >1.0 mg/dL, infectious hepatitis, gastroesophageal reflux disease, age <18 years, or current incarceration. Our primary outcome was the duration of severe-range hypertension, defined as the time (in hours) from delivery to the last blood pressure ≥160/110 mm Hg. Secondary outcomes were time from delivery to last blood pressure ≥150/100 mm Hg, mean arterial pressure, need for antihypertensive medication at discharge, prolongation of hospital stay for blood pressure control, postpartum use of short-acting antihypertensives for acute blood pressure control, and opioid use for breakthrough pain. We analyzed all outcome data according to intention-to-treat principles., Results: We assessed 154 women for eligibility, of whom 100 met entry criteria, agreed to participate, and were randomized to receive postpartum ibuprofen or acetaminophen for first-line pain control. Seven patients crossed over or did not receive their allocated study drug, and 93 completed the study protocol in their assigned groups. We found no differences in baseline characteristics between groups, including mode of delivery, body mass index, parity, race, chronic hypertension, and maximum blood pressure prior to delivery. We did not find a difference in the duration of severe-range hypertension in the ibuprofen vs acetaminophen groups (35.3 vs 38.0 hours, P = .30). There were no differences between groups in the secondary outcome measures of time from delivery to last blood pressure ≥150/100 mm Hg, postpartum mean arterial pressure, maximum postpartum systolic or diastolic blood pressures, any postpartum blood pressure ≥160/110 mm Hg, short-acting antihypertensive use for acute blood pressure control, length of postpartum stay, need to extend postpartum stay for blood pressure control, antihypertensive use at discharge, or opioid use for inadequate pain control. In a subgroup analysis of patients who experienced severe-range hypertension, the mean time to blood pressure control in the acetaminophen group was 68.4 hours and ibuprofen group was 56.7 hours (P = .26). At 6 weeks postpartum, there were no differences between groups in the rates of obstetric triage visits, hospital readmissions, continued opioid use, or continued antihypertensive use., Conclusion: The first-line use of ibuprofen rather than acetaminophen for postpartum pain did not lengthen the duration of severe-range hypertension in women with preeclampsia with severe features., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: Progress toward understanding brain mechanisms in psychosis is hampered by failures to account for within-group heterogeneity that exists across neuropsychological domains. We recently identified distinct cognitive subgroups that might assist in identifying more biologically meaningful subtypes of psychosis. In the present study, we examined whether underlying structural brain abnormalities differentiate these cognitively derived subgroups., Method: 1.5T T1 weighted structural scans were acquired for 168 healthy controls and 220 patients with schizophrenia/schizoaffective disorder. Based on previous work, 47 patients were categorized as being cognitively compromised (impaired premorbid and current IQ), 100 as cognitively deteriorated (normal premorbid IQ, impaired current IQ), and 73 as putatively cognitively preserved (premorbid and current IQ within 1 SD of controls). Global, subcortical and cortical volume, thickness, and surface area measures were compared among groups., Results: Whole cortex, subcortical, and regional volume and thickness reductions were evident in all subgroups compared to controls, with the largest effect sizes in the compromised group. This subgroup also showed abnormalities in regions not seen in the other patient groups, including smaller left superior and middle frontal areas, left anterior and inferior temporal areas and right lateral medial and inferior frontal, occipital lobe and superior temporal areas., Conclusions: This pattern of more prominent brain structural abnormalities in the group with the most marked cognitive impairments-both currently and putatively prior to illness onset, is consistent with the concept of schizophrenia as a progressive neurodevelopmental disorder. In this group, neurodevelopmental and neurodegenerative factors may be important for cognitive function.