Should forgiveness be considered a civic virtue that promotes peace and justice following injustice? In the aftermath of conflicts as severe as state-sponsored genocide, how can relationships be ...restored, communities reconciled, and justice achieved? We interviewed 15 adults in Rwanda-survivors of the 1994 genocide, nominated as exemplars for their youth-serving roles in their communities and their experiences with forgiving the traumas of the genocide-about their approaches to conflict resolution, their ideas about justice and forgiveness, and their community work. Phenomenological analysis supported considering forgiveness as a civic virtue, as exemplars described a restorative approach to conflict in which justice facilitates, and is completed by, forgiveness. Implications for education emerged from exemplars' accounts, including describing a process of conflict resolution that works toward peace and justice by means of listening, uncovering the truth, acting impartially, encouraging apology and forgiveness, advising for solutions, restoring rights and relationships, and fulfilling justice.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
OBJECTIVE:This study examines patient and operative factors associated with organ space infection (OSI) in children after appendectomy, specifically focusing on the role of operative approach.
...BACKGROUND:Although controversy exists regarding the risk of increased postoperative intra-abdominal infections after laparoscopic appendectomy, this approach has been largely adopted in the treatment of pediatric acute appendicitis.
METHODS:Children aged 2 to 18 years undergoing open or laparoscopic appendectomy for acute appendicitis were selected from the 2012 American College of Surgeons Pediatric National Surgical Quality Improvement Program database. Univariate analysis compared patient and operative characteristics with 30-day OSI and incisional complication rates. Factors with a P value of less than 0.1 and clinical importance were included in the multivariable logistic regression models. A P value less than 0.05 was considered significant.
RESULTS:For 5097 children undergoing appendectomy, 4514 surgical procedures (88.6%) were performed laparoscopically. OSI occurred in 155 children (3%), with half of these infections developing postdischarge. Significant predictors for OSI included complicated appendicitis, preoperative sepsis, wound class III/IV, and longer operative time. Although 5.2% of patients undergoing open surgery developed OSI (odds ratio = 1.82; 95% confidence interval, 1.21–2.76; P = 0.004), operative approach was not associated with increased relative odds of OSI (odds ratio = 0.99; confidence interval, 0.64–1.55; P = 0.970) after adjustment for other risk factors. Overall, the model had excellent predictive ability (c-statistic = 0.837).
CONCLUSIONS:This model suggests that disease severity, not operative approach, as previously suggested, drives OSI development in children. Although 88% of appendectomies in this population were performed laparoscopically, these findings support utilization of the surgeonʼs preferred surgical technique and may help guide postoperative counsel in high-risk children.
Objectives
People with bipolar disorder who also report binge eating have increased psychopathology and greater impairment than those without binge eating. Whether this co‐occurrence is related to ...binge eating as a symptom or presents differently across full‐syndrome eating disorders with binge eating is unclear.
Methods
We first compared networks of 13 lifetime mania symptoms in 34,226 participants from the United Kingdom's National Institute for Health and Care Research BioResource with (n = 12,104) and without (n = 22,122) lifetime binge eating. Second, in the subsample with binge eating, we compared networks of mania symptoms in participants with lifetime anorexia nervosa binge‐eating/purging (n = 825), bulimia nervosa (n = 3737), and binge‐eating disorder (n = 3648).
Results
People with binge eating endorsed every mania symptom significantly more often than those without binge eating. Within the subsample, people with bulimia nervosa most often had the highest endorsement rate of each mania symptom. We found significant differences in network parameter statistics, including network structure (M = 0.25, p = 0.001) and global strength (S = 1.84, p = 0.002) when comparing the binge eating with no binge‐eating participants. However, network structure differences were sensitive to reductions in sample size and the greater density of the latter network was explained by the large proportion of participants (34%) without mania symptoms. The structure of the anorexia nervosa binge‐eating/purging network differed from the bulimia nervosa network (M = 0.66, p = 0.001), but the result was unstable.
Conclusions
Our results suggest that the presence and structure of mania symptoms may be more associated with binge eating as a symptom rather than any specific binge‐type eating disorder. Further research with larger sample sizes is required to confirm our findings.
The fatty acid synthesis type II pathway has received considerable interest as a candidate therapeutic target in Plasmodium falciparum asexual blood-stage infections. This apicoplast-resident ...pathway, distinct from the mammalian type I process, includes FabI. Here, we report synthetic chemistry and transfection studies concluding that Plasmodium FabI is not the target of the antimalarial activity of triclosan, an inhibitor of bacterial FabI. Disruption of fabI in P. falciparum or the rodent parasite P. berghei does not impede blood-stage growth. In contrast, mosquito-derived, FabI-deficient P. berghei sporozoites are markedly less infective for mice and typically fail to complete liver-stage development in vitro. This defect is characterized by an inability to form intrahepatic merosomes that normally initiate blood-stage infections. These data illuminate key differences between liver- and blood-stage parasites in their requirements for host versus de novo synthesized fatty acids, and create new prospects for stage-specific antimalarial interventions.
Background There is currently little information regarding the impact of procedure volume on outcomes after open inguinal hernia repair in the United States. Our hypothesis was that increasing ...procedure volume is associated with lesser rates of reoperation and resource use. Methods The database of the Statewide Planning and Research Cooperative System was queried for elective open initial inguinal hernia repairs performed in New York State from 2001 to 2008 via the use of International Classification of Diseases, 9th Revision and Current Procedural Terminology codes. Surgeon and hospital procedure volumes were grouped into tertiles based on the number of open inguinal hernia repairs performed per year. Bivariate, hierarchical mixed effects Cox proportional-hazards, and negative binomial regression analyses were performed assessing for factors associated with reoperation for recurrence, procedure time, and downstream total charges. Results Among 151,322 patients who underwent open inguinal hernia repair, the overall rate of reoperation for recurrence within 5 years was 1.7% with a median time to reoperation of 1.9 years. An inverse relationship was seen between surgeon volume and reoperation rate, procedure time, and health care costs ( P < .001). After we controlled for surgeon, facility, operative and patient characteristics, low-volume surgeons (<25 repairs/year) had greater rates of reoperation (hazard ratio 1.23,95% confidence interval 95% CI 1.11–1.36), longer procedure times (incidence rate ratio 1.22, 95% CI 1.21–1.24), and greater downstream costs (incidence rate ratio 1.13,95% CI 1.10–1.17) than high-volume surgeons (≥25 repairs/year). Conclusion Surgeon volume <25 cases per year for open inguinal hernia repair was independently associated with greater rates of reoperation for recurrence, worse operative efficiency, and greater health care costs. Referral to surgeons who perform ≥25 inguinal hernia repairs per year should be considered to decrease reoperation rates and resource use.
The high energy demands of dairy cows during the transition period from late gestation into early lactation can place them at an increased risk for the development of metabolic and infectious ...diseases. Modification of the dry period diet has been investigated as a preventive means to minimize the detrimental aspects of metabolic shifts during the transition period. Studies investigating the impact of dry period diet on lipid parameters during the transition period have largely focused on markers of lipolysis and ketogenesis. Total cholesterol declines during the periparturient period and increases in early lactation. The impact total energy in the dry period diet has on the ability of the cow to maintain total serum cholesterol, as well as its natural high‐density lipoprotein‐rich status, during this metabolically challenging window is not clear. The impact of lipoproteins on inflammation and immune function may have a clinical impact on the cow's ability to ward off production‐related diseases. In this study, we hypothesized that the provision of adequate, but not excessive, total metabolizable energy, would better allow the cow to maintain total cholesterol and a higher relative proportion of HDL throughout the transition period. Cows were allocated to one of three dry period dietary treatment groups following a randomized block design. Total serum triglycerides, cholesterol and lipoprotein fractions were measured on a weekly basis from approximately 7 weeks pre‐calving to 6 weeks post‐calving. The cows on the high energy diet maintained total serum cholesterol as compared to the cows provided a lower energy diet, but there was no significant increase in the LDL fraction of lipoproteins between diet treatment groups.
In this research, we study the feasibility of using the solid-state additive manufacturing process, additive friction stir deposition (AFSD), as a suitable technology for creating bulk structural ...components using aluminum alloy 7020. Using a set of the acceptable processing conditions, a fully dense 92-mm-tall build was successful created. Microstructural characterization of the as-deposited AA7020 revealed a highly refined and equiaxed grain structure compared to the AA7020-T651 feedstock material. Tensile specimens were extracted from the as-deposited component in longitudinal direction to evaluate strain-rate dependance and fatigue behavior. In the quasi-static regime (0.001 s
−1
), the as-deposited AA7020 exhibited layer dependence throughout the build direction indicated by a diminished YS and UTS when comparing the final, intermediate, and initial layers of the deposit and the feedstock material. The layer dependence noted in the quasi-static regime is attributed to the increasing thermal input in the build direction during AFSD process. However, in the high-rate regime (2000 s
−1
), the as-deposited material had a similar flow stress to the feedstock material. Additionally, stress-life experiments determined a decrease in fatigue life between the final, intermediate, and initial layers of the deposit due to the inconsistent MgZn-rich particle coarsening inherent to the AFSD process.
The search for antimalarial chemotypes with modes of action unrelated to existing drugs has intensified with the recent failure of first-line therapies across Southeast Asia. Here, we show that the ...trisubstituted imidazole MMV030084 potently inhibits hepatocyte invasion by Plasmodium sporozoites, merozoite egress from asexual blood stage schizonts, and male gamete exflagellation. Metabolomic, phosphoproteomic, and chemoproteomic studies, validated with conditional knockdown parasites, molecular docking, and recombinant kinase assays, identified cGMP-dependent protein kinase (PKG) as the primary target of MMV030084. PKG is known to play essential roles in Plasmodium invasion of and egress from host cells, matching MMV030084's activity profile. Resistance selections and gene editing identified tyrosine kinase-like protein 3 as a low-level resistance mediator for PKG inhibitors, while PKG itself never mutated under pressure. These studies highlight PKG as a resistance-refractory antimalarial target throughout the Plasmodium life cycle and promote MMV030084 as a promising Plasmodium PKG-targeting chemotype.
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•MMV030084 inhibits P. falciparum liver and asexual blood stages and male gametes•Proteomic and conditional knockdown studies identified PfPKG as the target•Resistance selection studies identified TKL3 as a low-level resistance mediator•PKG is a promising resistance-refractory target for antimalarial drug development
Vanaerschot et al. report an antimalarial, MMV030084, with potent antiplasmodial activity against all stages of human infection by Plasmodium falciparum. Metabolomic, phosphoproteomic, chemoproteomic, and gene-editing studies identified cGMP-dependent protein kinase (PKG) as the primary target, which did not mutate under selective drug pressure.
Immune defences often trade off with other life-history components. Within species, optimal allocation to immunity may differ between the sexes or between alternative life-history strategies. ...White-throated sparrows (Zonotrichia albicollis) are unusual in having two discrete plumage morphs, white-striped and tan-striped. Within each sex, white-striped individuals are more aggressive and provide less parental care than tan-striped individuals. We extended immunocompetence handicap models, which predict sex differences in immunity and parasitism, to hypothesize that infection susceptibility should be greater in white-striped than tan-striped birds. We inoculated birds of both morphs with malarial parasites. Contrary to our prediction, among birds that became infected, parasite loads were higher in tan-striped than white-striped individuals and did not differ between the sexes. Circulating androgen levels did not differ between morphs but were higher in males than females. Our findings are not consistent with androgen-mediated immunosuppression. Instead, morph differences in immunity could reflect social interactions or life-history-related differences in risk of injury, and/or genetic factors. Although plumage and behavioural morphs of white-throated sparrow may differ in disease resistance, these differences do not parallel sex differences that have been reported in animals, and do not appear to be mediated by differences in androgen levels.
We briefly review an existing model of the structure of reconnection layers which predicts that several more distinct layers, in the form of contact discontinuities, rotational Alfvèn waves, or slow ...shocks, should be identifiable in solar wind reconnection events than are typically reported in studies of reconnection outflows associated with bifurcated current sheets. We re-examine this notion and recast the identification of such layers in terms of the changes associated with the boundaries of both the ion and electron outflows from the reconnection current layers. We then present a case study using Solar Orbiter MAG and SWA data, which provides evidence consistent with this picture of extended multiple layers around the bifurcated current sheet. A full confirmation of this picture requires more detailed examination of the particle distributions in this and other events. However, we believe this concept is a valuable framework for considering the nature of reconnection layers in the solar wind.
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