Early Encounters Research Articles

Extreme enthalpy‒entropy compensation in the dimerization of small solutes in aqueous solution.

This communication summarizes findings from the earliest encounters with extreme enthalpy‒entropy compensation, a phenomenon first detected in the 1950s by a reappraisal of isopiestic and calorimetric measurements on aqueous urea solutions in terms of solute self-association. Because concurrent studies of carboxylic acid association were confined to measurement of the equilibrium constant by conductance, IR spectrophotometry or potentiometric titration measurements, temperature-independence of the dimerization constant was mistakenly taken to signify a value of zero for Δ instead of (Δ ‒TΔ ). In those studies of small-solute self-association the extreme enthalpy‒entropy compensation was reflecting the action of water as a reactant whose hydroxyl groups were competing for the solute carbonyl involved in self-association. Such action gives rise to a positive temperature dependence of Δ that could well be operating in concert with that responsible for the commonly observed negative dependence for protein‒ligand interactions exhibiting extreme enthalpy‒entropy compensation, where the solvent contribution to the energetics reflects changes in the extent of ordered water structure in hydrophobic environments.

Trends in Respiratory Viral Testing in Pediatric Emergency Departments Following the COVID-19 Pandemic

ObjectiveTo evaluate for increases in the use and costs of respiratory viral testing in pediatric emergency departments (EDs) due to the COVID-19 pandemic. MethodsWe performed a cross-sectional study using the Pediatric Health Information System. Eligible subjects were children (90 days-18 years) who were discharged from a pediatric ED included in PHIS from October 2016 through March 2024. To evaluate for changes in the frequency and costs of respiratory viral testing, we performed an interrupted time series analysis across three study periods: pre-pandemic (October 1, 2016 to March 14, 2020), early pandemic (March 15, 2020 to December 31, 2023), and late pandemic (January 1, 2023 to March 31, 2024). ResultsWe included 15,261,939 encounters from 34 pediatric EDs over the 90-month study period. At least one viral respiratory test was performed for 460,826 of 7,311,177 pre-pandemic encounters (6.3%), 1,240,807 of 5,100,796 early pandemic encounters (24.3%), and 545,696 of 2,849,966 late pandemic encounters (19.1%). There was a positive pre-pandemic slope in viral testing (0.17% encounters/month; 95% confidence interval [CI] 0.17, 0.18). The early pandemic was associated with a shift change of 4.98% (95% CI 4.90, 5.07) and positive slope (0.54% encounters/month; 95% CI 0.54, 0.55). The late pandemic period was associated with a negative shift (-17.80%, 95% CI -17.90, -17.70) and positive slope (0.42% encounters/month; 95% CI 0.41, 0.42). The slope in testing costs increased from $5,000/month (95% CI $4,200, 5,700) to $33,000/month (95% CI $32,000, $34,000) during the early pandemic. ConclusionRespiratory testing and associated costs increased during the COVID-19 pandemic and were sustained, despite decreasing incidence of disease. These findings highlight a need for further efforts to clarify indications for viral testing in the ED and efforts to reduce low-value testing.

Rhetoric’s Unconscious: Freud, Burke, Lacan

ABSTRACT Despite seemingly broad acceptance within rhetorical theory, the category of the unconscious has remained understudied and misunderstood ever since Kenneth Burke first appropriated the concept from psychoanalysis, and his unquestioned commitment to conventional anthropocentric binaries continues to obscure the role and function of the unconscious within communication into this century. Offering a corrective reanalysis of the Freudian apparatus for contemporary rhetoricians, this article shows where Burke went wrong in his early encounter with psychoanalysis and suggests a vital alternative approach in the cybernetic recasting of Jacques Lacan, which suggests the possibility of an unconscious without Dramatism’s traditional humanist assumptions. In a lateral turn bringing this imagined dialogue between Burke and Lacan into our era, the article demonstrates how a Lacan-inflected posthumanist revision of rhetoric’s unconscious is better suited to address contemporary issues of mediated communication, such as the pedagogical import of AI and ChatGPT.

Experiences of service and diagnosis among immigrant families of young children with suspected or diagnosed developmental disabilities

ABSTRACT Objectives While early diagnosis is fundamental to the development of children with developmental disabilities (DD), limited attention has been paid to immigrant parents’ experience of early encounters with systems when they begin seeking supports for their children with DD. This study aimed to contribute to better understanding of immigrant parents’ experiences of early encounters with services for families and children with suspected or diagnosed DD. Design A longitudinal, qualitative approach was adopted. Over 12 months, multiple interviews were conducted with four immigrant families with children aged between two and four years who were attending a mobile playgroup offering early learning supports for children with suspected or diagnosed DD in communities with low access to formal supports. During the first three months of the study, families were accompanied by the first author on weekly visits to the playgroup. Participant observations and informal discussions with staff delivering early intervention supports via the playgroup provided further insight into families’ initial and on-going encounters with services and supports. During the remaining nine months, multiple interviews were conducted with participating families, to document their on-going experiences and encounters with medical practitioners and therapists. Results Thematic analysis of data generated four key themes: Initial encounters with medical professionals, Confusion and ‘missed’ diagnosis, Gaps in understanding, collaboration and communication, and Families’ desire to learn and implement strategies. Conclusion Families made concerted efforts to locate appropriate supports. They also faced barriers including a lack of openness and genuine consultation, particularly in their encounters with health professionals. These barriers resulted in a level of mistrust and detachment from formalised supports. Results highlight the critical importance for health professionals of ‘tuning into’ family concerns through relationship-based approaches, in order to establish shared understanding and mutual respect between professionals and families, particularly for immigrant families seeking support for their young children.

The bi-musical subject: Dwarkanath Tagore and European music in early-nineteenth century Calcutta

ABSTRACT What was the Indians’ early encounter with European music like? How did they access the music of the coloniser and get socialised in it? Following Dwarkanath Tagore’s engagements with European music in early-19th century Calcutta, this essay maps the sites and spaces of western music in the city through which the contemporary Bengali elite first got exposed to the music that their colonial masters had brought into the subcontinent. In conceptually framing this process, it borrows the concept of ‘bi-musicality’ from ethnomusicology and repurposes it as a historical analytic to understand the new and emergent form of musicality that was organic to the colonial encounter in India and constitutively modern.

A Plum Story? Early Encounters and Colonial Views of the Safu in Central Africa, Seventeenth-Twentieth Centuries

ABSTRACT The diversity of edible species originating in Africa is considerable, but the history of their use and domestication remains largely neglected, despite existing historical records. This essay aims to explore attitudes towards safu (Pachylobus edulis), a Central African fruit that defies Western categories. Based on more than one hundred archival documents, this study examines the history of the safu and the tree that produces it as seen by Europeans (German, English, Belgian, Spanish, French, Italian, Portuguese, Swedish, etc.) present in Central Africa. The documentation collected on safus and safu trees reflects not only local views of the species but also the broader European projects pursued on the continent and the vision of African foodways. Indeed, their valuation is symptomatic of food encounters and hierarchies during colonial settlement. More broadly, it reveals how subsistence and agriculture were viewed in the region: the ubiquity of this fruit tree around villages, as often reported, contrasts sharply with the historical narrative of the absence of African agriculture in the tropics. Finally, it shows how colonial enterprises, despite hindered dispersal and missed opportunities, circulated the species in different parts of the planet.

Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer

Numerous studies show that early palliative care improves quality of life and other key outcomes in patients with advanced cancer and their caregivers, although most lack access to this evidence-based model of care. To evaluate whether delivering early palliative care via secure video vs in-person visits has an equivalent effect on quality of life in patients with advanced non-small cell lung cancer (NSCLC). Randomized, multisite, comparative effectiveness trial from June 14, 2018, to May 4, 2023, at 22 US cancer centers among 1250 patients within 12 weeks of diagnosis of advanced NSCLC and 548 caregivers. Participants were randomized to meet with a specialty-trained palliative care clinician every 4 weeks either via video visit or in person in the outpatient clinic from the time of enrollment and throughout the course of disease. The video visit group had an initial in-person visit to establish rapport, followed by subsequent virtual visits. Equivalence of the effect of video visit vs in-person early palliative care on quality of life at week 24 per the Functional Assessment of Cancer Therapy-Lung questionnaire (equivalence margin of ±4 points; score range: 0-136, with higher scores indicating better quality of life). Participants completed study questionnaires at enrollment and at weeks 12, 24, 36, and 48. By 24 weeks, participants (mean age, 65.5 years; 54.0% women; 82.7% White) had a mean of 4.7 (video) and 4.9 (in-person) early palliative care encounters. Patient-reported quality-of-life scores were equivalent between groups (video mean, 99.7 vs in-person mean, 97.7; difference, 2.0 [90% CI, 0.1-3.9]; P = .04 for equivalence). Rate of caregiver participation in visits was lower for video vs in-person early palliative care (36.6% vs 49.7%; P < .001). Study groups did not differ in caregiver quality of life, patient coping, or patient and caregiver satisfaction with care, mood symptoms, or prognostic perceptions. The delivery of early palliative care virtually vs in person demonstrated equivalent effects on quality of life in patients with advanced NSCLC, underscoring the considerable potential for improving access to this evidence-based care model through telehealth delivery. ClinicalTrials.gov Identifier: NCT03375489.

The Traumas of Troy and the Elizabethan Schoolboy in Marlowe’s Dido, Queene of Carthage

Abstract Dido, Queene of Carthage is calibrated to disrupt the smooth passage of the translation of empire and studies embraced by humanist pedagogy. Taking full advantage of the theatrical affordances offered by the boy actors of the Children of her Majesty’s Chapel, the play aims to whisk its target audience, the sophisticated wits of the Inns of Court, back to their early encounters with the matter of Troy in their studies of Vergil and Ovid in grammar school. This essay focuses on the play’s first two acts to show how Marlowe deploys the materials of classical letters and rhetoric in ways that test and contest their ideological functions.

The long way round: drawing to know by ‘not knowing’

While the reflexive and investigative potential of observational drawing is now acknowledged clearly within human geography, drawing practices are still most often brought to bear upon research subjects once they have been defined, rather than in helping to identify subjects for investigation. Reflecting upon the author’s own experience of artistic fieldworking, this article explores how expanded drawing can help researchers hold positions of ‘not knowing’ and maintain an openness to the possibilities that exist within a site during their earliest encounters with it. It is argued here that some forms of expanded drawing can foster ‘not knowing’ by offering access to information about the field beyond the visual, through direct and close physical engagement with it. By shifting emphasis towards sensory and embodied information, expanded drawing can generate fragmentary, partial and fugitive understandings which can unsettle assumptions about a place. Cultivating such positions of ‘not knowing’ can open up the field, break down pre-conceived object hierarchies and enable the site to ‘speak back’ and be heard more evenly. Expanded drawing also has the capacity to foster new relations between the researcher and their site as they persistently and intimately interrogate it. This is proposed as a form of ‘noticing-as-care’; a tentative artistic counter-strategy which may reveal unevenness in the attention paid across post-industrial landscapes undergoing regeneration, where areas of profound neglect and hyper-curation often sit close to each other.

A Political and Intellectual Memoir of Early Encounters with LAP

A Political and Intellectual Memoir of Early Encounters with <i>LAP</i>

Clinical and Demographic Characteristics of Patient-Initiated Encounters Before the 6-Week Postpartum Visit.

To identify characteristics associated with a higher likelihood of patient-initiated encounters with a health care professional before the scheduled 6-week postpartum visit. We performed a retrospective cohort study of postpartum persons who received prenatal care and delivered at a single academic level IV maternity care center in 2019. We determined associations between maternal sociodemographic and obstetric characteristics and the likelihood of patient-initiated early postpartum encounters with χ2 tests for categorical variables and Wilcoxon rank sum tests for continuous and ordinal variables. A total of 796 patients were included in our analysis, and 324 (40.7%) initiated an early postpartum encounter. Significantly more postpartum persons who initiated early postpartum encounters were primiparous persons (54.3%) than multiparous (33.8%) persons (P < .001). Postpartum persons who desired breastfeeding or who had prolonged maternal hospitalization, episiotomy, or cesarean or operative vaginal delivery were also significantly more likely to initiate early postpartum encounters (all P≤.002). Of postpartum persons who initiated early encounters, 44 (13.6%) initiated in-person visits, 138 (42.6%) initiated telephone or patient portal communication, and 142 (43.8%) initiated encounters of both types. Specifically, 39.2% of postpartum persons initiated at least one early postpartum encounter for lactation support, and nearly half of early postpartum encounters occurred during the first week after hospital discharge. Early postpartum encounters were more common among primiparas and postpartum persons who were breastfeeding or had prolonged hospitalization, episiotomy, cesarean delivery, or operative vaginal delivery. Future studies should focus on the development of evidence-based guidelines for recommending early postpartum visits.

Promoting Student Wellness in Early Encounters with Seriously Ill and Dying Patients

Promoting Student Wellness in Early Encounters with Seriously Ill and Dying Patients

Having a seat at the table—A feminist autoethnography of the university kitchen

Research on the social construction of the scientific personality has shown that one is not simply born a scientist, but rather becomes one through processes of social recognition and attribution. By emphasizing the reciprocal constitution of gender and science, the notion of science as (gender) neutral and objective has been rejected. Although feminist scholars have always recognized the complex ways in which gender (and other social categories) play an important role in how people can or cannot inhabit spaces, little attention has been paid to the role of the university kitchen and its practices in becoming a scholar, and the role of gender in the appropriation of this academic space. The article addresses this research void by using a feminist autoethnographic approach to situate the author’s personal experiences within a broader cultural and social context. The findings show that the practices that take place in the university kitchen (e.g. conversations around the kitchen table) can be understood as symbolic practices in which symbolic capital can be accumulated. These practices are a crucial initiation rite for early career researchers, as they show whether one belongs to the scientific field. Findings suggest that (bodily) orientations shape how the university kitchen appears and what it means to inhabit this space. The results indicate that female early career researchers encounter physical and psychological borders when trying to access the university kitchen. The article thus points to the subtle mechanisms of exclusion and distinction that contradict the self-image of science. Implications for early career researchers and scientific practice are discussed.

Factors Associated With Early Palliative Care Among Patients With Heart Failure.

Background: Heart failure (HF) is a progressive, life-limiting illness for which palliative care (PC) is considered standard of care. Among patients that do receive PC, consultation tends to occur late in the illness course. Objective: Our primary aim was to examine patient factors associated with receiving PC in HF. Secondarily, we sought to determine factors associated with early PC encounters. Design: This was a retrospective cohort study of U.S. Veterans with prior hospitalization who died between January 1, 2011 and December 31, 2020. Setting/Subjects: Subjects were Veterans with HF who died with a prior admission to a Veterans Affairs hospital in the United States. Measurements: We calculated the time from PC encounter to death. We characterized HF patients who died without PC, with late PC (≤90 days before death), and with early PC (>90 days before death). Results: We identified 232,079 Veterans with a mean age of (76.5 ± 10.7) years. Within the cohort, 56.5% (n = 131,122) of Veterans died with no PC, 22.5% (n = 52,114) had PC <90 days before death, and 21.0% (n = 48,843) had PC >90 days before death. Veterans who died without PC tended to be younger with fewer comorbidities. Conclusions: While more than 20% of HF patients in our cohort had PC well in advance of death, more than half died without PC. PC involvement seemed to be driven by comorbidities rather than HF. Effective collaboration with Cardiology is needed to identify patients who would benefit from earlier PC involvement.

Evolving policies, enduring impacts: Cross-sectional surveys of mental health, risk-related perceptions, and coping behaviors throughout China's U-turn in its stringent zero-COVID policy.

China's early encounter with COVID-19 and protracted prevention policies, presents an ideal case to study psychological changes during a prolonged and evolving crisis. This study aims to examine the shifts in mental health symptoms, risk-related perceptions, and associated coping behaviors within two large-scale samples of Chinese respondents, spanning from the pandemic's onset to the relaxation of the zero-COVID policy. Moreover, the study strives to identify protective factors that could potentially mitigate the pandemic's impact. Two online surveys were conducted during China's initial pandemic phase (February 25-28, 2020) and the relaxation of the zero-COVID policy (March 30-April 18, 2023). Participants' mental health indicators, risk-related perceptions, and coping behaviors were assessed using the Depression, Anxiety, and Stress Scale-21 Items, the 9-item Bergen Burnout Inventory, and other adopted scales. Multivariable linear models were employed to examine the enduring psychological impact of the pandemic and identify potential protective factors. Analysis of two datasets comprising 1946 and 1878 participants from the onset and the remission of China's COVID-19 pandemic revealed an upward trend in various mental health indicators of Chinese respondents between 2020 and 2023. Similarly, risk-related perceptions, encompassing perceived severity, susceptibility, and self-efficacy, and risk-related information sharing witnessed an increase. Being female, single, residing in rural areas, having higher education, and lacking acquaintances with COVID-19 are protective factors against mental health risks. Additionally, being female, married, over 30, living in big cities, having higher education, and lacking personal or acquaintances' infection history are associated with engaging in protective behaviors and reduced information avoidance. The study investigated the changes in mental health symptoms, risk-related perceptions, and coping behaviors of Chinese respondents between 2020 and 2023 and identified protective factors against the pandemic's impact, including demographic (gender, age), social (education, marital status, residence), and exposure (infection history) elements. Understanding these fluctuations and protective elements is crucial for policymakers, as it can inform the development of targeted strategies to alleviate negative psychological impacts while effectively managing future pandemics.

Mutation Detection in MYO15A Gene in an Iranian Family with Non-Syndromic Hearing Loss

Hearing loss, recognized as one of the most prevalent sensory disorders, encompasses both syndromic and non-syndromic manifestations, with the identification of 87 genes and over 100 genetic loci in autosomal recessive non-syndromic hearing loss marking significant progress in understanding its genetic basis. In this case report, we showcase a non-syndromic hearing loss scenario involving a 21-year-old man experiencing progressive hearing loss. Through whole-exome sequencing, we unveiled a previously unreported homozygous mutation, c.1178_1179delAC; p.Tyr393Serfs*38, located in exon 2 (NM_016239.4) of the MYO15A gene in the proband. The newly identified mutation, causing a new reading frame (p.Tyr393Serfs*38), results in an early encounter with a stop codon, leading to the formation of a shortened protein. These findings advance our understanding of the molecular mechanisms involved in autosomal recessive non-syndromic hearing loss, contributing to broader scientific knowledge and potential breakthroughs in hearing loss research.

Part II–(Re)imagining Cinematic Histories of Africa: African Women, Cinema, and the Tale of Kadidia Pâté

Abstract: "Le dit du cinéma africain" (The Tale of African Cinema), by the inimitable griothistorian Amadou Hampâté Bâ, is an extraordinary tale of Mali's early encounter with cinema, revealing an equally fascinating story of an early instance of an African woman and cinematic spectatorship. In his tale, he recounts in her own words, his mother Kadidia Pâté's first experience with cinema. This enchanting and edifying rendezvous with the moving image provides us not only with a unique introduction to the histories of African women's encounter with cinema but also to the trans-global nature of these cinematic experiences. As Toni Cade Bambara reminds us, as early as 1897, "operators for Lumière, Meliès, and Edison were presenting, in various countries, programs of flickers shot from all over the world." And in the case of Mali in this tale, movies imposed on the inhabitants who refused to look. This section relates her extraordinary story.

The early encounter: shallow looking and the manifest presence in medical education

If the pressure of patient flow limits a doctor’s visit to fifteen minutes, the importance of the early encounter is increasing. My proposal is dedicated to the first moment of the intersubjective encounter (with art or otherwise), that defined by the unconscious assessment a priori to conscious interpretation, its authority in the clinical encounter, and how to address this moment in medical education.The dynamics between observer and artwork occur in two stages. First, the observer’s senses are attacked, indeed overwhelmed, by the work. Our adaptive unconscious uses reflexive techniques (e.g. thin-slicing) to triage and resolve this information to a more manageable load. Because pattern collection, discovery, and comparison are under unconscious control, the question arises concerning accountability for snap judgments. By studying the patterns that thin-slicing utilizes and our immediate reaction given these patterns, the conscious self can predict—or at least become more accountable—for these judgments.Second, uncomfortable as the victim of a sensory attack, the observer dominates the artwork through the act of interpretation. The observer’s intellect and desire to interpret (both under conscious control) dissolve the uncertainty of the encounter by categorizing it into a comfortable system. Once attuned to this conscious power reversal, we can restrain the unconscious desire prompting the reversal and maintain space in the intersubjective encounter.As visual art is a strong vehicle to discuss the theory behind the dynamics of the early encounter, it is also the appropriate method by which to coach medical students through the early medical encounter.

Forgeries, Falsifications, Fictions, Fälschungen?

This article examines—and rejects—the idea that, in the course of the seventeenth and eighteenth centuries, Europeans who sought to obtain copies of the Vedas were repeatedly duped by having other works (purporting to be Vedas) passed off on them. The focus is on a text entitled “The Essence of the Yajur Veda,” produced by a Pietist missionary, Christoph Theodosius Walther (1699–1741), and a Brahmin identified only as Krishna, published in a German missionary periodical in 1740. This text is examined in the context of a series of similar works produced by Indian intellectuals with, or at the behest of, European missionaries and colonial officials in the seventeenth and eighteenth centuries. Rather than seeing these works as fakes, it is argued here that they are better understood as the outcome of distinctive modes of composition, transmission, and translation of Indian religious literature emerging from the early modern encounter of Indian and European scholars.

Early encounters with Buddhism

Early encounters with Buddhism