bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors for and Prediction Model of Skip Metastasis to Lateral Lymph Nodes in Papillary Thyroid Carcinoma
Authors: Hu Daixing , Lin Huapeng , Zeng Xuan , Wang Tielin , Deng Jie , Su Xinliang
Published: December 2019

Background

Cervical lymph node metastasis is a prognostic factor of papillary thyroid carcinoma (PTC). Skip metastasis (central lymph node negative and lateral lymph node positive) of PTC is not uncommon. This study aimed to retrospectively investigate the risk factors for skip metastasis in PTC and develop a prediction model for skip metastasis.

Methods

A total of 745 PTC patients underwent total thyroidectomy and central plus lateral lymph node dissection at the First Affiliated Hospital of Chongqing Medical University from January 2012 to December 2017. Clinicopathological characteristics were collected and analyzed. Univariate and multivariate analyses were performed to detect the risk factors for skip metastasis. A prediction model was established based on the results of multivariate analyses.

Results

The skip metastasis rate was 9.7% (72/745). Age > 55 years (OR 2.63, 95% CI 1.34–5.04, p = 0.004), tumor located in the upper portion (OR 4.15, 95% CI 2.30–7.63, p = 0.001), and unilaterality (OR 2.76, 95% CI 1.14–8.23, p = 0.040) were independent risk factors for skip metastasis. Clinically lymph node‐negative (cN0) patients with tumor in the upper portion (24.6%, 43/175) had higher possibility of skip metastasis than those of clinically lateral lymph node‐positive (cN1b) patients (5.9%, 10/169) (p = 0.001). The area under the receiver operating characteristic curve of prediction model was 0.734 and 0.740 in derivation group and validation group, respectively. However, skip metastasis was not associated with tumor‐free survival rate of PTC patients (p = 0.274).

Conclusion

Age > 55 years, tumor located in the upper portion, and unilaterality may increase the risk of skip metastasis. We developed the first prediction model for skip metastasis based on clinicopathological parameters in PTC patients.
Aflibercept for choroidal neovascularizations secondary to pseudoxanthoma elasticum: a prospective study
Authors: Gliem Martin , Birtel Johannes , Herrmann Philipp , Fimmers Rolf , Berger Moritz , Coch Christoph , Wingen Almut , Holz Frank G. , Charbel Issa Peter
Published: December 2019

Purpose

To evaluate the use of 2 mg intravitreal aflibercept for treatment of choroidal neovascularization (CNV) secondary to angioid streaks in patients with pseudoxanthoma elasticum (PXE).

Methods

In this 12-month prospective, open-label, uncontrolled, non-randomized interventional clinical trial, 15 PXE patients with CNV (mean age: 53 years, range 22–65) received one initial intravitreal injection of 2 mg aflibercept. Further injections were based on CNV activity at monthly examinations. The primary endpoint was change of best corrected visual acuity (BCVA) after 12 months. Secondary outcomes were change of central retinal thickness (CRT), leakage from CNV, retinal sensitivity, and vision-related quality of life.

Results

BCVA improved from 75.0 ± 10.8 (± SD, Snellen equivalent 20/32) to 79.3 ± 7.3 ETDRS letters (20/32) at final visit (p = 0.083). CRT decreased from 317 ± 81 to 279 ± 51 μm (p = 0.004). Retinal sensitivity on microperimetry changed from 17.8 ± 4.5 to 18.5 ± 4.3 dB (p = 0.103) and vision-related quality of life from a VQF-25 score of 80.7 ± 10.4 to 83.5 ± 14.5 (p = 0.554). The mean number of injections was 6.7 ± 2.6, and 5 participants had persistent or reactivated CNV activity at final visit. The observed adverse events were comparable with studies on aflibercept for other indications.

Conclusion

The results of this study indicate that intravitreal aflibercept is a treatment option for CNV secondary to PXE.
Maternal personality traits moderate treatment response in the Multimodal Treatment Study of attention-deficit/hyperactivity disorder
Authors: Perez Algorta Guillermo , MacPherson Heather A. , Arnold L. Eugene , Hinshaw Stephen P. , Hechtman Lily , Sibley Margaret H. , Owens Elizabeth B.
Published: December 2019

Some mothers of children with attention-deficit/hyperactivity disorder (ADHD) present with maladaptive personality profiles (high neuroticism, low conscientiousness). The moderating effect of maternal personality traits on treatment outcomes for childhood ADHD has not been examined. We evaluate whether maternal neuroticism and conscientiousness moderated response in the Multimodal Treatment Study of Children with ADHD. This is one of the first studies of this type. In a randomized controlled trial (RCT), 579 children aged 7–10 (M = 8.5); 19.7% female; 60.8% White with combined-type ADHD were randomly assigned to systematic medication management (MedMgt) alone, comprehensive multicomponent behavioral treatment (Beh), their combination (Comb), or community comparison treatment-as-usual (CC). Latent class analysis and linear mixed effects models included 437 children whose biological mothers completed the NEO Five-Factor Inventory at baseline. A 3-class solution demonstrated best fit for the NEO: MN&MC = moderate neuroticism and conscientiousness (n = 284); HN&LC = high neuroticism, low conscientiousness (n = 83); LN&HC = low neuroticism, high conscientiousness (n = 70). Per parent-reported symptoms, children of mothers with HN&LC, but not LN&HC, had a significantly better response to Beh than to CC; children of mothers with MN&MC and LN&HC, but not HN&LC, responded better to Comb&MedMgt than to Beh&CC. Per teacher-reported symptoms, children of mothers with HN&LC, but not LN&HC, responded significantly better to Comb than to MedMgt. Children of mothers with high neuroticism and low conscientiousness benefited more from behavioral treatments (Beh vs. CC; Comb vs. MedMgt) than other children. Evaluation of maternal personality may aid in treatment selection for children with ADHD, though additional research on this topic is needed.
The safety and effectiveness of chenodeoxycholic acid treatment in patients with cerebrotendinous xanthomatosis: two retrospective cohort studies
Authors: Verrips Aad , Dotti Maria Teresa , Mignarri Andrea , Stelten Bianca M. L. , Verma Sue , Federico Antonio
Published: December 2019

Objective

To evaluate the safety and effectiveness of chenodeoxycholic acid (CDCA) treatment in patients with cerebrotendinous xanthomatosis (CTX).

Methods

Two retrospective cohort studies were conducted in CTX patients who underwent CDCA treatment: one in the Netherlands (NL; CDCA-STUK-15-001) and one in Italy (IT; CDCA-STRCH-CR-14-001). Eligible patients were aged 2–75 years, had been diagnosed with CTX, and were treated with CDCA orally for ≥1 year. The impact of CDCA treatment on biochemical markers (including serum cholestanol levels) and disease signs and symptoms were assessed, in addition to the safety and tolerability of CDCA treatment.

Results

A total of 35 patients were screened in the NL study and were diagnosed with CTX at 25.6 (± 13.7 SD) years on average. These patients were treated with CDCA and followed up for a median of 9.00 (range: 0.4–26.3) years. In addition, 28 patients were enrolled in the IT study and were diagnosed at 35.0 (± 11.4 SD) years on average (median duration of CDCA treatment: 5.75 [range: 0.0–25.0] years). Signs and symptoms of disease resolved, improved, or remained stable in many patients, with concomitant improvements in biochemical marker levels (serum cholestanol,p< 0.001; 7α-hydroxy-4-cholesten-3-one,p< 0.001 [IT study]).

Conclusions

The outcomes of these retrospective cohort studies indicate that CDCA is effective in the long-term treatment of CTX, with an acceptable safety profile.
A case study and implication: particle finite element modelling of the 2010 Saint-Jude sensitive clay landslide
Authors: Zhang Xue , Wang Liang , Krabbenhoft Kristian , Tinti Stefano
Published: December 2019

Modelling of landslides in sensitive clays has long been recognised as a challenge. The strength reduction of sensitive clays when undergoing plastic deformation makes the failure proceed in a progressive manner such that a small slope failure may lead to a series of retrogressive failures and thus to an unexpected catastrophic landslide. The clay in the entire process may mimic both solid-like (when it is intact) and fluid-like (when fully remoulded, especially for quick clays) behaviours. Thereby, a successful numerical prediction of landslides in sensitive clays requires not only a robust numerical approach capable of handling extreme material deformation but also a sophisticated constitutive model to describe the complex clay behaviour. In this paper, the particle finite element method (PFEM) associated with an elastoviscoplastic model with strain softening is adopted for the reconstruction of the 2010 Saint-Jude landslide, Quebec, Canada, and detailed comparisons between the simulation results and available data are carried out. It is shown that the present computational framework is capable of quantitatively reproducing the multiple rotational retrogressive failure process, the final run-out distance and the retrogression distance of the Saint-Jude landslide. Furthermore, the failure mechanism and the kinematics of the Saint-Jude landslide and the influence of the clay viscosity are investigated numerically, and in addition, their implications to real landslides in sensitive clays are discussed.
An Exploratory Study of Imagining Sounds and “Hearing” Music in Autism
Authors: Bacon Alex , Beaman C. Philip , Liu Fang
Published: December 2019

Individuals with autism spectrum disorder (ASD) reportedly possess preserved or superior music-processing skills compared to their typically developing counterparts. We examined auditory imagery and earworms (tunes that get “stuck” in the head) in adults with ASD and controls. Both groups completed a short earworm questionnaire together with the Bucknell Auditory Imagery Scale. Results showed poorer auditory imagery in the ASD group for all types of auditory imagery. However, the ASD group did not report fewer earworms than matched controls. These data suggest a possible basis in poor auditory imagery for poor prosody in ASD, but also highlight a separability between auditory imagery and control of musical memories. The separability is present in the ASD group but not in typically developing individuals.
Positive legacy effect of previous legume proportion in a ley on the performance of a following crop of Lolium multiflorum
Authors: Fox Aaron , Suter Matthias , Widmer Franco , Lüscher Andreas
Published: December 2019

Aims

We investigated the legacy effects of a previous ley’s legume proportion on the performance of a following grass crop in a rotation.

Methods

In April 2015, a pure Lolium multiflorum L. crop was sown after the removal of legume containing swards (0–100% legumes), and was harvested four times over the following one-year period (3 times in 2015 and once the following April 2016). Labeled 15N fertilizer (50 kg N ha−1) was applied during the 2nd and 3rd re-growth periods to determine N fluxes.

Results

Across the one-year period, a significant legume-legacy induced increase in biomass yield of L. multiflorum was observed over the entire range of previous legume proportions when compared against the non-legume ley, the effect being 2.15 and 1.73 t ha−1 (P ≤ 0.001 each) in swards with 50% and 100% previous legume proportion, respectively, or up to +31%. The legume-legacy effect on biomass yield was most pronounced at the 1st harvest (June) and persisted into the 2nd harvest in August (P ≤ 0.05 both, over the entire range of previous legume proportion), though was no longer evident at the 3rd harvest (September). Importantly, the legume-legacy effect returned in the 4th harvest in April (P ≤ 0.05). Examining the source of N contributing to N yield confirmed that more N was derived from the soil at harvest 1 and 2 for previous legume containing leys (P ≤ 0.001) compared to those which contained no legumes, with a significant increase still seen for legume mixtures at harvest 3 (P ≤ 0.01).

Conclusions

The results demonstrate a sustained soil-transferred performance-enhancing legacy effect on a following crop in a rotation, with previous legume proportions of 50% having a comparable effect compared with that of a previous legume monoculture.
Macroalgal Bioindicators of Recovery from Eutrophication in a Tidal Lagoon Following Wastewater Diversion and Earthquake Disturbance
Authors: Barr Neill , Zeldis John , Scheuer Kristin , Schiel David
Published: December 2019

Together, macroalgal tissue biochemical nitrogen indices (N-indices) and macroalgal abundance can be used as bioindicators of N-enrichment in estuaries. In this study, we examine the extent and rates of response of Ulva bioindicators during rapid N-enrichment perturbations in the eutrophic Avon-Heathcote Estuary (AHE) (Christchurch, New Zealand). With the diversion of the city’s wastewater discharge away from the estuary in March 2010, a ~ 90% reduction in the estuary’s N-concentration was expected. In turn, this was expected to reduce macroalgal biomass and improve the overall trophic condition of the estuary. We surveyed Ulva bioindicators over a five-year period spanning the diversion. There was a rapid (within one year) transition away from eutrophic condition reflected in N-indices (tissue-chlorophyll, -free amino acids, -N and -δ15N) following wastewater diversion, towards values corresponding with ‘cleaner’ water quality. This was accompanied by large reductions in Ulva percent cover, based on seasonal surveys conducted from 2001 to 2014. However, two large earthquakes in February and June 2011 caused a breakdown of the city’s wastewater infrastructure, resulting in overflows of untreated sewage into the estuary between February and November 2011. The re-enrichment of N and changes in N-sources (treated versus untreated sewage) were rapidly reflected in Ulva bioindicators, notably δ15N. Following repair of infrastructure, Ulva bioindicators again reverted towards a less eutrophic state. Overall, bioindicators were sensitive to changes in N-availability and N-source, and useful for identifying the position of algal populations on a eutrophic-to-oligotrophic gradient. These attributes demonstrated their utility as adjuncts to water quality monitoring and algal biomass surveys.
Coupling to Variant Information: an Ecological Account of Comparative Mental Imagery Generation
Authors: Sims Matthew
Published: December 2019

Action-based theories of cognition place primary emphasis upon the role that agent-environment coupling plays in the emergence of psychological states. Prima facie, mental imagery seems to present a problem for some of these theories because it is understood to be stimulus-absent and thus thought to be decoupled from the environment. However, mental imagery is much more multifaceted than this “naïve” view suggests. Focusing on a particular kind of imagery, comparative mental imagery generation, this paper demonstrates that although such imagery is stimulus-absent, it is also stimulus-sensitive. Exhibiting stimulus-sensitivity is sufficient for a process to qualify as coupled to the environment. The notion of variant coupling is explicated as the coupling of a cognizer’s perceptual system to variant environmental information. By demarcating the categories of stimulus-absent and stimulus-sensitive cognition, and variant and invariant coupling, this paper expands the conceptual apparatus of action-based theories, suggesting not only a way to address the problem that comparative mental imagery generation presents, but perhaps a way to account for other forms of imagery too.
A Thematic Analysis of the Online Discussion Board, FrankTalk, Regarding Penile Implant
Authors: Lu Jennifer Y. , Miller Eric J. , Welliver Charles
Published: December 2019

Introduction

Medical websites and discussion boards are commonly used by patients to obtain information. The online forum FrankTalk.org provides a venue specifically for men to discuss sexual dysfunction and particularly inflatable penile prosthesis (IPP). By querying and better understanding the content of this forum related to implants, we can better understand patient concerns before and after IPP.

Aim

The aim of this study is to understand the main topics being discussed about IPPs online and to use these topics to understand patient concerns and patient needs and to improve care.

Methods

Messages posted in a 6-month window from January 2018 to June 2018 under the topic “Implant” were identified on FrankTalk.org. Posts were broken down into preoperative and postoperative and then organized using a 3-stage analysis to determine central themes of each post: open coding, axial coding, and selective coding.

Main Outcome Measure

The primary outcome measure is the prevalence of each selective code.

Results

Of all 587 posts, 304 were written preoperatively with the most common theme being “Size” (23.0%), followed by “seeking support” (18.4%). 283 posts were considered postoperative, of which the most common theme was “Concern about healing” (22.6 %) which questioned if they needed to see a physician, followed by size concerns (20.1%).When analyzed with the 3-stage coding system, there were a total of 41 axial codes which were organized into 6 selective codes: “Social Support” (27.8% of all posts), “Pre-Operative Worries” (23.58%),“Technical Issues” (11.1%), “Prosthesis Logistics” (14.37%), “Post-Operative Worries” (20.22%), “Forum and Misc” (2.93%) for topics outside the scope of penile prosthesis.

Clinical Implications

The percentage of men seeking medical opinion is concerning, and providers should consider using resources to better educate patients on normal postoperative findings. Implanters should continue to preoperatively counsel patients on size-related changes with surgery.

Strength & Limitations

Strengths include the use of a common online website for men to discuss IPPs and a systematic coding system. Limitations include the applicability of these results to nonheterosexual men as these are likely oversampled in this population. The inherent bias of those willing to post on an online forum may have influenced results along with no oversight for factual accuracy.

Conclusion

Patients use online discussion boards like FrankTalk.org for social support, medical advice, and validation of their concerns. Providers should be aware of these online topic focuses to help open a discussion with patients about concerns they may feel are difficult to approach with providers.
Thrombotic Microangiopathy Following Hypnale zara (Hump-Nosed Pit Viper) Envenoming: The First Known Case Report from Sri Lanka
Authors: Namal Rathnayaka Rathnayaka Mudiyanselage M.K. , Nishanthi Ranathunga P.E. Anusha , Kularatne Senanayake A.M.
Published: December 2019

A 65-y-old previously healthy farmer developed thrombotic microangiopathy (TMA) comprising the triad of acute kidney injury, microangiopathic haemolysis, and thrombocytopenia after a proven Hypnale zara (hump-nosed pit viper) bite. He developed coagulopathy, which was treated with fresh frozen plasma, and underwent 8 cycles of hemodialysis. He is being followed up in the nephrology clinic for acute kidney injury. TMA caused by Hypnale hypnale, the commonest species of genus Hypnale, has previously been reported, but this is the first known case of TMA following a bite by H zara, the endemic species in Sri Lanka.
Application of GO methodology in reliability analysis of aircraft flap hydraulic system
Authors: Ma J. , Duan F.
Published: December 2019

The Goal-Oriented methodology (GO methodology) is an effective method for the reliability analysis of complex systems. It is especially suitable for the reliability analysis of multi-state complex systems containing the actual logistics, such as current, airflow and liquid flow. In order to solve the limitation that the GO methodology is not suitable for the reliability analysis of the system with feedback loop, the Boolean algebra idea is introduced to construct the Boolean operation formula of the feedback loop. In this paper, a certain type of civil aircraft flap hydraulic system with feedback loop is taken as the research object. According to the structural schematic diagram of the flap hydraulic system, the GO model of the flap hydraulic system is established. Next, the GO calculation is carried out to obtain the reliability of the flap hydraulic system. The comparison between the system reliability without feedback loop and that with feedback loop proves that the GO methodology with feedback loop is more accurate. The reliability of the system is analyzed by using the fault tree analysis (FTA) method, and the GO methodology with feedback loop is compared with the FTA method to verify the availability and correctness of the GO methodology in the reliability analysis and safety evaluation of aircraft flap hydraulic system.
Happiness, public policy and the notion of development
Authors: ROJAS MARIANO
Published: December 2019

The Happiness Movement is moving from research to action; this contribution discusses some public policy issues that emerge in this process. The paper also states that the Happiness Movement proposes a new notion of development and a new narrative of social progress. The contribution argues that wellbeing is a goal of governments, but also, fundamentally, a goal of societies.
Association between statewide adoption of the CDC’s Core Elements of Hospital Antimicrobial Stewardship Programs and rates of methicillin-resistant Staphylococcus aureus bacteremia and Clostridioides difficile infection in the United States
Authors: Garcia Reeves Alessandra B. , Lewis James W. , Trogdon Justin G. , Stearns Sally C. , Weber David J. , Weinberger Morris
Published: December 2019

Objective:

To measure the association between statewide adoption of the Centers for Disease Control and Prevention’s (CDC’s) Core Elements for Hospital Antimicrobial Stewardship Programs (Core Elements) and hospital-associated methicillin-resistant Staphylococcus aureus bacteremia (MRSA) and Clostridioides difficile infection (CDI) rates in the United States. We hypothesized that states with a higher percentage of reported compliance with the Core Elements have significantly lower MRSA and CDI rates.

Participants:

All US states.

Design:

Observational longitudinal study.

Methods:

We used 2014–2016 data from Hospital Compare, Provider of Service files, Medicare cost reports, and the CDC’s Patient Safety Atlas website. Outcomes were MRSA standardized infection ratio (SIR) and CDI SIR. The key explanatory variable was the percentage of hospitals that meet the Core Elements in each state. We estimated state and time fixed-effects models with time-variant controls, and we weighted our analyses for the number of hospitals in the state.

Results:

The percentage of hospitals reporting compliance with the Core Elements between 2014 and 2016 increased in all states. A 1% increase in reported ASP compliance was associated with a 0.3% decrease (P < .01) in CDIs in 2016 relative to 2014. We did not find an association for MRSA infections.

Conclusions:

Increasing documentation of the Core Elements may be associated with decreases in the CDI SIR. We did not find evidence of such an association for the MRSA SIR, probably due to the short length of the study and variety of stewardship strategies that ASPs may encompass.
Let's explore with a divided team! The effects of top management team demographic faultlines on technological exploration
Authors: Li Mengge , Liu Kun (Carl)
Published: December 2019

Research on top management team (TMT) diversity suggests that diverse backgrounds improve technological exploration. However, this diversity may also cause demographic faultlines that break a team into subgroups and undermine team performance, and the status difference between CEO and top managers may change inter-subgroup dynamics. We predicted that TMT faultline had an inverted U-shape relationship with technological exploration. Further, we predicted that the effects of TMT faultline were more prominent when the CEO is in the minority subgroup than when the CEO was in the majority subgroup. Using a longitudinal sample from the US IT services industry, the results found that TMT faultline exhibited an inverted U-shape relationship with technological exploration only when the CEO was in the minority subgroup, and such relationship disappeared when the CEO was in the majority subgroup.
Luminescence chronology and lithic technology of Tianhuadong Cave, an early Upper Pleistocene Paleolithic site in southwest China
Authors: Hu Yue , Ruan Qijun , Liu Jianhui , Marwick Ben , Li Bo
Published: December 2019

Tianhuadong is a cave site located in the northwest of Yunnan Province, China. Since 2010, several surveys and one test excavation have yielded more than 1000 stone artifacts. The lithic assemblage shows some features of Levallois and Quina technologies, similar to those found in Middle Paleolithic sites in the Western Hemisphere. In this study, we summarize the lithic industry and propose a reliable chronology for the site using optically stimulated luminescence (OSL) dating of individual quartz grains extracted from sediments. We applied the standardized growth curve method to deal with the problem associated with the saturation in natural OSL signals in quartz. Our dating results yielded ages of 90–40 ka, suggesting that the associated lithic assemblage could be assigned to Marine Oxygen Isotope Stages 5 and 4 and could potentially represent Middle Paleolithic technologies. Because the number of Middle Paleolithic sites in southwest China is small, this site provides one of the few traces of human occupation in southwest China during the early upper Pleistocene. Thus, it is important for understanding hominin evolution and dispersal in this region.
Ecchordosis physaliphora: a cautionary tale
Authors: Georgalas C , Terzakis D , Tsikna M , Alatzidou Z , de Santi S , Seccia V , Dallan I
Published: December 2019

Background

Ecchordosis physaliphora is a congenital, benign lesion originating from notochordal remnants along the craniospinal axis, most frequently located at the level of the clivus and sacrum. Sometimes ecchordosis physaliphora is difficult to recognise and treat, with a total of twenty-six cases described in the literature.

Methods

This study reports on three cases of previously undiagnosed ecchordosis physaliphora presenting with cerebrospinal fluid rhinorrhoea and meningitis.

Conclusion

Endoscopic transclival or transsphenoid surgery including three-layer (fat, fascia and nasoseptal flap) reconstruction was used in all cases with complete resolution of the symptoms.
Systematic epidemiological and clinical comparisons across all 12 DSM-IV psychotic diagnoses in the Cavan–Monaghan First Episode Psychosis Study (CAMFEPS)
Authors: Nkire Nnamdi , Scully Paul J. , Browne David J. , Baldwin Patrizia A. , Kingston Tara , Owoeye Olabisi , Kinsella Anthony , O'Callaghan Eadbhard , Russell Vincent , Waddington John L.
Published: December 2019

Background

Research on psychotic illness is loosening emphasis on diagnostic stringency in favour of including a more dimensionally based conceptualization of psychopathology and pathobiology. However, to clarify these notions requires investigation of the full scope of psychotic diagnoses.

Methods

The Cavan–Monaghan First Episode Psychosis Study ascertained cases of first episode psychosis across all 12 DSM-IV psychotic diagnoses via all routes to care: public, private or forensic; home-based, outpatient or inpatient. There was no arbitrary upper age cut-off and minimal impact of factors associated with variations in social milieu, ethnicity or urbanicity. Cases were evaluated epidemiologically and assessed for psychopathology, neuropsychology, neurology, antecedent factors, insight and quality of life.

Results

Among 432 cases, the annual incidence of any DSM-IV psychotic diagnosis was 34.1/100 000 of population and encompassed functional psychotic diagnoses, substance-induced psychopathology and psychopathology due to general medical conditions, through to psychotic illness that defied contemporary diagnostic algorithms. These 12 DSM-IV diagnostic categories, including psychotic disorder not otherwise specified, showed clinical profiles that were consistently more similar than distinct.

Conclusions

There are considerable similarities and overlaps across a broad range of diagnostic categories in the absence of robust discontinuities between them. Thus, psychotic illness may be of such continuity that it cannot be fully captured by operational diagnostic algorithms that, at least in part, assume discontinuities. This may reflect the impact of diverse factors each of which acts on one or more overlapping components of a common, dysfunctional neuronal network implicated in the pathobiology of psychotic illness.
Reevaluating Benefits in the Moral Justification of Animal Research: A Comment on “Necessary Conditions for Morally Responsible Animal Research”
Authors: EGGEL MATTHIAS , NEUHAUS CAROLYN P. , GRIMM HERWIG
Published: December 2019

In a recent paper in Cambridge Quarterly of Healthcare Ethics on the necessary conditions for morally responsible animal research David DeGrazia and Jeff Sebo claim that the key requirements for morally responsible animal research are (1) an assertion of sufficient net benefit, (2) a worthwhile-life condition, and (3) a no-unnecessary-harm condition. With regards to the assertion (or expectation) of sufficient net benefit (ASNB), the authors claim that morally responsible research offers unique benefits to humans that outweigh the costs and harms to humans and animals. In this commentary we will raise epistemic, practical, and ethical challenges to DeGrazia and Sebo’s emphasis on benefits in the prospective assessment of research studies involving animals. We do not disagree with DeGrazia and Sebo that, at the theoretical level, the benefits of research justify our using animals. Our contribution intends to clarify, at the practical level, how we should understand benefits in the prospective assessment and moral justification of animal research. We argue that ASNB should be understood as an assessment of Expectation of Knowledge Production (EKP) in the prospective assessment and justification of animal research. EKP breaks down into two further claims: (1) that morally responsible research generates knowledge worth having and (2) that morally responsible research is designed and executed to produce generalizable knowledge. We understand the condition called knowledge worth having as scientists’ testing a hypothesis that, whether verified or falsified, advances an important interest, and production of generalizable knowledge in terms of scientific integrity. Generalizable knowledge refers to experimental results that generalize to a larger population beyond the animals studied. Generalizable scientific knowledge is reliable, replicable, and accurately descriptive. In sum, morally responsible research will be designed and carefully executed to successfully test a hypothesis that, whether verified or falsified, advances important interests. Our formulation of EKP, crucially, does not require further showing that an experiment involving animals will produce societal benefits.
A Dashboard to Improve the Alignment of Healthcare Organization Decisionmaking to Core Values and Mission Statement
Authors: LAHEY TIMOTHY , NELSON WILLIAM
Published: December 2019

The mission and value statements of healthcare organizations serve as the foundational philosophy that informs all aspects of the organization. The ultimate goal is seamless alignment of values to mission in a way that colors the overall life and culture of the organization. However, full alignment between healthcare organizational values and mission in a fashion that influences the daily life and culture of healthcare organizations does not always occur. Grounded in the belief that a lack of organizational alignment to explicit organizational mission and value statements often stems from the failure to develop processes that enable realization of the leadership’s good intentions, the authors propose an organizational ethics dashboard to empower leaders of healthcare organizations to assess the adequacy of systems in place to support alignment with the stated ethical mission.
Combined Focused Ion Beam-Ultramicrotomy Method for TEM Specimen Preparation of Porous Fine-Grained Materials
Authors: Ohtaki Kenta K. , Ishii Hope A. , Bradley John P.
Published: December 2019

A new transmission electron microscopy (TEM) specimen preparation method that utilizes a combination of focused ion beam (FIB) methods and ultramicrotomy is demonstrated. This combined method retains the benefit of site-specific sampling by FIB but eliminates ion beam-induced damage except at specimen edges and allows recovery of many consecutive sections. It is best applied to porous and/or fine-grained materials that are amenable to ultramicrotomy but are located in bulk samples that are not. The method is ideal for unique samples from which every specimen is precious, and we demonstrate its utility on fine-grained material from the one-of-a-kind Paris meteorite. Compared with a specimen prepared by conventional FIB methods, the final sections are uniformly thin and free from re-deposition and curtaining artifacts common in FIB specimens prepared from porous, heterogeneous samples.
Approaches to Exploring Spatio-Temporal Surface Dynamics in Nanoparticles with In Situ Transmission Electron Microscopy
Authors: Lawrence Ethan L. , Levin Barnaby D.A. , Miller Benjamin K. , Crozier Peter A.
Published: December 2019

Many nanoparticles in fields such as heterogeneous catalysis undergo surface structural fluctuations during chemical reactions, which may control functionality. These dynamic structural changes may be ideally investigated with time-resolved in situ electron microscopy. We have explored approaches for extracting quantitative information from large time-resolved image data sets with a low signal to noise recorded with a direct electron detector on an aberration-corrected transmission electron microscope. We focus on quantitatively characterizing beam-induced dynamic structural rearrangements taking place on the surface of CeO2 (ceria). A 2D Gaussian fitting procedure is employed to determine the position and occupancy of each atomic column in the nanoparticle with a temporal resolution of 2.5 ms and a spatial precision of 0.25 Å. Local rapid lattice expansions/contractions and atomic migration were revealed to occur on the (100) surface, whereas (111) surfaces were relatively stable throughout the experiment. The application of this methodology to other materials will provide new insights into the behavior of nanoparticle surface reconstructions that were previously inaccessible using other methods, which will have important consequences for the understanding of dynamic structure–property relationships.
High Suicide Rates Among Unaccompanied Minors/Youth Seeking Asylum in Sweden
Authors: Mittendorfer-Rutz Ellenor , Hagström Ana , Hollander Anna-Clara
Published: December 2019

Abstract. Background and aim: We aimed to assess rates and background factors of suicide among unaccompanied minors/youth (10–21 years of age) seeking asylum in Sweden in 2017, and to compare these rates with rates in the Swedish general population of the same age. Method: Data were collected and validated using information from four governmental agencies and two nongovernmental organizations. Suicide rates were calculated for 100,000 individuals. Results: The suicide rate was 51.2 per 100,000 among unaccompanied minors/youth, which compares to 6.1 per 100,000 in the host population. Characteristics of asylum seekers who died by suicide were: male gender (100%) and from Afghanistan (83%). Hanging was the predominant method (60%). Limitations: As estimation of an exact population of asylum seekers is difficult; we overestimated the number of individuals in the population of asylum seekers, resulting in an underestimation of their suicide rates. Conclusion: The suicide rate in unaccompanied minors/youth seeking asylum in 2017 in Sweden can be regarded as very high. Rapid implementation of suicide preventive measures is warranted.
Identifying Suicide Typologies Among Trauma-Exposed Veterans
Authors: Bounoua Nadia , Hayes Jasmeet P. , Sadeh Naomi
Published: December 2019

Abstract. Background: Suicide among veterans has increased in recent years, making the identification of those at greatest risk for self-injurious behavior a high research priority. Aims: We investigated whether affective impulsivity and risky behaviors distinguished typologies of self-injurious thoughts and behaviors in a sample of trauma-exposed veterans. Method: A total of 95 trauma-exposed veterans (ages 21–55; 87% men) completed self-report measures of self-injurious thoughts and behaviors, impulsivity, and clinical symptoms. Results: A latent profile analysis produced three classes that differed in suicidal ideation, suicide attempts and nonsuicidal self-injury (NSSI): A low class that reported little to no self-injurious thoughts or behaviors; a self-injurious thoughts (ST) class that endorsed high levels of ideation but no self-harm behaviors; and a self-injurious thoughts and behaviors (STaB) class that reported ideation, suicide attempts and NSSI. Membership in the STaB class was associated with greater affective impulsivity, disinhibition, and distress/arousal than the other two classes. Limitations: Limitations include an overrepresentation of males in our sample, the cross-sectional nature of the data, and reliance on self-report measures. Conclusion: Findings point to affective impulsivity and risky behaviors as important characteristics of veterans who engage in self-injurious behaviors.
Natural Disasters Are Prejudiced Against Disadvantaged and Vulnerable Populations: The Lack of Publicly Available Health‐Related Data Hinders Research at the Cusp of the Global Climate Crisis
Authors: Mazdiyasni Omid , AghaKouchak Amir
Published: December 2019

Natural disasters often affect the most vulnerable countries/communities around the world. However, within the same countries/communities, the impact of natural disasters is far greater on disadvantaged populations. We investigate how wildfires affect asthma prevalence in different populations across California. Our results indicate that although there is no discernible relationship between wildfires and asthma prevalence for California's population as a whole, wildfires and asthma prevalence in Black and senior populations have a strong relationship. We believe there is an urgent need to make high‐resolution health‐related data publicly available for in‐depth analyses of climate change impacts on society and disadvantage communities
Ionospheric D Region Parameters Obtained Using VLF Measurements in the South Pacific Region
Authors: Kumar Abhikesh , Kumar Sushil
Published: December 2019

The diurnal variations in the phase and amplitude of very low frequency (VLF) transmissions with the call signs NWC, NPM, and NLK, received at Suva, Fiji, have been modeled using the Long Wave Propagation Capability (V2.1) code to determine the ionospheric D region parameters, H΄ (reference height), and β (rate of increase of electron density with height), for different daytime and nighttime conditions along the transmitter‐receiver great circle paths (TRGCPs). Measured VLF signal amplitude and phase show explicit variation over the day and nighttime along a TRGCP, also revealing amplitude minima and phase steps during sunrise and sunset as the day/night terminator traverses a TRGCP. While the daytime signal strength is reasonably smooth, at nighttime, the signal exhibits a great deal of variability. For three signal paths, the mean daytime H΄ and β were found to be 70.7 km and 0.40 km−1, respectively, while nighttime mean values of these parameters were found to be 84.2 km and 0.68 km‐1, respectively. The temporal and day‐to‐day variability of the nighttime D region parameters shows that H΄ and β ranges in between 83.0 and 85.0 km and 0.58 and 0.80 km−1, respectively. One of the possible sources of nighttime signal variability is increase in the number of modes propagating and relative complex interference between them along the TRGCPs, whereby the weaker modes also become significant at night due to reduced attenuation. In addition, the variations in the nighttime D region may also be a cause of high signal variability.
Support Vector Machine Classification of Seismic Events in the Tianshan Orogenic Belt
Authors: Tang Lanlan , Zhang Miao , Wen Lianxing
Published: December 2019

Discriminating between various types of seismic events is of significant scientific and societal importance. We use a machine learning method employing support vector machine (SVM) to classify tectonic earthquakes (TEs), quarry blasts (QBs), and induced earthquakes (IEs) among 30,181 1.5 <ML<2.9 seismic events that occurred in the Tianshan orogenic belt in China from 2009 to 2017. SVM classifiers are derived based on discriminant features of a training data set consisting of 1,400 TEs selected from the aftershock sequences of 18ML≥ 5.0 earthquakes, 2,881 QBs from repeating events occurring in those areas with a percentage of event daytime occurrence greater than 0.9, and 987 IEs from events in the known oil/gas fields and water reservoirs. The discriminant features include spectral amplitudes of observed P and S wave signals in a frequency range of 1–15 Hz normalized by the P spectrum and averaged over the entire seismic network, and an optional feature of the percentage of event daytime occurrence. Statistics analyses indicate that the accuracies of the SVM classifiers are 99.81% for TEs, 99.93% for QBs, and 99.62% for IEs. Our classification indicates that 37.57% of the seismic events are QBs occurring in possible mine areas and appearing mostly as clusters with a percentage of event daytime occurrence greater than 0.9, 50.12% are TEs occurring in various thrust faults in the Tianshan orogenic belt, and 12.31% are IEs or shallow tectonic earthquakes occurring mostly as clusters near oil and gas fields and water reservoirs. We reevaluatebvalues in the region and obtain relatively uniform values for the classified TEs with most of them below 1.0, as opposed to a large range of values (0.5–2.7) when all the seismic events are used in the analysis.
From Andes to Amazon: Assessing Branched Tetraether Lipids as Tracers for Soil Organic Carbon in the Madre de Dios River System
Authors: Kirkels Frédérique M. S. A. , Ponton Camilo , Galy Valier , West A. Joshua , Feakins Sarah J. , Peterse Francien
Published: December 2019

We investigate the implications of upstream processes and hydrological seasonality on the transfer of soil organic carbon (OC) from the Andes mountains to the Amazon lowlands by the Madre de Dios River (Peru), using branched glycerol dialkyl glycerol tetraether (brGDGT) lipids. The brGDGT signal in Andean soils (0.5 to 3.5 km elevation) reflects air temperature, with a lapse rate of −6.0 °C/km elevation (r2 = 0.89, p < 0.001) and −5.6 °C/km elevation (r2 = 0.89, p < 0.001) for organic and mineral horizons, respectively. The same compounds are present in river suspended particulate matter (SPM) with a lapse rate of −4.1 °C/km elevation (r2 = 0.82, p < 0.001) during the wet season, where the offset in intercept between the temperature lapse rates for soils and SPM indicates upstream sourcing of brGDGTs. The lapse rate for SPM appears insensitive to an increasing relative contribution of 6‐methyl isomer brGDGTs produced within the river. River depth profiles show that brGDGTs are well mixed in the river and are not affected by hydrodynamic sorting. The brGDGTs accumulate relative to OC downstream, likely due to the transition of particulate OC to the dissolved phase and input of weathered soils toward the lowlands. The temperature‐altitude correlation of brGDGTs in Madre de Dios SPM contrasts with the Lower Amazon River, where the initial soil signature is altered by changes in seasonal in‐river production and variable provenance of brGDGTs. Our study indicates that brGDGTs in the Madre de Dios River system are initially soil derived and highlights their use to study OC sourcing in mountainous river systems.
scRNA-seq in medulloblastoma shows cellular heterogeneity and lineage expansion support resistance to SHH inhibitor therapy
Authors: Ocasio Jennifer Karin , Babcock Benjamin , Malawsky Daniel , Weir Seth J. , Loo Lipin , Simon Jeremy M. , Zylka Mark J. , Hwang Duhyeong , Dismuke Taylor , Sokolsky Marina , Rosen Elias P. , Vibhakar Rajeev , Zhang Jiao , Saulnier Olivier , Vladoiu Maria , El-Hamamy Ibrahim , Stein Lincoln D. , Taylor Michael D. , Smith Kyle S. , Northcott Paul A. , Colaneri Alejandro , Wilhelmsen Kirk , Gershon Timothy R.
Published: December 2019

Targeting oncogenic pathways holds promise for brain tumor treatment, but inhibition of Sonic Hedgehog (SHH) signaling has failed in SHH-driven medulloblastoma. Cellular diversity within tumors and reduced lineage commitment can undermine targeted therapy by increasing the probability of treatment-resistant populations. Using single-cell RNA-seq and lineage tracing, we analyzed cellular diversity in medulloblastomas in transgenic, medulloblastoma-prone mice, and responses to the SHH-pathway inhibitor vismodegib. In untreated tumors, we find expected stromal cells and tumor-derived cells showing either a spectrum of neural progenitor-differentiation states or glial and stem cell markers. Vismodegib reduces the proliferative population and increases differentiation. However, specific cell types in vismodegib-treated tumors remain proliferative, showing either persistent SHH-pathway activation or stem cell characteristics. Our data show that even in tumors with a single pathway-activating mutation, diverse mechanisms drive tumor growth. This diversity confers early resistance to targeted inhibitor therapy, demonstrating the need to target multiple pathways simultaneously.
Standing genetic variation fuels rapid adaptation to ocean acidification
Authors: Bitter M. C. , Kapsenberg L. , Gattuso J.-P. , Pfister C. A.
Published: December 2019

Global climate change has intensified the need to assess the capacity for natural populations to adapt to abrupt shifts in the environment. Reductions in seawater pH constitute a conspicuous global change stressor that is affecting marine ecosystems globally. Here, we quantify the phenotypic and genetic modifications associated with rapid adaptation to reduced seawater pH in the Mediterranean mussel, Mytilus galloprovincialis. We reared a genetically diverse larval population in two pH treatments (pHT 8.1 and 7.4) and tracked changes in the shell-size distribution and genetic variation through settlement. Additionally, we identified differences in the signatures of selection on shell growth in each pH environment. Both phenotypic and genetic data show that standing variation can facilitate adaptation to declines in seawater pH. This work provides insight into the processes underpinning rapid evolution, and demonstrates the importance of maintaining variation within natural populations to bolster species’ adaptive capacity as global change progresses.