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A variety of larvae and parthenitae of trematodes have been detected in gastropods in the intertidal zone in Japan. However, because of the difficulty associated with the morphological identification of these stages, they have rarely been identified to the species or higher taxonomic levels. In this study, trematodes of these stages were sampled from intertidal gastropods in the Japanese coastal regions and were identified to the species, genus, or family levels morphologically and molecularly to elucidate or predict their life cycles. Investigation of 17 gastropod species (682 individuals in total) from 14 localities led to the detection of trematodes in 47 individuals belonging to six snail species. The infected gastropods were morphologically identified as Nipponacmea fuscoviridis, Monodonta confusa, Trochus sacellum, Batillaria attramentaria, Littorina brevicula, and Purpuradusta gracilis. Our molecular analyses revealed that sporocysts, rediae, and metacercariae from the gastropods were divided into 14 species belonging to nine families: Philophthalmidae, Fellodistomidae, Gymnophallidae, Lepocreadiidae, Heterophyidae, Opisthorchiidae, Notocotylidae, Microphallidae, and Opecoelidae. These trematodes were thought to use fishes, octopuses, seabirds, and marine mammals as their definitive hosts. Marine organisms such as jellyfishes, crustaceans, and fishes are also thought to act as the second intermediate and paratenic hosts of few present trematode species. As for the other trematode species, DNA barcodes of trematodes from various marine organisms will also illuminate the life cycles in future.
Background: Quality of life (QoL) is the awareness of individuals’ well-being in life in physical, personal, mental and social wellbeing and needs to be addressed in brain tumor patients. Methods: A retrospective study conducted in 2017 in a single academic center that included patients diagnosed with brain tumors in a 10 year period. The assessment of the QoL was done using the European Organization for Research and Treatment of Cancer (EORTC), a standardized model (QLQ-C30) that assess several domains (Global Health, Physical function, Role functioning, Emotional Functioning, Cognitive functioning, social functioning and symptoms domain) and Brain cancer model (BN20) to assess symptoms to evaluate all aspects of wellbeing. Results: The total number of patients included in this study is 76 patients with no gender predilection. The most common brain tumor was meningioma by 40% followed by glioma/ others. More than half of the brain tumor patients had a WHO grade I (65%), intermediate grading grade II (15%) and higher grading grade III/IV (20%). The scales and measurements of functioning in life were low in all types of brain tumors. Conclusions: Quality of life in brain tumor patients seemed poor regardless of the type. Further prospective studies are needed to assess QoL worldwide.
Obesity is highly prevalent and disabling, especially in individuals with severe mental illness including bipolar disorders (BD). The brain is a target organ for both obesity and BD. Yet, we do not understand how cortical brain alterations in BD and obesity interact.
Methods:
We obtained body mass index (BMI) and MRI-derived regional cortical thickness, surface area from 1231 BD and 1601 control individuals from 13 countries within the ENIGMA-BD Working Group. We jointly modeled the statistical effects of BD and BMI on brain structure using mixed effects and tested for interaction and mediation. We also investigated the impact of medications on the BMI-related associations.
Results:
BMI and BD additively impacted the structure of many of the same brain regions. Both BMI and BD were negatively associated with cortical thickness, but not surface area. In most regions the number of jointly used psychiatric medication classes remained associated with lower cortical thickness when controlling for BMI. In a single region, fusiform gyrus, about a third of the negative association between number of jointly used psychiatric medications and cortical thickness was mediated by association between the number of medications and higher BMI.
Conclusions:
We confirmed consistent associations between higher BMI and lower cortical thickness, but not surface area, across the cerebral mantle, in regions which were also associated with BD. Higher BMI in people with BD indicated more pronounced brain alterations. BMI is important for understanding the neuroanatomical changes in BD and the effects of psychiatric medications on the brain.
Maternal behaviour in free-ranging sows is normally performed in an isolated nest that the sow has built during the pre-parturient period. Consequently there is much concern over the use of restrictive farrowing crates, in which manipulable substrates are often not provided, for parturient sows under commercial conditions. This study examined the impact of the provision of space and substrate on the performance of maternal behaviour by gilts (primiparous sows) on physiological indicators of stress and on the progress of parturition. Gilts had an indwelling jugular catheter implanted 12 days before their expected farrowing date. At 5 days before expected farrowing, 34 gilts were placed in one of four farrowing treatments: crate without straw (C, n = 8), crate with straw (CS, n = 9), pen without straw (P, n = 9) or pen with straw (PS, n = 8). Behavioural observations of gilts and piglets were made during an 8 h period after the expulsion of the first piglet. Blood samples were taken via a catheter extension to minimise disturbance throughout the parturition period. Gilts in all treatments were most active in the first 2 h: performing more standing/walking, substrate-directed and piglet-directed behaviour. This active phase was followed by inactivity and passivity, as has been seen in free-ranging sows. However, this temporal profile of behaviour was more pronounced in the penned gilts (P and PS), which were more active during the first 2 h than the crated gilts (C and CS). Gilts in crates spent longer sitting throughout the 8 h period and tended to show more savaging of their piglets. Savaging gilts were found to be more active and responsive to piglets. The provision of straw did not alter gilt behaviour but did alter piglet behaviour, with piglets that were born into environments with no straw (C and P) spending more time next to the gilt's udder. The provision of straw increased the length of parturition (CS and PS), but this did not have detrimental effects on piglet survival. Plasma cortisol was unaffected by space or substrate, however, plasma ACTH was found to be highest in C gilts during the second hour of parturition. Plasma oxytocin was unaffected by space or substrate, however, there was a positive relationship between plasma oxytocin and unresponsiveness to piglets. In conclusion, it appears that farrowing crates thwart interactions between the gilt and her piglets, and that the provision of space during parturition, irrespective of straw availability, facilitates the performance of maternal behaviour that more closely resembles that performed by free-ranging sows.
Occupational burnout has become a pervasive problem in human services. Medical professionals are particularly vulnerable to burnout, which may lead to reduced motivation, medical errors, and voluntary absenteeism. To ensure effect functioning of medical systems, better understanding of burnout among medical professionals is warranted.
Objectives
We aimed to investigate the structural brain correlates of burnout severity among medical professionals.
Methods
Nurses in active service underwent structural magnetic resonance imaging. We assessed their burnout severity using self-reported psychological questionnaires. This study was approved by the Committee on Medical Ethics of Kyoto University and was conducted in accordance with the Code of Ethics of the World Medical Association.
Results
The results reflected considerable individual differences in burnout severity in our sample. Our findngs revealed that the levels of burnout severity were associated with the regional gray matter volumes in brain areas such as ventromedial prefrontal cortex and insula.
Conclusions
Since the outbreak of the COVID-19 pandemic, medical professionals have faced even greater stress. We hope that our findings will contribute to a better understanding of the mechanisms of burnout and offer useful insights for developing effective interventions to manage stress and burnout.
Cross-cultural studies of posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) based on ICD-11 diagnostic criteria are scarce, especially in adolescence. The study aimed to evaluate the trauma exposure, prevalence and factors associated with PTSD and CPTSD in general populations of adolescents in Lithuania and Japan.
Methods
The study sample comprised 1746 adolescents from Lithuania (n = 832) and Japan (n = 914), 49.8% female. The mean age of study participants was 15.52 (s.d. = 1.64), ranging from 12 to 18 years. ICD-11 posttraumatic disorders were assessed using the International Trauma Questionnaire – Child and Adolescent version (ITQ-CA).
Results
More than half of the adolescents in a total sample (61.5%) reported exposure to at least one traumatic event in their lifetime, 80.0% in Lithuania and 44.6% in Japan, with a higher prevalence of interpersonal trauma in Lithuania and more natural disaster exposure in Japan. The prevalence of PTSD was 5.2% (95% CI 3.8–6.9%) and 2.3% (95% CI 1.4–3.5%), CPTSD 12.3% (95% CI 10.1–14.7%) and 4.1% (95% CI 2.9–5.5%) in Lithuanian and Japanese samples, respectively. Cumulative trauma exposure, female gender, loneliness and financial difficulties in family predicted both PTSD and CPTSD in the total sample. Loneliness discriminated CPTSD v. PTSD in both Lithuanian and Japanese samples.
Conclusions
This cross-cultural study is among the first which reported different patterns of trauma exposure in Asian Japanese and Lithuanian adolescents in Europe. Despite differences in trauma exposure and PTSD/CPTSD prevalence, we found similar predictors in both studies, particularly the importance of cumulative trauma exposure for PTSD/CPTSD, and social interpersonal factors for the risk of CPTSD. The study supports the universality of traumatic stress reactions to adverse life experiences in adolescence across cultures and regions and highlights different levels of traumatisation of adolescents in various countries.
We compared the rates of hospital-onset secondary bacterial infections in patients with coronavirus disease 2019 (COVID-19) with rates in patients with influenza and controls, and we investigated reports of increased incidence of Enterococcus infections in patients with COVID-19.
Design:
Retrospective cohort study.
Setting:
An academic quaternary-care hospital in San Francisco, California.
Patients:
Patients admitted between October 1, 2019, and October 1, 2020, with a positive SARS-CoV-2 PCR (N = 314) or influenza PCR (N = 82) within 2 weeks of admission were compared with inpatients without positive SARS-CoV-2 or influenza tests during the study period (N = 14,332).
Methods:
National Healthcare Safety Network definitions were used to identify infection-related ventilator-associated complications (IVACs), probable ventilator-associated pneumonia (PVAP), bloodstream infections (BSIs), and catheter-associated urinary tract infections (CAUTIs). A multiple logistic regression model was used to control for likely confounders.
Results:
COVID-19 patients had significantly higher rates of IVAC and PVAP compared to controls, with adjusted odds ratios of 4.7 (95% confidence interval [CI], 1.7–13.9) and 10.4 (95 % CI, 2.1–52.1), respectively. COVID-19 patients had higher incidence of BSI due to Enterococcus but not BSI generally, and whole-genome sequencing of Enterococcus isolates demonstrated that nosocomial transmission did not explain the increased rate. Subanalyses of patients admitted to the intensive care unit and patients who required mechanical ventilation revealed similar findings.
Conclusions:
COVID-19 is associated with an increased risk of IVAC, PVAP, and Enterococcus BSI compared with hospitalized controls, which is not fully explained by factors such as immunosuppressive treatments and duration of mechanical ventilation. The mechanism underlying increased rates of Enterococcus BSI in COVID-19 patients requires further investigation.
Electronic cigarettes have been a popular alternative to tobacco smoking. The effect of tobacco smoking on nasal airway resistance has been investigated before; however, the effect of the aerosol generated by electronic cigarettes is still unknown. This study aimed to evaluate the short-term effects of e-cigarettes on nasal airway resistance.
Methods
Sixty-one participants were recruited into a vapers group and a control group. The vapers group was instructed to smoke for 5 minutes, and their nasal resistance was measured pre-procedure and at 1 and 5 minutes post-procedure. The results were compared between both groups.
Results
Repeated measures analysis of variance demonstrated that vaping has no statistically significant effect on total nasal airway resistance.
Conclusion
Although the differences between both groups were not statistically significant overall, the vapers group showed a reduction in nasal airway resistance in the short term.
Deep learning, a subset of artificial intelligence, has shown great potential in several recent applications to pathology. These have mainly involved the use of classifiers to diagnose disease, while generative modelling techniques have been less frequently used. Generative adversarial networks (GANs) are a type of deep learning model that has been used to synthesize realistic images in a range of domains, both general purpose and medical. In the GAN framework, a generator network is trained to synthesize fake images, while a dueling discriminator network aims to distinguish between the fake images and a set of real training images. As GAN training progresses, the generator network ideally learns the important features of a dataset, allowing it to create images that the discriminator cannot distinguish from the real ones. We report on our use of GANs to synthesize high resolution, realistic histopathology images of gliomas. The well- known Progressive GAN framework was trained on a set of image patches extracted from digital slides in the Cancer Genome Atlas repository, and was able to generate fake images that were visually indistinguishable from the real training images. Generative modelling in pathology has numerous potential applications, including dataset augmentation for training deep learning classifiers, image processing, and expanding educational material.
LEARNING OBJECTIVES
This presentation will enable the learner to:
1. Explain basic principles of generative modelling in deep learning.
2. Discuss applications of deep learning to neuropathology image synthesis.
To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality.
Design:
Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4·8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income.
Setting:
Urbanised areas in multiple regions of the USA, years 2000–2002 and 2010–2012.
Participants:
Participants aged 45–84 years were followed for 10 years (n 3567).
Results:
Median HEI (out of 100) was fifty-nine at baseline and sixty-two at follow-up. The cross-sectional analysis found that residing in areas with a high density of restaurants (highest-ranked quartile) was associated with 52 % higher odds of frequently eating restaurant meals (≥3 times/week, OR: 1·52, 95 % CI 1·18, 1·98) and 3 % higher odds of having lower dietary quality (HEI lowest quartile < 54, OR: 1·03, 95 % CI 1·01, 1·06); associations were not sustained in longitudinal analyses. The cross-sectional analysis found 34 % higher odds of having lower dietary quality for those who frequently ate at restaurants (OR: 1·34, 95 % CI 1·12, 1·61), and more restaurant meals (over time increase ≥ 1 time/week) were associated with higher odds of having worse dietary quality at follow-up (OR: 1·21, 95 % CI 1·00, 1·46).
Conclusions:
Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.
Studies on community-acquired pneumonia (CAP) and pneumococcal pneumonia (PP) related to the 13-valent pneumococcal conjugate vaccine (PCV13) introduction in Asia are scarce. This study aimed to investigate the epidemiological and microbiological determinants of hospitalised CAP and PP after PCV13 was introduced in Japan. This observational hospital-based surveillance study included children aged ⩽15 years, admitted to hospitals in and around Chiba City, Japan. Participants had bacterial pneumonia based on a positive blood or sputum culture for bacterial pathogens. Serotype and antibiotic-susceptibility testing of Streptococcus pneumoniae and Haemophilus influenzae isolates from patients with bacterial pneumonia were assessed. The CAP hospitalisation rate per 1000 child-years was 17.7, 14.3 and 9.7 in children aged <5 years and 1.18, 2.64 and 0.69 in children aged 5–15 years in 2008, 2012 and 2018, respectively. There was a 45% and 41% reduction in CAP hospitalisation rates, between the pre-PCV7 and PCV13 periods, respectively. Significant reductions occurred in the proportion of CAP due to PP and PCV13 serotypes. Conversely, no change occurred in the proportion of CAP caused by H. influenzae. The incidence of hospitalised CAP in children aged ⩽15 years was significantly reduced after the introduction of PCV13 in Japan. Continuous surveillance is necessary to detect emerging PP serotypes.
Competing theories on the aetiology of eating disorders originate from a diverse set of disciplines. One such discipline is Evolutionary Psychology which assumes that the human mind has been shaped by natural and sexual selection. Most evolutionary theories on eating disorders limit themselves to the causation of anorexia nervosa only. The Sexual Competition Hypothesis (SCH), based on the Darwinian theory of sexual selection, provides an explanatory framework for the whole spectrum of eating disorders. It contends that intense female intrasexual competition (ISC) is the ultimate cause of eating disorders. The SCH explains the phenomenon of the pursuit of thinness as an adaptation to ISC in the modern environment. It argues that eating disorders are pathological phenomena that arise from the mismatch between the modern environment and the inherited female adaptations for ISC.
Objectives
To test predictions from a novel evolutionary hypothesis for eating disorders.
Aims
i) To examine the relationship between disordered eating behaviour (DEB) and ISC in a sample of female undergraduates.
ii) To establish whether there is any relationship between DEB and Life History (LH) strategy.
Methods
A group of 206 female undergraduates were recruited. A structural equation model was constructed to analyse the data.
Results
ISC for mates was significantly associated with DEB, as predicted by the SCH. DEB was found to be predicted by fast LH strategy, which was only partially mediated by the SCH.
Conclusions
The results of this study are supportive of the SCH and justify research on a clinical sample.
There have been significant changes in the diagnostic criteria for diffuse gliomas in the 2016 WHO CNS tumor classification, with the incorporation of molecular criteria into a number of definitions. This has placed a greater emphasis on the availability of key immunohistochemical and molecular tests. In order to determine the effect that these changes have had on neuropathology practice and the access of different centres to these tests, we designed a survey that was sent to all members of the Canadian Association of Neuropathology member list in the fall of 2017. This survey asked a number of questions relating to the approach to glioma diagnosis, immunohistochemical/molecular test ordering patterns, in-house test availability, and need to send out for testing. In this presentation we will present preliminary results from this survey, with a focus on institutional testing capabilities. This provides a valuable resource that could ultimately need to a national database of immunohistochemical and molecular test availability for each neuropathology centre.
LEARNING OBJECTIVES
This presentation will enable the learner to:
1. Review the key molecular markers in the diagnosis of adult gliomas and methods of testing for them
2. Discuss the effect that the 2016 WHO CNS tumor update has had on clinical practice in Canada
This paper describes and analyzes a new technique used in Q-slot antenna to generate circular polarization (CP). The CP characteristics were investigated carefully by studying the surface current distribution, the phase difference between the left hand circular polarization (LHCP) and right hand circular polarization (RHCP) at some resonant frequencies, and the measured values of the axial ratio bandwidth (ARBW). Normal arms (E1 and E2) were cut in the upper elliptical feeding strip line to form an open-mouth structure. The arms E1 and E2 were made equal in length and set perpendicular to each other to have normal electric fields, leading to the generation of CP radiation. A formula was modified for the dual resonant frequencies f1, f2 of the modes TM010 and TM001. The measured values of the ARBW indicated that the antenna has a wide ARBW of 4.8–5.93 GHz, which is approximately 52% of the 3rd operating band of 4.7–6.8 GHz. The wide ARBW in a small size indicated that the design of the Q-slot antenna overcame the limits of designing antennas with wide ARBW in small size and low profile. A formula for normalized field was driven according to the complementary of the Q-slot antenna.
A new planar multiple-input–multiple-output (MIMO) antenna for ultra wideband (UWB) applications is presented. The proposed antenna operates over the frequency band from 3.1 to 10.6 GHz and it consists of two identical circular monopoles on an FR4 substrate. The wide isolation is achieved through a novel planar decoupling structure that is being inserted between the dual antennas. Moreover, a center slot is etched on the common ground to further increase isolation. The effectiveness of the decoupling structure is analyzed, and performance study has been performed to investigate the mutual coupling reduction. A good isolation of more than 31 dB has been achieved through the entire UWB band (more than 12 dB improvement over the reference antenna). The proposed UWB antenna with and without the wideband decoupling structure has been investigated and verified both numerically and experimentally. The measurement results of the proposed UWB–MIMO antenna are in good agreement with the simulation results. The proposed UWB antenna has been compared with previous works regarding antenna size, geometric complexity, bandwidth, and isolation level. The proposed antenna has some outstanding characteristics such as a geometric simplicity, compact size, broad bandwidth, and low correlation which give the antenna an excellent diversity performance and a good candidate for UWB applications.
A cross-sectional survey was carried out in primary schools to determine prevalence, intensity and spatial co-distribution of Schistosomiasis and soil transmitted helminths (STH) infections in Ogun State, Nigeria. A total of 2148 pupils from 42 schools were examined for Schistosoma and STH infections from urine and fresh fecal samples respectively. Ethyl ether concentration method prepared in sodium acetate – acetic acid – formalin ether was used to concentrate parasites’ ova before microscopic examination. The overall prevalence of schistosomiasis and STH infections were 4.0% (95% CI = 3.21–4.92) and 34.64% (95% CI = 32.62–36.69) respectively. Schistosoma haematobium and Ascaris lumbricoides were the most prevalent across the study area among the Schistosoma and STH species respectively. Overall, intensity of infection was higher in males than in females for all Schistosoma and STH infections, but with no significant difference (P > 0.05), except for Trichuris trichiura (χ2 = 6.490, P < 0.05). Infection intensity was significantly inversely correlated (χ2 = 12.953, P < 0.05) with an increase in age group. Co-distribution of Schistosoma and STH infections occurred in 15 (35.7%) out of 42 schools, and only 30 children (1.4%) had co-infection of Schistosoma and STH. This study provides information on the prevalence and spatial risk of schistosomiasis and STH in Ogun State. This will serve as decision-support tool for Ogun State programme managers to help facilitate integration of schistosomiasis and STH control.
This paper discusses results from the second phase of the European Ice Sheet Modelling Initiative (EISMINT). It reports the intercomparison of ten operational ice-sheet models and uses a series of experiments to examine the implications of thermomechanical coupling for model behaviour. A schematic, circular ice sheet is used in the work which investigates both steady states and the response to stepped changes in climate. The major finding is that the radial symmetry implied in the experimental design can, under certain circumstances, break down with the formation of distinct, regularly spaced spokes of cold ice which extended from the interior of the ice sheet outward to the surrounding zone of basal melt. These features also manifest themselves in the thickness and velocity distributions predicted by the models. They appear to be a common feature to all of the models which took part in the intercomparison, and may stem from interactions between ice temperature, flow and surface form. The exact nature of these features varies between models, and their existence appears to be controlled by the overall thermal regime of the ice sheet. A second result is that there is considerable agreement between the models in their predictions of global-scale response to imposed climate change.
We report on the formation of shallow junctions with high activation in both n+/p and p+/n Ge junctions using ion implantation and Flash Lamp Annealing (FLA). The shallowest junction depths (Xj) formed for the n+/p and p+/n junctions were 7.6 nm and 6.1 nm with sheet resistances (Rs) of 860 ohms/sq. and 704 ohms/sq., respectively. By reducing knocked-on oxygen during ion implantation in the n+/p junctions, Rs was decreased by between 5% and 15%. The lowest Rs observed was 235 ohms/sq. with a junction depth of 21.5 nm. Hall measurements clearly revealed that knocked-on oxygen degraded phosphorus activation (carrier concentration). In the p+/n Ge junctions, we show that ion implantation damage induced high boron activation. Using this technique, Rs can be reduced from 475 ohms/sq. to 349 ohms/sq. These results indicate that the potential for forming ultra-shallow n+/p and p+/n junctions in the nanometer range in Ge devices using FLA is very high, leading to realistic monolithically-integrated Ge CMOS devices that can take us beyond Si technology.
The concept of cognitive reserve (CR) hypothesizes that intellectually stimulating activities provide resilience against brain pathology/disease. Whereas brain abnormalities and cognitive impairment are frequently reported in bipolar disorder (BD), it is unknown whether the impact of brain alterations can be lessened by higher CR in BD.
Method
We tested if higher CR would reduce the influence of total volumes of deep white matter hypointensities (WMH), ventricular cerebrospinal fluid (CSF), and prefrontal cortex on memory, executive, and attention/speed functions in patients with BD (n = 75). Linear regression models with interaction terms for CR and brain volumes were applied to directly test if CR reduces the influence of brain pathology on cognitive domains.
Results
CR reduced the influence of total volumes of deep WMH (β = −0.38, Q = 0.003) and ventricular CSF (β = −41, Q = 006) on executive functions.
Conclusions
The interactions between CR and total volumes of deep WMH/ventricular CSF appear to account for executive functioning in BD. The results suggest that the concept of CR is applicable in BD. Higher reserve capacity in BD alters the relationship between brain pathology and clinical presentation.
Documenting past changes in the East Antarctic surface mass balance is important to improve ice core chronologies and to constrain the ice-sheet contribution to global mean sea-level change. Here we reconstruct past changes in the ratio of surface mass balance (SMB ratio) between the EPICA Dome C (EDC) and Dome Fuji (DF) East Antarctica ice core sites, based on a precise volcanic synchronization of the two ice cores and on corrections for the vertical thinning of layers. During the past 216 000 a, this SMB ratio, denoted SMBEDC/SMBDF, varied between 0.7 and 1.1, being small during cold periods and large during warm periods. Our results therefore reveal larger amplitudes of changes in SMB at EDC compared with DF, consistent with previous results showing larger amplitudes of changes in water stable isotopes and estimated surface temperature at EDC compared with DF. Within the last glacial inception (Marine Isotope Stages, MIS-5c and MIS-5d), the SMB ratio deviates by up to 0.2 from what is expected based on differences in water stable isotope records. Moreover, the SMB ratio is constant throughout the late parts of the current and last interglacial periods, despite contrasting isotopic trends.