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We present the serendipitous radio-continuum discovery of a likely Galactic supernova remnant (SNR) G305.4–2.2. This object displays a remarkable circular symmetry in shape, making it one of the most circular Galactic SNRs known. Nicknamed Teleios due to its symmetry, it was detected in the new Australian Square Kilometre Array Pathfinder (ASKAP) Evolutionary Map of the Universe (EMU) radio–continuum images with an angular size of 1 320$^{\prime\prime}$$\times$1 260$^{\prime\prime}$ and PA = 0$^\circ$. While there is a hint of possible H$\alpha$ and gamma-ray emission, Teleios is exclusively seen at radio–continuum frequencies. Interestingly, Teleios is not only almost perfectly symmetric, but it also has one of the lowest surface brightnesses discovered among Galactic SNRs and a steep spectral index of $\alpha$=–0.6$\pm$0.3. Our best estimates from Hi studies and the $\Sigma$–D relation place Teleios as a type Ia SNR at a distance of either $\sim$2.2 kpc (near-side) or $\sim$7.7 kpc (far-side). This indicates two possible scenarios, either a young (under 1 000 yr) or a somewhat older SNR (over 10 000 yr). With a corresponding diameter of 14/48 pc, our evolutionary studies place Teleios at the either early or late Sedov phase, depending on the distance/diameter estimate. However, our modelling also predicts X-ray emission, which we do not see in the present generation of eROSITA images. We also explored a type Iax explosion scenario that would point to a much closer distance of $\lt$1 kpc and Teleios size of only $\sim$3.3 pc, which would be similar to the only known type Iax remnant SN1181. Unfortunately, all examined scenarios have their challenges, and no definitive Supernova (SN) origin type can be established at this stage. Remarkably, Teleios has retained its symmetrical shape as it aged even to such a diameter, suggesting expansion into a rarefied and isotropic ambient medium. The low radio surface brightness and the lack of pronounced polarisation can be explained by a high level of ambient rotation measure (RM), with the largest RM being observed at Teleios’s centre.
Saflufenacil, atrazine, and pyroxasulfone represent herbicides with a relative field persistence of low, medium, and high, respectively. Field studies were conducted over 2 yr when herbicides and rates were assembled in a factorial arrangement of treatments, and herbicides were applied at rates of 100, 1,000, and 10,000 g ai ha−1. Soil samples were collected over the course of 365 d and analyzed to detect dissipation of the herbicides. Regression analysis was used to quantify the dissipation of each herbicide. The initial herbicide concentration had no effect on the observed dissipation rates of atrazine or saflufenacil; however, pyroxasulfone dissipation was slower at the highest field dosage in both years. Soils from Georgia, Illinois, and Tennessee were fortified with known concentrations of the three herbicides dissolved in water and incubated at 22 C for 154 d. Laboratory studies generally demonstrated slower dissipation compared to field studies, which is plausible because the important loss mechanisms of volatilization or photodegradation do not occur in the laboratory test system. Pyroxasulfone and saflufenacil exhibited no effect of half-life from various initial concentrations, but atrazine exhibited slower degradation occurring at lower initial concentrations. Findings from these studies suggest that initial herbicide concentration has a limited effect on the dissipation of some herbicides: pyroxasulfone in the field and atrazine in the laboratory. This finding is important for researchers who use herbicide degradation rates in simulation modeling because herbicide degradation is often assumed to be independent of the rate applied. Another aspect of this research was the application of each herbicide alone and in combination with the others. Under field and laboratory conditions, there was no change in dissipation if the herbicides were applied alone or in combination.
Low vitamin D status (circulating 25-hydroxyvitamin D [25(OH)D] concentration < 50 nmol/L) affects nearly one in four Australian adults(1). The primary source of vitamin D is sun exposure; however, a safe level of sun exposure for optimal vitamin D production has not been established. As supplement use is uneven, increasing vitamin D in food is the logical option for improving vitamin D status at a population level. The dietary supply of vitamin D is low since few foods are naturally rich in vitamin D. While there is no Australia-specific estimated average requirement (EAR) for vitamin D, the Institute of Medicine recommends an EAR of 10 μg/day for all ages. Vitamin D intake is low in Australia, with mean usual intake ranging from 1.8–3.2 μg/day across sex/age groups(2), suggesting a need for data-driven nutrition policy to improve the dietary supply of vitamin D. Food fortification has proven effective in other countries. We aimed to model four potential vitamin D fortification scenarios to determine an optimal strategy for Australia. We used food consumption data for people aged ≥ 2 years (n = 12,153) from the 2011–2012 National Nutrition and Physical Activity Survey, and analytical food composition data for vitamin D3, 25(OH)D3, vitamin D2 and 25(OH)D2(3). Certain foods are permitted for mandatory or voluntary fortification in Australia. As industry uptake of the voluntary option is low, Scenario 1 simulated addition of the maximum permitted amount of vitamin D to all foods permitted under the Australia New Zealand Food Standards Code (dairy products/plant-based alternatives, edible oil spreads, formulated beverages and permitted ready-to-eat breakfast cereals (RTEBC)). Scenarios 2–4 modelled higher concentrations than those permitted for fluid milk/alternatives (1 μg/100 mL) and edible oil spreads (20 μg/100 g) within an expanding list of food vehicles: Scenario 2—dairy products/alternatives, edible oil spreads, formulated beverages; Scenario 3—Scenario 2 plus RTEBC; Scenario 4—Scenario 3 plus bread (which is not permitted for vitamin D fortification in Australia). Usual intake was modelled for the four scenarios across sex and age groups using the National Cancer Institute Method(4). Assuming equal bioactivity of the D vitamers, the range of mean usual vitamin D intake across age groups for males for Scenarios 1 to 4, respectively, was 7.2–8.8, 6.9–8.3, 8.0–9.7 and 9.3–11.3 μg/day; the respective values for females were 5.8–7.5, 5.8–7.2, 6.4–8.3 and 7.5–9.5 μg/day. No participant exceeded the upper level of intake (80 μg/day) under any scenario. Systematic fortification of all foods permitted for vitamin D fortification could substantially improve vitamin D intake across the population. However, the optimal strategy would require permissions for bread as a food vehicle, and addition of higher than permitted concentrations of vitamin D to fluid milks/alternatives and edible oil spreads.
Medical and surgical advancements have enabled a 95% survival rate for children with CHD. However, these survivors are disproportionately affected by neurodevelopmental disabilities. In particular, they have behavioural problems in toddlerhood. Because there is a known relationship between behavioural problems and early language delay, we hypothesise that children with critical CHD have early detectable language deficits. To test our hypothesis, we performed a retrospective study on a cohort of children with critical CHD to visualise their early language developmental trajectories.
Methods:
We identified a cohort of 27 children with two diagnoses: single ventricle physiology (19) and transposition of the great arteries (8). As part of their routine clinical care, all of these children had serial developmental evaluations with the language subsection of the Capute Scales. We visualised their developmental language trajectories as a function of chronologic age, and we used a univariate linear regression model to calculate diagnosis-specific expected developmental age equivalents.
Results:
In each group, language development is age-appropriate in infancy. Deviation from age-appropriate development is apparent by 18 months. This results in borderline-mild language delay by 30 months.
Discussion:
Using the Capute Scales, our team quantified early language development in infants and toddlers with critical CHD. Our identification of deceleration in skill acquisition reinforces the call for ongoing neurodevelopmental surveillance in these children. Understanding early language development will help clinicians provide informed anticipatory guidance to families of children with critical CHD.
Social Media Synopsis:
Children with single ventricle physiology and transposition of the great arteries have measurable early language delays.
Studies show that people with severe mental illness (SMI) have a greater risk of dying from colorectal cancer (CRC). These studies mostly predate the introduction of national bowel cancer screening programmes (NBCSPs) and it is unknown if these have reduced disparity in CRC-related mortality for people with SMI.
Methods
We compared mortality rates following CRC diagnosis at colonoscopy between a nationally representative sample of people with and without SMI who participated in Australia’s NBCSP. Participation was defined as the return of a valid immunochemical faecal occult blood test (iFOBT). We also compared mortality rates between people with SMI who did and did not participate in the NBCSP. SMI was defined as receiving two or more Pharmaceutical Benefits Scheme prescriptions for second-generation antipsychotics or lithium.
Results
Amongst NBCSP participants, the incidence of CRC in the SMI cohort was lower than in the controls (hazard ratio [HR] 0.77, 95% confidence interval [CI] 0.61–0.98). In spite of this, their all-cause mortality rate was 1.84 times higher (95% CI 1.12–3.03), although there was only weak evidence of a difference in CRC-specific mortality (HR 1.82; 95% CI 0.93–3.57). People with SMI who participated in the NBCSP had better all-cause survival than those who were invited to participate but did not return a valid iFOBT (HR 0.67, 95% CI 0.50–0.88). The benefit of participation was strongest for males with SMI and included improved all-cause and CRC-specific survival.
Conclusions
Participation in the NBCSP may be associated with improved survival following a CRC diagnosis for people with SMI, especially males, although they still experienced greater mortality than the general population. Approaches to improving CRC outcomes in people with SMI should include targeted screening, and increased awareness about the benefits or participation.
Trial registration
Australian and New Zealand Clinical Trials Registry (Trial ID: ACTRN12620000781943).
Understanding post-stroke spasticity (PSS) treatment in everyday clinical practice may guide improvements in patient care.
Methods:
This was a retrospective cohort study that used population-level administrative data. Adults (aged ≥18 years) who initiated PSS treatment (defined by the first PSS clinic visit, focal botulinum toxin injection, or anti-spasticity medication dispensation [baclofen, dantrolene and tizanidine] with none of these treatments occurring during the 2 years before the stroke) were identified between 2012 and 2019 in Alberta, Canada. Spasticity treatment use, time to treatment start and type of prescribing/treating physician were measured. Descriptive statistics were performed.
Results:
Within the cohort (n = 1,079), the most common PSS treatment was oral baclofen (initial treatment: 60.9%; received on/after the initial treatment date up to March 31, 2020: 69.0%), largely prescribed by primary care physicians (77.6%) and started a median of 348 (IQR 741) days after the stroke. Focal botulinum toxin (23.3%; 37.7%) was largely prescribed by physiatrists (72.2%) and started 311 (IQR 446) days after the stroke; spasticity clinic visits (18.6%; 23.8%) were also common.
Conclusions:
We found evidence of gaps in provision of spasticity management in persons with PSS including overuse of systemic oral baclofen (that has common adverse side effects and lacks evidence of effectiveness in PSS) and potential underuse of focal botulinum toxin injections. Further investigation and strategies should be pursued to improve alignment of PSS treatment with guideline recommendations that in turn will support better outcomes for those with PSS.
The behaviour of an axisymmetric bubble in a pure liquid forced by an acoustic pressure field is analysed. The bubble is assumed to have a sharp deformable interface, which is subject both to surface tension and to Rayleigh viscosity damping. Two modelling regimes are considered. The first is a linearized solution, based on the assumption of small axisymmetric deformations to an otherwise spherical bubble. The second involves a semi-numerical solution of the fully nonlinear problem, using a novel spectral method of high accuracy. For large-amplitude nonspherical bubble oscillations, the fully nonlinear solutions show that a complicated resonance structure is possible and that curvature singularities may occur at the interface, even in the presence of surface tension. Rayleigh viscosity at the interface prevents singularity formation, but eventually causes the bubble to become purely spherical unless shape-mode resonances occur. An extended analysis is also presented for purely spherical bubbles, which allows for a more detailed study of the effects of resonance and the Rayleigh viscosity at the bubble surface.
Traditional approaches for evaluating the impact of scientific research – mainly scholarship (i.e., publications, presentations) and grant funding – fail to capture the full extent of contributions that come from larger scientific initiatives. The Translational Science Benefits Model (TSBM) was developed to support more comprehensive evaluations of scientific endeavors, especially research designed to translate scientific discoveries into innovations in clinical or public health practice and policy-level changes. Here, we present the domains of the TSBM, including how it was expanded by researchers within the Implementation Science Centers in Cancer Control (ISC3) program supported by the National Cancer Institute. Next, we describe five studies supported by the Penn ISC3, each focused on testing implementation strategies informed by behavioral economics to reduce key practice gaps in the context of cancer care and identify how each study yields broader impacts consistent with TSBM domains. These indicators include Capacity Building, Methods Development (within the Implementation Field) and Rapid Cycle Approaches, implementing Software Technologies, and improving Health Care Delivery and Health Care Accessibility. The examples highlighted here can help guide other similar scientific initiatives to conceive and measure broader scientific impact to fully articulate the translation and effects of their work at the population level.
Soybean [Glycine max (L.) Merr.] that lack resistance to auxin herbicides [i.e., not genetically modified for resistance] have well-documented responses to those particular herbicides, with yield loss being probable. When a soybean field is injured by auxin herbicides, regulatory authorities often collect a plant sample from that field. This research attempted to simulate soybean exposures due to accidental mixing of incorrect herbicides, tank contamination, or particle drift. This research examined whether analytical testing of herbicide residues on soybean to aminocyclopyrachlor (ACP), aminopyralid, 2,4-D, or dicamba would be related to the visual observations and yield responses from these herbicides. ACP and aminopyralid were applied to R1 soybean at 0.1, 1, and 10 g ae ha−1; 2,4-D and dicamba were applied at 1, 10, and 100 g ae ha−1. Visual evaluations and plant sample collections were undertaken at 1, 3, 7, 14, and 21 d after treatment (DAT), and yield was measured. The conservative limits of detection for the four herbicides in this project were 5, 10, 5, and 5 ng g−1 fresh weight of soybean for ACP, aminopyralid, 2,4-D, and dicamba, respectively. Many of the plant samples were non-detects, especially at lower application dosages. All herbicide concentrations rapidly declined soon after application, and many reached nondetectable limits by 14 DAT. All herbicide treatments caused soybean injury, although the response to 2,4-D was markedly lower than the responses to the other three herbicides. There was no apparent correlation between herbicide concentrations (which were declining over time) and the observed soybean injury (which was increasing over time or staying the same). This research indicated that plant samples should be collected as soon as possible after soybean exposure to auxin herbicides.
Coronavirus disease 2019 can be indistinguishable from lower respiratory tract infections (LRTIs) caused by other viral and bacterial agents. This likely contributed to antimicrobial use (AU) and antimicrobial resistance (AMR) during the pandemic. Our antimicrobial stewardship program targeted the selection and duration of therapy for LRTIs and led to a reduction in AU and AMR.
The Tertiary silicic volcanic rocks in the Silent Canyon Caldera beneath Pahute Mesa, of the Department of Energy's Nevada Test Site have been divided into three vertical mineralogical zones that vary in thickness and transgress stratigraphic boundaries. Zonal contacts are generally sharp. Zone 1, the uppermost zone, includes unaltered or incipiently altered rhyolitic glass. Zone 2 is characterized by a predominance of clinoptilolite and subordinate amounts of smectite, cristobalite, and mordenite. Zone 3 is a complex mineral assemblage that includes analcime, quartz, calcite, authigenic K-feldspar and albite, kaolinite, chlorite, and mixed-layer illite/smectite. The mixed-layer clay shows an increase in ordering and a decrease in expandability with depth.
Shortly after deposition and after shallow burial, hydration of relatively impermeable, highly porous vitric rocks resulted in the rapid formation of the Zone 2 assemblage (except mordenite). This stage of alteration resulted in a net porosity loss and negligible mass transfer. Continued burial and rise in temperature led to a dehydration stage in which the Zone 2 assemblage was replaced by the Zone 3 minerals. The dehydration stage resulted in a porosity increase and an increase in permeability of several orders of magnitude. This process, like the earlier reactions, also conserved mass. Precipitation of mordenite followed the formation of this zonal configuration. The diagenetic zones below Pahute Mesa were caused by: (1) changing pore-water chemistry in an essentially closed hydrologic system; (2) disequilibrium or kinetic precipitation of metastable phases; and (3) a higher thermal gradient than that now present.
This article is the first comprehensive treatment of countermajoritarian roll call outcomes in the U.S. Senate, 1789–2022. Divergences from majoritarian principles are rooted in part in malapportionment and equal representation by state. Roll calls where a majority of the chamber votes one way while the other side represents most of the U.S. population are frequent across Senate history, depending on the proportion of the population covered by the majority party and the degree of conflict in the agenda. Other departures from majoritarian principles derive from the presence of supermajority requirements within the chamber. Such decision thresholds likewise are prevalent across Senate history, with significant increases since the 1970s. Although the two sources of countermajoritarian potential tend to be mutually reinforcing, under certain conditions they work against one another. The partisan impact varies over time, but in the modern chamber, Republicans have benefited more from Senate countermajoritarianism than have Democrats.
Multiple herbicide–resistant (MHR) Palmer amaranth is among the most problematic summer annual broadleaf weeds in Nebraska and several other states. A new MHR corn cultivar (resistant to 2,4-D/glufosinate/glyphosate, also known as Enlist corn) has been commercially available in the United States since 2018. Growers are searching for herbicide programs for control and reduce seed production of MHR Palmer amaranth among Enlist corn crops. The objectives of this study were to evaluate herbicides applied preemergence, early postemergence, or preemergence followed by (fb) late postemergence for the management of MHR Palmer amaranth in Enlist corn fields and to assess their effect on Palmer amaranth biomass, density, seed production, and corn yield. Field experiments were conducted near Carleton, NE, in 2020 and 2021, in a grower’s field of Enlist corn infested with acetolactate synthase–inhibitor/atrazine/glyphosate–resistant Palmer amaranth. Herbicides applied preemergence, such as flufenacet/isoxaflutole/thiencarbazone-methyl, acetochlor/clopyralid/flumetsulam, or acetochlor/clopyralid/mesotrione, provided 75% to 99% control of Palmer amaranth 30 d after preemergence. Preemergence fb late postemergence herbicides resulted in 94% Palmer amaranth control 90 d after late postemergence, reduced weed density to 0 to 8 plants m−2 30 d after late postemergence, and reduced biomass to 2 to 14 g m−2 15 d after late postemergence compared to preemergence-only (59% control, 0 to 15 plants m−2, and 4 to 123 g m−2) and early postemergence–only herbicides (78% control, 6 to 30 plants m−2, and 8 to 25 g m−2). Based on contrast analysis, Palmer amaranth seed production was reduced to 14,050 seeds m–2 in preemergence fb late postemergence herbicide programs compared with 325,490 seed m–2 in preemergence-only and 376,750 seed m–2 in early postemergence–only programs. Based on orthogonal contrast, higher corn yield of 12,340 and 11,730 kg ha−1 was obtained with preemergence fb late postemergence herbicide programs compared with preemergence-only (10,840 and 11,510 kg ha−1) and early postemergence–only programs (10,850 and 10,030 kg ha−1) in 2020 and 2021, respectively.
Broad-spectrum antimicrobials are commonly used without indication and contribute to antimicrobial resistance (AMR). We implemented a syndrome-based stewardship intervention in a community hospital that targeted common infectious syndromes and antipseudomonal beta-lactam (APBL) use. Our intervention successfully reduced AMR, C. difficile rates, use of APBLs, and cost.
We present new stable oxygen and carbon isotope composite records (δ18O, δ13C) of speleothems from Sandkraal Cave 1 (SK1) on the South African south coast for the time interval between 104 and 18 ka (with a hiatus between 48 and 41 ka). Statistical comparisons using kernel-based correlation analyses and semblance analyses based on continuous wavelet transforms inform the relationships of the new speleothem records to other proxies and their changes through time. Between 105 and ~70 ka, changes of speleothem δ18O values at SK1 are likely related to rainfall seasonality. Variations of δ13C values are associated with changes of vegetation density, prior carbonate precipitation (PCP), CO2 degassing in the cave, and possibly variations of the abundance of C3 and C4 grasses in the vegetation. The relationships of δ18O with other proxies shift between ~70 and 48 ka (Marine Isotope Stages 4–3) so that both stable isotope records now reflect CO2 degassing, evaporation, and PCP. Similar relationships also continue after the hiatus for the deposition phase between 42 and 18 ka. Our findings support modeling results suggesting drier conditions in the study area when the Southern Hemisphere westerlies are shifted north and the paleo–Agulhas Plain is exposed.
Palmer amaranth, which is resistant to glyphosate and protoporphyrinogen oxidase inhibitors, remains a threat to cotton and soybean production in Tennessee. This is partly due to the recent evolution of dicamba-resistant Palmer amaranth in western Tennessee, which further complicates weed management. Experiments were conducted in 2021 and 2022 to determine the best timing between sequential applications and the order in which 2,4-D or dicamba should be used with glufosinate to control resistant Palmer amaranth. Palmer amaranth control increased when the interval between postemergence herbicide applications decreased from 21 to 7 d. At the 7-d interval in a dicamba-based system, the order of herbicides did not affect Palmer amaranth control. However, in a 2,4-D-based system, the greatest control was achieved when 2,4-D was applied first, followed by either 2,4-D or glufosinate. While weed height at the time of application had a significant effect on Palmer amaranth control with auxin herbicides, control was still unacceptable in the field at the labeled rates of dicamba or 2,4-D when applied to weeds that were <10 cm tall (48% and 53%, respectively). Neither dicamba nor 2,4-D provided acceptable control of the Palmer amaranth populations evaluated in this study. Sequential applications separated by 7 d provided better weed control than those separated by 21 d. Given that the better 7-d sequential treatments provided less than 90% control and resulted in more than 64,000 surviving Palmer amaranth plants per hectare suggests that relying solely on these herbicides for Palmer amaranth control is not a sustainable weed management strategy.
Recent research has shown the potential of speleothem δ13C to record a range of environmental processes. Here, we report on 230Th-dated stalagmite δ13C records for southwest Sulawesi, Indonesia, over the last 40,000 yr to investigate the relationship between tropical vegetation productivity and atmospheric methane concentrations. We demonstrate that the Sulawesi stalagmite δ13C record is driven by changes in vegetation productivity and soil respiration and explore the link between soil respiration and tropical methane emissions using HadCM3 and the Sheffield Dynamic Global Vegetation Model. The model indicates that changes in soil respiration are primarily driven by changes in temperature and CO2, in line with our interpretation of stalagmite δ13C. In turn, modelled methane emissions are driven by soil respiration, providing a mechanism that links methane to stalagmite δ13C. This relationship is particularly strong during the last glaciation, indicating a key role for the tropics in controlling atmospheric methane when emissions from high-latitude boreal wetlands were suppressed. With further investigation, the link between δ13C in stalagmites and tropical methane could provide a low-latitude proxy complementary to polar ice core records to improve our understanding of the glacial–interglacial methane budget.
When assessing individuals from diverse backgrounds, APA ethical principles emphasize the consideration of language and culture when selecting appropriate measures. Research among hearing, English-speaking individuals has shown the effects in identifying cognitive deficits when language, culture, and educational background are not considered in the selection and administration of measures (Ardilla, 2007). Among the Deaf community in the US, a minority group with a unique culture and language (American Sign Language: ASL), there have been few attempts to adapt existing English cognitive measures. Factors complicating this include research resources given the limited number of neuropsychologists and researchers who understand both the complexities of the measures as well as the linguistic and cultural factors within the Deaf population. The goal of the current project is to develop a culturally informed interpretation of a cognitive screening tool for appropriate use with older Deaf adults.
Participants and Methods:
Item selection was informed by MMSE data from Dean et al. (2009) and methods utilized by Atkinson et al. (2015). Items selection occurred through consultation with three neuropsychologists and graduate peers with either native signing abilities or demonstrated ASL fluency, as well as Deaf identities, cultural affiliation and or community engagement. Selection considered the potential for translation errors, particularly related to equivalence of translation from a spoken modality to a signed. Items were categorized into the following domains: Orientation, Attention, Memory, Language, Executive Functioning, Visuospatial, and Performance Validity. Two native signers (Deaf interpreters) provided formal translation of the items. The measure was piloted with 20 deaf and hard of hearing (DHH) adult signers (ages M=41.10, SD=5.50, Range=31-48). Items were prerecorded to standardize the administration, which was shown to participants through the screenshare function of Zoom software.
Results:
The average performance was 100.80 (SD=3.91)/ 105 possible points. Within the memory domain, some errors, especially for word selection on delayed recall, were noted which may be related to sign choice and dialect. Additionally, with culture-specific episodic memory items, participants 35% of participants were unable to provide a correct answer with qualitative responses indicating this information may be more familiar to a subset of the Deaf community that had attended Gallaudet University in Washington, D.C. There was a significant positive relationship between ASL fluency, determined by the ASL-Comprehension Test, and performance on the cognitive screener (r(18)=.54, p=.01) while age of onset of deafness (r(18)=-.16, p=.51) and age of ASL acquisition (r(18)= .21, p=.37), were not significant.
Conclusions:
Results of this preliminary project yielded a measure that benefited from inclusion of content experts in the field during the process of interpretation and translation. It appears appropriate for Deaf signers who are proficient in ASL. The pattern of correlations suggests the measure may be appropriate for use with fluent signers with experience in ASL acquisition. Further development of the measure should focus on appropriate items that address the diversity of the Deaf experience as well as continue to explore inclusive translation approaches.