Background: Inuit children have been observed to have high rates of macrocephaly, which leads to burdensome travel for medical evaluation, often with no pathology identified. Given reports that WHO growth charts may not reflect all populations, we compared head circumference (HC) measurements in a cohort of Inuit children with the WHO charts. Methods: We extracted HC data from a retrospective cohort study where, with Inuit partnership, we reviewed medical records of Inuit children, born between 2010-2013, and residing in Nunavut. We excluded children with preterm birth, documented neurologic/genetic disease, and most congenital anomalies. We compared HC values with the 2007 WHO charts. Results: We analyzed records of 1960 Inuit children (8866 data points). Most data were from ages 0-36 months. At all age points, the cohort had statistically significantly larger HC than WHO medians. At age 12 months, median HC were 1.3 cm and 1.5 cm larger for male and female Inuit children. Using WHO growth curves, macrocephaly was overdiagnosed and microcephaly underdiagnosed. Conclusions: Our results support the observation that Inuit children from Nunavut have larger HCs, and use of the WHO charts may lead to overdiagnosis of macrocephaly and underdiagnosis of microcephaly. Population specific growth curves for Inuit children should be considered.

Studies of early fourth-millennium BC Britain have typically focused on the Early Neolithic sites of Wessex and Orkney; what can the investigation of sites located in areas beyond these core regions add? The authors report on excavations (2011–2019) at Dorstone Hill in Herefordshire, which have revealed a remarkable complex of Early Neolithic monuments: three long barrows constructed on the footprints of three timber buildings that had been deliberately burned, plus a nearby causewayed enclosure. A Bayesian chronological model demonstrates the precocious character of many of the site's elements and strengthens the evidence for the role of tombs and houses/halls in the creation and commemoration of foundational social groups in Neolithic Britain.

Social robots have limited social competences. This leads us to view them as depictions of social agents rather than actual social agents. However, people also have limited social competences. We argue that all social interaction involves the depiction of social roles and that they originate in, and are defined by, their function in accounting for failures of social competence.

Evidence for working rock crystal, a rare form of water-clear type of quartz, is occasionally recovered from prehistoric sites in Britain and Ireland, however, very little has been written on the specific methods of working this material, and its potential significance in the past. This paper presents the first synthesis of rock crystal evidence from Britain and Ireland, before examining a new assemblage from the Early Neolithic site of Dorstone Hill, Herefordshire. This outlines a methodology for analysing and interpreting this unusual material, and, through comparison with the flint assemblage, examines the specific uses and treatments of this material. Far from being used to make tools, we argue the distinctive and exotic rock crystal was being used to create distinctive and memorable moments, binding individuals together, forging local identities, and connecting the living and the dead.

The Reinforcement Sensitivity Theory of Personality has as its main foundation a Behavioural Inhibition System (BIS), defined by anxiolytic drugs, in which high trait sensitivity should lead to internalising, anxiety, disorders. Conversely, it has been suggested that low BIS sensitivity would be a characteristic of externalising disorders. BIS output should lead to increased arousal and attention as well as behavioural inhibition. Here, therefore, we tested whether an externalising disorder, Attention Deficit Hyperactivity Disorder (ADHD), involves low BIS sensitivity. Goal-Conflict-Specific Rhythmicity (GCSR) in an auditory Stop Signal Task is a right frontal EEG biomarker of BIS function. We assessed children diagnosed with ADHD-I (inattentive) or ADHD-C (combined) and healthy control groups for GCSR in: a) an initial smaller study in Dunedin, New Zealand (population ~120,000: 15 control, 10 ADHD-I, 10 ADHD-C); and b) a main larger one in Tehran, Iran (population ~9 [city]-16 [metropolis] million: 27 control, 18 ADHD-I, 21 ADHD-C). GCSR was clear in controls (particularly at 6–7 Hz) and in ADHD-C (particularly at 8–9 Hz) but was reduced in ADHD-I. Reduced attention and arousal in ADHD-I could be due, in part, to BIS dysfunction. However, hyperactivity and impulsivity in ADHD-C are unlikely to reflect reduced BIS activity. Increased GCSR frequency in ADHD-C may be due to increased input to the BIS. BIS dysfunction may contribute to some aspects of ADHD (and potentially other externalising disorders) and to some differences between the ADHD subtypes but other prefrontal systems (and, e.g. dopamine) are also important.

The linear stability of plane Couette flow is investigated when the plates are horizontal, and the fluid is stably stratified with a cubic basic density profile. The disturbances are treated as inviscid and diffusion of the density field is neglected. Previous studies have shown that this density profile can develop multiple neutral curves, despite the stable stratification, and the fact that plane Couette flow of homogeneous fluid is stable. It is shown that when the neutral curves are plotted with wave angle on one axis, and location of the density inflexion point on the other axis, they produce a self-similar fractal pattern. The repetition on smaller and smaller scales occurs in the limit when the waves are highly oblique, i.e. longitudinal vortices almost aligned with the flow; the corresponding limit for two-dimensional waves is that of strong buoyancy/weak flow. The fractal set of neutral curves also represents a fractal of bifurcation points at which nonlinear solutions can be continued from the trivial state, and these may be helpful for understanding turbulent states. This may be the first example of a fractal generated by a linear ordinary differential equation.

Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia affecting 1-2% of the population. Oral anticoagulation (OAC) reduces stroke risk by 60-80% in AF patients, but only 50% of indicated patients receive OAC. Many patients present to the ED with AF due to arrhythmia symptoms, however; lack of OAC prescription in the ED has been identified as a significant gap in the care of AF patients. Methods: This was a multi-center, pragmatic, three-phase before-after study, in three Canadian sites. Patients who presented to the ED with electrocardiographically (ECG) documented, nonvalvular AF and were discharged home were included. Phase 1 was a retrospective chart review to determine OAC prescription of AF patients in each ED; Phase 2 was a low-intensity knowledge translation intervention where a simple OAC-prescription tool for ED physicians with subsequent short-term OAC prescription was used, as well as an AF patient education package and a letter to family physicians; phase 3 incorporated Phase 2 interventions, but added immediate follow-up in a community AF clinic. The primary outcome of the study was the rate of new OAC prescriptions at ED discharge in AF patients who were OAC eligible and were not on OAC at presentation. Results: A total of 632 patients were included from June, 2015-November, 2016. ED census ranged from 30000-68000 annual visits. Mean age was 71±15, 67±12, 67±13 years, respectively. 47.5% were women, most responsible ED diagnosis was AF in 75.8%. The mean CHA2DS2-VASc score was 2.6±1.8, with no difference amongst groups. There were 266 patients eligible for OAC and were not on this at presentation. In this group, the prescription of new OAC was 15.8% in Phase 1 as compared to 54% and 47%, in Phases 2 and 3, respectively. After adjustment for center, components of the CHA2DS2-VASc score, prior risk of bleeding and most responsible ED diagnosis, the odds ratio for new OAC prescription was 8.0 (95%CI (3.5,18.3) p<0.001) for Phase 3 vs 1, and 10.0 (95%CI (4.4,22.9) p<0.001), for Phase 2 vs 1). No difference in OAC prescription was seen between Phases 2 and 3. Conclusion: Use of a simple OAC-prescription tool was associated with an increase in new OAC prescription in the ED for eligible patients with AF. Further testing in a rigorous study design to assess the effect of this practice on stroke prevention in the AF patients who present to the ED is indicated.

This article examines the likely role of competition in the regulatory analysis of bank mergers in China. Despite financial reforms, the banking sector remains subject to a complex web of financial regulation, with industrial policy favouring stability to facilitate national economic development. While there are currently no Ministry of Commerce (MOFCOM) bank merger determinations under the Anti-Monopoly Law (AML), examples of MOFCOM’s merger analysis in other sensitive industries diverge from a pure competition-based analysis, favouring grounds linked to national economic development broadly within the terms of the AML. Given the importance of banking to the Chinese economy, this article argues that competition is unlikely to play a large part in any assessment of bank mergers by MOFCOM, particularly where a foreign bank is involved. Instead, issues linked to ‘national economic development’ and stability are likely to play the most important role, leading to less predictable merger approval outcomes.

Introduction: The recently published ProMISe, ARISE and ProCESS trials demonstrated that protocol-based resuscitation (EGDT) of ER patients in whom septic shock was diagnosed did not improve outcome when compared to usual care. The objective of this project was to survey McMaster emergency physicians in areas including sepsis definition, clinical recognition in adults, self-rated skills assessment, attitudes towards skills augmentation and compare results to the cohort surveyed 11 years ago, close to the introduction of EGDT. Methods: Full time faculty at McMaster’s Department of Emergency Medicine and ER residents were surveyed anonymously using an electronic survey. The questions covered demographics and training data, identification of septic patients, sepsis intervention and attitudes towards skills augmentation. Results: A total of 18 physicians responded to the electronic survey to date. All respondents were able to correctly input definitions for SIRS, sepsis, severe sepsis and septic shock. The majority of respondents felt the best strategy to identify potentially septic adults involved monitoring abnormal vital signs (67%) with some stating serum lactate assessment (33%). Of the 11 possible interventions options provided to care for septic patients, respondents appeared more comfortable with placement of lines, giving vasopressors and appropriate use of fluids for resuscitation. This was compared to more specialized interventions like initiating IV steroids in vasopressor dependant shock despite adequate fluid loading. 22% of respondents believed that patients without respiratory compromise with clinically severe sepsis should be intubated which was found to be 48% in the previous cohort surveyed 11 years ago. 78% believed patients in septic shock without respiratory comprise should be intubated, reassuringly similar to the previous survey result of 87%. Conclusion: Emergency physicians at our Canadian institution are comfortable with the skill set required to care for patients with sepsis. Respondents surveyed to date were all comfortable with important resuscitative measures including accurate identification, placement of lines and appropriate fluid administration and were receptive to additional training. Our study emphasizes that our physicians have the skill set to identify and provide care for sepsis using their clinical judgment in cases that may not require protocolized based care.

China and Australia are extremely significant trade partners and investors. Australia has a very well established competition law, now called the Competition and Consumer Law 2010, with a well-established merger regime. China has a relatively new competition law, the Anti-Monopoly Law 2007. This article compares merger control in the two jurisdictions. The Ministry of Commerce (MOFCOM) has already referred to an Australian decision in rejecting a merger, the only reference to a foreign decision to date, which confirms the utility of the comparison. This article critically evaluates the determinations of MOFCOM and compares the approach of the Australian Competition and Consumer Commission (ACCC), the Australian regulator. It assesses the transparency and predictability of procedures and decision-making in the two jurisdictions.

Hydrodynamic stability of round viscous fluid jets is considered within the framework of the non-modal approach. Both the jet fluid and surrounding gas are assumed to be incompressible and Newtonian; the effect of surface capillary pressure is taken into account. The linearized Navier–Stokes equations coupled with boundary conditions at the jet axis, interface and infinity are reduced to a system of four ordinary differential equations for the amplitudes of disturbances in the form of spatial normal modes. The eigenvalue problem is solved by using the orthonormalization method with Newton iterations and the system of least stable normal modes is found. Linear combinations of modes (optimal disturbances) leading to the maximum kinetic energy at a specified set of governing parameters are found. Parametric study of optimal disturbances is carried out for both an air jet and a liquid jet in air. For the velocity profiles under consideration, it is found that the non-modal instability mechanism is significant for non-axisymmetric disturbances. The maximum energy of the optimal disturbances to the jets at the Reynolds number of 1000 is found to be two orders of magnitude larger than that of the single mode. The largest growth is gained by the streamwise velocity component.

Several single nucleotide polymorphisms (SNPs) in candidate genes of DNA repair and hormone pathways have been reported to be associated with endometrial cancer risk. We sought to confirm these associations in two endometrial cancer case-control sample sets and used additional data from an existing genome-wide association study to prioritize an additional SNP for further study. Five SNPs from the CHEK2, MGMT, SULT1E1 and SULT1A1 genes, genotyped in a total of 1597 cases and 1507 controls from two case-control studies, the Australian National Endometrial Cancer Study and the Polish Endometrial Cancer Study, were assessed for association with endometrial cancer risk using logistic regression analysis. Imputed data was drawn for CHEK2 rs8135424 for 666 cases from the Study of Epidemiology and Risk factors in Cancer Heredity study and 5190 controls from the Wellcome Trust Case Control Consortium. We observed no association between SNPs in the MGMT, SULT1E1 and SULT1A1 genes and endometrial cancer risk. The A allele of the rs8135424 CHEK2 SNP was associated with decreased risk of endometrial cancer (adjusted per-allele OR 0.83; 95%CI 0.70-0.98; p = .03) however this finding was opposite to that previously published. Imputed data for CHEK2 rs8135424 supported the direction of effect reported in this study (OR 0.85; 95% CI 0.65–1.10). Previously reported endometrial cancer risk associations with SNPs from in genes involved in estrogen metabolism and DNA repair were not replicated in our larger study population. This study highlights the need for replication of candidate gene SNP studies using large sample groups, to confirm risk associations and better prioritize downstream studies to assess the causal relationship between genetic variants and cancer risk. Our findings suggest that the CHEK2 SNP rs8135424 be prioritized for further study as a genetic factor associated with risk of endometrial cancer.

Cognition and emotion, traditionally thought of as largely distinct, have recently begun to be conceptualized as dynamically linked processes that interact to influence functioning. This study investigated the moderating effects of cognitive functioning on the relationship between negative emotionality and attention deficit/hyperactivity disorder (ADHD) symptom severity. A total of 216 (140 hyperactive/inattentive; 76 typically developing) preschoolers aged 3–4 years were administered a neuropsychological test battery (i.e., NEPSY). To avoid method bias, child negative emotionality was rated by teachers (Temperament Assessment Battery for Children-Revised), and parents rated symptom severity on the ADHD Rating Scale (ADHD-RS-IV). Hierarchical Linear Regression analyses revealed that both negative emotionality and Perceptual-Motor & Executive Functions accounted for significant unique variance in ADHD symptom severity. Significant interactions indicated that when negative emotionality is low, but not high, neuropsychological functioning accounts for significant variability in ADHD symptoms, with lower functioning predicting more symptoms. Emotional and neuropsychological functioning, both individually and in combination, play a significant role in the expression of ADHD symptom severity. (JINS, 2011, 17, 502–510)

This study uses spatio-temporal stability analysis to investigate the convective and absolute instability properties of a steady unconfined planar liquid jet. The approach uses a piecewise linear velocity profile with a finite-thickness shear layer at the edge of the jet. This study investigates how properties such as the thickness of the shear layer and the value of the fluid velocity at the interface within the shear layer affect the stability properties of the jet. It is found that the presence of a finite-thickness shear layer can lead to an absolute instability for a range of density ratios, not seen when a simpler plug flow velocity profile is considered. It is also found that the inclusion of surface tension has a stabilizing effect on the convective instability but a destabilizing effect on the absolute instability. The stability results are used to obtain estimates for the breakup length of a planar liquid jet as the jet velocity varies. It is found that reducing the shear layer thickness within the jet causes the breakup length to decrease, while increasing the fluid velocity at the fluid interface within the shear layer causes the breakup length to increase. Combining these two effects into a profile, which evolves realistically with velocity, gives results in which the breakup length increases for small velocities and decreases for larger velocities. This behaviour agrees qualitatively with existing experiments on the breakup length of axisymmetric jets.

Recent simulations and experiments appear to show that the rotating-disk boundary layer is linearly globally stable despite the existence of local absolute instability. However, we argue that linear global instability can be created by local absolute instability at the edge of the disk. This argument is based on investigations of the linearized complex Ginzburg–Landau equation with weakly spatially varying coefficients to model the propagation of a wavepacket through a weakly inhomogeneous unstable medium. Therefore, this mechanism could operate in a variety of locally absolutely unstable flows. The corresponding nonlinear global mode has a front at the radius of onset of absolute instability when the disk edge is far from the front. This front moves radially outwards when the Reynolds number at the disk edge is reduced. It is shown that the laminar–turbulent transition front also behaves in this manner, possibly explaining the scatter in observed transitional Reynolds numbers.

Plots in the Jamaican montane forest were fertilized with nitrogen or with phosphorus to test the hypothesis that growth of trees in this natural forest is limited by the supply of N and P from the soil.

Once a year from 1983 to 1986, urea was added to one plot (at 150 kg N ha−1 y−1) and triple superphosphate was added to another (at 50 kg P ha−1 y−1). In each of these plots and in two control plots, foliage of four common tree species was collected immediately before each fertilizer addition. Trunk growth was measured in 105 individuals.

Foliar N concentrations were not significantly higher in trees fertilized with N compared to control trees. In Dendropanax cf. pendulus and Hedyosmum arborescens fertilization with N resulted in lower P concentrations but only after the third year of fertilization, possibly due to dilution by increased leaf production. Mean trunk diameter growth was significantly higher in the N-fertilized trees than in controls.

Mean foliar P concentrations were higher in Podocarpus urbanii and Clethra occidentalis following fertilization with P, but only after two years of fertilization. Trunk diameter growth was greater in the P fertilized plot.

Thus growth in some Jamaican montane forest trees was limited by the natural supplies of N and of P.

A 3000 bp cDNA insert (G6/1) from Giardia duodenalis, cloned into Escherichia coli is located on chromosome 3 of Giardia stocks which have 3 chromosomes detectable by field-inversion gel electrophoresis in the range 650–800 kb and on chromosome 3 and/or 4 of stocks with 4 chromosomes in this size range. The loss of this sequence from chromosome 4 but not chromosome 3 was associated with the induction of drug resistance in a previously sensitive laboratory stock. G6/1 appears to represent a single copy gene in Giardia as determined by hybridization of the probe to cleaved genomic DNA. Furthermore, the sequences flanking at least 12 kb of G6/1 are the same when G6/1 appears on both chromosomes 3 and 4. The cDNA encodes a protein associated with the nuclei of trophozoites during some stages of growth of the parasite. In a non-dividing culture, the antigen is associated with the nuclei of about 30% of trophozoites and fewer in a dividing culture. Three Giardia stocks with obvious chromosome rearrangements, which grow poorly and fail to divide normally, apparently lack the DNA sequence G6/1.