Background: Duchenne muscular dystrophy (DMD) is an X-linked disease that causes progressive muscle wasting. The Canadian Neuromuscular Disease Registry (CNDR) DMD subset collects data focused on body structure and function. Our objective is to develop a broader dataset including the priorities of those living with DMD in accordance with the International Classification of Functioning, Disability, and Health (ICF) – a framework for describing disease and health functions developed by the World Health Organization. Methods: Clinically relevant ICF categories for DMD were identified and reviewed by two independent committees including two patients and six parent representatives. The Delphi approach was used to narrow ICF categories to a core set representative of DMD, which will be mapped to the CNDR-DMD subset. Results: With full result expected by the conference, the mapping of the ICF to the CNDR-DMD subset will identify data collection priorities in the four domains of functioning and disability: body functions and structures, activities at the level of the individual, participation in all areas of life, and environmental factors. Conclusions: The ICF can be used to identify data collection priorities. Broadening the CNDR-DMD subset will foster future research to include outcome measures important to patients and families affected by DMD.

Magnetite is a common mineral in the Paleoproterozoic Stollberg Zn–Pb–Ag plus magnetite ore field (~6.6 Mt of production), which occurs in 1.9 Ga metamorphosed felsic and mafic rocks. Mineralisation at Stollberg consists of magnetite bodies and massive to semi-massive sphalerite–galena and pyrrhotite (with subordinate pyrite, chalcopyrite, arsenopyrite and magnetite) hosted by metavolcanic rocks and skarn. Magnetite occurs in sulfides, skarn, amphibolite and altered metamorphosed rhyolitic ash–siltstone that consists of garnet–biotite, quartz–garnet–pyroxene, gedrite–albite, and sericitic rocks. Magnetite probably formed from hydrothermal ore-bearing fluids (~250–400°C) that replaced limestone and rhyolitic ash–siltstone, and subsequently recrystallised during metamorphism. The composition of magnetite from these rock types was measured using electron microprobe analysis and LA–ICP–MS. Utilisation of discrimination plots (Ca+Al+Mn vs. Ti+V, Ni/(Cr+Mn) vs. Ti+V, and trace-element variation diagrams (median concentration of Mg, Al, Ti, V, Co, Mn, Zn and Ga) suggest that the composition of magnetite in sulfides from the Stollberg ore field more closely resembles that from skarns found elsewhere rather than previously published compositions of magnetite in metamorphosed volcanogenic massive sulfide deposits. Although the variation diagrams show that magnetite compositions from various rock types have similar patterns, principal component analyses and element–element variation diagrams indicate that its composition from the same rock type in different sulfide deposits can be distinguished. This suggests that bulk-rock composition also has a strong influence on magnetite composition. Principal component analyses also show that magnetite in sulfides has a distinctive compositional signature which allows it to be a prospective pathfinder mineral for sulfide deposits in the Stollberg ore field.

Recent excavations by the Ancient Southwest Texas Project of Texas State University sampled a previously undocumented Younger Dryas component from Eagle Cave in the Lower Pecos Canyonlands of Texas. This stratified assemblage consists of bison (Bison antiquus) bones in association with lithic artifacts and a hearth. Bayesian modeling yields an age of 12,660–12,480 cal BP, and analyses indicate behaviors associated with the processing of a juvenile bison and the manufacture and maintenance of lithic tools. This article presents spatial, faunal, macrobotanical, chronometric, geoarchaeological, and lithic analyses relating to the Younger Dryas component within Eagle Cave. The identification of the Younger Dryas occupation in Eagle Cave should encourage archaeologists to revisit previously excavated rockshelter sites in the Lower Pecos and beyond to evaluate deposits for unrecognized, older occupations.

The evidence base on the relationship between religion and mental health is growing rapidly, and we summarise the latest research on the topic. This includes studies on religious involvement and depression, bipolar disorder, suicide, post-traumatic stress disorder (PTSD), substance use disorders, personality disorder, chronic psychotic disorder, marital/family stability, social support and psychological well-being. We also review a relatively new topic in psychiatry, moral injury, which often accompanies PTSD and may interfere with its treatment. We describe a theoretical model that explains how religion might affect mental health and briefly discuss its applications in clinical practice, including a discussion of religiously integrated therapies for depression, anxiety and other emotional problems. Overall, studies indicate that religious involvement often serves as a powerful resource for patients, one that can be integrated into psychiatric care. At times, however, religion may impede or complicate treatment. This article will help clinicians determine, on the basis of the latest research, whether religion is an asset or a liability for a particular patient.

In an earlier article we reviewed the latest research on the relationship between religious involvement and mental health, the effects of religiosity on mental health and well-being over time and the impact of religious interventions. Here we focus on clinical applications that may be useful to psychiatrists and other mental health professionals. We discuss general clinical applications relevant to all patients (e.g. taking a spiritual history, supporting/encouraging religious beliefs, referring to clergy), violations of clinician–patient boundaries and the need to ensure that religious/spiritual interventions are patient-centred. We describe evidence-based religious interventions and how to identify appropriate patients for this approach. Finally, we explore situations in which religious beliefs and practices may be a problem, not a resource, and make recommendations on how to address such cases. Case vignettes illustrate clinical situations that mental health professionals are likely to encounter. Although the focus is on the North American context, we note how practice and culture in the UK may differ.

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons (MIC). We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

This paper describes a model of electron energization and cyclotron-maser emission applicable to astrophysical magnetized collisionless shocks. It is motivated by the work of Begelman, Ergun and Rees [Astrophys. J. 625, 51 (2005)] who argued that the cyclotron-maser instability occurs in localized magnetized collisionless shocks such as those expected in blazar jets. We report on recent research carried out to investigate electron acceleration at collisionless shocks and maser radiation associated with the accelerated electrons. We describe how electrons accelerated by lower-hybrid waves at collisionless shocks generate cyclotron-maser radiation when the accelerated electrons move into regions of stronger magnetic fields. The electrons are accelerated along the magnetic field and magnetically compressed leading to the formation of an electron velocity distribution having a horseshoe shape due to conservation of the electron magnetic moment. Under certain conditions the horseshoe electron velocity distribution function is unstable to the cyclotron-maser instability [Bingham and Cairns, Phys. Plasmas 7, 3089 (2000); Melrose, Rev. Mod. Plasma Phys. 1, 5 (2017)].

The physics of compressible turbulence in high energy density (HED) plasmas is an unchartered experimental area. Simulations of compressible and radiative flows relevant for astrophysics rely mainly on subscale parameters. Therefore, we plan to perform turbulent hydrodynamics experiments in HED plasmas (TurboHEDP) in order to improve our understanding of such important phenomena for interest in both communities: laser plasma physics and astrophysics. We will focus on the physics of supernovae remnants which are complex structures subject to fluid instabilities such as the Rayleigh–Taylor and Kelvin–Helmholtz instabilities. The advent of megajoule laser facilities, like the National Ignition Facility and the Laser Megajoule, creates novel opportunities in laboratory astrophysics, as it provides unique platforms to study turbulent mixing flows in HED plasmas. Indeed, the physics requires accelerating targets over larger distances and longer time periods than previously achieved. In a preparatory phase, scaling from experiments at lower laser energies is used to guarantee the performance of future MJ experiments. This subscale experiments allow us to develop experimental skills and numerical tools in this new field of research, and are stepping stones to achieve our objectives on larger laser facilities. We review first in this paper recent advances in high energy density experiments devoted to laboratory astrophysics. Then we describe the necessary steps forward to commission an experimental platform devoted to turbulent hydrodynamics on a megajoule laser facility. Recent novel experimental results acquired on LULI2000, as well as supporting radiative hydrodynamics simulations, are presented. Together with the development of LiF detectors as transformative X-ray diagnostics, these preliminary results are promising on the way to achieve micrometric spatial resolution in turbulent HED physics experiments in the near future.

The influence of a strong external magnetic field on the collimation of a high Mach number plasma flow and its collision with a solid obstacle is investigated experimentally and numerically. The laser irradiation ($I\sim 2\times 10^{14}~\text{W}\cdot \text{cm}^{-2}$ ) of a multilayer target generates a shock wave that produces a rear side plasma expanding flow. Immersed in a homogeneous 10 T external magnetic field, this plasma flow propagates in vacuum and impacts an obstacle located a few mm from the main target. A reverse shock is then formed with typical velocities of the order of 15–20 $\pm$ 5 km/s. The experimental results are compared with 2D radiative magnetohydrodynamic simulations using the FLASH code. This platform allows investigating the dynamics of reverse shock, mimicking the processes occurring in a cataclysmic variable of polar type.

Objectives: The objective of this study was to evaluate the feasibility and implementation of a standardized medically supervised concussion protocol established between a city-wide AAA hockey league and a multi-disciplinary concussion program. Methods: We conducted a retrospective review of injury surveillance, clinical and healthcare utilization data from all athletes evaluated and managed through the Winnipeg AAA Hockey concussion protocol during the 2016-2017 season. We also conducted post-season email surveys of head coaches and parents responsible for athletes who competed in the same season. Results: During the 2016-2017 season, 28 athletes were evaluated through the medically supervised concussion protocol, with two athletes undergoing evaluation for repeat injuries (a total of 30 suspected injuries and consultations). In all, 96.7% of the athletes managed through the concussion protocol were captured by the league-designated Concussion Protocol Coordinator and 100% of eligible athletes underwent complete medical follow-up and clearance to return to full hockey activities. Although 90% of responding head coaches and 91% of parents were aware of the concussion protocol, survey results suggest that some athletes who sustained suspected concussions were not managed through the protocol. Head coaches and parents also indicated that athlete education and communication between medical and sport stakeholders were other elements of the concussion protocol that could be improved. Conclusion: Successful implementation of a medically supervised concussion protocol for youth hockey requires clear communication between sport stakeholders and timely access to multi-disciplinary experts in traumatic brain and spine injuries. Standardized concussion protocols for youth sports may benefit from periodic evaluations by sport stakeholders and incorporation of national guideline best practices and resources.

A new target design is presented to model high-energy radiative accretion shocks in polars. In this paper, we present the experimental results obtained on the GEKKO XII laser facility for the POLAR project. The experimental results are compared with 2D FCI2 simulations to characterize the dynamics and the structure of plasma flow before and after the collision. The good agreement between simulations and experimental data confirms the formation of a reverse shock where cooling losses start modifying the post-shock region. With the multi-material structure of the target, a hydrodynamic collimation is exhibited and a radiative structure coupled with the reverse shock is highlighted in both experimental data and simulations. The flexibility of the laser energy produced on GEKKO XII allowed us to produce high-velocity flows and study new and interesting radiation hydrodynamic regimes between those obtained on the LULI2000 and Orion laser facilities.

We have developed a new radiography setup with a short-pulse laser-driven x-ray source. Using a radiography axis perpendicular to both long- and short-pulse lasers allowed optimizing the incident angle of the short-pulse laser on the x-ray source target. The setup has been tested with various x-ray source target materials and different laser wavelengths. Signal to noise ratios are presented as well as achieved spatial resolutions. The high quality of our technique is illustrated on a plasma flow radiograph obtained during a laboratory astrophysics experiment on POLARs.

Individuals engaging in self-injurious behavior (SIB) frequently report absence of pain during acts of SIB. While altered pain sensitivity is discussed as a risk factor for the engagement in SIB, results have been mixed with considerable variance across reported effect sizes, in particular with respect to the effect of co-morbid psychopathology. The present meta-analysis aimed to summarize the current evidence on pain sensitivity in individuals engaging in SIB and to identify covariates of altered pain processing. Three databases were searched without restrictions. Additionally a hand search was performed and reference lists of included studies were checked for potential studies eligible for inclusion. Thirty-two studies were identified after screening 720 abstracts by two independent reviewers. Studies were included if they reported (i) an empirical investigation, in (ii) humans, including a sample of individuals engaging in (iii) SIB and a group of (iv) healthy controls, (v) receiving painful stimulation. Random-effects meta-analysis was performed on three pain-related outcomes (pain threshold, pain tolerance, pain intensity) and several population- and study-level covariates (i.e. age, sex, clinical etiology) were subjected to meta-regression. Meta-analysis revealed significant main effects associated with medium to large effect sizes for all included outcomes. Individuals engaging in SIB show greater pain threshold and tolerance and report less pain intensity compared to healthy controls. Clinical etiology and age are significant covariates of pain sensitivity in individuals engaging in SIB, such that pain threshold is further increased in borderline personality disorder compared to non-suicidal self-injury. Mechanisms underlying altered pain sensitivity are discussed.