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DSM-5 differentiates avoidant/restrictive food intake disorder (ARFID) from other eating disorders (EDs) by a lack of overvaluation of body weight/shape driving restrictive eating. However, clinical observations and research demonstrate ARFID and shape/weight motivations sometimes co-occur. To inform classification, we: (1) derived profiles underlying restriction motivation and examined their validity and (2) described diagnostic characterizations of individuals in each profile to explore whether findings support current diagnostic schemes. We expected, consistent with DSM-5, that profiles would comprise individuals endorsing solely ARFID or restraint (i.e. trying to eat less to control shape/weight) motivations.
Methods
We applied latent profile analysis to 202 treatment-seeking individuals (ages 10–79 years [M = 26, s.d. = 14], 76% female) with ARFID or a non-ARFID ED, using the Nine-Item ARFID Screen (Picky, Appetite, and Fear subscales) and the Eating Disorder Examination-Questionnaire Restraint subscale as indicators.
Results
A 5-profile solution emerged: Restraint/ARFID-Mixed (n = 24; 8% [n = 2] with ARFID diagnosis); ARFID-2 (with Picky/Appetite; n = 56; 82% ARFID); ARFID-3 (with Picky/Appetite/Fear; n = 40; 68% ARFID); Restraint (n = 45; 11% ARFID); and Non-Endorsers (n = 37; 2% ARFID). Two profiles comprised individuals endorsing solely ARFID motivations (ARFID-2, ARFID-3) and one comprising solely restraint motivations (Restraint), consistent with DSM-5. However, Restraint/ARFID-Mixed (92% non-ARFID ED diagnoses, comprising 18% of those with non-ARFID ED diagnoses in the full sample) endorsed ARFID and restraint motivations.
Conclusions
The heterogeneous profiles identified suggest ARFID and restraint motivations for dietary restriction may overlap somewhat and that individuals with non-ARFID EDs can also endorse high ARFID symptoms. Future research should clarify diagnostic boundaries between ARFID and non-ARFID EDs.
To implement and evaluate a point-of-care (POC) molecular testing platform for respiratory viruses in congregate living settings (CLS).
Design:
Prospective quality improvement study.
Setting:
Seven CLS, including three nursing homes and four independent-living facilities.
Participants:
Residents of CLS.
Methods:
A POC platform for COVID-19, influenza A and B, and respiratory syncytial virus was implemented at participating CLS from December 1, 2022 to April 15, 2023. Residents with respiratory symptoms underwent paired testing, with respiratory specimens tested first with the POC platform and then delivered to an off-site laboratory for multiplex respiratory virus panel (MRVP) polymerase chain reaction (PCR) as per standard protocol. Turn-around time and diagnostic accuracy of the POC platform were compared against MRVP PCR. In an exploratory analysis, time to outbreak declaration among participating CLS was compared against a convenience sample of 19 CLS that did not use the POC platform.
Results:
A total of 290 specimens that underwent paired testing were included. Turn-around time to result was significantly shorter with the POC platform compared to MRVP PCR, with median difference of 36.2 hours (interquartile range 21.8–46.4 hours). The POC platform had excellent diagnostic accuracy compared to MRVP PCR, with area under the curve statistic of .96. Time to outbreak declaration was shorter in CLS that used the POC platform compared to CLS that did not.
Conclusion:
Rapid POC testing platforms for respiratory viruses can be implemented in CLS, with high diagnostic accuracy, expedited turn-around times, and shorter time to outbreak declaration.
The interaction of relativistically intense lasers with opaque targets represents a highly non-linear, multi-dimensional parameter space. This limits the utility of sequential 1D scanning of experimental parameters for the optimization of secondary radiation, although to-date this has been the accepted methodology due to low data acquisition rates. High repetition-rate (HRR) lasers augmented by machine learning present a valuable opportunity for efficient source optimization. Here, an automated, HRR-compatible system produced high-fidelity parameter scans, revealing the influence of laser intensity on target pre-heating and proton generation. A closed-loop Bayesian optimization of maximum proton energy, through control of the laser wavefront and target position, produced proton beams with equivalent maximum energy to manually optimized laser pulses but using only 60% of the laser energy. This demonstration of automated optimization of laser-driven proton beams is a crucial step towards deeper physical insight and the construction of future radiation sources.
We present the development and characterization of a high-stability, multi-material, multi-thickness tape-drive target for laser-driven acceleration at repetition rates of up to 100 Hz. The tape surface position was measured to be stable on the sub-micrometre scale, compatible with the high-numerical aperture focusing geometries required to achieve relativistic intensity interactions with the pulse energy available in current multi-Hz and near-future higher repetition-rate lasers ($>$kHz). Long-term drift was characterized at 100 Hz demonstrating suitability for operation over extended periods. The target was continuously operated at up to 5 Hz in a recent experiment for 70,000 shots without intervention by the experimental team, with the exception of tape replacement, producing the largest data-set of relativistically intense laser–solid foil measurements to date. This tape drive provides robust targetry for the generation and study of high-repetition-rate ion beams using next-generation high-power laser systems, also enabling wider applications of laser-driven proton sources.
Clozapine-induced gastrointestinal hypomotility (CIGH) affects some 75% of patients treated with clozapine.
Aims
To document the incidence of potentially harmful CIGH in the UK.
Method
We studied spontaneous UK pharmacovigilance reports recorded as clozapine-related gastrointestinal adverse drug reactions, 1992–2017.
Results
There were 527 patients reported with potentially harmful CIGH; 33% (n = 172) died. Deaths averaged 1 per year 1992–1999, 5 per year 2000–2009 and 15 per year 2010–2017. Those who died were older (median 52 years v. 49 years) and had been prescribed clozapine for longer than those who recovered (median 11.3 years v. 4.8 years), but there was no difference in prescribed dose. Within the first 4 years of clozapine treatment, there were 169 reports of CIGH, of which 3% (n = 5) were fatal. At 10–14 years there were 63 reports of CIGH, of which 25% (n = 16) were fatal. Among the deaths, males were younger (median 51, range 22–89 v. median 57, range 24–89 years) with higher clozapine doses (median 450, range 100–900 v. median 300, range 12.5–800 mg/d) than females. In non-fatal CIGH, surgery was the most frequent outcome (n = 92). The procedures included appendectomy, ileostomy, total/partial colectomy, colostomy/stoma and proctosigmoidectomy. Clozapine dosage was reduced in 6 patients, stopped and restarted in 23, ‘continued’ in 6 and discontinued permanently in at least 76 patients.
Conclusions
The risk of serious morbidity/mortality from CIGH is substantial. The need to actively monitor bowel function and give laxatives to patients treated with clozapine is clear.
Two introduced carnivores, the European red fox Vulpes vulpes and domestic cat Felis catus, have had extensive impacts on Australian biodiversity. In this study, we collate information on consumption of Australian birds by the fox, paralleling a recent study reporting on birds consumed by cats. We found records of consumption by foxes on 128 native bird species (18% of the non-vagrant bird fauna and 25% of those species within the fox’s range), a smaller tally than for cats (343 species, including 297 within the fox’s Australian range, a subset of that of the cat). Most (81%) bird species eaten by foxes are also eaten by cats, suggesting that predation impacts are compounded. As with consumption by cats, birds that nest or forage on the ground are most likely to be consumed by foxes. However, there is also some partitioning, with records of consumption by foxes but not cats for 25 bird species, indicating that impacts of the two predators may also be complementary. Bird species ≥3.4 kg were more likely to be eaten by foxes, and those <3.4 kg by cats. Our compilation provides an inventory and describes characteristics of Australian bird species known to be consumed by foxes, but we acknowledge that records of predation do not imply population-level impacts. Nonetheless, there is sufficient information from other studies to demonstrate that fox predation has significant impacts on the population viability of some Australian birds, especially larger birds, and those that nest or forage on the ground.
For recalcitrant chronic maxillary sinusitis, modified endoscopic medial maxillectomy has been shown to be clinically beneficial after failed maxillary antrostomy as endoscopic medial maxillectomy may offer improved topical therapy delivery. This study compared irrigation patterns after maxillary antrostomy versus endoscopic medial maxillectomy, using computational fluid dynamic modelling.
Case report
A 54-year-old female with left chronic maxillary sinusitis underwent maxillary antrostomy, followed by endoscopic medial maxillectomy. Computational fluid dynamic models were created after each surgery and used to simulate irrigations.
Results
After maxillary antrostomy, irrigation penetrated the maxillary sinus at 0.5 seconds, initially contacting the posterior wall. The maxillary sinus was half-filled at 2 seconds, and completely filled at 4 seconds. After endoscopic medial maxillectomy, irrigation penetrated the maxillary sinus at 0.5 seconds and immediately contacted all maxillary sinus walls. The maxillary sinus was completely filled by 2 seconds.
Conclusion
Computational fluid dynamic modelling demonstrated that endoscopic medial maxillectomy allowed faster, more forceful irrigation to all maxillary sinus walls compared with maxillary antrostomy.
Radiocarbon (14C) ages cannot provide absolutely dated chronologies for archaeological or paleoenvironmental studies directly but must be converted to calendar age equivalents using a calibration curve compensating for fluctuations in atmospheric 14C concentration. Although calibration curves are constructed from independently dated archives, they invariably require revision as new data become available and our understanding of the Earth system improves. In this volume the international 14C calibration curves for both the Northern and Southern Hemispheres, as well as for the ocean surface layer, have been updated to include a wealth of new data and extended to 55,000 cal BP. Based on tree rings, IntCal20 now extends as a fully atmospheric record to ca. 13,900 cal BP. For the older part of the timescale, IntCal20 comprises statistically integrated evidence from floating tree-ring chronologies, lacustrine and marine sediments, speleothems, and corals. We utilized improved evaluation of the timescales and location variable 14C offsets from the atmosphere (reservoir age, dead carbon fraction) for each dataset. New statistical methods have refined the structure of the calibration curves while maintaining a robust treatment of uncertainties in the 14C ages, the calendar ages and other corrections. The inclusion of modeled marine reservoir ages derived from a three-dimensional ocean circulation model has allowed us to apply more appropriate reservoir corrections to the marine 14C data rather than the previous use of constant regional offsets from the atmosphere. Here we provide an overview of the new and revised datasets and the associated methods used for the construction of the IntCal20 curve and explore potential regional offsets for tree-ring data. We discuss the main differences with respect to the previous calibration curve, IntCal13, and some of the implications for archaeology and geosciences ranging from the recent past to the time of the extinction of the Neanderthals.
Identifying factors that influence the functional outcome is an important goal in schizophrenia research. The 22q11.2 deletion syndrome (22q11DS) is a unique genetic model with high risk (20–25%) for schizophrenia. This study aimed to identify potentially targetable domains of neurocognitive functioning associated with functional outcome in adults with 22q11DS.
Methods
We used comprehensive neurocognitive test data available for 99 adults with 22q11DS (n = 43 with schizophrenia) and principal component analysis to derive four domains of neurocognition (Verbal Memory, Visual and Logical Memory, Motor Performance, and Executive Performance). We then investigated the association of these neurocognitive domains with adaptive functioning using Vineland Adaptive Behavior Scales data and a linear regression model that accounted for the effects of schizophrenia status and overall intellectual level.
Results
The regression model explained 46.8% of the variance in functional outcome (p < 0.0001). Executive Performance was significantly associated with functional outcome (p = 0.048). Age and schizophrenia were also significant factors. The effects of Executive Performance on functioning did not significantly differ between those with and without psychotic illness.
Conclusion
The findings provide the impetus for further studies to examine the potential of directed (early) interventions targeting Executive Performance to improve long-term adaptive functional outcome in individuals with, or at high risk for, schizophrenia. Moreover, the neurocognitive test profiles may benefit caregivers and clinicians by providing insight into the relative strengths and weaknesses of individuals with 22q11DS, with and without psychotic illness.
In September 2015, an outbreak of Escherichia coli Phage Type 32 with an indistinguishable multi locus variable number tandem repeat analysis profile was identified in Scotland. Twelve cases were identified; nine primary cases, two secondary and one asymptomatic case. Extensive food history investigations identified venison products containing wild venison produced by a single food business operator as the most likely source of the outbreak. Of the nine primary cases, eight had consumed venison products, and one case had not eaten venison themselves but had handled and cooked raw venison in the household. This was the first reported outbreak of Shiga toxin-producing Escherichia coli (STEC) linked to venison products in the UK, and was also notable due to the implicated products being commercially produced and widely distributed. In contrast, previous venison outbreaks reported from other countries have tended to be smaller and related to individually prepared carcases. The outbreak has highlighted some important knowledge gaps in relation to STEC in venison that are currently been investigated via a number of research studies.
Unit-cell parameters of synthesized members of the crandallite (a = 7.007 Å, c = 16.216 Å)-goyazite (a = 7.013 Å, c = 16.650 Å) series vary linearly with composition between end-members. Most members of the series consist of 0.1 μm platy crystals, but crandallite also contains some larger (1–5 µm) tapered crystals elongated along the c axis.
With increasing Sr substitution the dehydroxylation temperature decreases from c. 475 °C for crandallite to 420 °C at 20 mole % Sr, and then increases to 440 °C for goyazite. Partial dehydroxylation of crandallite is accompanied by contraction of the c unit cell parameter and expansion of a, thereby retaining an unaltered unit cell volume. The much greater sensitivity of c to both Sr substitution and dehydroxylation may be due to the rigidity of continuous sheets of Al(OH)4O2 octahedra which are parallel to the (001) plane in these minerals.
Alterations in reinforcement-based decision making may be associated with increased psychiatric vulnerability in children who have experienced maltreatment. A probabilistic passive avoidance task and a model-based functional magnetic resonance imaging analytic approach were implemented to assess the neurocomputational components underlying decision making: (a) reinforcement expectancies (the representation of the outcomes associated with a stimulus) and (b) prediction error signaling (the ability to detect the differences between expected and actual outcomes). There were three main findings. First, the maltreated group (n = 18; mean age = 13), relative to nonmaltreated peers (n = 19; mean age = 13), showed decreased activity during expected value processing in a widespread network commonly associated with reinforcement expectancies representation, including the striatum (especially the caudate), the orbitofrontal cortex, and medial temporal structures including the hippocampus and insula. Second, consistent with previously reported hyperresponsiveness to negative cues in the context of childhood abuse, the maltreated group showed increased prediction error signaling in the middle cingulate gyrus, somatosensory cortex, superior temporal gyrus, and thalamus. Third, the maltreated group showed increased activity in frontodorsal regions and in the putamen during expected value representation. These findings suggest that early adverse environments disrupt the development of decision-making processes, which in turn may compromise psychosocial functioning in ways that increase latent vulnerability to psychiatric disorder.
We document and describe the trilobite faunas of the Lower Cambrian Shackleton Limestone. The faunas include taxa of Atdabanian, Botomian and possible Toyonian ages and have affinities with those known previously from Gondwana or peri-Gondwana terranes. The geographic distribution of these organisms reveals a large measure of faunal connectedness around the margin of this vast supercontinent in Early Cambrian time. This connectedness extended even to taxa that inhabited shallow-water carbonate shelf environments, because the Shackleton Limestone accumulated in a variety of shallow subtidal and peritidal settings along the ocean-facing margin of the East Antarctic craton, subsequent to a Neoproterozoic rifting event. Although the fossilized Shackleton Limestone fauna is dominated by archaeocyathans, trilobites are common locally. We describe the remains of 35 trilobite taxa from 32 collecting localities. One species, H. granulosa, is assigned to the new genus Holyoakia; the remaining new species are Pagetides (Discomesites) spinosus, Lemdadella antarcticae, Kingaspis (?) convexus, Yunnanocephalus longioccipitalis, and Onchocephalina (?) spinosa.
Soil-applied herbicides alone or followed by postemergence (POST) applications of CGA-277476 were evaluated for season-long weed control in soybean. Common cocklebur, hemp sesbania, and pitted morningglory control was not consistently improved with a soil-applied herbicide followed by a POST application of 79 g ai/ha CGA-277476. However, in locations with heavy weed pressure, a tank-mix of chlorimuron + metribuzin + trifluralin or imazaquin + pendimethalin followed by CGA-277476 improved common cocklebur, hemp sesbania, and pitted morningglory over CGA-277476 alone. Sequential application of CGA-277476 following SAN 582 improved weed control over SAN 582 alone. When weed pressure was not severe, there were no differences in control from CGA-277476 alone or following soil-applied herbicides. A POST application of CGA-277476 following soil-applied herbicides did not consistently improve soybean yield over CGA-277476 alone. Yield from soybean treated with SAN 582 was improved when CGA-277476 was applied. In contrast, when chlorimuron + metribuzin + trifluralin or imazaquin + pendimethalin were applied at planting, yield was similar with or without POST application of CGA-277476.
Field research was conducted at three locations in Mississippi to evaluate CGA-277476 tank mixtures with four broadleaf herbicides for possible improvement of broadleaf weed control. Tank mixtures in this research were typically additive, although some instances of antagonism were noted. Control of morningglory (Ipomoea) species and hemp sesbania (Sesbania exaltata) was not consistently improved by the addition of acifluorfen, chlorimuron, fomesafen, or imazaquin to 59 or 79 g ai/ha CGA-277476. However, when a large population of weeds was present, the addition of acifluorfen, chlorimuron, or fomesafen to 59 or 79 g/ha CGA-277476 improved control over CGA-277476 alone. Prickly sida (Sida spinosa) was not controlled more than 68% with any treatment in this study; however, horse purslane (Trianthema portulacastrum) was controlled at least 90% with either 79 g/ha CGA-277476 alone or tank-mixed with acifluorfen, fomesafen, chlorimuron, or imazaquin. The addition of CGA-277476 to acifluorfen or fomesafen did not improve control over acifluorfen or fomesafen alone on any of the weeds evaluated; however, the addition of CGA-277476 to imazaquin improved hemp sesbania control over imazaquin alone. Tank mixtures did not result in yields greater than CGA-277476 alone in areas with moderate weed pressure, whereas in areas with severe weed pressure, tank mixtures improved soybean (Glycine max) yield over CGA-277476 alone.
One of the most conspicuous phenomena in the Arctic Is the fracture of sea ice. It is scarcely possible to travel far without seeing a variety of fracture forms, produced both by natural processes and by human activity.
At strain-rates below about 10−4 s−1, deformation is dominated by creep, but at higher strain-rates fracture is much more important. One of the reasons for this is the very low fracture toughness of ice. The movements of ice in contact with offshore structures often induce strain-rates well beyond the level at which fracture begins, and so offshore structures will often operate in the fracture regime, and it is fracture processes which will determine the design loads. We consider the different modes of repeated fracture that will occur, and classify them into distinct mechanisms of crushing, spalling, and radial and circumferential cracking. Experimental and field observations are plotted on a deformation mode map. A theoretical treatment of radial cracking confirms that very low loads can propagate cracks to long distances; these loads are small by comparison with those calculated from theoretical models that treat ice as a plastically-deforming continuum.
The interactions of strong-field few-cycle laser pulses with metastable states of noble gas atoms are examined. Metastable noble gas atoms offer a combination of low ionization potential and a relatively simple atomic structure, making them excellent targets for examining ionization dynamics in varying experimental conditions. A review of the current work performed on metastable noble gas atoms is presented.