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Intentional facial disfigurement is documented in archaeological contexts around the world. Here, the authors present the first archaeological evidence for intentional facial mutilation from Anglo-Saxon England—comprising the removal of the nose, upper lip and possible scalping—inflicted upon a young adult female. The injuries are consistent with documented punishments for female offenders. Although such mutilations do not appear in the written record until the tenth century AD, the instance reported here suggests that the practice may have emerged a century earlier. This case is examined in the context of a wider consideration of the motivations and significance of facial disfigurement in past societies.
Using existing data from clinical registries to support clinical trials and other prospective studies has the potential to improve research efficiency. However, little has been reported about staff experiences and lessons learned from implementation of this method in pediatric cardiology.
Objectives:
We describe the process of using existing registry data in the Pediatric Heart Network Residual Lesion Score Study, report stakeholders’ perspectives, and provide recommendations to guide future studies using this methodology.
Methods:
The Residual Lesion Score Study, a 17-site prospective, observational study, piloted the use of existing local surgical registry data (collected for submission to the Society of Thoracic Surgeons-Congenital Heart Surgery Database) to supplement manual data collection. A survey regarding processes and perceptions was administered to study site and data coordinating center staff.
Results:
Survey response rate was 98% (54/55). Overall, 57% perceived that using registry data saved research staff time in the current study, and 74% perceived that it would save time in future studies; 55% noted significant upfront time in developing a methodology for extracting registry data. Survey recommendations included simplifying data extraction processes and tailoring to the needs of the study, understanding registry characteristics to maximise data quality and security, and involving all stakeholders in design and implementation processes.
Conclusions:
Use of existing registry data was perceived to save time and promote efficiency. Consideration must be given to the upfront investment of time and resources needed. Ongoing efforts focussed on automating and centralising data management may aid in further optimising this methodology for future studies.
In 2013, the national surveillance case definition for West Nile virus (WNV) disease was revised to remove fever as a criterion for neuroinvasive disease and require at most subjective fever for non-neuroinvasive disease. The aims of this project were to determine how often afebrile WNV disease occurs and assess differences among patients with and without fever. We included cases with laboratory evidence of WNV disease reported from four states in 2014. We compared demographics, clinical symptoms and laboratory evidence for patients with and without fever and stratified the analysis by neuroinvasive and non-neuroinvasive presentations. Among 956 included patients, 39 (4%) had no fever; this proportion was similar among patients with and without neuroinvasive disease symptoms. For neuroinvasive and non-neuroinvasive patients, there were no differences in age, sex, or laboratory evidence between febrile and afebrile patients, but hospitalisations were more common among patients with fever (P < 0.01). The only significant difference in symptoms was for ataxia, which was more common in neuroinvasive patients without fever (P = 0.04). Only 5% of non-neuroinvasive patients did not meet the WNV case definition due to lack of fever. The evidence presented here supports the changes made to the national case definition in 2013.
The stellar winds of hot stars have an important impact on both stellar and galactic evolution, yet their structure and internal processes are not fully understood in detail. One of the best nearby laboratories for studying such massive stellar winds is the O4I(n)fp star ζ Pup. After briefly discussing existing X-ray observations from Chandra and XMM, we present a simulation of X-ray emission line profile measurements for the upcoming 840 kilosecond Chandra HETGS observation. This simulation indicates that the increased S/N of this new observation will allow several major steps forward in the understanding of massive stellar winds. By measuring X-ray emission line strengths and profiles, we should be able to differentiate between various stellar wind models and map the entire wind structure in temperature and density. This legacy X-ray spectrum of ζ Pup will be a useful benchmark for future X-ray missions.
The Paratoo copper deposit, located in the Neoproterozoic to Cambrian Adelaide Geosyncline, South Australia, produced around 360 tons of Cu between 1888 and 1967 from oxidized ores. The deposit is located in the core of a breached, doubly plunging anticline, near a zone of disruption containing brecciated Adelaidean sedimentary rocks and dolerite (‘Paratoo Diapir’), and hosted in dolomitic shales of the Neoproterozoic Burra Formation. Near the surface, the mineralization resides mainly in deeply weathered quartz-magnetite-sulphide (pyrite, chalcopyrite) veins (⩽10 cm wide). At depth, drill cores reveal disseminated magnetite, pyrite, chalcopyrite, copper sulphide and native copper associated with extensive potassic alteration. K-Na-rich fluids also affected the dolerite in the ‘Paratoo diapir’, resulting in the precipitation of K-feldspar, dravite and K-bearing chabazite-Na. The most likely scenario for the genesis of the Paratoo deposit involves circulation of basinal fluids, focusing into the ‘Paratoo Diapir’, and ore precipitation through neutralization by fluid-rock interaction with the dolomitic shales hosting the mineralization.
The Paratoo deposit is deeply weathered, with malachite and chrysocolla (± tenorite and cuprite) containing the bulk of the copper recovered from the shallow workings. A diverse assemblage of secondary REE-bearing carbonate minerals, including the new species decrespignyite-(Y) and paratooite-(La), is associated with the weathered base metal and magnetite ores. Whole-rock geochemical analyses of fresh and mineralized host rock and of vein material reveals that the mineralization is associated with a strong, albeit highly variable, enrichment in light rare earth elements (LREE). This association indicates that REE and base metals were introduced by the same hydrothermal fluid. The strong negative Ce anomaly found in secondary REE minerals and mineralized rock samples suggests an upgrade of the REE contents in the weathering zone, insoluble Ce4+ being left behind.
The Fe-oxide-REE-base metal association at Paratoo is also characteristic of the giant Mesoproterozoic Fe oxide copper gold deposit of Olympic Dam, located 350 km to the NW. A similar association is found in the Palaeozoic deposits of the Mt Painter Inlier, 300 km to the NNE. The widespread occurrence of this elemental association in the Province probably reflects the geochemistry of the basement, which contains numerous Mesoproterozoic granites enriched in REE and U.
The binary X-ray source GX 1 + 4 was observed during a balloon flight in 1986, November. The source was in a relatively high intensity state. Time analysis of the data shows that the pulsation period was 111.8 ± 1.0 s indicating that one or more episodes of spin-down occurred between 1980 and 1986. Folded pulse profiles are very broad with an indication of a notch at the peak. Evidence has been found for a correlation between hard X-ray intensity and phase of the proposed 304 day orbital period. The time averaged intensity since 1980 is an order of magnitude lower than during the 1970’s. A survey of the post 1980 data shows that several reversals of the period derivative have occurred. Spin-up at the rates typical of the 1970’s has been followed by a dramatic spin-down episode with dP/dt>2.4 × 10−7 s/s.
The purpose of this study was to describe disaster preparedness strategies and behaviors among rural families who have children with special health care needs and to examine the effect of self-efficacy and response-efficacy on disaster preparedness.
Methods
Data for this study were drawn from the baseline surveys of 287 rural families with children with special health care needs who were part of a randomized controlled trial examining the impact of an intervention on disaster preparedness. Distributions of child, parent, and family characteristics were examined by preparedness. Linear regression models were built to examine the impact of self-efficacy and response-efficacy on level of disaster preparedness.
Results
Disaster preparedness (overall, emergency plan, discussion/practice, and supplies) was low (40.9-69.7%) among study families. Disaster preparedness was found to increase with each unit increase in the level of self-efficacy and family resilience sources across all 4 categories of preparedness.
Conclusions
Disaster preparedness among rural families with children with special health care needs is low, which is concerning because these children may have increased vulnerability to adverse outcomes compared to the general population. Results suggest that increasing the levels of self-efficacy and family resilience sources may increase disaster preparedness. (Disaster Med Public Health Preparedness. 2016;10:225–232)
We present a review of our recent studies of Bias Temperature Instability (BTI) in Metal-Oxide-Semiconductor Field-Effect-Transistors (MOSFETs) fabricated with different material systems, highlighting the reliability opportunities and challenges of each novel device family. We discuss first the intrinsic reliability improvement offered by SiGe and Ge p-channel technologies, if a Si cap is used to passivate the channel, in order to fabricate a standard SiO2/HfO2 gate stack. We focus on SiGe gate stack optimizations for maximum BTI reliability, and on a simple physics-based model able to reproduce the experimental trends. This model framework is then used to understand the suboptimal BTI reliability and excessive time-dependent variability induced by oxide defect charging in different high-mobility channel gate stacks, such as Ge/GeOx/high-k and InGaAs/high-k. Finally we discuss how to pursue a reduction of charge trapping in alternative material systems in order to boost the device reliability and minimize time-dependent variability.
Calcium is considered important in buffering excess stomach acid in mammals, including horses. Control of stomach acid is important in preventing the development of ulcers within the stomach lining, which, in horses, are considered to be caused by acid splashing. Algae supplements contain various minerals which are in natural form, as seen in all plant and feedstuffs. The current trial was conducted to examine if a high calcium algae supplement had any impact on gastric ulceration in horses, which may be due to buffering stomach acid, reducing the pH in a gradual manner, without resorting to medication. Ten horses, of either thoroughbred, standardbred or sport horse breed, were selected on the basis of the presence of ulcers in their stomach, as ascertained by endoscopy. The average ulceration score before algae supplementation was 2.2 ± 0.75 according to the EGUC scoring system. The horses were then maintained on their normal diet (unchanged from the initial ulcer scoring) by the owner with the addition of 40 g per day of the high calcium, algae based Maxia Complete® (Seahorse Supplements Ltd, Christchurch, NZ) for thirty days (T30). All horses were then re endoscoped to assess any change in ulceration score. All horses showed a significant improvement in ulcer score, with seven having a score of zero (fully healed, no evidence of further ulceration) and two with a score of one (some residual inflammation or keratinosis in areas of healed ulcers). This resulted in a mean score of 0.3 ± 0.48 (P < 0.0001: T0 versus T30) at the end of the study. This trial demonstrated that feeding an organic form of high calcium from algae reduced ulceration in horses.
A number of studies have demonstrated that consuming almonds increases satiety but does not result in weight gain, despite their high energy and lipid content. To understand the mechanism of almond digestion, in the present study, we investigated the bioaccessibility of lipids from masticated almonds during in vitro simulated human digestion, and determined the associated changes in cell-wall composition and cellular microstructure. The influence of processing on lipid release was assessed by using natural raw almonds (NA) and roasted almonds (RA). Masticated samples from four healthy adults (two females, two males) were exposed to a dynamic gastric model of digestion followed by simulated duodenal digestion. Between 7·8 and 11·1 % of the total lipid was released as a result of mastication, with no significant differences between the NA and RA samples. Significant digestion occurred during the in vitro gastric phase (16·4 and 15·9 %) and the in vitro duodenal phase (32·2 and 32·7 %) for the NA and RA samples, respectively. Roasting produced a smaller average particle size distribution post-mastication; however, this was not significant in terms of lipid release. Light microscopy showed major changes that occurred in the distribution of lipid in all cells after the roasting process. Further changes were observed in the surface cells of almond fragments and in fractured cells after exposure to the duodenal environment. Almond cell walls prevented lipid release from intact cells, providing a mechanism for incomplete nutrient absorption in the gut. The composition of almond cell walls was not affected by processing or simulated digestion.
Patients with amyotrophic lateral sclerosis (ALS) often show deficits on neuropsychological tests that tap functions related to the integrity of the prefrontal lobes. Various aspects of personality are also known to be mediated by prefrontal regions, particularly ventromedial prefrontal cortex (vmPFC). Other than apathy, personality changes have not been widely reported in patients with ALS, although clinical observations indicate such changes might be relatively common. Here, we report on a middle-aged woman with bulbar onset ALS (diagnosed 06/2011, examined in Spring, 2012) whose neuropsychological exam did not reveal cognitive deficits. She performed normally on tests of executive functioning. Self-report measures of mood and personality were unremarkable. However, significant personality changes subsequent to disease onset were reported by her husband and two daughters, and these changes were quantified with the Iowa Scales of Personality Change. Results show that personality disturbance may manifest in the absence of notable cognitive changes in ALS, and careful assessment of personality may be important for documenting early neurobehavioral changes in some ALS patients. Findings also show that patients with ALS may not have good insight into personality changes, underscoring the importance of acquiring collateral information. More generally, the results provide further evidence that ALS may compromise the integrity of ventromedial prefrontal regions. (JINS, 2014, 20, 1–8)
Hemolytic disease of the fetus and newborn (HDFN) is the immune-mediated destruction of fetal red blood cells by maternal antibody. HDFN results when the fetal red blood cells express a paternally inherited red blood cell antigen not present on maternal red blood cells. The spectrum of illness ranges from clinically insignificant to the most severe form of a critically ill, anemic, hydropic, and jaundiced infant who may have subcutaneous edema, ascites, pleural effusions, and pericardial effusions.
There is no agreement when HDFN was first recognized. As reviewed by Stockman, Rosse suggested that the marriage of Catherine of Aragon and Henry VIII illustrates the natural history of HDFN (1). Catherine had five children, three boys and one girl dying in utero with only one surviving girl, Mary I, Tudor Queen of England. A clearer description of the disorder came in 1607 with the description of a twin-birth by a French midwife who delivered a hydropic dead child and a twin that died of jaundice – what we now recognize as kernicterus (2). It was the pivotal paper by Dr. Louis K. Diamond in 1932 that clearly identified the development of the maternal antibody in response to the incompatibility of the fetal red cells with maternal red cells even though the Rhesus red cell antigen had not yet been identified. Parallel to the understanding of HDFN, Landsteiner began the process of identification of the red cell antigens at the start of the 20th century, first with the identification of the ABO system and then with the identification of the Rh system (3). He described the development of antibodies against rhesus monkey red cells in rabbits. He suggested that this was a new antigen distinct from the ABO system and called it the Rhesus antigen. This name is now well established in spite of the early controversy, since the antigen identified was a simian antigen related to but not the same as the human antigen.
Equine Gastric Ulcer Syndrome (EGUS) is extremely prevalent in both racing and non-racing horse populations. The exact aetiology of EGUS is unclear but many stress related risk factors have been implicated including the feeding of grain-based diets. Current treatment techniques often necessitate drug therapy which, when added to feed costs, can be expensive and may have a detrimental effect on digestion due to the mode of action of these therapies. The following experiment set out to investigate if feeding fermented, forage-based feeds (Modified Bio-Fermentation (MBF) lucerne feeds treated with Xanotyde®, registered as FiberProtect® and FiberEdge®; Fiber Fresh Feeds Ltd, Reporoa, New Zealand), could assist in the healing and prevention of ulceration. Nine adult horses with demonstrable and sustained gastric ulceration (diagnosed by gastric endoscopy), were used in a two part study. The first 42 d healing phase investigated the impact of feeding FiberProtect® (FPT) or FiberEdge® (FED) on established gastric ulcers. After 14 d on these diets 44% (4/9) of horses had no ulceration or hyperaemia (inflammation) (EGUC grade 0) and all horses were ulcer free (EGUC grade 0) at d 42. A significant (P < 0.01) relationship was determined between length of time fed and disappearance of ulcers (R2 = 0.9004; DF = 2). The prevention phase utilised the same horses, ulcer-free at d 42, and fed them a grain-based high energy racing diet alongside FPT at 40% and 60% of the total diet (DM basis). The horses were monitored for a further 28 d (d 42 – d 70), and only three showed a recurrence of ulceration throughout this period. At d 70, eight out of nine horses were ulcer free (EGUC grade 0). The findings suggest that FPT and FED can be used to heal and prevent gastric ulceration, and that FPT can be fed alongside a high grain diet to prevent recurrence of gastric ulcers.
Humans are infected by 2 genetic assemblages (A and B) of Giardia duodenalis, a protozoan parasite that causes gastro-intestinal disease. Sub-assemblages AI, AII, BIII and BIV are commonly identified in human cases. Detection requires amplification of G. duodenalis loci. Subsequent DNA sequencing or restriction fragment length polymorphism (RFLP) identifies sub-assemblages but is expensive (DNA sequencing) or insensitive (RFLP). This study investigated a fluorescence-based detection method, using terminal-restriction fragment length polymorphism (T-RFLP) of the glutamate dehydrogenase gene to characterize human infections. Clinical samples (n=73), positive for Giardia were collected in New South Wales, Australia, and were used to evaluate T-RFLP detection. The accuracy and sensitivity of T-RFLP detection was established by comparison to DNA sequencing and RFLP. Sub-assemblage assignment by T-RFLP identified BIV as the common subtype in N.S.W cases, whilst AI, AII and BIII were also detected. When compared to DNA sequencing and RFLP, analysis by T-RFLP was a reliable and reproducible method. Automated fluorescent detection enabled accurate sizing of restriction fragments and provided a sensitive alternative to RFLP. Discrimination of sub-assemblages by T-RFLP was comparable to DNA sequencing, but was efficient and inexpensive. The protocol described here provides a rapid and sensitive diagnostic tool for routine sample screenings in epidemiological research.
The gallop is the preferred gait by mammals for agile traversal through terrain. This motion is intrinsically complex as the feet are used individually and asymmetrically. Simple models provide a conceptual framework for understanding this gait. In this light, this paper considers the footfall projections as suggested by an impulse model for galloping as a measurement simplifying strategy. Instead of concentrating on forces and inverse dynamics, this view focuses observations on leg motion (footfalls and stance periods) for subsequent gallop analysis and parameter estimation. In practice, this eases experiments (particularly for IR-based motion capture) by extending the experimental workspace, removing the need for single-leg contact force-plate measurements, and reducing the marker set. This provides shorter setup times, and it reduces postprocessing as data are less likely to suffer from occlusion, errant correspondence, and tissue flexion. This approach is tested using with three canine subjects (ranging from 8 to 24 kg) performing primarily rotary gallops down a 15 m runway. Normalized results are in keeping with insights from previous animal and legged robot studies and are consistent with motions suggested by said impulse model.
The design, control, and actuation of legged robots that walk is well established, but there remain unsolved problems for legged robots that run. In this work, dynamic principles are used to develop a set of heuristics for controlling bipedal running and acceleration. These heuristics are then converted into control laws for two very different bipedal systems: one with a high-inertia torso and prismatic knees and one with a low-inertia torso, articulated knees, and mechanical coupling between the knee and ankle joints. These control laws are implemented in simulation to achieve stable steady-state running, accelerating, and decelerating. Stable steady-state running is also achieved in a planar experimental system with a semiconstrained torso.
The few genetically informative studies to examine post-traumatic stress disorder (PTSD) and alcohol dependence (AD), all of which are based on a male veteran sample, suggest that the co-morbidity between PTSD and AD may be attributable in part to overlapping genetic influences, but this issue has yet to be addressed in females.
Method
Data were derived from an all-female twin sample (n=3768) ranging in age from 18 to 29 years. A trivariate genetic model that included trauma exposure as a separate phenotype was fitted to estimate genetic and environmental contributions to PTSD and the degree to which they overlap with those that contribute to AD, after accounting for potential confounding effects of heritable influences on trauma exposure.
Results
Additive genetic influences (A) accounted for 72% of the variance in PTSD; individual-specific environmental (E) factors accounted for the remainder. An AE model also provided the best fit for AD, for which heritability was estimated to be 71%. The genetic correlation between PTSD and AD was 0.54.
Conclusions
The heritability estimate for PTSD in our sample is higher than estimates reported in earlier studies based almost exclusively on an all-male sample in which combat exposure was the precipitating traumatic event. However, our findings are consistent with the absence of evidence for shared environmental influences on PTSD and, most importantly, the substantial overlap in genetic influences on PTSD and AD reported in these investigations. Additional research addressing potential distinctions by gender in the relative contributions of genetic and environmental influences on PTSD is merited.
Fifty-nine patients suffering from a major depressive episode, for whom electroconvulsive therapy (ECT) was clinically indicated, were randomly assigned to one of three electrode placement groups for treatment with brief pulse, threshold-level ECT: bitemporal (BT), right unilateral (RU) or bifrontal (BF). Comparison of these groups in terms of number of treatments, duration of treatment, or incidence of treatment failure, showed that the bilateral placements were superior to the unilateral; comparison of Hamilton, Montgomery–Åsberg, and visual analogue scale scores showed that the bifrontal placement was superior to both bitemporal and unilateral treatment. Bitemporal treatment showed therapeutic results intermediate between BF and RU. Because BF ECT causes fewer cognitive side effects than either RU or BT, and is independently more effective, it should be considered as the first choice of electrode position in ECT.