A general model is developed for the analysis of multivariate multilevel data structures. Special cases of the model include repeated measures designs, multiple matrix samples, multilevel latent variable models, multiple time series, and variance and covariance component models.

Conversion of tertiary butylacetate to isobutylene and acetic acid and cracking of n-octane were used as model reactions to monitor the catalytic activity of a condensate and aqueous extract derived from a sample of montmorillonite. The condensate was obtained by condensing the vapor phase evolved on heating the clay and the extract was derived from the clay by prolonged water extraction. Both condensate and extract were colloidal systems, which were separated into solid and liquid fractions by distillation. Reactions carried out in a dynamic system established that the solid components acted as true acid catalysts, whereas the liquid fractions were inactive under the experimental conditions adopted. The catalytic activity per weight of the condensate exceeded that of either the parent clay or the extract.

The present results confirm that colloidal size catalysts of high activity can be generated from clays. Such materials, mobilized and transported alone or with formation fluids, may act as catalysts in places removed in space and time from their source. This finding refutes objections previously raised to the operation of bulk clays as catalysts for reactions with particulate organics and supports the concept that acid catalysts derived from clays may participate in organic geochemical reactions in an aqueous medium.

There is limited information on the volume of antibiotic prescribing that is influenza-associated, resulting from influenza infections and their complications (such as streptococcal pharyngitis). We estimated that for the Kaiser Permanente Northern California population during 2010–2018, 3.4% (2.8%–4%) of all macrolide prescriptions (fills), 2.7% (2.3%–3.2%) of all aminopenicillin prescriptions, 3.1% (2.4%–3.9%) of all 3rd generation cephalosporins prescriptions, 2.2% (1.8%–2.6%) of all protected aminopenicillin prescriptions and 1.3% (1%–1.6%) of all quinolone prescriptions were influenza-associated. The corresponding proportions were higher for select age groups, e.g. 4.3% of macrolide prescribing in ages over 50 years, 5.1% (3.3%–6.8%) of aminopenicillin prescribing in ages 5–17 years and 3.3% (1.9%–4.6%) in ages <5 years was influenza-associated. The relative contribution of influenza to antibiotic prescribing for respiratory diagnoses without a bacterial indication in ages over 5 years was higher than the corresponding relative contribution to prescribing for all diagnoses. Our results suggest a modest benefit of increasing influenza vaccination coverage for reducing prescribing for the five studied antibiotic classes, particularly for macrolides in ages over 50 years and aminopenicillins in ages <18 years, and the potential benefit of other measures to reduce unnecessary antibiotic prescribing for respiratory diagnoses with no bacterial indication, both of which may contribute to the mitigation of antimicrobial resistance.

There is limited information on the volume of antibiotic prescribing that is influenza-associated, resulting from influenza infections and their complications (such as streptococcal pharyngitis and otitis media). Here, we estimated age/diagnosis-specific proportions of antibiotic prescriptions (fills) for the Kaiser Permanente Northern California population during 2010–2018 that were influenza-associated. The proportion of influenza-associated antibiotic prescribing among all antibiotic prescribing was higher in children aged 5–17 years compared to children aged under 5 years, ranging from 1.4% [95% CI (0.7–2.1)] in aged <1 year to 2.7% (1.9–3.4) in aged 15–17 years. For adults aged over 20 years, the proportion of influenza-associated antibiotic prescribing among all antibiotic prescribing was lower, ranging from 0.7% (0.5–1) for aged 25–29 years to 1.6% (1.2–1.9) for aged 60–64 years. Most of the influenza-associated antibiotic prescribing in children aged under 10 years was for ear infections, while for age groups over 25 years, 45–84% of influenza-associated antibiotic prescribing was for respiratory diagnoses without a bacterial indication. This suggests a modest benefit of increasing influenza vaccination coverage for reducing antibiotic prescribing, as well as the potential benefit of other measures to reduce unnecessary antibiotic prescribing for respiratory diagnoses with no bacterial indication in persons aged over 25 years, both of which may further contribute to the mitigation of antimicrobial resistance.

Cognitive theories of depression contend that biased cognitive information processing plays a causal role in the development of depression. Extensive research shows that deeper processing of negative and/or shallower processing of positive self-descriptors (i.e., negative and positive self-schemas) predicts current and future depression in adults and children. However, the neural correlates of the development of self-referent encoding are poorly understood. We examined children's self-referential processing using the self-referent encoding task (SRET) collected from 74 children at ages 6, 9, and 12; around age 10, these children also contributed structural magnetic resonance imaging data. From age 6 to age 12, both positive and negative self-referential processing showed mean-level growth, with positive self-schemas increasing relatively faster than negative ones. Further, voxel-based morphometry showed that slower growth in positive self-schemas was associated with lower regional gray matter volume (GMV) in ventrolateral prefrontal cortex (vlPFC). Our results suggest that smaller regional GMV within vlPFC, a critical region for regulatory control in affective processing and emotion development, may have implications for the development of depressogenic self-referential processing in mid-to-late childhood.

Albendazole, a benzimidazole anthelmintic, interferes with the formation of microtubules and inhibits meiosis in the nematode Ascaris lumbricoides var. suum. Pigs treated with albendazole had worms in their uteri that had a severely deteriorated central rachis, complete loss of synaptonemal complexes and irregular oocytes at meiotic prophase I. The nuclear matrix and envelope were poorly formed and there was formation of accessory nuclei. This study represents the first examination of the changes in meiotic nuclear architecture and meiotic chromosomes after exposure to albendazole. These results provide the basis for the loss of fecundity in A. suum after exposure to albendazole resulting in control in the population of the parasitic nematode.

We present a detailed guide to advanced collisionless fluid models that incorporate kinetic effects into the fluid framework, and that are much closer to the collisionless kinetic description than traditional magnetohydrodynamics. Such fluid models are directly applicable to modelling the turbulent evolution of a vast array of astrophysical plasmas, such as the solar corona and the solar wind, the interstellar medium, as well as accretion disks and galaxy clusters. The text can be viewed as a detailed guide to Landau fluid models and it is divided into two parts. Part 1 is dedicated to fluid models that are obtained by closing the fluid hierarchy with simple (non-Landau fluid) closures. Part 2 is dedicated to Landau fluid closures. Here in Part 1, we discuss the fluid model of Chew–Goldberger–Low (CGL) in great detail, together with fluid models that contain dispersive effects introduced by the Hall term and by the finite Larmor radius corrections to the pressure tensor. We consider dispersive effects introduced by the non-gyrotropic heat flux vectors. We investigate the parallel and oblique firehose instability, and show that the non-gyrotropic heat flux strongly influences the maximum growth rate of these instabilities. Furthermore, we discuss fluid models that contain evolution equations for the gyrotropic heat flux fluctuations and that are closed at the fourth-moment level by prescribing a specific form for the distribution function. For the bi-Maxwellian distribution, such a closure is known as the ‘normal’ closure. We also discuss a fluid closure for the bi-kappa distribution. Finally, by considering one-dimensional Maxwellian fluid closures at higher-order moments, we show that such fluid models are always unstable. The last possible non Landau fluid closure is therefore the ‘normal’ closure, and beyond the fourth-order moment, Landau fluid closures are required.

In Part 2 of our guide to collisionless fluid models, we concentrate on Landau fluid closures. These closures were pioneered by Hammett and Perkins and allow for the rigorous incorporation of collisionless Landau damping into a fluid framework. It is Landau damping that sharply separates traditional fluid models and collisionless kinetic theory, and is the main reason why the usual fluid models do not converge to the kinetic description, even in the long-wavelength low-frequency limit. We start with a brief introduction to kinetic theory, where we discuss in detail the plasma dispersion function $Z(\unicode[STIX]{x1D701})$, and the associated plasma response function $R(\unicode[STIX]{x1D701})=1+\unicode[STIX]{x1D701}Z(\unicode[STIX]{x1D701})=-Z^{\prime }(\unicode[STIX]{x1D701})/2$. We then consider a one-dimensional (1-D) (electrostatic) geometry and make a significant effort to map all possible Landau fluid closures that can be constructed at the fourth-order moment level. These closures for parallel moments have general validity from the largest astrophysical scales down to the Debye length, and we verify their validity by considering examples of the (proton and electron) Landau damping of the ion-acoustic mode, and the electron Landau damping of the Langmuir mode. We proceed by considering 1-D closures at higher-order moments than the fourth order, and as was concluded in Part 1, this is not possible without Landau fluid closures. We show that it is possible to reproduce linear Landau damping in the fluid framework to any desired precision, thus showing the convergence of the fluid and collisionless kinetic descriptions. We then consider a 3-D (electromagnetic) geometry in the gyrotropic (long-wavelength low-frequency) limit and map all closures that are available at the fourth-order moment level. In appendix A, we provide comprehensive tables with Padé approximants of $R(\unicode[STIX]{x1D701})$ up to the eighth-pole order, with many given in an analytic form.

Over the past several years, we have seen many attacks on publicly funded and mandated archaeology in the United States. These attacks occur at the state level, where governors and state legislatures try to defund or outright eliminate state archaeological programs and institutions. We have also seen several attacks at the federal level. Some members of Congress showcase archaeology as a waste of public tax dollars, and others propose legislation to move federally funded or permitted projects forward without consideration of impacts on archaeological resources. These attacks continue to occur, and we expect them to increase in the future. In the past, a vigilant network of historic preservation and archaeological organizations was able to thwart such attacks. The public, however, largely remains an untapped ally. As a discipline, we have not built a strong public support network. We have not demonstrated the value of archaeology to the public, beyond a scattering of educational and informational programs. In this article, we—a group of archaeologists whose work has focused on public engagement—provide a number of specific recommendations on how to build a strong public constituency for the preservation of our nation's archaeological heritage.

Introduction: Collaborative Emergency Centres (CECs) provide access to care in rural communities. After hours, registered nurses (RNs) and paramedics work together in the ED with telephone support by an emergency medical services (EMS) physician. The safety of such a model is unknown. Relapse visits are often used as a proxy measure for safety in emergency medicine. The primary outcome of this study is to measure unscheduled relapses to emergency care. Methods: The electronic patient care record (ePCR) database was queried for all patients who visited two CECs from April 1, 2012 to April 1, 2013. Abstracted data included demographics, time, acuity score, clinical impression, chief complaint, and disposition. Records were searched for each discharged CEC patient to identify unscheduled relapses to emergency care, defined as presenting back to EMS, CEC, or any other ED within the Health Authority within 48 hours of CEC discharge. Results: There were 894 CEC visits, of which 66 were excluded due to missing data. The dispositions from CEC were: 131/828 (15.8%) transferred to regional ED; 264/828 (31.9%) discharged home; 488/828 (58.9%) discharged with follow up visit booked; and 11/82 (1.2%) left the CEC without being seen. There was 37/828 (4.5%) visits which relapsed back to emergency care, all of whom were discharged from CEC or left without being seen: 3/828 (0.4%) relapsed back to EMS (two taken to regional ED and one to CEC); 16/828 (1.9%) relapsed to regional ED (by walking-in); and 18/828 (2.2%) had a relapse to the CEC (walk-in). 516/828 (62.3%) CEC visits were resolved in a single visit. Conclusion: This study was based on only two of the 7 operating CECs due to accessing paper-based charts for multiple health regions. We also acknowledge the limitations of using relapse as a proxy for safety, and that low volumes and acuity will make detection of adverse events challenging. Albeit a proxy measure, the rate of patients who relapse to emergency care was under 5% in this case series of two CECs. Most patients had their concern resolved in a single visit to a CEC. Further research is underway to determine the effectiveness, optimal utilization and safety of this collaborative model of rural emergency care.

The Universe is permeated by hot, turbulent, magnetized plasmas. Turbulent plasma is a major constituent of active galactic nuclei, supernova remnants, the intergalactic and interstellar medium, the solar corona, the solar wind and the Earth’s magnetosphere, just to mention a few examples. Energy dissipation of turbulent fluctuations plays a key role in plasma heating and energization, yet we still do not understand the underlying physical mechanisms involved. THOR is a mission designed to answer the questions of how turbulent plasma is heated and particles accelerated, how the dissipated energy is partitioned and how dissipation operates in different regimes of turbulence. THOR is a single-spacecraft mission with an orbit tuned to maximize data return from regions in near-Earth space – magnetosheath, shock, foreshock and pristine solar wind – featuring different kinds of turbulence. Here we summarize the THOR proposal submitted on 15 January 2015 to the ‘Call for a Medium-size mission opportunity in ESAs Science Programme for a launch in 2025 (M4)’. THOR has been selected by European Space Agency (ESA) for the study phase.

Lithium is a mood stabilizer rarely associated with drug-induced parkinsonism (DIP). We present a case of an elderly woman with bipolar disorder who developed parkinsonian symptoms after chronic lithium administration despite therapeutic serum levels. Upon evaluation, classic parkinsonian signs of muscle rigidity, tremor, bradykinesia, freezing of gait, and cognitive decline were observed. Initially, she was diagnosed with Parkinson's disease (PD); however, DaTscan SPECT imaging clarified the diagnosis as DIP. As the daily lithium dosage was reduced, the patient's motor symptoms improved. This report emphasizes close monitoring of lithium levels in geriatric populations and the need to consider lithium-induced parkinsonism when PD symptoms appear in chronic lithium users.

Introduction: Hospitalization due to ambulatory care sensitive conditions (ACSC) is a proxy measure for access to primary care. Emergency medical services (EMS) are increasingly called when primary care cannot be accessed. A novel paramedic-nurse EMS Mobile Care Team (MCT) was implemented in an under-serviced community. The MCT responds in a non-transport unit to bookings from EMS, emergency and primary care and to low-acuity 911 calls in a defined geographic region. Our objective was to compare the prevalence of ACSC in ground ambulance (GA) responses before and after the introduction of the MCT. Methods: A cross-sectional analysis of GA and MCT patients with ACSC (determined by chief complaint, clinical impression, treatment protocol and medical history) one year pre- and one year post-MCT implementation was conducted for the period Oct. 1, 2012 to Sept. 30, 2014. Demographics were described. Predictors of ACSC were identified via logistic regression. Prevalence was compared with chi-squared analysis. Results: There were 975 calls pre- and 1208 GA/95 MCT calls post-MCT. ACSC in GA patients pre- and post-MCT was similar: n=122, 12.5% vs. n=185, 15.3%; p=0.06. ACSC in patients seen by EMS (GA plus MCT) increased in the post-period: 122 (12.5%) vs. 204 (15.7%) p=0.04. Pre vs post, GA calls differed by sex (p=0.007) but not age (65.38 ± 15.12 vs. 62.51 ± 20.48; p=0.16). Post-MCT, prevalence of specific ACSC increased for GA: hypertension (p<0.001) and congestive heart failure (p=0.04). MCT patients with ACSC were less likely to have a primary care provider compared to GA (90.2% and 87.6% vs. 63.2%; p=0.003, p=0.004). Conclusion: The prevalence of ACSC did not decrease for GA with the introduction of the MCT, but ACSC in the overall patient population served by EMS increased. It is possible more patients with ACSC call or are referred to EMS for the new MCT service. Given that MCT patients were less likely to have a primary care provider this may represent an increase in access to care, or a shift away from other emergency/episodic care. These associations must be further studied to inform the ideal utility of adding such services to EMS and healthcare systems.