At coastal archaeological sites, measuring erosion rates and assessing artifact loss are vital to understanding the timescale(s) and spatial magnitude of past and future site loss. We describe a straightforward low-tech methodology for documenting shoreline erosion developed by professionals and volunteers over seven years at Calusa Island Midden (8LL45), one of the few remaining sites with an Archaic component in the Pine Island Sound region of coastal Southwest Florida. We outline the evolution of the methodology since its launch in 2016 and describe issues encountered and solutions implemented. We also describe the use of the data to guide archaeological research and document the impacts of major storms at the site. The response to Hurricane Ian in 2022 is one example of how simply collected data can inform site management. This methodology can be implemented easily at other coastal sites at low cost and in collaboration with communities, volunteers, and heritage site managers.

The European Clozapine Task Force is a group of psychiatrists and pharmacologists practicing in 18 countries under European Medicines Agency (EMA) regulation, who are deeply concerned about the underuse of clozapine in European countries. Although clozapine is the most effective antipsychotic for people with treatment-resistant schizophrenia, a large proportion of them do not have access to this treatment. Concerns about clozapine-induced agranulocytosis and stringent blood monitoring rules are major barriers to clozapine prescribing and use. There is a growing body of evidence that the incidence of clozapine-induced agranulocytosis is very low after the first year of treatment. Maintaining lifelong monthly blood monitoring after this period contributes to unjustified discontinuation of clozapine. We leverage recent and replicated evidence on the long-term safety of clozapine to call for the revision and updating of the EMA’s blood monitoring rules, thus aiming to overcome this major barrier to clozapine prescribing and use. We believe the time has come for relaxing the rules without increasing the risks for people using clozapine in Europe.

Scholars disagree as to whether Americans’ attitudes toward local issues are structured ideologically and whether these are related to national policy ideology. We use two surveys of American adults to assess whether and to what extent Americans' local policy attitudes exhibit a similar structure as do national policy attitudes. We find that items asking about local policy are just as likely to reflect a latent dimension of policy preferences as those asking about national policy. Additionally, when local and national items are scaled separately, those scales are highly correlated. Our findings indicate that attitudes toward many local issues are aligned with national ideology. A smaller subset of attitudes about local issues appears distinctively local and possibly structured by non-ideological cleavages.

The kaolinite crystallization by homogeneous precipitation with previous hydrolysis of the feldspars added has been followed by pH and potassium concentration measurements. The synthesized products were studied by X-ray powder diffraction and electron microscopy and consist of kaolinite and mica, accompanied occasionally by traces of smectite. The relative quantities of the synthesized minerals depend fundamentally on the supply rate of the alkaline ions.

Background: We evaluated vorasidenib (VOR), a dual inhibitor of mIDH1/2, in patients with mIDH1/2 glioma (Phase 3; NCT04164901). Methods: Patients with residual/recurrent grade 2 mIDH1/2 oligodendroglioma or astrocytoma were enrolled (age ≥12; Karnofsky Performance Score ≥80; measurable non-enhancing disease; surgery as only prior treatment; not in immediate need of chemoradiotherapy). Patients were stratified by 1p19q status and baseline tumor size and randomized 1:1 to VOR 40 mg or placebo (PBO) daily in 28-day cycles. Endpoints included imaging-based progression-free survival (PFS), time to next intervention (TTNI), tumor growth rate (TGR), health-related quality of life (HRQoL), neurocognition and seizure activity. Results: 331 patients were randomized (VOR, 168; PBO, 163). The median age was 40.0 years. 172 and 159 patients had histologically confirmed oligodendroglioma and astrocytoma, respectively. Treatment with VOR significantly improved PFS and TTNI. Median PFS: VOR, 27.7 mos; PBO, 11.1 mos (P=0.000000067). Median TTNI: VOR, not reached; PBO, 17.8 mos (P=0.000000019). Treatment with VOR resulted in shrinkage of tumor volume. Post-treatment TGR: VOR, -2.5% (95% CI: -4.7, -0.2); PBO, 13.9% (95% CI: 11.1, 16.8). HRQoL and neurocognition were preserved and seizure control was maintained. VOR had a manageable safety profile. Conclusions: VOR was effective in mIDH1/2 diffuse glioma not in immediate need of chemoradiotherapy.

Background: Cerebral venous thrombosis (CVT)most commonly affects younger women. Diagnosis may be delayed due to its distinct presentation and demographic profile compared to other stroke types. Methods: We examined delays to diagnosis of CVT in the SECRET randomized trial and TOP-SECRET parallel registry. Adults diagnosed with symptomatic CVT within <14 days were included. We examined time to diagnosis and number of health care encounters prior to diagnosis and associations with demographics, clinical and radiologic features and functional and patient-reported outcomes (PROMS) at days 180&365. Results: Of 103 participants, 68.9% were female; median age was 45 (IQR 31.0-61.0). Median time from symptom onset to diagnosis was 4 (1-8) days. Diagnosis on first presentation to medical attention was made in 60.2%. The difference in time to diagnosis for single versus multiple presentations was on the order of days (3[1-7] vs. 5[2-11.75], p=0.16). Women were likelier to have multiple presentations (OR 2.53; 95% CI1.00-6.39; p=0.05) and longer median times to diagnosis (5[2-8]days vs. 2[1-4.5] days; p=0.005). However, this was not associated with absolute or change in functional, or any patient reported, outcome measures (PROMs) at days 180&365. Conclusions: Diagnosis of CVT was commonly delayed; women were likelier to have multiple presentations. We found no association between delayed diagnosis and outcomes.

Background: Considering regional and temporal trends, we sought to explore the incidence of primary malignant brain tumours in Newfoundland and Labrador. Methods: We reviewed all primary, malignant brain tumour cases from 2015-2022 confirmed by St. John’s Health Sciences Centre pathology reports. Incidence rates were standardized using the 2011 Canadian standard population. Results: We included 362 cases. The average annual age-standardized incidence rate of primary, malignant brain tumours per 100,000 was 7.0 (95% CI: 6.3-7.7), lower than the national average (7.93; 95% CI: 7.78-8.08). The incidence of glioblastoma (5.1; 95% CI: 4.5-5.7) was significantly higher than the national average (4.05; 95% CI: 3.95-4.16). Temporal trends revealed that oligodendroglioma incidence spiked from 0.5 (95% CI: 0.2-0.7) in 2015-2019 to 1.5 (95% CI: 0.4-2.6) in 2020 before returning to baseline in 2022. Regional trends indicated a lower incidence of malignant tumours in Labrador-Grenfell (5.1; 95% CI: 2.5-7.6), compared to 6.9 (95% CI: 6.2-7.6) averaged elsewhere. Conclusions: Higher rates of glioblastoma in Newfoundland and Labrador could have a genetic or multi-factorial cause. The increased occurrence of oligodendroglioma during the COVID-19 pandemic necessitates broader investigation, potentially linked to delays in patient care during this period. Regional trends could suggest less access to care in rural populations and underestimated incidence.

Background: Brain metastases indicate an advanced tumour stage for many cancers. We sought to investigate the incidence change of tissue-sampled brain metastases and its relation to staging challenges during the COVID-19 pandemic in Newfoundland and Labrador. Methods: We reviewed all brain metastasis cases from 2015-2022 requiring first-time tissue sampling according to pathology reports from the St. John’s Health Sciences Centre. Incidence rates were calculated using yearly population data by regional health authorities and standardized using the 2011 Canadian standard population. Results: We included 173 cases. The average annual age-standardized incidence rate of brain metastases requiring tissue sampling per 100,000 increased from 2.5 (95% CI: 2.0-3.1) pre-COVID-19 to 4.1 (95% CI: 3.3-5.0) post-COVID-19. Brain metastases from lung primaries accounted for 69% of this increase. While incidence declined to near-baseline in the Eastern provincial population by 2022 (3.3; 95% CI: 1.5-5.1), incidence rose into 2022 in the Western population (8.6; 95% CI: 3.9-13.2). Conclusions: These data suggest a delayed presentation of malignancies during the COVID-19 pandemic and underscore the importance of prioritized staging during times of strain on healthcare systems. Regional, temporal trends suggest regions distant from tertiary care centres could face challenges in resolving cases with delayed presentation post-COVID-19.

Dealumination of vermiculite was carried out using (NH4)2SiF6 solutions. The dealuminated products were studied by high-resolution solid state 29Si and 27Al nuclear magnetic resonance. A decrease in the cation-exchange capacity (CEC) resulted from the partial removal of Al from the tetrahedral layer, which decreased the framework negative charge, and from the partial replacement of Mg by Al in the octahedral layer, which increased its positive charge contribution. The lowest CEC was obtained by swelling the structure with butyl-ammonium prior to the reaction with (NH4)2SiF6. Thus, CECs in the range observed for beidellite were measured; however, the lowest (Al/Si)IV ratio was still more than twice as high as in beidellite. In addition, the dealumination reaction yielded noncrystalline silica as a by-product.

In contact with a solution of Al hydroxypolymer (Al13), the dealuminated vermiculite showed no 18-Å reflection characteristic of Al13-intercalated smectite; instead it showed an ill-defined interstratification. For some samples, however, a significant increase in the specific surface area (as much as 230 m2/g) was observed, suggesting that an intercalation of Al moieties did occur. The 27Al resonance spectra of the intercalated structure showed at least two components in octahedral coordination. On thermal activation, a resonance line attributable to pentacoordinated Al was observed.

NMR spectra of PF1-1 Floridan palygorskite strongly suggest that Al3+ occurs only in octahedral coordination. X-ray microanalysis of the palygorskite fibers indicate a chemical composition defined by the atomic ratios: Mg/Si = 0.34, Al/Si = 0.27, and Fe/Si = 0.04. Considering the NMR and CEC data in this report along with the previously published results of IR and Mössbauer spectroscopic studies, the following structural formula is proposed for PF1-1 palygorskite:

$${\rm{(M{g_{2.12}}A{l_{1.68}}F{e^{3 + }}_{0.24}{\square _{0.96}})S{i_8}{O_{20}}{(OH)_2}{(O{H_2})_4}}}$$

In this paper we analyzed by electron microscopy and X-ray diffraction (XRD) the exposed lacustrine clay in a stratigraphic column at Charo Canyon, State of Michoacán, Mexico. Smectite, cris-tobalite, albite and quartz are the main mineral species in the sediments. Smectite is the most abundant and has a nanometric twinned small particle habit. The low crystallinity of the smectite detected in some of the samples seems to be associated with instability of the paleohydrological regime in which clayey material was deposited. Iron from underlying volcanic ash is apparently responsible for the iron concentration detected in the smectite structure.

The Mg-vermiculite from Santa Olalla has been treated with aliphatic amides—formamide (FM), acetamide (AM) and propionamide (PM)—in aqueous solution. These treatments produce the transformation towards NH4-vermiculite and interstratified NH4-vermiculite-Mg-vermiculite phases. The NH4-vermiculite, Mg-vermiculite and interstratified (mixed-layer) phases have been identified from basal X-ray diffraction (XRD) interval peaks between 10.3 Å and 14.4 Å, and confirmed by direct Fourier transform method, as well as by atomic absorption spectrometry (AAS), infrared (IR) spectroscopy and thermal analysis.

According to their NH4-vermiculite/Mg-vermiculite probability coefficients ratio (PA/PB), and PAA, these interstratified phases can be divided into 3 categories: 1) If the PA/PB ratio is ≥ 7/3 and PAA ≥ 0.7, there are interstratified phases with a strong tendency toward segregation (case of FM, AM and PM). 2) If the PA/PB ratio is between 5/5 and 6/4, with PAA in the range 0.45–0.6, there are nearly regular alternating and random interstratified phases (case of AM and PM). 3) If the PA/PB ratio is ≤ 5/5 and PAA ≤ 0.45, there are interstratified phases with a strong tendency toward alternation (case of PM).

Experimental evidence reported in the present work indicates that the mechanism of interaction of Mg-vermiculite with FM, AM and PM in an aqueous medium takes place by ion exchange of NH4 between the layers. The hydrolysis of these aliphatic amides leads to the liberation of NH4+ into the medium. It has been found that the NH4+ sorption depends on the physico-chemical characteristics of the particular aliphatic amide, and the transformation of Mg-vermiculite to interstratified and/or NH4-vermiculite phases depends on the amide concentration. These treatments allow one to control the formation of interstratified and NH4-vermiculite phases.

The stacking order of a bi-ionic K/Mg vermiculite from Malawi (Nyasaland), has been determined from Weissenberg data. The sample corresponds to a K/Mg interstratified vermiculite containing 50% K layers (dK = 1.01 nm) and 50% Mg layers with two layers of water (dMg = 1.44 nm). The observed intensities along (0, 0), (h, 0), (0, k) and (1, k) reciprocal rods were compared to the calculated intensities given by model defect structures. It was found that: 1) The (h, 0), (0, k) and (1, k) rods reveal the interstratification phenomenon which was previously observed on the (0, 0) rod; 2) The exchange of Mg by K does not occur randomly in a single interlayer, but occurs in interlayer domains sufficiently extensive to allow the reorganisation of the layer stacking and development of the ordered K-vermiculite structure from the semi-ordered structure characteristic of magnesium vermiculites; 3) For this sample, the interlayer water of the Mg phase occurs in two coexisting configurations; one configuration has water molecules forming octahedral coordination around the Mg2+, the other has water which is not linked to the Mg2+ cation forming two planes.