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Self-interaction is the process by which a microinstability eigenmode that is extended along the direction parallel to the magnetic field interacts non-linearly with itself. This effect is particularly significant in gyrokinetic simulations accounting for kinetic passing electron dynamics and is known to generate stationary
zonal flow shear layers at radial locations near low-order mode rational surfaces (Weikl et al. Phys. Plasmas, vol. 25, 2018, 072305). We find that self-interaction, in fact, plays a very significant role in also generating fluctuating zonal flows, which is critical to regulating turbulent transport throughout the radial extent. Unlike the usual picture of zonal flow drive in which microinstability eigenmodes coherently amplify the flow via modulational instabilities, the self-interaction drive of zonal flows from these eigenmodes are uncorrelated with each other. It is shown that the associated shearing rate of the fluctuating zonal flows therefore reduces as more toroidal modes are resolved in the simulation. In simulations accounting for the full toroidal domain, such an increase in the density of toroidal modes corresponds to an increase in the toroidal system size, leading to a finite system size effect that is distinct from the well-known profile shearing effect.
Hypothetical thinking involves imagining possibilities and mentally exploring their consequences. This chapter overviews a contemporary, integrative account of such thinking in the form of Jonathan Evans’s hypothetical thinking theory. This default-interventionist, dual–process theory operates according to three principles: relevance, singularity, and satisficing. To illustrate the explanatory strength of the theory a range of empirical evidence is considered that has arisen from extensive research on hypothesis testing, which involves individuals generating and evaluating hypotheses as they attempt to derive a more general understanding of information. The chapter shows how key findings from hypothesis-testing research undertaken in both laboratory and real-world studies (e.g. in domains such as scientific reasoning) are readily explained by the principles embedded in hypothetical thinking theory. The chapter additionally points to important new directions for future research on hypothetical thinking, including the need for: (1) further studies of real-world hypothesis testing in collaborative contexts, including ones outside of the domain of scientific reasoning; (2) increased neuroscientific analysis of the brain systems underpinning hypothetical thinking so as to inform theoretical developments; and (3) systematic individual-differences investigations to explore the likely association between people’s capacity to think creatively and their ability to engage in effective hypothetical thinking.
The human insular cortex is involved in a wide range of functions. A recent study done by conducting an activation likelihood estimate (ALE) meta-analysis suggests that there are anatomical subregions with functional specializations for motor processing, auditory perception and homeostatic control, which plays an important role in emotional processing (Mutschler et al., 2009). An increasing number of studies propose the involvement of the anterior insula in experiencing pain and empathy for pain, e.g. when someone perceives a loved one feeling pain (Craig, 2009, Singer et al., 2004). In this present work, the activation likelihood estimate (ALE) method (Turkeltaub et al., 2002) was applied and 59 studies reporting pain processing and 19 investigating empathy for pain entered the meta-analysis to investigate the questions whether there are functional specializations within the insular cortex for pain processing and empathy for pain. Pain studies revealed activation in the posterior and mid-anterior part of the insula. In contrast, the ALE-maximum of studies investigating empathy for pain was located more anterior than studies investigating physically induced pain. The present findings provide insights into the organization of the human anterior insula and support the posterior-to-anterior gradient for interoceptive representations in the Insula proposed by Craig (2009). According to this view, an increasingly elaborate and complex representation of bodily states may progress from the posterior to the anterior insula region. Meta-analyses represent an important methodological approach for ruling out false positive results and contribute to the generation of hypotheses which can be experimentally proven.
To investigate the nutrition education provided by primary-care physicians (PCP).
An integrative review was used to examine literature on nutrition care provided by PCP from 2012 to 2018. A literature search was conducted in MEDLINE, PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Scopus using key search terms.
USA, Netherlands, Germany, Denmark, UK, Lebanon, Australia and New Zealand.
Sixteen qualitative and quantitative studies were analysed thematically using meta-synthesis informed by the COM-B model of behaviour (capability, motivation and opportunity), to understand the influences on PCP behaviours to provide nutrition care. PCP perceive that they lack nutrition capability. While PCP motivation to provide nutrition care differs based on patient characteristics and those of their own, opportunity is influenced by medical educators, mentors and policy generated by professional and governmental organisations.
The development of PCP capability, motivation and opportunity to provide nutrition care should begin in undergraduate medical training, and continue into PCP training, to create synergy between these behaviours for PCP to become confident providing nutrition care as an integral component of disease prevention and management in contemporary medical practice.
High-resolution Chirp sub-bottom data were obtained offshore from the Northern Channel Islands (NCI), California, to image submerged paleoshorelines and assess local uplift rates. Although modern bathymetry is often used for modeling paleoshorelines, Chirp data image paleoshorelines buried beneath sediment that obscures their seafloor expression. The NCI were a unified landmass during the last glacial maximum (LGM; ~20 ka), when eustatic sea level was ~120 m lower than present. We identified seven paleoshorelines, ranging from ~28 to 104 m in depth, across this now-submerged LGM platform. Paleoshoreline depths were compared to local sea-level curves to estimate ages, which suggest that some were reoccupied over multiple sea-level cycles. Additionally, previous studies determined conflicting uplift rates for the NCI, ranging from 0.16 to 1.5 m/ka. Our results suggest that a rate on the lower end of this range better fits the observed submerged paleoshorelines. Using the uplift rate of ~0.16 m/ka, we estimate that paleoshorelines formed during Marine Oxygen Isotope Stage 3, the LGM, and the Younger Dryas stade are preserved on the NCI platform. These results help clarify uplift rates for the NCI and illustrate the importance of sub-bottom data for mapping submerged paleoshorelines.
The Australian prime lamb industry is seeking to improve lean meat yield (LMY) as a means to increasing efficiency and profitability across the whole value chain. The LMY of prime lambs is affected by genetics and on-farm nutrition from birth to slaughter and is the total muscle weight relative to the total carcass weight. Under the production conditions of south eastern Australia, many ewe flocks experience a moderate reduction in nutrition in mid to late pregnancy due to a decrease in pasture availability and quality. Correcting nutritional deficits throughout gestation requires the feeding of supplements. This enables the pregnant ewe to meet condition score (CS) targets at lambing. However, limited resources on farm often mean it is difficult to effectively manage nutritional supplementation of the pregnant ewe flock. The impact of reduced ewe nutrition in mid to late pregnancy on the body composition of finishing lambs and subsequent carcass composition remains unknown. This study investigated the effect of moderately reducing ewe nutrition in mid to late gestation on the body composition of finishing lambs and carcass composition at slaughter on a commercial scale. Multiple born lambs to CS2.5 target ewes were lighter at birth and weaning, had lower feedlot entry and exit weights with lower pre-slaughter and carcass weights compared with CS3.0 and CS3.5 target ewes. These lambs also had significantly lower eye muscle and fat depth when measured by ultrasound prior to slaughter and carcass subcutaneous fat depth measured 110 mm from the spine along the 12th rib (GR 12th) and at the C-site (C-fat). Although carcasses were ~5% lighter, results showed that male progeny born to ewes with reduced nutrition from day 50 gestation to a target CS2.5 at lambing had a higher percentage of lean tissue mass as measured by dual energy X-ray absorptiometry and a lower percentage of fat during finishing and at slaughter, with the multiple born progeny from CS3.0 and CS3.5 target ewes being similar. These data suggest lambs produced from multiple bearing ewes that have had a moderate reduction in nutrition during pregnancy are less mature. This effect was also independent of lamb finishing system. The 5% reduction in carcass weight observed in this study would have commercially relevant consequences for prime lamb producers, despite a small gain in LMY.
Over 80% of CTSA programs have a community advisory board (CAB). Little is known about how research discussed with CABs aligns with community priorities (bidirectionality). This program evaluation assessed researcher presentations from 2014 to 2018 to the CABs linked to our CTSA at all three sites (Minnesota, Arizona, and Florida) for relevance to local community needs identified in 2013 and/or 2016. From content analysis, of 65 presentations total, 41 (63%) addressed ≥1 local health needs (47% Minnesota, 60% Florida, and 80% Arizona). Cross-cutting topics were cancer/cancer prevention (physical activity/obesity/nutrition) and mental health. Results could help to prioritize health outcomes of community-engaged research efforts.
The verse hinc subitae mortes atque intestata senectus (Juv. 1.144) has long fuelled considerable debate and discussion among classical scholars. This hexameter occurs in the passage of the first satire that describes the aspect of the patron-client relationship where the rich patron, ignoring the plight of his poor and hungry clients, enjoys a sumptuous but deadly feast. After dining on delicacies such as boar and peacock, he bathes on a bloated stomach, causing him to die suddenly and apparently intestate, and causing those angry at being deprived of their legacy to cheer at his funeral (1.140b–6):
Urinary tract infections (UTIs) are common among college-aged women and often recur. Some antibiotics recommended to treat UTIs trigger dysbiosis of intestinal and vaginal microbiomes – where uropathogens originate, though few studies have investigated associations between these therapies with recurrent infections. We retrospectively analysed the electronic medical records of 6651 college-aged women diagnosed with a UTI at a US university student health centre between 2006 and 2014. Women were followed for 6 months for incidence of a recurrent infection. In a secondary analysis, associations in women whose experienced UTI recurrence within 2 weeks were also considered for potential infection relapse. Logistic regression was used to assess associations between infection recurrence or relapse and antibiotics prescribed, in addition to baseline patient characteristics including age, race/ethnicity, region of origin, year of encounter, presence of symptomology, pyelonephritis, vaginal coinfection and birth control consultation. There were 1051 instances of infection recurrence among the 6620 patients, indicating a prevalence of 16%. In the analysis of patient characteristics, Asian women were statistically more likely to experience infection recurrence whereas African American were less likely. No significant associations were identified between the antibiotic administered at the initial infection and the risk of infection recurrence after multivariable adjustment. Treatment with trimethoprim-sulphamethoxazole and being born outside of the USA were significantly associated with increased odds of infection relapse in the multivariate analysis. The results of the analyses suggest that treatment with trimethoprim-sulphamethoxazole may lead to an increased risk of UTI relapse, warranting further study.
OBJECTIVES/SPECIFIC AIMS: Over 80% of CTSA programs have a community advisory board (CAB), an effective strategy to increase community engagement (CE) in research. Little is known about how the research discussed with CABs aligns with community priorities (i.e., bi-directionality). This program evaluation assessed the health topics presented by researchers to the CABs linked to our CE Program at all three Mayo Clinic sites (MN, AZ, and FL) for relevance to local community needs. METHODS/STUDY POPULATION: Two coders classified Mayo researcher presentations to our CABs from 2014-2018 for relevance to needs identified in the local 2013 and/or 2016 County Health Needs Assessments and specific topic(s); with high levels of agreement (Kappa=0.90). RESULTS/ANTICIPATED RESULTS: Overall, of the 65 presentations 41 (63%) addressed one or more local health needs (47% MN, 60% FL, 80% AZ). Cross-cutting health topics addressed at 2 sites were physical activity/obesity/nutrition and mental health. DISCUSSION/SIGNIFICANCE OF IMPACT: Findings were shared with our CABs to obtain input on future directions. The FL and AZ CABs are systematic in seeking out or initiating research projects that address local health needs, an approach the MN site is interested in adopting. Ultimately, it is important to demonstrate improved health outcomes with CTSA-based CE research strategies. Understanding community health needs and depth of researchers in those areas may help to focus priorities for demonstrating such outcomes.
Breakthrough Listen is a 10-yr initiative to search for signatures of technologies created by extraterrestrial civilisations at radio and optical wavelengths. Here, we detail the digital data recording system deployed for Breakthrough Listen observations at the 64-m aperture CSIRO Parkes Telescope in New South Wales, Australia. The recording system currently implements two modes: a dual-polarisation, 1.125-GHz bandwidth mode for single-beam observations, and a 26-input, 308-MHz bandwidth mode for the 21-cm multibeam receiver. The system is also designed to support a 3-GHz single-beam mode for the forthcoming Parkes ultra-wideband feed. In this paper, we present details of the system architecture, provide an overview of hardware and software, and present initial performance results.
To test the feasibility of using telehealth to support antimicrobial stewardship at Veterans Affairs medical centers (VAMCs) that have limited access to infectious disease-trained specialists.
A prospective quasi-experimental pilot study.
Two rural VAMCs with acute-care and long-term care units.
At each intervention site, medical providers, pharmacists, infection preventionists, staff nurses, and off-site infectious disease physicians formed a videoconference antimicrobial stewardship team (VAST) that met weekly to discuss cases and antimicrobial stewardship-related education.
Descriptive measures included fidelity of implementation, number of cases discussed, infectious syndromes, types of recommendations, and acceptance rate of recommendations made by the VAST. Qualitative results stemmed from semi-structured interviews with VAST participants at the intervention sites.
Each site adapted the VAST to suit their local needs. On average, sites A and B discussed 3.5 and 3.1 cases per session, respectively. At site A, 98 of 140 cases (70%) were from the acute-care units; at site B, 59 of 119 cases (50%) were from the acute-care units. The most common clinical syndrome discussed was pneumonia or respiratory syndrome (41% and 35% for sites A and B, respectively). Providers implemented most VAST recommendations, with an acceptance rate of 73% (186 of 256 recommendations) and 65% (99 of 153 recommendations) at sites A and B, respectively. Qualitative results based on 24 interviews revealed that participants valued the multidisciplinary aspects of the VAST sessions and felt that it improved their antimicrobial stewardship efforts and patient care.
This pilot study has successfully demonstrated the feasibility of using telehealth to support antimicrobial stewardship at rural VAMCs with limited access to local infectious disease expertise.
The combination of sensitivity and large sky coverage of the ALFALFA HI survey has enabled the detection of difficult to observe low mass galaxies in large numbers, including dwarf galaxies overlooked in optical surveys. Three different, but connected, studies of dwarf galaxies from the ALFALFA survey are of particular interest: SHIELD (Survey of HI in Extremely Low-mass Dwarfs), candidate gas-rich ultra-faint dwarf galaxies, and the (Almost) Dark population. SHIELD is a systematic multiwavelength study of all dwarf galaxies from ALFALFA with MHI < 107.2M⊙ and clear optical counterparts. Candidate gas-rich ultra-faint dwarf galaxies extend the dwarf galaxy population to even lower masses. These galaxies are identified as isolated HI clouds with no discernible optical counterpart but subsequent observations reveal that some are extremely faint, gas-dominated galaxies. Leo P, discovered first as an HI detection, and then found to be an actively star-forming galaxy, bridges the gap between these candidate galaxies and the SHIELD sample. The (Almost) Dark sample consists of galaxies whose optical counterparts are overlooked in current optical surveys but which are clear detections in ALFALFA. This sample includes field gas-rich ultra-diffuse galaxies. Coma P, with a peak surface brightness of only ∼26.4 mag arcsec−2 in g’, demonstrates the sort of extreme low surface brightness galaxy that can be discovered in an HI survey.
Introduction: Trauma teams have been shown to improve outcomes in severely injured patients. The criteria used to mobilize trauma teams is highly variable and debated. This study was undertaken to define the triage accuracy at our level 1 trauma centre and identify the criteria predictive of appropriate activations. Methods: A 3-month prospective observational study was performed and all patients presenting to the ER who received a trauma flag were identified. Patient demographics, vital signs, trauma team activation and criteria for activation were documented. Trauma activations were deemed appropriate if the patient met any of the following; airway intervention, needle/tube thoracostomy, resuscitative thoracotomy, ED blood product transfusion, invasive hemodynamic monitoring, central line insertion, emergent OR (<8 hours), admission to ICU, and death within 72 hours. Over and undertriage rates were calculated and a multivariate logistic regression was performed to identify activation criteria predictive of appropraite activations. The activation criteria were then modified and the prospective study was repeated to assess the impact on triage accuracy. Results: Between September to December 2015, 188 patients received a trauma flag. 137 patients met the activation criteria, however only 78 received a trauma team activation. 57% of patients who had TTA met the definition of appropriate activation, while 45% who met criteria for activation met the definition of appropriate. The rates of under and overtriage were 30.4% and 30.3%, respectively. Logistic regression revealed the following criteria to be predictive of appropriate activation; hypotension (OR 10.2 95% CI 2.3,45.5), arrival by HEMS (OR 3.2, 95% CI 1.4,7.6), pedestrian struck (OR 3.5, 95% CI 1.4,8.5) and fall (OR 5.1, 95% CI 1.7, 15.1). Tachycardia (OR 1.1, 95% 0.3,4.6) and high energy MVC (OR 1.4, 95% CI 0.7,3.1) were not found to be predictive. The post-modification study occured between September to December 2016. Data analysis to assess the impact of criteria alteration are currently underway and will be presented at CAEP 2017. Conclusion: Triage accuracy for the mobilization of a multi-disciplinary trauma team is important, both to ensure optimal patient care as well as to reduce unnecessary resource strain. Our previous criteria lead to high rates of undertriage and subsequent modifications have been made. The impact of these changes will be ascertained and presented at CAEP 2017.
The ‘voice quality symbols’ (VoQS) transcription system for voice quality was introduced some 20 years ago, and no major revision has been undertaken since then. In this account we describe the first major revision of the VoQS chart, these changes being mostly in the form of additions to the section on phonation types, but include also changes to the layout of the supralaryngeal settings section. These reflect recent developments in the understanding of the physiological underpinnings of sounds produced in the larynx including certain phonation types.