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Fungal hyphae associated with tree roots extending into the surrounding substrate are suspected to have to contaminated buried plant material with recent carbon in two examples and to have resulted in erroneously young radiocarbon ages. This problem might be overcome by choosing sampling sites far from trees or by analyzing the lignin component of samples, although the latter is presently difficult.
This study aimed to examine the predictors of cognitive performance in patients with pediatric mild traumatic brain injury (pmTBI) and to determine whether group differences in cognitive performance on a computerized test battery could be observed between pmTBI patients and healthy controls (HC) in the sub-acute (SA) and the early chronic (EC) phases of injury.
203 pmTBI patients recruited from emergency settings and 159 age- and sex-matched HC aged 8–18 rated their ongoing post-concussive symptoms (PCS) on the Post-Concussion Symptom Inventory and completed the Cogstate brief battery in the SA (1–11 days) phase of injury. A subset (156 pmTBI patients; 144 HC) completed testing in the EC (∼4 months) phase.
Within the SA phase, a group difference was only observed for the visual learning task (One-Card Learning), with pmTBI patients being less accurate relative to HC. Follow-up analyses indicated higher ongoing PCS and higher 5P clinical risk scores were significant predictors of lower One-Card Learning accuracy within SA phase, while premorbid variables (estimates of intellectual functioning, parental education, and presence of learning disabilities or attention-deficit/hyperactivity disorder) were not.
The absence of group differences at EC phase is supportive of cognitive recovery by 4 months post-injury. While the severity of ongoing PCS and the 5P score were better overall predictors of cognitive performance on the Cogstate at SA relative to premorbid variables, the full regression model explained only 4.1% of the variance, highlighting the need for future work on predictors of cognitive outcomes.
Intermetallic γ-TiAl-based alloys are commonly used as structural materials for components in high-temperature applications, although they generally suffer from a lack of ductility and crack resistance at ambient temperatures. Within this study, the process-adapted 4th generation TNM+ alloy, exhibiting a fully lamellar microstructure, was examined using notched micro-cantilevers with defined orientations of lamellar interfaces. These configurations were tested in situ using superimposed continuous stiffness measurement methods during loading with simultaneous scanning electron microscopy observations. Subsequently, the video signal was used for visual crack length determination by computer vision and compared to values calculated from in situ changes in stiffness data. Applying this combinatorial approach enabled to determine the J-integral as a measure of the fracture toughness for microstructurally different local crack propagation paths. Thus, distinct differences in conditional fracture toughness could be determined from 3.7 MPa m1/2 for γ/γ-interface to 4.4 MPa m1/2 for α2/γ-interface.
The need for increased testing for SARS-CoV-2, the virus that causes COVID-19, has resulted in an increase of testing facilities outside of traditional clinical settings and sample handling by individuals without appropriate biohazard and biocontainment training. During the repatriation and quarantine of passengers from the Grand Princess cruise ship at a U.S. military base, biocontainment of a potentially infectious sample from a passenger was compromised. This paper describes the steps taken to contain the spill, decontaminate the area, and discusses the needs for adequate training in a biohazard response.
Late Antiquity, it has long been assumed, is the historical period in which we first observe the widespread rise of religious intolerance.1 Hand in hand with this view goes the premise that there is a direct causal relationship between religious intolerance and religious violence. That is, intolerance leads to conflict; conflict leads to violence.2 Late Antiquity, in which Constantine’s conversion to Christianity is viewed as a watershed moment,3 is thus the period to which scholars look to observe religious violence and its origins.4 In the past decade and a half there has been a move to unpack these entrenched ideas, with a growing number of scholars concluding that these assumed relationships – between the rise of Christianity and religious intolerance, and between religious intolerance and religious violence – are neither inevitable nor simple.
Background: Hospital-onset bacteremia and fungemia (HOB) may be a preventable hospital-acquired condition and a potential healthcare quality measure. We developed and evaluated a tool to assess the preventability of HOB and compared it to a more traditional consensus panel approach. Methods: A 10-member healthcare epidemiology expert panel independently rated the preventability of 82 hypothetical HOB case scenarios using a 6-point Likert scale (range, 1= “Definitively or Almost Certainly Preventable” to 6= “Definitely or Almost Certainly Not Preventable”). Ratings on the 6-point scale were collapsed into 3 categories: Preventable (1–2), Uncertain (3–4), or Not preventable (5–6). Consensus was defined as concurrence on the same category among ≥70% expert raters. Cases without consensus were deliberated via teleconference, web-based discussion, and a second round of rating. The proportion meeting consensus, overall and by predefined HOB source attribution, was calculated. A structured HOB preventability rating tool was developed to explicitly account for patient intrinsic and extrinsic healthcare-related risks (Fig. 1). Two additional physician reviewers independently applied this tool to adjudicate the same 82 case scenarios. The tool was iteratively revised based on reviewer feedback followed by repeat independent tool-based adjudication. Interrater reliability was evaluated using the Kappa statistic. Proportion of cases where tool-based preventability category matched expert consensus was calculated. Results: After expert panel round 1, consensus criteria were met for 29 cases (35%), which increased to 52 (63%) after round 2. Expert consensus was achieved more frequently for respiratory or surgical site infections than urinary tract and central-line–associated bloodstream infections (Fig. 2a). Most likely to be rated preventable were vascular catheter infections (64%) and contaminants (100%). For tool-based adjudication, following 2 rounds of rating with interim tool revisions, agreement between the 2 reviewers was 84% for cases overall (κ, 0.76; 95% CI, 0.64–0.88]), and 87% for the 52 cases with expert consensus (κ, 0.79; 95% CI, 0.65–0.94). Among cases with expert consensus, tool-based rating matched expert consensus in 40 of 52 (77%) and 39 of 52 (75%) cases for reviewer 1 and reviewer 2, respectively. The proportion of cases rated “uncertain“ was lower among tool-based adjudicated cases with reviewer agreement (15 of 69) than among cases with expert consensus (23 of 52) (Fig. 2b). Conclusions: Healthcare epidemiology experts hold varying perspectives on HOB preventability. Structured tool-based preventability rating had high interreviewer reliability, matched expert consensus in most cases, and rated fewer cases with uncertain preventability compared to expert consensus. This tool is a step toward standardized assessment of preventability in future HOB evaluations.
Cognitive behavioural therapy for psychosis (CBTp) is a recommended treatment for psychotic experiences, but its effectiveness has been questioned. One way of addressing this may be to tailor therapy materials to the phenomenology of specific psychotic experiences.
In this study, we investigated the acceptability of a novel treatment manual for subtypes of ‘voice-hearing’ experiences (i.e. auditory verbal hallucinations). An uncontrolled, single-arm design was used to assess feasibility and acceptability of using the manual in routine care for people with frequent voice-hearing experiences.
The manual was delivered on a smart tablet and incorporated recent research evidence and theory into its psychoeducation materials. In total, 24 participants completed a baseline assessment; 19 started treatment, 15 completed treatment and 12 participants completed a follow-up assessment (after 10 sessions of using the manual).
Satisfaction with therapy scores and acceptability ratings were high, while completion rates suggested that the manual may be more appropriate for help with participants from Early Intervention in Psychosis services rather than Community Mental Health Teams.
Within-group changes in symptom scores suggested that overall symptom severity of hallucinations – but not other psychosis features, or beliefs about voices – are likely to be the most appropriate primary outcome for further evaluation in a full randomised controlled trial.
Literary condemnations of manual work and commerce and trade were a discourse of social distinction that emphasized philosophical morality over avaricious money making. It did not matter socially beyond its immediate intellectual context, and neither prevented artisans and professionals from publicly displaying pride in their work nor imperial elites from treating traders, engineers, and artisans with dignity and respect in their personal interactions.
The title of this chapter may seem provocative. While a
port society is typically perceived to be an
unambiguous concept, it is an anachronistic one when
applied to the ancient world. 1It has yet
to be conclusively proven that societies living in
areas connected by waterways, and therefore with
access to major commercial routes, differed
significantly from other land-based urban
settlements of equal size. However, we ought to
pause here a moment to observe an undoubted fact,
especially evident for example in Hispania: the
social behaviours of coastal cities differ from
those of inland settlements of a similar scale. The
evidence related to social promotion is crucial in
this case, with freedmen playing a key role. In
contrast, the noted social conservatism of inland
societies has contributed to the creation of a power
struggle between such open and closed
societies.2 Perhaps this is not the
forum to discuss and clarify these issues, but it
can be argued that the society of Narona was an open
one, and its port access can be considered an
essential determinant of this characteristic, as it
was for most coastal cities for which there is
sufficient historical information. Furthermore, its
location at the midpoint of the north Adriatic
maritime trade route enhanced the significance of
Market concentration is a significant and growing problem in precisely the digital markets where the Internet was supposed to herald an era of healthy competition. Algorithmic systems are subject to a significant new force shifting market competition, the “feedback effect.” More data not only produces better results through traditional scale and scope economies, but also by generating better machine learning models. This means that traditional antitrust and regulatory remedies are poorly suited to redress competitive imbalances. Instead, regulators should impose a progressive data-sharing mandate. With this novel mechanism, dominant digital platforms would be required to make data available to competitors, blunting their inherent advantage in algorithm-dominated markets.