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Wind-driven snow redistribution can increase the spatial heterogeneity of snow accumulation on ice caps and ice sheets, and may prove crucial for the initiation and survival of glaciers in areas of marginal glaciation. We present a snowdrift model (Snow_Blow), which extends and improves the model of Purves, Mackaness and Sugden (1999, Journal of Quaternary Science 14, 313–321). The model calculates spatial variations in relative snow accumulation that result from variations in topography, using a digital elevation model (DEM) and wind direction as inputs. Improvements include snow redistribution using a flux routing algorithm, DEM resolution independence and the addition of a slope curvature component. This paper tests Snow_Blow in Antarctica (a modern environment) and reveals its potential for application in palaeoenvironmental settings, where input meteorological data are unavailable and difficult to estimate. Specifically, Snow_Blow is applied to the Ellsworth Mountains in West Antarctica where ablation is considered to be predominantly related to wind erosion processes. We find that Snow_Blow is able to replicate well the existing distribution of accumulating snow and snow erosion as recorded in and around Blue Ice Areas. Lastly, a variety of model parameters are tested, including depositional distance and erosion vs wind speed, to provide the most likely input parameters for palaeoenvironmental reconstructions.
Group-based trajectory modeling holds promise for the study of prognostic indicators in the mood disorders because the courses that the individuals with these disorders follow are so highly variable. However, trajectory analyses of major depressive disorder have so far not included some of the more robust predictors of mood disorder outcome, nor have they described interactions between these predictors.
A group of 186 individuals aged 15–20 years with past or current depressive symptoms, who had recently begun taking a serotonin reuptake inhibitors antidepressant, underwent extensive baseline evaluations and were then followed for up to 2 years. Trajectory analyses used weekly ratings of depressive symptoms and the resulting groups were compared by the risk factors of sex, psychiatric comorbidity, negative emotionality, and childhood adversity.
A three-group solution provided the best statistical fit to the 2-year symptom trajectory. Negative emotionality and childhood adversity, though correlated, independently predicted membership in higher-morbidity groups. Female sex and comorbidity with generalized anxiety disorder (GAD) were also significantly more likely in the trajectory groups with higher symptom levels. However, the presence of GAD, rather than female sex, was the most important determinant of group membership. Negative emotionality was predictive of group membership only among women.
Trajectory analyses indicated that week-to-week variations in depressive symptoms across individuals could best be condensed into low, remitting and persistent symptom patterns. Female sex, anxiety symptoms, negative emotionality and childhood adversity were each independently associated with trajectories of higher morbidity but negative emotionality may be prognostically important only among women.
‘Mineral evolution’ has attracted much attention in the last decade as a counterpart of the long-established biological concept, but is there a corresponding ‘mineral extinction’? We present new geochronological data from uranium-bearing secondary minerals and show that they are relatively recent, irrespective of the age of their primary uranium sources. The secondary species that make up much of the diversity of minerals appear to be ephemeral, and many may have vanished from the geological record without trace. Nevertheless, an ‘extinct’ mineral species can recur when physiochemical conditions are appropriate. This reversibility of ‘extinction’ highlights the limitations of the ‘evolution’ analogy. Mineral occurrence may be time-dependent but does not show the unique contingency between precursor and successor species that is characteristic of biological evolution.
To improve healthcare practices and increase cultural safety when working with First Peoples, it is essential that students engage with challenging discourses that critically engage their social, political, personal, professional and historical positioning. Such engagement may provoke emotional responses in students. However, little is known about the nature of non-indigenous students’ emotional engagement when learning First Peoples health content that integrates cultural safety principles. The pedagogy of discomfort is a process of self-examination that requires students to critically engage their ideological assumptions and may be useful in examining the emotional dimension that occurs when learning this content. Eighty-two non-indigenous health students gave permission for their critical reflective essays, submitted as an assessment requirement of a First Peoples health course to be analysed. Elements of the pedagogy of discomfort informed the analytical and theoretical framework. The emotional engagement by students was captured in the following overarching themes: Acknowledging preconceived ideas; Uncomfortable emotions; Fragile identities; Spectating and Witnessing. Findings highlight how students' emotional engagement may contribute to changes in perspective and frames of reference, transpiring to a ‘call to action’ that challenges systems of differential privilege. While many students expressed discomfort when learning about key cultural safety concepts, the extent of transformative potential varied.
In January of 2010, North Carolina (NC) USA implemented state-wide Trauma Triage Destination Plans (TTDPs) to provide standardized guidelines for Emergency Medical Services (EMS) decision making. No study exists to evaluate whether triage behavior has changed for geriatric trauma patients.
The impact of the NC TTDPs was investigated on EMS triage of geriatric trauma patients meeting physiologic criteria of serious injury, primarily based on whether these patients were transported to a trauma center.
This is a retrospective cohort study of geriatric trauma patients transported by EMS from March 1, 2009 through September 30, 2009 (pre-TTDP) and March 1, 2010 through September 30, 2010 (post-TTDP) meeting the following inclusion criteria: (1) age 50 years or older; (2) transported to a hospital by NC EMS; (3) experienced an injury; and (4) meeting one or more of the NC TTDP’s physiologic criteria for trauma (n = 5,345). Data were obtained from the Prehospital Medical Information System (PreMIS). Data collected included proportions of patients transported to a trauma center categorized by specific physiologic criteria, age category, and distance from a trauma center.
The proportion of patients transported to a trauma center pre-TTDP (24.4% [95% CI 22.7%-26.1%]; n = 604) was similar to the proportion post-TTDP (24.4% [95% CI 22.9%-26.0%]; n = 700). For patients meeting specific physiologic triage criteria, the proportions of patients transported to a trauma center were also similar pre- and post-TTDP: systolic blood pressure <90 mmHg (22.5% versus 23.5%); respiratory rate <10 or >29 (23.2% versus 22.6%); and Glascow Coma Scale (GCS) score <13 (26.0% versus 26.4%). Patients aged 80 years or older were less likely to be transported to a trauma center than younger patients in both the pre- and post-TTDP periods.
State-wide implementation of a TTDP had no discernible effect on the proportion of patients 50 years and older transported to a trauma center. Under-triage remained common and became increasingly prevalent among the oldest adults. Research to understand the uptake of guidelines and protocols into EMS practice is critical to improving care for older adults in the prehospital environment.
Better understanding of the variation in macronutrient content of human donor milk (HDM) potentiates targeted nutrition for preterm babies. This study describes the relationship of maternal age, parity, monthly lactation stage estimate (LSEm), daily volume of milk expressed (Vd), sex, gestation, and birthweight z scores, with macronutrient content of HDM. Multilevel mother-infant pair ID random intercept models were performed using the predictor variables above on the outcome HDM macronutrient content determined using mid infrared spectroscopy. Mean macronutrient content was also compared by gestational age, and small or appropriate for gestational age (SGA) (z score <-1.28) or (AGA) (z score ≥ -1.28) categories. 2966 samples of donations from 1175 mother-infant pairs to the UK North West Human Milk Bank between 2011-2017 were analysed. Mean (sd) protein, fat, carbohydrate, and calculated energy, were 0.89 (0.24) g/dl, 2.99 (0.96) g/dl, 7.09 (0.44) g/dl, and 60.37 (8.41) kcal/dl respectively. Preterm SGA HDM was significantly higher in protein, fat, and energy content than term AGA HDM, and significantly lower in carbohydrate content than term AGA HDM after controlling for LSEm, Vd, and between subject effects. Degree of prematurity did not influence macronutrient content. Between subject effects accounted for more of the variance in macronutrient content than the fixed effects in the model. Despite this, SGA status, as well as prematurity, may be an important determinant of macronutrient content in human milk. As bioavailability of macronutrients from HDM is uncertain, studies evaluating growth and body composition in preterm and SGA babies fed HDM are warranted.
Mineral species should be identified by an end-member formula and by using the dominant-valency rule as recommended by the IMA–CNMNC. However, the dominant-end-member approach has also been used in the literature. These two approaches generally converge, but for some intermediate compositions, significant differences between the dominant-valency rule and the dominant end-member approach can be observed. As demonstrated for garnet-supergroup minerals, for example, the end-member approach is ambiguous, as end-member proportions strongly depend on the calculation sequence. For this reason, the IMA–CNMNC strongly recommends the use of the dominant-valency rule for mineral nomenclature, because it alone may lead to unambiguous mineral identification. Although the simple application of the dominant-valency rule is successful for the identification of many mineral compositions, sometimes it leads to unbalanced end-member formulae, due to the occurrence of a coupled heterovalent substitution at two sites along with a heterovalent substitution at a single site. In these cases, it may be useful to use the site-total-charge approach to identify the dominant root-charge arrangement on which to apply the dominant-constituent rule. The dominant-valency rule and the site-total-charge approach may be considered two procedures complementary to each other for mineral identification. Their critical point is to find the most appropriate root-charge and atomic arrangements consistent with the overriding condition dictated by the end-member formula. These procedures were approved by the IMA−CNMNC in May 2019.
This study used repeated measures data to identify developmental profiles of elevated risk for ADHD (i.e., six or more inattentive and/or hyperactive-impulsive symptoms), with an interest in the age at which ADHD risk first emerged. Risk factors that were measured across the first 3 years of life were used to predict profile membership. Participants included 1,173 children who were drawn from the Family Life Project, an ongoing longitudinal study of children's development in low-income, nonmetropolitan communities. Four heuristic profiles of ADHD risk were identified. Approximately two thirds of children never exhibited elevated risk for ADHD. The remaining children were characterized by early childhood onset and persistent risk (5%), early childhood limited risk (10%), and middle childhood onset risk (19%). Pregnancy and delivery complications and harsh-intrusive caregiving behaviors operated as general risk for all ADHD profiles. Parental history of ADHD was uniquely predictive of early onset and persistent ADHD risk, and low primary caregiver education was uniquely predictive of early childhood limited ADHD risk. Results are discussed with respect to how changes to the age of onset criterion for ADHD in DSM5 may affect etiological research and the need for developmental models of ADHD that inform ADHD symptom persistence and desistance.
There is an absence of research into online friendships and video gaming activities of students with autism spectrum disorder (ASD). In this article we describe how friendships of students with ASD were developed in an online multiplayer context using the popular sandbox game, Minecraft. Multimodal analysis of the data demonstrated that online multiplayer gaming supported students’ use of speech to engage in conversations about their friendships, and to share gaming experiences with their offline and online friends. Online gaming enabled students to visually gather information about their friends’ online status and activities, and to engage in the creative and adventurous use of virtual images and material representations with friends. Despite the benefits for friendships, students with ASD experienced difficulties in friendships in multimodal ways. Notably, students engaged in verbal disagreements about video gaming discourses, sought out activities associated with the themes of death and damage using written text, and tended to dominate shared creations of virtual images and their representation. The findings have implications to better support the friendships of students through inclusive literacy practices online.
Clinical Enterobacteriacae isolates with a colistin minimum inhibitory concentration (MIC) ≥4 mg/L from a United States hospital were screened for the mcr-1 gene using real-time polymerase chain reaction (RT-PCR) and confirmed by whole-genome sequencing. Four colistin-resistant Escherichia coli isolates contained mcr-1. Two isolates belonged to the same sequence type (ST-632). All subjects had prior international travel and antimicrobial exposure.
In an oracular tablet from Dodona dating to the mid-fourth century bc, a slave named Kittos inquires whether his master, Dionysios, will set him free. A roughly contemporary entry in the Athenian phialai inscriptions records Dionysios isotelēs manumitting Kittos the metalworker. This paper suggests that the individuals in both documents may be identical. Along the way, it also takes a position on a number of questions surrounding the phialai inscriptions. These inscriptions are not really inventories, I propose, nor can they be explained in terms of lawsuits unrelated to manumission. (The presence of families and children in the inscriptions is especially important in demonstrating this point.) Instead, they represent acts of manumission effectuated through dikē apostasiou prosecutions, an Athenian practice which, I believe, dates back to the 350s. It was not until the 330s, under the financial administration of Lycurgus, that the city imposed mandatory phialai dedications upon all manumissions in court, with the phialē serving as a manumission fee paid to the treasurers of Athena.