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An ongoing challenge in understanding and treating personality disorders (PDs) is a significant heterogeneity in disorder expression, stemming from variability in underlying dynamic processes. These processes are commonly discussed in clinical settings, but are rarely empirically studied due to their personalized, temporal nature. The goal of the current study was to combine intensive longitudinal data collection with person-specific temporal network models to produce individualized symptom-level structures of personality pathology. These structures were then linked to traditional PD diagnoses and stress (to index daily functioning).
Using about 100 daily assessments of internalizing and externalizing domains underlying PDs (i.e. negative affect, detachment, impulsivity, hostility), a temporal network mapping approach (i.e. group iterative multiple model estimation) was used to create person-specific networks of the temporal relations among domains for 91 individuals (62.6% female) with a PD. Network characteristics were then associated with traditional PD symptomatology (controlling for mean domain levels) and with daily variation in clinically-relevant phenomena (i.e. stress).
Features of the person-specific networks predicted paranoid, borderline, narcissistic, and obsessive-PD symptom counts above average levels of the domains, in ways that align with clinical conceptualizations. They also predicted between-person variation in stress across days.
Relations among behavioral domains thought to underlie heterogeneity in PDs were indeed associated with traditional diagnostic constructs and with daily functioning (i.e. stress) in person-specific networks. Findings highlight the importance of leveraging data and models that capture person-specific, dynamic processes, and suggest that person-specific networks may have implications for precision medicine.
Laboratory-identified bloodstream infections (LAB-ID BSIs) in recently discharged patients are likely to be classified as healthcare-associated community-onset (HCA-CO) infections, even though they may represent hospital-onset (HO) infections. A review of LAB-ID BSIs among patients discharged within 14 days revealed that 109 of 756 cases (14.4%) were HO infections. The BSI risk being misclassified as HCA CO may underestimate the hospital infection risk.
We report on an initial long-term study of dissolved inorganic and organic carbon (DIC) from Sabino Creek, located in Sabino Canyon, Pima County, Arizona. The purpose of this study was to monitor changes in dissolved radiocarbon (14C) with time and to understand the processes contributing to these variations. Our results span the period 2009–2016 and show a mixing trend between dissolved inorganic and organic carbon modern end-members with an older component. This study provides preliminary information for more detailed research on recycling of organic components in this stream system.
The objective was to determine the longitudinal associations between callous-unemotional (CU) and oppositional defiant (OD) behaviors from the first to fourth grades for Spanish children. Four possible outcomes were evaluated: (a) CU behaviors in the first grade predict increases in OD behaviors in the fourth grade, controlling for OD behaviors in the first grade; (b) OD behaviors in the first grade predict increases in CU behaviors in the fourth grade, controlling for CU behaviors in the first grade; (c) both unique effects are significant; and (d) neither unique effect is significant. A longitudinal panel model with two latent variables (CU and OD behaviors), three sources (mothers, fathers, teachers), and two occasions (spring of the first and fourth grades) was used to evaluate the four possibilities among 758 (54% boys) first grade and 469 (53% boys) fourth grade Spanish children. For mother-, father-, and teacher-reports, OD behaviors in the first grade predicted increases in CU behaviors in the fourth grade, after controlling for CU behaviors in the first grade, whereas CU behaviors in the first grade did not predict increases in OD behaviors in the fourth grade, after controlling for OD behaviors in the first grade. OD behaviors thus conferred independent vulnerability to increases in CU behaviors 3 years later among young children.
Wearable devices are fast evolving to address mobility and autonomy needs of elderly people who would benefit from physical assistance. Recent developments in soft robotics provide important opportunities to develop soft exoskeletons (also called exosuits) to enable both physical assistance and improved usability and acceptance for users. The XoSoft EU project has developed a modular soft lower limb exoskeleton to assist people with low mobility impairments. In this paper, we present the design of a soft modular lower limb exoskeleton to improve person’s mobility, contributing to independence and enhancing quality of life. The novelty of this work is the integration of quasi-passive elements in a soft exoskeleton. The exoskeleton provides mechanical assistance for subjects with low mobility impairments reducing energy requirements between 10% and 20%. Investigation of different control strategies based on gait segmentation and actuation elements is presented. A first hip–knee unilateral prototype is described, developed, and its performance assessed on a post-stroke patient for straight walking. The study presents an analysis of the human–exoskeleton energy patterns by way of the task-based biological power generation. The resultant assistance, in terms of power, was 10.9% ± 2.2% for hip actuation and 9.3% ± 3.5% for knee actuation. The control strategy improved the gait and postural patterns by increasing joint angles and foot clearance at specific phases of the walking cycle.
Oesophageal disorders and osteonecrosis of the jaw are recognised complications of the commonly prescribed medication bisphosphonate. Despite these diagnoses being seen comparatively frequently within the ENT clinic, osteonecrosis of the external ear is a less well reported complication.
The current literature is reviewed and our experience with six cases of bisphosphonate-related ear canal osteonecrosis is presented.
Six cases were identified as suffering from ear canal osteonecrosis as a result of bisphosphonate treatment. One of our cases suffered bilateral ear canal osteonecrosis after only 20 months of oral alendronic acid treatment. Management ranged from bisphosphonate cessation and topical treatment, to surgical debridement in the operating theatre.
Bisphosphonate-related ear canal osteonecrosis is undoubtedly under-diagnosed. For such a commonly prescribed medication, the risks and side effects of bisphosphonate should be better known and long-term treatment should be avoided if possible.
Out-of-home foods (takeaway, take-out and fast foods) have become increasingly popular in recent decades and are thought to be a key driver in increasing levels of overweight and obesity due to their unfavourable nutritional content. Individual food choices and eating behaviours are influenced by many interrelated factors which affect the results of nutrition-related public health interventions. While the majority of research based on out-of-home foods comes from Australia, the UK and USA, the same issues (poor dietary habits and increased prevalence of non-communicable disease) are of equal concern for urban centres in developing economies undergoing ‘nutrition transition’ at a global scale. The present narrative review documents key facets, which may influence out-of-home food consumption, drawn from biological, societal, environmental, demographic and psychological spheres. Literature searches were performed and references from relevant papers were used to find supplementary studies. Findings suggest that the strongest determinants of out-of-home food availability are density of food outlets and deprivation within the built environment; however, the association between socio-economic status and out-of-home food consumption has been challenged. In addition, the biological and psychological drives combined with a culture where overweight and obesity are becoming the norm makes it ‘fashionable’ to consume out-of-home food. Other factors, including age group, ethnicity and gender demonstrate contrasting effects and a lack of consensus. It is concluded that further consideration of the determinants of out-of-home food consumption within specific populations is crucial to inform the development of targeted interventions to reduce the impact of out-of-home foods on public health.
Temperature profiles of first-year landfast sea ice have been recorded continuously over the 2003 winter growth season at McMurdo Sound, Antarctica. The temperature gradients in the ice were used to calculate the growth rate due to conductive heat flux, which is shown to account for only part of the total ice growth. Remaining ice growth must be due to a negative oceanic heat flux. Significantly, this oceanic heat flux is shown to occur episodically, sometimes with sustained daily rates in excess of –30Wm–2. There is no direct correlation between oceanic heat flux and water temperature. Times of increased oceanic heat flux do coincide with the appearance of platelet ice in cores, and appear to account for the growth of 35% of the total platelet ice depth measured in ice cores.
A 14 year kinematic survey of Spruce Creek rock glacier, Colorado, USA, provides information on rates and controls of surface strain. Steel-tape measurements of differential movement yield data of cm-scale accuracy, sufficient to assess strain patterns over small portions of the very slowly deforming rock glacier. Flow rates are typically <10cma–1, and measured strain rates range from 1.0 × 10–5a–1 to 1.5 × 10–3a–1. The primary control on longitudinal strain is changing surface slope, with extending flow occurring in areas of down-valley increase in slope, and compressing flow in areas of down-valley slope decrease. Relatively high strain rates are associated with higher flow velocities and with the impingement of faster-flowing up-valley portions of the rock glacier on the slower-moving lower portion. Overall strain rates decreased through the study period, probably as a result of a slowing of the upper part of the rock glacier. Transverse ridges are associated with longitudinal shortening, caused by either slope changes or impingement of faster-moving sections of the rock glacier on slower-moving sections, but transverse ridges do not occur in every area of strong longitudinal shortening.
We examine the validity of two methods for estimating glacier equilibrium-line altitudes (ELAs) from topographic maps. The ELA determined by contour inflection (the kinematic ELA) and the mean elevation of the glacier correlate extremely well with the ELA determined from mass-balance data (observed ELA). However, the range in glacier elevations above sea level is much larger than the variation in ELA, making this correlation unhelpful. The data were normalized and a reasonable correlation (r2 = 0.59) was found between observed and kinematic ELA.The average of the normalized kinematic ELAs was consistently located down-glacier from the observed ELA, consistent with theory. The normalized mean elevation of the glacier exhibited no correlation and suggests that the toe–headwall altitude ratio is not a good approximation for the ELA. Kinematic waves had no effect on the position of the kinematic ELA. Therefore, topographic maps of glacier surfaces can be used to infer the position of the ELA and provide a method for estimating past ELAs from historic topographic maps.
A distinctive feature of polar regions is the formation of ice clusters attached to the seabed, known as ‘anchor ice’. Anchor ice plays an important role in mobilizing bed sediments, and serves ecological roles providing habitats, or as an agent of disturbance creating potentially fatal environments to benthic fauna. The sublittoral zone associated with the landward margin represents the most likely environment for anchor ice formation, where conditions conducive to the advection of supercooled water from sub-ice-shelf cavities are favourable. We develop a framework to estimate the areal extent of anchor ice formation assuming a northerly flow of 75m deep supercooled water plumes from the Ross and McMurdo Ice Shelf cavities, Antarctica. In McMurdo Sound our results indicate that regions beneath the McMurdo Ice Shelf, extending along Brown Peninsula and White and Black Islands, are likely conducive to anchor ice formation. Anchor ice may also form along the Hut Point Peninsula and around Ross Island, and in pockets along the southern Victoria Land coast. The limitations of our approach include an imposed northerly flow of Ice Shelf Water, poorly constrained sub-ice-shelf bathymetry, and temporal variability in supercooled water depth production, particularly in the eastern Sound.
Using in situ data from 2011 and 2013, we evaluate the ability of CryoSat-2 (CS-2) to retrieve sea-ice freeboard over fast ice in McMurdo Sound. This provides the first systematic validation of CS-2 in the coastal Antarctic and offers insight into the assumptions currently used to process CS-2 data. European Space Agency Level 2 (ESAL2) data are compared with results of a Waveform Fitting (WfF) procedure and a Threshold-First-Maximum-Retracker-Algorithm employed at 40% (TFMRA40). A supervised freeboard retrieval procedure is used to reduce errors associated with sea surface height identification and radar velocity in snow. We find ESAL2 freeboards located between the ice and snow freeboard rather than the frequently assumed snow/ice interface. WfF is within 0.04 m of the ice freeboard but is influenced by variable snow conditions causing increased radar backscatter from the air/snow interface. Given such snow conditions and additional uncertainties in sea surface height identification, a positive bias of 0.14 m away from the ice freeboard is observed. TFMRA40 freeboards are within 0.03 m of the snow freeboard. The separation of freeboard estimates is primarily driven by the different assumptions of each retracker, although waveform alteration by variations in snow properties and surface roughness is evident. Techniques are amended where necessary, and automatic freeboard retrieval procedures for ESAL2, WfF and TFMRA40 are presented. CS-2 detects annual fast-ice freeboard trends using all three automatic procedures that are in line with known sea-ice growth rates in the region.
The dependence of oxygen isotope fractionation on ice growth rate during the freezing of sea water is investigated based on laboratory experiments and field observations in McMurdo Sound, Antarctica. The laboratory experiments were performed in a tank filled with sea water, with sea ice grown under calm conditions at various room temperatures ranging from −5°C to −20°C. In McMurdo Sound, the ice growth rate was monitored using thermistor probes for first-year landfast ice that grew to ∼2 m in thickness. Combining these datasets allows, for the first time, examination of fractionation at a wide range of growth rates from 0.8 × 10−7 to 9.3 × 10−7 m s−1. In the analysis a stagnant boundary-layer model is parameterized using these two independent datasets. As a result, the optimum values of equilibrium pure-ice fractionation factor and boundary-layer thickness are estimated. It is suggested that a regime shift may occur at a growth rate of ∼2.0 × 10−7 m s−1. A case study on sea ice in the Sea of Okhotsk, where the growth rate is modeled by coupling the thermodynamic properties of the sea ice with meteorological data, demonstrates the utility of the fitted models.
Measurements made by an underwater glider deployed near the Ross Ice Shelf were used to identify the presence of Ice Shelf Water (ISW), which is defined as seawater with its potential temperature lower than its surface freezing point temperature. Properties logged by the glider included in situ temperature, electrical conductivity, pressure, GPS location at surfacings and time. For most of the first 30 recorded dives of its deployment, evidence suggests the glider was prevented from surfacing due to being under the ice shelf. For dives under the ice shelf, farthest from the ice shelf front, ISW layers of varying thicknesses and depth locations were observed; between 2 m thick (centred at 231 m depth) to >93 m thick (centred at >360 m). For dives under the ice shelf, close to the ice shelf front, either no ISW was observed or ISW layers were centred at shallower depths (116–127 m). Thicker ISW layers (e.g. up to 250 m thickness centred at 421 m) were observed for some glider dives in open water in front of the Ross Ice Shelf. No in situ supercooling (water colder than the pressure-dependent freezing point temperature) was observed.
Because polarization encodes geometrical information about unresolved scattering regions, it provides a unique tool for analyzing the 3-D structures of supernovae (SNe) and their surroundings. SNe of all types exhibit time-dependent spectropolarimetric signatures produced primarily by electron scattering. These signatures reveal physical phenomena such as complex velocity structures, changing illumination patterns, and asymmetric morphologies within the ejecta and surrounding material. Interpreting changes in polarization over time yields unprecedentedly detailed information about supernovae, their progenitors, and their evolution.
Begun in 2012, the SNSPOL Project continues to amass the largest database of time-dependent spectropolarimetric data on SNe. I present an overview of the project and its recent results. In the future, combining such data with interpretive radiative transfer models will further constrain explosion mechanisms and processes that shape SN ejecta, uncover new relationships among SN types, and probe the properties of progenitor winds and circumstellar material.
There have been a number of studies that have attempted to estimate the past radiocarbon reservoir effects in Qinghai Lake, China. This article reports on measurements on modern samples collected at the lake in October 2003 and October 2009, which allow us to better understand the systematics of the lake and shed new insights on the processes occurring in the lake. The results indicate that atmospheric exchange of 14C is the main process affecting surface dissolved inorganic carbon (DIC) in the lake, but dissolved organic carbon (DOC) can be explained as a combination of sources. We also conclude that sediment carbon can be explained by a model where input from the surrounding rivers and groundwater are important, in agreement with the model of Yu et al. (2007).