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The warm, equable, and ice-free early Eocene Epoch permits investigation of ecosystem function and macro-ecological patterns during a very different climate regime than exists today. It also provides insight into what the future may entail, as anthropogenic CO2 release drives Earth toward a comparable hothouse condition. Studying plant–insect herbivore food webs during hothouse intervals is warranted, because these account for the majority of nonmicrobial terrestrial biodiversity. Here, we report new plant and insect herbivore damage census data from two floodplain sites in the Wind River Basin of central Wyoming, one in the Aycross Formation (50–48.25 Ma) at the basin edge (WRE) and the second in the Wind River Formation in the interior of the basin (WRI). The WRI site is in stratigraphic proximity to a volcanic ash that is newly dated to 52.416 ± 0.016/0.028/0.063 (2σ). We compare the Wind River Basin assemblages to published data from a 52.65 Ma floodplain flora in the neighboring Bighorn (BH) Basin and find that only 5.6% of plant taxa occur at all three sites and approximately 10% occur in both basins. The dissimilar floras support distinct suites of insect herbivores, as recorded by leaf damage. The relatively low-diversity BH flora has the highest diversity of insect damage, contrary to hypotheses that insect herbivore diversity tracks floral diversity. The distinctiveness of the WRE flora is likely due to its younger age and cooler reconstructed paleotemperature, but these factors are nearly identical for the WRI and BH floras. Site-specific microenvironmental factors that cannot be measured easily in deep time may account for these differences. Alternatively, the Owl Creek Mountains between the two basins may have provided a formidable barrier to the thermophilic organisms that inhabited the basin interiors, supporting Janzen's hypothesis that mountain passes appear higher in tropical environments.
Background: SMA is a neurodegenerative disease caused by biallelic deletion/mutation of the survival motor neuron (SMN1) gene. In the phase 1 trial (NCT02122952), SMN GRT onasemnogene abeparvovec (AVXS-101) improved outcomes of 15 symptomatic SMA1 patients (3 at a lower dose [cohort 1] and 12 at the proposed therapeutic dose [cohort 2]). This report describes long-term follow-up study design and data from the phase 1 study. Methods: Patients in the phase 1 study could rollover into a long-term follow-up study (NCT03421977). The primary objective is to collect long-term safety data (serious adverse events, hospitalizations, and adverse events of special interest). Annual follow-up will occur for 15 years. Additionally, patient record transfers from local clinician(s) will be requested. Safety assessments include medical history and record review, physical examination, clinical laboratory evaluation, and pulmonary assessments. Efficacy assessments include physical examination to assess developmental milestones. Results: As of September 27, 2018, the oldest patients are 59.2 (cohort 1) and 52.1 (cohort 2) months old and free of permanent ventilation. Preliminary data, including survival and developmental milestones, will be presented. Conclusions: Patients treated with a one-time dose of AVXS-101 continue to gain strength, develop, and achieve new milestones, demonstrating a long-term, durable response.
Background: Preterm infants are at risk for adverse neurodevelopmental outcomes, however studies examining preterm twins are limited. The aim of this study was to examine whether preterm monozygotic (MZ) and dizygotic (DZ) twins have similar morbidities and long-term neurodevelopmental outcomes. Methods: From a cohort of 225 preterm neonates studied with MRI, 24 MZ and 52 DZ twins were included. Outcomes at 1.5-years, 3-years and 4.5-years were assessed with the Bayley-III, Movement Assessment Battery for Children and Wechsler Preschool and Primary Scale of Intelligence. Results: Twin pairs had substantial concordance for retinopathy of prematurity but only moderate-fair concordance for bronchopulmonary dysplasia, infection and brain injury. Differences in cognitive and language scores were stable over time, while motor differences increased. Discordant twins had significantly lower gestational age [Mean1(SD)=26.7(1.38); Mean2(SD)=29.1(2.1); P<0.001] and birth weight [Mean1(SD)=892.2(291.2); Mean2(SD)=1208.0(289.4); P=0.001] and a higher incidence of bronchopulmonary dysplasia and retinopathy of prematurity. In discordant twins, cognitive and language score differences decreased over time while motor differences increased. Conclusions: Preterm twin pairs have similar neurodevelopmental outcomes through early childhood despite poor concordance for perinatal illness. Discordant twins were born earlier and had more morbidities. Increasing concordance in cognitive and language outcomes over time may reflect the positive impact of early intervention programs.
Developmental care of neonates with CHD is essential for proper neurodevelopment. Measurement of developmental care specific to these neonates is needed to ensure consistent implementation within and across cardiac ICUs. The purpose of this study was to psychometrically test the Developmental Care Scale for Neonates with Congenital Heart Disease, which measures the quality of developmental care provided by bedside nurses to neonates in the cardiac ICU.
Psychometric testing was conducted with 119 cardiac ICU nurses to provide evidence of internal consistency reliability and construct validity. Participants were predominantly young (median = 32 years), white (90%) females (93%) with bachelor’s degrees (78%) and a median experience in the cardiac ICU of 7 years.
Evidence of internal consistency reliability (α =.89) was provided with corrected item-total correlations ranging from .31 to .77. Exploratory factor analysis provided evidence of construct validity as a unidimensional scale, as well as a multidimensional scale consisting of four subscales: creating the external environment, assessment of family well-being, caregiver activities toward the neonate, and basic human needs.
Evidence of reliability and validity of the 31-item Developmental Care Scale for Neonates with Congenital Heart Disease was established with nurses caring for neonates in the cardiac ICU. This instrument will serve as a valuable outcome measure tasked with improving developmental care performance and makes it possible to identify relationships between developmental care performance and neonatal neurodevelopmental outcomes in future research.
Introduction: Abdominal pain is one of the most frequent reasons for an emergency department (ED) visit. Most cases are functional and no therapy has proven effective. Our objective was to determine if hyoscine butylbromide (HBB) (BuscopanTM) is effective for children who present to the ED with functional abdominal pain. Methods: We conducted a randomized, blinded, superiority trial comparing HBB 10 mg plus acetaminophen placebo to oral acetaminophen 15 mg/kg (max 975 mg) plus HBB placebo using a double-dummy approach. We included children 8-17 years presenting to the ED at London Health Sciences Centre with colicky abdominal pain rated >40 mm on a 100 mm visual analog scale (VAS). The primary outcome was VAS pain score at 80 minutes post-administration. Secondary outcomes included adverse effects; caregiver satisfaction with pain management using a five-item Likert scale; recidivism and missed surgical diagnoses within 24-hours of discharge. Analysis was based on intention to treat. Results: We analyzed 225 participants (112 acetaminophen; 113 HBB). The mean (SD) age was 12.4 (3.0) years and 148/225 (65.8%) were females. Prior to enrollment, the median (IQR) duration of pain prior was 2 (4.5) hours and analgesia was provided to 101/225 (44.9%) of participants. The mean (SD) pre-intervention pain scores in the acetaminophen and HBB groups were 62.7 (15.9) mm and 60.3 (17.3) mm, respectively. At 80 minutes, the mean (SD) pain scores in the acetaminophen and HBB groups were 30.1 (28.8) mm and 29.4 (26.4) mm, respectively and there were no significant differences adjusting for pre-intervention scores (p = 0.96). The median (IQR) caregiver satisfaction was high in the acetaminophen [5 (2)] and HBB [5 (1)] groups (p = 0.79). The median (IQR) length of stay between acetaminophen [235 (101)] and HBB [234 (103)] was not significantly different (p = 0.53). The proportion of participants with a return visit for abdominal pain was 4/112 (3.5%) in the acetaminophen group and 6/113 (5.3%) in the HBB group. The most common adverse effect was nausea (9% in each group) and there were no significant differences in adverse effects between acetaminophen (26/112, 23.2%) and HBB (31/113, 27.4%) (p = 0.52). There were no missed surgical diagnoses. Conclusion: For children with presumed functional abdominal pain who present to the ED, both acetaminophen and HBB produce a clinically important (VAS < 30 mm) reduction in pain and should be routinely considered in this clinical setting.
Understanding the properties of time averaging (age mixing) in a stratigraphic layer is essential for properly interpreting the paleofauna preserved in the geologic record. This work assesses the age and quantifies the scale and structure of time averaging of land snail-rich colluvial sediments from the Madeira Archipelago (Portugal) by dating individual shells using amino acid racemization calibrated with graphite-target and carbonate-target accelerator mass spectrometry radiocarbon methods. Gastropod shells of Actinella nitidiuscula were collected from seven sites on the volcanic islands of Bugio and Deserta Grande (Desertas Islands), where snail shells are abundant and well preserved in Quaternary colluvial deposits. Results show that the shells ranged in age from modern to ~48 cal ka BP (calibrated radiocarbon age), covering the last glacial and present interglacial periods. Snail shells retrieved from two of the colluvial sites exhibit multimillennial age mixing (>6 ka), which significantly exceeds the analytical error from dating methods and calibration. The observed multimillennial mixing of these assemblages should be taking into consideration in upcoming paleoenvironmental and paleoecological studies in the region. The extent of age mixing may also inform about the time span of colluvial deposition, which can be useful in future geomorphological studies. In addition, this study presents the first carbonate-target radiocarbon results for land snail shells and suggests that this novel, rapid, and more affordable dating method offers reliable age estimates for small land snail shells younger than ~20 cal ka BP.
Numerous studies have been conducted into the microstructural origin of the instability and unpredictability of various energetic materials. Some of these materials are RDX/HMX, Ammonium Perchlorate, Aluminum, etc. Many techniques both destructive and non-destructive have so far been utilized in an attempt to quatify the energetic properties of their composites. These composites may contain one or more energetic constituents in an elastomeric binder. Non-destructive X-ray characterization techniques have been successfully employed to measure several microstructural parameters. Previous studies have shown considerable differences among various production grade RDX. These studies reveal marked differences in the amounts of residual elastic strain and the distribution of dislocations (residual plastic strain) in the constituent RDX phase.
The focus of this study is to develop a technique for quantitative constituent phase analysis of solid-propellant (fuel) composites using conventional diffractometry. The use of a Curved Position Sensitive Detector (CPSD) greatly enhances the technique and allows real time applications in production environments. Through the use of computer based Systems and "user friendly" software the required Operator, skill and training have been considerably reduced. The CPSD System has been successfully used to quantify constituent phases (peak heights) and the amounts of residual elastic strain (peak shifts) in these molecular crystal powder mixtures.
It is envisioned that rapid, automated, non-destructive X-ray characterization techniques will greatly facilitate production based propellant quality control. A thorough understanding of the relationship between the energetics and microstructural parameters can also he obtained.
The lattice parameter-composition curves for several nickel solid solutions and for some chromium and. iron solid solutions are discussed. It is shown that the size effect may be the predominating influence on the change of lattice parameters in these systems. This is demonstrated by comparing observed and calculated data employing various methods. A new scheme for evaluating the atomic size in solid solutions is proposed, based on regarding the atom, as an incompressible core surrounded by a smeared-out compressible volume. The suggestion that classical elasticity theory may be used as a basis for understanding the size effect in solid solutions is justified by examination of the Ag-Pd system for additions of Ag from 0 to 100 at. %.
The impact of dementia-related stressors and strains have been examined for their potential to threaten the well-being of either the person with dementia or the family care partner, but rarely have studies considered the dyadic nature of well-being in dementia. The purpose of this study was to examine the dyadic effects of multiple dimensions of strain on the well-being of dementia care dyads.
Using multilevel modeling to account for the inter-relatedness of individual well-being within dementia care dyads, we examined cross-sectional responses collected from 42 dyads comprised of a hospitalized patient diagnosed with a primary progressive dementia (PWD) and their family care partner (CP). Both PWDs and CPs self-reported on their own well-being using measures of quality of life (QOL-Alzheimer’s Disease scale) and depressive symptoms (Center for Epidemiological Studies Depression Scale).
In adjusted models, the PWD’s well-being (higher QOL and lower depressive symptoms) was associated with significantly less strain in the dyad’s relationship. The CP’s well-being was associated with significantly less care-related strain and (for QOL scale) less relationship strain.
Understanding the impact of dementia on the well-being of PWDs or CPs may require an assessment of both members of the dementia care dyad in order to gain a complete picture of how dementia-related stressors and strains impact individual well-being. These results underscore the need to assess and manage dementia-related strain as a multi-dimensional construct that may include strain related to the progression of the disease, strain from providing care, and strain on the dyad’s relationship quality.
Nutritional strategies to mitigate the negative effects of heat stress on animal welfare and productivity often involve changes in ration formulation. However, cattle commonly sort their ration in favour of certain components, and it is not clear how feed sorting responds to heat stress. This study investigated the association between heat stress and feed sorting behaviour. Lactating Holstein dairy cows (n=32; parity=2.8±1.2; mean±SD) were housed in a free stall barn and milked 3×/day. Cows were fed individually using the Calan Broadbent Feeding System and offered ad libitum access to a total mixed ration (containing on a dry matter basis: 3.3% ryegrass hay, 16.5% ryegrass baleage, 24.7% corn silage, 11.1% brewers grains, 19.7% ground corn, 19.8% concentrate and 4.9% protein/mineral supplement), provided 1×/day. Beginning at 186±60 days in milk, cows were exposed to either: heat stress conditions (HT; n=15) (average temperature–humidity index: 77.6), or evaporative cooling (CL; n=17), consisting of misters and fans over the freestall and feed bunks. Data were collected during a 4-day baseline period, and two 4-day experimental periods: starting at 10 days after implementing treatments (defined as acute heat stress for HT cows), and at 62 days after implementing treatments (defined as chronic heat stress for HT cows). Daily feed intake and physiological responses to heat stress (body temperature, respiration rate) were recorded. Samples of fresh and refused feed were collected daily from individual cows for particle size analysis. The particle size separator had three screens (19, 8 and 1.18 mm) and a bottom pan, resulting in 4 fractions (long, medium, short and fine particles). Feed sorting was calculated as the actual intake of each particle size fraction expressed as a percentage of the predicted intake of that fraction. During both heat stress periods, HT cows sorted for long particles more than CL cows (105.0% v. 100.6%; SE=1.1). During acute heat stress, HT cows sorted to a greater extent than CL cows against medium and short particles, whereas sorting of these fractions did not differ during chronic heat stress. Body temperature and respiration rate were associated across treatments with the extent of sorting for long particles and against short particles during acute heat stress. These results suggest that feed sorting is particularly influenced during acute heat stress, and that sorting for longer particles may increase in heat stress.
Acquired diaphragmatic hernia is a rare complication of pediatric intervention or surgery. In this study, we report an infant with iatrogenic diaphragmatic hernia following neonatal complex congenital cardiac surgery, and then we review the associated literature.
Social stratification is an important mechanism of human organization that helps to explain health differences between demographic groups commonly associated with socioeconomic gradients. Individuals, or group of individuals, with similar health profiles may have had different stratification experiences. This is particularly true as social stratification is a significant non-measurable source of systematic unobservable differences in both SES indicators and health statuses of disadvantage. The goal of the present study was to expand the bulk of research that has traditionally treated socioeconomic and demographic characteristics as independent, additive influences on health by examining data from the United States. It is hypothesized that variation in an index of multi-system physiological dysregulation – allostatic load – is associated with social differentiation factors, sorting individuals with similar demographic and socioeconomic characteristics into mutually exclusive econo-demographic classes. The data were from the Longitudinal and Biomarker samples of the national Study of Midlife Development in the US (MIDUS) conducted in 1995 and 2004/2006. Latent class analyses and regression analyses revealed that physiological dysregulation linked to socioeconomic variation among black people, females and older adults are associated with forces of stratification that confound socioeconomic and demographic indicators. In the United States, racial stratification of health is intrinsically related to the degree to which black people in general, and black females in particular, as a group, share an isolated status in society. Findings present evidence that disparities in health emerge from group-differentiation processes to the degree that individuals are distinctly exposed to the ecological, political, social, economic and historical contexts in which social stratification is ingrained. Given that health policies and programmes emanate from said legal and political environments, interventions should target the structural conditions that expose different subgroups to different stress risks in the first place.
In several recently published phylogenetic analyses, two Lower Devonian taxa, Doliodus and Pucapampella, both fall on the chondrichthyan stem, very close to the base of ‘conventionally defined chondrichthyans’ (i.e., forms possessing tessellated mineralization of the cartilaginous endoskeleton). These two taxa nevertheless exhibit strongly discordant morphologies from each other. A summary of the anatomical data concerning these taxa is presented here, including new, as well as previously published, findings. A new family Pucapampellidae is erected, containing Pucapampella and a newly recognized genus from South Africa. Morphological evidence is summarized for the monophyly of crown elasmobranchs (sharks and rays), holocephalans (chimaeras) and other chondrichthyans. Based on these data, Doliodus and pucapampellids both fall outside the chondrichthyan crown, but their relative phylogenetic positions on the chondrichthyan stem are unclear. Pucapampellid interrelationships are particularly hard to assess because little is known beyond their cranial and visceral arch morphology and also because pucapampellids possess a suite of ontogenetically primitive (and thus potentially neotenic) features. By contrast, the phylogenetic position of Doliodus seems less elusive; it possessed an ‘acanthodian-like’ complex of dermal spines, including pectoral fin spines, prepectoral, admedian, and prepelvic spines, and possibly dorsal and pelvic fin spines, in conjunction with numerous ‘chondrichthyan-like’ endoskeletal features and a heterodont ‘sharklike’ dentition. Doliodus can be viewed as a quintessential component of the evolutionary transition between ‘acanthodians’ and ‘conventionally defined chondrichthyans’, leaving little doubt that the chondrichthyan total group includes ‘acanthodians’ (now widely perceived to be a paraphyletic group, populating the basal part of the chondrichthyan stem). Although Doliodus has been resolved as a basal member of the ‘conventionally defined chondrichthyans’, it could occupy a more basal position on the chondrichthyan stem.
The panel, “Negotiating the Personal and Professional: Ethnomusicologists and Uncomfortable Truths,” presented at the Forty-third ICTM World Conference in Astana, Kazakhstan, grew out of informal conversations common among ethnomusicologists. As practitioners in our discipline, we are involved in complex webs of experience, relationships, and representations focused around music, broadly defined. Our work is inherently social and, when in the field, we develop close relationships with our teachers and consultants as we become comfortable in our sites of research. We are grateful for priceless access to communities and individuals. The intensity and combination of certain relationships and circumstances, however, can lead to conflicting expectations, unanticipated misunderstanding, and situations of personal and professional conflict.