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Studies suggest that alcohol consumption and alcohol use disorders have distinct genetic backgrounds.
We examined whether polygenic risk scores (PRS) for consumption and problem subscales of the Alcohol Use Disorders Identification Test (AUDIT-C, AUDIT-P) in the UK Biobank (UKB; N = 121 630) correlate with alcohol outcomes in four independent samples: an ascertained cohort, the Collaborative Study on the Genetics of Alcoholism (COGA; N = 6850), and population-based cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC; N = 5911), Generation Scotland (GS; N = 17 461), and an independent subset of UKB (N = 245 947). Regression models and survival analyses tested whether the PRS were associated with the alcohol-related outcomes.
In COGA, AUDIT-P PRS was associated with alcohol dependence, AUD symptom count, maximum drinks (R2 = 0.47–0.68%, p = 2.0 × 10−8–1.0 × 10−10), and increased likelihood of onset of alcohol dependence (hazard ratio = 1.15, p = 4.7 × 10−8); AUDIT-C PRS was not an independent predictor of any phenotype. In ALSPAC, the AUDIT-C PRS was associated with alcohol dependence (R2 = 0.96%, p = 4.8 × 10−6). In GS, AUDIT-C PRS was a better predictor of weekly alcohol use (R2 = 0.27%, p = 5.5 × 10−11), while AUDIT-P PRS was more associated with problem drinking (R2 = 0.40%, p = 9.0 × 10−7). Lastly, AUDIT-P PRS was associated with ICD-based alcohol-related disorders in the UKB subset (R2 = 0.18%, p < 2.0 × 10−16).
AUDIT-P PRS was associated with a range of alcohol-related phenotypes across population-based and ascertained cohorts, while AUDIT-C PRS showed less utility in the ascertained cohort. We show that AUDIT-P is genetically correlated with both use and misuse and demonstrate the influence of ascertainment schemes on PRS analyses.
Carbon nanomaterials are consistently providing new excitement over their properties and potential applications, but many of these material have yet to fully live up to their expectations commercially. The barrier to adoption often exists as a result of complex processing, fragility of the as-produced material, or difficulty scaling beyond laboratory quantities. This work provides a new approach for utilizing fibrous carbon nanomaterials to advance the technology toward new applications and industrial utility. This is accomplished by creating tailored device architectures through in-situ integration of activated carbon powder using carbon nanofiber deposition. The resulting hybrid materials and components can serve in diverse applications, with each instance able to be fine-tuned through a combination of processing parameters. The applications of such materials are anticipated to directly serve current carbon-based technology in filtration, energy storage and delivery, and thermal management, but the concepts are not limited to current carbon applications.
Grotesque and vulgar, the masked character Gongoli upends the codes of Mende decorum in his madcap pursuit of laughs. His impropriety goes so far as to allow his mask to fall, comically revealing the identity of his dancer and subverting the anonymity so elemental to his fellow spirits’ vaunted status. Yet despite such transgressions, he stands among the most beloved figures of Sierra Leone's rich performance traditions. Gongoli's popularity hinges on his irreverence towards the fundamental laws of masked dance, laws that also regulate the balance between individual agency and communal responsibility, between internal desire and external restraint. The only quality necessary to play Gongoli is shamelessness (ngufe baa), and the greatest performers are acrobats braving risks that are not physical, but social. This article follows Siloh, an itinerant performer whose celebrity inheres in his uncanny similarity to the Gongoli he often plays. The composite figure Siloh Gongoli exemplifies a comic aesthetic relished throughout Sierra Leone in storytelling, ritual, festivals, videos and radio shows. Although mobilized for different ends, each of these conventions undermines principles of self-effacement, gerontocratic privilege and esoteric power by shamelessly playing with and within the existential tensions between interior and exterior selves.
In this investigation, we reported the increase in emergency department and inpatient admission cases during the month of November 2012 post Hurricane Sandy as compared with baseline (November 2010, 2011, and 2013) for elderly patients aged 65 and up.
Medical claims data for patients aged 65 and over treated at emergency department and inpatient health care facilities in New Jersey were analyzed to examine the surge in frequencies of diagnoses treated immediately following Hurricane Sandy. The differences were quantified using gap analysis for 2 years before and 1 year after the event.
There was an average increase of 1700 cases for the month of November 2012 relative to baseline for the top 15 most frequently diagnosed emergency department medical conditions. On a daily basis, a volume increase by an average 57 cases could be expected, including significant numbers of limb fractures and other trauma cases for these most frequently encountered medical conditions.
Understanding the surge level in medical services needed in emergency departments and inpatient facilities during a natural disaster aftermath is critical for effective emergency preparation and response for the elderly population. (Disaster Med Public Health Preparedness. 2018;12:730-738)
THE study of architectural fragments offers us the possibility of understanding – and even reconstructing – long-vanished medieval buildings. In a city such as London – where the Dissolution, the Great Fire, redevelopment and wartime bombing have taken a severe toll on the stock of medieval architecture – architectural fragments are the only surviving primary source for understanding the architectural styles and features of great lost medieval buildings, including the London friaries. More general discussion of the architecture of the friaries can be found in the friary-by-friary chapters of Part I of this book (Chapters 1 to 9), and in Chapter 10: Churches.
The architectural fragments have usually come to us through two processes: demolition and excavation. When masons were dismantling a medieval monastic building, for example in the fourteenth century in order to rebuild it or in the sixteenth century in order to destroy it, the more decorative pieces of stonework – windows, arches, door surrounds – were often recycled as rough foundation material: their particular shapes meant that they were not generally suitable for ‘ordinary’ recycling in new wall superstructures. Several centuries later, modern archaeologists encounter batches of this recycled ‘low value’ stonework in wall foundations. Sometimes this material is studied to great advantage; on other occasions the architectural fragments are retained but languish unstudied in museum store rooms.
About 140 architectural fragments from archaeological sites within the London friary precincts were identified at the Museum of London's archive and stores. The present author then examined this material to assess its potential to yield useful information about the architecture, structure and decoration of the friary buildings. It would be misleading to talk of a ‘statistically meaningful sample’ in what is essentially an art-historical exercise, but a sample of about thirty items (the majority of which are window fragments) has proved useful in answering the above points (Table 14). The tradition of art-historical and archaeological study of medieval architecture means that several important pieces of friary architecture that were discovered in the early twentieth century were preserved. A pillar and an arch from the undercroft of the late thirteenth-century chapter house at Black Friars survive, the former in the new Dominican priory in Belsize Park (London) and the latter in the wooded garden of the Selsdon Park Hotel in Croydon (London and Surrey).
Previous research on agriculture in the American Southwest focuses overwhelmingly on archaeological survey methods to discern surface agricultural features, which, in combination with climatological, geological, and geographical variables, are used to create models about agricultural productivity in the past. However, with few exceptions, the role of floodplain irrigation and floodwater farming in ancestral Pueblo agriculture is generally downplayed in scholarly discourse. Using a variety of methods, including Unmanned Aerial Vehicles (UAV), satellite imagery, pedestrian survey, and supervised classification of remotely sensed imagery, we examine this issue through a consideration of how ancestral Ohkay Owingeh (Tewa) people solved the challenges of arid land farming in the lower Rio Chama watershed of New Mexico during the Classic period (A.D. 1350–1598). Based on acreage estimates, our results indicate that runoff and rainwater fields in terrace environments would have been insufficient to supply the nutritional needs of an ancestral Tewa population exceeding 10,000 individuals. Based on these observations, we present a case for the substantial role of subsistence agriculture in the floodplain of the Rio Chama and its associated tributaries.
A major goal of biological classification is to provide a system that conveys phylogenetic relationships while facilitating lucid communication among researchers. Phylogenetic taxonomy is a useful framework for defining clades and delineating their taxonomic content according to well-supported phylogenetic hypotheses. The Crinoidea (Echinodermata) is one of the five major clades of living echinoderms and has a rich fossil record spanning nearly a half billion years. Using principles of phylogenetic taxonomy and recent phylogenetic analyses, we provide the first phylogeny-based definition for the Clade Crinoidea and its constituent subclades. A series of stem- and node-based definitions are provided for all major taxa traditionally recognized within the Crinoidea, including the Camerata, Disparida, Hybocrinida, Cladida, Flexibilia, and Articulata. Following recommendations proposed in recent revisions, we recognize several new clades, including the Eucamerata Cole 2017, Porocrinoidea Wright 2017, and Eucladida Wright 2017. In addition, recent phylogenetic analyses support the resurrection of two names previously abandoned in the crinoid taxonomic literature: the Pentacrinoidea Jaekel, 1918 and Inadunata Wachsmuth and Springer, 1885. Last, a phylogenetic perspective is used to inform a comprehensive revision of the traditional rank-based classification. Although an attempt was made to minimize changes to the rank-based system, numerous changes were necessary in some cases to achieve monophyly. These phylogeny-based classifications provide a useful template for paleontologists, biologists, and non-experts alike to better explore evolutionary patterns and processes with fossil and living crinoids.
As a label for a distinct category of life, “living fossil” is controversial. The term has multiple definitions, and it is unclear whether the label can be genuinely used to delimit biodiversity. Even taking a purely phylogenetic perspective in which a proxy for the living fossil is evolutionary distinctness (ED), an inconsistency arises: Does it refer to “dead-end” lineages doomed to extinction or “panchronic” lineages that survive through multiple epochs? Recent tree-growth model studies indicate that speciation rates must have been unequally distributed among species in the past to produce the shape of the tree of life. Although an uneven distribution of speciation rates may create the possibility for a distinct group of living fossil lineages, such a grouping could only be considered genuine if extinction rates also show a consistent pattern, be it indicative of dead-end or panchronic lineages. To determine whether extinction rates also show an unequal distribution, we developed a tree-growth model in which the probability of speciation and extinction is a function of a tip’s ED. We simulated thousands of trees in which the ED function for a tip is randomly and independently determined for speciation and extinction rates. We find that simulations in which the most evolutionarily distinct tips have lower rates of speciation and extinction produce phylogenetic trees closest in shape to empirical trees. This implies that a distinct set of lineages with reduced rates of diversification, indicative of a panchronic definition, is required to create the shape of the tree of life.
Despite the advent of technologies that enhance productivity, the workload of many individuals, including psychologists, remains onerous, provoking burnout and similar complications. Although the circumstances that mitigate or exacerbate the effects of workload have been studied extensively, the antecedents of these demands have not been established definitively. Without this insight, managers cannot be sure of which practices are likely to contain the workload of individuals. To resolve this shortfall, we first pose the possibility that many cognitive biases, heuristics, and illusions may, at least partly, explain elevated levels of workload. Specifically, we demonstrate that 14 established biases, such as the restraint bias and IKEA effect, are likely to prolong work hours and increase the demands on individuals. For example, according to research on the restraint bias, individuals tend to inflate their capacity to inhibit their temptations and, therefore, may overestimate their ability to work extensive hours. Second, we show that all these biases can be divided into four constellations—self-enhancement, stable worldviews, need for closure, and just world—each of which tends to dissipate whenever people experience a sense of meaning in their lives. These observations, therefore, imply that attempts to foster meaning may contain the workload of workers.
Predicting the number of patient encounters and transports during mass gatherings can be challenging. The nature of these events necessitates that proper resources are available to meet the needs that arise. Several prediction models to assist event planners in forecasting medical utilization have been proposed in the literature.
The objective of this study was to determine the accuracy of the Arbon and Hartman models in predicting the number of patient encounters and transportations from the Baltimore Grand Prix (BGP), held in 2011 and 2012. It was hypothesized that the Arbon method, which utilizes regression model-derived equations to estimate, would be more accurate than the Hartman model, which categorizes events into only three discreet severity types.
This retrospective analysis of the BGP utilized data collected from an electronic patient tracker system. The actual number of patients evaluated and transported at the BGP was tabulated and compared to the numbers predicted by the two studied models. Several environmental features including weather, crowd attendance, and presence of alcohol were used in the Arbon and Hartman models.
Approximately 130,000 spectators attended the first event, and approximately 131,000 attended the second. The number of patient encounters per day ranged from 19 to 57 in 2011, and the number of transports from the scene ranged from two to nine. In 2012, the number of patients ranged from 19 to 44 per day, and the number of transports to emergency departments ranged from four to nine. With the exception of one day in 2011, the Arbon model overpredicted the number of encounters. For both events, the Hartman model overpredicted the number of patient encounters. In regard to hospital transports, the Arbon model underpredicted the actual numbers whereas the Hartman model both overpredicted and underpredicted the number of transports from both events, varying by day.
These findings call attention to the need for the development of a versatile and accurate model that can more accurately predict the number of patient encounters and transports associated with mass-gathering events so that medical needs can be anticipated and sufficient resources can be provided.
NableJV, MargolisAM, LawnerBJ, HirshonJM, PerriconeAJ, GalvagnoSM, LeeD, MillinMG, BissellRA, AlcortaRL. Comparison of Prediction Models for Use of Medical Resources at Urban Auto-racing Events. Prehosp Disaster Med. 2014;29(6):1-6.
Epilepsy is a common medical condition for which physicians perform driver fitness assessments. The Canadian Medical association (CMA) and the Canadian Council of Motor transportation administrators (CCMTA) publish documents to guide Canadian physicians’ driver fitness assessments.
We aimed to measure the consistency of driver fitness counseling among epileptologists in Canada, and to determine whether inconsistencies between national guidelines are associated with greater variability in counseling instructions.
We surveyed 35 epileptologists in Canada (response rate 71%) using a questionnaire that explored physicians’ philosophies about driver fitness assessments and counseling practices of seizure patients in common clinical scenarios. Of the nine scenarios, CCMTA and CMA recommendations were concordant for only two. Cumulative agreement for all scenarios was calculated using Kappa statistic. Agreement for concordant (two) vs. discordant (seven) scenarios were split at the median and analyzed using the Wilcoxon signed rank sum test.
Overall the agreement between respondents for the clinical scenarios was not acceptable (Kappa=0.28). For the two scenarios where CMa and CCMta guidelines were concordant, specialists had high levels of agreement with recommendations (89% each). A majority of specialists disagreed with CMa recommendations in three of seven discordant scenarios. The lack of consistency in respondents’ agreement attained statistical significance (p<0.001).
Canadian epileptologists have variable counseling practices about driving, and this may be attributable to inconsistencies between CMa and CCMta medical fitness guidelines. This study highlights the need to harmonize driving recommendations in order to prevent physician and patient confusion about driving fitness in Canada.