Background: New-onset refractory status epilepticus (NORSE) is a rare clinical presentation affecting previously healthy individuals. Febrile infection-related epilepsy syndrome (FIRES) is a subcategory of NORSE and applies when a preceding fever occurs. The NORSE/FIRES Family Registry has been developed to gain insight into risk factors and to assess the spectrum of clinical outcomes amongst survivors. Methods: Survivors, surrogates, and physicians can enter patient data into the REDCap-based registry: https://www.norseinstitute.org/norse-registry-2. Information collected includes medical history, clinical presentation, and quality of life, among others. Participants are invited to complete follow-up surveys for up to two years following presentation of seizures. Enrollment is ongoing in multiple languages. Results: 56 participants are enrolled from 12 countries (2-78 years, median: 12.5, IQR: 20.5, 31 survivors). At ≥6 months after onset, survivors experience a mean of ≥12 seizures per month and remain on a median of 4 (IQR: 3) anti-seizure medications. The median quality of life amongst all survivors was rated 4/10 (IQR: 3.5). Conclusions: Preliminary data suggests that survivors of NORSE/FIRES have a high seizure burden and poor quality of life. This international multi-lingual family registry will help develop hypotheses for future studies and provides an opportunity for families to contribute to the scientific understanding of this disease.

The present study sought to unravel the psychological processes through which mass incarceration, specifically paternal incarceration, is negatively affecting the next generation of children. Data came from 4,327 families from 20 cities who participated in a 10-year longitudinal study. Parents and children reported on children’s rule-breaking behaviors and depressive symptoms when they were on average ages 5 (2003–2006), 9 (2007–2010), and 15 (2014–2017). Parental surveys and disposition information were combined to assess paternal incarceration at each age. Results showed that children who experienced paternal incarceration at age 5 also demonstrated more rule-breaking behaviors at age 15. Children’s age-9 depressive symptoms partially mediated our finding, such that children who experienced paternal incarceration at age 5 also showed greater depressive symptoms at age 9, which in turn predicted greater rule-breaking behaviors at age 15. Paternal incarceration predicted future rule-breaking behaviors more strongly than did other forms of father loss. Because we found paternal incarceration during childhood is associated with worsened adjustment into adolescence, we discussed the need for developmentally appropriate practices in the criminal justice system.

As Ngāi Tahu (southern Maori), we take issue with widespread reference in scholarly publication to Polynesian voyagers reaching the Antarctic, an idea that originated in the translation of Rarotongan traditions in the nineteenth century. Analysis of those indicates that they contain no plausible reference to Antarctic seafaring. Southern Māori interests have extended into the Subantarctic Islands for 800 years but there is no reference to Antarctica in our historical traditions. Our archaeology and history document a southern boundary to Māori occupation at Port Ross (Auckland Islands), despite habitable islands existing further south. We think it is very unlikely that Māori or other Polynesian voyaging reached the Antarctic.

Background: A significant proportion of glioblastoma multiforme (GBM) patients are considered for repeat resection, but evidence regarding best management remains elusive. Methods: An electronic portfolio of MR images of 37 cases of pathologically confirmed recurrent GBM with an accompanying clinical vignette was constructed. Surgical responders from various countries, training backgrounds, and years’ experience were asked for each case to select: their chosen management (repeat surgery, chemotherapy, radiation, or conservative), confidence in recommended management, and whether they would include the patient in a randomized trial that gave a 50% chance of re-operation. Responses were evaluated with kappa statistics and values interpreted according to Landis and Koch (0–0.2, slight; 0.21–0.4, fair; 0.41–0.6, moderate; 0.61–0.8, substantial; 0.81-1.0 perfect agreement). Results: 26 surgeons responded to the survey. Agreement regarding best management of recurrent GBM was slight, even when management options were dichotomized (repeat surgery vs. all others) (k=0.198 (95%CI 0.133-0.276). Country of practice, years’ experience, and training background did not improve agreement. Responders were willing to include more than 70% of patients in a randomized trial. Conclusions: Only slight agreement exists regarding the question of re-operation for patients with recurrent GBM. This supports the need for a randomized controlled trial.

We report a case of a monochorionic diamniotic twin with an uncomplicated pregnancy, but with an unexpected large intertwin hemoglobin (Hb) difference at birth. Twin 1 was delivered vaginally and had an uneventful neonatal course. The umbilical cord of Twin 1 was clamped approximately 5 min after birth. After the birth of Twin 1, Twin 2 developed severe bradycardia and showed limited cardiac output on ultrasound, for which an emergency cesarean section was performed. A full blood count revealed an Hb of 20.1 g/dL for Twin 1 and 10.2 g/dL for Twin 2 (intertwin difference 9.9 g/dL). Reticulocyte counts were similar, 40‰ and 38‰, respectively. Placental examination revealed 10 vascular anastomoses, including one arterio-arterial anastomosis with a diameter of 1.4 mm. Additionally, a large chorangioma was present on the placental surface of Twin 2. There was no color difference on the maternal side of the placenta. Based on the reticulocyte count ratio and the placental characteristics, twin anemia polycythemia sequence was ruled out as the cause of the large intertwin Hb difference. In this report, we discuss the various potential causes that could explain the large intertwin Hb difference including the role of delayed cord clamping in Twin 1, and the role of a large chorangioma, which may have attracted blood from the fetal circulation of Twin 2.

Viburnum is a temperate-zone genus that also occurs in mountains of South America and Malesia, and seeds of many species have morphophysiological dormancy (MPD). Information on the level of MPD in seeds of species in various clades of Viburnum potentially would increase our understanding of the evolutionary relationships between the nine levels of MPD. Our aim was to determine the level of MPD in seeds of Viburnum plicatum var. formosanum that is endemic to mountains (1800–3000 m a.s.l.) in Taiwan and a member of the Lutescentia clade. The temperature requirements for embryo growth and root and shoot emergence and response of seeds to gibberellic acid (GA) were determined. No fresh seeds germinated during 16 weeks of incubation at 15/5, 20/10, 25/15, 30/20 or 25°C. Embryo growth and root emergence occurred during moist cold stratification at 5°C or at a temperature sequence of 15/5 to 5°C. During cold stratification, embryos length increased from 0.76 ± 0.06 to 3.40 ± 0.26 mm and the embryo length:seed length ratio from 0.20 ± 0.02 to 0.68 ± 0.07. In a temperature sequence simulating field conditions, embryos grew inside seeds at 5°C, roots emerged at 15/5°C and shoots emerged at 20/10°C. The optimum temperature for embryo growth was 5°C. Neither GA3 nor GA4 was effective in promoting root emergence. We conclude that seeds of V. plicatum var. formosanum have deep complex MPD, which is a first report for Viburnum. Dormancy release during the cool season at high elevations helps to ensure that seeds germinate at the beginning of the warm season.

During the last few decades, the lake-terminating glaciers in the Himalaya have receded faster than the land-terminating glaciers as proglacial lakes have exacerbated the mass loss of their host glaciers. Monitoring the impacts of glacier recession and dynamics on lake extent and water volume provides an approach to assess the mass interplay between glaciers and proglacial lakes. We describe the recession of Longbasaba Glacier and estimate the mass wastage and its contribution to the water volume of its proglacial lake. The results show that the glacier area has decreased by 3% during 1988–2018, with a more variable recession prior to 2008 than in the last decade. Longbasaba Lake has expanded by 164% in area and 237% in water volume, primarily as a result of meltwater inflow produced from surface lowering of the glacier. Over the periods 1988–2000 and 2000–18, the mass loss contributed by glacier thinning has decreased from 81 to 61% of the total mass loss, accompanied by a nearly doubled contribution from terminus retreat. With the current rate of retreat, Longbasaba glacier is expected to terminate in its proglacial lake for another four decades. The hazard risk of this lake is expected to continue to increase in the near future because of the projected continued glacier mass loss and related lake expansion.

Deep neural networks (DNN) have solved many tasks, including image classification, object detection, and semantic segmentation. However, when there are huge parameters and high level of computation associated with a DNN model, it becomes difficult to deploy on mobile devices. To address this difficulty, we propose an efficient compression method that can be split into three parts. First, we propose a cross-layer matrix to extract more features from the teacher's model. Second, we adopt Kullback Leibler (KL) Divergence in an offline environment to make the student model find a wider robust minimum. Finally, we propose the offline ensemble pre-trained teachers to teach a student model. To address dimension mismatch between teacher and student models, we adopt a $1\times 1$ convolution and two-stage knowledge distillation to release this constraint. We conducted experiments with VGG and ResNet models, using the CIFAR-100 dataset. With VGG-11 as the teacher's model and VGG-6 as the student's model, experimental results showed that the Top-1 accuracy increased by 3.57% with a $2.08\times$ compression rate and 3.5x computation rate. With ResNet-32 as the teacher's model and ResNet-8 as the student's model, experimental results showed that Top-1 accuracy increased by 4.38% with a $6.11\times$ compression rate and $5.27\times$ computation rate. In addition, we conducted experiments using the ImageNet$64\times 64$ dataset. With MobileNet-16 as the teacher's model and MobileNet-9 as the student's model, experimental results showed that the Top-1 accuracy increased by 3.98% with a $1.59\times$ compression rate and $2.05\times$ computation rate.