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Demographic trends and the globalization of neuropsychology have led to a push toward inclusivity and diversity in neuropsychological research in order to maintain relevance in the healthcare marketplace. However, in a review of neuropsychological journals, O’Bryant et al. found systematic under-reporting of sample characteristics vital for understanding the generalizability of research findings. We sought to update and expand the findings reported by O’Bryant et al.
We evaluated 1648 journal articles published between 2016 and 2019 from 7 neuropsychological journals. Of these, 1277 were original research or secondary analyses and were examined further. Articles were coded for reporting of age, sex/gender, years of education, ethnicity/race, socioeconomic status (SES), language, and acculturation. Additionally, we recorded information related to sample size, country, and whether the article focused on a pediatric or adult sample.
Key variables such as age and sex/gender (both over 95%) as well as education (71%) were frequently reported. Language (20%) and race/ethnicity (36%) were modestly reported, and SES (13%), and acculturation (<1%) were more rarely reported. SES was more commonly reported in pediatric than adult samples, and the opposite was true for education. There were differences between the present results and those of O’Bryant et al., though the same general trends remained.
Reporting of demographic data in neuropsychological research appears to be slowly changing toward greater comprehensiveness, though clearly more work is needed. Greater systematic reporting of such data is likely to be beneficial for the generalizability and contextualization of neurocognitive function.
Background: Antimicrobial exposure is a significant risk factor for the development of antibiotic-resistant organisms (ARO); however, the depth and duration of this impact is not well described. The study goal is to define impact of antibiotics on the gut microbiome of healthy volunteers (HVs). Methods: HVs were randomized to receive either 5 days of levofloxacin (LVX), azithromycin (AZM), cefpodoxime (CPD), or AZM + CPD (Fig. 1). Stool samples were collected at 15 time points per patient before, during, and after antibiotics. Remnant stool samples from the microbiology laboratory were collected from patients admitted to the medical intensive care unit (MICU) as a comparison of the microbiome in a critically ill state. DNA was extracted from samples and was submitted for shotgun sequencing. Relative abundance, resistome, and metabolic pathway abundance of bacterial taxa were determined and statistical analysis conducted in R software. Results: In total, 289 stool specimens from 20 HVs, and 26 remnant stool specimens were obtained from patients admitted from the MICU (Fig. 1). Community diversity and richness decreased in the first week post-ABX for all HVs (P < .01). Linear discriminant analysis identified Bacteroides and Clostridium as taxonomic groups enriched after CPD, while AZM and LVX produced a relative abundance increase in diverse Firmicutes spp. Longitudinal tracking confirmed that after all antibiotics except LVX, HV microbiomes lost species diversity and shifted toward a state similar to that observed in MICU patients (Fig. 2). The gut microbiome of most HVs exhibited resiliency and returned to a higher diversity level similar to their starting point; however, 10% of HVs did not. Moreover, antibiotic-specific increases in resistance markers reveal innate resistance to β-lactams and macrolides within the gut microbiome of the HVs. Finally, HV microbiomes, which shifted toward a MICU-like taxonomic state, also clustered with microbial metabolic profiles from MICU patients.
The HV microbial metabolic profiles were significantly enriched for important biosynthesis pathways producing chorismate and polysaccharides. MICU patient gut microbiomes were enriched for fatty acid regulation and quinolone biosynthesis, and for many degradation pathways important for different aspects of antibiotic resistance such as membrane integrity, alternative respiration, and antibiotic inactivation. Conclusions: Short courses of antibiotics can cause acute and chronic microbiome disruptions in HVs, as evidenced by decreased microbiome diversity and increases in specific innate resistance elements. These data support the need for antimicrobial stewardship to support rationale antibiotic use to prevent gut microbiome disruptions.
Evidence from animal models demonstrate that intrauterine growth restriction (IUGR) alters airway structure and function which may affect susceptibility to disease. Airway inflammation and dysregulated epithelial barrier properties are features of asthma which have not been examined in the context of IUGR. This study used a maternal hypoxia-induced IUGR mouse model to assess lung-specific and systemic inflammation and airway epithelial tight junctions (TJs) protein expression. Pregnant BALB/c mice were housed under hypoxic conditions (10.5% O2) from gestational day (GD) 11 to 17.5 (IUGR group; term, GD 21). Following hypoxic exposure, mice were returned to a normoxic environment (21% O2). A Control group was housed under normoxic conditions throughout pregnancy. Offspring weights were recorded at 2 and 8 weeks of age and euthanized for bronchoalveolar lavage (BAL) and peritoneal cavity fluid collection for inflammatory cells counts. From a separate group of mice, right lungs were collected for Western blotting of TJs proteins. IUGR offspring had greater inflammatory cells in the BAL fluid but not in peritoneal fluid compared with Controls. At 8 weeks of age, interleukin (IL)-2, IL-13, and eotaxin concentrations were higher in male IUGR compared with male Control offspring but not in females. IUGR had no effect on TJs protein expression. Maternal hypoxia-induced IUGR increases inflammatory cells in the BAL fluid of IUGR offspring with no difference in TJs protein expression. Increased cytokine release, specific to the lungs of IUGR male offspring, indicates that both IUGR and sex can influence susceptibility to airway disease.
We completely classify the possible extensions between semistable vector bundles on the Fargues–Fontaine curve (over an algebraically closed perfectoid field), in terms of a simple condition on Harder–Narasimhan (HN) polygons. Our arguments rely on a careful study of various moduli spaces of bundle maps, which we define and analyze using Scholze’s language of diamonds. This analysis reduces our main results to a somewhat involved combinatorial problem, which we then solve via a reinterpretation in terms of the Euclidean geometry of HN polygons.
Highly-directional image artifacts such as ion mill curtaining, mechanical scratches, or image striping from beam instability degrade the interpretability of micrographs. These unwanted, aperiodic features extend the image along a primary direction and occupy a small wedge of information in Fourier space. Deleting this wedge of data replaces stripes, scratches, or curtaining, with more complex streaking and blurring artifacts—known within the tomography community as “missing wedge” artifacts. Here, we overcome this problem by recovering the missing region using total variation minimization, which leverages image sparsity-based reconstruction techniques—colloquially referred to as compressed sensing (CS)—to reliably restore images corrupted by stripe-like features. Our approach removes beam instability, ion mill curtaining, mechanical scratches, or any stripe features and remains robust at low signal-to-noise. The success of this approach is achieved by exploiting CS's inability to recover directional structures that are highly localized and missing in Fourier Space.
Childhood maltreatment is one of the strongest predictors of adulthood depression and alterations to circulating levels of inflammatory markers is one putative mechanism mediating risk or resilience.
To determine the effects of childhood maltreatment on circulating levels of 41 inflammatory markers in healthy individuals and those with a major depressive disorder (MDD) diagnosis.
We investigated the association of childhood maltreatment with levels of 41 inflammatory markers in two groups, 164 patients with MDD and 301 controls, using multiplex electrochemiluminescence methods applied to blood serum.
Childhood maltreatment was not associated with altered inflammatory markers in either group after multiple testing correction. Body mass index (BMI) exerted strong effects on interleukin-6 and C-reactive protein levels in those with MDD.
Childhood maltreatment did not exert effects on inflammatory marker levels in either the participants with MDD or the control group in our study. Our results instead highlight the more pertinent influence of BMI.
Declaration of interest
D.A.C. and H.W. work for Eli Lilly Inc. R.N. has received speaker fees from Sunovion, Jansen and Lundbeck. G.B. has received consultancy fees and funding from Eli Lilly. R.H.M.-W. has received consultancy fees or has a financial relationship with AstraZeneca, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Ferrer, Janssen-Cilag, Lundbeck, MyTomorrows, Otsuka, Pfizer, Pulse, Roche, Servier, SPIMACO and Sunovian. I.M.A. has received consultancy fees or has a financial relationship with Alkermes, Lundbeck, Lundbeck/Otsuka, and Servier. S.W. has sat on an advisory board for Sunovion, Allergan and has received speaker fees from Astra Zeneca. A.H.Y. has received honoraria for speaking from Astra Zeneca, Lundbeck, Eli Lilly, Sunovion; honoraria for consulting from Allergan, Livanova and Lundbeck, Sunovion, Janssen; and research grant support from Janssen. A.J.C. has received honoraria for speaking from Astra Zeneca, honoraria for consulting with Allergan, Livanova and Lundbeck and research grant support from Lundbeck.
China makes a unique and vital contribution to maintaining global and regional waterbird diversity and conservation. Despite considerable historical conservation efforts, the continued loss of waterbird diversity and abundance necessitates a contemporary review of Chinese sites of conservation significance. The Ecological Protection Red Line (EPRL) was proposed by China’s Central Government in 2013 to protect areas providing crucial ecosystem services and provides the opportunity for such a review to enhance waterbird conservation in China. By incorporating various sources of data, surveys and information, we identified a suite of sites of waterbird conservation significance in China, following the Ramsar Site Criteria/Important Bird and Biodiversity Area (IBA) Criteria. In total, we identified 422 sites, of which the existing 286 IBA sites formed the basis of the site safeguard network. Altogether, these sites of waterbird conservation significance constitute over 727,000 km2 (7.6% of China’s land surface). Over half of the area of these sites is outside China’s national nature reserves, thus confirming the importance and urgency of including them in the EPRL for the effective conservation of waterbird sites. We suggest that this assessment of sites of waterbird importance offers a useful model to apply to other taxa, such as terrestrial birds and mammals.
To determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [MDROs]) on high-touch healthcare environmental surfaces after routine or terminal cleaning.
Prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2).
MDRO contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states.
Samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms).
Using a standard sponge-wipe sampling protocol, 2 composite samples were collected from each room; a third sample was collected from each Clostridium difficile room. Composite 1 included the TV remote, telephone, call button, and bed rails. Composite 2 included the room door handle, IV pole, and overbed table. Composite 3 included toileting surfaces. Total bacteria and MDROs (ie, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci [VRE], Acinetobacter baumannii, Klebsiella pneumoniae, and C. difficile) were quantified, confirmed, and tested for drug resistance.
The mean microbial bioburden and range from routine cleaned room composites were higher (2,700 colony-forming units [CFU]/100 cm2; ≤1–130,000 CFU/100 cm2) than from terminal cleaned room composites (353 CFU/100 cm2; ≤1–4,300 CFU/100 cm2). MDROs were recovered from 34% of routine cleaned room composites (range ≤1–13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (≤1–524 CFU/100 cm2). MDROs were recovered from 40% of rooms; VRE was the most common (19%).
This multicenter bioburden summary provides a first step to determining microbial bioburden on healthcare surfaces, which may help provide a basis for developing standards to evaluate cleaning and disinfection as well as a framework for studies using an evidentiary hierarchy for environmental infection control.
For wheeled mobile robots moving in rough terrains or uncertain environments, driving failure will be encountered when trafficability failure occurs. Continuous mobility of mobile robots with special ability for overcoming driving failure on rough terrain has rarely been considered. This study was conducted using a four-wheel-steering and four-wheel-driving mobile robot equipped with a binocular visual system. First, quasi-static force analysis is carried out to understand the effects of different driving-failure modes on the mobile robot while moving on rough terrain. Secondly, to make the best of the rest of the driving force, robot configuration transformation is employed to select the optimal configuration that can overcome the driving failure. Thirdly, sliding mode control based on back-stepping is adopted to enable the robot achieve continuous trajectory tracking with visual feedback. Finally, the efficacy of the presented approach is verified by simulations and experiments.
To identify comorbid conditions associated with surgical site infection (SSI) among patients undergoing renal transplantation and improve existing risk adjustment methodology used by the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN).
Patients (≥18 years) who underwent renal transplantation at University of Maryland Medical Center January 1, 2010-December 31, 2011.
Trained infection preventionists reviewed medical records to identify surgical site infections that developed within 30 days after transplantation, using NHSN criteria. Patient demographic characteristics and risk factors for surgical site infections were identified through a central data repository. International Statistical Classification of Disease, Ninth Revision, Clinical Modification codes were used to analyze individual component comorbid conditions and calculate the Charlson and Elixhauser comorbidity indices. These indices were compared with the current NHSN risk adjustment methodology.
A total of 441 patients were included in the final cohort. In bivariate analysis, the Charlson components of cerebrovascular disease, peripheral vascular disease, and rheumatologic disorders and Elixhauser components of obesity, rheumatoid arthritis, and weight loss were significantly associated with the outcome. A model utilizing the variables from the NHSN methodology had a c-statistic of 0.56 (95% CI, 0.48–0.63), whereas a model that also included comorbidities from the Charlson and Elixhauser indices had a c-statistic of 0.65 (95% CI, 0.58–0.73). The model with all 3 risk adjustment scores performed best and was statistically different from the NHSN model alone, demonstrated by improvement in the c statistic (0.65 vs 0.56).
Risk adjustment models should incorporate electronically available comorbid conditions.
This paper describes a linear-polarized reflector that reflects incident wave almost parallel to its surface at 60 GHz, when illuminated by an impinging plane wave with normal incidence. This structure is designed as a simple and low-cost passive repeater with both a quasi-endfire radiation and a flat profile. Working as a transmission relay, it is a quite potential and possible solution to improve the radio-coverage in the T-shaped corridor, which is a typical scenario of non-light-of-sight (NLOS) environment for 60 GHz indoor communications. The proposed repeater consists of an array of parallel grooves with appropriate depths, drilled in a metallic plate. Full-wave simulations and theoretical investigations are carried out to demonstrate the working principle and to optimize the performance. Then, an 80-groove breadboard in the size of 200 mm × 200 mm is fabricated and measured to explore the feasibility of the concept. In a practical measurement, when the distance from the repeater to transmitting antenna (Tx) is 2 m, and to the receiving antenna (Rx) is 1.5 m, the repeater exhibits a main beam at ±75° with gain up to 22.7 dB. The communication between Tx and Rx in NLOS areas is thus successfully recovered.
To determine the prevalence of Pseudomonas aeruginosa colonization on intensive care unit (ICU) admission, risk factors for P. aeruginosa colonization, and the incidence of subsequent clinical culture with P. aeruginosa among those colonized and not colonized.
We conducted a cohort study of patients admitted to a medical or surgical intensive care unit of a tertiary care hospital. Patients had admission perirectal surveillance cultures performed. Risk factors analyzed included comorbidities at admission, age, sex, antibiotics received during current hospitalization before ICU admission, and type of ICU.
Of 1,840 patients, 213 (11.6%) were colonized with P. aeruginosa on ICU admission. Significant risk factors in the multivariable analysis for colonization were age (odds ratio, 1.02 [95% CI, 1.01–1.03]), anemia (1.90 [1.05–3.42]), and neurologic disorder (1.80 [1.27–2.54]). Of the 213 patients colonized with P. aeruginosa on admission, 41 (19.2%) had a subsequent clinical culture positive for P. aeruginosa on ICU admission and 60 (28.2%) had a subsequent clinical culture positive for P. aeruginosa in the current hospitalization (ICU period and post-ICU period). Of these 60 patients, 49 (81.7%) had clinical infections. Of the 1,627 patients not colonized on admission, only 68 (4.2%) had a subsequent clinical culture positive for P. aeruginosa in the current hospitalization. Patients colonized with P. aeruginosa were more likely to have a subsequent positive clinical culture than patients not colonized (incidence rate ratio, 6.74 [95% CI, 4.91–9.25]).
Prediction rules or rapid diagnostic testing will help clinicians more appropriately choose empirical antibiotic therapy for subsequent infections.
World-record solar-to-electricity energy conversion efficiency has been previously achieved by photovoltaic devices that maximize the use of the solar spectrum, such as multi-junction tandem solar cells. These cells are made of III-V materials whose high cost is a strong limitation on their widespread commercial application. One solution to suppress the cost of these types of devices is to grow III-V solar cells on low-cost carrier materials such as silicon. We will discuss the material, structure and analysis of GaAsP/SiGe-on-silicon multi-junction tandem solar cells. A low threading dislocation density is realized by effective lattice-matching of the top and bottom cells which demonstrate a device that achieves high open-circuit voltage in the top solar cell. The GaAsP/SiGe solar cells have reached a measured efficiency of 20.6% under one sun concentration. Analysis of these results based on the product of the best parameters shows efficiency potential of 26% under one sun, 30.8% at 20× and 35.1% at 400×.