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The Homa Peninsula has been known to science since 1911, and fossil specimens from the area comprise many type specimens for common African mammalian paleospecies. Here we discuss the fauna and the paleoenvironmental information from the Homa Peninsula. The Homa Peninsula is a 200 km2 area in Homa Bay County, situated on the southern margin of the Winam Gulf of Lake Victoria in Kenya (Figure 29.1). Lake Victoria is estimated to be the third largest lake in the world, with a surface area of 68,900 km2 and a maximum length of approximately 616 km. Although its catchment is extensive, it is relatively shallow compared to any other lake of similar size, with a maximum depth of 84 m. Lake Victoria is located in a depression formed by the western and eastern branches of the East African Rift System (EARS), and is at an average elevation of 1135 m a.s.l. (Database for Hydrological Time Series of Inland Waters, 2017).
To compare 2 methods of communicating polymerase chain reaction (PCR) blood-culture results: active approach utilizing on-call personnel versus passive approach utilizing notifications in the electronic health record (EHR).
Retrospective observational study.
A tertiary-care academic medical center.
Adult patients hospitalized with ≥1 positive blood culture containing a gram-positive organism identified by PCR between October 2014 and January 2018.
The standard protocol for reporting PCR results at baseline included a laboratory technician calling the patient’s nurse, who would report the critical result to the medical provider. The active intervention group consisted of an on-call pager system utilizing trained pharmacy residents, whereas the passive intervention group combined standard protocol with real-time in-basket notifications to pharmacists in the EHR.
Of 209 patients, 105, 61, and 43 patients were in the control, active, and passive groups, respectively. Median time to optimal therapy was shorter in the active group compared to the passive group and control (23.4 hours vs 42.2 hours vs 45.9 hours, respectively; P = .028). De-escalation occurred 12 hours sooner in the active group. In the contaminant group, empiric antibiotics were discontinued faster in the active group (0 hours) than in the control group and the passive group (17.7 vs 7.2 hours; P = .007). Time to active therapy and days of therapy were similar.
A passive, electronic method of reporting PCR results to pharmacists was not as effective in optimizing stewardship metrics as an active, real-time method utilizing pharmacy residents. Further studies are needed to determine the optimal method of communicating time-sensitive information.
The Mayo Normative Studies (MNS) represents a robust dataset that provides demographically corrected norms for the Rey Auditory Verbal Learning Test. We report MNS application to an independent cohort to evaluate whether MNS norms accurately adjust for age, sex, and education differences in subjects from a different geographic region of the country. As secondary goals, we examined item-level patterns, recognition benefit compared to delayed free recall, and derived Auditory Verbal Learning Test (AVLT) confidence intervals (CIs) to facilitate clinical performance characterization.
Participants from the Emory Healthy Brain Study (463 women, 200 men) who were administered the AVLT were analyzed to demonstrate expected demographic group differences. AVLT scores were transformed using MNS normative correction to characterize the success of MNS demographic adjustment.
Expected demographic effects were observed across all primary raw AVLT scores. Depending on sample size, MNS normative adjustment either eliminated or minimized all observed statistically significant AVLT differences. Estimated CIs yielded broad CI ranges exceeding the standard deviation of each measure. The recognition performance benefit across age ranged from 2.7 words (SD = 2.3) in the 50–54-year-old group to 4.7 words (SD = 2.7) in the 70–75-year-old group.
These findings demonstrate generalizability of MNS normative correction to an independent sample from a different geographic region, with demographic adjusted performance differences close to overall performance levels near the expected value of T = 50. A large recognition performance benefit is commonly observed in the normal aging process and by itself does not necessarily suggest a pathological retrieval deficit.
Experimental studies of the influence of fluid–structure interaction on cloud cavitation about a stiff stainless steel (SS) and a flexible composite (CF) hydrofoil have been presented in Parts I (Smith et al., J. Fluid Mech., vol. 896, 2020a, p. A1) and II (Smith et al., J. Fluid Mech., vol. 897, 2020b, p. A28). This work further analyses the data and complements the measurements with reduced-order model predictions to explain the complex response. A two degrees-of-freedom steady-state model is used to explain why the tip bending and twisting deformations are much higher for the CF hydrofoil, while the hydrodynamic load coefficients are very similar. A one degree-of-freedom dynamic model, which considers the spanwise bending deflection only, is used to capture the dynamic response of both hydrofoils. Peaks in the frequency response spectrum are observed at the re-entrant jet-driven and shock-wave-driven cavity shedding frequencies, system bending frequency and heterodyne frequencies caused by the mixing of the two cavity shedding frequencies. The predictions capture the increase of the mean system bending frequency and wider bandwidth of frequency modulation with decreasing cavitation number. The results show that, in general, the amplitude of the deformation fluctuation is higher, but the amplitude of the load fluctuation is lower for the CF hydrofoil compared with the SS hydrofoil. Significant dynamic load amplification is observed at subharmonic lock-in when the shock-wave-driven cavity shedding frequency matches with the nearest subharmonic of the system bending frequency of the CF hydrofoil. Both measurements and predictions show an absence of dynamic load amplification at primary lock-in because of the low intensity of cavity load fluctuations with high cavitation number.
What have we learned about the development of creativity throughout the lifespan? The rich and comprehensive review by Bornstein (Chapter 4) captures the complexity of creativity within a developmental framework. How do we integrate the constructs and empirical findings in the field of creativity with developmental approaches? Understanding the development of creativity requires perspectives from different disciplines and a number of different investigative approaches, which this Handbook has provided. Here, we highlight some areas of consensus and implications for the future.
The focus of this Handbook is on the development, nurturance, and enhancement of creative processes and creative achievement across the lifespan. What do we currently know about the development of creativity? How can we develop the processes important for creative thinking, and how can we help individuals translate that creative potential into creative achievement throughout their lives? We are pleased that leading scholars and researchers in the field agreed to contribute to the Handbook and share their perspectives. There are 25 chapters addressing a variety of topics in the area. This Handbook provides a review of each area, including current research findings, consensus in the literature, best practices in each area, and key questions for future research. In addition, many chapters raise provocative questions that point the way for future consideration and research.
Problematic anger is frequently reported by soldiers who have deployed to combat zones. However, evidence is lacking with respect to how anger changes over a deployment cycle, and which factors prospectively influence change in anger among combat-deployed soldiers.
Reports of problematic anger were obtained from 7298 US Army soldiers who deployed to Afghanistan in 2012. A series of mixed-effects growth models estimated linear trajectories of anger over a period of 1–2 months before deployment to 9 months post-deployment, and evaluated the effects of pre-deployment factors (prior deployments and perceived resilience) on average levels and growth of problematic anger.
A model with random intercepts and slopes provided the best fit, indicating heterogeneity in soldiers' levels and trajectories of anger. First-time deployers reported the lowest anger overall, but the most growth in anger over time. Soldiers with multiple prior deployments displayed the highest anger overall, which remained relatively stable over time. Higher pre-deployment resilience was associated with lower reports of anger, but its protective effect diminished over time. First- and second-time deployers reporting low resilience displayed different anger trajectories (stable v. decreasing, respectively).
Change in anger from pre- to post-deployment varies based on pre-deployment factors. The observed differences in anger trajectories suggest that efforts to detect and reduce problematic anger should be tailored for first-time v. repeat deployers. Ongoing screening is needed even for soldiers reporting high resilience before deployment, as the protective effect of pre-deployment resilience on anger erodes over time.