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Turbidity currents commonly bypass sediment in submarine channels on the continental slope, and deposit sediment lobes farther down-dip on the flat and unconfined abyssal plain. Seafloor and outcrop data have shown that the transition from bypass to deposition usually occurs over complex zones referred to as channel–lobe transition zones (CLTZs). Recognition of these zones in cores and outcrop remains challenging due to a lack of characteristic sedimentary facies and structures. This paper focuses on Unit E of the Permian Fort Brown Formation in the Karoo Basin, South Africa, in the Slagtersfontein outcrop complex, which has previously been interpreted as a CLTZ. This study integrates thin-section micrographs, sedimentary facies, bed-set and stratigraphic architecture, and palaeoflow directions to achieve a multiscale analysis of CLTZ features. A novel process-based facies scheme is developed to evaluate deposits in terms of the depositional or erosional tendencies of the flows that formed them. This scheme allows bypass to be distinguished from depositional zones by the spatial distribution of certain sediment facies. Areas of net sediment bypass were predominantly marked by erosive sediment facies and a larger variability in palaeoflow direction while depositional areas showed a lower variability in palaeoflow directions. Metre-scale structures in the bypass-dominated area reveal seafloor erosion and scour formation. Field relations suggest the presence of a ∼500 m long mega-scour in the CLTZ. The characteristic structures documented here are applicable for identifying CLTZs in sparse datasets such as outcrops with limited palaeogeographical context and sediment cores obtained from subsurface systems.
The coronavirus disease 2019 (COVID-19) pandemic has significantly increased depression rates, particularly in emerging adults. The aim of this study was to examine longitudinal changes in depression risk before and during COVID-19 in a cohort of emerging adults in the U.S. and to determine whether prior drinking or sleep habits could predict the severity of depressive symptoms during the pandemic.
Participants were 525 emerging adults from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA), a five-site community sample including moderate-to-heavy drinkers. Poisson mixed-effect models evaluated changes in the Center for Epidemiological Studies Depression Scale (CES-D-10) from before to during COVID-19, also testing for sex and age interactions. Additional analyses examined whether alcohol use frequency or sleep duration measured in the last pre-COVID assessment predicted pandemic-related increase in depressive symptoms.
The prevalence of risk for clinical depression tripled due to a substantial and sustained increase in depressive symptoms during COVID-19 relative to pre-COVID years. Effects were strongest for younger women. Frequent alcohol use and short sleep duration during the closest pre-COVID visit predicted a greater increase in COVID-19 depressive symptoms.
The sharp increase in depression risk among emerging adults heralds a public health crisis with alarming implications for their social and emotional functioning as this generation matures. In addition to the heightened risk for younger women, the role of alcohol use and sleep behavior should be tracked through preventive care aiming to mitigate this looming mental health crisis.
Background: Approximately 1,000 children present with AIS annually in North America. Most suffer from long-term disability. Childhood AIS is diagnosed after a median of 23 hours post-symptom onset, limiting thrombolytic treatment options that may improve outcomes. Pediatric stroke protocols decrease time to diagnosis. AIS treatment is not uniform across Canada, nor are pediatric stroke protocols standardized. Methods: We contacted neurologists at all 16 Canadian pediatric hospitals regarding their AIS management. Results: Response rate was 100%. Seven centers have an AIS protocol and two have a protocol under development. Seven centers do not have a protocol – two redirect patients to adult neurology, and five use a case-by-case approach for management. Analysis of the seven AIS protocols reveals differences: 1) IV-tPA dosage: age-dependent 0.75-0.9 mg/kg (n=1) versus age-independent 0.9 mg/kg (n=6), with maximum doses 75 mg (n=1) or 90 mg (n=6); 2) IV-tPA lower age cut-off: 2 years (n=4) versus 3, 4 or 10 years (n=1); 3) IV-tPA exclusion criteria: PedNIHSS score <4 (n=3), <5 (n=1), or <6 (n=3); 4) Pre-treatment neuroimaging: CT (n=3) versus MRI (n=4); 5) Intra-arterial tPA use (n=3). Conclusions: The seven Canadian pediatric AIS protocols show prominent differences. We plan a teleconference discussing a Canadian pediatric AIS consensus approach.
Childhood acute arterial ischemic stroke (AIS) is diagnosed at a median of 23 hours post-symptom onset, delaying treatment. Pediatric stroke pathways can expedite diagnosis. Our goal was to understand the similarities and differences between Canadian pediatric stroke protocols with the aim of optimizing AIS management.
We contacted neurologists at all 16 Canadian pediatric hospitals regarding AIS management. Established protocols were analyzed for similarities and differences in eight domains.
Response rate was 100%. Seven (44%) centers have an established AIS protocol and two (13%) have a protocol under development. Seven centers do not have a protocol; two redirect patients to adult neurology, five rely on a case-by-case approach for management. Analysis of the seven protocols revealed differences in: 1) IV-tPA dosage: age-dependent 0.75–0.9 mg/kg (N = 1) versus age-independent 0.9 mg/kg (N = 6), with maximum doses of 75 mg (N = 1) or 90 mg (N = 6); 2) IV-tPA lower age cut-off: 2 years (N = 5) versus 3 or 10 years (each N = 1); 3) IV-tPA exclusion criteria: PedNIHSS score <4 (N = 3), <5 (N = 1), <6 (N = 3); 4) first choice of pre-treatment neuroimaging: computed tomography (CT) (N = 3), magnetic resonance imaging (MRI) (N = 2) or either (N = 2); 5) intra-arterial tPA use (N = 3) and; 6) mechanical thrombectomy timeframe: <6 hour (N = 3), <24 hour (N = 2), unspecified (N = 2).
Although 44% of Canadian pediatric hospitals have established AIS management pathways, several differences remain among centers. Some criteria (dosage, imaging) reflect adult AIS literature. Canadian expert consensus regarding IV-tPA and endovascular treatment should be established to standardize and implement AIS protocols across Canada.
Under naturalistic conditions the influence of monotherapy versus combined therapy on the outcome of psychoeducation was to be investigated. As amisulpride has a very positive receptor profile and causes no sedation, it was of interest to which degree amisulpride has a positive influence on knowledge gain in comparison to other atypicals.
In-patients with schizophrenia (ICD -10: F2) under therapy with atypicals. 8 psychoeducational group sessions; indication for groups independent of psychopathology, insight and compliance. Medication with atypicals non restricted.
94 patients (47% female, 35 years), 40 % (38 of 94) were treated at discharge with a monotherapy and 60 % with a combination of atypicals. PANSS monotherapy at admission: 74; at discharge: 49. Patients with combination therapy had significantly higher values: 92 at admission and 66 at discharge (p<0.001). Knowledge-gain was comparable; monotherapy group: Mean= 6,0 (SD 6,5); combination therapy: Mean=6,9 (SD 12,4) (n.s.). 23 % (22 of 94) got amisulpride (5 in monotherapy and 17 in combination). Concerning safety profile and therapeutic effectiveness the non-inferior hypothesis could be confirmed. Patients with monotherapy of amisulpride at discharge had a mean knowledge gain of 10.7; that was higher than the mean knowledge gain of 6.5 of all patients (n.s.).
Monotherapy with atypicals was only possible among 40 %. Psychoeducation is efficient for severely ill patients with combined therapy as well. Amisulpride monotherapy showed a knowledge-gain higher than the average atypicals. For patients with high expectations concerning rehabilitation, a monotherapy with amisulpride seems to be useful.
The Empire of Aksum was one of Africa's most influential ancient civilisations. Traditionally, most archaeological fieldwork has focused on the capital city of Aksum, but recent research at the site of Beta Samati has investigated a contemporaneous trade and religious centre located between Aksum and the Red Sea. The authors outline the discovery of the site and present important finds from the initial excavations, including an early basilica, inscriptions and a gold intaglio ring. From daily life and ritual praxis to international trade, this work illuminates the role of Beta Samati as an administrative centre and its significance within the wider Aksumite world.
Background: Non-convulsive seizures are common in critically ill patients and are best detected by continuous EEG (cEEG) monitoring. A recent consensus statement from the American Clinical Neurophysiology Society (ACNS) outlines the indications for EEG monitoring in critically ill patients. Our aim was to assess adherence to these indications, barriers to cEEG utilization as well as to optimize cEEG monitoring in critically ill children. Methods: We conducted a retrospective review of electronic medical records, analyzing patients admitted to the PICU from January 1st until June 23rd 2018, followed by an 8-week mentorship period, consisting of educational interventions as well as daily patient rounds to help identify patients meeting cEEG monitoring criteria. Results: Prevalence of patients meeting cEEG monitoring indications were similar in both the retrospective and mentorship period (18% vs. 23%). During the retrospective period, 23% of patients received cEEG monitoring, reaching 100% at the end of the mentorship period. The median delay for initiation of monitoring was 17 hours, largely due to restrictions in the availability of technologists. All cEEGs performed informed anti-convulsive management. Conclusions: An educational intervention was effective in increasing PICU cEEG monitoring. However, limited hours of technologist availability represented the largest barrier to timely cEEG monitoring.
Background: The classic ketogenic diet is the main non-pharmacological treatment for refractory epilepsy; however, adherence is often challenging. The low glycemic index diet (LGID) is less strict, almost equally effective, and associated with improved adherence. Little is known about the quality of life of children treated with LGID. The objective of this study was to explore changes in the quality of life of children with epilepsy transitioning to the LGID. Methods: Patients on LGID and their parents filled out Pediatric Quality of Life Epilepsy Module questionnaires; one while being on the LGID, and one retrospectively for the time prior to starting the LGID. Results: Data was collected from five children ages 3-13 and their parents. Complete seizure control was seen in two children, >50% seizure reduction in one, and no change in two children. Parental reported quality of life while on the LGID increased with two participants but decreased in all child self reports. Conclusions: Although the LGID led to improved seizure control in three out of five patients, the child-reported quality of life decreased in all children. Larger prospective studies are warranted to reliably assess the impact of the LGID on the quality of life in children with epilepsy.
Background: Benign spasms of infancy (BSI), previously described as benign non-epileptic infantile spasms or benign myoclonus of early infancy, are non-epileptic movements manifesting during the first year of life and spontaneously resolving in the second year of life. BSI are characterized by spasms typically lasting 1-2 seconds, involving to varying degrees the head, neck, trunk, shoulders and upper extremities. Ictal and interictal EEG recordings are normal. BSI are not associated with developmental retardation and do not require treatment. Distinction between BSI and infantile epileptic disorders, such as epileptic spasms or myoclonic epilepsy of infancy, can be challenging given the clinical similarities. Moreover, interictal EEGs can be normal in all conditions. Epileptic spasms and myoclonic epilepsy require timely treatment to improve neurodevelopmental outcomes. Methods: We describe a 6-month old infant presenting with spasm-like movements. His paroxysms as well as a positive family history for epileptic spasms were in keeping with a likely diagnosis of West syndrome. Results: Surprisingly, ictal video EEG did not reveal epileptiform activity, and suggested a diagnosis of BSI. Conclusions: We emphasize that ictal EEG is the gold standard for classification of infantile paroxysms as either epileptic or non-epileptic, thereby avoiding overtreatment of BSI and facilitating timely targeted treatment of infantile epilepsies.
Acute tonsillitis represents a significant proportion of admissions to ENT departments nationally. Given current hospital pressures, it is vital to look for safe alternatives to admission. This study explores the safe management of patients in an ambulatory medical unit, without the need for admission.
A retrospective review of 48 patients’ notes was carried out. Following the development and implementation of a guideline for acute tonsillitis, a prospective re-audit of 41 patients was carried out, measuring length of stay, overnight admissions and re-admissions.
The rate of overnight admission following implementation of the guideline fell from 0.75 to 0.29, and average length of stay dropped from 19.2 to 9.5 hours. There were two re-admissions in each cycle of the audit, which represents a non-significant increase.
The tonsillitis guideline has significantly reduced admissions and length of stay. Re-admissions remain low, demonstrating that this is a safe and cost-effective intervention.
The apicomplexan protozoan parasites include the causative agents of animal and human diseases ranging from malaria (Plasmodium spp.) to toxoplasmosis (Toxoplasma gondii). The complex life cycle of T. gondii is regulated by a unique family of calcium-dependent protein kinases (CDPKs) that have become the target of intensive efforts to develop new therapeutics. In this review, we will summarize structure-based strategies, recent successes and future directions in the pursuit of specific and selective inhibitors of T. gondii CDPK1.
In agriculture, tank mixtures with several plant protection products (PPP) are frequently used, which makes it impossible to apply specific plant protection products to specific areas. Therefore a prototype of a field sprayer with a direct injection system was developed as part of a joint project between the company Herbert Dammann GmbH and the Julius Kühn- Institute. This framework enables a real-time site-specific dosing of plant protection products and water from separate containers with direct mixing before the application without residual amounts. Results show a high accuracy in the working range of the selected dosing pumps by means of test bench measurements and field tests Field tests for site-specific weed control in winter wheat demonstrate the applicability of the system under practical conditions and enable a precise application of various herbicides.
We investigated particle acceleration and shock structure associated with an unmagnetized
relativistic jet propagating into an unmagnetized plasma. Strong magnetic fields generated
in the trailing shock contribute to the electrons transverse deflection and acceleration.
We have calculated, self-consistently, the radiation from electrons accelerated in these
turbulent magnetic fields. We found that the synthetic spectra depend on the bulk Lorentz
factor of the jet, its temperature and strength of the generated magnetic fields. We have
also investigated accelerated electrons in strong magnetic fields generated by kinetic
shear (Kelvin-Helmholtz) instabilities. The calculated properties of the emerging
radiation will guide our understanding of the complex time evolution and/or spectral
structure in gamma-ray bursts, relativistic jets in general, and supernova remnants.
LOFT (Large Observatory For X-ray Timing) is one of the four candidate missions currently
under assessment study for the M3 mission in ESAs Cosmic Vision program to be launched in
2024. LOFT will carry two instruments with prime sensitivity in the 2–30 keV range: a 10
m2 class large area detector (LAD) with a <1° collimated field of view
and a wide field monitor (WFM) instrument. The WFM is based on the coded mask principle,
and 5 camera units will provide coverage of more than 1/3 of the sky. The prime goal of
the WFM is to detect transient sources to be observed by the LAD. With its wide field of
view and good energy resolution of <500 eV, the WFM will be an excellent instrument
for detecting and studying GRBs and X-ray flashes. The WFM will be able to detect
~150 gamma ray bursts per year, and a burst alert system will enable the
distribution of ~100 GRB positions per year with a ~1 arcmin location
accuracy within 30 s of the burst.