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Introduction: The acute antidepressant effect of sleep deprivation (SD) in patients with depressive disorders has been studied for more than 60 years. However, hypomanic mood swings after partial or total SD have also been described in people without diagnosed mental disorders. Studying this phenomenon in the general population may yield insights about the mechanisms of therapeutic SD, mania and bipolar disorders. Methods: A cross-sectional sample of young adults was recruited and classified into those who described having regularly occurring subclinical hypomanic experiences (ROHE) after SD and those who did not. History of psychiatric and physical illness, with screening for depression and mania, as well as alcohol or drug consumption, family history of depressive disorders or suicide, 5-HTTLPR polymorphism, and MEQ-SA chronotype were collected. Results: A total of 251 participants were included; 39.0% indicated regularly having subclinical hypomanic experiences after SD. These experiences were not associated with depressive or mania screening, history of psychiatric illness, family history, 5-HTTLPR polymorphism, or MEQ-SA chronotype. Conclusions: ROHE after non-therapeutic SD seem to be a relatively common phenomenon in young adults, independent of depressive mood state. Our results suggest that therapeutic SD may depend on a physiological phenomenon of subclinical affective disturbance after SD that affects a part of the general population, independent of psychiatric diagnosis. Further studies could elucidate associated factors and contribute to our understanding of (hypo-)manic mood states. [ABSTRACT FROM AUTHOR]

A new form of volunteer-based intervention is mushrooming across Europe: social mentoring. Such programmes turn 'ordinary' citizens into mentors for individuals from disadvantaged groups. Related initiatives are becoming more institutionalised and social mentoring has gained popularity as a social policy measure, especially in the face of crises. However, the social work discussion has taken little notice of this burgeoning phenomenon adjoining our professional field. There is a lack of concepts and data that could fuel a debate at the intersection of mentoring for social inclusion, human services, and welfare policies. This paper presents a first attempt to outline what social mentoring means, why social work should engage with it and how we can research into it. It offers theoretical reflection on ongoing developments in the EU, based on observation of the literature and field. To expand the available knowledge, it is suggested that research should pay equal attention to all three constituent elements of the topic: personal relationships, programmes, and policies. In line with critical traditions, this paper suggests a holistic, multi-scalar perspective that is sensitive to social inequalities and power imbalances, while also embracing innovative and transformative aspects of social mentoring as a 'popular' form of social problems work. [ABSTRACT FROM AUTHOR]

The Oceania region has often been overlooked in fundamental hydrological research owing to assumptions that cultural complexities hinder such efforts. However, this perspective is somewhat naïve. Substantial evidence demonstrates that Pacific Islanders actively engage in research, contributing both local Indigenous knowledge and expert capabilities in "island hydrology." Numerous projects and publications by Pacific Island scholars showcase this expertise. To enhance self-reliance in smaller Pacific nations, it is crucial to improve access to advanced hydrology education and secure funding to support it. Overcoming these challenges is essential to unlocking the full potential of future hydrological research in the Pacific Islands. [ABSTRACT FROM AUTHOR]

Transaction costs, related to either investigating improved land management practices (ILMP), engaging in adoption support programs for these practices and/or implementing changes on-ground, create barriers to ILMP adoption. Perceived and actual transaction costs have long been hypothesised as a potential barrier to grazier adoption of ILMPs in catchments to the Great Barrier Reef. Applying a framework derived from transaction cost theory, we assess this hypothesis. Through semi-structured interviews of a sample of participants in two ILMP programs, we find that ILMP adoption support program characteristics have a large influence on perceived and actual transaction costs of landholders seeking to engage in ILMP programs or adopt ILMPs. The importance of establishing and nurturing relationships between landholders and extension officers was also highlighted as critical to reducing landholder transaction costs. The degree to which relationships reduce transaction costs demonstrates the importance of fostering landholder leadership in ILMP program design as well as targeted extension in supporting adoption. [ABSTRACT FROM AUTHOR]

Epidemiological data on extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales are most often based on microbiological laboratory isolates and do not consider important clinical data such as infection or colonisation, treatment, and outcome. This study aimed to assess prevalence of ESBL-producing Enterobacterales as the cause of infection in patients with suspected sepsis in the emergency department based on clinical data. It also examined the number of patients with suspected sepsis who had ESBL-producing pathogens, comparing estimates that were based on laboratory data versus a combination of laboratory and clinical data. Patients with suspected sepsis in the emergency department at Skåne University Hospital, Lund, Sweden were included consecutively. Data were collected retrospectively from medical records. Of the 764 included patients, 223 patients had growth of Enterobacterales in any specimen (i.e. colonisation or infection according to laboratory data), while 191 patients had Enterobacterales detected in the blood or in the suspected focus of infection (i.e. an infection according to clinical and laboratory data). Eighteen patients had ESBL-producing Enterobacterales in any clinical specimen, 11 of whom had an infection with ESBL-producing Enterobacterales, resulting in a prevalence of infections with ESBL-producing Enterobacterales in infected patients with suspected sepsis of 1.8%. The number of patients with ESBL-producing Enterobacterales was not significantly different when infection was defined using laboratory data alone versus a combination of laboratory and clinical data [18/223 (8.1%) vs 11/191 (5.8%), p = 0.36]. The prevalence of ESBL-producing Enterobacterales infections among patients with suspected sepsis is low in an acute care setting in Sweden. [ABSTRACT FROM AUTHOR]

Immature platelets are newly formed platelets with an increased prothrombotic potential. This study evaluates whether immature platelets are associated with relevant complications in neurosurgical patients. Data were obtained in the frame of a prospectively conducted observational study exploring the association between immature platelets and major cardiovascular events after surgery. Immature platelet fraction (IPF) and H-IPF (highly fluorescent immature platelet fraction) were measured preoperatively and postoperatively at the neurosurgical ward (24-72 hours after surgery). Therapy-relevant complications after surgery were stratified using the Clavien-Dindo Grade (CDG >2) as primary outcome. Data were analyzed in 391 neurosurgical patients. While preoperatively there were no differences in IPF or H-IPF, patients with higher therapy-complication grades had higher values post-op compared to patients with lower grade complications (≤2 CDG). Cut-off values identified by receiver operating characteristic curve analysis revealed that there were significantly more patients with H-IPF ≥0.95% in the group with serious complications (CDG >2) [odds ratio OR (95% confidence interval CI) = 2.06 (1.09-3.9), p = .025], whereas this association was not present for the IPF cutoff value. In a multivariate model, H-IPF≥0.95% was independently associated with serious complications after surgery [OR (95% CI) = 1.97 (1.03-3.78), p = .041]. These findings suggest that H-IPF is associated with surgical complications and may improve risk stratification of neurosurgical patients (clinicaltrials.gov: NCT02097602, registration date: 27/03/2014). [ABSTRACT FROM AUTHOR]

We present a mathematical model for the full drying process of a single protein formulation droplet taking into account the convective impact arising from its levitation by a standing ultrasound wave. Using the finite element method allows us to compute the evaporation rate directly from the fully resolved heat and mass transfer within and around the levitated droplet. We apply our model to simulate the drying kinetics of pure water and aqueous phosphoglycerate kinase (PGK) droplets under various levitation and drying conditions. Empirical data from the literature are used to validate and discuss our numerical results. The acoustic streaming turns out to accelerate not only the first but also the second drying stage. Moreover, the dehydration of the protein molecules is found to be primarily responsible for their enzymatic inactivation throughout the drying process. [ABSTRACT FROM AUTHOR]

In this paper, we consider a bilevel polynomial optimization problem, where the constraint functions of both the upper-level and lower-level problems involve uncertain parameters. We employ the deterministic robust optimization approach to examine the bilevel polynomial optimization problem under data uncertainties by providing lower bound approximations and convergences of sum-of-squares (SOS) relaxations for the robust bilevel polynomial optimization problem. More precisely, we show that under the convexity of the lower-level problem and either the boundedness of the feasible set or the coercivity of the objective function, the global optimal values of SOS relaxation problems are lower bounds of the global optimal value of the robust bilevel polynomial problem and they converge to this global optimal value when the degrees of SOS polynomials in the relaxation problems tend to infinity. Moreover, an application to an electric vehicle charging scheduling problem with renewable energy sources demonstrates that using the proposed SOS relaxation schemes, we obtain more stable optimal values than applying a direct solution approach as the SOS relaxations are capable of solving these models involving data uncertainties in dynamic charging price and weather conditions. [ABSTRACT FROM AUTHOR]

Possible functions of several species-specific, sexually dimorphic male structures and of the male genitalia of Lytta eucera were deduced from observations of behaviour in the field and captivity, and were used to test theories of sexual selection. The male rubbed and tapped on the female's antennae with sexually dimorphic segments of his antennae, and on her elytra with brushes of setae on his hind tarsi. He forcefully grasped the female's prothorax and at least occasionally perforated the female's prothoracic membranes with his modified middle tibiae, and her relatively uniform, membranous vaginal lining with his strong aedeagal teeth. His aedeagal teeth snagged her vaginal lining, and his gonostyli usually pressed against a featureless external female intersegmental membrane. None of these male structures was used as a weapon or in threat displays. No female structure fitted tightly in a "lock-and-key" manner with any of the male structures, nor was any female structure capable of selectively impeding their use, thus ruling out some hypotheses explaining their species-specificity in males. Female resistance to males, including occasional violent "tantrum" displays, was energetic, persistent, and highly effective; the functional significance of this resistance is unclear. If females distinguish the stimuli produced by species-specific traits of male genitalia, as supposed by some hypotheses, they likely use higher-level analyses in the central nervous system rather than the locations of the particular sense organs that are stimulated. The functional morphology of species-specific genital and nongenital sexually dimorphic traits of male Lytta eucera beetles was deduced using behavioural and morphological data. Two nongenital male traits function exclusively to stimulate females during courtship. Two other nongenital male traits may have mixed functions; one is unique in Meloidae in serving to grasp the female prothorax in a tong-like fashion. The traits were compared with predictions of hypotheses that have been proposed to explain species-specificity. No nongenital or genital trait fit well with mechanical versions of the species isolation or the sexually antagonistic coevolution (SAC) hypothesis. Inconsistency in the points of male–female genital contact indicated that stimulation versions of the cryptic female choice and SAC hypotheses could not be true unless female analyses of male stimuli occur not at the receptors themselves, but deeper in the female's nervous system. [ABSTRACT FROM AUTHOR]

High-resolution Fourier transform spectroscopy and Laser-induced fluorescence have been performed on LiCa in the infrared spectral range. We analyse rovibrational transitions of the (2) 2 Σ + – X (1) 2 Σ + system of LiCa and find the (2) 2 Σ + state to be perturbed by spin–orbit coupling to the (1) 2 Π state. We study the coupled system obtaining molecular parameters for the (2) 2 Σ + and the (1) 2 Π state together with effective spin–orbit and spin–rotation coupling constants. The coupled system has also been evaluated by applying a potential function instead of rovibrational molecular parameters for the state (2) 2 Σ + . An improved analytic potential function of the X (1) 2 Σ + state is derived, due to the extension of the observed rotational ladder. [ABSTRACT FROM AUTHOR]

Leveraged and inverse exchange-traded funds seek daily returns equal to fixed multiples of indexes' returns, but the ensuing rebalancing costs create a tension between a high correlation with the index and a low average deviation from the leveraged index' performance. With proportional trading costs, we find that the optimal replication policy is robust to the index' dynamics and obtain a sufficient statistic for index replication performance, the implied spread, which is insensitive to risk-premia and enables comparisons of funds tracking different factors of an index. Overall, the impact of trading costs on replication performance is comparable to or higher than the effect of management fees. [ABSTRACT FROM AUTHOR]

Interested in maternal determinants of infant fat mass index (FMI) and fat-free mass index (FFMI), considered as predictors for later development of obesity, we analysed amino acids (AA) and oxylipins in maternal serum and breast milk (BM). FMI and FFMI were calculated in 47 term infants aged 4 months (T4). Serum AA were analysed in pregnancy (T1, T2) and 6–8 weeks postpartum (T3). At T3, AA and oxylipins were analysed in BM. Biomarker-index-associations were identified by regression analysis. Infant FMI (4.1 ± 1.31 kg/m2; MW ± SD) was predicted by T2 proline (R2 adj.: 7.6%, p =.036) and T3 BM 11-hydroxy-eicosatetraenoic-acid (11-HETE) and 13-hydroxy-docosahexaenoic-acid (13-HDHA; together:35.5% R2 adj., p <.001). Maternal peripartum antibiotics (AB) emerged as confounders (+AB: 23.5% higher FMI; p =.025). Infant FFMI (12.1 ± 1.19 kg/m2; MW ± SD) was predicted by histidine (R2 adj.: 14.5%, p <.001) and 17-HDHA (BM, R2 adj.:19.3%, p <.001), determined at T3. Confirmed in a larger cohort, the parameters could elucidate connections between maternal metabolic status, nutrition, and infant body development. [ABSTRACT FROM AUTHOR]

When micro-single-lip deep hole drilling the efficiency of the cutting fluid supply cannot be investigated experimentally due to the inaccessibility of the cutting zone. For this reason, this paper examines the cutting fluid behavior, taking into account the chip formation and the transient chip position, with the help of various combined simulation methods. Therefore, experimentally obtained chips are digitalized and converted into a Computer-Aided Design model for the following simulations. Furthermore, for a comparison of the simulations with the experiments, the velocity of the cutting fluid in the chip flute of the tool is measured by a similar Particle Image Velocimetry method. Then, a transient coupled particle simulation of Smoothed Particle Hydrodynamics and the Discrete Element Method is performed to obtain the transient chip positions along the chip flute under the influence of the cutting fluid. Based on these chip positions, a Computational Fluid Dynamics simulation follows to derive insights about the flow field and pressure field at certain points in time. This multi-physics simulation chain allows to deal with experimental results in a simulation context to gain further insights about the deep hole drilling process, which are experimentally inaccessible and allows further connections between experiment and simulation. [ABSTRACT FROM AUTHOR]

Males of the agaonid wasp Heterandrium fallax have wing spots that they display during aggressive encounters near the ostioles of syconia of the fig Ficus pertusa, apparently in competition for the opportunity to copulate with emerging females. In accord with predictions of the "functional allometry hypothesis" for the allometry of structures that are under sexual selection as threat devices and that do not function as weapons, larger males tended to have proportionally larger wing spots. Some smaller males lacked spots, and smaller males were less likely to be collected near female emergence sites or to show antennal damage that probably results from male fights. [ABSTRACT FROM AUTHOR]

Too many ammonia emissions are released into the environment from cattle farming. These damage the environment and have an impact on animal and human health. Ammonia Emissions could be reduce by urease inhibitors. Before using the urease inhibitor suspension Atmowell® in cattle farming a risk assessment is required. This includes exposure data on the animal and human in the barn. As there is no method for exposure measurements yet the approach of fluorometry was taken. The fluorescent dye pyranine shall replace Atmowell® in later studies as a tracer. Before Atmowell® can be replaced, the interaction between Atmowell® and pyranine—according to the fluorescence and storage stability under the influence of ultraviolet light, has to be observed and excluded. Also, the spray and drift behavior must be examined in the wind tunnel with three different nozzles. The results show that Atmowell® has no effect on neither the fluorescence nor the degradation rate of a pyranine-solution. Furthermore, it is shown that a pyranine + Atmowell® mixture does not differ in drift behavior from a pure pyranine-solution. Because of these findings, an Atmowell®-solution can be substituted by a pyranine-solution without any effects on the results of an exposure measurement being expected. [ABSTRACT FROM AUTHOR]

Serious mental illnesses (SMIs) exert a considerable financial burden on health-care systems. In this study, the resource utilization in mental illness (RUMI) tool was developed and employed to evaluate resource utilization in patients with SMI. Data from 107 patients with SMI treated in four psychiatric outpatient clinics in Sweden were collected. The relationships between costs for physical and psychiatric care, social services, and the justice system, to self-reported health and quality of life, educational level, Global Assessment of Functioning (GAF), the Clinical Global Impressions scale score (CGI), and body mass index (BMI) were studied. Sixteen out of 107 patients accounted for 74% of the total costs. The mean and median cost for 6 months included in the survey for social services, family and social welfare and healthcare, psychiatric and physical treatment interventions, mean 8349 EUR, median 2599 EUR per patient (currency value for 2021). Education and psychosocial function (GAF) were both negatively correlated with costs for the social services (education, r=–0.207, p < 0.014; GAF, r=–0.258, p < 0.001). CGI was correlated with costs for physical and psychiatric healthcare (r = 0.161, p < 0.027), social services support (r = 0.245, p = 0.002) and total cost (r = 0.198, p = 0.007). BMI correlated with costs for psychiatric and physical health settings interventions (r = 0.155, p < 0.019) and for somatic and psychiatric medicines (r = 0.154, p < 0.019). The RUMI scale was acceptable and enabled estimation of resource utilization in a comparable manner across different care settings. Such comparable data have potential to provide a basis for budgeting and resource allocation. [ABSTRACT FROM AUTHOR]

The Nuclear Physics European Collaboration Committee (NuPECC) has approved the Long Range Plan (LRP) 2024 for nuclear physics in Europe. The LRP serves as a framework for coordinated advances in nuclear science and provides national funding agencies, ESFRI, and the European Commission with priorities and opportunities for nuclear science in Europe. The LRP was developed through a bottom-up approach, with contributions from over 400 scientists, collaborations, research infrastructures, and institutions. The final version of the LRP will be published in the second half of 2024 and presented in Brussels on November 19, 2024. [Extracted from the article]

In this article, domain of the third order generalized difference operator Δi³ in Hahn sequence space h is introduced. Some topological properties and inclusion relations are shown. Additionally, Schauder basis of the new Hahn sequence space h(Δi³) is calculated and α-, β- and γ-dual of the space h(Δi³) are computed. In the last section, some new matrix classes (h; bv), (h; bvp), (h; bv∞), (h; bs), (h; cs), (bv; h), (bv0; h), (bs; h), (cs0; h), (cs; h) are characterized. We conclude the paper with characterization of the classes (h(Δi³); μ) and (μ; h(Δi³)) where μ = {c, c0, l1, lp, l∞, h, bs, cs, cs0, bv, bv0}. [ABSTRACT FROM AUTHOR]

Background: Although in clinical practice an impairment of sensory perception is frequently reported by depressed patients no mention of these symptoms is made in DSM-5, ICD-10 or ICD-11. Previous studies on colour perception have largely relied on patient self-reports and few have studied colour discrimination. Methods: The ability to discriminate small colour differences was assessed in 30 patients currently experiencing a moderate to severe depressive episode (ICD-10: F32.1-2, F33.1-2 or F31.3-4) and 32 healthy controls using the colour buttons of the Farnsworth Munsell 100-Hue test. Data were analysed by standard tests for comparing two groups (t-test, Mann–Whitney U-test, Chi-square test) and by ordinal regression and generalised estimating equation models. Results: Depressed patients failed significantly earlier (i.e., at larger differences between adjacent buttons) to discriminate between colours. This finding was retained after adjustment for potential confounders. There was no significant association with age, gender or depression score. Conclusions: We found a reduction in the ability to discriminate colours in depressed patients. This finding underlines the importance of sensory deficits as part of the symptomatology of depression. Sensory impairments should be taken into account in clinical care of patients with depression and should be included in diagnostic manuals. Further studies in larger samples including intra-individual comparisons between the depressed and the remitted state of patients are needed. In clinical practice, an impairment of sensory perception is frequently reported by depressed patients. However, no mention of these symptoms is made in the commonly used diagnostic manuals. In this pilot study, depressed patients and controls differed significantly in terms of the ability to discriminate colours with patients performing worse than their healthy counterparts. Sensory impairments should be taken into account in clinical care of patients with depression and should be included in diagnostic manuals. [ABSTRACT FROM AUTHOR]

Perinatal mental health disorders affect a significant number of women with debilitating and potentially life-threatening consequences. Researchers in Nordic countries have access to high quality, population-based data sources and the possibility to link data, and are thus uniquely positioned to fill current evidence gaps. We aimed to review how Nordic studies have contributed to existing evidence on perinatal mental health. We summarized examples of published evidence on perinatal mental health derived from large population-based longitudinal and register-based data from Denmark, Finland, Iceland, Norway and Sweden. Nordic datasets, such as the Danish National Birth Cohort, the FinnBrain Birth Cohort Study, the Icelandic SAGA cohort, the Norwegian MoBa and ABC studies, as well as the Swedish BASIC and Mom2B studies facilitate the study of prevalence of perinatal mental disorders, and further provide opportunity to prospectively test etiological hypotheses, yielding comprehensive suggestions about the underlying causal mechanisms. The large sample size, extensive follow-up, multiple measurement points, large geographic coverage, biological sampling and the possibility to link data to national registries renders them unique. The use of novel approaches, such as the digital phenotyping data in the novel application-based Mom2B cohort recording even voice qualities and digital phenotyping, or the Danish study design paralleling a natural experiment are considered strengths of such research. Nordic data sources have contributed substantially to the existing evidence, and can guide future work focused on the study of background, genetic and environmental factors to ultimately define vulnerable groups at risk for psychiatric disorders following childbirth. [ABSTRACT FROM AUTHOR]

The article discusses the role of clinical intuition in medical judgment, particularly in the field of psychiatry. It argues that intuition, which is often seen as experience assimilated by senior colleagues, is an essential aspect of clinical reasoning that cannot be captured in algorithms or flowcharts. The article explores the definition of intuition as a rapid form of logical discursivity that incorporates familiarity and synthesizes diverse conceptions from medical knowledge. It emphasizes the importance of intuition in providing holistic data for generating humanistic hypotheses about a patient's condition and suggests that further research is needed to understand and validate the role of intuition in clinical judgment. [Extracted from the article]

In ophthalmology, data from both eyes of a person are frequently included in the statistical evaluation. This violates the requirement of data independence for classical statistical tests (e.g. t-Test or analysis of variance (ANOVA)) because it is correlated data. Linear mixed models (LMM) were used as a possibility to include the data of both eyes in the statistical evaluation. The LMM is available for a variety of statistical software such as SPSS or R. The application was applied to a retrospective longitudinal analysis of an accelerated corneal cross-linking (ACXL (9*10)) treatment in progressive keratoconus (KC) with a follow-up period of 36 months. Forty eyes of 20 patients were included, whereas sequential bilateral CXL treatment was performed within 12 months. LMM and ANOVA for repeated measurements were used for statistical evaluation of topographical and tomographical data measured by Pentacam (Oculus, Wetzlar, Germany). Both eyes were classified into a worse and better eye concerning corneal topography. Visual acuity, keratometric values and minimal corneal thickness were statistically significant between them at baseline (p < 0.05). A significant correlation between worse and better eye was shown (p < 0.05). Therefore, analyzing the data at each follow-up visit using ANOVA partially led to an overestimation of the statistical effect that could be avoided by using LMM. After 36 months, ACXL has significantly improved BCVA and flattened the cornea. The evaluation of data of both eyes without considering their correlation using classical statistical tests leads to an overestimation of the statistical effect, which can be avoided by using the LMM. [ABSTRACT FROM AUTHOR]

The technical feasibility of transumbilical single-incision surgery (SIL) for pancreatic resections has been demonstrated. However, this technique is hampered by the limited degrees of freedom for instrument handling. Dual-incision laparoscopy (DIL) with an additional trocar may simplify dissection and allow drainage. Between December 2009 and May 2017, 21 patients were treated with SIL (12/2009 to 01/2014) or DIL (02/2014 to 05/2017) pancreatic resection. All data were collected in a database and retrospectively analysed. Demographic parameters of the patients did not differ significantly in the DIL or the SIL group. No conversion to open surgery was required. No intraoperative complication occurred in either group. The surgical difficulty score was significantly higher in the SIL group (4.4 ± 1.56 vs 2.18 ± 1.95; p =.006). Postoperative serum amylase levels were higher (101.9 U/l ± 50.11 vs 48.91 U/l ± 35.20; p =.01) and return to normal levels (6.4 ± 9.66 days vs 2.09 ± 1.98 days; p =.045) was later in the SIL group. Three complications requiring radiological or surgical intervention were witnessed in the SIL group and one complication in the DIL group (p =.42). DIL surgery is a safe and feasible alternative to SIL surgery, facilitating key steps of distal pancreatic tail resection. [ABSTRACT FROM AUTHOR]

An incomplete fossil record and unstable phylogenies of extinct taxa hamper reconstructing the early evolution of Caimaninae. We describe previously unpublished articulated fossils of a key species, Tsoabichi greenriverensis from the early Eocene Green River Formation of North America, exhibiting further character evidence for the caimanine affinities of this taxon. Parsimony analysis of modified morphological taxon-character datasets coupled with a critical review of character evolution and published phylogenies reveals that fossil evidence for Palaeogene crown group and Late Cretaceous total-group representatives is unreliable due to uncertain character evolution in early Alligatoridae. The earliest unambiguous fossil age for total and crown-group Caimaninae are 63.5 Ma and 18.06 Ma, respectively. These calibration points follow best practices and are vital for better constrained estimates of time calibrated analyses. Phylogeny continues to imply two separate Caimaninae dispersals between North and South America, but instead of a northward back-dispersal, we find two Palaeogene dispersals to South America an equally likely hypothesis. Miocene taxa of Central America previously assigned to the stem lineage ancestral to South American Caimaninae are reinterpreted as part of a Neogene northward expansion of the crown group. [ABSTRACT FROM AUTHOR]

The integration of biology with mathematics and computer science mandates the training of students capable of comfortably navigating among these fields. We address this formidable pedagogical challenge with the creation of transdisciplinary modules that guide students toward solving realistic problems with methods from different disciplines. Knowledge is gradually integrated as the same topic is revisited in biology, mathematics, and computer science courses. We illustrate this process with a module on the homeostasis and dynamic regulation of red blood cell production, which was first implemented in an introductory biology course and will be revisited in the mathematics and computer science curricula. [ABSTRACT FROM AUTHOR]

The postcranial skeleton of the gliding neodiapsid reptile Coelurosauravus elivensis (Lower Sakamena Formation, ?upper Permian, southwestern Madagascar) is re-described in detail based on all previously referred specimens. The exquisite preservation of the material provides three-dimensional details of the individual bones, which are missing in the Laurasian weigeltisaurid material. A new skeletal reconstruction of C. elivensis is proposed including the first reconstruction of a weigeltisaurid reptile in lateral view. The re-examination of the material highlights interspecific differences in the postcranium of weigeltisaurids, in particular in the trunk and patagial spars. These animals have long been considered as arboreal and gliding reptiles. However, new information on the postcranium of C. elivensis reveals strong similarities with both extant and extinct quadrupeds specialized for a clinging arboreal lifestyle. Additionally, the presence of an additional phalanx in the fifth digit of the manus is now attested for all weigeltisaurids where this region is preserved. We suggest that this morphology could have allowed weigeltisaurids to grasp their patagium as observed in the extant gliding agamid Draco. Weigeltisaurids are thus the earliest known gliding vertebrates and some of the first tetrapods with an obligatory arboreal lifestyle, but also represent the only known vertebrates with a hyperphalangy aligned with a gliding apparatus. [ABSTRACT FROM AUTHOR]

Purpose is to investigate and compare professional quality of life (ProQoL) among health care providers (HCPs) in cystic fibrosis (CF) ambulances and inpatient clinic for child and adolescent psychiatry. The ProQoL R-IV Inventory was administered to 96 HCPs to investigate: compassion satisfaction, burnout, and secondary traumatic stress (STS). HCPs in CF centers and inpatient psychiatry did not differ in their ProQoL. However, the occupational groups differed regarding STS (F(3,92)=3.726, p=.01). Physicians reported more STS than other groups. Longer work experience was associated with more STS (r=-0.21, p=.04). Regular screening should be put in place to identify HCPs at risk of decreased ProQoL. [ABSTRACT FROM AUTHOR]

Ongoing investigations in submerged cave systems of Quintana Roo in south-eastern Mexico reveal a rich Late Pleistocene megafaunal assemblage, among them the megalonychid ground sloth Xibalbaonyx oviceps. The taxon has been described based on a complete skull and mandible from El Zapote cenote west of Puerto Morelos. We here add hitherto unreported postcranial material from El Zapote, attributed to the holotype. This new material allows us to reconstruct unexpected locomotion capabilities for Xibalbaonyx oviceps including steep slope and rock climbing. This may have enabled the ground sloth to use the sinkholes and underground caverns as water resource and shelter. The Late Pleistocene age of the fossil allows for a co-existence with early human settlers on the Yucatán Peninsula. [ABSTRACT FROM AUTHOR]

Recent palaeontological research in submerged caves of the north-eastern Yucatán Peninsula (YP) in Mexico has resulted in the identification of a diverse megafaunal assemblage in the area, among them Late Pleistocene ground sloths assigned to the family Megalonychidae (Xenarthra). Here we report on a new species of Megalonychidae, Xibalbaonyx exinferis n. sp., from a new fossil locality named cenote Tortugas, located west of Puerto Morelos in the federal state of Quintana Roo. The taxon is based on a fragmentary left mandibular ramus, an atlas, and a left humerus. The new taxon is diagnosed by the presence of two mental foramina on the short symphyseal spout, a caniniform being the smallest mandibular tooth, and the anterolaterally directed aperture of the mandibular foramen on the lateral surface of the mandible. Xibalbaonyx exinferis is the third endemic megalonychid documented for the north-eastern Yucatán Peninsula and thus provides increasing evidence for an ecological isolation of the area from the rest of Mexico during the Pleistocene. [ABSTRACT FROM AUTHOR]

There is growing evidence that lay health workers providing counselling is a feasible approach of addressing the universally large treatment gap for mental disorders. This study illuminates the experiences of the counsellors in the Youth Friendship Bench in Zimbabwe, a pilot project where students provide problem-solving therapy to adolescents with common mental disorders. Twelve interviews were analysed using content analysis. The first theme "Working in a meaningful project" describes how the counsellors managed to create an alliance with the clients. The project was perceived as helpful, meaningful and urgent, and the counsellors' experienced a professional and individual development through the support of the Friendship Bench organization. The second theme "Encountering obstacles" illuminates how counsellors experienced situations where they failed to reach out to clients, felt unprepared and inadequate, and how they combated preconceptions and taboos. In the third theme, "Carrying an emotional burden," the counsellors described experiences of recognising own problems and empathising with the client. [ABSTRACT FROM AUTHOR]

This study investigates specialist healthcare visits of older people with intellectual disability ID having affective and anxiety diagnoses in comparison with the general population, as well as across different levels of ID, behavioural impairment, and living in special housing in Sweden. The study is a retrospective national-register-based study from 2002–2012 of people with ID 55 years and older (n = 7936) and a control group the same size matched by birth year and sex from the general population at the end of study. The study groups comprised those with affective (n = 918) and anxiety (n = 825) diagnoses who visited specialist healthcare, including data about living in special housing at the end of study in 2012. Older people with ID and with affective and anxiety diagnoses have a higher risk of inpatient and unplanned visits to psychiatric and somatic healthcare than the general population. The average length of stay in inpatient psychiatric healthcare was higher in older people with ID and anxiety diagnoses than in the general population. Within the ID group, more inpatient and unplanned visits were made by those with moderate and severe levels of ID, behavioural impairment, and living in special housing. Older people with ID and affective and anxiety diagnoses are more likely to have inpatient and unplanned visits for specialist healthcare than the general population. Future research should explore the quality of healthcare services delivered by healthcare providers to older people with ID and with affective and anxiety diagnoses. [ABSTRACT FROM AUTHOR]

In Europe, Norway spruce forests are facing challenges due to climate change. One possible adaptive option is to enhance the resilience of forests by thinning. Usually, thinning requires two working steps: (i) tree marking by a forest manager and (ii) the harvesting operation. Since the typical tree selection procedure by forest managers is expensive and time consuming, the integration of the tree selection process in the harvesting operation is of high interest. In this paper, we examined four tree selection methods on 21 experimental plots located within eight Norway spruce stands and assessed their impact on the future stand development. The future stand development by tree selection methods was examined by means of a simulation study using the tree growth model MOSES (MOdeling Stand rESponse). The selection methods were (i) tree selection by forest managers, (ii) tree selection by the harvester operator as part of a fully mechanized harvesting system. Since we used the tree growth model MOSES, we additionally employed (iii) a random tree selection process implemented in MOSES, and (iv) a control simulation assuming no thinning. The Norway spruce stands are located in Lower Austria. The results show that 70% of the trees selected by the forest managers were identical to those chosen by the harvester operator and thus no significant differences in the key stand parameters after a 50-year simulation is detectable. Our study suggests that the tree selection for thinning by a trained harvester operator is a cost-efficient and fast method. [ABSTRACT FROM AUTHOR]

Objective/Background: Insomnia and depression are disorders that affect many perinatal women and that often are interrelated. The present study aimed to examine concurrent and prospective associations between mid-pregnancy insomnia and depression during mid-pregnancy and 8 weeks postpartum. Furthermore, differences in depression and in the sleep-related characteristics insomnia, chronotype, and sleep efficiency were explored between the two time points (mid-pregnancy versus 8 weeks postpartum), and between primiparous and multiparous participants. Participants/Methods: The study was part of the Norwegian population-based Depression and Anxiety in the Perinatal Period (DAPP) prospective cohort study. Among 539 women that were recruited for participation when receiving a routine ultrasound examination, we analyzed data from hospital birth records and questionnaire responses from pregnancy week 17 and postpartum week 8. We used the Edinburgh Postnatal Depression Scale to measure depression. The Bergen Insomnia Scale, the reduced Horne-Östberg Morningness-Eveningness Questionnaire, and three questions from the Pittsburgh Sleep Quality Index were used to measure the sleep-related characteristics. Results: Mid-pregnancy insomnia was significantly associated with concurrent depression (p <.001), but not with postpartum depression (p =.288), in a linear mixed model with adjustment for several reproductive and psychosocial variables. Sleep efficiency was reduced from mid-pregnancy to postpartum (from 88% to 77%), and primiparous women reported less efficient sleep than multiparous women after childbirth. Conclusions: The results indicate that mid-pregnancy insomnia may be a marker for concurrent depression but not a predictor of postpartum depression. Future research should examine the extent to which treatment of insomnia from mid-pregnancy on reduces both perinatal insomnia and depression. [ABSTRACT FROM AUTHOR]

Background: Poor sleep quality is a common problem in pregnant women, however there is scarce research evidence regarding the association between maternal perinatal insomnia and later social-emotional child development. Participants: This study is part of the Akershus Birth Cohort, a longitudinal population-based study. Birth record and questionnaire data of 1,346 women were used. Methods: Maternal symptoms of insomnia were measured at pregnancy week 32 and at eight weeks postpartum and social-emotional child development was assessed at two years of child age. Correlational and multiple linear regression analyzes were performed. Results: Both, pre- and postnatal symptoms of insomnia were significantly correlated with poorer social-emotional child development two years later (r = 0.09, p <.01 and r = 0.13, p <.001). Adjusting for potential confounding factors, the prospective effect of maternal symptoms of perinatal insomnia on social-emotional child development remained significant in the multiple linear regression analyzes (β = 0.08, p <.01 and β = 0. 10, p <.01). Conclusions: We found a prospective effect of maternal symptoms of perinatal insomnia on social-emotional child development, highlighting the potential relevance of both pre- and postnatal maternal sleep for later social-emotional child development. Future studies ought to examine the bio-psycho-social mechanisms and implications of poor maternal sleep in the perinatal time in more detail. [ABSTRACT FROM AUTHOR]

Introduction: Preeclampsia is characterised by an increased platelet consumption with consecutive reduction of overall platelet count and a consecutive rise in mean platelet volume (MPV). MPV has therefore been suggested as a predictive marker for preeclampsia. We aimed to investigate MPV longitudinally in women with preeclampsia compared to healthy controls during pregnancy for potential early detection of preeclampsia and to compare potential MPV changes against the sFlt-1/PlGF ratio.Study Design: This longitudinal study included 38 women with preeclampsia and 84 women with normal pregnancies, where MPV and sFlt-1 and PLGF levels were determined every 4 weeks, starting in early pregnancy.Results: MPV was significantly higher in women who developed preeclampsia compared to women with normal pregnancies at 12, (p = .029), 24 (p = .011), 28 (p = .037), 32 (p = .002), and 36 weeks of gestation, respectively (p = .015). Further analysis revealed a cut-off point of 10.85 fl (sensitivity 65.6%, specificity 26.2%) for the prediction of preeclampsia. The sFlt-1/PlGF ratio was significantly higher in women who developed preeclampsia compared to women with normal pregnancies at the same time points (p = .001). The cut-off point for predicting preeclampsia was 10.3 (sensitivity 87.5%, specificity 11.9%). ROC curve analysis showed that MPV has a high predictive value for early-onset preeclampsia (p < .05) but not for late-onset preeclampsia.Conclusion: MPV is significantly elevated even in early pregnancy in women who develop preeclampsia and seems, therefore, a valuable predictor for preeclampsia even at early gestation. However, according to our results, MPV seems reliable in predicting early onset preeclampsia. [ABSTRACT FROM AUTHOR]

The cranial skeleton of the enigmatic gliding neodiapsid reptile Coelurosauravus elivensis (Lower Sakamena Formation, Lopingian, Southwestern Madagascar) is re-described in detail. All previously referred specimens are re-examined under both direct observations and Reflectance Transformation Imaging. Their exquisite preservation yields detailed three-dimensional information on the outline of individual bones and their osteological relationships, which are missing in the Laurasian remains. In contrast to previous studies, the ontogenetic maturity of all specimens is re-affirmed. Previously unidentified elements of the palate, braincase and mandible are described, and a novel reconstruction is proposed, including the first palatal reconstruction in a weigeltisaurid reptile. C. elivensis has the smallest skull of all weigeltisaurids and differs from other species in its facial ornamentation, parietosquamosal frill and larger anterior maxillary dentition. We also provide extensive comparisons with contemporaneous reptiles, possibly closely related taxa and more recent analogs, as well as a preliminary discussion of the functional anatomy of the peculiar cranial morphology of weigeltisaurids. The cranial skeleton is a truss construction with large orbits and temporal fenestrae. By analogy with extant chamaeleonids, the elongate parietosquamosal frill is associated with an increase in length and diameter of the temporal jaw adductors, resulting in an increased gape and/or bite force and speed. Additionally, the spikes and frills of weigeltisaurids most likely served as a display and defensive structure. [ABSTRACT FROM AUTHOR]

Little is known about the growing phenomenon of 'mentorship for "unaccompanied refugee minors"'. This article looks into one serious gap, based on a case study in Austria, asking: How do these young people, most of them seeking asylum, represent relationships in a mentorship programme? Here, youth mentoring is understood as a community-based form of social intervention carried out by an organisation that connects trained adult volunteers with young people. The findings from two multilingual group interviews focus on various dimensions of social support and social capital, e.g. with regard to settling in and life course transitions. Reacting to calls for methodological reflection in studies on the refugee experience, the article presents in detail the setting and approach, which partly built on the concept of the 'tripled Otherness of "unaccompanied minors"'. An analysis of their narrations is discussed against the wider context, particularly that of systematic discrimination by welfare agencies and efforts by various actors to rearrange URMs' differential inclusion. The conclusion proposes that research should better reflect the political dimension in mentoring for marginalised populations. It argues that the potential of such programmes should be tapped to develop progressive protection arrangements extending beyond the limits of the welfarist nation state. [ABSTRACT FROM AUTHOR]

A recent theoretical model predicts that the allometries of structures under sexual selection vary according to their functions in sexual interactions. Structures that are specialized for exclusive use as courtship devices, and not as weapons or threat devices, were predicted to tend to show low allometric values. Detailed observations of behavior and morphological design in Leseha vespa indicated that the sexually dimorphic abdominal tergite VIII of males functions to court females, but does not function as a weapon or in threats directed toward other males. As predicted by the theory, the allometric slope of tergite VIII length was lower than those of other body traits that were not modified for sexual interactions. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of chronic hyperglycemia in diabetes mellitus (DM) on spatial corneal thickness distribution and to analyze the influence of disease-specific factors. Methods: DM patients and healthy subjects were matched according to age and intraocular pressure (IOP). In diabetics, disease duration, DM type, and HbA1c value were assessed. Spatially resolved corneal thickness was measured by Pentacam HR. Thinnest corneal thickness (TCT) and peripheral pachymetry of concentric circles around TCT were determined. The Dynamic Scheimpflug Analyzer Corvis ST (CST) was used to measure the parameter pachy slope, which is an indicator of the change of corneal thickness from the apex to the periphery. Results: 59 DM patients and 57 healthy subjects were included. Age (P =.486) and IOP (P =.154) were not different between the groups. In DM, pachy slope was significantly higher than in healthy subjects (41.1 ± 9.87 vs. 35.18 ± 10.64 μm, P =.004). Also, the differences between TCT and the average of peripheral corneal thickness of concentric circles with a diameter of 2 mm (10.3 ± 1.7 vs. 9.3 ± 3.8 μm, P <.001) to 6 mm (82.2 ± 12.4 vs. 76.8 ± 12.6 μm, P =.011) were increased in patients. Changes in thickness profile were associated with HbA1c value and presence of diabetic retinopathy or maculopathy. Conclusion: In DM, a stronger peripheral corneal thickness increase was detectable. This change was shown using the novel CST parameter pachy slope and confirmed by Pentacam readings. These alterations might affect IOP and biomechanical measurements, and influence refractive procedures. [ABSTRACT FROM AUTHOR]

Here we describe a new species of a Pleistocene felid based on the distal third of a right humerus from the submerged El Pit cenote (sinkhole) near Tulum in Quintana Roo, Mexico. The new taxon, Panthera balamoides sp. nov., is characterized by a large entepicondylar foramen, a gracile and straight humeral shaft with a prominent supracondylar ridge with a small depression on the lateral epicondyle and a distal articular surface located medially with respect to the long axis of the shaft. Two felid clavicles from the same locality have been assigned to Panthera atrox, while a humerus fragment from the Kim Ha cave near Tulum likely corresponds to Smilodon gracilis. Panthera balamoides lines up with other likely endemic mammals in the region, which suggest that at least northern Quintana Roo, if not the entire Yucatán peninsula, may have been ecologically isolated during the Pleistocene, due to the repeated expansion of grassland. [ABSTRACT FROM AUTHOR]

Male courtship signals often stimulate female sense organs whose sensitivities originally evolved under natural selection. In classic female choice models of sexual selection, females can benefit from increasing their sensitivity and responsiveness to male stimuli; but in sexually antagonistic models, increased female sensitivity or responsiveness to males could increase the costs that females are thought to suffer from male stimulation. We tested these contrasting expectations in a previously discovered sexually dimorphic trait in the spider Leucauge mariana: 12 elongate setae on the female's sternum that are deflected by movements of the male's cheliceral fangs during copulation. By removing these setae, we tested whether this stimulation induces female responses that favor the male's chances of paternity. We found that these stimuli induced females to add a product crucial to the formation of copulatory plugs. These results do not fit expectations from sexually antagonistic coevolution models of sexual selection. This conclusion resembles the heretofore unappreciated implications of specialized female sense organs in other species, and of the temporary increases in female sensitivities and responsiveness to male stimuli during the breeding season in female fish and frogs. [ABSTRACT FROM AUTHOR]

The use of live animals in instruction plays an important role in biological education, with the intention that attitudes and emotions should be positively influenced. To date, studies in this field have given mixed results, and there has certainly been a lack of studies on student attitudes and knowledge of poisonous and venomous animals. This study focuses on the effect of the use of poisonous and venomous animals in biology instruction. Two treatment groups of Slovenian seventh and eighth graders (N = 123; age 12.3 and 13.2 years, respectively) were compared. The experimental group (N = 82) was given the opportunity to observe with adequate risk assessment live animal species. The observation of live poisonous and venomous animals led to higher values on different attitudinal dimensions. After instruction, we found no differences between both treatment groups in knowledge. Interest in learning about the different poisonous and venomous animals increased significantly. The level of disgust decreased for the viper, spider, and scorpion. However, 'fear' seems to be more stable and less influenceable than 'disgust'. We recommend that students should be offered as many first-hand experiences with live poisonous and venomous animals as possible mainly through informal learning environments, such as zoos. [ABSTRACT FROM AUTHOR]

This trial evaluated quality of life (QoL) using the EORTC QLQ-C30 and the EORTC QLQ-MY20 instruments in 90 patients with relapsed/refractory multiple myeloma during induction and maintenance therapy with eight cycles of ixazomib-thalidomide-dexamethasone, followed by 12 months of ixazomib maintenance therapy. When patient's baseline QoL was compared with data of the general population, a significant impairment in health-related QoL, physical, role, and social functioning and several other dimensions, as well as more pain and fatigue, was noted. Induction therapy resulted in significant improvement of pain and worsening of neuropathy, with no significant variation of other parameters. During maintenance treatment, scores for most dimensions including health-related QoL, physical functioning and pain, improved, while for neuropathy no improvement was observed. Time to deterioration (≥10 score points) of health-related QoL, physical functioning, pain, and neuropathy was distinctly shorter than time to progression. Health-related QoL and physical functioning at baseline correlated with overall survival. [ABSTRACT FROM AUTHOR]

Obesity is a well-established risk factor for colorectal cancer (CRC), but the association with the tumor microenvironment has been sparsely described. Herein, we examined the relationship between pre-diagnostic anthropometry and CRC risk according to tumor immune cell composition, with particular reference to potential sex differences. The density of different immune cell subsets was assessed by immunohistochemistry in tissue microarrays with tumors from 584 incident CRC cases in a prospective, population-based cohort (n = 28098). Multivariable Cox regression models, adjusted for age, smoking, alcohol intake, and educational level, were applied to calculate risk of immune marker-defined CRC in relation to quartiles of pre-diagnostic height, weight, body mass index (BMI), waist and hip circumferences, waist-hip ratio (WHR), and body fat percentage (BFP). Obesity was all over significantly associated with risk of CRC with low density of FoxP3+ T cells and low programmed cell-death protein 1 (PD-L1) expression on tumor cells, but with high density of CD8+ T cells and CD20+ B cells. In women, obesity was significantly associated with risk of PD-L1 high tumors (p= 0.009 for weight, p= 0.039 for BMI). Contrastingly, in men, obesity defined by all anthropometric factors was significantly associated with PD-L1 low tumors (p= 0.005 for weight, p = 0.002 for BMI, p<0.001 for waist, p= 0.011 for hip, p<0.001 for WHR, and p= 0.004 for BFP). In summary, obesity appears to influence the immune landscape of CRC, possibly in a sex-dependent manner. Thus, anthropometry and sex may be important factors to take into account when assessing the prognostic or predictive value of relevant complementary immune biomarkers. [ABSTRACT FROM AUTHOR]

Background: Non-technical skills (NTS) are essential for healthcare professionals. Earlier the students are made aware of this, the more time they have to acquire these skills. Escape rooms have been introduced in the medical literature but a detailed published manual on setting up and running such a learning modality is lacking. The purpose of this paper is to describe the use of an escape room to create learning opportunities, including detailed instructions, as well as an evaluation from two settings. Methods: A medical escape room focusing on NTS was developed and run in two different settings: a university summer school – EMSS17, and an international healthcare congress – EMS2018. Questionnaire data investigating entertainment value, self-evaluated use of NTS and ideas for further use of the escape room concept was obtained. Further, video analyses were conducted to triangulate self-rated analyses. Results: Majority of the participants found the escape room psychologically safe and enjoyable and would recommend the concept to other students and healthcare professionals. Video analyses showed the same tendencies regarding the use of NTS as reported by participants. Conclusions: This paper presents a fully applicable escape room manual, ready to implement, adapt, and modify. Evaluation data support the proof of concept. [ABSTRACT FROM AUTHOR]

Tailored for a complex application in the process industry, this article examines a multi-product production planning and scheduling problem with sequence-dependent setup cost and times. The manufacturing process is characterised by a two-stage structure where the sequencing problem occurs on the first level and contribution margin, holding cost, penalty cost are accounted on the second level. We present a hybrid mixed-binary optimisation model based on the general lot-sizing and scheduling problem [Fleischmann, B. and Meyr, H. 1997. The general lotsizing and scheduling problem. OR Spectrum, 19 (1), 11-21], which combines discrete and continuous-time elements within a standard inventory and lot-size (I&L) formulation. Since the I&L formulation does not provide sharp linear programming-relaxation bounds, we present two alternative reformulations based on a transportation problem. In a numerical study inspired by real industry data, we show that on average, both reformulations yield significant improvements in computation time and integrality gap. [ABSTRACT FROM AUTHOR]

Chelydropsis is a genus of the clade Pan-Chelydridae, which existed and was distributed in Eurasia from the Eocene to the end of the Pliocene. The Chelydropsis fossil record of North of the Alps is particularly rich throughout the Miocene. In this study, we describe a new Chelydropsis species from the Late Miocene (Vallesian, MN9) fossiliferous site of Höwenegg in southwestern Germany. The new species is based on a nearly complete Chelydropsis skeleton, which stands out among the best preserved and most complete specimens ever found until now. The new species, Chelydropsis heweneggensis sp. nov. is of particular importance. It differs from the coeval Chelydropsis murchisoni, which recent studies suggest is the only Chelydropsis species known to have existed in Europe from the Middle Miocene to the Pliocene. The species described herein thus adds to the diversity of the European Neogene Chelydropsis record. [ABSTRACT FROM AUTHOR]

Fibromyalgia is a chronic illness characterized by pain and fatigue. Persons with fibromyalgia experience increased the risk for poor mental and physical health-related quality of life, which may be dependent on multiple factors, including health beliefs, such as confidence in physicians and the health-care system, and health behaviors, such as treatment adherence. Respondents with fibromyalgia (n = 409) were recruited nationally, via support organizations, and completed self-report measures: Multidimensional Health Profile – Health Functioning Index (MHP-H), Short-Form-36 Health Survey (SF-36v2), and Medical Outcomes Study (MOS) Measure of Patient Adherence – General Adherence Items. In mediation models, belief in the healthcare system and health-care personnel, and health efficacy exerted an indirect effect through treatment adherence on mental and physical quality of life. Adaptive health beliefs and attitudes were related to greater treatment adherence and, in turn, to a better quality of life. Maladaptive health beliefs and mistrusting attitudes about physician-level and systemic-level healthcare provision are negatively related to both treatment adherence and consequent physical and mental health-related quality of life in persons with fibromyalgia. Future randomized controlled trials are needed to determine if therapeutic strategies to alter health values might improve adherence and self-rated health. [ABSTRACT FROM AUTHOR]

We generalize the outer subdifferential construction suggested by Cánovas, Henrion, López and Parra for max type functions to pointwise minima of regular Lipschitz functions. We also answer an open question about the relation between the outer subdifferential of the support of a regular function and the end set of its subdifferential posed by Li, Meng and Yang. [ABSTRACT FROM AUTHOR]

Introduction: The demarcation line (DL) observed since the pioneering crosslink (CLX) protocol at the posterior edge of the cross-linked stroma has been universally accepted as a therapeutic milestone of treatment. Numerous laboratory and clinical CXL studies demonstrate that a deeper DL is associated with a higher amount and saturation level of crosslinks, a more pronounced stiffening effect, and a more durable ectasia stability. Areas covered: A critical revision of laboratory, clinical, and analytical studies on the DL depth supports the significance of the DL as an evaluator of the performance of CLX procedures in terms of biomechanical efficacy and safety avoiding extensive experiments. A mechanical approach based on experimental data shows that the DL depth obtained with different CXL protocols relates with an asymptotic non-linear increasing function to the modified biomechanical corneal stiffness (elastic modulus). Expert opinion: The strong connection between the depth of the DL and the increase of the biomechanical efficacy can be explained by means of UV cross-linking chemical investigations demonstrating that only a limited amount of free reactive collagen residues is involved in the short-wave UV-mediated CXL. Thus, the CXL density can rise only up to an upper boundary value, i.e. the saturation value. [ABSTRACT FROM AUTHOR]