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BACKGROUND: By the beginning of December 2020, some vaccines against COVID-19 already presented efficacy and security, which qualify them to be used in mass vaccination campaigns. Thus, setting up strategies of vaccination became crucial to control the COVID-19 pandemic. METHODS: We use daily COVID-19 reports from Chicago and New York City (NYC) from 01-Mar2020 to 28-Nov-2020 to estimate the parameters of an SEIR-like epidemiological model that accounts for different severity levels. To achieve data adherent predictions, we let the model parameters to be time-dependent. The model is used to forecast different vaccination scenarios, where the campaign starts at different dates, from 01-Oct-2020 to 01-Apr-2021. To generate realistic scenarios, disease control strategies are implemented whenever the number of predicted daily hospitalizations reaches a preset threshold. RESULTS: The model reproduces the empirical data with remarkable accuracy. Delaying the vaccination severely affects the mortality, hospitalization, and recovery projections. In Chicago, the disease spread was under control, reducing the mortality increment as the start of the vaccination was postponed. In NYC, the number of cases was increasing, thus, the estimated model predicted a much larger impact, despite the implementation of contention measures. The earlier the vaccination campaign begins, the larger is its potential impact in reducing the COVID-19 cases, as well as in the hospitalizations and deaths. Moreover, the rate at which cases, hospitalizations and deaths increase with the delay in the vaccination beginning strongly depends on the shape of the incidence of infection in each city.

Action-stopping in humans involves bursts of beta oscillations in prefrontal-basal ganglia regions. To determine the functional role of these beta bursts we took advantage of the Race Model framework describing action-stopping. We incorporated beta bursts in three race model variants, each implementing a different functional contribution of beta to action-stopping. In these variants, we hypothesized that a transient increase in beta could 1) modulate decision thresholds, 2) change stop accumulation rates, or 3) promote the interaction between the Stop and the Go process. We then tested the model predictions using EEG recordings in humans performing a Stop-signal task. We found that the model variant in which beta increased decision thresholds for a brief period of time best explained the empirical data. The model parameters fitted to the empirical data indicated that beta bursts involve a stronger decision threshold modulation for the Go process than for the Stop process. This suggests that prefrontal beta influences stopping by temporarily holding the response from execution. Our study further suggests that human action-stopping could be multi-staged with the beta acting as a pause, increasing the response threshold for the Stop process to modulate behavior successfully. Our novel approach of introducing transient oscillations into the race model and testing against human neurophysiological data allowed us to discover potential mechanisms of prefrontal beta, possibly generalizing its role in situations requiring executive control over actions.

Optimizing the positive end-expiratory pressure remains challenging for any clinician treating a patient with acute respiratory distress syndrome. This paper presents an approach to automate a PEEP titration maneuver and identify the best PEEP according to maximal compliance. The respiratory system was modeled by a single-compartment model, and parameters were estimated using multiple linear regression. A classifier identified the best PEEP using the scaled relative change in compliance between PEEP levels based on empirical data from previous manual PEEP titrations. An experimental system allows the in vivo testing of the automated PEEP titration, including additional safety measures. The complete system was tested in a single animal experiment and correctly identified the best PEEP. The introduced system is a step closer towards an automated, standardized PEEP optimization and closed-loop control of mechanical ventilation.

Background Condition-specific quality of life (QoL) instruments are more representative of the priorities of people with lived experience. As such, the development of the first and only bipolar disorder (BD) specific measurement instrument, the Quality of Life in Bipolar Disorder (QoL.BD) questionnaire, marked an important step forward for the literature. The present systematic review aims to characterise applications of the QoL.BD in the BD literature and review empirical findings obtained from studies using this measure. Methods A systematic search identified 37 peer-reviewed publications which reported original empirical data using the QoL.BD in a BD population. No restrictions were placed on language/study type. Results Adaptations to the QoL.BD displayed appropriate psychometric properties. Although clinical trials were typically underpowered, promising effect sizes for a number of treatment modalities were reported. QoL.BD scores were moderately correlated with depressive symptoms; a number of candidate predictors were identified. Limitations Due to resource limitations, the present review used one database (Google Scholar), and a single author reviewed articles for eligibility. On balance the risks of missing relevant studies were deemed minimal. Conclusion A sizeable, international body of evidence now exists regarding the measurement, presentation, and treatment of condition-specific aspects of QoL in BD. Key avenues for future research include large scale, randomized control clinical trials using the QoL.BD as a primary outcome, and granular exploration of potential correlates of QoL.BD domain scores. Finally, longer follow-up periods are required to inform understanding of the dynamic relationship between clinical variables and condition-specific aspects of QoL in BD.

As the occurrence of traumatic events has increased in mainstream media the study of Trauma-Related Sleep Disturbance (TRSD) has gained more traction within the field of sleep health. TRSD is prevalent in youth and can have deleterious outcomes that impact function, yet empirical data that examine this topic are limited. This review seeks to highlight the extant literature focusing on TRSD and to identify critical areas of future research.

SUMMARY Super-spreading events in an outbreak can change the nature of an epidemic. Therefore, it is useful for public health teams to determine if an ongoing outbreak has any contribution from such events, which may be amenable to interventions. We estimated the basic reproductive number (R0) and the dispersion factor (k) from empirical data on clusters of epidemiologically-linked COVID-19 cases in Hong Kong, Japan and Singapore. This allowed us to infer the presence or absence of super-spreading events during the early phase of these outbreaks. The relatively large values of k implied that large cluster sizes, compatible with super-spreading, were unlikely.

Much of service-learning research has been characterized as anecdotal and testimonial with widespread calls for more empirical data to support the claimed benefits of this pedagogical tool. The present longitudinal experiment answered these calls by testing the effect of service-learning projects on several oral communication skills during a 4-month period, as well as some boundary conditions affecting this impact. The intervention consisted of involvement in 1 of 20 different team-developed service-learning projects compared to traditional research projects. This was hypothesized to boost management students' public speaking self-efficacy, lower anxiety, and improve public speaking mechanics competence along with actual public speaking performance (evaluated by independent raters). Results indicated that a wide array of service-learning projects can positively impact students in each of these important areas of public speaking. It was also found that service-learning more strongly benefited those initially lower in public speaking self-efficacy. Thus, this experiment suggests that instructors can include a service-learning component in their courses that can aid students’ oral communication skill development.

Urban greenery such as trees can effectively reduce air pollution in a natural and eco-friendly way. However, how to spatially locate and arrange greenery in an optimal way remains as a challenging task. We developed an agent-based model of air pollution dynamics to support the optimal allocation and configuration of tree clusters in a city. The Pareto optimal solutions for greenery in the city were computed using the suggested heuristic optimisation algorithm, considering the complex absorptive-diffusive interactions between agent-trees (tree clusters) and air pollutants produced by agent-enterprises (factories) and agent-vehicles (car clusters) located in the city. We applied and tested the model with empirical data in Yerevan, Armenia, and successfully found the optimal strategy under the budget constraint: planting various types of trees around kindergartens and emission sources.

After over a century of orthopaedic attention, injuries to the posterior cruciate ligament (PCL) continue to pose a significant management challenge. Isolated PCL tears constitute the minority of cases, with multiligament trauma (most commonly posterolateral corner injuries) predominating. Surgical reconstruction of the PCL remains technically demanding. Historical long-term outcomes have been associated with persisting knee instability and secondary degenerative arthrosis, irrespective of surgical intervention. The past two decades have witnessed a renewed focus on understanding the anatomy and biomechanics of the PCL, and its spectrum of injury. This, along with advancements in surgical technology and techniques, has heralded a renewed impetus for operative reconstruction. While there remains no clinically demonstrated difference in outcomes of double-bundle surgery over single-bundle reconstruction, many prefer a double bundle approach due to empirical data supporting its biomechanical superiority. Concomitant bony realignment in the coronal and sagittal plane should be considered where necessary. Graft reinforcement is an emerging concept that may aid in protecting the neoligament during the early healing phase. With modern approaches, there are increasing reports of more favourable short and mid-term post-operative outcomes. Despite this, most studies remain of a low level of evidence, with relatively small case series, and there is a paucity of well-designed controlled studies contrasting operative techniques.

There is substantive evidence for the importance of physical activity (PA) for people with mental illness (MI). Health care providers play an integral role in helping individuals with MI engage in PA, yet there are numerous factors that impede the promotion of PA within clinical practice. Objective The purpose of this review was to identify and theoretically analyze the barriers and facilitators for health care providers in promoting PA to individuals with MI. Methods A scoping review with systematic searches was conducted. Eligible studies required sample populations of health care providers working with individuals with MI that reported empirical data on barriers and/or facilitators to PA promotion using quantitative and/or qualitative methods. Barriers and facilitators were extracted and classified into the fourteen domains of the Theoretical Domains Framework (TDF). Results Thirty-three studies were included (15 quantitative, 12 qualitative, 6 mixed-methods), with a total of 231 factors extracted and coded to the TDF domains. Barriers and facilitators were most often classified under the domains of ‘Beliefs about Consequences’ and ‘Environmental Context & Resources’. The most common barriers to PA promotion was a belief that clients could not overcome barriers to PA engagement, and a lack of training on how to promote PA to individuals with MI. Conclusions Education and training that incorporates behaviour change techniques for health care providers are needed to address the identified barriers and to facilitate implementation of clinical guidelines into practice. Greater integration of PA promotion within mental health care will likely require broader systemic change.

Background A critical adaptation strategy for reducing heat-related health risk under climate change is to establish a heat warning system with a proper threshold that requires evaluation of heat-health relationships using empirical data. Objectives This work presents a new approach to selecting proper health-based thresholds for a heat warning system which are different from thresholds of heat-health relationship. Methods The proposed approach examined heat-health relationships through analyzing 15 years of health records with a modified generalized additive model (GAM), compared risk ratio increments (RRIs) of threshold candidates against a reference, assessed frequency of days above these candidates, and presented results graphically for easy communication. The candidate with the maximum RRI and proper occurring frequency is potentially the best threshold. Three heat indicators, including wet-bulb globe temperature (WBGT), temperature (T), and apparent temperature (AT), as well as three health outcomes, including all-cause mortality, heat-related hospital admissions, and heat-related emergency visits were evaluated. Results Risk ratios for all three health outcomes showed a consistent rising trend with increasing threshold candidates for all three heat indicators among different age and gender groups. WBGT had the most obvious increasing trend of RRIs with the three health outcomes. The maximum RRI was observed in heat-related emergency visits (242%), followed by heat-related hospital admissions (73%), and all-cause mortality (9%). The RRIs assessed for the three health outcomes pointed to the same thresholds, 33.0 °C, 34.0 °C, and 37.5 °C for WBGT, T, and AT, respectively. The number of days above these thresholds and for warning to be issued ranged between 0 and 7 days during 2000–2014. Discussion This study demonstrated a new approach to determining heat-warning thresholds with different heat indicators and health outcomes. The proposed approach provides a straightforward, feasible, and flexible scientific tool that assists the authorities around the world in selecting a proper threshold for a heat warning system., Highlights • This work shows a new approach to select proper thresholds for heat warning systems. • Modified generalized additive model and risk ratio increments (RRIs) were applied. • Threshold of wet-bulb globe temperature (WBGT) at 33.0 °C were identified for Taiwan. • WBGT had the most obvious increasing trend of RRIs among three heat indicators. • The maximum RRI of WBGT was observed in emergency visits (242%).

Although some studies suggest a possible association between food allergy (FA) and depression/psychological distress, empirical data are still scarce. We aimed to examine whether this association exists in a large sample of the Japanese population.This web-based cross-sectional survey included 1000 individuals with self-reported lifetime history of clinical depression (mean age: 41.4 years, 501 men), and the remaining 10,876 subjects served as controls (mean age: 45.1 years, 5691 men). A six-item Kessler scale (K6) test was used to evaluate severe psychological distress. Information on FA was obtained by a self-report checking for 27 specific allergens.Participants with FA, 2 or more, 3 or more, and 4 or more allergens were more common in the depression group than in the control group (odds ratio [OR] = 1.64, 1.75, 2.02, and 2.27, respectively; p 0.001). In the allergen analyses, allergies for shrimp, egg, mackerel, crab, kiwi fruit, milk, banana, and squid (nominal, p 0.05) were more common in the depression group than in the controls. The proportion of individuals who had a K6 test cut-off score ≥ 13 was higher in the FA group than in the non-FA group, in the total sample (OR = 1.32, 1.62, 2.04 and 2.51; 1, 2, 3, and 4 or more allergens, respectively; p 0.001).The identification of FA and depression was based on self-reports.Our data suggest that FA is a risk factor for depression and severe psychological distress, which depends on the number of allergens.

There is a growing body of investigations showing that shame and guilt are important features of various psychological problems including anxiety disorders. This study quantitatively summarized the magnitude of the associations of shame and guilt with anxiety symptoms. We looked both at the associations with broader categories of anxiety symptoms (i.e., undifferentiated anxiety symptoms, trait and state anxiety), but also with symptoms specific to individual anxiety disorders. In most cases, shame was more strongly associated with anxiety symptoms (in general medium effect sizes) than guilt (in general small effect sizes). When controlling for the shared variance of shame and guilt, in most cases only shame remained significantly associated with anxiety symptoms. Moderation analyses testing for the effect of subtype of shame/guilt, type of measurement, clinical status, age and gender were conducted. Two types of guilt seem to be equally maladaptive as shame, generalized guilt (involving a free-floating guilt separated from specific contexts) and contextual-maladaptive guilt (involving an inappropriate or exaggerated feeling of responsibility). External shame (perceived negative evaluations of others) seems to be more strongly associated with social anxiety symptoms than internal shame (negative self-evaluations). Results for other moderators and implications are discussed in light of the existing theoretical and empirical data.

Objectives Randomised clinical trials (RCTs) are costly. We aimed to provide a systematic overview of the available evidence on resource use and costs for RCTs to support budget planning. Study Design and Setting We systematically searched MEDLINE, EMBASE and HealthSTAR from inception until November 30, 2016 without language restrictions. We included any publication reporting empirical data on resource use and costs of RCTs and categorised them depending on whether they reported (i) resource and costs of all aspects at all study stages of an RCT (including conception, planning, preparation, conduct, and all tasks after the last patient has completed the RCT); (ii) on several aspects, (iii) on a single aspect (e.g. recruitment); or (iv) on overall costs for RCTs. Median costs of different recruitment strategies were calculated. Other results (e.g. overall costs) were listed descriptively. All cost data were converted into USD 2017. Results A total of 56 articles that reported on cost or resource use of RCTs were included. None of the articles provided empirical resource use and cost data for all aspects of an entire RCT. Eight articles presented resource use and cost data on several aspects (e.g. aggregated cost data of different drug development phases, site specific costs, selected cost components). Thirty-five articles assessed costs of one specific aspect of an RCT (i.e. 30 on recruitment; 5 others). The median costs per recruited patient were USD 409 (range: USD 41-6,990). Overall costs of an RCT, as provided in 16 articles, ranged from USD 43-103,254 per patient, and USD 0.2-611.5 Mio per RCT but the methodology of gathering these overall estimates remained unclear in 12 out of 16 articles (75%). Conclusion The usefulness of the available empirical evidence on resource use and costs of RCTs is limited. Transparent and comprehensive resource use and cost data are urgently needed to support budget planning for RCTs and help improve sustainability.

Individuals at risk of developing anxiety and those with (sub-) clinical anxiety have robust attention biases to irrelevant threats, among them facilitated engagement, difficulty in disengaging and later avoidance of threat. These attention biases are thought to be associated with abnormal activation and connectivity in prefrontal-limbic-sensory neural circuits. Attention biases were shown to be related to other processing biases, but more empirical data are needed to better understand the causal role of each processing bias and to develop effective treatments. These attention biases have further been suggested as playing a causal role in anxiety, although mixed findings from attention bias modification studies challenge this contention.

Grapevine trunk diseases threaten grape production worldwide. In California, preventative practices (delayed pruning, fungicide applications after pruning) that reduce infections of pruning wounds by pathogen spores produced with rain are timed during the dormant season, when high spore-trap counts of the causal fungi are reported from studies in mature, symptomatic vineyards. Similar studies in young, asymptomatic vineyards are lacking. Given infrequent usage by California growers of preventative practices in young vineyards, empirical data on spore detection may provide convincing evidence to start preventing trunk diseases before symptoms appear. Active and passive spore traps were examined after rain from December to March for four years (2013–2017) in six young, asymptomatic (

Little empirical data support the use of telemedicine to provide medical and developmental follow-up care to preterm and high-risk infants after hospital discharge. Nevertheless, the COVID-19 pandemic temporarily rendered telemedicine the only means by which to provide essential follow-up care to this population. In this article we discuss our institution's experience with rapid implementation of telemedicine in a multi-site neonatal follow-up program as well as benefits and limitations of the use of telemedicine in this context. Finally, we discuss the current problems that must be solved in order to optimize telemedicine as a tool for providing comprehensive, multidisciplinary medical and developmental care to high risk infants and their families.

International audience; Food waste is a burning issue, one that is both local and global. Although most consumers hate wasting and do not intend to waste, they still end up wasting food. By focusing on routines that prevent waste rather than on waste behaviours, and by defining and measuring consumer concern for food waste (CFW), this study seeks to address this apparent contradiction. A follow-up to three preliminary studies, this quantitative study proposes a valid and reliable measure of CFW, and examines the links between CFW, the antecedents of this concern, and seven waste-prevention routines. Empirical data reveals two dimensions of CFW that have a very distinct influence on food-related and waste-prevention routines. The first, “individual/interpersonal concern”, has a strong relationship with these routines, whereas the second, “global concern”, has no significant relationship with them. For researchers, the authors provide a model integrating the antecedents and behavioural consequences of CFW. For both policy makers and managers seeking to reduce food waste at the household level, this research provides recommendations to have an impact on food-waste-related behaviours through individual/interpersonal CFW and its proven antecedents (economic concerns, food involvement, food education).

The ICH M7(R1) guideline describes a framework to assess the carcinogenic risk of mutagenic and carcinogenic pharmaceutical impurities following less-than-lifetime (LTL) exposures. This LTL framework is important as many pharmaceuticals are not administered for a patient's lifetime and as clinical trials typically involve LTL exposures. While there has been regulatory caution about applying LTL concepts to cohort of concern (COC) impurities such as N-nitrosamines, ICH M7 does not preclude this and indeed literature data suggests that the LTL framework will be protective of patient safety for N-nitrosamines. The goal was to investigate if applying the LTL framework in ICH M7 would control exposure to an acceptable excess cancer risk in humans. Using N-nitrosodiethylamine as a case study, empirical data correlating exposure duration (as a percentage of lifespan) and cancer incidence in rodent bioassays indicate that the LTL acceptable intake (AI) as derived using the ICH M7 framework would not exceed a negligible additional risk of cancer. Therefore, controlling N-nitrosamines to an LTL AI based on the ICH M7 framework is thus demonstrated to be protective for potential carcinogenic risk to patients over the exposure durations typical of clinical trials and many prescribed medicines.

Purpose We explored caregiving variables that may significantly affect treatment outcomes in patients with left-ventricular assist devices (LVAD) post-hospital discharge. Specific aims were to examine the pattern and change of caregivers’ self-efficacy (ie, self-confidence) and adherence to support patients with LVAD care over 6 months. Methods This observational study included 34 adults designated as primary caregivers for patients implanted with durable LVAD for the first time. Caregivers' demographics, self-efficacy, and adherence data were collected at 1, 3, and 6 months post-discharge. Caregivers completed LVAD Self-Efficacy (21 items) and Home Management Adherence (17 items) Scales. Both instruments use 0 to 5 response scales; higher scores imply better outcomes. Data were analyzed with SPSS 25.0. Results Caregivers’ mean age was 54.0 ± 13.8 years, mostly White (60%), female (70%), and had some college education or higher (62.5%). Half were married with some form of health condition (52.5%) managed by medications (55%). Caregivers’ self-efficacy scores significantly increased over time: Mean = 4.37 ± .64 (month 1), 4.63 ± .53 (month 3), and 4.80 ± .44 (month 6), p = .007. On the contrary, their adherence scores significantly decreased over time: Mean = 2.60 ± 1.50 (month 1), 1.89 ± 1.50 (month 3), and 1.90 ± 1.52 (month 6), p = .039. Conclusion We report the first longitudinal data describing the caregivers' self-efficacy and adherence in helping patients perform daily LVAD care post-hospital discharge. As expected, caregivers' confidence increased over time. The decrease in adherence may be related to patients' increasing independence with self-management over time or caregiver complacency. Future research should examine the mechanism of the presently observed self-efficacy and adherence patterns in large patient-caregiver dyad study. Additional studies are needed to determine the degree to which caregiving behaviors affect patient outcomes, and to obtain empirical data supporting or refuting the need for 24/7 caregiver assistance for LVAD implant selection and long-term care.

Violence can lead to posttraumatic stress disorder (PTSD), which in turn is related to perpetration of aggression. Importantly, not all aggression is motivated by the same mechanisms, and understanding the driving force behind the aggression is imperative in order to select treatments that will assist the individual in decreasing the behavior. PTSD is specifically related to impulsive aggression, or aggression that is emotionally charged and uncontrolled, rather than premeditated aggression, which is planned, unemotional, and goal-directed. Emotion regulation, or the ability to recognize emotions, accept them, and control emotion-related behaviors, is related to both PTSD and impulsive aggression. This conceptual paper uses the Catalyst Model to review the literature on PTSD, impulsive aggression, and emotion regulation. Because of their high rates of PTSD, veterans are presented as a demonstration of the relationship between emotion regulation and impulsive aggression. The integrative model can be viewed as an alternative to the traditional model that proposes anger is the primary underlying mechanism of impulsive aggression in adults. Treatment recommendations, such as helping clients develop emotion regulation skills, are offered for providers who are working with individuals who have experienced trauma and who are now perpetrating impulsive aggression.

We combined an epidemic model with an objective function to minimize the weighted sum of people with excess weight and the cost of a medication and surgical intervention in the population. The epidemic model is consisted of ordinary differential equations to describe three subpopulation groups based on weight. We introduced an intervention using medication and surgery to deal with excess weight. An objective function is constructed taking into consideration the cost of the intervention as well as the weight distribution of the population. Using empirical data, we show that fixed participation rate reduces the size of obese population but increases the size for overweight. An optimal participation rate exists and decreases with respect to time. Both theoretical analysis and empirical example confirm the existence of an optimal participation rate, u ⁎ . Under u ⁎ , the weighted sum of overweight (S) and obese (O) population as well as the cost of the program is minimized. This article highlights the existence of an optimal participation rate that minimizes the number of people with excess weight and the cost of the intervention. The time-varying optimal participation rate could contribute to designing future public health interventions of excess weight.

Background Biodiesel produced primarily from plants and algal feedstocks is believed to have advantages for production and use compared to petroleum and to some other fuel sources. There is some speculation that exposure to biodiesel combustion emissions may not induce biological responses or health effects or at a minimum reduce the effects relative to other fuels. In evaluating the overall environmental and health effects of biodiesel production to end use scenario, empirical data or modeling data based on such data are needed. Scope of review This manuscript examines the available toxicology reports examining combustion derived biodiesel emissions since approximately 2007, when our last review of the topic occurred. Toxicity derived from other end uses of biodiesel - e.g., spills, dermal absorption, etc. - are not examined. Findings from biodiesel emissions are roughly divided into three areas: whole non-human animal model exposures; in vitro exposures of mammalian and bacterial cells (used for mutation studies primarily); and human exposures in controlled or other exposure fashions. Major conclusions Overall, these more current studies clearly demonstrate that biodiesel combustion emission exposure- to either 100% biodiesel or a blend in petroleum diesel- can induce biological effects. There are reports that show biodiesel exposure generally induces more effects or a greater magnitude of effect than petroleum diesel, however there are also a similar number of reports showing the opposite trend. It is unclear whether effects induced by exposure to a blend are greater than exposure to 100% biodiesel. Taken together, the evidence suggest biodiesel emissions can have some similar effects as diesel emissions on inflammatory, vascular, mutagenic, and other responses. General significance While acute biodiesel exposures can show toxicity with a variety of endpoints, the potential effects on human health need further validation. Additionally there are few or no findings to date on whether biodiesel emissions can induce effects or even a weaker response that petroleum diesel with repeated exposure scenarios such as in an occupational setting. This article is part of a Special Issue entitled Air Pollution, edited by Wenjun Ding, Andrew J. Ghio and Weidong Wu.

The article presents empirical data obtained in a study into the causes of children abuse in formally well-to-do families, the analysis of which enabled us to identify and describe the conditions for primary children abuse prevention in preschool educational organizations. Conditions for primary prevention are revealed by the author from the point of an event approach and a principle of non-violence used as the leading one in developing programs aimed at providing the child with a certain level of consciousness and self-reliance in activity manifestation.

Modern psychology has accumulated large amounts of data from theoretical and empirical studies on aggression and creativity as phenomena that are independent of each other. The article presents a synthesis of empirical data on the relationship between aggression and creativity in children of the senior preschool age. The findings reveal gender differences in the manifestation of aggression and creativity in preschool children. We believe that correctional and developmental work with senior preschool children can contribute to redesigning aggression and developing creativity.

Background For most adolescent and young adult (AYA) cancers, age-specific molecular features are poorly understood. SPECTA, an academic translational research infrastructure for biomaterial collection and molecular analysis, will explicitly recruit AYA patients and will therefore collect empirical data to bridge the molecular gap between pediatric and adult oncology. Trial Design The initial pilot study, activated in February 2019 across Europe, will recruit 100 patients aged 12-29 years with newly diagnosed or relapsed high-grade gliomas and high-grade bone and soft tissue sarcomas. The primary objective of the pilot is to determine feasibility and recruitment rates. Formalin-fixed tumor tissue, whole blood and clinical data from study participants will be prospectively collected; the biomaterial will be stored centrally at the Integrated BioBank of Luxembourg (IBBL). Whole exome sequencing (WES) of matched tumor and blood, and tumor RNA sequencing and DNA methylation profiling will be performed at the German Cancer Research Center (DKFZ), Heidelberg. Virtual central pathology review of scanned diagnostic slides will be undertaken by an international expert panel, and diagnostic material returned to the participating centers. A multidisciplinary molecular tumor board will release a clinically validated report to referring clinicians within 4-6 weeks after biopsy. SPECTA-AYA constitutes a major opportunity to gain knowledge about the tumor biology of this unique age group. It incorporates notable innovative aspects: AYA specificity, pan-European academic collaboration, centralized biobanking, comprehensive molecular profiling, and virtual central pathology review, among others. SPECTA-AYA will help untangle the tumor particularities of AYAs with cancer and aims to improve their access to novel drugs and personalized medicine. Legal entity responsible for the study EORTC (European Organisation for Research and Treatment of Cancer). Funding Walgreens Boots Alliance. Disclosure W. Van der Graaf: Research grant / Funding (self): Novartis; Honoraria (institution), Advisory / Consultancy: Bayer. F. Bielle: Research grant / Funding (self), Shareholder / Stockholder / Stock options, Spouse / Financial dependant: Celgene; Research grant / Funding (self), Shareholder / Stockholder / Stock options, Spouse / Financial dependant: Crossject; Research grant / Funding (self), Shareholder / Stockholder / Stock options, Spouse / Financial dependant: Sanofi; Research grant / Funding (self), Shareholder / Stockholder / Stock options, Spouse / Financial dependant: AbbVie. M. Preusser: Honoraria (self): Bayer; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Novartis; Honoraria (self): Gerson Lehrman Group (GLG); Honoraria (self): CMC Contrast; Honoraria (self): GlaxoSmithKline; Honoraria (self): Mundipharma; Honoraria (self): Roche; Honoraria (self): Astra Zeneca; Honoraria (self): AbbVie; Honoraria (self): Lilly; Honoraria (self): Medahead; Honoraria (self): Daiichi Sankyo; Honoraria (self): Merck Sharp & Dohme. S. Frohling: Advisory / Consultancy, Travel / Accommodation / Expenses: Bayer; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Honoraria (self), Travel / Accommodation / Expenses: Amgen; Honoraria (self), Travel / Accommodation / Expenses: Eli Lilly; Honoraria (self), Research grant / Funding (self), Travel / Accommodation / Expenses: PharmaMar; Research grant / Funding (self): AstraZeneca; Research grant / Funding (self): Pfizer. M.G. McCabe: Advisory / Consultancy: Ipsen Pharma. All other authors have declared no conflicts of interest.

Doehl et al. have combined empirical data with computer simulation to demonstrate that RAG-2 mice intravenously infected with Leishmania donovani form heterogeneous skin parasite patches that govern infectiousness to sand flies. This model provides a much-needed tool to explore the relevance of asymptomatic and symptomatic visceral leishmaniasis patients as infection reservoirs.

Introduction Various invasive medical procedures can cause bacteremia and, therefore, cause infectious endocarditis. However, empirical data in humans on the potential dangers of invasive medical procedures in this regard are very sparse. In the absence of sufficient data, it is currently debated whether the risk of endocarditis with these procedures is substantial or rather negligible. The objective of this case study was to quantify the excess risk of infectious endocarditis in association with invasive medical and surgical procedures. Methods The study involved 118 patients hospitalized for infectious endocarditis in the cardiology department of CHU Ibn Rochd Casablanca. The study included all invasive medical procedures in the 12 weeks preceding the onset of endocarditis; with the exception of those likely to be undertaken due to: endocarditis or septicemia or due to infections which may eventually lead to endocarditis. Results 112 cases of infectious endocarditis were recorded during the study period. Among which 17 patients (15.6%) had undergone invasive procedures: 47% central KT; 17.6% skin procedures; 11.8% pacemaker; 23.6% endoscopy; insertion of IUD and dental prosthesis. Conclusion This study suggests that several invasive medical procedures are associated with a markedly increased risk of infectious endocarditis.

Regular cannabis use and cannabis use disorder (CUD) have become increasingly prevalent in the United States over the past two decades. Theory and empirical data suggest that the incentive salience of cannabis cues is important to the development and chronicity of CUD. Cannabis cue incentive salience is often assessed with a cannabis cue reactivity paradigm wherein cannabis-related and neutral images are presented. However, prior cannabis cue reactivity studies have been limited by the use of heterogeneous stimuli that were not properly characterized across motivational/affective characteristics, physical image attributes, or non-cannabis-related salient image features (e.g., human presence, face visibility). In order to increase standardization and flexibility of future cannabis cue reactivity tasks, the aim of the present study was to develop and validate a cannabis cue and matched neutral image database comprised of motivational/affective ratings as well as physical image attributes. 234 regular cannabis users varying in primary use method (i.e., bowl, blunt/joint, bong, vaporizer) made motivational (i.e., urge to smoke cannabis) and affective (i.e., arousal, valence) ratings of cannabis-related and neutral images matched on salient, non-cannabis-related features. Physical features (hue, saturation, value) of each image were also analyzed. Motivational/affective ratings of cannabis-related and neutral images differed as expected, and cannabis use frequency and cannabis craving correlations with cannabis image ratings generally supported stimulus validity. Motivational/affective ratings did not significantly differ across cannabis use method-specific images. This database may be a useful tool for future behavioral and neuroscience research on cannabis cue reactivity.

Introduction Psychiatric disorders cause a high burden of disease and disability for the society. Liquid biopsies provide potent opportunities for screening programs, diagnosis, prognostic stratification and treatment monitorization. Previously, the liquid biopsy studies were mainly focused on the several malignancies without proper screen methods, but this approach has also a strong potential for decreasing disease burden in CNS pathologies. The main restriction for the diagnosis of CNS diseases is the lack of the methods to receive biochemical/functional information form a tightly enveloped compartment. The hypothesis/theory In this proposal, we aim to develop a fast and cheap diagnostic platform based on the detection of exosomes originating from the central nervous system (CNS) cells. We intended to develop a sensor device with minimum maintenance costs, which is highly specific and sensitive for psychiatric diseases. Evaluation of the hypothesis/idea In order to give background information for our proposal; we began with reviewing the concept of liquid biopsies and adaptation of this concept for psychiatric disorders. Then we discussed the conventional and novel methods for the detection of extracellular vesicles (EV). Furthermore, we discussed the detection of exosomes originating from central nervous system and methods analyzing the content of the EVs. Additionally, we reviewed the imaging techniques for detection and visualization of EVs. Empirical data We used in silico research tools (MetaCore™ version 6.37, Clarivate Analytics, and ExoCarta database) to detect appropriate disease specific exosomal markers. We proposed our design for the detection of EVs based on the immune-capture of EVs and detection of surface antigens via the antibody conjugated fluorophores. We also proposed a design to increase the channels for detection of exosomal antigens by using bioinformatics methods, including pathway networks, RDOC matrices and exosome databases which we called “Mentalexo” approach. We applied this approach on depression and addiction disorders in order to find appropriate exosomal markers. Consequences of the hypothesis and discussion We believe that our proposal may contribute to the conception of new diagnostic devices focusing on the detection of exosomes in psychiatric conditions.

Microbiological surveillance of ready-to-eat (RTE) meat products provides empirical data to inform scientific guidance for improving food safety. In this study we conducted the first nation-wide survey of food-borne pathogens in RTE meat products in China in 2013. We analyzed the prevalence of food-borne pathogen in different product categories, market distribution, packaged forms, seasonal variation and regions. In total, 4047 samples were collected from all seven regions in China representing distinct geographical areas: Northern, Northeastern, Eastern, Central, Southern, Southwestern, and Northwestern Regions. Samples were collected from catering, retail, and wholesale sources in different seasons throughout the course of the year. The presence of Listeria monocytogenes, Salmonella spp. , Staphylococcus aureus and diarrheagenic Escherichia coli in all the samples was examined by China's national food safety standard method. All the surveillance data were analyzed according to meat product category, market distribution, packaged form, seasonal variation and regions, respectively. Microbial prevalence of L. monocytogenes, Salmonella spp., S . aureus and diarrheagenic E. coli were detected in 1.43% (57/3974), 0.64% (26/4035), 0.79% (32/4047) and 1.06% (40/3774), respectively. The prevalence of heat-treated category RTE meat products was high, probably due to cross contamination. Prevalence data for Salmonella spp. and S. aureus were higher in the third quarter of the year. We found packaging method played a consistent role in the prevalence of all four food-borne pathogens in packaged ready-to-eat meat products. Bulk ready-to-eat meat products were significantly more likely to contain contamination than portion packaged products. In all, this study implied a potential public health problem. It is necessary to improve control measures of RTE meat products.

Mathematical models have been used to study Ebola disease transmission dynamics and control for the recent epidemics in West Africa. Many of the models used in these studies are based on the model of Legrand et al. (2007), and most failed to accurately project the outbreak’s course (Butler, 2014). Although there could be many reasons for this, including incomplete and unreliable data on Ebola epidemiology and lack of empirical data on how disease-control measures quantitatively affect Ebola transmission, we examine the underlying assumptions of the Legrand model, and provide alternate formulations that are simpler and provide additional information regarding the epidemiology of Ebola during an outbreak. We developed three models with different assumptions about disease stage durations, one of which simplifies to the Legrand model while the others have more realistic distributions. Control and basic reproduction numbers for all three models are derived and shown to provide threshold conditions for outbreak control and prevention.

© 2016 The Author. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). The current review and synthesis was designed to provocatively develop and evaluate the proposition that “fear of the unknown may be a, or possibly the, fundamental fear” (Carleton, 2016) underlying anxiety and therein neuroticism. Identifying fundamental transdiagnostic elements is a priority for clinical theory and practice. Historical criteria for identifying fundamental components of anxiety are described and revised criteria are offered. The revised criteria are based on logical rhetorical arguments using a constituent reductionist postpositivist approach supported by the available empirical data. The revised criteria are then used to assess several fears posited as fundamental, including fear of the unknown. The review and synthesis concludes with brief recommendations for future theoretical discourse as well as clinical and non-clinical research. R. N. Carleton’s research is supported by the Canadian Institutes of Health Research through a New Investigator Salary Award (FRN: 13666). Open Access for this publication was provided by the University of Regina President’s Publication Fund. Faculty yes

Hepatitis B infections are responsible for more than 300 thousand deaths per year in the Western Pacific Region. Because of this high burden, the countries and areas of the Region established a goal of reducing hepatitis B chronic infection prevalence among children to less than 1% by 2017. This study was conducted to measure the progress in hepatitis B prevention and assess the status of achievement of the 2017 Regional hepatitis B control goal. A literature review was conducted to identify studies of hepatitis B prevalence in the countries and areas of the region, both before and after vaccine introduction. A mathematical model was applied to assess infections and deaths prevented by hepatitis B vaccination and hepatitis B prevalence in countries without recent empirical data. The majority of countries and areas (22 out of 36) were estimated to have over 8% prevalence of chronic hepatitis B infection among persons born before vaccine introduction. After introduction of hepatitis B vaccine, most countries and areas (24 out of 36) had chronic infection prevalence of less than 1% among children born after vaccine introduction. It was estimated that in the past 25 years immunization programmes in the Western Pacific Region have averted 7,167,128 deaths that would have occurred in the lifetime of children born between 1990 and 2014 if hepatitis B vaccination programmes had not been established. Regional prevalence among children born in 2012 was estimated to be 0.93%, meaning that the Regional hepatitis B control goal was achieved. While additional efforts are needed to further reduce hepatitis B transmission in the region, this study demonstrates the great success of the hepatitis B vaccination efforts in the Western Pacific Region.

The dentate gyrus (DG) and area CA3 of the hippocampus are highly organized lamellar structures which have been implicated in specific cognitive functions such as pattern separation and pattern completion. Here we describe how the anatomical organization and physiology of the DG and CA3 are consistent with structures that perform pattern separation and completion. We then raise a new idea related to the complex circuitry of the DG and CA3 where CA3 pyramidal cell ‘backprojections’ play a potentially important role in the sparse firing of granule cells (GCs), considered important in pattern separation. We also propose that GC axons, the mossy fibers, already known for their highly specialized structure, have a dynamic function that imparts variance – ‘mossy fiber variance’ – which is important to pattern separation and completion. Computational modeling is used to show that when a subset of GCs become ‘dominant,’ one consequence is loss of variance in the activity of mossy fiber axons and a reduction in pattern separation and completion in the model. Empirical data are then provided using an example of ‘dominant’ GCs – subsets of GCs that develop abnormally and have increased excitability. Notably, these abnormal GCs have been identified in animal models of disease where DG-dependent behaviors are impaired. Together these data provide insight into pattern separation and completion, and suggest that behavioral impairment could arise from dominance of a subset of GCs in the DG-CA3 network.

Social anxiety commonly occurs across the course of schizophrenia, including in the premorbid and prodromal phases of psychotic disorders. Some have posited that social anxiety may exist on a continuum with paranoia; however, empirical data are lacking. The study aim was to determine whether attenuated positive psychotic symptoms are related to social anxiety. Young adults (N=1378) were administered the Prodromal Questionnaire (PQ), which measures attenuated positive psychotic symptoms (APPS), and the Social Phobia Scale (SPS), which measures a subset of social anxiety symptoms. Confirmatory factor analyses were conducted to address the extent to which social anxiety and APPS tap distinct dimensions. Confirmatory factor analyses support the existence of a separate social anxiety factor scale and four separate, though interrelated, APPS factor domains (unusual thought content, paranoia/suspiciousness, disorganized thinking, and perceptual abnormalities). Additionally, social anxiety was significantly, but not differently related to each APPS domain, although the magnitude was reduced between social anxiety and distressing APPS. The current study suggests that social anxiety and attenuated positive psychotic symptoms are separable constructs, but are significantly associated with each other.

This paper develops a probabilistic approach that could use empirical data to derive values of performance shaping factor (PSF) multipliers for use in quantitative human reliability analysis (HRA). The proposed approach is illustrated with data on sleep deprivation effects on performance. A review of existing HRA methods reveals that sleep deprivation is not explicitly included at present, and expert opinion is frequently used to inform HRA model multipliers. In this paper, quantitative data from empirical studies regarding the effect of continuous hours of wakefulness on performance measures (reaction time, accuracy, and number of lapses) are used to develop a method to derive PSF multiplier values for sleep deprivation, in the context of the SPAR-H model. Data is extracted from the identified studies according to the meta-analysis research synthesis method and used to investigate performance trends and error probabilities. The error probabilities in test and control conditions are compared, and the resulting probability ratios are suggested for use in informing the selection of PSF multipliers in HRA methods. Although illustrated for sleep deprivation, the proposed methodology is general, and can be applied to other performance shaping factors.

Empirical data on the processes underlying knowledge brokering (KB) interventions, including their determining factors and effects, remain scarce. Furthermore, these interventions are rarely built on explicit theoretical foundations, making their critical analysis difficult, even a posteriori. For these reasons, it appeared relevant to revisit the results of a qualitative evaluation undertaken in the province of Quebec in parallel with a Canada-wide randomized controlled trial (RCT) evaluating various KB strategies in public health. This paper looks critically at the theoretical foundations of the KB interventions in light of two conceptual models: (1) the dissemination model underlying the KB interventions used in the Canadian trial and (2) a systemic KB model developed later. This critical analysis sheds light on the processes involved in KB interventions and the factors influencing their implementation and effects. The conclusions of the critical analysis are consistent with the systemic model, in which interpersonal contact is an essential condition for effective KB interventions. This analysis may advance knowledge in the field by enhancing our understanding of the role of knowledge brokers as essential mediators in KB processes and outcomes.

What measure of relative deprivation best predicts health? While numerous indices of relative deprivation exist, few studies have compared how well different measures account for empirical data. Hounkpatin et al. (2016) demonstrated that the relative ranked position of an individual i's income within a comparison group (their relative rank) was a better predictor of i's health than i's relative deprivation as assessed by the widely-used Yitzhaki index. In their commentary, Stark and Jakubek (2020) argue that both relative rank and relative deprivation may matter, and they develop a composite index. Here we identify some issues with their composite index, develop an alternative based on behavioural evidence, and test the various indices against data. Although almost all existing indices assume that the significance of an income yj to an individual with income yi (yj > yi) will be some increasing function of the difference between yj and yi , we find that the influence of j''s income on i's health is actually a reducing function of (yj > yi). This finding — that less significance is assigned to distant higher incomes than to near higher incomes — is consistent with the well-established idea that we compare ourselves primarily to similar others.

In this paper we attempt to explain the problems that can arise when assumptions made by experts in their respective fields of Medicine become widely accepted as established knowledge. Our hypothesis is that these problems are in large part attributable to a failure of the experts to follow the principles of logical argument. Empirical data to evaluate our hypothesis derives from an analysis of the reasoning processes employed in the generation of three syndromes drawn from the clinical discipline of Pain Medicine: myofascial pain, shoulder impingement and central sensitisation. We demonstrate a failure by the proponents of these syndromes to structure their scientific arguments in a logically valid fashion, which lead them to promote assumptions to the status of facts. In each instance those in relevant scientific journals responsible for content review accepted - and thereby promulgated - this fundamental error in reasoning. The wide acceptance of each of these assumptions as established knowledge affirms our hypothesis. Furthermore, we show that such uncritical acceptance has had significant consequences for many patients.

Avoidant/restrictive food intake disorder (ARFID) was recently introduced to psychiatric nosology to describe a group of patients who have avoidant or restrictive eating behaviours that are not motivated by a body image disturbance or a desire to be thinner. This scoping review aimed to systematically assess the extent and nature of the ARFID literature, to identify gaps in current understanding, and to make recommendations for further study. Following an extensive database search, 291 unique references were identified. When matched against pre-determined eligibility criteria, 78 full-text publications from 14 countries were found to report primary, empirical data relating to ARFID. This literature was synthesised and categorised into five subject areas according to the central area of focus: diagnosis and assessment, clinical characteristics, treatment interventions, clinical outcomes, and prevalence. The current evidence base supports ARFID as a distinct clinical entity, but there is a limited understanding in all areas. Several possible avenues for further study are indicated, with an emphasis placed on first parsing this disorder's heterogeneous presentation. A better understanding of the varied mechanisms which drive food avoidance and/or restriction will inform the development of targeted treatment interventions, refine screening tools and impact clinical outcomes.

Substance use and misuse experiences of foster youth remain an under-researched area. Given that early use of drugs is said to be a common factor among 90% of those who develop substance misuse problems in their lifetime, this is an important area of academic study ( Dennis, White, & Ives, 2009 ). By drawing upon primary empirical data from a mixed-methods study, this paper addresses an important gap in the literature and seeks to provide an improved understanding of foster youth, drug use and vulnerability. A total of 261 foster youth, who had exited care, contributed to a quantitative survey, and a further 35 provided qualitative narratives of their lived experience. Key risk factors including experience of homelessness, school exclusion and living setting are identified as strong influences that predict high levels of drug use among foster youth. Targeted social support and interventions in the form of pre-leaving care in the context of a strong practitioner/youth relationship are suggested to help ameliorate poor outcomes to obviate the problem of substance misuse among foster youth.

Sleep problems are not a core feature of obsessive-compulsive disorder (OCD), but emerging empirical data indicate some form of sleep disruption to be highly common. Available research in both adult and child patients is limited in several important ways, including the use of subjective reports (particularly in children), high rates of comorbid depression, and concurrent use of psychotropic medication. The presence of sleep disruption in OCD patients may compound severity and impairment of the disorder. More research is needed to fully understand the nature and consequences of sleep-wake disruption in children with OCD.

Background: Radiography as a concept has mainly been associated with the functional role of the radiographer. The concept has been studied from a theoretical point of view. However, there is a lack of a theoretical foundation and research on the actual substance of the term radiography used in education. It is therefore important to undertake an investigation in order to determine how students after three years education understand the subject of radiography. Aim: The aim of this study was to analyse how students in the Swedish radiographers' degree program understand the concept of radiography. Method: A concept analysis was made according to the hybrid model, which combines theoretical, fieldwork and analytical phases. A summative content analysis was used to identify the number and content of statements. The empirical data were collected from questionnaires answered by radiography students at four universities in Sweden. Findings: All radiography students' exemplified radiography with statements related to the practical level although some of them also identified radiography at an abstract level, as a subject within a discipline. The attribute ‘An interdisciplinary area of knowledge’ emerged, which is an attribute on the

Infectious disease models are both concise statements of hypotheses and powerful techniques for creating tools from hypotheses and theories. As such, they have tremendous potential for guiding data collection in experimental and observational studies, leading to more efficient testing of hypotheses and more robust study designs. In numerous instances, infectious disease models have played a key role in informing data collection, including the Garki project studying malaria, the response to the 2009 pandemic of H1N1 influenza in the United Kingdom and studies of T-cell immunodynamics in mammals. However, such synergies remain the exception rather than the rule; and a close marriage of dynamic modeling and empirical data collection is far from the norm in infectious disease research. Overcoming the challenges to using models to inform data collection has the potential to accelerate innovation and to improve practice in how we deal with infectious disease threats.

There were ten initiatives in the primary and urgent care system in the English NHS during the New Labour government, 1997-2010, aimed at delivering higher quality, more accessible and responsive care by expanding access, increasing convenience and introducing greater patient choice of provider. We examine their impact on demand, equity, patient satisfaction, referrals, and costs.Studies were systematically identified through electronic databases and reference lists of publications. Studies of all designs were included if published between 1997 and 2013, and with empirical data on the impacts above.Nineteen studies of ten initiatives were included. Innovations often overlapped, complicating care. There was some demand for new provision on grounds of convenience, but little evidence of substitution between services. Patient satisfaction varied across schemes. There was little evidence on the costs and benefits of new versus existing provision.New services generated a more complex system where new and existing providers delivered overlapping services. The new provision did not induce substitution and was likely to have increased overall demand. Initiatives to improve access to existing provision may have greater potential to improve access and convenience at lower marginal costs than developing new forms of provision.

Introduction High triage volumes can delay rapid identification of walk in ESI level 2 patients. This concern coupled with persistently increasing volumes prompted the Reading Hospital Emergency Department to move from single-tiered triage to duel-tiered rapid triage in 2008, then brought the addition of the RN Greeter in 2011. The purpose of this study was to assess how rapid triage then the RN Greeter impacted the ability to quickly identify the walk-in ESI 2 patient. Methods A retrospective analysis of mini-registration to triage time was conducted on ESI level 2 patients entering the ED by means other than ambulance. Data was collected from three separate time frames: The first representing single-tiered triage, the second duel-tiered rapid triage, and the third duel-tiered triage with the RN Greeter. Results Data demonstrated despite increasing volumes both rapid triage and the RN Greeter improved the prompt identification of ESI 2 patients. Discussion While moving from single to duel-tiered triage met little resistance from staff, the RN Greeter role was initially not as well received. However, as empirical data demonstrated the efficacy of the RN Greeter to quickly identify the potential ESI 2 patient, the role ultimately became an integral part of triage.

Providers who treat adolescents with co-occurring substance use and mental health issues may prioritize treatment of one set of symptoms believing that improvements in one domain will result in improvements of the other. However, limited empirical data for adolescents provide evidence of such “spillover effects.” Using data from 2900 youth in an outpatient treatment, we examined whether during-treatment changes in substance use or mental health symptoms predicted 12-month outcomes in the analogous and opposite domains. There was very little evidence of spillover effects, only that youth with no internal distress at 0 and 3 months reported lower levels of substance use problems at 12-months relative to youth with internal distress that stayed the same from 0 to 3 months. These findings suggest that providers treat both sets of substance use and mental health symptoms in an integrated manner given that these symptoms commonly co-occur among youth with either set.

A growing amount of empirical data is showing that the ability to manipulate quantities in a precise and efficient fashion is rooted in cognitive mechanisms devoted to specific aspects of numbers processing. The analog number system (ANS) has a reasonable representation of quantities up to about 4, and represents larger quantities on the basis of a numerical ratio between quantities. In order to represent the precise cardinality of a number, the ANS may be supported by external algorithms such as language, leading to a "precise number system". In the setting of limited language, other number-related systems can appear. For example the parallel individuation system (PIS) supports a "chunking mechanism" that clusters units of larger numerosities into smaller subsets. In the present study we investigated number processing in non-aphasic patients with corticobasal syndrome (CBS) and posterior cortical atrophy (PCA), two neurodegenerative conditions that are associated with progressive parietal atrophy. The present study investigated these number systems in CBS and PCA by assessing the property of the ANS associated with smaller and larger numerosities, and the chunking property of the PIS. The results revealed that CBS/PCA patients are impaired in simple calculations (e.g., addition and subtraction) and that their performance strongly correlates with the size of the numbers involved in these calculations, revealing a clear magnitude effect. This magnitude effect was correlated with gray matter atrophy in parietal regions. Moreover, a numeral-dots transcoding task showed that CBS/PCA patients were able to take advantage of clustering in the spatial distribution of the dots of the array. The relative advantage associated with chunking compared to a random spatial distribution correlated with both parietal and prefrontal regions. These results shed light on the properties of systems for representing number knowledge in non-aphasic patients with CBS and PCA.