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Background: Little is known regarding how patient insurance status influences outcomes after extensor tendon-injury repair. We aim to establish a relationship between the outcomes of primarily repaired extensor tendon injuries and patient insurance status. We hypothesize that commercially insured patients will achieve superior outcomes due to more facile access to postoperative hand therapy and fewer barriers to appropriate postoperative care. Methods: A retrospective chart review was conducted of patients who underwent primary extensor tendon repair in any zone, excluding the thumb, at a single large safety-net hospital. Inclusion criteria included a minimum of eight weeks of follow-up, complete data available for review, and an extensor tendon injury requiring primary surgical repair. Four cohorts were examined: patients with commercial insurance, patients with Medicare/Medicaid, patients with county hospital-sponsored insurance, and uninsured patients. Statistical analysis was performed using Chi-Square and ANOVA analyses, with significance defined as p ≤ 0.05. Results: Of the 62 patients (100 digits) included, 20 had commercial insurance, 12 had Medicare/Medicaid, 13 had hospital-sponsored insurance, and 17 were uninsured. Except for mean age, there were no significant differences between groups in terms of demographic data, medical comorbidities, or digit characteristics. There were also no significant differences in mean follow-up, time to return to full activity, or surgical complications among groups. Procedure duration differed significantly between groups, with procedures lasting longer in uninsured patients. Postoperative final flexion total arc of motion (TAM) and extension measurements were similar across all groups. Additionally, hand therapy visits did not differ significantly between groups. Conclusions: Following extensor tendon repair, patient insurance status did not affect outcomes in terms of final range of motion, return to full activity, or postoperative complications.

IntroductionEmpathic behaviors are driven by the ability to understand the emotional states of others along with the motivation to improve it. Evidence points towards forms of empathy, like targeted helping, in many species including rats. There are several variables that may modulate targeted helping, including sex, sensory modalities, and activity of multiple neural substrates.MethodsUsing a model of social contact-independent targeted helping, we first tested whether sex differences exist in helping behavior. Next, we explored sex differences in sensory and affective signaling, including direct visualization and an analysis of ultrasonic vocalizations made between animal pairs. Finally, we examined the neural activity in males and females of multiple regions of interest across time. Here, we aim to examine any behavioral differences in our lab’s social contact independent targeted helping task between males and females.Results and DiscussionThese findings are the first to intimate that, like other prosocial behaviors, males and females may exhibit similar social-independent targeted helping behavior, but the underlying sensory communication in males and females may differ. In addition, this is the first set of experiments that explore the neural correlates of social-independent targeted helping in both males and females. These results lay the groundwork for future studies to explore the similarities and differences that drive targeted helping in both sexes.

Abstract The East Antarctic Ice Sheet (EAIS) has its origins ca. 34 million years ago. Since then, the impact of climate change and past fluctuations in the EAIS margin has been reflected in periods of extensive vs. restricted ice cover and the modification of much of the Antarctic landscape. Resolving processes of landscape evolution is therefore critical for establishing ice sheet history, but it is rare to find unmodified landscapes that record past ice conditions. Here, we discover an extensive relic pre-glacial landscape preserved beneath the central EAIS despite millions of years of ice cover. The landscape was formed by rivers prior to ice sheet build-up but later modified by local glaciation before being dissected by outlet glaciers at the margin of a restricted ice sheet. Preservation of the relic surfaces indicates an absence of significant warm-based ice throughout their history, suggesting any transitions between restricted and expanded ice were rapid.

The Wilkes Subglacial Basin in East Antarctica contains ice equivalent to 3–4 m of global mean sea level rise and is primarily drained by Cook Glacier. Of concern is that recent observations (since the 1970s) show an acceleration in ice speed over the grounding line of both the Eastern and Western portions of Cook Glacier. Here, we use a numerical ice-flow model (Úa) to simulate the instantaneous effects of observed changes at the terminus of Cook Glacier in order to understand the link between these changes and recently observed ice acceleration. Simulations suggest that the acceleration of Cook West was caused by a retreat in calving-front position in the 1970s, potentially enhanced by grounding-line retreat, while acceleration of Cook East was likely caused by ice-shelf thinning and grounding-line retreat in the mid-1990s. Moreover, we show that the instantaneous ice discharge at Cook East would increase by up to 85% if the whole ice shelf is removed and it ungrounds from a pinning point; and that the discharge at Cook West could increase by ~300% if its grounding line retreated by 10 km.

Abstract Antarctica’s contribution to global mean sea level rise has been driven by an increase in ice discharge into the oceans. The rate of change and the mechanisms that drive variability in ice discharge are therefore important to consider in the context of projected future warming. Here, we report observations of both decadal trends and inter-annual variability in ice discharge across the Antarctic Ice Sheet at a variety of spatial scales that range from large drainage basins to individual outlet glacier catchments. Overall, we find a 37 ± 11 Gt year−1 increase in discharge between 1999 and 2010, but a much smaller increase of 4 ± 8 Gt year−1 between 2010 and 2018. Furthermore, comparisons reveal that neighbouring outlet glaciers can behave synchronously, but others show opposing trends, despite their close proximity. We link this spatial and temporal variability to changes in ice shelf buttressing and the modulating effect of local glacier geometry.

Antarctic supraglacial lakes (SGLs) have been linked to ice-shelf collapse and the subsequent acceleration of inland ice flow, but observations of SGLs remain relatively scarce and their interannual variability is largely unknown. This new study shows that lake area and volume vary substantially from year-to-year around the East Antarctic Ice Sheet and between ice shelves.

Abstract Empathy, the understanding of the emotional state of others, can be examined across species using the Perception Action Model, where shared affect promotes an action by “Observers” to aid a distressed “Target”. The anterior insula (AI) has garnered interest in empathic behavior due to its role integrating sensory and emotional information of self and other. In the following studies, the AI was inhibited pharmacologically and chemogenetically during targeted helping. We demonstrate the insula is active during, and is necessary for the maintenance of, targeted helping. Analysis of ultrasonic vocalizations revealed distress calls from Targets increased when Observers’ helping was attenuated due to insula inhibition. Targets’ elevated distress was directly correlated to Observers’ diminished helping behavior, suggesting emotional transfer between Observer and Target is blunted following Observer AI inhibition. Finally, the AI may selectively blunt targeted helping, as social exploration did not change in a social reward place conditioning task. These studies help further establish the anterior insula as a critical node in the empathic brain during targeted helping, even in the absence of direct social contact.

The weakening and/or removal of floating ice shelves in Antarctica can induce inland ice flow acceleration. Numerical modelling suggests these processes will play an important role in Antarctica's future sea-level contribution, but our understanding of the mechanisms that lead to ice tongue/shelf collapse is incomplete and largely based on observations from the Antarctic Peninsula and West Antarctica. Here, we use remote sensing of structural glaciology and ice velocity from 2001 to 2020 and analyse potential ocean-climate forcings to identify mechanisms that triggered the rapid disintegration of ~2445 km2 of ice mélange and part of the Voyeykov Ice Shelf in Wilkes Land, East Antarctica between 27 March and 28 May 2007. Results show disaggregation was pre-conditioned by weakening of the ice tongue's structural integrity and was triggered by mélange removal driven by a regional atmospheric circulation anomaly and a less extensive latent-heat polynya. Disaggregation did not induce inland ice flow acceleration, but our observations highlight an important mechanism through which floating termini can be removed, whereby the break-out of mélange and multiyear landfast sea ice triggers disaggregation of a structurally-weak ice shelf. These observations highlight the need for numerical ice-sheet models to account for interactions between sea-ice, mélange and ice shelves.

There are still many uncertainties about the climatic forcing that drove the glacier fluctuations of the Patagonian Ice Sheet (PIS, 38–55°S) during the last glacial period. A key source of uncertainty is the asynchrony of ice lobe fluctuations between the northern, central, and southern PIS. To fully understand the regional trends requires careful mapping and extensive geochronological studies. This paper presents geomorphological and geochronological reconstructions of the glacial and deglacial landforms formed during the last glacial period at the Seno Skyring lobe, southernmost Patagonia (52°S, 71°W). We present a detailed geomorphological map, where we identify two moraine systems. The outer and older is named Laguna Blanca (LB) and the inner Río Verde (RV). The LB moraines were built subaerially, whereas parts of the RV were deposited subaqueously under the palaeo lake Laguna Blanca, which developed during deglaciation. We conducted surface exposure 10Be dating methods on boulder samples collected from LB and RV glacial margins. The moraine LB III and LB IV formed at 26.3 ± 2.3 ka (n = 5) and 24.3 ± 0.9 ka (n = 3), respectively. For the inner RV moraine, we obtained an age of 18.7 ± 1.5 ka (n = 6). For the palaeo Laguna Blanca evolution, we performed 10Be exposure ages on shoreline berms and optically stimulated luminesce dating to constrain the lake levels, and 10Be depth profile dating on an outwash deposit formed by a partial lake drainage event, which occurred at 22 ± 3 ka. For the RV moraine deglaciation, we performed radiocarbon dating of basal sediments in a peat bog, which indicates that the glacier retreated from the terminal RV moraine by at least c. 16.4 cal kyr BP. Our moraine geochronology shows an asynchrony in the maximum extents and a different pattern of ice advances between neighbouring lobes in southern Patagonia. We speculate that this may be due, at least in part, to the interaction between topography and the precipitation carried by the southern westerly wind belt. However, we found broad synchrony of glacial readvances contemporaneous with the RV moraine.

Characterising glaciological change within the tropical Andes is important because tropical glaciers are sensitive to climate change. Our understanding of glacier dynamics and how tropical glaciers respond to global climate perturbations is poorly constrained. Studies of past glaciation in the tropical Andes have focused on locations where glaciers are still present or recently vacated cirques at high elevations. Few studies focused on lower elevation localities because it was assumed glaciers did not exist or were not as extensive. We present the first geomorphological evidence for past glaciations of the Lagunas de Las Huaringas, northern Peru, at elevations of 3,900–2,600 m a.s.l. Mapping was conducted using remotely-sensed optical imagery and a newly created high-resolution (∼2.5 m) digital elevation model (DEM). The area has abundant evidence for glaciation, including moraines, glacial cirques, hummocky terrain, glacial lineations and ice-sculpted bedrock. Two potential models for glaciation are hypothesised: 1) plateau-fed ice cap, or 2) valley glaciation. Assuming glaciers reached their maximum extent during the Local Last Glacial Maximum (LLGM), between 23.5 ± 0.5 and 21.2 ± 0.8 ka, the maximum reconstructed glacial area was 75.6 km2. A mean equilibrium line altitude (ELA) of 3,422 ± 30 m was calculated, indicating an ELA change of −1,178 ± 10 m compared to modern snowline elevation. There is an east to west ELA elevation gradient, lower in the east and higher in the west, in-line with modern day transfer of moisture. Applying lapse rates between 5.5 and 7.5°C/km provides a LLGM temperature cooling of between 6.5–8.8°C compared to present. These values are comparable to upper estimates from other studies within the northern tropical Andes and from ice-core reconstructions. The mapping of glacial geomorphology within the Lagunas de las Huaringas, evidences, for the first time, extensive glaciation in a low elevation region of northern Peru, with implications for our understanding of past climate in the sub-tropics. Observations and reconstructions support a valley, rather than ice cap glaciation. Further work is required to constrain the timing of glaciations, with evidence of moraines younger than the LLGM up-valley of maximum glacier extents. Numerical modelling will also enable an understanding of the controls of glaciation within the region.

Stephen Stewart, Wing Chan Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK Abstract: Pneumatic retinopexy is a minimally invasive, non-incisional procedure for repairing retinal detachment. This procedure is associated with reduced morbidity, reduced cost and faster postoperative recovery compared to pars plana vitrectomy and scleral buckling. Superior visual acuity outcomes have also been reported. Intraoperative complications are primarily related to the intraocular pressure rise caused by gas injection, or the misdirection of the gas. There is a low rate of postoperative complications. Anatomic success rates of over 90% can be achieved when strict selection criteria are applied. However, a number of studies have revealed good outcomes in cases with expanded clinical indications. Pneumatic retinopexy is currently underutilized. With appropriate patient selection, a high success rate can be achieved, and therefore, this procedure has an important role in the armamentarium of the vitreoretinal surgeon. Keywords: retina, vitreoretinal surgery, retinal detachment

Current knowledge about functional connectivity in obsessive-compulsive disorder (OCD) is based on small-scale studies, limiting the generalizability of results. Moreover, the majority of studies have focused only on predefined regions or functional networks rather than connectivity throughout the entire brain. Here, we investigated differences in resting-state functional connectivity between OCD patients and healthy controls (HC) using mega-analysis of data from 1024 OCD patients and 1028 HC from 28 independent samples of the ENIGMA-OCD consortium. We assessed group differences in whole-brain functional connectivity at both the regional and network level, and investigated whether functional connectivity could serve as biomarker to identify patient status at the individual level using machine learning analysis. The mega-analyses revealed widespread abnormalities in functional connectivity in OCD, with global hypo-connectivity (Cohens d: -0.27 to -0.13) and few hyper-connections, mainly with the thalamus (Cohens d: 0.19 to 0.22). Most hypo-connections were located within the sensorimotor network and no fronto-striatal abnormalities were found. Overall, classification performances were poor, with area-under-the-receiver-operating-characteristic curve (AUC) scores ranging between 0.567 and 0.673, with better classification for medicated (AUC = 0.702) than unmedicated (AUC = 0.608) patients versus healthy controls. These findings provide partial support for existing pathophysiological models of OCD and highlight the important role of the sensorimotor network in OCD. However, resting-state connectivity does not so far provide an accurate biomarker for identifying patients at the individual level.

Wheat (Triticum aestivum) production in the rainfed area of Pothwar Pakistan is extremely vulnerable to high temperature. The expected increase in temperature due to global warming should result in shorter crop life cycles, and thus lower biomass and grain yield. Two major factors control wheat phenological development: temperature and photoperiod. To evaluate wheat development in response to these factors, we conducted experiments that created diverse temperature and daylength conditions by adjusting the crop sowing time. The study was conducted during 2013–14 and 2014–15 using five spring wheat genotypes, four sowing times, at three sites under rainfed management in Pothwar, Pakistan. Wheat crops experienced more cold days with early sowing, but later sowing dates resulted in higher temperatures, especially from anthesis to maturity. These treatments produced large differences in phenology, biomass production, and yield. To investigate whether growing degree days (GDD) and photoperiod algorithms could predict wheat phenology under these changing conditions, GDD was calculated based on the method proposed by Wang and Engel while photoperiod followed the approach introduced in the APSIM crop growth model. GDD was calculated separately and in combination with photoperiod from germination to anthesis. For the grain filling period, only GDD was calculated. The observed and predicted number of days to anthesis and maturity were in good agreement, showing that the combination of GDD and photoperiod algorithms provided good estimations of spring wheat phenology under variable temperature and daylength conditions.

Agriculture in the dryland region of the Inland Pacific Northwest (IPNW, including northern Idaho, eastern Washington and northern Oregon) is typically characterized based on annual rainfall and associated distribution of cropping systems that have evolved in response to biophysical and socio-economic factors. Three agro-ecological classes (AEC) have been proposed for the region: (a) crop/fallow (CF), (b) annual crop/fallow transition (CCF), and (c) continuous cropping (CC). AECs attempt to associate land use into relatively homogeneous areas that result in common production systems. Although there is an interest in sustainable intensification of cropping systems (e.g., reduction of fallow), the question remains whether climate change will preclude intensification or shift the borders of existing AECs toward greater fallow utilization. A simulation study was conducted to address this question, with the aim of classifying 4 × 4 km pixels throughout the region into one of the three AECs for baseline (1979–2010) and future periods (2030s, 2015–2045; 2050s, 2035–2065; 2070s, 2055–2085). Baseline data were derived from traditional rotations and historical climate records. Data for future projections were derived from atmospheric CO2 concentration considering daily weather downloaded from 12 global circulation models and 2 representative concentration pathways (RCP 4.5 and 8.5). Due to the direct effect of atmospheric CO2 on photosynthesis and stomatal conductance, the transpiration use efficiency of crops (TUE; g above-ground biomass kg water−1) showed an increasing trend, with winter wheat TUE changing from 4.76 in the historical period to 6.17 and 7.08 g kg−1 in 2070s, depending on AEC. Compared to the baseline, total grain yield by the 2070s in the region was projected to increase in the range of 18–48% (RCP 4.5) and 30–65% (RCP 8.5), depending on AEC. As a consequence of these changes, compared to the historical baseline period, the future fraction of the area classified as CF decreased from 50% to 39–36%, CC increased from 16% to 24–28%, and CCF decreased slightly (~1%), with the greater change projected for the RCP 8.5 scenario.

BACKGROUND: Little is known about specific obsessive-compulsive clinical features associated with lifetime history of suicide attempt in individuals with obsessive-compulsive disorder (OCD) and major depression. METHODS: The study sample included 515 adults with OCD and a history of major depression. In exploratory analyses, we compared the distributions of demographic characteristics and clinical features in those with and without a history of attempted suicide and used logistic regression to evaluate the association between specific obsessive-compulsive clinical features and lifetime suicide attempt. RESULTS: Sixty-four (12%) of the participants reported a lifetime history of suicide attempt. Those who had attempted suicide were more likely to report having experienced violent or horrific images (52% vs. 30%; p

Sterile inflammation occurs when inflammatory proteins are increased in blood and tissues by nonpathogenic states and is a double-edged sword depending on its cause (stress, injury, or disease), duration (transient versus chronic), and inflammatory milieu. Short-term fasting can exert a host of health benefits through unknown mechanisms. The following experiment tested if a 24 h fast would modulate basal and stress-evoked sterile inflammation in plasma and adipose. Adult male F344 rats were either randomized to ad libitum access to food or fasted for 24 h prior to 0 (control), 10, or 100, 1.5 mA-5 s intermittent, inescapable tail shocks (IS). Glucose, nonesterified free fatty acids (NEFAs), insulin, leptin, and corticosterone were measured in plasma and tumor necrosis factor- (TNF-) α, interleukin- (IL-) 1β, IL-6, and IL-10 in plasma, and subcutaneous, intraperitoneal, and visceral compartments of white adipose tissue (WAT). In control rats, a 24 h fast reduced all measured basal cytokines in plasma and visceral WAT, IL-1β and IL-6 in subcutaneous WAT, and IL-6 in intraperitoneal WAT. In stressed rats (IS), fasting reduced visceral WAT TNF-α, subcutaneous WAT IL-1β, and plasma insulin and leptin. Short-term fasting may thus prove to be a useful dietary strategy for reducing peripheral inflammatory states associated with visceral obesity and chronic stress.

OBJECTIVE: Cognitive-behavioral therapy (CBT) is considered a first-line treatment for obsessive-compulsive disorder (OCD) in pediatric and adult populations. Nevertheless, some patients show partial or null response. The identification of predictors of CBT response may improve clinical management of patients with OCD. Here, we aimed to identify structural magnetic resonance imaging (MRI) predictors of CBT response in 2 large series of children and adults with OCD from the worldwide ENIGMA-OCD consortium. METHOD: Data from 16 datasets from 13 international sites were included in the study. We assessed which variations in baseline cortical thickness, cortical surface area, and subcortical volume predicted response to CBT (percentage of baseline to post-treatment symptom reduction) in 2 samples totaling 168 children and adolescents (age range 5-17.5 years) and 318 adult patients (age range 18-63 years) with OCD. Mixed linear models with random intercept were used to account for potential cross-site differences in imaging values. RESULTS: Significant results were observed exclusively in the pediatric sample. Right prefrontal cortex thickness was positively associated with the percentage of CBT response. In a post hoc analysis, we observed that the specific changes accounting for this relationship were a higher thickness of the frontal pole and the rostral middle frontal gyrus. We observed no significant effects of age, sex, or medication on our findings. CONCLUSION: Higher cortical thickness in specific right prefrontal cortex regions may be important for CBT response in children with OCD. Our findings suggest that the right prefrontal cortex plays a relevant role in the mechanisms of action of CBT in children.

Bacteria from the genus Vibrio are a common and environmentally important group of bacteria within coastal environments and include species pathogenic to aquaculture organisms. Their distribution and abundance are linked to specific environmental parameters, including temperature, salinity and nutrient enrichment. Accurate and efficient detection of Vibrios in environmental samples provides a potential important indicator of overall ecosystem health while also allowing rapid management responses for species pathogenic to humans or species implicated in disease of economically important aquacultured fish and invertebrates. In this study, we developed a surface immuno-functionalisation protocol, based on an avidin-biotin type covalent binding strategy, allowing specific sandwich-type detection of bacteria from the Vibrio genus. The assay was optimized on 12 diverse Vibrio strains, including species that have implications for aquaculture industries, reaching detection limits between 7×10(3) to 3×10(4) cells mL(-1). Current techniques for the detection of total Vibrios rely on laborious or inefficient analyses resulting in delayed management decisions. This work represents a novel approach for a rapid, accurate, sensitive and robust tool for quantifying Vibrios directly in industrial systems and in the environment, thereby facilitating rapid management responses.

This paper measures the perception of Yemeni citizens on the severity of tax evasion relative to other crimes and violations. Perception of tax evasion may somewhat explain the degree of non-compliance with tax laws. Using data from a self-administered survey and a structured interview, the results of mean and comparative analysis show that the three tax evasion offences were ranked as the least serious crimes among 30 listed crimes. Further, tax evasion is categorized the least serious category out of six categories. The results of this study should be useful to policy makers in Yemen and elsewhere, as it is an alarming signal that tax evasion is relatively ranked as the least serious offence, which could lead to an environment where taxpayers may not be afraid of cheating on their tax returns.

Neuroimaging has played an important part in advancing our understanding of the neurobiology of obsessive-compulsive disorder (OCD). At the same time, neuroimaging studies of OCD have had notable limitations, including reliance on relatively small samples. International collaborative efforts to increase statistical power by combining samples from across sites have been bolstered by the ENIGMA consortium; this provides specific technical expertise for conducting multi-site analyses, as well as access to a collaborative community of neuroimaging scientists. In this article, we outline the background to, development of, and initial findings from ENIGMA's OCD working group, which currently consists of 47 samples from 34 institutes in 15 countries on 5 continents, with a total sample of 2,323 OCD patients and 2,325 healthy controls. Initial work has focused on studies of cortical thickness and subcortical volumes, structural connectivity, and brain lateralization in children, adolescents and adults with OCD, also including the study on the commonalities and distinctions across different neurodevelopment disorders. Additional work is ongoing, employing machine learning techniques. Findings to date have contributed to the development of neurobiological models of OCD, have provided an important model of global scientific collaboration, and have had a number of clinical implications. Importantly, our work has shed new light on questions about whether structural and functional alterations found in OCD reflect neurodevelopmental changes, effects of the disease process, or medication impacts. We conclude with a summary of ongoing work by ENIGMA-OCD, and a consideration of future directions for neuroimaging research on OCD within and beyond ENIGMA.

The heterogeneity of polymer electrolyte fuel cell catalyst degradation is studied under varied relative humidity and types of feed gas. Accelerated stress tests (ASTs) are performed on four membrane electrode assemblies (MEAs) under wet and dry conditions in an air or nitrogen environment for 30 000 square voltage cycles. The largest electrochemically active area loss is observed for MEA under wet conditions in a nitrogen gas environment AST due to constant upper potential limit of 0.95 V and significant water content. The mean Pt particle size is larger for the ASTs under wet conditions compared to dry conditions, and the Pt particle size under land is generally larger than under the channel. Observations from ASTs in both conditions and gas environments indicate that water content promotes Pt particle size growth. ASTs under wet conditions and an air environment show the largest difference in Pt particle size growth for inlet versus outlet and channel versus land, which can be attributed to larger water content at outlet and under land compared to inlet and under channel. From X-ray fluorescence experiments Pt particle size increase is a local phenomenon as Pt loading remains relatively uniform across the MEA.

Numerical modeling has been a vital tool in proton-exchange-membrane fuel-cell (PEMFC) analysis; however, the predictive capabilities of these models depend on the input physical parameters, several of which are either not experimentally measured or have large scatter in measured values. This article presents an uncertainty propagation-based sensitivity analysis to identify the model parameters that impact the model predictions most. A comprehensive 2-D membrane electrode assembly (MEA) model is used to perform local sensitivity analysis at multiple operating conditions, which encompass the range of environments and operating conditions a cell can encounter. While at lower humidities, cathode kinetics and membrane-ohmic-loss related parameters are crucial, gas transport and porous-media saturation behavior are more important at humidified conditions. Several of these findings are different from previous studies presented in literature. Identifying the crucial parameters helps focus future material and cell optimization studies as well as experimental studies to quantify these parameters with higher accuracy.

Over the last year, the coronavirus disease 2019 (COVID-19) pandemic has resulted in profound disruptions across the globe, with school closures, social isolation, job loss, illness, and death affecting the lives of children and families in myriad ways. In an Editors' Note in our June 2020 issue,1 our senior editorial team described this Journal's role in advancing knowledge in child and adolescent mental health during the pandemic and outlined areas we identified as important for science and practice in our field. Since then, the Journal has published articles on the impacts of the pandemic on child and adolescent mental health and service systems,2-5 which are available in a special collection accessible through the Journal's website.6 Alongside many opinion papers, the pace of publication of empirical research in this area is rapidly expanding, covering important issues such as increased frequency of mental health symptoms among children and adolescents3,5,7-10 and changes in patterns of clinical service use such as emergency department visits.11-14 As the Senior Editors prepared that Editors' Note, they were acutely aware that the priorities that they identified were broad and generated by only a small group of scientists and clinicians. Although this had the advantage of enabling us to get this information out to readers quickly, we decided that a more systematic approach to developing recommendations for research priorities would be of greater long-term value. We were particularly influenced by the efforts of the partnership between the UK Academy of Medical Scientists and a UK mental health research charity (MQ: Transforming Mental Health) to detail COVID-19-related research priorities for "Mental Health Science" that was published online by Holmes et al. in The Lancet Psychiatry in April 2020.15 Consistent with its focus on mental health research across the lifespan, several recommendations highlighted child development and children's mental health. However, a more detailed assessment of research priorities related to child and adolescent mental health was beyond the scope of that paper. Furthermore, the publication of that position paper preceded the death of George Floyd at the hands of Minneapolis police on May 25, 2020, which re-energized efforts to acknowledge and to address racism and healthcare disparities in the United States and many other countries. To build upon the JAACAP Editors' Note1 and the work of Holmes et al.,15 we conducted an international survey of professionals-practitioners and researchers-working on child and adolescent development and pediatric mental health to identify concerns about the impact of the pandemic on children, adolescents, and their families, as well as what is helping families navigate these impacts, and the specific research topics that are of greatest importance.

Background: Pediatric obsessive-compulsive disorder (OCD) has been associated with poorer planning in laboratory, school and home settings. It is unclear whether this impairment is a standalone cognitive issue or the result of OCD symptoms. No study has examined the influence of provoked distress on planning performance and neural correlates in pediatric OCD. Methods: Before and after a symptom provocation task, youth with OCD (n = 23; 9 boys; mean age [+ or -] standard deviation 15.1 [+ or -] 2.6 years) and matched healthy controls (n = 23) completed the Tower of London task during functional MRI scanning. Results: During planning, participants with OCD recruited the left superior frontal gyrus to a greater extent than healthy controls after symptom provocation (group x time point interaction; [t.sub.44] = 5.22, p < 0.001). In a seeded, region of interest-constrained, functional connectivity analysis, we identified greater connectivity between the left superior frontal gyrus and the right middle frontal gyrus, left precuneus and left inferior parietal lobule in participants with OCD than healthy controls. We also identified greater connectivity between the right amygdala and right medial frontal gyrus in patients with OCD than healthy controls, but only before symptom provocation. Limitations: The fixed-order design of the study and the number of participants taking medication (n = 20) should be noted. Conclusion: Participants with OCD demonstrated greater amygdalar-cortical connectivity before symptom provocation, while sustaining greater recruitment and connectivity of task-related planning areas throughout the task. These results suggest that brain activity and connectivity is altered after symptom provocation, in the absence of impaired planning performance., Introduction Pediatric obsessive-compulsive disorder (OCD) is a common neurodevelopmental illness (0.25% to 2.9% prevalence (1,2)) characterized by distressing thoughts and repetitive behaviours. (3) Neuroimaging studies have associated OCD with altered [...]

No diagnostic biomarkers are available for obsessive-compulsive disorder (OCD). Here, we aimed to identify magnetic resonance imaging (MRI) biomarkers for OCD, using 46 data sets with 2304 OCD patients and 2068 healthy controls from the ENIGMA consortium. We performed machine learning analysis of regional measures of cortical thickness, surface area and subcortical volume and tested classification performance using cross-validation. Classification performance for OCD vs. controls using the complete sample with different classifiers and cross-validation strategies was poor. When models were validated on data from other sites, model performance did not exceed chance-level. In contrast, fair classification performance was achieved when patients were grouped according to their medication status. These results indicate that medication use is associated with substantial differences in brain anatomy that are widely distributed, and indicate that clinical heterogeneity contributes to the poor performance of structural MRI as a disease marker.

Pt catalysts in polymer electrolyte fuel cells degrade heterogeneously as the catalyst particles are exposed to local variations throughout the catalyst layer during operation. State-of-the-art analytical techniques for studying degradation of Pt catalysts do not possess fine spatial resolution to elucidate such non-uniform degradation behavior at a large electrode level. A new methodology is developed to spatially resolve and quantify the heterogeneous Pt catalyst degradation over a large area (several cm2) of aged MEAs based on synchrotron X-ray microdiffraction. PEFC single cells are aged using voltage cycling as an accelerated stress test and the degradation heterogeneity at a micrometer length scale is visualized by mapping Pt catalyst particle size after voltage cycling. It is demonstrated in detail that the Pt catalyst particle size growth is non-uniform and follows the flow field geometry. The Pt particle size growth is greater in the area under the flow field land, while it is minimal in the area under the flow field channel. Additional non-uniformity is observed with the Pt particle size increasing more rapidly at the air outlet area than the Pt particle size at the inlet area.

BackgroundLateralized dysfunction has been suggested in obsessive-compulsive disorder (OCD). However, it is currently unclear whether OCD is characterized by abnormal patterns of brain structural asymmetry. Here we carried out what is by far the largest study of brain structural asymmetry in OCD.MethodsWe studied a collection of 16 pediatric datasets (501 patients with OCD and 439 healthy control subjects), as well as 30 adult datasets (1777 patients and 1654 control subjects) from the OCD Working Group within the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Consortium. Asymmetries of the volumes of subcortical structures, and of measures of regional cortical thickness and surface areas, were assessed based on T1-weighted magnetic resonance imaging scans, using harmonized image analysis and quality control protocols. We investigated possible alterations of brain asymmetry in patients with OCD. We also explored potential associations of asymmetry with specific aspects of the disorder and medication status.ResultsIn the pediatric datasets, the largest case-control differences were observed for volume asymmetry of the thalamus (more leftward; Cohen's d = 0.19) and the pallidum (less leftward; d = -0.21). Additional analyses suggested putative links between these asymmetry patterns and medication status, OCD severity, or anxiety and depression comorbidities. No significant case-control differences were found in the adult datasets.ConclusionsThe results suggest subtle changes of the average asymmetry of subcortical structures in pediatric OCD, which are not detectable in adults with the disorder. These findings may reflect altered neurodevelopmental processes in OCD.

General personality dimensions are associated with clinical severity and treatment response in individuals with depression and many anxiety disorders, but little is known about these relationships in individuals with obsessive-compulsive disorder (OCD). Individuals in the current study included 705 adults with OCD who had participated in family and genetic studies of the disorder. Participants self-completed the Neuroticism, Extraversion, Openness Personality Inventory or Neuroticism, Extraversion, Openness Five-Factor Inventory-3. Relationships between personality scores, and subjective impairment and OCD treatment response, were evaluated. The odds of subjective impairment increased with (unit increase in) the neuroticism score (odds ratio, OR = 1.03; 95% CI = 1.01-1.04; p < 0.01) and decreased with extraversion scores (OR = 0.98; 95% CI = 0.96-0.99; p < 0.01). The odds of reporting a good response to serotonin/selective serotonin reuptake inhibitors (OR = 1.02; 95% CI = 1.01-1.04; p < 0.01) or cognitive behavioural therapy (OR = 1.03; 95% CI = 1.01-1.05; p < 0.01) increased with the extraversion score. The magnitude of these relationships did not change appreciably after adjusting for other clinical features related to one or more of the personality dimensions. The findings suggest that neuroticism and extraversion are associated with subjective impairment, and that extraversion is associated with self-reported treatment response, in individuals with OCD. © 2019 John Wiley & Sons, Ltd.

Objective: To evaluate the lifetime prevalence of infectious, inflammatory, and autoimmune disorders in a multisite study of probands with childhood-onset obsessive compulsive disorder (OCD) and their first-degree relatives. Methods: Medical questionnaires were completed by 1401 probands and 1045 first-degree relatives in the OCD Collaborative Genetics Association Study. Lifetime prevalence of immune-related diseases was compared with the highest available population estimate and reported as a point estimate with 95% adjusted Wald interval. Worst-episode OCD severity and symptom dimensions were assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS) and Symptom Checklist (YBOCS-CL). Results: Probands reported higher-than-expected prevalence of scarlet fever (4.0 [3.1-5.2]% vs. 1.0%-2.0%, z = 1.491, p

Abstract: Background: WISDOM is a 100,000 healthy women preference-tolerant, pragmatic study comparing annual to personalized risk-based breast screening. The novelty of WISDOM personalized screening is the integration of previously validated genetic and clinical risk factors (age, family history, breast biopsy results, ethnicity, mammographic density) into a single risk assessment model that directs the starting age, timing, and frequency of screening. The goal of WISDOM is to determine if personalized screening, compared to annual screening, is as safe, less morbid, enables prevention, and is preferred by women. The study is registered on ClinicalTrials.gov, NCT02620852. Methods: Women aged 40-74 years with no history of breast cancer or DCIS, and no previous double mastectomy can join the study online at wisdomstudy.org. Participants can elect randomization or self-select a study arm, and provide electronic consent and Release for Medical Information using DocuSign. For all participants, 5-year risk of developing breast cancer is calculated according to the Breast Cancer Screening Consortium (BCSC) model. Participants in the personalized arm undergo panel-based mutation testing, and their 5-year risk is calculated using the BCSC score combined with a Polygenic Risk Score (BCSC-PRS) that includes 75 single nucleotide polymorphisms (SNPs, increase to 229) known to increase breast cancer risk. SNPs and mutations (BRCA1, BRCA2, TP53, PTEN, STK11, CDH1, ATM, PALB2, and CHEK2) are assessed by saliva-based testing through Color Genomics. 5-year risk level thresholds are used to stratify for low-, moderate- and high risk. Risk stratification determines age to start, stop, and frequency of screening. Enrollment: As of July 2018, the WISDOM study is open to all eligible women in California, North Dakota, South Dakota, Minnesota and Iowa. To date, 23,329 eligible women have registered and 14,393 women have consented to participate in the trial. We analyzed 3,255 participants who have completed risk assessment in the personalized arm. The median age was 56 years. 82% were Caucasian, 1% African-American, and 6% Asian. 9% self-reported as Hispanic. We are partnering with health insurers and self-insured companies using coverage with evidence progression. To strengthen generalizability, we are expanding to other states. WISDOM enrollment will continue past 2019. Feasibility: To evaluate the addition of PRS, we used paired statistical tests (McNemar) to compare the distributions of BCSC, and BCSC-PRS risk estimates around low-risk (6%) thresholds, the latter corresponding to 5-year risk of a BRCA mutation carrier. The median 5-year risk was 1.5% (IQR 1.0-2.1%) using the BCSC model, and 1.4% (IQR 0.8-2.5%) using the BCSC-PRS model. The BCSC-PRS model classified more women into the low (

Only a small number of studies have assessed structural differences between the two hemispheres during childhood and adolescence. However, the existing findings lack consistency or are restricted to a particular brain region, a specific brain feature, or a relatively narrow age range. Here, we investigated associations between brain asymmetry and age as well as sex in one of the largest pediatric samples to date (n = 4265), aged 1–18 years, scanned at 69 sites participating in the ENIGMA (Enhancing NeuroImaging Genetics through Meta‐Analysis) consortium. Our study revealed that significant brain asymmetries already exist in childhood, but their magnitude and direction depend on the brain region examined and the morphometric measurement used (cortical volume or thickness, regional surface area, or subcortical volume). With respect to effects of age, some asymmetries became weaker over time while others became stronger; sometimes they even reversed direction. With respect to sex differences, the total number of regions exhibiting significant asymmetries was larger in females than in males, while the total number of measurements indicating significant asymmetries was larger in males (as we obtained more than one measurement per cortical region). The magnitude of the significant asymmetries was also greater in males. However, effect sizes for both age effects and sex differences were small. Taken together, these findings suggest that cerebral asymmetries are an inherent organizational pattern of the brain that manifests early in life. Overall, brain asymmetry appears to be relatively stable throughout childhood and adolescence, with some differential effects in males and females. [ABSTRACT FROM AUTHOR]

Abstract: Fingering is a hydrodynamic instability that occurs when a more mobile fluid displaces a fluid of lower mobility. When the primary source of the mobility difference is viscosity, the instability is termed viscous fingering. Viscous fingering is often, though not always, undesirable in industrial processes, particularly secondary petroleum recovery. Linear stability analysis by Hejazi et al. has indicated that the production of a non-monotonic viscosity profile can stabilize the interface. Herein, we use step-growth polymerization at the interface between two miscible monomers as a model system. In particular, a dithiol monomer displaced a diacrylate that reacted to form a linear polymer that behaves as a Newtonian fluid. Viscous fingering was imaged in a horizontal Hele-Shaw cell via Schlieren, which is sensitive to changes in index of refraction, and therefore polymer conversion. By varying reaction rate via initiator concentration along with flow rate via a syringe pump, we were able to demonstrate increasing stabilization of the flow with increasing Damköhler number. Graphical abstract: [Figure not available: see fulltext.].

BackgroundClinicians have long considered doubt to be a fundamental characteristic of obsessive-compulsive disorder (OCD). However, the clinical relevance of doubt in OCD has not been addressed.MethodsParticipants included 1182 adults with OCD who had participated in family and genetic studies of OCD. We used a clinical measure of the severity of doubt, categorized as none, mild, moderate, severe, or extreme. We evaluated the relationship between doubt and OCD clinical features, Axis I disorders, personality and personality disorder dimensions, impairment, and treatment response.ResultsThe severity of doubt was inversely related to the age at onset of OCD symptoms. Doubt was strongly related to the number of checking symptoms and, to a lesser extent, to the numbers of contamination/cleaning and hoarding symptoms. Doubt also was related to the lifetime prevalence of recurrent major depression and generalized anxiety disorder; to the numbers of avoidant, dependent, and obsessive-compulsive personality disorder traits; and to neuroticism and introversion. Moreover, doubt was strongly associated with global impairment and poor response to cognitive behavioral treatment (CBT), even adjusting for OCD severity and other correlates of doubt.ConclusionsDoubt is associated with important clinical features of OCD, including impairment and cognitive-behavioral treatment response.