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Research has shown that vignettes are useful in disseminating complex and applied information to practitioners with research mainly utilising written and audio vignettes to disseminate good practice. The current study examined the utility of a research-based vignette, presented in different formats (written, audio, video), to disseminate information to elite strength and conditioning (S&C) coaches. A single vignette was developed in three formats: a written, an audio, and a video vignette. The vignette involved an experienced S&C coach as the main character, and the plot outlined how this S&C coach aimed to learn more about effective coaching. Nineteen elite S&C coaches reflected on the utility of different vignette formats. Data were analysed using a thematic analysis. Overall, the results suggest that vignettes are useful in translating knowledge and encourage action, regardless of which format is used. Furthermore, the S&C coaches reported a preference for the video format, due to the video’s ability to communicate emotional, verbal and non-verbal behaviours. Practically, the vignette prompted the S&C coaches to reflect on areas such as coaching philosophy and values resulting in initial changes in their coaching practice.

We define a measure for the accuracy of tomographic reconstruction in atom probe tomography, named here the spatial error index. We demonstrate that this index can be used to compare rigorously the spatial accuracy of various different approaches to the calculation of tomographic reconstruction. This is useful, for example, to evaluate the performance of alternate tomographic reconstruction approaches, and ensures that the comparisons are independent of individual data quality or other instrumental parameters. We then introduce a new “adaptive reconstruction” formalism that uses a progression of reconstruction parameters based on a per-atom correction from the cube root of the inverse of the voltage, along with linear correction factors linked to the evaporation sequence. We apply the measure for spatial accuracy to this new reconstruction protocol.

This article presents two alternative methods to null hypothesis significance testing (NHST) for improving inferences from underpowered research designs. Post hoc design analysis (PHDA) assesses whether an NHST analysis generating null findings might otherwise have had sufficient power to detect effects of plausible magnitudes. Bayesian analysis with default priors offers advantages over NHST for assessing null findings and detecting signals in underpowered data. Both methods are illustrated by application to Pager and Quillian’s influential study on attitude-behavior correspondence. PHDA results suggest the original study lacked sufficient power to detect strong associations between employers’ attitudes and behaviors. Bayesian analysis confirms strong attitude–behavior associations cannot be ruled out given the data. Together, these results question a frequently cited conclusion about attitude–behavior incongruence in survey vignettes. Overall, the examples illustrate how these analytical tools can be useful for describing uncertainty surrounding estimates and for improving substantive and theoretical debates across sociology.

Landscape connectivity is a key component for successful dispersal of wildlife. Many approaches to quantify landscape connectivity utilize landscape characteristics and wildlife behavior in response to those characteristics, whereas other approaches focus on wildlife dispersal behavior. Combining landscape structure and wildlife behavior (e.g. movement, food acquisition, response to predation risk) provides critical information for conservation and management of many species. Individual-based models (IBM) are useful tools for evaluating the interaction between landscape characteristics and individual behaviors, thereby providing insights into management and conservation. Our objective was to evaluate the effect of reductions in landscape connectivity on northern flying squirrel dispersal movements under alternative timber management scenarios within the modeling framework of a spatially-explicit IBM. We simulated timber harvests of 6% and 9% of old-growth forest, the primary habitat for this species, distributed across 5, 10 or 15 harvest locations. We measured the influence of these scenarios upon landscape connectivity for flying squirrels. Landscapes with greater connectivity exhibited longer flying squirrel dispersal distances, more sinuous dispersal paths, and a greater total area of landscape utilization. However, connectivity was not directly correlated with habitat loss. The harvest scenario with 6% harvest of old growth distributed among 15 harvest locations had the lowest connectivity index value despite other scenarios modeling a greater percentage of old growth loss. The IBM demonstrated the importance of behaviors such as path tortuosity and movement rates in conjunction with landscape configuration in influencing the movement of dispersing individuals. The spatially explicit IBM provided a framework to evaluate connectivity from a fine-scale behavioral rather than structural perspective as well as to evaluate the distribution of new home range locations, which could be a useful management tool when evaluating the influence of landscape heterogeneity and stochastic behavior on wildlife movement and dispersal.

Patterns of dispersal behavior are often driven by the composition and configuration of suitable habitat in a matrix of unsuitable habitat. Interactions between animal behavior and landscapes can therefore influence population dynamics, population and species distributions, population genetic structure, and the evolution of behavior. Spatially explicit individual-based models (IBMs) are ideal tools for exploring the effects of landscape structure on dispersal. We developed an empirically parameterized IBM in the modeling framework SEARCH to simulate dispersal of translocated American martens in Wisconsin. We tested the hypothesis that a time-limited disperser should be willing to settle in lower quality habitat over time. To evaluate model performance, we used a pattern-oriented modeling approach. Our best model matched all empirical dispersal patterns (e.g., dispersal distance) except time to settlement. This model incorporated a required search phase as well as the mechanism for declining habitat selectivity over time, which represents the first demonstration of this hypothesis for a vertebrate species. We suggest that temporal plasticity in habitat selectivity allows individuals to maximize fitness by making a tradeoff between habitat quality and risk of mortality. Our IBM is pragmatic in that it addresses a management need for a species of conservation concern. However, our model is also paradigmatic in that we explicitly tested a theory of dispersal behavior. Linking these 2 approaches to ecological modeling can further the utility of individual-based modeling and provide direction for future theoretical and empirical work on animal behavior., Home range selection is a complex task for animal dispersers. Using a simulation modeling approach, we created virtual American martens whose dispersal patterns matched those of actual martens. The best-performing model included martens that were willing to settle in lower quality habitat over time and searched for at least 2 weeks prior to settlement. We demonstrate how such a modeling approach can simultaneously answer questions that are of a theoretical and an applied nature.

The extent to which climate change causes significant societal disruption remains controversial. An important example is the decline of the Akkadian Empire in northern Mesopotamia ∼4.2 ka, for which the existence of a coincident climate event is still uncertain. Here we present an Iranian stalagmite record spanning 5.2 ka to 3.7 ka, dated with 25 U/Th ages that provide an average age uncertainty of 31 y (1σ). We find two periods of increased Mg/Ca, beginning abruptly at 4.51 and 4.26 ka, and lasting 110 and 290 y, respectively. Each of these periods coincides with slower vertical stalagmite growth and a gradual increase in stable oxygen isotope ratios. The periods of high Mg/Ca are explained by periods of increased dust flux sourced from the Mesopotamia region, and the abrupt onset of this dustiness indicates threshold behavior in response to aridity. This interpretation is consistent with existing marine and terrestrial records from the broad region, which also suggest that the later, longer event beginning at 4.26 ka is of greater regional extent and/or amplitude. The chronological precision and high resolution of our record indicates that there is no significant difference, at decadal level, between the start date of the second, larger dust event and the timing of North Mesopotamia settlement abandonment, and furthermore reveals striking similarity between the total duration of the second dust event and settlement abandonment. The Iranian record demonstrates this region’s threshold behavior in dust production, and its ability to maintain this climate state for multiple centuries naturally.

ObjectivesTo describe the relationships between axial length and intraoperative complications in patients undergoing cataract surgery.DesignCohort analysis of the Royal College of Ophthalmologists’ National Ophthalmology Database (RCOphth NOD).Setting110 National Health Service Trusts in England, Health Boards in Wales, Independent Sector Treatment Centres and Guernsey.Participants820 354 patients, aged 18 years or older, undergoing cataract surgery. Eligible operations were those from centres with at least 50 operations with a recorded axial length measurement and age at surgery between 1 April 2010 and 31 August 2019.InterventionsPhacoemulsification where the primary intention was cataract surgery alone.Outcome measuresPosterior capsule rupture (PCR) and other recorded intraoperative complications.Results1 211 520 eligible operations were performed by 3210 surgeons. The baseline axial length was 28 mm (long eyes) for 11 837 (1.0%) eyes. The median age at surgery was younger for patients with long eyes than those with short or medium eyes. The rate of any intraoperative complication was higher for short eyes than medium or long with complication rates of 4.5%, 2.9% and 3.3%, respectively (pConclusionsOverall PCR rates for cataract surgery in RCOphth NOD contributing centres are lower than previously reported and there is little change in PCR rates by axial length. Short eyes were more likely to have an intraoperative complication than medium or long eyes.

There are many factors that may influence parenting, from societal norms and expectations, dispositional differences, experience and maturity, and availability of resources. In the current research, we examined how stable demographic characteristics associated with these different factors predict the goals parents pursue with their children. We examined whether the pursuit of four parenting goals—child love and security, child development, parent image, and child acceptance—varies based on the characteristics of parents (i.e., gender, age, and socioeconomic status) and their children (i.e., gender and age). First, we provided evidence for the measurement invariance of the Parenting Goals Scale. The results suggested that across key characteristics, parents largely pursue the same four parenting goals on which they could be meaningfully compared. Second, meta-analytic results ( k = 5; Ntotal = 2,240) indicated that parents were largely similar in the goals they pursued with their children across their own and their child’s characteristics. We identified only a few exceptions, with these differences being small in magnitude: mothers and noncollege-educated parents pursued child love and security goals more than fathers and college-educated parents, older parents pursued child development goals less than younger parents, parents of older children pursued image goals more than parents of younger children, and lower income parents pursued child acceptance goals more than higher income parents. These results suggest that while there may be some small differences in parenting goal pursuit based on demographic characteristics, parents are largely motivated by similar goals when caring for their children.

Background Integrated molecular profiling has identified intrinsic expression-based bladder cancer molecular subtypes. Despite frequent histological diversity, robustness of subtypes in paired conventional (urothelial) and squamous components of the same bladder tumor has not been reported. Objective To assess the impact of histological heterogeneity on expression-based bladder cancer subtypes. Design, setting, and participants We performed clinically applicable, targeted DNA and/or RNA sequencing (multiplexed DNA and RNA sequencing [mxDNAseq and mxRNAseq, respectively]) on 112 formalin-fixed paraffin-embedded (FFPE) bladder cancer samples, including 12 cases with paired urothelial/squamous components and 21 bladder cancer cell lines. Outcome measurements and statistical analysis Unsupervised hierarchical and consensus clustering of target gene expression enabled derivation of basal/luminal molecular subtyping. Results and limitation Across 21 bladder cancer cell lines, our custom mxRNAseq panel was highly concordant with whole transcriptome sequencing, and assessed targets robustly determined expression-based basal/luminal subtypes from The Cancer Genome Atlas data (in silico) and internally sequenced FFPE tissues. Frequent deleterious TP53 (56%) and activating hotspot PIK3CA (30%) somatic mutations were seen across 69 high-quality tissue samples. Potentially targetable focal ERBB2 (6%) or EGFR (6%) amplifications were also identified, and a novel subgene copy-number detection approach is described. Combined DNA/RNA analysis showed that focally amplified samples exhibit outlier EGFR and ERBB2 expression distinct from subtype-intrinsic profiles. Critically, paired urothelial and squamous components showed divergent basal/luminal status in three of 12 cases (25%), despite identical putatively clonal prioritized somatic genomic alterations. Limitations include lack of profiled paired normal tissues for formal somatic alteration determination, and the need for formal analytical and clinical validation. Conclusions Our results support the feasibility of clinically relevant integrative bladder cancer profiling and challenge the intrinsic nature of expression subtypes in histologically diverse bladder cancers. Patient summary A targeted RNA sequencing assay is capable of assessing gene expression-based subtypes in individual components of clinical bladder cancer tissue specimens. Different histological components of the same tumor may yield divergent expression profiles, suggesting that expression-based subtypes should be interpreted with caution in heterogeneous cancers.

PURPOSE: To report the outcomes of laser in situ keratomileusis (LASIK) for hyperopia using the Triple-A ablation profile with the MEL 90 excimer laser (Carl Zeiss Meditec, Jena, Germany). METHODS: This retrospective analysis included 1,383 eyes treated by LASIK for hyperopia using the Triple-A ablation profile with the MEL 90 at London Vision Clinic, London, United Kingdom, between September 2013 and December 2016. Inclusion criteria were attempted hyperopic correction of +0.25 diopters (D) or higher and corrected distance visual acuity (CDVA) of 20/40 or better. Patients were observed for 1 year after surgery. Standard outcomes analysis was performed. RESULTS: One-year data were available for 1,350 (97%) eyes. Mean attempted spherical equivalent refraction (SEQ) was +2.77 ± 1.34 D (range: +0.13 to +6.50 D) and mean cylinder was −0.67 ± 0.66 D (range: 0.00 to −5.00 D). Mean age was 54 ± 11 years (range: 21 to 75 years), and 57% were female. Postoperative spherical equivalent was ±0.50 D in 73% and ±1.00 D in 93% of eyes. Uncorrected distance visual acuity was 20/20 or better in 75% of eyes, relative to 93% with preoperative CDVA of 20/20 or better. One line of CDVA was lost in 17% of eyes and two lines were lost in 0.6% of eyes. There was a clinically insignificant but statistically significant increase ( P < .01) in contrast sensitivity at 3 and 6 cycles per degree (cpd) and no change for 12 and 18 cpd. CONCLUSIONS: LASIK for hyperopia with the MEL 90 excimer laser was found to satisfy accepted criteria for safety, efficacy, and stability. [ J Refract Surg . 2018;34(12):799–808.]

Inhaled corticosteroids (ICS) have a class effect of increasing pneumonia risk in patients with COPD. However, pneumonia incidence varies widely across clinical trials of ICS use in COPD. This review clarifies methodological differences in defining and recording pneumonia events in these trials and discusses factors that could contribute to the varying pneumonia incidence. Literature searches and screening yielded 40 relevant references for inclusion. Methods used to capture pneumonia events in these studies included investigator-reported pneumonia adverse events, standardised list of signs or symptoms, radiographic confirmation of suspected cases and/or confirmation by an independent clinical end-point committee. In general, more stringent pneumonia diagnosis criteria led to lower reported pneumonia incidence rates. In addition, studies varied in design and population characteristics, including exacerbation history and lung function, factors that probably contribute to the varying pneumonia incidence. As such, cross-trial comparisons are problematic. A minimal set of standardised criteria for diagnosis and reporting of pneumonia should be used in COPD studies, as well as reporting of patients’ pneumonia history at baseline, to allow comparison of pneumonia rates between trials. Currently, within-trial comparison of ICS-containing versus non-ICS-containing treatments is the appropriate method to assess the influence of ICS on pneumonia incidence.

Monitoring the health of coral reefs is essential to understand the damaging impacts of anthropo-genic climate change. Non-invasive methods to survey coral reefs are the most desirable and op-tics-based surveys, ranging from simple photography to multispectral satellite imaging are well es-tablished. Herein, we review these techniques, focusing on their value for coral monitoring and health diagnosis. A new, low-cost hyperspectral imaging technique using linear variable filters is also described. This system is capable of simultaneously producing hyperspectral and photogrammetric outputs, which provides integrated information of reef structure and physiology.

Objective To evaluate whether opt out framing, messaging incorporating behavioral science concepts, or electronic communication increases the uptake of hepatitis C virus (HCV) screening in patients born between 1945 and 1965. Design Pragmatic randomized controlled trial. Setting 43 primary care practices from one academic health system (Philadelphia, PA, USA) between April 2019 and May 2020. Participants Patients born between 1945 and 1965 with no history of screening and at least two primary care visits in the two years before the enrollment period. Interventions This multilevel trial was divided into two studies. Substudy A included 1656 eligible patients of 17 primary care clinicians who were randomized in a 1:1 ratio to a mailed letter about HCV screening (letter only), or a similar letter with a laboratory order for HCV screening (letter+order). Substudy B included the remaining 19 837 eligible patients followed by 417 clinicians. Active electronic patient portal users were randomized 1:5 to receive a mailed letter about HCV screening (letter), or an electronic patient portal message with similar content (patient portal); inactive patient portal users were mailed a letter. In a factorial design, patients in substudy B were also randomized 1:1 to receive standard content (usual care), or content based on principles of social norming, anticipated regret, reciprocity, and commitment (behavioral content). Main outcome measures Proportion of patients who completed HCV testing within four months. Results 21 303 patients were included in the intention-to-treat analysis. Among the 1642 patients in substudy A, 19.2% (95% confidence interval 16.5% to 21.9%) completed screening in the letter only arm and 43.1% (39.7% to 46.4%) in the letter+order arm (P Conclusions Opt out framing and effort reduction by including a signed laboratory order with outreach increased screening for HCV. Behavioral science messaging content did not increase uptake, and mailed letters achieved a greater response rate than patient portal messages. Trial registration ClinicalTrials.gov NCT03712553 .

Purpose To evaluate the impact of surgery restrictions on cataract surgery performance. Setting Moorfields Eye Hospital, NHS Foundation Trust, London, UK. Design Retrospective, observational cross-sectional study. Methods Single-centre, retrospective review of all patients that underwent phacoemulsification surgery at Moorfields Eye Hospital, between September 2019 and January 2021. Our main outcome measure was Posterior Capsule Rupture (PCR) rate before and after COVID-19 imposed restrictions to elective cataract surgery. Results We identified a total of 15689 surgeries in the period of the study performed by 256 different surgeons. In the pre-surgery restriction period (September 2019 to March 2020), the PCR rate was 0.99% while on surgery restarting after 19 weeks, the PCR rate spiked to 1.62% (Odds Ratio 1.65; p=0.001; CI 1.24-2.20; Relative Risk: 1.64). Conclusions COVID-19 pandemic provided a unique opportunity to assess a large group of surgeons' performances after prolonged surgical abstinence. A 19-weeks period of restrictions in surgical activity showed an increased incidence of PCR complications. This is relevant as it can concern any surgeon on extended time off work such as sickness, sabbatical, research and parental leave. Supporting strategies should be implemented by associated regulators to minimize this negative impact.

While there has been sustained interest in understanding the role of reward processing in autism spectrum disorder (ASD), researchers are just beginning to focus on the anticipation phase of reward processing in this population. This review aimed to briefly summarize recent advancements in functional imaging studies of anticipatory social and nonsocial reward processing in individuals with and without ASD and provide suggestions for avenues of future research. Reward salience and activation of the complex network of brain regions supporting reward anticipation vary across development and by important demographic characteristics, such as sex assigned at birth. Current research comparing social and nonsocial reward anticipation may possess confounds related to the mismatch in tangibility and salience of social and nonsocial experimental stimuli. Growing evidence suggests individuals with ASD demonstrate aberrant generalized reward anticipation that is not specific to social reward. Future research should carefully match social and nonsocial reward stimuli and consider employing a longitudinal design to disentangle the complex processes contributing to the development of reward anticipation. It may be useful to conceptualize differences in reward anticipation as a transdiagnostic factor, rather than an ASD-specific deficit.

While there has been sustained interest in understanding the role of reward processing in autism spectrum disorder (ASD), researchers are just beginning to focus on the anticipation phase of reward processing in this population. This review aimed to briefly summarize recent advancements in functional imaging studies of anticipatory social and nonsocial reward processing in individuals with and without ASD and provide suggestions for avenues of future research.Reward salience and activation of the complex network of brain regions supporting reward anticipation vary across development and by important demographic characteristics, such as sex assigned at birth. Current research comparing social and nonsocial reward anticipation may possess confounds related to the mismatch in tangibility and salience of social and nonsocial experimental stimuli. Growing evidence suggests individuals with ASD demonstrate aberrant generalized reward anticipation that is not specific to social reward. Future research should carefully match social and nonsocial reward stimuli and consider employing a longitudinal design to disentangle the complex processes contributing to the development of reward anticipation. It may be useful to conceptualize differences in reward anticipation as a transdiagnostic factor, rather than an ASD-specific deficit.

Terrestrial ecosystems are intimately linked with the global climate system, but their response to ongoing and future anthropogenic climate change remains poorly understood. Reconstructing the response of terrestrial ecosystem processes over past periods of rapid and substantial climate change can serve as a tool to better constrain the sensitivity in the ecosystem-climate response.In this talk, we will present a new reconstruction of soil respiration in the temperate region of Western Europe based on speleothem carbon isotopes (δ13C). Soil respiration remains poorly constrained over past climatic transitions, but is critical for understanding the global carbon cycle and its response to ongoing anthropogenic warming. Our study builds upon two decades of speleothem research in Western Europe, which has shown clear correlation between δ13C and regional temperature reconstructions during the last glacial and the deglaciation, with exceptional regional coherency in timing, amplitude, and absolute δ13C variation. By combining innovative multi-proxy geochemical analysis (δ13C, Ca isotopes, and radiocarbon) on three speleothems from Northern Spain, and quantitative forward modelling of processes in soil, karst, and cave, we show how deglacial variability in speleothem δ13C is best explained by increasing soil respiration. Our study is the first to quantify and remove the effects of prior calcite precipitation (PCP, using Ca isotopes) and bedrock dissolution (open vs closed system, using the radiocarbon reservoir effect) from the speleothem δ13C signal to derive changes in respired δ13C over time. Our approach allows us to estimate the temperature sensitivity of soil respiration (Q10), which is higher than current measurements, suggesting that part of the speleothem signal may be related to a change in the composition of the soil respired δ13C. This is likely related to changing substrate through increasing contribution from vegetation biomass with the onset of the Holocene.These results highlight the exciting possibilities speleothems offer as a coupled archive for quantitative proxy-based reconstructions of climate and ecosystem conditions.

Many coastal and marine ecosystems around the world are under increasing threat from a range of anthropogenic influences. The management of these threats continues to present ongoing challenges, with many ecosystems increasingly requiring active restoration to support or re-establish the ecosystem's biological, cultural, social and economic values. The current condition of Australia's Great Barrier Reef (GBR) and its threats, including water quality, climate change and the loss of wetlands, causing the continuing decline in the GBR's ecological condition and function, has received global attention. Activities aimed at halting these declines and system restoration have been underway for over forty years. These activities are challenging to implement, and much has been learnt from their various outcomes. This paper considers the GBR and the associated management activities as a case study for regional scale catchment to reef management. It summarises the management approaches to date, describing the key role that science, policy and community have played in underpinning various investments. Four criteria for success are proposed: the lead role of the community, the need for a systems approach, the need for targeted, cost-effective and sustainable long-term investment, and importantly, building knowledge and maintaining consensus and political commitment.

Rationale: In the IMPACT (Informing the Pathway of COPD Treatment) trial, single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy reduced exacerbation risk versus FF/VI and UMEC/VI and mortality risk versus UMEC/VI. However, pneumonia incidence was higher in the inhaled corticosteroid (FF)containing arms, raising questions about the relative benefit of exacerbation reduction compared with the increased risk of pneumonia.Objectives: Determine benefit-risk of the three treatments by evaluating time-to-first and rates of composite exacerbation or pneumonia outcomes.Methods: We evaluated time-to-first (prespecified) and rates (post hoc) of investigator-reported pneumonia, serious pneumonia leading to hospitalization or death, and the composite endpoints of 1) moderate (required antibiotics/corticosteroids)/severe (hospitalized) exacerbation or pneumonia and 2) severe exacerbation or serious (hospitalized) pneumonia. Analyses were repeated for radiographically confirmed pneumonia (post hoc).Results: Moderate/severe exacerbations occurred in 47%, 49%, and 50% of patients randomized to FF/UMEC/VI, FF/VI andUMEC/VI, and pneumonias in 8%, 7%, and 5%, respectively. FF/UMEC/VI reduced the risk of combined moderate/severe exacerbation or pneumonia (time-to-first) versus FF/VI (hazard ratio, 0.87 [95% confidence interval (CI), 0.82-0.92]) and UMEC/VI (0.87 [0.81-0.94]), as well as the risk of combined severe exacerbation or serious pneumonia versus UMEC/VI (0.83 [0.72-0.96]). FF/UMEC/VI reduced the rate of combined moderate/severe exacerbation or pneumonia (rate ratio, 0.78 [0.72-0.84]) and combined severe exacerbation or serious pneumonia (rate ratio, 0.76 [0.65-0.89]) versus UMEC/VI. Results were similar for radiographically confirmed pneumonia endpoints.Conclusions: Despite higher incidence of pneumonia in FF-containing arms, these composite exacerbation/pneumonia outcomes support a favorable benefit-risk profile of FF/UMEC/VI versus FF/VI and UMEC/VI in patients with symptomatic chronic obstructive pulmonary disease and a history of exacerbations.

The crystal structure of perraultite from the Oktyabr'skii massif, Donetsk region, Ukraine (bafertisite group, seidozerite supergroup), ideally NaBaMn4Ti2(Si2O7)2O2(OH)2F, Z = 4, was refined in space group C to R1 = 2.08% on the basis of 4839 unique reflections [Fo > 4σFo]; a = 10.741(6), b = 13.841(8), c = 11.079(6) Å, α = 108.174(6), β = 99.186(6), γ = 89.99(1)°, V = 1542.7(2.7) Å3. Refinement was done using data from a crystal with three twin domains which was part of a grain used for electron probe microanalysis. In the perraultite structure [structure type B1(BG), B – basic, BG – bafertisite group], there is one type of TS (Titanium-Silicate) block and one type of I (Intermediate) block; they alternate along c. The TS block consists of HOH sheets (H – heteropolyhedral, O – octahedral). In the O sheet, the ideal composition of the five [6]MO sites is Mn4apfu. There is no order of Mn and Fe2+ in the O sheet. The MH octahedra and Si2O7 groups constitute the H sheet. The ideal composition of the two [6]MH sites is Ti2apfu. The TS blocks link via common vertices of MH octahedra. The I block contains AP(1,2) and BP(1,2) cation sites. The AP(1) site is occupied by Ba and the AP(2) site by K > Ba; the ideal composition of the AP(1,2) sites is Ba apfu. The BP(1) and BP(2) sites are each occupied by Na > Ca; the ideal composition of the BP(1,2) sites is Na apfu. We compare perraultite and surkhobite based on the work of Sokolova et al. (2020) on the holotype sample of surkhobite: space group C, R1 = 2.85 %, a = 10.728(6), b = 13.845(8), c = 11.072(6) Å, α = 108.185(6), β = 99.219(5), γ = 90.001(8)°, V = 1540.0(2.5) Å3; new EPMA data. We show that (1) perraultite and surkhobite have identical chemical composition and ideal formula NaBaMn4Ti2(Si2O7)2O2(OH)2F; (2) perraultite and surkhobite are isostructural, with no order of Na and Ca at the BP(1,2) sites. Perraultite was described in 1991 and has precedence over surkhobite, which was redefined as “a Ca-ordered analogue of perraultite” in 2008. Surkhobite is not a valid mineral species and its discreditation was approved by CNMNC IMA (IMA 20-A).

Background Cataract surgery is one of the most common operations. Femtosecond laser-assisted cataract surgery (FLACS) is a technique that automates a number of operative steps. Objectives To compare FLACS with phacoemulsification cataract surgery (PCS). Design Multicentre, outcome-masked, randomised controlled non-inferiority trial. Setting Three collaborating NHS hospitals. Participants A total of 785 patients with age-related cataract in one or both eyes were randomised between May 2015 and September 2017. Intervention FLACS (n = 392 participants) or PCS (n = 393 participants). Main outcome measures The primary outcome was uncorrected distance visual acuity in the study eye after 3 months, expressed as the logarithm of the minimum angle of resolution (logMAR): 0.00 logMAR (or 6/6 if expressed in Snellen) is normal (good visual acuity). Secondary outcomes included corrected distance visual acuity, refractive outcomes (within 0.5 dioptre and 1.0 dioptre of target), safety and patient-reported outcome measures at 3 and 12 months, and resource use. All trial follow-ups were performed by optometrists who were masked to the trial intervention. Results A total of 353 (90%) participants allocated to the FLACS arm and 317 (81%) participants allocated to the PCS arm attended follow-up at 3 months. The mean uncorrected distance visual acuity was similar in both treatment arms [0.13 logMAR, standard deviation 0.23 logMAR, for FLACS, vs. 0.14 logMAR, standard deviation 0.27 logMAR, for PCS, with a difference of –0.01 logMAR (95% confidence interval –0.05 to 0.03 logMAR; p = 0.63)]. The mean corrected distance visual acuity values were again similar in both treatment arms (–0.01 logMAR, standard deviation 0.19 logMAR FLACS vs. 0.01 logMAR, standard deviation 0.21 logMAR PCS; p = 0.34). There were two posterior capsule tears in the PCS arm. There were no significant differences between the treatment arms for any secondary outcome at 3 months. At 12 months, the mean uncorrected distance visual acuity was 0.14 logMAR (standard deviation 0.22 logMAR) for FLACS and 0.17 logMAR (standard deviation 0.25 logMAR) for PCS, with a difference between the treatment arms of –0.03 logMAR (95% confidence interval –0.06 to 0.01 logMAR; p = 0.17). The mean corrected distance visual acuity was 0.003 logMAR (standard deviation 0.18 logMAR) for FLACS and 0.03 logMAR (standard deviation 0.23 logMAR) for PCS, with a difference of –0.03 logMAR (95% confidence interval –0.06 to 0.01 logMAR; p = 0.11). There were no significant differences between the arms for any other outcomes, with the exception of the mean binocular corrected distance visual acuity with a difference of –0.02 logMAR (95% confidence interval –0.05 to 0.00 logMAR) (p = 0.036), which favoured FLACS. There were no significant differences between the arms for any health, social care or societal costs. For the economic evaluation, the mean cost difference was £167.62 per patient higher for FLACS (95% of iterations between –£14.12 and £341.67) than for PCS. The mean QALY difference (FLACS minus PCS) was 0.001 (95% of iterations between –0.011 and 0.015), which equates to an incremental cost-effectiveness ratio (cost difference divided by QALY difference) of £167,620. Limitations Although the measurement of outcomes was carried out by optometrists who were masked to the treatment arm, the participants were not masked. Conclusions The evidence suggests that FLACS is not inferior to PCS in terms of vision after 3 months’ follow-up, and there were no significant differences in patient-reported health and safety outcomes after 12 months’ follow-up. In addition, the statistically significant difference in binocular corrected distance visual acuity was not clinically significant. FLACS is not cost-effective. Future work To explore the possible differences in vision in patients without ocular co-pathology. Trial registration Current Controlled Trials ISRCTN77602616. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 6. See the NIHR Journals Library website for further project information. Moorfields Eye Charity (grant references GR000233 and GR000449 for the endothelial cell counter and femtosecond laser used).

Simple Summary Mutation of the APC gene is a common early event in colorectal cancer, however lower rates have been reported in younger cohorts of colorectal cancer patients. In sporadic cancer, mutations are typically clustered around a mutation cluster region, a narrowly defined hotspot within the APC gene. In this study we used a sequencing strategy aimed at identifying mutations more widely throughout the APC gene in patients aged 50 years or under. We found high rates of APC mutation in our young cohort that were similar to rates seen in older patients but the mutations we found were spread throughout the gene in a pattern more similar to that seen in inherited rather than sporadic mutations. Our study has implications both for the sequencing of the APC gene in early-onset colorectal cancer and for the etiology of this disease. Abstract While overall colorectal cancer (CRC) cases have been declining worldwide there has been an increase in the incidence of the disease among patients under 50 years of age. Mutation of the APC gene is a common early event in CRC but is reported at lower rates in early-onset colorectal cancer (EOCRC) than in older patients. Here we investigate the APC mutation status of a cohort of EOCRC patients in New Zealand using a novel sequencing approach targeting regions of the gene encompassing the vast majority of known APC mutations. Using this strategy we find a higher rate (72%) of APC mutation than previously reported in EOCRC with mutations being spread throughout the gene rather than clustered in hotspots as seen with sporadic mutations in older patients. The rate of mutations falling within hotspots was similar to those previously seen in EOCRC and as such our study has implications for sequencing strategies for EOCRC patients. Overall there were low rates of both loss of heterozygosity and microsatellite instability whereas a relatively high rate (40%) of APC promoter methylation was found, possibly reflecting increasing exposure of young people to pro-oncogenic lifestyle factors.

Although the mechanism of DNA demethylating drugs has been understood for many years, the direct effect of these drugs on methylation of the complementary strands of DNA has not been formally demonstrated. By using hairpin-bisulphite sequencing, we describe the kinetics and pattern of DNA methylation following treatment of cells by the DNA methyltransferase 1 (DNMT1) inhibitor, decitabine. As expected, we demonstrate complete loss of methylation on the daughter strand following S-phase in selected densely methylated genes in synchronized Jurkat cells. Thereafter, cells showed a heterogeneous pattern of methylation reflecting replication of the unmethylated strand and restoration of methylation.

The temperate region of western Europe underwent significant climatic and environmental change during the last deglaciation. Much of what is known about the terrestrial ecosystem response to deglacial warming stems from pollen preserved in sediment sequences, providing information on vegetation composition. Other ecosystem processes, such as soil respiration, remain poorly constrained over past climatic transitions but are critical for understanding the global carbon cycle and its response to ongoing anthropogenic warming. Here we show that speleothem carbon isotope (δ13Cspel) records may retain information on soil respiration and allow its reconstruction over time. While this notion has been proposed in the past, our study is the first to rigorously test it, using a combination of multi-proxy geochemical analysis (δ13C, Ca isotopes, and radiocarbon) on three speleothems from the NW Iberian Peninsula and quantitative forward modelling of processes in soil, karst, and cave. Our study is the first to quantify and remove the effects of prior calcite precipitation (PCP, using Ca isotopes) and bedrock dissolution (using the radiocarbon reservoir effect) from the δ13Cspel signal to derive changes in respired δ13C. The coupling of soil gas pCO2 and δ13C via a mixing line describing diffusive gas transport between an atmospheric and a respired end-member allows the modelling of changes in soil respiration in response to temperature. Using this coupling and a range of other parameters describing carbonate dissolution and cave atmospheric conditions, we generate large simulation ensembles from which the results most closely matching the measured speleothem data are selected. Our results robustly show that an increase in soil gas pCO2 (and thus respiration) is needed to explain the observed deglacial trend in δ13Cspel. However, the Q10 (temperature sensitivity) derived from the model results is higher than current measurements, suggesting that part of the signal may be related to a change in the composition of the soil respired δ13C, likely from changing substrate through increasing contribution from vegetation biomass with the onset of the Holocene.

International audience; Purpose: A few de novo missense variants in the cytoplasmic FMRP-interacting protein 2 (CYFIP2) gene have recently been described as a novel cause of severe intellectual disability, seizures, and hypotonia in 18 individuals, with p.Arg87 substitutions in the majority.Methods: We assembled data from 19 newly identified and all 18 previously published individuals with CYFIP2 variants. By structural modeling and investigation of WAVE-regulatory complex (WRC)-mediated actin polymerization in six patient fibroblast lines we assessed the impact of CYFIP2 variants on the WRC.Results: Sixteen of 19 individuals harbor two previously described and 11 novel (likely) disease-associated missense variants. We report p.Asp724 as second mutational hotspot (4/19 cases). Genotype–phenotype correlation confirms a consistently severe phenotype in p.Arg87 patients but a more variable phenotype in p.Asp724 and other substitutions. Three individuals with milder phenotypes carry putative loss-of-function variants, which remain of unclear pathogenicity. Structural modeling predicted missense variants to disturb interactions within the WRC or impair CYFIP2 stability. Consistent with its role in WRC-mediated actin polymerization we substantiate aberrant regulation of the actin cytoskeleton in patient fibroblasts.Conclusion: Our study expands the clinical and molecular spectrum of CYFIP2-related neurodevelopmental disorder and provides evidence for aberrant WRC-mediated actin dynamics as contributing cellular pathomechanism.

Theoretical frameworks grounded in the social cognitive theory are used to discuss the need for assessing motivation, self-efficacy for learning and performance, metacognitive self-regulation of dually enrolled students. This study assessed motivation and learning strategy usage by Dually Enrolled Students participating in Georgia’s Dual Enrollment program. The research was conducted on 213 high school aged 14 to 18 years, in grades 9–12, and attended a high school in a seven-county service area in southwest Georgia. Participants all were taking classes under a program that allows them to simultaneously earn high school and college credit, and required them to attend a high school and college concurrently either at a technical college of the Technical System of Georgia, or a state college of the University System of Georgia. The research questions were answered using a cross-sectional survey, the Motivated Strategies for Learning Questionnaire, and demographics were used to classify participants based on age, grade, gender, number of classes completed in the Dual Enrollment program, teacher type for instruction, and the format/location of college class taken. The study’s findings added to the existing knowledge base regarding teenage students who are expected to conform to the role of college student simply because they were deemed academically equipped to take college classes. Furthermore, the findings of this study suggest the importance of implementing additional acceptance requirements to make sure students possess the maturity, motivation, and learning strategy application knowledge to be successful in college classes and that faculty has been trained to accommodate the learning needs of this specific type of learner.

Funded by the NIHR Health Technology Assessment Panel (project reference number HTA 13/04/46) and sponsored by University College London (UCL). Supported by the NIHR Biomedical Research Centre (A. C. Day) based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. Partly supported by the NIHR Biomedical Research Centre, (C. Bunce) based at Guy's and St Thomas' NHS Foundation Trust and King's College London. Purpose : To report the 1-year outcomes of a randomized trial comparing femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification cataract surgery (PCS). Setting : Moorfields Eye Hospital, New Cross Hospital, and Sussex Eye Hospital, United Kingdom. Design : Multicenter, randomized controlled noninferiority trial. Methods : Patients undergoing cataract surgery were randomized to FLACS or PCS. Postoperative assessments were masked. Outcomes included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), complications, corneal endothelial cell count, and patient-reported outcomes measures. Results : The study enrolled 785 participants. A total of 311 of 392 (79%) participants were allocated to FLACS and 292 of 393 (74%) participants were allocated to PCS attended follow-up at 1 year. Mean UDVA was 0.14 (SD = 0.22) for FLACS and 0.17 (0.25) for PCS with difference of -0.03 logarithm of the minimum angle of resolution (logMAR) (95%, -0.06 to 0.01, P = .17). Mean CDVA was 0.003 (0.18) for FLACS and 0.03 (0.23) for PCS with difference of -0.03 logMAR (95% CI, -0.06 to 0.01, P = .11); 75% of both FLACS (230/307) and PCS (218/290) cases were within +/- 0.5 diopters (D) refractive target, and 292 (95%) of 307 eyes of FLACS and 279 (96%) of 290 eyes of PCS groups were within +/- 1.0 D. There were no significant differences between arms for all other outcomes with the exception of binocular CDVA mean difference -0.02 (-0.05 to 0.002) logMAR (P = .036) favoring FLACS. Mean cost difference was £167.62 per patient greater for FLACS (95% iterations between -£14.12 and £341.67). Conclusions : PCS is not inferior to FLACS regarding vision, patient-reported health, and safety outcomes after 1-year follow-up. A difference was found for binocular CDVA, which, although statistically significant, was not clinically important. FLACS was not cost-effective. Publisher PDF

Rapidly and repeatedly ascertaining the health status of coral reefs is an ever more pressing issue as part of activities to understand and monitor the damaging impacts of climate change. A combination of increasing ocean temperatures, acidity and frequency of extreme storm events continues to alter the marine environment beyond what sensitive organisms, such as coral, can cope with. It is therefore vital to establish technologies and validated methods to provide a metric or indication into the health of these organisms. There are currently many surveys and techniques used by coral scientists to uncover insights into the status and assessment of coral reefs, from colour wheels to multispectral satellite surveys. Here we outline an array of current techniques and methods focused specifically on coral monitoring and health diagnosis, ranging across the length scales from simple diver-based surveyance to satellite remote sensing. The technique of using hyperspectral fluorescence imaging is also introduced as a viable novel addition to aid and extend the current toolbox of available technologies.

In this chapter we take stock of growth following adversity research in sport (i.e., first-wave research) with the goal of illuminating its strengths and shortcomings and suggesting how the strengths might be harnessed and the shortcomings alleviated to inform future work (i.e., second-wave research). The shift from first- to second-wave research involves moving from: (a) intradisciplinary to multi/inter/transdisciplinary research, (b) narrow to diverse pathways to growth, and (c) uncritical to critical considerations. We believe this shift will mature this field of research and help to support the evolving objectives of applied sport psychology.

Many studies in the sport psychology literature have identified growth but it is important that growth researchers are transparent in respect of the theories that underpin their research to provide greater coherence between how terms are conceptualized, operationalized, and theorized. We argue for a move from the mere description of growth to more detailed theoretical explanations of the processes that lead to, and the factors that influence, the experience and consequences of growth. This chapter provides a useful starting point to develop theoretically informed, high-quality research that will foster a rich and diverse understanding of the growth following adversity landscape that we have encouraged in this book. To facilitate this we provide (a) an overview of the theoretical paradigms that have informed the development of theories and models as this is often absent from discussions around theory in both sport psychology and the wider literature, and (b) a clear description and critique of each theory or model which includes an appraisal of how each of them has been used by sport psychology researchers to date.

The aim of this research was to explore the experiential knowledge of patient-facing staff working in a prosthetic rehabilitation center in the United Kingdom. Eleven members of staff with varied roles and levels of experience took part in semi-structured interviews. Transcripts were analyzed using thematic analysis. Six themes were identified: (a) defining successful rehabilitation, (b) the complex reality of patient-centered care, (c) organizational and interpersonal challenges, (d) who provides psychological support? (e) prosthetic as a panacea, and (f) crash landing. These findings highlight the impact of rotational roles in an environment reliant on experiential knowledge, the challenge of applying patient-centered care models, and the negative effect of unrealistic beliefs about prosthetics on patients and staff. This study contributes to a limited pool of literature articulating the experiential knowledge of staff in the context of rehabilitation after major lower limb loss, facilitating the translation of practice-based evidence into evidence-based practice.

The objectives of this research were to extend previous research by exploring the psychosocial experiences of patients over the first year after major lower limb amputation (MLLA) and identify implications for rehabilitation practice. This research took place at a United Kingdom–based National Health Service–operated prosthetic rehabilitation center. Thirty patients were recruited who had experienced MLLA within the last year and were undertaking prosthetic rehabilitation. Data were collected through semi-structured narrative interviews, observation, and a reflexive journal and analyzed using dialogical narrative analysis. The concept of well-being was used to map patients’ recovery trajectories, and five narrative typologies were identified: accelerated decline, adaptation, illusory cure, muddling along, and projection. This article advances knowledge by opening up new possibilities for anticipating patients’ future needs through the stories they are telling in the present and provides the basis for additional resources supporting psychosocial recovery.

Delirium is a common, serious, underdiagnosed condition in medical and surgical inpatients with acute conditions. It is associated with increased risk of mortality and morbidity. Data of geriatric cohorts are largely limited to developed countries.To describe prevalence, risk factors and outcomes of delirium among general medical patients admitted to two hospitals in Cape Town, South Africa.This was a prospective cohort study of patients with acute conditions admitted to a general medical inpatient service in secondary- and tertiary-level public hospitals in the Metro West area of Cape Town. Patients ≥18 years of age were recruited daily from all acute medical admissions. Patients were excluded if they were aphasic or their Glasgow coma scale waslt;8/15. Delirium was diagnosed using the validated confusion assessment method (CAM) tool and performed by trained neuropsychologists. Demographic data were collected by a clinical team and short- and long-term mortality data were obtained using linkage analysis of hospitalised patients and routinely collected provincial death certification records.The median age of inpatients was 51 (interquartile range 36 - 65) years, 29% were HIV-infected and the overall prevalence of delirium was 12.3%. Multivariate predictors of delirium included the presence of an indwelling urinary catheter (odds ratio (OR) 4.47; confidence interval (CI) 2.43 - 8.23), admission with a central nervous system disease (OR 4.34; CI 2.79 - 7.90), pre-existing cognitive impairment (OR 3.02; CI 1.22 - 7.43) and immobility (OR 1.88; CI 1.01 - 3.51). HIV infection was not associated with increased risk of delirium. Delirium was associated with an increased risk of inhospital (delirium v. no delirium: 29% v. 12%; plt;0.01) and 12-month (30% v. 20%; plt;0.01) mortality, as well as increased length of hospital stay (7 days v. 5 days; plt;0.01).In this cohort of medical inpatients (relatively young and with a high HIV prevalence) 1 of 8 (12.3%) patients was delirious. Delirium was associated with adverse outcomes. Delirium risk factors in this young cohort were similar to those in geriatric cohorts in developed countries, and neither HIV nor opportunistic infections increased risk.

To assess the safety, efficacy, and complication rate of phacoemulsification and intraocular lens (IOL) implantation in patients with congenital uveal coloboma and to evaluate the role of pupilloplasty. A retrospective review of 41 eyes (31 patients) with congenital coloboma that underwent phacoemulsification and IOL implantation between September 2012 and September 2018. Preoperative, intraoperative, and postoperative data were collected for analysis. The mean patient age at surgery was 53.9 years (range 15–82). The primary indication for surgery was cataract removal for visual improvement, and lens subluxation was additionally present in two eyes (5%) preoperatively. The mean preoperative corrected distance visual acuity (CDVA) was 0.90 LogMAR. Phacoemulsification surgery was performed in all cases and nine eyes (22%) had pupilloplasty for pupil reconstitution at the time of the procedure. Surgeon grade varied from trainee surgeon under supervision to consultant. Eight patients (19.5%) had posterior capsular rupture (PCR) with or without vitreous loss requiring anterior vitrectomy. Of these, 2 cases (5%) had dropped nuclear fragments requiring subsequent pars plana vitrectomy and lens fragment removal. The mean postoperative CDVA was 0.62 LogMAR (p = 0.0003). Patients with iridolenticular choroidal coloboma appear to be more at risk of complications, as were cases performed by non-consultant surgeons. Contrary, patients with phakodonesis, preoperative anterior chamber vitreous, dense cataracts, and cases were iris hooks used had no significant difference at PCR rate. The risk of postoperative glare and pupilloplasty needs to be considered in cases with good visual potential to avoid a possible second procedure.