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Mechanisms accounting for the effects of mutually responsive orientation (MRO) at 7, 15, and 25 months in 102 mother-child and father-child dyads on child internalization and self-regulation at 52 months were examined. Two mediators at 38 months were tested: parental power assertion and child self-representation. For mother-child relationships, the causal pathway involving power assertion was supported for both outcomes. Diminished power assertion fully mediated beneficial effect of mother-child MRO on internalization and partially mediated its effect on self-regulation. For father-child relationships, MRO predicted self-regulation, but the mediational paths were unsupported. Paternal power assertion correlated negatively with both outcomes but was not a mediator. Although MRO with both parents correlated with child self-representation, and it correlated with self-regulation, this mediational path was unsupported. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors have declared that no competing interests exist.

Biodegradation is important for the fate of oil spilled in marine environments, yet parameterization of biodegradation varies across oil spill models, which usually apply constant first-order decay rates to multiple pseudo-components describing an oil. To understand the influence of model parameterization on the fate of subsurface oil droplets, we reviewed existing algorithms and rates and conducted a model sensitivity study. Droplets were simulated from a blowout at 2000 m depth and were either treated with sub-surface dispersant injection (2% dispersant to oil ratio) or untreated. The most important factor affecting oil fate was the size of the droplets, with biodegradation contributing substantially to the fate of droplets ≤0.5 mm. Oil types, which were similar, had limited influence on simulated oil fate. Model results suggest that knowledge of droplet sizes and improved estimation of pseudo-component biodegradation rates and lag times would enhance prediction of the fate and transport of subsurface oil., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Hurricane Sandy made landfall on the eastern coast of the United States on October 29, 2012 resulting in 117 deaths and 71.4 billion dollars in damage. Persons with undiagnosed HIV infection might experience delays in diagnosis testing, status confirmation, or access to care due to service disruption in storm-affected areas. The objective of this study is to describe the impact of Hurricane Sandy on HIV testing rates in affected areas and estimate the magnitude and duration of disruption in HIV testing associated with storm damage intensity., Methods: Using MarketScan data from January 2011‒December 2013, this study examined weekly time series of HIV testing rates among privately insured enrollees not previously diagnosed with HIV; 95 weeks pre- and 58 weeks post-storm. Interrupted time series (ITS) analyses were estimated by storm impact rank (using FEMA's Final Impact Rank mapped to Core Based Statistical Areas) to determine the extent that Hurricane Sandy affected weekly rates of HIV testing immediately and the duration of that effect after the storm., Results: HIV testing rates declined significantly across storm impact rank areas. The mean decline in rates detected ranged between -5% (95% CI: -9.3, -1.5) in low impact areas and -24% (95% CI: -28.5, -18.9) in very high impact areas. We estimated at least 9,736 (95% CI: 7,540, 11,925) testing opportunities were missed among privately insured persons following Hurricane Sandy. Testing rates returned to baseline in low impact areas by 6 weeks post event (December 9, 2012); by 15 weeks post event (February 10, 2013) in moderate impact areas; and by 17 weeks after the event (February 24, 2013) in high and very high impact areas., Conclusions: Hurricane Sandy resulted in a detectable and immediate decline in HIV testing rates across storm-affected areas. Greater storm damage was associated with greater magnitude and duration of testing disruption. Disruption of basic health services, like HIV testing and treatment, following large natural and man-made disasters is a public health concern.  Disruption in testing services availability for any length of time is detrimental to the efforts of the current HIV prevention model, where status confirmation is essential to control disease spread.

Introduction: Using Interrupted Time Series Analysis and generalized estimating equations, this study identifies factors that influence the size and significance of Hurricane Sandy's estimated impact on HIV testing in 90 core-based statistical areas from January 1, 2011 to December 31, 2013., Methods: Generalized estimating equations were used to examine the effects of sociodemographic and storm-related variables on relative change in HIV testing resulting from Interrupted Time Series analyses., Results: There is a significant negative relationship between HIV prevalence and the relative change in testing at all time periods. A one unit increase in HIV prevalence corresponds to a 35% decrease in relative testing the week of the storm and a 14% decrease in relative testing at week twelve. Building loss was also negatively associated with relative change for all time points. For example, a one unit increase in building loss at week 0 corresponds with an 8% decrease in the relative change in testing (p=0.0001) and a 2% at week twelve (p=0.001)., Discussion: Our results demonstrate that HIV testing can be negatively affected during public health emergencies. Communities with high percentages of building loss and significant HIV disease burden should prioritize resumption of testing to support HIV prevention.

Subsea oil well blowouts and pipeline leaks release oil and gas to the environment through vigorous jets. Predicting the breakup of the released fluids in oil droplets and gas bubbles is critical to predict the fate of petroleum compounds in the marine water column. To predict the gas bubble size in oil well blowouts and pipeline leaks, we observed and quantified the flow behavior and breakup process of gas for a wide range of orifice diameters and flow rates. Flow behavior at the orifice transitions from pulsing flow to continuous discharge as the jet crosses the sonic point. Breakup dynamics transition from laminar to turbulent at a critical value of the Weber number. Very strong pure gas jets and most gas/liquid co-flowing jets exhibit atomization breakup. Bubble sizes in the atomization regime scale with the jet-to-plume transition length scale and follow -3/5 power-law scaling for a mixture Weber number., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The present study aims to synthesize current evidence on the impact of LVAD implantation on quality of life. Current evidence was systematically reviewed to obtain relevant quantitative and qualitative articles published after 2007. Sandelowski's recommended steps for meta-summary were used to analyze the 19 studies that met the inclusion criteria. LVADs can improve HF symptoms and some aspects of QoL. Emotional and physical adaptation involves many changes and learning to manage the device takes time. Functional limitations still exist and patients still lack independence. LVAD-related complications significantly impact QoL. Psychological distress remains high after implantation. LVADs significantly impact the caregiver as well and their perspective is not well heard in the existing evidence. It is important for providers to have ongoing, in-depth discussions with patients and their caregivers regarding treatment options, goals of care, anticipated end-of-life trajectories with an LVAD, possible LVAD-complications, and the caregiver burden associated with an LVAD., (Copyright © 2018 Elsevier Inc. All rights reserved.)

We compare oil spill model predictions for a prototype subsea blowout with and without subsea injection of chemical dispersants in deep and shallow water, for high and low gas-oil ratio, and in weak to strong crossflows. Model results are compared for initial oil droplet size distribution, the nearfield plume, and the farfield Lagrangian particle tracking stage of hydrocarbon transport. For the conditions tested (a blowout with oil flow rate of 20,000 bbl/d, about 1/3 of the Deepwater Horizon), the models predict the volume median droplet diameter at the source to range from 0.3 to 6mm without dispersant and 0.01 to 0.8 mm with dispersant. This reduced droplet size owing to reduced interfacial tension results in a one to two order of magnitude increase in the downstream displacement of the initial oil surfacing zone and may lead to a significant fraction of the spilled oil not reaching the sea surface., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Coarctation is a congenital narrowing of the aorta that often requires repair during infancy. The subclavian flap aortoplasty was once widely favored for its avoidance of a circumferential suture line and low incidence of recoarctation. The aim of this study is to report the long-term results of the subclavian flap repair for coarctation of the aorta in infants., Methods: Our operative database was queried for infants with coarctation who underwent subclavian flap aortoplasty from 1966 to 1991. Medical records were reviewed for patient characteristics and outcomes. Survivors were identified for additional phone interview., Results: Fifty-five patients met the inclusion criteria. There were 7 early deaths (in hospital), 11 late deaths, 5 patients lost to follow-up, and 32 known long-term survivors with a mean follow-up of 22.0 years (range 2.4-34.9). Hospital mortality was not associated with patient characteristics but was associated with earlier year of surgery (P = .015). A trend toward decreased overall survival was seen in patients with coarctation with associated cardiac defects (P = .072). Reintervention for recoarctation was required in 3 (6.6%) patients and was not related to the patient characteristics. There were no apparent complications related to subclavian artery sacrifice., Conclusions: Subclavian flap aortoplasty provides excellent long-term results for the repair of coarctation in infants. The incidence of recoarctation requiring reintervention is low and compares favorably with other techniques. Compromise of growth or function of the left arm was not appreciated. The subclavian flap technique remains a viable surgical option for the repair of coarctation in infants.

Objective: To assess parental knowledge regarding lifelong congenital cardiac care (LLCCC)., Background: National guidelines recommend that nearly 50% of adult survivors with congenital heart disease (CHD) receive LLCCC; the number of adults who receive such care seems far less. Inadequate parental knowledge of LLCCC might contribute to care interruption., Methods: In this multicenter study, we administered a questionnaire to parents of children with moderate and complex CHD to assess knowledge of LLCCC., Results: A total of 500 parents participated; the median age of their children was 10 years (range: 2-18 years). Most parents (81%) understood that their child would need LLCCC, but only 44% recognized that their child's cardiology care should be guided by an adult congenital heart specialist in adulthood. More than half (59%) of the parents stated that their current cardiology team had never spoken to them about LLCCC, but 96% wished to learn more. Variables associated with parental LLCCC knowledge included previous discussions regarding LLCCC, underlying cardiac surgical diagnosis, and level of parental education., Conclusions: A substantial number of parents of children with moderate and complex CHD lack knowledge about LLCCC, but almost all of them have a desire to learn more about the care their child will need as an adult.

Behçet's disease is a chronic multisystemic inflammatory disorder characterized by orogenital ulcerations, uveitis, and occasional cardiac involvement. This report describes an atypical presentation of pediatric Behçet's disease with pulmonary emboli and a cardiac mass. A 16-year-old boy with a 2-year history of oral ulcers presented with weight loss, fever, joint pain, and a large tumor adhering to the free wall of the heart's right ventricle. Surgical biopsy demonstrated endomyocarditis with thrombus formation and led to the diagnosis. At the 2-year follow-up evaluation, intracardiac thrombus and pulmonic emboli had not recurred. Symptom control with immunosuppressive therapy was good.

We have carried out the second phase of field studies to determine the effectiveness of a coflow injector which mixes liquid CO2 and ambient seawater to produce a hydrate slurry as a possible CO2 delivery method for ocean carbon sequestration. The experiments were carried out at ocean depths of 1000-1300 m in Monterey Bay, CA, using a larger injector than that initially employed under remotely operated vehicle control and imaging of the product. Solidlike composite particles comprised of water, solid CO2 hydrate, and liquid CO2 were produced in both studies. In the recent injections, the particles consistently sank at rates of approximately 5 cm s(-1). The density of the sinking particles suggested that approximately 40% of the injected CO2 was converted to hydrate, while image analysis of the particle shrinking rate indicated a CO2 dissolution rate of 0.76-1.29 micromol cm(-2) s(-1). Plume modeling of the hydrate composite particles suggests that while discrete particles may sink 10-70 m, injections with CO2 mass fluxes of 1-1000 kg s(-1) would result in sinking plumes 120-1000 m belowthe injection point.

Lake Vida, one of the largest lakes in the McMurdo Dry Valleys of Antarctica, was previously believed to be shallow (<10 m) and frozen to its bed year-round. New ice-core analysis and temperature data show that beneath 19 m of ice is a water column composed of a NaCl brine with a salinity seven times that of seawater that remains liquid below -10 degrees C. The ice cover thickens at both its base and surface, sealing concentrated brine beneath. The ice cover is stabilized by a negative feedback between ice growth and the freezing-point depression of the brine. The ice cover contains frozen microbial mats throughout that are viable after thawing and has a history that extends to at least 2,800 (14)C years B.P., suggesting that the brine has been isolated from the atmosphere for as long. To our knowledge, Lake Vida has the thickest subaerial lake ice cover recorded and may represent a previously undiscovered end-member lacustrine ecosystem on Earth.

Data from ice 3590 meters below Vostok Station indicate that the ice was accreted from liquid water associated with Lake Vostok. Microbes were observed at concentrations ranging from 2.8 x 10(3) to 3.6 x 10(4) cells per milliliter; no biological incorporation of selected organic substrates or bicarbonate was detected. Bacterial 16S ribosomal DNA genes revealed low diversity in the gene population. The phylotypes were closely related to extant members of the alpha- and beta-Proteobacteria and the Actinomycetes. Extrapolation of the data from accretion ice to Lake Vostok implies that Lake Vostok may support a microbial population, despite more than 10(6) years of isolation from the atmosphere.

Background: Health care workers are potentially exposed to a number of carcinogens. Studies among women in this field have focused on white nurses; however, workers in many health care occupations share exposures experienced by nurses., Methods: Cancer mortality was examined among female health care workers using death certificate data collected in 24 U.S. states from 1984 through 1993. Cancer mortality odds ratios (MORs) were calculated by race (white, black) and age group., Results: White nurses had a 30% elevation of mortality due to liver cancer and myeloid leukemia. White registered nurses (RNs) had a small excess and white licensed practical nurses (LPNs) had a small deficit of mortality due to breast cancer. Ovarian cancer was in excess among RNs, but decreased among LPNs. Among black nurses, excesses of death due to kidney cancer (MOR = 1.7) and multiple myeloma (MOR = 1.3), and a significant 50% deficit in mortality due to cancer of the esophagus were found. Black RNs, but not LPNs, had an excess of breast cancer (MOR = 1.3; 95% CI = 1.0-1.5). Ovarian cancer was elevated by 30% in both RNs and LPNs. Excess deaths due to cancers of the breast, ovary, and uterus occurred among white physicians. Among black physicians, lung cancer was significantly elevated (MOR = 2.8). White pharmacists had significant excesses of breast (MOR = 1.5) and ovarian (MOR = 2.4) cancers, and myeloid leukemia (MOR = 2.0). White clinical laboratory technicians had excess deaths from several cancers. The greatest excess was for myeloid leukemia (MOR = 2.3; 95% CI = 1.5-3.4). Excesses among radiologic technologists included cancers of the lung, pancreas, breast, uterus, and ovary., Conclusion: Several findings reported here warrant further investigation. In particular, excesses of myeloid leukemia among nurses, pharmacists, and clinical laboratory technicians and liver cancer among nurses should be investigated in studies with data on occupational and other exposures. Patterns of mortality from breast and ovarian cancer found in this study must be evaluated further in studies with data on reproductive history.

The etiology of capsular contracture is unclear and probably multifactorial. This review covers the literature on several proposed contracture factors, including filler material, implant placement, surface texture, and bacterial infection. The pilot study's goal was to test the feasibility of a data collection form, which could be used in a scaled-up study analyzing multiple surgeon's records. The goal of the expanded version of this study will be to determine the efficacy of available interventions for capsular contracture, including surveillance. The Breast Implant Public Health Project, LLC (BIPHP), piloted a retrospective review of outcomes in women who had interventions to relieve capsular contracture or had chosen a wait-and-watch approach. An evaluation of the efficacy of various treatments can help women decide if they want to pursue treatment at all and, if so, which treatment might offer them the best solution. BIPHP researchers (E.E.A., M.E.) developed a data collection form after reviewing records of three surgeons (B.C., W.P., V.L.Y.). During the data collection using the same records, we tested a randomization process to identify women with capsular contracture who underwent various interventions, including a wait-and-watch strategy, and those who had no mention of any intervention or waiting approach. Data were gathered on a total of 90 breasts with capsular contracture (scored Baker I-IV or qualitatively), of which 45 underwent a total of 102 interventions for capsular contracture. Interventions were classified as "closed capsulotomy," "surgical," or "watchful waiting." Closed capsulotomy was performed most often (47%), followed by surgery (29%) and watchful waiting (21%). Presurgical Baker scores averaged higher in breasts that underwent surgery (3.1) than for watchful waiting (2.5) or closed capsulotomy (2.3). Though closed capsulotomies had 100% of outcomes scoring "improved" or "same," 58% of the breasts underwent the procedure more than once, suggesting that the favorable outcome was short-lived. The wait-and-watch approach resulted in scores of either "same" or "worse"; surgery (open capsulotomy, repositioning, or capsulectomy) resulted in 79% improved, 16% same, and 5% worse outcomes in breasts with outcomes listed. In all intervention procedure categories, outcomes were frequently unavailable; they were noted only 60% of the time (52/87). The missing 40% may have resulted from the doctor's failure to note it in the chart, satisfied patients not returning for additional treatment, or dissatisfied patients seeking treatment elsewhere. Generally, the data collection forms and procedures were workable; however, we uncovered issues to address in the scale-up of this pilot study: (1) the outcome report rate was 60%; (2) though Baker scores are commonly used to evaluate the degree of capsular contracture, it seems that grade I may have different meanings for different surgeons, which would need to be clarified; (3) participating surgeons will need to divulge standard-of-care items that they may not have included in medical records, but routinely performed (e.g., patient massage, use of prophylactic antibiotics); and (4) records were initially separated by "implant," then researchers realized that a more useful collection would be by "breast." The latter approach captures the history of the breast in one record, which may be more important to contracture than the differences in implants. With the modifications discussed, the study can be scaled up to encompass as many records as necessary to achieve robust statistical power. These data will add to the existing literature regarding factors associated with capsular contracture and identify factors that affect the successful outcome of capsular contracture interventions.

This pilot study's goal was to test the feasibility of a data collection form which will be used in a scale-up study analyzing multiple surgeons' records. The goal of this expanded study will be to develop identifying factors for women who are at greater risk for having ruptured implants and, if necessary, target them for screening, surveillance, or intervention. In the pilot study, we compared factors associated with implant rupture in women with and without rupture. Similar studies have considered one or a few factors at a time and, generally, have given little attention to implant generation. We developed a data collection form after reviewing records of three surgeons. A total of 92 records was collected and analyzed. An important feature in the pilot was to compare the results of patients whose implants the surgeons had both implanted and explanted (n = 34) with those of patients whose implants the surgeons had only explanted (n = 55) (unknown = 3). This comparison could show if including all explantation patients in a surgeon's practice would bias the sample; however, based on this pilot data, concerns regarding this type of bias seem to be minimal. Similar amounts of data (e.g., implant information, history of capsular contracture, etc.) were collectable on patients whose surgeons both implanted and explanted them (87%) and who had different surgeons for implantation and explantation (84%). Though the data from this limited sample cannot offer firm conclusions on rupture associations, a few factors stood out: size of implants (38. 3% of ruptured versus 15.9% of intact implants were 100-200 cm3), history of mammography (46.8% of ruptured versus 24.4% of intact had mammograms, which is likely due to older women with older implants having more mammograms), and history of closed capsulotomy (85.1% of ruptured versus 68.9% of intact). Interestingly, additional procedures performed on the breast (e.g., scar revision, wound repair, etc.) did not affect rupture: both the ruptured and the intact groups had an average of 1.7 procedures performed. The data collection form tested very well in this pilot study. Also, including all patients in the study sample, instead of excluding those who received their implants elsewhere, did not change the results. Though there are not enough data to draw any firm conclusions regarding rupture factors, the collection instrument was rigorously tested and should perform well in an expanded study.

The permanent ice covers of Antarctic lakes in the McMurdo Dry Valleys develop liquid water inclusions in response to solar heating of internal aeolian-derived sediments. The ice sediment particles serve as nutrient (inorganic and organic)-enriched microzones for the establishment of a physiologically and ecologically complex microbial consortium capable of contemporaneous photosynthesis, nitrogen fixation, and decomposition. The consortium is capable of physically and chemically establishing and modifying a relatively nutrient- and organic matter-enriched microbial "oasis" embedded in the lake ice cover.

Female radium dial workers first employed before 1930 were analyzed for breast cancer mortality and incidence using method and rate tables described by Monson and the Mantel-Haenszel summary chi-square test for significance. Of 1,180 located women, 736 were measured to estimate radium intake. This measured group was analyzed for breast cancer mortality and incidence according to four possible risk factors: radium intake dose, duration of employment, age at first exposure, and parity. The located women had a mortality ratio of 1.51 (p < 0.05). The measured women showed a significant excess of breast cancer incidence and mortality only among those women with a radium intake of 50 microCi or greater. Although the differences were not significant, incidence and mortality ratios were slightly higher for nulliparous women.

Kinetic parameters (KM and Vmax) of the 5 alpha-reductase activities in homogenates of stroma and epithelium, isolated from BPH tissue, were determined using both testosterone and progesterone as substrate. The mean KM values for stromal 5 alpha-reductase, at 67.9 nM and 27.7 nM for testosterone and progesterone respectively, were 3-4-fold higher than the comparable KM estimates for the epithelial enzyme. The KM estimates for the epithelial 5 alpha-reductase showed little variation whereas those measured in the stromal homogenates could be subgrouped at less than 50 nM and greater than 100 nM. The mean Vmax for the stromal 5 alpha-reductase was approximately 235 pmol/30 min/mg protein irrespective of the substrate used; a value 10-fold higher than the Vmax of the epithelial 5 alpha-reductase. Preliminary experiments with inhibitors of 5 alpha-reductase demonstrated that the stromal and epithelial enzymes differed in their relative sensitivity to these compounds. Three major conclusions can be drawn from these results: first, that progesterone is a better substrate for prostatic 5 alpha-reductase than testosterone; second, that BPH tissue has at least two isoenzymes of 5 alpha-reductase--one in the epithelium and one (or more) in the stroma; and third, in hyperplastic prostates, most of the 5 alpha-reductase molecules are located in the stroma.

A survey of the medical records of 813 female radium dial workers first exposed to radium before 1930 yielded reports of 119 cataracts in the group whose radium body burden had been measured at least once. After dividing the subjects into high and low dose groups, the data were analyzed according to latency (time between first employment and first diagnosis of cataract), duration of employment and age at first exposure. Duration of employment and age at employment showed no significant correlation with dose. Latency, however, showed a significant negative correlation with dose. Since radiation cataracts tend to occur earlier than so-called senile cataracts, these preliminary data suggest the need for further investigation.