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The Alternative Model for Personality Disorders (AMPD) in Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) conceptualizes personality pathology as a combination of impairment (Criterion A) and traits (Criterion B). One measure used to develop Criterion A was the Social Cognition and Object Relations Scale - Global Rating Method (SCORS-G), which is a multidimensional, object-relational clinician-rated measure of personality functioning. Although there are conceptual links between the AMPD and SCORS-G dimensions, there exists no research examining the relationship. To address this, we examined associations between the SCORS-G dimensions and measures of the AMPD constructs in a large, archival dataset of outpatients and inpatients. More pathological scores on SCORS-G dimensions reflecting self- and interpersonal functioning were associated with greater pathological traits and impairment. Overall, results support further investigation into SCORS-G as a useful measure in AMPD research and assessment.

The COVID-19 pandemic is an ongoing global health threat, yet our understanding of the cellular disease dynamics remains limited. In our unique COVID-19 human challenge study we used single cell genomics of nasopharyngeal swabs and blood to temporally resolve abortive, transient and sustained infections in 16 seronegative individuals challenged with preAlpha-SARS-CoV-2. Our analyses revealed rapid changes in cell type proportions and dozens of highly dynamic cellular response states in epithelial and immune cells associated with specific timepoints or infection status. We observed that the interferon response in blood precedes the nasopharynx, and that nasopharyngeal immune infiltration occurred early in transient but later in sustained infection, and thus correlated with preventing sustained infection. Ciliated cells showed an acute response phase, upregulated MHC class II while infected, and were most permissive for viral replication, whilst nasal T cells and macrophages were infected non-productively. We resolve 54 T cell states, including acutely activated T cells that clonally expanded while carrying convergent SARS-CoV-2 motifs. Our novel computational pipeline (Cell2TCR) identifies activated antigen-responding clonotype groups and motifs in any dataset. Together, we show that our detailed time series data (covid19cellatlas.org) can serve as a “Rosetta stone” for the epithelial and immune cell responses, and reveals early dynamic responses associated with protection from infection.

A cell’s function is defined by its intrinsic characteristics and its niche: the tissue microenvironment in which it dwells. Here, we combine single-cell and spatial transcriptomic data to discover cellular niches within eight regions of the human heart. We map cells to micro-anatomic locations and integrate knowledge-based and unsupervised structural annotations. For the first time, we profile the cells of the human cardiac conduction system, revealing their distinctive repertoire of ion channels, G-protein coupled receptors, and cell interactions using a customCellPhoneDB.orgmodule. We show that the sinoatrial node is compartmentalised, with a core of pacemaker cells, fibroblasts and glial cells supporting paracrine glutamatergic signalling. We introduce a druggable target prediction tool, drug2cell, which leverages single-cell profiles and drug-target interactions, providing unexpected mechanistic insights into the chronotropic effects of drugs, including GLP-1 analogues. In the epicardium, we show enrichment of both IgG+ and IgA+ plasma cells forming immune niches which may contribute to infection defence. We define a ventricular myocardial-stress niche enriched for activated fibroblasts and stressed cardiomyocytes, cell states that are expanded in cardiomyopathies. Overall, we provide new clarity to cardiac electro-anatomy and immunology, and our suite of computational approaches can be deployed to other tissues and organs.

Children infected with SARS-CoV-2 rarely progress to respiratory failure, but the risk of mortality in infected people over 85 years of age remains high, despite vaccination and improving treatment options. Here, we take a comprehensive, multidisciplinary approach to investigate differences in the cellular landscape and function of paediatric (70y) nasal epithelial cells experimentally infected with SARS-CoV-2. Our data reveal that nasal epithelial cell subtypes show different tropism to SARS-CoV-2, correlating with age, ACE2 and TMPRSS2 expression. Ciliated cells are a viral replication centre across all age groups, but a distinct goblet inflammatory subtype emerges in infected paediatric cultures, identifiable by high expression of interferon stimulated genes and truncated viral genomes. In contrast, infected elderly cultures show a proportional increase in ITGB6hiprogenitors, which facilitate viral spread and are associated with dysfunctional epithelial repair pathways.Graphical Abstract

During human development, lungs develop their roles of gas exchange and barrier function. Recent single cell studies have focused on epithelial and mesenchymal cell types, but much less is known about the developing lung immune cells, although the airways are a major site of mucosal immunity after birth. An open question is whether tissue-resident immune cells play a role in shaping the tissue as it developsin utero. In order to address this, we profiled lung immune cells using scRNAseq, smFISH and immunohistochemistry. At the embryonic stage, we observed an early wave of innate immune cells, including ILCs, NK, myeloid cells and lineage progenitors. By the canalicular stage, we detected naive T lymphocytes high in cytotoxicity genes, and mature B lymphocytes, including B1 cells. Our analysis suggests that fetal lungs provide a niche for full B cell maturation. Given the abundance of immune cells, we investigated their possible effect on epithelial maturation and found that IL-1β drives epithelial progenitor exit from self-renewal and differentiation to basal cellsin vitro.In vivo, IL-1β-producing myeloid cells were found adjacent to epithelial tips, suggesting that immune cells may direct the developing lung epithelium.

The influence of depth and associated gradients in light, nutrients, and plankton on the ecological organisation of tropical reef communities was first described over six decades ago but remains untested across broad geographies. Humans have also become the dominant driver of planetary change, requiring we re-visit historic ecological paradigms to ensure they capture the dynamics of contemporary ecological systems. Analysing >5,500 in-water reef fish surveys between 0–30 m depth across reef slopes at 35 islands in the Pacific, we assess whether a depth gradient consistently predicts variation in reef fish biomass. We reveal predictable ecological organisation in the absence of local human populations, with increased biomass of planktivores and piscivores, and decreased biomass of primary consumers with increasing depth. Bathymetric steepness also had a striking influence on biomass patterns, primarily for planktivores, emphasising potential links between local hydrodynamics and the upslope propagation of pelagic subsidies to the shallows. However, signals of resource-driven depth zonation were altered or lost at populated islands, likely due to depleted fish biomass baselines. While principles of depth zonation broadly held, our findings expose limitations of the paradigm for predicting ecological dynamics where human-mediated impacts confound the connections between ecological communities and their surrounding environment.

This study aims to assess whether mothers reporting high and low child abuse potential differ in their experiences of childhood abuse and use of defense mechanisms, and to examine factors which might predict child abuse potential. 120 pregnant mothers in their third trimester completed demographic questionnaires, trauma and abuse potential measures, and a semi-structured parenting interview, which was coded for defense mechanisms. Multivariate and univariate analyses of variance were conducted to determine group differences of mothers with high and low abuse potential. A stepwise linear regression was conducted to identify variables which significantly predicted abuse potential. Mothers reporting high abuse potential were found to have significantly greater emotional and physical childhood abuse experiences, greater immature defense use, and lower overall defensive functioning than mothers with low abuse potential. Emotional abuse and immature defense use significantly predicted total child abuse potential scores. Results are consistent with existing literature and provide a novel approach to understanding influences on child abuse potential including maternal history of childhood abuse and current defense mechanisms. These variables further serve as points of prevention and intervention for improving the negative outcomes associated with intergenerational risk for child abuse.

Focusing on the establishment of maternity care services predominantly for young, working-class white and coloured unmarried mothers, this article examines social and institutional responses to and...

Ocean warming is increasing the incidence, scale, and severity of global-scale coral bleaching and mortality, culminating in the third global coral bleaching event that occurred during record marine heatwaves of 2014-2017. While local effects of these events have been widely reported, the global implications remain unknown. Analysis of 15,066 reef surveys during 2014-2017 revealed that 80% of surveyed reefs experienced significant coral bleaching and 35% experienced significant coral mortality. The global extent of significant coral bleaching and mortality was assessed by extrapolating results from reef surveys using comprehensive remote-sensing data of regional heat stress. This model predicted that 51% of the world’s coral reefs suffered significant bleaching and 15% significant mortality, surpassing damage from any prior global bleaching event. These observations demonstrate that global warming’s widespread damage to coral reefs is accelerating and underscores the threat anthropogenic climate change poses for the irreversible transformation of these essential ecosystems.

SummaryThe proteome provides unique insights into biology and disease beyond the genome and transcriptome. Lack of large proteomic datasets has restricted identification of new cancer biomarkers. Here, proteomes of 949 cancer cell lines across 28 tissue types were analyzed by mass spectrometry. Deploying a clinically-relevant workflow to quantify 8,498 proteins, these data capture evidence of cell type and post-transcriptional modifications. Integrating multi-omics, drug response and CRISPR-Cas9 gene essentiality screens with a deep learning-based pipeline revealed thousands of protein-specific biomarkers of cancer vulnerabilities. Proteomic data had greater power to predict drug response than the equivalent portion of the transcriptome. Further, random downsampling to only 1,500 proteins had limited impact on predictive power, consistent with protein networks being highly connected and co-regulated. This pan-cancer proteomic map (ProCan-DepMapSanger), available at https://cellmodelpassports.sanger.ac.uk, is a comprehensive resource revealing principles of protein regulation with important implications for future clinical studies.

The proteome provides unique insights into disease biology beyond the genome and transcriptome. A lack of large proteomic datasets has restricted the identification of new cancer biomarkers. Here, proteomes of 949 cancer cell lines across 28 tissue types are analyzed by mass spectrometry. Deploying a workflow to quantify 8,498 proteins, these data capture evidence of cell-type and post-transcriptional modifications. Integrating multi-omics, drug response, and CRISPR-Cas9 gene essentiality screens with a deep learning-based pipeline reveals thousands of protein biomarkers of cancer vulnerabilities that are not significant at the transcript level. The power of the proteome to predict drug response is very similar to that of the transcriptome. Further, random downsampling to only 1,500 proteins has limited impact on predictive power, consistent with protein networks being highly connected and co-regulated. This pan-cancer proteomic map (ProCan-DepMapSanger) is a comprehensive resource available at https://cellmodelpassports.sanger.ac.uk.

T1 Figure 1ConclusionsOverall, this largest paediatric single cell COVID-19 study to date showed significant differences in response to SARS-CoV-2 between children and adults, reflecting the changes of the immune landscape over developmental time, which in children are dominated by naive and innate responses.

We present a multiomic cell atlas of human lung development that combines single cell RNA and ATAC sequencing, high throughput spatial transcriptomics and single cell imaging. Coupling single cell methods with spatial analysis has allowed a comprehensive cellular survey of the epithelial, mesenchymal, endothelial and erythrocyte/leukocyte compartments from 5-22 post conception weeks. We identify new cell states in all compartments. These include developmental-specific secretory progenitors and a new subtype of neuroendocrine cell related to human small cell lung cancer. Our datasets are available through our web interface (https://lungcellatlas.org). Finally, to illustrate its general utility, we use our cell atlas to generate predictions about cell-cell signalling and transcription factor hierarchies which we test using organoid models.HighlightsSpatiotemporal atlas of human lung development from 5-22 post conception weeks identifies 144 cell types/states.Tracking the developmental origins of multiple cell compartments, including new progenitor states.Functional diversity of fibroblasts in distinct anatomical signalling niches.Resource applied to interrogate and experimentally test the transcription factor code controlling neuroendocrine cell heterogeneity and the origins of small cell lung cancer.

Combinations of anti-cancer drugs can overcome resistance and provide new treatments1,2. The number of possible drug combinations vastly exceeds what could be tested clinically. Efforts to systematically identify active combinations and the tissues and molecular contexts in which they are most effective could accelerate the development of combination treatments. Here we evaluate the potency and efficacy of 2,025 clinically relevant two-drug combinations, generating a dataset encompassing 125 molecularly characterized breast, colorectal and pancreatic cancer cell lines. We show that synergy between drugs is rare and highly context-dependent, and that combinations of targeted agents are most likely to be synergistic. We incorporate multi-omic molecular features to identify combination biomarkers and specify synergistic drug combinations and their active contexts, including in basal-like breast cancer, and microsatellite-stable orKRAS-mutant colon cancer. Our results show that irinotecan and CHEK1 inhibition have synergistic effects in microsatellite-stableorKRAS–TP53double-mutant colon cancer cells, leading to apoptosis and suppression of tumour xenograft growth. This study identifies clinically relevant effective drug combinations in distinct molecular subpopulations and is a resource to guide rational efforts to develop combinatorial drug treatments.

While a substantial proportion of adults infected with SARS-CoV-2 progress to develop severe disease, children rarely manifest respiratory complications. Therefore, understanding differences in the local and systemic response to SARS-CoV-2 infection between children and adults may provide important clues about the pathogenesis of SARS-CoV-2 infection. To address this, we first generated a healthy reference multi-omics single cell data set from children (n=30) in whom we have profiled triple matched samples: nasal and tracheal brushings and PBMCs, where we track the developmental changes for 42 airway and 31 blood cell populations from infancy, through childhood to adolescence. This has revealed the presence of naive B and T lymphocytes in neonates and infants with a unique gene expression signature bearing hallmarks of innate immunity. We then contrast the healthy reference with equivalent data from severe paediatric and adult COVID-19 patients (total n=27), from the same three types of samples: upper and lower airways and blood. We found striking differences: children with COVID-19 as opposed to adults had a higher proportion of innate lymphoid and non-clonally expanded naive T cells in peripheral blood, and a limited interferon-response signature. In the airway epithelium, we found the highest viral load in goblet and ciliated cells and describe a novel inflammatory epithelial cell population. These cells represent a transitional regenerative state between secretory and ciliated cells; they were found in healthy children and were enriched in paediatric and adult COVID-19 patients. Epithelial cells display an antiviral and neutrophil-recruiting gene signature that is weaker in severe paediatricversusadult COVID-19. Our matched blood and airway samples allowed us to study the spatial dynamics of infection. Lastly, we provide a user-friendly interface for this data1as a highly granular reference for the study of immune responses in airways and blood in children.

1568 Background: Screening and counseling for health risk behaviors (RB) are recommended but infrequently performed, particularly in individuals undergoing cancer therapy. Unmet needs among adolescents and young adults (AYAs) with cancer translate to poor physical and psychosocial outcomes. The authors aimed to 1) modify an existing RB electronic health assessment (eHA) and intervention tool and 2) determine the feasibility and acceptability of the RB eHA and intervention tool among AYAs with cancer and their oncology providers. Methods: The internally developed HRB eHA and intervention tool Check Yourself was adapted by a multidisciplinary healthcare professional panel for an AYA oncology population and informed by literature review and AYA stakeholder feedback. “Check Yourself Oncology” assesses risk and health domains including home, education, sexual health, safety, alcohol/drugs, mental health and medication adherence. Optional feedback is provided for sexual health, safety, alcohol/drugs and mental health domains. Eligible AYAs were 13 to 29 years old, diagnosed with cancer, receiving cancer directed therapy, follow-up scheduled with a Seattle Children’s Hospital oncology physician or nurse practitioner, and fluent in English. 72 hours prior to their next oncology clinic visit, participants were text messaged or emailed a personalized link to the Check Yourself Oncology tool to be completed prior to their next visit. Upon completion, a detailed report was sent to the primary clinical oncology team prior to the patient’s visit. Feasibility was defined as 1) ≥70% completion of the RB eHA and 2) a Feasibility of Intervention Measure (FIM) mean score >4. Acceptability was defined as an Acceptability of Intervention Measure (AIM) mean score >4 and qualitatively. The FIM and AIM were sent by REDCap survey following the clinical visit; verbal feedback from AYAs and clinicians was analyzed with qualitative content analysis. Results: Of 30 eligible, approached AYAs, 25 (83%) enrolled in the study and 23 (76%) completed the Check Yourself Oncology tool and follow-up assessments. The AYAs had a mean age of 17 years (SD = 2.9 years) and 50% identified as female. Four AYAs declined participation due to lack of interest, 1 due to declined parental consent, 1 passively declined after enrollment, and 1 declined further participation following the confidentiality terms. The mean FIM and AIM scores were 4.1 (SD=0.6) and 4.0 (SD =0.7) respectively. Seventeen AYAs (74%) felt that the feedback provided was relevant and useful. 74% of visits providers reported that they incorporated the results in the care of the patient and 87% reported the results positively impacted care. Conclusions: Risk behavior screening with motivational feedback though the modified eHA tool Check Yourself Oncology is feasible and acceptable in AYAs undergoing cancer directed therapy. Clinical trial information: NCT04484194.

The SPECTRA: Indices of Psychopathology is a broadband assessment inventory compatible with contemporary hierarchical models of psychopathology (internalizing, externalizing, reality impairing dimensions and global psychopathology factor). This study explored the SPECTRA's construct validity using a wide range of life event (extra-test) variables in a clinical sample. The life event variables included the following: education level, school failure, childhood adversity, suicide attempts, psychiatric hospitalizations, depression, psychotic symptoms, self-injury, substance abuse, arrests, physical violence, marital status, employment status and current medications. Results showed that all SPECTRA clinical scales had significant life event correlations. For the higher-order Spectra scales, the global index of psychopathology had the greatest number and range of life event correlations. Correlations for the externalizing and reality impairing Spectra scales provided solid validity evidence, while correlations for the internalizing Spectra scale were more diffuse. These findings provide the first non-test-based evidence of construct validity for the SPECTRA.

The objective of this research is to determine the influence of temperature on the mechanical and dissolution performance of pharmaceutical printlets (tablets) fabricated via selective laser sintering (SLS) additive manufacturing. When compared to traditional high-volume pharmaceutical manufacturing, additive manufacturing has the potential to effectively cater to personalized and just-in-time medicine. Among additive manufacturing methods, SLS has the advantage of not needing to reconstitute the drug(s) with other liquids or powders, as well as the ability to tailor certain location-specific properties via process parameter control. One of the critical parameters that affect the printlet quality is the temperature during the printing process. To explore the thermal effects, two separate experiment sets were conducted. First, process parameters including chamber temperature were studied based on a partial-factorial design of experiments, and their effects on parameters such as weight, hardness, structural disintegration and dissolution rates studied. Next, a smaller scale study was conducted to correlate surface temperatures with structural integrity. Results showed the beneficial and detrimental effects of operating at chamber and bed temperature ranges, in relation to the polymer percentage and melting point. A certain minimum energy density needed to be imparted onto the powder mixture combinations (resulting in a certain surface temperature) for proper fusion and performance of the printlets. This work served to investigate and show the potential of using SLS to reliably fabricate pharmaceutical formulations.

Low success rates during drug development are due, in part, to the difficulty of defining drug mechanism‐of‐action and molecular markers of therapeutic activity. Here, we integrated 199,219 drug sensitivity measurements for 397 unique anti‐cancer drugs with genome‐wide CRISPR loss‐of‐function screens in 484 cell lines to systematically investigate cellular drug mechanism‐of‐action. We observed an enrichment for positive associations between the profile of drug sensitivity and knockout of a drug's nominal target, and by leveraging protein–protein networks, we identified pathways underpinning drug sensitivity. This revealed an unappreciated positive association between mitochondrial E3 ubiquitin–protein ligase MARCH5 dependency and sensitivity to MCL1 inhibitors in breast cancer cell lines. We also estimated drug on‐target and off‐target activity, informing on specificity, potency and toxicity. Linking drug and gene dependency together with genomic data sets uncovered contexts in which molecular networks when perturbed mediate cancer cell loss‐of‐fitness and thereby provide independent and orthogonal evidence of biomarkers for drug development. This study illustrates how integrating cell line drug sensitivity with CRISPR loss‐of‐function screens can elucidate mechanism‐of‐action to advance drug development.

Financial support for the analyses was from grants from the Natural Sciences and Engineering Research Council Discovery program, the Canada Foundation for Innovation and the Ontario Innovation Trust (TKK, NPJ)

Although current sports nutrition recommendations advocate for a high carbohydrate (CHO) intake among endurance athletes, recent research has suggested that training with low CHO availability may augment adaptations to aerobic training. The purpose of this study was to observe the dietary habits of collegiate distance runners and to investigate the effects of habitual CHO intake on aerobic performance [VODuring an 8-week trial period, 12 (N = 12) collegiate track athletes recorded their self-selected dietary intake via 24-hour recall. Analysis of CHO intake was conducted by a registered dietitian. Pre [VOThe average CHO was 4.11 ± 1.03 g/kg body mass (BM), with only one female athlete meeting dietary recommendations, consuming ≥ 6 g/kg BM. Male distance runners on average had a lower CHO than females. After adjusting for VOCollegiate distance runners exhibited marked improvements in maximal aerobic capacity during the in-season while consuming a marginally low-CHO diet, with a predominant effect in males. Therefore, CHO intakes below current recommendations for endurance athletes might not be detrimental to aerobic training adaptations.

The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) measures the quality of object relations in narrative material. The reliability and validity of this measure have been well established. However, a psychometric oddity of this scale is that default ratings are given to select dimensions when the relevant construct is not present. This can result in narrative 'blandness' and may impact clinical findings. The aim of these two studies is to understand these phenomena both psychometrically and clinically. In the first study, we identified 276 outpatients who had SCORS-G ratings for TAT Cards 1, 2, 3BM, and 14, set criteria for narrative 'blandness' across all eight dimensions, and examined group differences. In Study 2, we used a subset (N = 99) of Study 1 and examined how percentage of formal default ratings for Emotional Investment in Values and Moral Standards (EIM), Experience and Management of Aggressive Impulses (AGG), Self-Esteem(SE), and Identify and Coherence of Self (ICS) impacted robustness of correlations across tests of intelligence, psychopathology, and normal personality functioning. Taken together, we identified clinical characteristics of patients who are more likely to produce 'bland' narratives and increased percentages of formal default ratings. Also, an excess of default ratings per protocol impacts robustness of correlations and weakens significant correlations. As cut-off scores increase (>25% and >28.12%), the likelihood of being able to interpret EIM, AGG, SE, and ICS decreases. Psychometric and clinical implications are discussed.

Background Adolescents account for 1 in 4 sexually transmitted infections (STIs) diagnosed annually in the United States. Many adolescents seek care in emergency departments (ED) for acute medical problems which offers an opportunity to screen for risk behaviors including sexual health. As emergency medicine provider time is focused on the acute medical problem, using technology may be an acceptable and effective alternative to identify and decrease screening risky sexual behaviors. Methods Adolescents aged 13–18 years participated in a randomized controlled trial of an electronic health behavior screening and feedback tool in a pediatric emergency department. All participants were surveyed about risky behaviors at the baseline ED visit and 3 months later, and only intervention arm participants received immediate individualized electronic feedback about their risk behaviors, normative comparisons and brief educational information, including on birth control and condoms. In this secondary analysis, we used Chi-squared analyses to compare differences in 3-month STI risk defined as sexually active and reporting inconsistent condom use. Results A total of 296 adolescents including 55% females enrolled in the study with 72% (n=212) completing the 3 month follow-up survey. At baseline 23% (69/296) reported ever having sex and 67% (46/69) reported using a condom at last sex. At follow-up 16% (17/105) of the intervention group and 23% (25/107) of controls reported having sex in the last 3 months. Of those sexually active, 35% (6/17) of intervention group compared to 56% (14/25) of control group reported not always using condoms in the last 3 months (p=0.19). STI risk at 3 months was 6% (6/105) for intervention participants compared to 13% (14/107) for controls (p=0.07). Conclusion Electronic sexual health screening in the emergency department increases opportunities to assess, identify, and intervene in risky sexual behaviors in adolescents and may contribute to a decrease in risky behaviors. Disclosure No significant relationships.

Background Employment is a key determinant in quality of life. However, less than 50% of adults with ASD are employed. Objective In order to better support community-based employment for persons with ASD who use augmentative and alternative communication (AAC), there is a need to better understand those situations in which successful outcomes have been achieved. Method This study utilized a multiple case design to investigate the experiences of seven individuals with ASD who use AAC and are successfully employed in the community. Results Results provide evidence that individuals with ASD who use AAC can be successfully employed, when provided with appropriate supports. Expressive and receptive communication were commonly identified as challenges, however, mobile devices provided support to communication and participation for many of the participants with ASD. Conclusions Results from the current study provide evidence that successful employment for individuals with ASD who use AAC is possible when intervention addresses three key areas: the development of skills that are valued in the workplace, the identification and creation of good job matches, and access to needed supports.

The current study sought to develop and validate a new measure of chronic suicide risk (the S_Chron) from the Personality Assessment Inventory in a mixed sample of psychiatric inpatients and outpatients. In an initial development sample (N=397), hierarchical logistic regression identified six PAI variables uniquely associated with multiple versus single/no prior suicide attempts after controlling for sample demographics: Negative Impression Management, Situational Stress, Mania - Grandiosity, Borderline - Negative Relationships, Borderline - Self-Harm, and Antisocial Behaviors. These indicators were then aggregated into a single index (S_Chron) and evaluated in terms of validity in an independent clinical sample (N=398). Results indicated the S_Chron effectively differentiated between groups with multiple versus single/no prior suicide attempts, even after controlling for the effects of the PAI Suicidal Ideation (SUI) and Suicide Potential (SPI) indices, with moderate to large effect sizes observed (range of Cohen's d's=0.30-0.91). Further, the S_Chron incremented all other PAI indices and SUI in predicting multiple suicide attempts. The potential clinical application and ways in which the S_Chron may augment other existing measures of suicide risk are discussed.

An analysis is presented of hydrographic and nutrient data collected over three years for the Kangaroo Island upwelling region, Lincoln Shelf, South Australia, to determine the signature of upwelled water, depth of upwelling and the source water mass being brought onto the shelf. Strong upwelling seasons were recorded during the 2007–2008 and 2009–2010 summers, while the summer of 2008–2009 had only one weak upwelling event. Strong upwelling events during February and March 2008 and February and March 2010 recorded temperatures and salinities as low as 10.4°C and 34.85, and NOx and phosphate concentrations as high as 13.35 and 0.94 μmol/L, respectively, at 105 m on the shelf. Upwelled water properties matched slope water properties between 240 and 370 m, indicating water can be upwelled over depths of 200 m or more. Upwelling from these depths sources South Australian Basin Central Water of Southern Ocean origin, which is transported west along the slope by the Flinders Current System. New results for nutrients show average values of NOx and phosphate during months of strong upwelling to be 6.1 times and 4.6 times greater, respectively, than during winter months, and that upwelled water can have nutrient concentrations up to 90 times higher than those in summer surface waters. Strong relationships between temperature and nutrients on the slope can help estimate nutrient concentrations supplied to the shelf during upwelling events. Upwelled water was also low in silicate, a signature of Southern Ocean water masses, which has implications for phytoplankton community structure and diatom abundance on the shelf.

The purpose of this project was to understand the hopes of parents with children with ASD. Particularly understudied are the hopes parents have for long-term outcomes for their child. A cross-sectional focus group design was used and six focus groups were completed. These groups included parents of (1) preschool aged children who were recently diagnosed, (2) children in early elementary school, (3) children in later elementary school, (4) children in middle school, (5) children in high school, and (6) children who are adults with ASD. Results indicated 77.4% of the data were devoted to hopes for the children's independence, happiness, and skill improvement; increased authentic socially significant relationships; and future employment.

Background and Purpose— Faster treatment with intravenous tissue-type plasminogen activator (tPA) is likely to improve outcomes. Optimizing prehospital triage by mobile stroke units (MSUs) may speed treatment times. The Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit (BEST-MSU) study was launched in May 2014 using the first MSU in the United States to compare stroke management using an MSU versus standard management (SM). Herein, we describe the results of the prespecified, nonrandomized run-in phase designed to obtain preliminary data on study logistics. Methods— The run-in phase consisted of 8 MSU weeks when all-patient care occurred on the MSU and 2 SM weeks when the MSU nurse met personnel on scene or at the emergency department to ensure comparability with MSU patients. Telemedicine was independently performed in 9 MSU cases. Results— Of 130 alerts, 24 MSU and 2 SM patients were enrolled. Twelve of 24 MSU patients received tPA on board; 4 were treated within 60 minutes of last seen normal, and 4 went on to endovascular treatment. There were no hemorrhagic complications. Four had primary intracerebral hemorrhage. Agreement on tPA eligibility between the onsite and telemedicine physician was 90%. Conclusions— The run-in phase provided a tPA treatment rate of 1.5 patients per week, assured us that treatment within 60 minutes of onset is possible, and enabled enrollment of patients on SM weeks. We also recognized the opportunity to assess the effect of the MSU on endovascular treatment and intracerebral hemorrhage. Challenges include the need to control biased patient selection on MSU versus SM weeks and establish inter-rater agreement for tPA treatment using telemedicine.

Summary Obesity is a steadily growing epidemic affecting all segments of the population including college-aged students. The weight gain that is evidenced amid the transitional stage of college years increases the risks associated with cardiovascular and metabolic diseases. The BodyMetrix® BX-2000 (ULTRA) using a seven-site method has been evaluated against dual-energy X-ray absorptiometry (DXA) for estimation of body composition, which has yielded conflicting results. To date, no studies have compared the three-site method Jackson and Pollock three-site method to DXA. Purpose The purpose of the study was twofold (i) to compare agreement between Jackson–Pollock seven site (JP7), Jackson–Pollock three site (JP3) and Pollock three site (P3) to predict body fat (%BF) using ULTRA and (ii) and to compare the three ULTRA methodologies against DXA. Methods Seventy-six healthy college-aged subjects (ages = 22·08 ± 2·50 years) participated in this study. DXA and ULTRA body composition assessments were performed following manufacturer's instructions to estimate %BF. Paired sample t-tests were used to assess agreement between JP7, P3 and JP3. Additionally, a two-tailed sample t-test was performed by sex. ULTRA and DXA results were also performed for agreement and bivariate correlation. Results No significant differences between JP7 and P3, P = 0·38, were observed. In males, no significant differences were observed between JP7 and P3, P = 0·18. Significant differences were observed in all other pairs, P≤0·001 and between ULTRA and DXA. Conclusions The Pollock 3-site method estimates body fat percentage with comparable accuracy to JP7 using ULTRA.

Research has indicated that as many as 10% to 15% of primary care patients have symptoms that are not well explained medically. These patients could be labeled as "somatizers." This study assessed the extent to which underlying psychological characteristics contribute to a person's level of somatization and service utilization. The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011; Westen, 1995) was used to rate early memory narratives of 100 patients in a suburban primary care setting. Using principal axis factoring, the SCORS-G was divided into 2 components and these components (cognitive and affective) were used in subsequent analyses. The affective component was significantly negatively correlated with 2 measures of somatization and positively related to physician ratings of global health. The affective component also showed a trend toward significance on overnight hospital stays and patient-rated health. The cognitive component showed a trend toward significance with both measures of somatization, but it was not correlated with other measures of health. This study demonstrates the value of assessing underlying processes (via SCORS-G ratings of early memory narratives) that contribute to increased rates of somatization and health care utilization. Clinical implications for the relationship between affect and physical health are explored.

Contrary to a long history of scholarship that considers Sitwell’s personality a major detriment to her historical and contemporary reception, this chapter understands Sitwell’s self-marketing strategy as genius critical self-doubling. To this end, Sitwell’s most important genre is criticism, in which she displays a penchant for often unattributed self-reference and self-explication. Sitwell doubles herself in her criticism, forging an arbitrary division between Sitwell the empirical critic and Sitwell the poet-philosopher; the empirical critic functions as a stand-in for the critico-literary institution, providing an “external” imprimatur for the poet-philosopher. Examining Noël Coward’s creation of Sitwell’s parodic poet-doppelgänger, Hernia Whittlebot, thus allows an understanding of Sitwell’s own self-doubling as integral to her self-marketing genius—Whittlebot’s relationship to Sitwell reenacts Sitwell’s approach to her own work. More broadly, these relations are a microcosm for the institution of modernist literary criticism that developed conterminously with the maturation and solidification of Sitwell’s strategies of authorship.

The purpose of this study is twofold: first, to take an initial step toward determining whether leadership theory is valued in public relations (PR) undergraduate education; second, to explore the focus on leadership as a distinct pedagogical concentration within the leading undergraduate PR programs in the United States. The results indicate that most departments offer one or two leadership-specific courses within the PR curriculum. However, PR instruction focuses more on skills training than leadership theory. It appears that PR professors do an adequate job teaching students good management skills, but curricula need more focus on theoretical understanding of leadership and application within the PR profession.

Handling a rodent disease outbreak in a facility can be a challenge. After the University of Colorado Denver Office of Laboratory Animal Resources enhanced its sentinel monitoring program, > 90% of the animal colonies housed in a vivarium at the Anschutz Medical Campus (with an area of 50,000 net ft(2)), serving the labs of > 250 principal investigators, tested positive for multiple infective agents including mouse parvovirus, fur mites, pinworms and epizootic diarrhea of infant mice. The authors detail the process by which they planned and executed a shutdown and a decontamination of the facility, which involved the rederivation or cryopreservation of > 400 unique genetically modified mouse lines. The authors discuss the aspects of the project that were successful as well as those that could have been improved.

A systematic review of the literature was conducted to investigate what is currently known about support for social participation for adults with autism spectrum disorders (ASD). A computerized database search followed by hand searching was conducted to locate empirical studies published after 1995 in peer-reviewed journals that described social participation or social support for adults with ASD. 14 studies were identified, evaluated for strength of evidence, and organized into topical themes. These studies focused on support for social participation from two perspectives: social functioning and quality of life (QoL). Supporting social functioning and social participation is important, as this is one route through which individuals with ASD may be able to form relationships and establish natural support networks, which can in turn contribute to QoL. In addition, working to improve social skills is of key importance as social functioning heavily impacts outcomes in a variety of areas. Social participation, social functioning, and QoL for adults with ASD appear to be facilitated through informal social support from social networks, participation in social skills groups, and membership in support groups.

Four water masses are identified and described using hydrographic, nutrient and stable isotope data for the top 1000 m water depth of the southern Australian continental margin, from Cape Leeuwin to Tasmania. Three are identified from previous literature on the southeast Indian Ocean: Subtropical Surface Water (STSW), Tasmanian Subantarctic Mode Water (TSAMW) and Tasmanian Intermediate Water (TIW), and one is newly identified and named: South Australian Basin Central Water (SABCW). STSW (0–250 m) is transported east by the Leeuwin Current System and is modified by heating and evaporation along the subtropical continental shelf. SABCW (250–400 m) and TSAMW (400–650 m) form southwest of Tasmania from deep winter mixing in the region: SABCW at the Subtropical Front and TSAMW north of the Subantarctic Front. TIW (>650 m) forms southwest of Tasmania from mixing of warm, saline Antarctic Intermediate Water from the Tasman Sea and cool, fresh Antarctic Intermediate Water from the Antarctic Circumpolar Current. SABCW, TSAMW and TIW are transported west along the slope by the Flinders Current System, here defined as the western slope-trapped Flinders Current, Tasman Outflow and equatorward Sverdrup transport. Water mass distributions on the slope identify the interface between subantarctic water from the Southern Ocean and subtropical water transported by the Leeuwin Current System. This interface is ~300 m during winter and ~250 m during summer, but can be 150 m during summer in upwelling regions and off western Tasmania. Furthermore, stable isotope data of the water masses south and west of Australia show connectivity between the Subantarctic Zone, the southern Australian margin and the western Australian margin.