Exploring Gender Differences Between Bipolar Disorder and Borderline Personality Disorder in Responses on the Personality Assessment Inventory (PAI)

Bipolar disorder and borderline personality disorder are two diagnoses that are often difficult to differentiate. Current literature supports this challenge and reveals a high rate of misdiagnosis between the two, as well as a high prevalence of borderline personality disorder diagnoses in women. Diagnostic accuracy remains a vital skill for clinicians to effectively address the needs of clients, and diagnostic assessment tools are often used to aid in this endeavor. The focus in this study was to explore gender discrepancies in responses across the main features of borderline personality disorder (i.e., affective instability, identity problems, negative relationships, and self-harm) and the main features of bipolar disorder (i.e., activity level, grandiosity, and irritability), each corresponding with the specific Personality Assessment Inventory Borderline and Mania subscales. This study used archival data from 102 outpatient individuals who completed the PAI at intake. Results showed men scored significantly higher on the Mania Grandiosity subscale and scored within the high elevation range of the Mania scale at a rate of 3.70 times that of women. No statistical differences were found in the remaining subscale mean scores or in the elevations in the three Mania subscales across gender. Further, no significant results were found in comparing the mean scores or elevations of the Borderline scale or its four subscales. The results of the current study may support the use of the PAI in differentiating between bipolar disorder and borderline personality disorder, as well as objectively assessing for borderline personality disorder criteria after controlling for gender bias

Texas\u27s Excessive Demand Doctrine Impacts Recoveries in Litigation.

A party demanding money they are not entitled to becomes subject to the excessive demand doctrine. Because the excessive demand doctrine is an affirmative defense, a defending party must allege its claim of excessive demand in its pleadings. A party must “plead it, prove it, and obtain findings of fact on its essential elements.” To obtain findings on the issue, both the pleadings and the evidence are required to put a question or instruction before the jury. Ensuring that the evidence is enough depends upon the trial court—whose judgment will only be overturned upon a showing of an abuse of discretion. Preventing excessive demands serves the purpose of resolving disputes fairly and efficiently by eliminating improper motives to delay settlement. Knowing the ins and outs of the doctrine enables litigants to either preserve their recovery against diminution on one side or protect against unjust exposure to mounting attorney’s fees and damages based on unreasonable, bad faith demands on the other. Texas’s excessive demand defense is powerful against recovery and a potential deterrent to the proffering of inordinate demands and costly stalling in litigation. The recurring lessons yielded from these cases are that failure to raise the defense and failure to meet the elements ruins application of the defense. The excessive demand can vitiate the recovery of substantial attorney’s fees and prejudgment interest. This could occur if a party makes an unreasonable or bad faith demand for a sum the party is not entitled to receive and further refuses or reveals an unwillingness to accept tender of the amount owed

Texas\u27s Excessive Demand Doctrine Impacts Recoveries in Litigation.

A party demanding money they are not entitled to becomes subject to the excessive demand doctrine. Because the excessive demand doctrine is an affirmative defense, a defending party must allege its claim of excessive demand in its pleadings. A party must “plead it, prove it, and obtain findings of fact on its essential elements.” To obtain findings on the issue, both the pleadings and the evidence are required to put a question or instruction before the jury. Ensuring that the evidence is enough depends upon the trial court—whose judgment will only be overturned upon a showing of an abuse of discretion. Preventing excessive demands serves the purpose of resolving disputes fairly and efficiently by eliminating improper motives to delay settlement. Knowing the ins and outs of the doctrine enables litigants to either preserve their recovery against diminution on one side or protect against unjust exposure to mounting attorney’s fees and damages based on unreasonable, bad faith demands on the other. Texas’s excessive demand defense is powerful against recovery and a potential deterrent to the proffering of inordinate demands and costly stalling in litigation. The recurring lessons yielded from these cases are that failure to raise the defense and failure to meet the elements ruins application of the defense. The excessive demand can vitiate the recovery of substantial attorney’s fees and prejudgment interest. This could occur if a party makes an unreasonable or bad faith demand for a sum the party is not entitled to receive and further refuses or reveals an unwillingness to accept tender of the amount owed

Epidural Analgesia Decreases Narcotic Requirements in Low Level Spina Bifida Patients Undergoing Urologic Laparotomy for Neurogenic Bladder and Bowel

Purpose Concern of anatomical anomalies and worsening neurologic symptoms has prevented widespread use of epidural catheters in patients with low level spina bifida (LLSB). We hypothesize that thoracic epidural placement in the T9-T10 interspace is safe and decreases narcotic requirements in LLSB patients following major open lower urinary tract reconstruction (LUTR). Materials and Methods We reviewed consecutive LLSB patients who had LUTR and epidurals for post-operative pain control. Controls were LLSB patients who received single shot transversus abdominis plane (TAP) blocks with similar procedures. Complications from epidural placement, including changes in motor and sensory status were recorded. Opioid consumption was calculated utilizing equivalent IV morphine doses. Mean and maximum pain scores on post-operative day (POD) 0-3 were calculated. Results 10 LLSB patients who had lower urinary tract reconstruction and epidurals were matched to 10 LLSB patients who had lower urinary tract reconstruction and transverse abdominis plane blocks. Groups were demographically similar. All had full abdominal sensation and functional levels at or below L3. No epidural complications or changes in neurological status were noted. The epidural group had decreased opioid consumption on POD 0-3 (0.75 mg/kg vs. 1.29 mg/kg, p=0.04). Pain scores were similar or improved in the epidural group. Conclusions Thoracic epidural analgesia appears to be a safe and effective opioid sparing option to assist with post-operative pain management following lower urinary tract reconstruction in LLSB patients

The magnetic field environment of active region 12673 that produced the energetic particle events of September 2017

Forecasting solar energetic particles (SEPs), and identifying flare/CMEs from active regions (ARs) that will produce SEP events in advance is extremely challenging. We investigate the magnetic field environment of AR 12673, including the AR's magnetic configuration, the surrounding field configuration in the vicinity of the AR, the decay index profile, and the footpoints of Earth-connected magnetic field, around the time of four eruptive events. Two of the eruptive events are SEP-productive (2017 September 4 at 20:00~UT and September 6 at 11:56~UT), while two are not (September 4 at 18:05~UT and September 7 at 14:33~UT). We analysed a range of EUV and white-light coronagraph observations along with potential field extrapolations and find that the CMEs associated with the SEP-productive events either trigger null point reconnection that redirects flare-accelerated particles from the flare site to the Earth-connected field and/or have a significant expansion (and shock formation) into the open Earth-connected field. The rate of change of the decay index with height indicates that the region could produce a fast CME ($v >$ 1500~km~s$^{-1}$), which it did during events two and three. The AR's magnetic field environment, including sites of open magnetic field and null points along with the magnetic field connectivity and propagation direction of the CMEs play an important role in the escape and arrival of SEPs at Earth. Other SEP-productive ARs should be investigated to determine whether their magnetic field environment and CME propagation direction are significant in the escape and arrival of SEPs at Earth.Comment: Accepted in ApJ, 18 pages, 8 Figures, 2 Table

Trait-based diet selection: Prey behaviour and morphology predict vulnerability to predation in reef fish communities

SUMMARY: 1. Understanding how predators select their prey can provide important insights into community structure and dynamics. However, the suite of prey species available to a predator is often spatially and temporally variable. As a result, species-specific selectivity data are of limited use for predicting novel predator–prey interactions because they are assemblage specific. 2. We present a method for predicting diet selection that is applicable across prey assemblages, based on identifying general morphological and behavioural traits of prey that confer vulnerability to predation independent of species identity. We apply this trait-based approach to examining prey selection by Indo-Pacific lionfish (Pterois volitans), an invasive predator that preys upon species-rich reef fish communities and is rapidly spreading across the Western Atlantic. 3. We first generate hypotheses about morphological and behavioural traits recurring across fish species that could facilitate or deter predation by lionfish. Constructing generalized linear mixed-models that account for relatedness among prey taxa, we test whether these traits predict patterns of diet selection by lionfish within two independent data sets collected at different spatial scales: (1) in situ visual observations of prey consumption and availability for individual lionfish and (2) comparisons of prey abundance in lionfish stomach contents to availability on invaded reefs at large. 4. Both analyses reveal that a number of traits predicted to affect vulnerability to predation, including body size, body shape, position in the water column and aggregation behaviour, are important determinants of diet selection by lionfish. Small, shallow-bodied, solitary fishes found resting on or just above reefs are the most vulnerable. Fishes that exhibit parasite cleaning behaviour experience a significantly lower risk of predation than non-cleaning fishes, and fishes that are nocturnally active are at significantly greater risk. Together, vulnerable traits heighten the risk of predation by a factor of nearly 200. 5. Our study reveals that a trait-based approach to studying diet selection yields insights into predator–prey interactions that are robust across prey assemblages. Importantly, in situ observations of selection yield similar results to broad-scale comparisons of prey use and availability, which are more typically gathered for predator species. A trait-based approach could therefore be of use across predator species and ecosystems to predict the outcomes of changing predator–prey interactions on community dynamics.Keywords: In situ observations, Pterois volitans/miles, Resource use and availability, Stomach contents analysis, Predator-prey interactions, Foraging behaviour, Prey characteristics, Selective predatio

The Merging of a Coronal Dimming and the Southern Polar Coronal Hole

We report on the merging between the southern polar coronal hole and an adjacent coronal dimming induced by a coronal mass ejection on 2022 March 18, resulting in the merged region persisting for at least 72 hr. We use remote sensing data from multiple co-observing spacecraft to understand the physical processes during this merging event. The evolution of the merger is examined using Extreme-UltraViolet (EUV) images obtained from the Atmospheric Imaging Assembly on board the Solar Dynamic Observatory and Extreme Ultraviolet Imager, which is on board the Solar Orbiter spacecraft. The plasma dynamics are quantified using spectroscopic data obtained from the EUV Imaging Spectrometer on board Hinode. The photospheric magnetograms from the Helioseismic and Magnetic Imager are used to derive the magnetic field properties. To our knowledge, this work is the first spectroscopical analysis of the merging of two open-field structures. We find that the coronal hole and the coronal dimming become indistinguishable after the merging. The upflow speeds inside the coronal dimming become more similar to that of a coronal hole, with a mixture of plasma upflows and downflows observable after the merging. The brightening of the bright points and the appearance of coronal jets inside the merged region further imply ongoing reconnection processes. We propose that component reconnection between the coronal hole and coronal dimming fields plays an important role during this merging event because the footpoint switching resulting from the reconnection allows the coronal dimming to intrude onto the boundary of the southern polar coronal hole

An Interdisciplinary Approach to Community-Engaged Research Surrounding Lead in Drinking Water in the Mississippi Delta

Childhood lead poisoning is a problem requiring interdisciplinary attention from toxicology, public health, social sciences, environmental law, and policy. In the U.S., Mississippi was ranked as one of the worst states for lead poisoning with limited childhood screening measures. We conducted community-engaged research by working with leaders in the largely rural Mississippi Delta region from 2016-2019 to collect household water samples and questionnaires and involve their communities in lead poisoning risk awareness and outreach. Drinking water from 213 homes was collected and analyzed for pH and lead concentrations. Highest lead concentrations were from households served by private wells, and detectable concentrations at or above 0.09 ppb were found in 66.2 percent of all samples. Nine samples exceeded 5 ppb, and these households received certified sink filters. Findings indicated that community-engaged research and outreach could be used to address data gaps relating to lead in drinking water in rural decentralized water systems

Semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts of the knee at 3T MRI: A comparison between intermediate-weighted fat-suppressed spin echo and Dual Echo Steady State sequences

Background\ud Choice of appropriate MR pulse sequence is important for any research studies using imaging-derived data. The aim of this study was to compare semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts using intermediate-weighted (IW) fat-suppressed (fs) spin echo and Dual Echo Steady State (DESS) sequences on 3 T MRI.\ud \ud Methods\ud Included were 201 subjects aged 35-65 with frequent knee pain. 3T MRI was performed with the same sequence protocol as in the Osteoarthritis Initiative (OAI). In a primary reading subchondral bone marrow edema-like lesions were assessed according to the WORMS system. Two hundred subregions with such lesions were randomly chosen. The extent of subchondral bone marrow edema-like lesions was re-evaluated separately using sagittal IW fs and DESS sequences according to WORMS. Lesion size and confidence of the differentiation between subchondral bone marrow edema-like lesions and subchondral cysts located within or adjacent to them was rated from 0 to 3. Wilcoxon signed-rank tests and chi-square statistics were used to examine differences between the two sequences.\ud \ud Results\ud Of 200 subchondral bone marrow edema-like lesions detected by IW fs sequence, 93 lesions (46.5%) were not depicted by the DESS sequence. The IW fs sequence depicted subchondral bone marrow edema-like lesions to a larger extent than DESS (p < 0.0001), and the opposite was true for subchondral cysts. Confidence scores for differentiation of the two types of lesions were not significantly different between the two sequences.\ud \ud Conclusions\ud In direct comparison the IW fs sequence depicts more subchondral bone marrow edema-like lesions and better demonstrate the extent of their maximum size. The DESS sequence helps in the differentiation of subchondral bone marrow edema-like lesions and subchondral cysts. The IW fs sequence should be used for determination of lesion extent whenever the size of subchondral bone marrow edema-like lesions is the focus of attention