Strategies used in the pursuit of achievability during goal setting in rehabilitation

We used conversation analysis of six audio- and video-recorded goal setting meetings that were attended by patients and their respective treating team to explore and describe the interaction of participants during interdisciplinary goal setting, and to identify the strategies used to agree goals. The health care professionals involved in the six sessions included four physiotherapists, four occupational therapists, four nurses, one speech and language therapist, and one neuropsychologist. The participants included 3 patients with multiple sclerosis, 2 patients with spinal cord lesions, and 1 patient with stroke from an inpatient neurological rehabilitation unit. Detailed analysis revealed how the treating team shaped the meetings. The most notable finding was that there was rarely a straightforward translation of patient wishes into agreed-on written goals, with the treating team leading goal modification so that goals were achievable. Despite professional dominance, patients also influenced the course of the interaction, particularly when offering resistance to goals proposed by the treating team

A faunal analysis of the Jackson Site (diMe-17) in southwestern Manitoba

The Jackson site (DiMe-17) is a Late Precontact site located in the Lauder Sandhills of southwestern Manitoba. The majority of the site consists of a Vickers Focus bison kill and associated processing/refuse areas radiocarbon dated to 290±50, 300±70, and 410±60 BP. At the southwestern corner of the site, a small amount of Blackduck pottery was recovered below the Vickers Focus occupation. Excavations occurred at the site between 1994 and 1997 and were completed by university archaeological field school students, paid crew members, and one volunteer. The site was excavated in an attempt to better understand the Vickers Focus presence in the Lauder Sandhills and to provide archaeological field school students with an opportunity to gain first hand knowledge of field excavation techniques. A total of 194, 198 bone specimens were analyzed from the Vickers Focus occupation at the Jackson site. Element and species distribution patterns verified proposed activity areas, while an examination of bison mandible eruption and wear patterns in conjunction with foetal bison remains corroborate that the site was occupied during the winter months. The fragmented nature of the assemblage is a result of human butchery and subsequent processing of elements for marrow and grease. Non-cultural processes such as carnivore modification, weathering, rootlet etching, and trampling left visible traces on the assemblage but did not cause density-mediated destruction. A comparison of the subsistence strategies employed by the Jackson and Sanderson site inhabitants did not provide sufficient information to confirm proposed contact between Vickers Focus and Mortlach groups. The Sanderson site is a multiple Mortlach occupation located on the Souris River in southeastern Saskatchewan. Inhabitants of both sites were reliant on bison, and both employed a smash and strip method of bison butchery. Intensive bison utilization was evident at both sites but the Jackson site inhabitants may have been under greater nutritional stress. The greatest difference between the two groups was visible in the method of meat storage. The Mortlach inhabitants at the Sanderson site used frozen meat caches while no such evidence for this exists at the Jackson site

Comparison of Lipoprotein Based Insulin Resistance Score and Traditional Risk Factors in Adolescents with Obesity

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Orbital Dimer Model for Spin-Glass State in Y2_2Mo2_2O7_7

The formation of a spin glass usually requires both structural disorder and frustrated magnetic interactions. Consequently, the origin of spin-glass behaviour in Y$_2$Mo$_2$O$_7$ $-$ in which magnetic Mo$^{4+}$ ions occupy a frustrated pyrochlore lattice with minimal compositional disorder $-$ has been a longstanding question. Here, we use neutron and X-ray pair-distribution function (PDF) analysis to develop a disorder model that resolves apparent incompatibilities between previously-reported PDF, EXAFS and NMR studies and provides a new and physical mechanism for spin-glass formation. We show that Mo$^{4+}$ ions displace according to a local "2-in/2-out" rule on each Mo$_4$ tetrahedron, driven by orbital dimerisation of Jahn-Teller active Mo$^{4+}$ ions. Long-range orbital order is prevented by the macroscopic degeneracy of dimer coverings permitted by the pyrochlore lattice. Cooperative O$^{2-}$ displacements yield a distribution of Mo$-$O$-$Mo angles, which in turn introduces disorder into magnetic interactions. Our study demonstrates experimentally how frustration of atomic displacements can assume the role of compositional disorder in driving a spin-glass transition.Comment: 6 pages, 3 figure

Relative incidence and predictors of pulmonary arterial hypertension complicating type 2 diabetes: The Fremantle Diabetes Study Phase I

Aims: To determine the relative incidence and predictors of pulmonary arterial hypertension (PAH) in type 2 diabetes. Methods: Hospitalizations for/with and death from/with PAH, and all-cause mortality, were ascertained from validated databases for participants from the longitudinal, community-based Fremantle Diabetes Study Phase I (FDS1; n = 1287) and age-, sex- and zip code-matched people without diabetes (n = 5153) between entry (1993–1996) and end-2017. Incidence rates (IRs) and IR ratios (IRRs) were calculated. Cox proportional hazards and competing risk models generated cause-specific (cs) and subdistribution (sd) hazard ratios (HRs) for incident PAH. Results: In the pooled cohort (mean age 64.0 years, 49% males), 49 (3.8%) of the type 2 diabetes participants and 133 (2.6%) of those without diabetes developed PAH during 106,556 person-years of follow-up (IRs (95% CI) 262 (194– 346) and 151 (127–179) /100,000 person-years, respectively; IRR 1.73 (1.22–2.42), P = 0.001). Type 2 diabetes was associated with an unadjusted csHR of 1.97 (1.42–2.74) and sdHR of 1.44 (1.04–2.00) (P ≤ 0.03); after adjustment for age, sex, and co-morbidities, these were 1.43 (0.83–2.47) and 1.36 (0.97–1.91), respectively (P ≥ 0.07). Conclusions: Type 2 diabetes is associated with an increased risk of PAH but this is no longer significant after adjustment for other explanatory variables and the competing risk of death. © 2020 Elsevier Inc. All rights reserved

Assessing a standardised approach to measuring corticospinal integrity after stroke with DTI

The structural integrity of the corticospinal tract (CST) after stroke is closely linked to the degree of motor impairment. Simple and reliable methods of assessing white matter integrity within the CST would facilitate the use of this measure in routine clinical practice. Commonly, diffusion tensor imaging is used to measure voxel-wise fractional anisotropy (FA) in a variety of regions of interest (ROIs) representing the CST. Several methods are currently in use with no consensus about which approach is best. ROIs are usually either the whole CST or the posterior limb of the internal capsule (PLIC). These are created manually on brain images or with reference to an individual's CST determined by tractography. Once the ROI has been defined, the FA can be reported as an absolute measure from the ipsilesional side or as a ratio in comparison to the contralesional side. Both corticospinal tracking and manual ROI definition in individual stroke patients are time consuming and subject to bias. Here, we investigated whether using a CST template derived from healthy volunteers was a feasible method for defining the appropriate ROI within which to measure changes in FA. We reconstructed the CST connecting the primary motor cortex to the ipsilateral pons in 23 age-matched control subjects and 21 stroke patients. An average healthy CST template was created from the 23 control subjects. For each patient, FA values were then calculated for both the template CST and for their own CST. We compared patients' FA metrics between the two tracts by considering four measures (FA in the ipsilesional side, FA in the contralesional side, FA ratio of the ipsilesional side to the contralesional side and FA asymmetry between the two sides) and in two tract-based ROIs (whole tract and tract section traversing the PLIC). There were no significant differences in FA metrics for either method, except for contralesional FA. Furthermore, we found that FA metrics relating to CST damage all correlated with motor ability post-stroke equally well. These results suggest that the healthy CST template could be a surrogate structure for defining tract-based ROIs with which to measure stroke patients' FA metrics, avoiding the necessity for CST tracking in individual patients. CST template-based automated quantification of structural integrity would greatly facilitate implementation of practical clinical applications of diffusion tensor imaging

Structural disorder in (Bi,M)2(Fe,Mn,Bi)2O6+x (M = Na or K) pyrochlores seen from reverse Monte Carlo analysis of neutron total scattering

The average structures of the polycrystalline pyrochlores (Na0.60Bi1.40)(Fe1.06Mn0.17Bi0.77)O6.87 and (K0.24Bi1.51)(Fe1.07Mn0.15Bi0.78)O6.86 can be refined through Rietveld refinement against Bragg scattering data using cubic space group Fd3 ̅m, with off-centred 96h and 32e positions describing the A2Oʹ network. Investigation of their local structures through neutron total scattering confirms the extent of disorder within these materials, and furthermore shows significant deviation from the average structure, which is not accounted for through analysis of Bragg data alone. Reverse Monte Carlo (RMC) analysis with a 6 × 6 × 6 supercell was used to model accurately this local disorder, revealing ellipsoidal distributions for A-site potassium, distinctly different to the hollow torus-shaped distributions for the sodium and bismuth cations. It is shown through bond valence sum analysis that whilst these atomic displacements allow for the steric preferences of Bi3+, they are also necessary to satisfy the valence of both the bismuth and the alkali metals on the A sites. Analysis of the final RMC configuration showed the BO6 octahedra for the separate B site metals to be more regular (O–B–O ≈ 90°) than those in the Rietveld model (O–B–O ≈ 85/95°) which describes an average of the three different environments

Structure–property insights into nanostructured electrodes for Li-ion batteries from local structural and diffusional probes

Microwave heating presents a faster, lower energy synthetic methodology for the realization of functional materials. Here, we demonstrate for the first time that employing this method also leads to a decrease in the occurrence of defects in olivine structured LiFe1−xMnxPO4. For example, the presence of antisite defects in this structure precludes Li+ diffusion along the b-axis leading to a significant decrease in reversible capacities. Total scattering measurements, in combination with Li+ diffusion studies using muon spin relaxation (μ+SR) spectroscopy, reveal that this synthetic method generates fewer defects in the nanostructures compared to traditional solvothermal routes. Our interest in developing these routes to mixed-metal phosphate LiFe1−xMnxPO4 olivines is due to the higher Mn2+/3+ redox potential in comparison to the Fe2+/3+ pair. Here, single-phase LiFe1−xMnxPO4 (x = 0, 0.25, 0.5, 0.75 and 1) olivines have been prepared following a microwave-assisted approach which allows for up to 4 times faster reaction times compared to traditional solvothermal methods. Interestingly, the resulting particle morphology is dependent on the Mn content. We also examine their electrochemical performance as active electrodes in Li-ion batteries. These results present microwave routes as highly attractive for reproducible, gram-scale syntheses of high quality nanostructured electrodes which display close to theoretical capacity for the full iron phase