Identification of the High-Risk Gravida

In the past, there has been considerable pessimism about our ability to identify the pregnant patient at risk. However, with the development of sophisticated diagnostic techniques these patients can be identified and with appropriate treatment their outcome can be improved. This paper presents the overall benefit of categorizing obstetrical patients, the method that has been developed at the Medical College of Virginia (MCV), and certain categories of high-risk obstetrical patients who continue to present problems and have unacceptably high complication rates

A novel fluorescent tracer for real-time tracing of clay transport over soil surfaces

Clay is an important vector for the transport of pollutants in the environment, including nutrients, pesticides and metals; therefore, the fate of many chemicals in soil systems is closely linked to that of clay. Understanding the mechanisms responsible for clay transport has been hampered by the lack of a suitable tracer. Producing a tracer that accurately mimics clay transport is challenging, due to the small size of the particles and their unique physical properties. Here we describe the design and synthesis of a tracer using natural clay particles as a foundation, exploiting the natural ability of clay to sorb molecules to coat the clay with a thin layer of fluorophore. Application of the tracer has been demonstrated through the collection of real-time images of the tracer moving over the surface of a soil box during a rainfall event. These images allow, for the first time, clay to be tracked spatially and temporally without need to remove soil for analysis, thus resulting in minimal experimental artefacts. Custom written software has been used to extract high resolution data describing tracer movement and extent throughout the experiment

Patterns of comorbidity associated with ICD-11 PTSD among older adults in the United States

Little research has been conducted on posttraumatic stress disorder (PTSD) comorbidity among older adults regarding the description of PTSD in the 11th version of the International Classification of Diseases (ICD-11). This study sought to provide evidence of a dimensional model of psychopathology using the ‘Hierarchical Taxonomy of Psychopathology’ (HiTOP) model as a theoretical framework to explain patterns of ICD-11 PTSD comorbidity. Distinct patterns of ICD-11 PTSD comorbidity among a nationally representative sample (n = 530) of adults aged 60 years and older from the United States were examined using latent class analysis (LCA). Covariates associated with comorbidity classes were assessed through multinomial logistic regression. ICD-11 PTSD was highly comorbid with other psychopathologies. LCA results favoured a two-class solution. Class 1 (71.7%) was characterised by moderate probabilities for major depressive disorder and alcohol use disorder; Class 2 (28.3%) was characterised by a moderate-high probability of general psychopathology and was associated with lower social support, spousal/partner physical abuse, and history of attempted suicide. PTSD was highly comorbid with other disorders among older adults. Distinct patterns of PTSD comorbidity exist among this cohort and these findings can aid clinicians and researchers in understanding and predicting maladaptive responses to trauma and associated psychopathology

Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults

Abstract Objectives: Research examining the relationship between loneliness and Complex Posttraumatic Stress Disorder (CPTSD) is scarce, particularly among older adults. CPTSD includes the core symptoms of PTSD along with additional symptoms reflecting “disturbances in self‐organisation” (DSO). This study examined the cross‐sectional relationships between loneliness (emotional and social loneliness) and CPTSD symptoms (i.e., PTSD and DSO symptoms) in older adults. Methods: Structural equation modelling was used to examine these relationships in a nationally representative sample of US adults aged 60–70 years (n = 456). Results: Controlling for covariates, emotional loneliness was associated with PTSD (β = 0.31) and DSO (β = 0.57) symptoms whereas social loneliness was only associated with DSO symptoms (β = 0.25). The model explained 35.0% of the variance in PTSD symptoms and 71.3% in DSO symptoms. Conclusion: These findings have important implications for treating and understanding PTSD/CPTSD and their corre�lates among older adults

Neighborhood health‐promoting resources and obesity risk (the multi‐ethnic study of atherosclerosis)

Objective: While behavioral change is necessary to reverse the obesity epidemic, it can be difficult to achieve and sustain in unsupportive residential environments. This study hypothesized that environmental resources supporting walking and a healthy diet are associated with reduced obesity incidence. Design and Methods: Data came from 4,008 adults aged 45‐84 at baseline who participated in a neighborhood ancillary study of the Multi‐Ethnic Study of Atherosclerosis. Participants were enrolled at six study sites at baseline (2000‐2002) and neighborhood scales were derived from a supplementary survey that asked community residents to rate availability of healthy foods and walking environments for a 1‐mile buffer area. Obesity was defined as BMI ≥ 30 kg/m 2 . Associations between incident obesity and neighborhood exposure were examined using proportional hazards and generalized linear regression. Results: Among 4,008 nonobese participants, 406 new obesity cases occurred during 5 years of follow‐up. Neighborhood healthy food environment was associated with 10% lower obesity incidence per s.d. increase in neighborhood score. The association persisted after adjustment for baseline BMI and individual‐level covariates (hazard ratio (HR) 0.88, 95% confidence interval (CI): 0.79, 0.97), and for correlated features of the walking environment but CIs widened to include the null (HR 0.89, 95% CI: 0.77, 1.03). Associations between neighborhood walking environment and lower obesity were weaker and did not persist after adjustment for correlated neighborhood healthy eating amenities (HR 0.98, 95% CI: 0.84, 1.15). Conclusions: Altering the residential environment so that healthier behaviors and lifestyles can be easily chosen may be a precondition for sustaining existing healthy behaviors and for adopting new healthy behaviors.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97459/1/20255_ftp.pd

Crustal structure of the Trans-Atlantic Geotraverse (TAG) segment (Mid-Atlantic Ridge, 26°10′N) : implications for the nature of hydrothermal circulation and detachment faulting at slow spreading ridges

Author Posting. © American Geophysical Union, 2007. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry Geophysics Geosystems 8 (2007): Q08004, doi:10.1029/2007GC001629.New seismic refraction data reveal that hydrothermal circulation at the Trans-Atlantic Geotraverse (TAG) hydrothermal field on the Mid-Atlantic Ridge at 26°10′N is not driven by energy extracted from shallow or mid-crustal magmatic intrusions. Our results show that the TAG hydrothermal field is underlain by rocks with high seismic velocities typical of lower crustal gabbros and partially serpentinized peridotites at depth as shallow as 1 km, and we find no evidence for low seismic velocities associated with mid-crustal magma chambers. Our tomographic images support the hypothesis of Tivey et al. (2003) that the TAG field is located on the hanging wall of a detachment fault, and constrain the complex, dome-shaped subsurface geometry of the fault system. Modeling of our seismic velocity profiles indicates that the porosity of the detachment footwall increases after rotation during exhumation, which may enhance footwall cooling. However, heat extracted from the footwall is insufficient for sustaining long-term, high-temperature, hydrothermal circulation at TAG. These constraints indicate that the primary heat source for the TAG hydrothermal system must be a deep magma reservoir at or below the base of the crust.This research was supported by NSF grant OCE-0137329

Seismic reflection images of a near-axis melt sill within the lower crust at the Juan de Fuca ridge

Author Posting. © The Author(s), 2009. This is the author's version of the work. It is posted here by permission of Nature Publishing Group for personal use, not for redistribution. The definitive version was published in Nature 460 (2009): 89-93, doi:10.1038/nature08095.The oceanic crust extends over two thirds of the Earth’s solid surface and is generated along mid-ocean ridges from melts derived from the upwelling mantle. The upper and mid crust are constructed by dyking and seafloor eruptions originating from magma accumulated in mid-crustal lenses at the spreading axis, but the style of accretion of the lower oceanic crust is actively debated. Models based on geological and petrological data from ophiolites propose that the lower oceanic crust is accreted from melt sills intruded at multiple levels between the Moho transition zone (MTZ) and the mid-crustal lens, consistent with geophysical studies that suggest the presence of melt within the lower crust. However, seismic images of molten sills within the lower crust have been elusive. To date only seismic reflections from mid-crustal melt lenses and sills within the MTZ have been described, suggesting that melt is efficiently transported through the lower crust. Here we report deep crustal seismic reflections off the southern Juan de Fuca Ridge that we interpret as originating from a molten sill presently accreting the lower oceanic crust. The sill sits 5-6 km beneath the seafloor and 850-900 m above the MTZ, and it is located 1.4-3.2 km off thespreading axis. Our results provide evidence for the existence of low permeability barriers to melt migration within the lower section of modern oceanic crust forming at intermediate-to-fast spreading rates, as inferred from ophiolite studies.This research was supported by grants form the US NSF

Primitive layered gabbros from fast-spreading lower oceanic crust

Three-quarters of the oceanic crust formed at fast-spreading ridges is composed of plutonic rocks whose mineral assemblages, textures and compositions record the history of melt transport and crystallization between the mantle and the sea floor. Despite the importance of these rocks, sampling them in situ is extremely challenging owing to the overlying dykes and lavas. This means that models for understanding the formation of the lower crust are based largely on geophysical studies and ancient analogues (ophiolites) that did not form at typical mid-ocean ridges. Here we describe cored intervals of primitive, modally layered gabbroic rocks from the lower plutonic crust formed at a fast-spreading ridge, sampled by the Integrated Ocean Drilling Program at the Hess Deep rift. Centimetre-scale, modally layered rocks, some of which have a strong layering-parallel foliation, confirm a long-held belief that such rocks are a key constituent of the lower oceanic crust formed at fast-spreading ridges. Geochemical analysis of these primitive lower plutonic rocks-in combination with previous geochemical data for shallow-level plutonic rocks, sheeted dykes and lavas-provides the most completely constrained estimate of the bulk composition of fast-spreading oceanic crust so far. Simple crystallization models using this bulk crustal composition as the parental melt accurately predict the bulk composition of both the lavas and the plutonic rocks. However, the recovered plutonic rocks show early crystallization of orthopyroxene, which is not predicted by current models of melt extraction from the mantle and mid-ocean-ridge basalt differentiation. The simplest explanation of this observation is that compositionally diverse melts are extracted from the mantle and partly crystallize before mixing to produce the more homogeneous magmas that erupt