Wide-Area Debris Field and Seabed Characterization of a Deep Ocean Dump Site Surveyed by Autonomous Underwater Vehicles.

Disposal of industrial and hazardous waste in the ocean was a pervasive global practice in the 20th century. Uncertainty in the quantity, location, and contents of dumped materials underscores ongoing risks to marine ecosystems and human health. This study presents an analysis of a wide-area side-scan sonar survey conducted with autonomous underwater vehicles (AUVs) at a dump site in the San Pedro Basin, California. Previous camera surveys located 60 barrels and other debris. Sediment analysis in the region showed varying concentrations of the insecticidal chemical dichlorodiphenyltrichloroethane (DDT), of which an estimated 350-700 t were discarded in the San Pedro Basin between 1947 and 1961. A lack of primary historical documents specifying DDT acid waste disposal methods has contributed to the ambiguity surrounding whether dumping occurred via bulk discharge or containerized units. Barrels and debris observed during previous surveys were used for ground truth classification algorithms based on size and acoustic intensity characteristics. Image and signal processing techniques identified over 74,000 debris targets within the survey region. Statistical, spectral, and machine learning methods characterize seabed variability and classify bottom-type. These analytical techniques combined with AUV capabilities provide a framework for efficient mapping and characterization of uncharted deep-water disposal sites.

Anticoagulation in Pulmonary Arterial Hypertension: Do We Know the Answer?

The shear stress and hypoxia in the pulmonary artery in patients with pulmonary arterial hypertension(PAH) causes endothelial dysfunction, smooth muscle proliferation and activation of thrombotic pathways leading to in situ thrombosis. Targeting the thrombotic pathways is a proposed mechanism to slow disease progression and improve survival. Over the years, the survival in patients with PAH has improved due to multiple factors with the increased use of anticoagulation as one of them. Both European Respiratory Society/European Society of Cardiology and American College of Cardiology/American Heart Association guidelines make grade II recommendations for using anticoagulation in PAH. The guidelines are based on weak observational studies with high risk of bias which have only studied warfarin as the choice of anticoagulation. In this article, we review the pathophysiology, rationale and the current literature investigating the role of anticoagulation in PAH.

Disentangling Stigma from Functional Neurological Disorders: Conference Report and Roadmap for the Future.

A multidisciplinary expert review of key issues and future directions from the conference "Controversial labels and clinical uncertainties: psychogenic disorders, conversion disorder, and functional symptoms." On October 9 and 10, 2015, a conference entitled "Controversial labels and clinical uncertainties: psychogenic disorders, conversion disorder, and functional symptoms" was held at the Center for Ethics, Emory University, Atlanta, GA, USA. This conference brought together a select group of 30 distinguished thought leaders and practitioners, including ethicists, researchers, clinicians, humanities scholars, and advocates to discuss the unique challenges and controversies related to the diagnosis, treatment, and stigma for patients with what is currently recognized as functional ("psychogenic") neurological disorders. Our group of experts explored the conflicts and ethical tensions within health care that must be addressed in order to advance care for these disorders. What follows is a reflection on the conversations between conference attendees outlining key challenges and value conflicts in the diagnosis and treatment of patients with functional disorders. With this report, we aim to provide a roadmap for reducing stigma and improving care for functional neurological disorders (FND). A path forward would involve (1) setting a multifactorial research agenda that equally prioritized access to effective psychotherapy as well as identification of novel biomarkers; (2) empowering patients with FND to be heard and to drive changes in care; and (3) reducing isolation for clinicians by providing formal training and setting up multidisciplinary care teams and support networks.

Incidence and early outcomes associated with pre-transplant antivimentin antibodies in the cardiac transplantation population.

BACKGROUND: In cardiac transplant recipients, the development of antibodies to the endothelial intermediate filament protein vimentin (antivimentin antibodies, AVA) has been associated with rejection and poor outcomes. However, the incidence of these antibodies prior to transplantation and their association with early rejection has not been investigated. METHODS: Pre-transplant serum was analyzed from 50 patients who underwent de novo cardiac transplant at Johns Hopkins Hospital from 2004 to 2012. Demographic, one-yr rejection, and survival data were obtained from the transplant database. RESULTS: The incidence of pre-transplant AVA was 34%. AVA-positive patients were younger (p = 0.03), and there was an a trend toward incidence in females (p = 0.08). Demographic data were similar among both groups. AVA positivity did not predict rejection in the first year post-transplant. There was no difference in rejection-free graft survival (53 vs. 52%, p = 0.85) at one yr. Similarly, there was no difference in graft survival at one yr (82 vs. 88%, p = 0.56) or graft survival at a median follow-up of 23 and 26 months, respectively (76 vs. 85%, p = 0.41). CONCLUSIONS: AVA is common in the cardiac pre-transplant population with a higher incidence in the young. The presence of detectable AVA did not correlate with early post-transplant rejection or graft survival.

Role of non-invasive imaging in the work-up of cardiomyopathies.

Cardiomyopathy is an intrinsic structural disorder of the myocardium that may result in ventricular dysfunction and can progress to clinical heart failure. Non-invasive imaging modalities can determine whether abnormalities are present in the myocardium, valves, pericardium, or vessels. These imaging techniques can also present important prognostic information, as well as direct treatment and further management. Echocardiography is the most common imaging technique used for the initial diagnosis and management of cardiomyopathy; however, other imaging modalities, including nuclear cardiac imaging, cardiac magnetic resonance imaging, and cardiac computed tomography, may play an important role depending on the underlying etiology of the cardiomyopathy. This article reviews the role of non-invasive imaging in the work-up and management of patients with cardiomyopathy.

Some behavioral aspects of energy descent: how a biophysical psychology might help people transition through the lean times ahead.

We may soon face biophysical limits to perpetual growth. Energy supplies may tighten and then begin a long slow descent while defensive expenditures rise to address problems caused by past resource consumption. The outcome may be significant changes in daily routines at the individual and community level. It is difficult to know when this scenario might begin to unfold but it clearly would constitute a new behavioral context, one that the behavioral sciences least attends to. Even if one posits a less dramatic scenario, people may still need to make many urgent and perhaps unsettling transitions. And while a robust response would be needed, it is not at all clear what should be the details of that response. Since it is likely that no single response will fix things everywhere, for all people or for all time, it would be useful to conduct many social experiments. Indeed, a culture of small experiments should be fostered which, at the individual and small group level, can be described as behavioral entrepreneurship. This may have begun, hidden in plain sight, but more social experiments are needed. To be of help, it may be useful to both package behavioral insights in a way that is practitioner-oriented and grounded in biophysical trends and to propose a few key questions that need attention. This paper begins the process of developing a biophysical psychology, incomplete as it is at this early stage.

Some strategies for sustaining a walking routine: insights from experienced walkers.

BACKGROUND: This study explores the strategies that experienced walkers felt were most useful for sustaining outdoor walking routines. To investigate this issue, a survey-based instrument was used in combination with a Conceptual Content Cognitive Mapping (3CM) exercise. METHODS: Seventy-one experienced walkers were asked to complete the 3CM exercise to explore the strategies that have helped them regularly walk outdoors. After 1 week these same individuals received a survey investigating these same issues as well as demographics and physical activity participation. RESULTS: There was general agreement between 3CM and survey data with respect to the strategies used by experienced walkers. The most highly endorsed strategies involved using health goals and supportive walking environments. Survey results also revealed that those more likely to endorse the use of social support took fewer walks per week, but engaged in more nonwalking related physical activity. CONCLUSIONS: Overall, the findings suggest that experienced walkers use a variety of strategies. Strategies such as focusing of the positive health outcomes, using attractive natural settings, and developing realistic action plans appeared to be the most useful. These results also indicate the 3CM technique may be an effective way to explore beliefs and motivations regarding physical activity.

A double blind, placebo-controlled pilot study of galantamine augmentation of antidepressant treatment in older adults with major depression.

OBJECTIVE: Depression in older adults is often associated with cognitive abnormalities and may predict later development of a primary cognitive disorder. This double-blind, randomized, placebo-controlled pilot study was designed to assess the safety and efficacy of galantamine augmentation of antidepressant treatment for depressive and cognitive symptoms in older adults with major depression. METHODS: Thirty-eight, non-demented older adults (age >50) with major depression were randomized to receive galantamine or placebo augmentation of standard antidepressant pharmacotherapy (venlafaxine XR or citalopram). Mood and cognitive status were monitored for 24 weeks using the 24-item Hamilton Rating Scale for Depression and the Repeatable Battery for the Assessment of Neuropsychological Status. RESULTS: Both groups showed significant improvements in mood and cognition over 24 weeks, but no significant difference was found in change over time between groups. An exploratory post-hoc analysis suggested that patients randomized to galantamine had lower depression scores compared to patients in the placebo group after 2 weeks of treatment. Dropout was high with more subjects randomized to antidepressant plus galantamine withdrawing early from the study. CONCLUSIONS: This pilot study failed to demonstrate a benefit for galantamine augmentation of antidepressant medication in the treatment of depression in older adults. Future studies should explore strategies for reducing dropout in such longitudinal trials and more carefully assess time to response with cholinesterase inhibitor augmentation.

Enzymatic and fungal treatments on sugarcane bagasse for the production of mechanical pulps.

Crude ligninolytic enzyme extracts from Phanerochaete chrysosporium fungi were applied to sugarcane bagasse, prior to thermomechanical (TMP) and chemithermomechanical pulping (CTMP), and their properties were compared with the normal TMP and CTMP and also with TMP and CTMP pretreated with Ceriporiopsis subvermispora and P. chrysosporium fungi. The sugarcane bagasse was impregnated with the crude enzyme extract containing lignin peroxidase (LiP), manganese peroxidase (MnP), and laccase (Lac). The results show that pretreatment with enzyme crude extract is an advantageous way to produce TMP and CTMP from sugarcane bagasse, as compared with only fungal pretreatment. Enzymatic pretreatments need only hours to enhance pulping and paper properties, compared with the weeks necessary for fungal treatments. Higher pulp yields were obtained compared with the fungal pretreatments. Enzymatic pretreatment reduced the energy consumption in a proportion similar to that of C. subvermispora fungal pretreatment and increased the pulp tensile index compared with the normal TMP and CTMP pulps, although the tensile strength was somewhat lower than that for pulps from C. subvermispora fungal pretreatment before CTMP processing. An advantage of enzymatic pretreatment is that brightness is increased compared with normal TMP and CTMP processes, whereas fungal pretreatments reduce the brightness.

Manual asymmetries in tool-use: implications for apraxia.

Previous examinations of manual performance asymmetries have utilised relatively simple movements such as goal-directed aiming and rapid finger-tapping. In the present research, three-dimensional kinematic analyses were employed to examine manual asymmetries in the production of transitive limb gestures. Transitive limb gestures involve the use of tools and/or objects and are complex movements used in the evaluation of limb apraxia. Ten healthy right hand dominant participants produced two transitive limb gestures in response to verbal command both with (tool-use) and without (pantomime) the appropriate tool. Analyses revealed a dominant (right) hand advantage, although the magnitude of this advantage was influenced by movement context (pantomime vs tool-use). This study provides the first evidence that manual asymmetries are elicited during the production of transitive limb gestures, and mandates that future kinematic analyses of limb apraxia consider the impact of pre-morbid manual asymmetries when contrasting the performance of left and right hemisphere damaged patients.