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\"Between 1850 and 1880, Impressionist landscape painting and early forms of photography flourished within the arts in France. In the context of massive social and political change that also marked this era, painters and photographers composed competing visions of France as modern and industrialized or as rural and anti-modern. Impressionist France explores the resonances between landscape art and national identity as reflected in the paintings and photographs made during this period, examining and illustrating in particular the works of key artists such as âEdouard Baldus, Gustave Le Gray, the Bisson Freres, âEdouard Manet, Jean-Franًcois Millet, Claude Monet, Charles Negre, and Camille Pissarro. This ambitious premise focuses on the whole of France, exploring the relationship between landscape art and the notion of French nationhood across the country's varied and spectacular landscapes in seven geographical sections and four scholarly essays, which provide new information regarding the production and impact of French Impressionism. \"-- Provided by publisher.

Sex-specific niche differentiation is common in marine vertebrates, but how this varies long-term is poorly understood. Here we investigated interannual variation in sexual segregation among breed ing northern gannets Morus bassanus, wide-ranging central-place foragers with slight sexual dimorphism. Over 11 breeding seasons, we used GPS tracking and/or stable isotopes to test for sex differences in foraging trip characteristics (range, duration and timing); spatial distribution; habitat selection; and carbon and nitrogen isotopes in blood. When combining data from all years, females foraged further and for longer than males, yet despite this, the foraging areas of the sexes almost completely overlapped. Males and females selected foraging habitats that differed in terms of oceanography but not fishing vessel density. We also detected temporal segregation: females were more likely to be at sea during the day than at night, while males were more likely to be at sea during the night. However, foraging be haviour quantified by all GPS analyses varied interannually, with sex differences detected in some years but not others. Finally, males had consistently higher red blood cell δ13C and δ15N than females across all years, which was not driven by size dimorphism, in stead likely by prey choice or very fine-scale habitat selection. We conclude that environmental variation influenced short-term sex differences in movement, but sex differences in stable isotopes that in tegrate behaviour over longer periods re veal more consistent differences. Our results suggest that inferences drawn from single-year studies may not relate to general patterns, highlighting the importance of long-term studies and combining methods.

Nearshore (littoral) habitats of clear lakes with high water quality are increasingly experiencing unexplained proliferations of filamentous algae that grow on submerged surfaces. These filamentous algal blooms (FABs) are sometimes associated with nutrient pollution in groundwater, but complex changes in climate, nutrient transport, lake hydrodynamics, and food web structure may also facilitate this emerging threat to clear lakes. A coordinated effort among members of the public, managers, and scientists is needed to document the occurrence of FABs, to standardize methods for measuring their severity, to adapt existing data collection networks to include nearshore habitats, and to mitigate and reverse this profound structural change in lake ecosystems. Current models of lake eutrophication do not explain this littoral greening. However, a cohesive response to it is essential for protecting some of the world’s most valued lakes and the flora, fauna, and ecosystem services they sustain.

An Alzheimer's Association workgroup published new clinical criteria for the diagnosis and staging of Alzheimer's disease (AD) that includes a six-stage (1-6) clinical staging schema. Stages 1 (asymptomatic stage) and 3-6 (mild cognitive impairment and dementia stages) are familiar to clinicians. However, Stage 2 does not have a known clinical analogue; it consists of biomarker positivity and transitional cognitive decline (TCD) that does not rise to the level of impairment. To ensure we capture people in Stage 2, we need consensus on the nomenclature and measurement strategies used to define TCD. This goal is especially important given the advent of new AD criteria and the increasing number of clinical trials of pharmacotherapies targeting early stages of AD. This presentation will outline a protocol for conducting a Delphi study to establish consensus regarding the nomenclature and measurement of TCD in AD. Leaders from the International Neuropsychological Society Dementia Special Interest Group are convening a steering committee of ∼10 individuals with expertise in TCD, Delphi studies, and mixed methods research. The steering committee will guide the conduct of a Delphi consensus study, including identifying Delphi panel members, developing and disseminating surveys, and analyzing and summarizing data on consensus. We propose the following protocol for the Delphi panel study. 1. Delphi panel selection: Identification of ∼30 Delphi panel members via majority vote of steering committee members or selected from among authors identified in a literature review on TCD. 2. Survey development: Develop ∼30 survey items focused on the most appropriate clinical label for TCD and the most promising measurement approaches for this construct. 3. Collect participant responses via online surveys over 3 iterative rounds with summary feedback provided to participants between rounds. 4. Consensus to be defined by 75% agreement among Delphi panelists, with qualitative feedback assessed to provide insight into factors promoting or preventing consensus. Completing this Delphi study will provide consensus-based resources to inform clinical trial selection and analytic processes for interventions targeting the earliest stages of AD.

A countermovement jump (CMJ) performed on a force plate is commonly applied in soccer to quantify acute neuromuscular fatigue (NMF), which may manifest immediately following soccer match play. Jump height (JH) is the main outcome variable reported for this purpose; however, it is sensitive to alterations in movement strategy, which may act to mask JH and, therefore, mask any presence of NMF. Acute reductions in body mass (BM) during match play could also lead to the maintenance of JH, but this is yet to be explored. This study sought to explore soccer-match-induced alterations to JH, movement strategy, and BM to inform future variable selection for the study of acute NMF. Fourteen male English National League soccer players performed three CMJs on a dual-force plate system immediately before and after a competitive soccer match. Differences in jump height were non-significant and trivial (p = 0.924, g = 0.03) before and after soccer match play, but there was a large post-match decrease in BM (g = 1.66). Furthermore, moderate decreases in jump momentum (g = 0.56) and countermovement depth (g = 0.72) were noted. As JH was determined by the take-off velocity, reduced BM could have augmented it (less mass to accelerate); however, reduced countermovement depth seemingly counteracted this (less distance to attain velocity). It may, therefore, be beneficial to report these variables when monitoring acute NMF via the CMJ.

Background We postulated that the worse prognosis of melanoma with advancing age reflected more aggressive tumor biology and that in younger patients the prognosis would be more favorable. Materials and Methods The expanded AJCC melanoma staging database contained 11,088 patients with complete data for analysis, including mitotic rate. Results With increasing age by decade, primary melanomas were thicker, exhibited higher mitotic rates, and were more likely to be ulcerated. In a multivariate analysis of patients with localized melanoma, thickness and ulceration were highly significant predictors of outcome at all decades of life (except for patients younger than 20 years). Mitotic rate was significantly predictive in all age groups except patients <20 and >80 years. For patients with stage III melanoma, there were four independent variables associated with patient survival: number of nodal metastases, patient age, ulceration, and mitotic rate. Patients younger than 20 years of age had primary tumors with slightly more aggressive features, a higher incidence of sentinel lymph node metastasis, but, paradoxically, more favorable survival than all other age groups. In contrast, patients >70 years old had primary melanomas with the most aggressive prognostic features, were more likely to be head and neck primaries, and were associated with a higher mortality rate than the other age groups. Surprisingly, however, these patients had a lower rate of sentinel lymph node metastasis per T stage. Among patients between the two age extremes, clinicopathologic features and survival tended to be more homogeneous. Conclusions Melanomas in patients at the extremes of age have a distinct natural history.

Purpose We have previously reported that older patients with clinical stage I and II primary cutaneous. Melanoma had lower survival rates compared to younger patients. We postulated that the incidence of nodal metastasis would therefore be higher among older melanoma patients. Methods The expanded American Joint Committee on Cancer melanoma staging database contains a cohort of 7,756 melanoma patients who presented without clinical evidence of regional lymph node or distant metastasis and who underwent a sentinel node biopsy procedure as a component of their staging assessment. Results Although older patients had primary melanoma features associated with more aggressive biology, we paradoxically observed a significant decrease in the incidence of sentinel node metastasis as patient age increased. Overall, the highest incidence of sentinel node metastasis was 25.8 % in patients under 20 years of age, compared to 15.5 % in patients 80 years and older ( p  < 0.001). In contrast, 5-year mortality rates for clinical stage II patients ranged from a low of 20 % for those 20–40 years of age up to 38 % for those over 70 years of age. Patient age was an independent predictor of sentinel node metastasis in a multifactorial analysis ( p  < 0.001). Conclusions Patients with clinical stage I and II melanoma under 20 years of age had a higher incidence of sentinel lymph node metastasis but, paradoxically, a more favorable survival outcome compared to all other age groups. In contrast, patients >70 years had the most aggressive primary melanoma features and a higher mortality rate compared to all other age groups but a lower incidence of sentinel lymph node metastasis.

Care following transient ischaemic attack (TIA) and minor stroke is variable and often leaves patients feeling abandoned and uncertain. We developed a theoretically-informed, multifaceted intervention which comprised nurse-led, structured follow-up at 4 weeks after TIA/minor stroke to identify and address patient needs. This study evaluated the feasibility and acceptability of both the intervention and procedures to inform a future randomised controlled trial. We conducted a multicentre, randomised feasibility study with mixed-methods process evaluation (ISRCTN registry reference: ISRCTN39864003). We collected patient reported outcome measures (PROMs) at 1, 12 and 24 weeks and clinical data at baseline and 24 weeks. The process evaluation comprised qualitative interviews with a sub-sample, feedback questionnaires, and observations of intervention delivery. We recruited 54 patients over 12 months, achieving 90% of the target sample size (n = 60). PROMs return rates were 94.4% (51/54), 85.2% (46/54) and 71.1% (27/38) at 1, 12, and 24-weeks, respectively. Intervention fidelity was high and the intervention largely aligned with the theoretical underpinnings. The process evaluation illustrated how patients benefitted from the intervention through support they would not have received through usual care. This included direct referral or signposting to support services, information and education, actionable advice, and reassurance about and normalisation of recovery. The trial design was feasible and acceptable for both patients and clinicians. Nurse-led, structured follow-up after TIA and minor stroke is feasible, acceptable and valued by patients and clinicians. Our intervention can identify and help address unmet needs. A definitive randomised trial to evaluate intervention effectiveness and cost-effectiveness is feasible and acceptable.

A detailed damage survey of the El Reno, Oklahoma, tornado of 31 May 2013 combined with rapid-scanning data recorded from two mobile radars is presented. One of the radars was equipped with polarimetric capability. The relationship between several suction vortices visually identified in pictures with the high-resolution Doppler velocity data and swath marks in fields is discussed. The suction vortices were associated with small shear features in Doppler velocity and a partial ringlike feature of high spectral width. For the first time, a suction vortex that created a swath mark in a field was visually identified in photographs and high-definition video while the rotational couplet was tracked by radar. A dual-Doppler wind synthesis of the tornadic circulation at low levels near the location of several storm chaser fatalities resolved ground-relative wind speeds in excess of 90 m s −1 , greater than the minimum speed for EF5 damage. The vertical vorticity analysis revealed a rapid transition from a single tornadic vortex centered on the weak-echo hole (WEH) to suction vortices surrounding the WEH and collocated with the ring of enhanced radar reflectivities. Several bands/zones of enhanced convergence were resolved in the wind syntheses. One of the bands was associated with an internal or secondary rear-flank gust front. An inner band of convergence appeared to be a result of the positive bias in tornado-relative radial velocity owing to centrifuging of large lofted debris swirling within the tornado. An outer band of convergence formed at the northern edge of a region of strong inflow that was lofting small debris and dust into the storm.

Background Non-pharmaceutical interventions (NPIs) are used to reduce transmission of SARS coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19). However, empirical evidence of the effectiveness of specific NPIs has been inconsistent. We assessed the effectiveness of NPIs around internal containment and closure, international travel restrictions, economic measures, and health system actions on SARS-CoV-2 transmission in 130 countries and territories. Methods We used panel (longitudinal) regression to estimate the effectiveness of 13 categories of NPIs in reducing SARS-CoV-2 transmission using data from January to June 2020. First, we examined the temporal association between NPIs using hierarchical cluster analyses. We then regressed the time-varying reproduction number ( R t ) of COVID-19 against different NPIs. We examined different model specifications to account for the temporal lag between NPIs and changes in R t , levels of NPI intensity, time-varying changes in NPI effect, and variable selection criteria. Results were interpreted taking into account both the range of model specifications and temporal clustering of NPIs. Results There was strong evidence for an association between two NPIs (school closure, internal movement restrictions) and reduced R t . Another three NPIs (workplace closure, income support, and debt/contract relief) had strong evidence of effectiveness when ignoring their level of intensity, while two NPIs (public events cancellation, restriction on gatherings) had strong evidence of their effectiveness only when evaluating their implementation at maximum capacity (e.g. restrictions on 1000+ people gathering were not effective, restrictions on < 10 people gathering were). Evidence about the effectiveness of the remaining NPIs (stay-at-home requirements, public information campaigns, public transport closure, international travel controls, testing, contact tracing) was inconsistent and inconclusive. We found temporal clustering between many of the NPIs. Effect sizes varied depending on whether or not we included data after peak NPI intensity. Conclusion Understanding the impact that specific NPIs have had on SARS-CoV-2 transmission is complicated by temporal clustering, time-dependent variation in effects, and differences in NPI intensity. However, the effectiveness of school closure and internal movement restrictions appears robust across different model specifications, with some evidence that other NPIs may also be effective under particular conditions. This provides empirical evidence for the potential effectiveness of many, although not all, actions policy-makers are taking to respond to the COVID-19 pandemic.