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The Sm–Nd isotope systematics and geochemistry of eclogitic, websteritic and peridotitic garnet and clinopyroxene inclusions together with characteristics of their corresponding diamond hosts are presented for the Letlhakane mine, Botswana. These data are supplemented with new inclusion data from the nearby (20–30 km) Orapa and Damtshaa mines to evaluate the nature and scale of diamond-forming processes beneath the NW part of the Kalahari Craton and to provide insight into the evolution of the deep carbon cycle. The Sm–Nd isotope compositions of the diamond inclusions indicate five well-defined, discrete eclogitic and websteritic diamond-forming events in the Orapa kimberlite cluster at 220 ± 80 Ma, 746 ± 100 Ma, 1110 ± 64 Ma, 1698 ± 280 Ma and 2341 ± 21 Ma. In addition, two poorly constrained events suggest ancient eclogitic (> 2700 Ma) and recent eclogitic and websteritic diamond formation (< 140 Ma). Together with sub-calcic garnets from two harzburgitic diamonds that have Archaean Nd mantle model ages (TCHUR) between 2.86 and 3.38 Ga, the diamonds studied here span almost the entire temporal evolution of the SCLM of the Kalahari Craton. The new data demonstrate, for the first time, that diamond formation occurs simultaneously and episodically in different parageneses, reflecting metasomatism of the compositionally heterogeneous SCLM beneath the area (~ 200 km2). Diamond formation can be directly related to major tectono-magmatic events that impacted the Kalahari Craton such as crustal accretion, continental breakup and large igneous provinces. Compositions of dated inclusions, in combination with marked variations in the carbon and nitrogen isotope compositions of the host diamonds, record mixing arrays between a minimum of three components (A: peridotitic mantle; B: eclogites dominated by mafic material; C: eclogites that include recycled sedimentary material). Diamond formation appears dominated by local fluid–rock interactions involving different protoliths in the SCLM. Redistribution of carbon during fluid–rock interactions generally masks any potential temporal changes of the deep carbon cycle.

The Mössbauer milliprobe allows the determination of Fe3+/ΣFe in samples as small as 50 μm. For the first time this technique is applied to a suite of diamonds of eclogitic paragenesis, where three garnet and five clinopyroxene inclusions in diamonds from George Creek, Colorado have been analysed. For garnet Fe3+/ΣFe ranges from 0-7%, while values for clinopyroxene range from 8-14%. These results are consistent with the low oxygen fugacity conditions implied by the presence of the inclusions in diamond.

Primary immunodeficiency diseases represent an expanding set of heterogeneous conditions which are difficult to recognize clinically. Diagnostic rates outside of the newborn period have not changed appreciably. This concern underscores a need for novel methods of disease detection. We built a Bayesian network to provide real-time risk assessment about primary immunodeficiency and to facilitate prescriptive analytics for initiating the most appropriate diagnostic work up. Our goal is to improve diagnostic rates for primary immunodeficiency and shorten time to diagnosis. We aimed to use readily available health record data and a small training dataset to prove utility in diagnosing patients with relatively rare features. We extracted data from the Texas Children's Hospital electronic health record on a large population of primary immunodeficiency patients (n = 1762) and appropriately-matched set of controls (n = 1698). From the cohorts, clinically relevant prior probabilities were calculated enabling construction of a Bayesian network probabilistic model(PI Prob). Our model was constructed with clinical-immunology domain expertise, trained on a balanced cohort of 100 cases-controls and validated on an unseen balanced cohort of 150 cases-controls. Performance was measured by area under the receiver operator characteristic curve (AUROC). We also compared our network performance to classic machine learning model performance on the same dataset. PI Prob was accurate in classifying immunodeficiency patients from controls (AUROC = 0.945; p<0.0001) at a risk threshold of ≥6%. Additionally, the model was 89% accurate for categorizing validation cohort members into appropriate International Union of Immunological Societies diagnostic categories. Our network outperformed 3 other machine learning models and provides superior transparency with a prescriptive output element. Artificial intelligence methods can classify risk for primary immunodeficiency and guide management. PI Prob enables accurate, objective decision making about risk and guides the user towards the appropriate diagnostic evaluation for patients with recurrent infections. Probabilistic models can be trained with small datasets underscoring their utility for rare disease detection given appropriate domain expertise for feature selection and network construction.

This contribution updates federal survey findings on children's oral health and dental care since release of Oral Health in America: A Report of the Surgeon General in 2000. Dental caries experience continued at high levels, impacting 40% of all children aged 2 to 11 years, with greater disease and untreated disease burden borne by poor and low-income children and racial/ethnic minorities. Caries rates increased for young children (to 28% of 2- to 5-year-olds in the period 1999–2004) and remained flat for most other ages. The total volume of caries and untreated caries increased as the numbers of children increased. The proportion of US children with a dental visit increased modestly (from 42% to 45% between 1996 and 2004), with the greatest increases occurring among children newly covered by the State Children's Health Insurance Program (SCHIP). Disparities in dental visits continued to be evidenced by age, family income, race/ethnicity, and caregiver education. Parental reports of children's oral health and dental care parallel these findings and also reveal higher unmet dental needs among children with special health care needs. Racial- and income-based disparities in both oral health and dental care continue into adolescence and young adulthood. These disparities can, as in the past, be expected to exacerbate under the forces of growing income disparities and demographic trends.

Purpose To present a theoretical model that grounds teaching and learning in nursing in the focus, values, and ideals of nursing as a discipline. Organizing Constructs The critical caring pedagogy model was formed by integrating Falk‐Rafael's theory of critical caring in public health nursing, Noddings’ philosophy of caring education, and Chinn's theory of peace and power. Methods The model of critical caring pedagogy was developed by logical analysis of the three organizing constructs and the conceptual relationships between and among these constructs. The analysis was informed by the authors’ experiences implementing the theoretical constructs in teaching and learning. Conclusions When nurse educators ground teaching and learning practice in nursing's own theoretical and philosophic foundation, they teach nursing in powerful ways that show nursing values and ideals through action, revealing deeper meanings of the words that form texts, lectures, and objectives set forth in a curriculum outline. Clinical Relevance Nursing students who experience education that is grounded in nursing's own disciplinary focus acquire an appreciation of nursing's disciplinary knowledge grounded in experience, paving the way for grounding their eventual practice in nursing theoretical perspectives.

Purpose The purpose of this study was to identify predatory journals in nursing, describe their characteristics and editorial standards, and document experiences of authors, peer reviewers, and editors affiliated with these journals. Design Using two sources that list predatory journals, the research team created a list of nursing journals. In Phase One, the team collected data on characteristics of predatory nursing journals such as types of articles published, article processing charge, and peer review process. In Phase Two, the team surveyed a sample of authors, reviewers, and editors to learn more about their experiences with their affiliated journals. Methods Data from the review of predatory nursing journals were analyzed using descriptive statistics. Written comments were summarized and categorized. Findings There were 140 predatory nursing journals from 75 publishers. Most journals were new, having been inaugurated in the past 1 to 2 years. One important finding was that many journals only published one or two volumes and then either ceased publishing or published fewer issues and articles after the first volume. Journal content varied widely, and some journals published content from dentistry and medicine, as well as nursing. Qualitative findings from the surveys confirmed previously published anecdotal evidence, including authors selecting journals based on spam emails and inability to halt publication of a manuscript, despite authors’ requests to do so. Conclusions Predatory journals exist in nursing and bring with them many of the “red flags” that have been noted in the literature, including lack of transparency about editorial processes and misleading information promoted on websites. The number of journals is high enough to warrant concern in the discipline about erosion of our scholarly literature. Clinical Relevance Nurses rely on the published literature to provide evidence for high‐quality, safe care that promotes optimal patient outcomes. Research published in journals that do not adhere to the highest standards of publishing excellence have the potential to compromise nursing scholarship and is an area of concern.

Precise dating of diamond growth is required to understand the interior workings of the early Earth and the deep carbon cycle. Here we report Sm-Nd isotope data from 26 individual garnet inclusions from 26 harzburgitic diamonds from Venetia, South Africa. Garnet inclusions and host diamonds comprise two compositional suites formed under markedly different conditions and define two isochrons, one Archaean (2.95 Ga) and one Proterozoic (1.15 Ga). The Archaean diamond suite formed from relatively cool fluid-dominated metasomatism during rifting of the southern shelf of the Zimbabwe Craton. The 1.8 billion years younger Proterozoic diamond suite formed by melt-dominated metasomatism related to the 1.1 Ga Umkondo Large Igneous Province. The results demonstrate that resolving the time of diamond growth events requires dating of individual inclusions, and that there was a major change in the magmatic processes responsible for harzburgitic diamond formation beneath Venetia from the Archaean to the Proterozoic. Dating of inclusions within diamonds is used to reconstruct Earth’s geodynamic history. Here, the authors report isotope data on individual garnet inclusions within diamonds from Venetia, South Africa, showing that two suites of diamonds define two isochrons, showing the importance of dating individual inclusions.

Self-regulation (SR) is critical to healthy development in children, and intervention approaches (i.e., professional training, classroom-based curricula, parent-focused intervention) have shown to support or enhance SR. However, to our knowledge, none have tested whether changes in children's SR across an intervention relate to changes in children's health behavior and outcomes. This study, the Promoting Activity and Trajectories of Health (PATH) for Children-SR Study uses a cluster-randomized control trial to examine the immediate effects of a mastery-climate motor skills intervention on SR. Secondly, this study examines the associations between changes in SR and changes in children's health behaviors (i.e., motor competence, physical activity, and perceived competence) and outcomes (i.e., body mass index and waist circumference) (ClinicalTrials.gov Identifier, NCT03189862). The PATH-SR study will be a cluster-randomized clinical trial. A total of 120 children between the ages of 3.5 to 5 years of age will be randomized to a mastery-climate motor skills intervention (n = 70) or control (n = 50) condition. SR will be assessed using measures that evaluate cognitive SR (cognitive flexibility and working memory), behavioral SR (behavioral inhibition), and emotional SR (emotional regulation). Health behaviors will be assessed with motor skills, physical activity, and perceived competence (motor and physical) and health outcomes will be waist circumference and body mass index. SR, health behaviors, and health outcomes will be assessed before and after the intervention (pre-test and post-test). Given the randomization design, 70 children in the intervention group and 50 in the control group, we have 80% power to detect an effect size of 0.52, at a Type I error level of 0.05. With the data collected, we will test the intervention effect on SR with a two-sample t-test comparing the intervention group and the control group. We will further evaluate the associations between changes in SR and changes in children's health behaviors and health outcomes, using mixed effect regression models, with a random effect to account for within-subject correlations. The PATH-SR study addresses gaps in pediatric exercise science and child development research. Findings hold the potential to help shape public health and educational policies and interventions that support healthy development during the early years. Ethical approval for this study was obtained through the Health Sciences and Behavioral Sciences Institutional Review Board, University of Michigan (HUM00133319). The PATH-SR study is funded by the National Institutes of Health Common Fund. Findings will be disseminated via print, online media, dissemination events and practitioner and/or research journals. ClinicalTrials.gov Identifier, NCT03189862.

Although learning disorders (LD) and developmental language disorder (DLD) can be linked to overlapping psychological and behavioral deficits, such as phonological, morphological, orthographic, semantic, and syntactic deficits, as well as academic (e.g., reading) difficulties, they are currently separate diagnoses in the DSM-5 with explicit phenotypic differences. At a neural level, it is yet to be determined to what extent they have overlapping or distinct signatures. The identification of such neural markers/endophenotypes could be important for the development of physiological diagnostic tools, as well as an understanding of disorders across different dimensions, as recommended by the Research Domain Criteria Initiative (RDoC). The current systematic review and meta-analysis examined whether the two disorders can be differentiated based on the auditory brainstem response (ABR). Even though both diagnoses require hearing problems to be ruled out, a number of articles have demonstrated associations of these disorders with the auditory brainstem response. We demonstrated that both LD and DLD are associated with longer latencies in ABR Waves III, V, and A, as well as reduced amplitude in Waves V and A. However, multilevel subgroup analyses revealed that LD and DLD do not significantly differ for any of these ABR waves. Results suggest that less efficient early auditory processing is a shared mechanism underlying both LD and DLD.

BackgroundPatients undergoing salvage laryngectomy are predisposed to radiation-induced hypothyroidism and impaired wound healing secondary to the tissue effects of prior treatment. The impact of hypothyroidism on postoperative wound healing is not established.MethodsA single-institution retrospective case series was performed. The inclusion criteria specified preoperatively euthyroid adults who underwent salvage laryngectomy with concurrent neck dissection between 1997 and 2015 for persistent or recurrent laryngeal squamous cell carcinoma after radiation or chemoradiation therapy (n = 182). The principal explanatory variable was postoperative hypothyroidism, defined as thyroid-stimulating hormone (TSH) higher than 5.5 mIU/L. The primary end points of the study were pharyngocutaneous fistulas and wounds requiring reoperation. Multivariate analysis was performed.ResultsThe fistula rate was 47% among hypothyroid patients versus 23% among euthyroid patients. In the multivariate analysis, the patients who experienced hypothyroidism in the postoperative period had a 3.6-fold greater risk of fistula [95% confidence interval (CI) 1.8–7.1; p = 0.0002]. The hypothyroid patients had an 11.4-fold greater risk for a required reoperation (24.4 vs 5.4%) than the euthyroid patients (95% CI 2.6–49.9; p = 0.001). The risk for fistula (p = 0.003) and reoperation (p = 0.001) increased with increasing TSH. This corresponds to an approximate 12.5% incremental increase in the absolute risk for fistula and a 10% increase in the absolute risk for reoperation with each doubling of the TSH.ConclusionPostoperative hypothyroidism independently predicts postoperative wound-healing complications. The association of hypothyroidism with fistula formation may yield opportunities to modulate wound healing with thyroid supplementation or to provide a biomarker of wound progression.