This paper uses case studies of scour at bridges in Rhode Island to evaluate the current HEC-18 scour equations used to assess bridge safety and design. The study utilizes data from two major historical storm events—a 500-year flood and a 25-year hurricane (Sandy). Hydraulic analyses were performed using the HEC-RAS program at three bridge study sites, two in riverine environments and one in a tidal environment. Detailed bathymetry and topography of each site was obtained using a variety of methods. Flow boundary conditions were obtained from USGS gages and a numerical storm surge model. Sediment samples indicated that the bed materials were cohesionless ranging from silts to boulders. Scour predictions were compared to sounding data collected before and after the historical events. The results of the analyses indicated that the HEC-18 equations yielded conservative predictions of scour at all bridges analyzed in this study. The level of conservatism depended on the particular equation that was utilized. The results also suggested that the level of conservatism could be reduced by better characterization of the D50 of the bed materials and consideration of the transient nature of storm events.

The Olorgesailie Drilling Project and the related Hominin Sites and Paleolakes Drilling Project in East Africa were initiated to test hypotheses and models linking environmental change to hominin evolution by drilling lake basin sediments adjacent to important archeological and paleoanthropological sites. Drill core OL012-1A recovered 139 m of sedimentary and volcaniclastic strata from the Koora paleolake basin, southern Kenya Rift, providing the opportunity to compare paleoenvironmental influences over the past million years with the parallel record exposed at the nearby Olorgesailie archeological site. To refine our ability to link core-to-outcrop paleoenvironmental records, we institute here a methodological framework for deriving a robust age model for the complex lithostratigraphy of OL012-1A. Firstly, chronostratigraphic control points for the core were established based on 4 Ar/39Ar ages from intercalated tephra deposits and a basal trachyte flow, as well as the stratigraphic position of the Brunhes-Matuyama geomagnetic reversal. This dataset was combined with the position and duration of paleosols, and analyzed using a new Bayesian algorithm for high-resolution age-depth modeling of hiatus-bearing stratigraphic sections. This model addresses three important aspects relevant to highly dynamic, nonlinear depositional environments: 1) correcting for variable rates of deposition, 2) accommodating hiatuses, and 3) quantifying realistic age uncertainty with centimetric resolution. Our method is applicable to typical depositional systems in extensional rifts as well as to drill cores from other dynamic terrestrial or aquatic environments. We use the core age model and lithostratigraphy to examine the inter connectivity of the Koora Basin to adjacent areas and sources of volcanism. (C) 2019 Elsevier Ltd. All rights reserved.

Page 13 Coastal communities on the East Coast of the United States (US) are likely to experience a greater impact from tropical storms in the future.1 In addition to sea level rise (SLR), a number of studies have related climate change to an increase in the number of higher intensity tropical storm activity (Holland and Bruyere 2014; Yoshida et al. 2017). Along the barrier beaches and barrier islands bordering the U.S. East Coast, severe storms often cause widespread dune and beach erosion, resulting in beach recession and damage to infrastructure. As beaches erode, the natural protection they provide to coastal Numerical simulation of coastal erosion and its mitigation by living shoreline methods: A case study in southern Rhode Island

OBJECTIVE To evaluate and compare the long-term skeletodental stability of mandibular symphyseal distraction osteogenesis (MSDO) achieved with the use of tooth-borne vs. hybrid distraction appliances. MATERIALS AND METHODS Posttreatment and follow-up orthodontic records were collected for 33 patients. The 14 patients who underwent distraction with a tooth-borne appliance had a mean follow-up of 5.08 years. The 19 patients who underwent distraction with a hybrid appliance had a mean follow-up of 6.07 years. Records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Total changes of 16 measurements were analyzed to compare patients who underwent the tooth-borne vs. the hybrid distraction. RESULTS Both groups shared several similar and significant (P < .05) changes from posttreatment to follow-up records. Cast analysis showed a decrease in intercanine width and arch length and an increase in irregularity index. The postero-anterior cephalometric radiograph showed an increase in the width of the interincisal apices. The lateral cephalometric radiograph showed a decrease in the MP-L1 angle. The only statistically significant difference between the two appliances was the intercentral incisor contact point. CONCLUSION Changes found are consistent with those found in untreated and orthodontically treated individuals over time. The long-term changes in the current patient sample can be determined to be expected and acceptable. MSDO is a viable treatment option with the use of either a hybrid or tooth-borne appliance.

OBJECTIVE To evaluate and compare, retrospectively, the skeletal and dental effects of mandibular symphyseal distraction osteogenesis (MSDO) achieved through the use of tooth-borne versus hybrid distractors. MATERIALS AND METHODS Pretreatment (T1), predistraction (T2), postdistraction (T3), and posttreatment (T4) orthodontic records were collected and analyzed for 47 patients (20 tooth-borne, 27 hybrid). At each time point, records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Submental vertex radiographs were taken at T2, T3, and T4. Changes in a total of 18 measurements were analyzed to compare patients undergoing tooth-borne versus hybrid distraction. RESULTS The cumulative effects of orthodontics and MSDO produced similar gains in measured arch widths, with a decreased irregularity index in both groups (P > .05). However, there were differences in the timing during which the expansion was achieved. The hybrid distractor group gained space during the distraction phase of treatment. The tooth-borne group showed greater gains during pre- and postdistraction orthodontics. Comparisons of intercanine and interbone marker widths demonstrated a more parallel separation of bone during distraction with the hybrid distractor (P < .001). Distraction with the tooth-borne distractor was disproportionate, with greater separation of the canines in alveolar bone than of the bone markers in basal bone. During postdistraction orthodontics, the tooth-borne distractor group showed statistically greater increases in measurements. CONCLUSION Both skeletal and dental expansion was achieved with both appliances. Greater skeletal expansion was achieved with a hybrid distractor. Greater dental expansion was achieved with a tooth-borne distractor.

Introduction: The purpose of this study was to examine the long-term skeletal and dental stability of mandibular symphyseal distraction osteogenesis (MSDO) with a tooth-borne and bone-borne hybrid distractor. To differentiate the effects of MSDO from the orthodontic movement and relapse, each phase of treatment was analyzed. Methods: Twenty-five patients were included in the study, ranging in age from 12.0 to 30.9 years at the initiation of treatment (mean, 15.8 +/- 4.8 years). Of this group, 16 patients were recalled at a mean of 7.5 +/- 0.9 years (range, 6.3-9.6 years) after distraction for long-term analysis of skeletal and dental changes. Orthodontic records were taken at 5 times: T1, pretreatment; T2, predistraction; T3, postdistraction; T4, posttreatment, and T5, postretention. The data were statistically analyzed by using repeated-measures analysis of variance (ANOVA). Results: There were significant increases in all interdental transverse measurements except the mandibular intersecond molar distance from T1 to T4. The largest overall expansion was achieved between the mandibular second premolars (4.32 +/- 0.60 mm), followed by the interfirst premolar (3.44 +/- 0.44 mm), the interfirst molar (2.60 +/- 0.65 mm), and the intercanine (1.87 +/- 0.44 mm) widths. The overall amount of transverse dental expansion was substantially less when analyzed from the time of the mandibular symphyseal osteotomy to posttreatment (T2-T4). From T3 to T4, there were significant decreases between the mandibular intersecond premolars (-3.10 +/- 0.52 mm), interfirst premolars (-3.90 +/- 0.35 m), intercanines (-4.47 +/- 0.38 mm), and intercentral incisors (-5.60 +/- 0.32 mm). There were no significant changes in bicondylar, bigonial, and biantigonial widths. At the long-term follow-up, there were no significant changes in the interdental or skeletal measurements between T4 and T5, except for interincisor apices. The irregularity index significantly decreased during the orthodontic treatment but significantly increased in the long-term follow-up period (T4-T5). After the MSDO, T3 to T5, the results indicated symphyseal basal bone skeletal stability. Conclusions: The results indicate that the expansion of the mandibular arch with MSDO and conventional orthodontic mechanics produces no statistically significant transverse changes from posttreatment to long-term follow-up. The risks of using a surgical procedure and MSDO to achieve additional expansion should be evaluated by the clinician and compared with more traditional orthodontic methods. (Am J Orthod Dentofacial Orthop 2012;141:60-70)

Many more people show classic symptoms of narcissism than merit a diagnosis of Narcissistic Personality Disorder (NPD). This has affected the whole of society, but potentially more importantly, it has invaded the realm of romantic interaction. This study seeks to fill gaps in the current research by exploring how narcissists interact within romantic relationships during problem solving discussions. Participants were 38 adult married or cohabiting couples who reported on their relationship’s security and functioning, and who participated in two problem solving discussions. Discussions were videotaped and coded for the presence of narcissistic behaviors. Those partners who engaged in greater narcissistic behavior during the discussions reported greater insecurity and greater aggression in their relationships. Findings highlight the importance of narcissism in romantic relationships, and shed light on how narcissism may affect interpersonal interactions.

Background 82 Aims: Interferon-alfa (IFN)-related cytopenias are common and may be dose-limiting. We performed a genome wide association study on a well-characterized genotype 1 HCV cohort to identify genetic determinants of peginterferon-alpha, (pegIFN)-related thrombocytopenia, neutropenia, and leukopenia.Methods: 1604/3070 patients in the IDEAL study consented to genetic testing. Trial inclusion criteria included a platelet (PI) count >= 80 x 10(9)/L and an absolute neutrophil count (ANC) >= 1500/mm(3). Samples were genotyped using the Illumina Human610-quad BeadChip. The primary analyses focused on the genetic determinants of quantitative change in cell counts (PI, ANC, lymphocytes, monocytes, eosinophils, and basophils) at week 4 in patients >80% adherent to therapy (n = 1294).Results: 6 SNPs on chromosome 20 were positively associated with PI reduction (top SNP rs965469, p = 10(-10)). These tag SNPs are in high linkage disequilibrium with 2 functional variants in the ITPA gene, rs1127354 and rs7270101, that cause ITPase deficiency and protect against ribavirin (RBV)-induced hemolytic anemia (HA). rs1127354 and rs7270101 showed strong independent associations with PI reduction (p = showed strong independent associations with PI reduction (p = 10(-12), p = 10(-7)) and entirely explained the genome-wide significant associations. We believe this is an example of an indirect genetic association due to a reactive thrombocytosis to RBV-induced anemia: Hb decline was inversely correlated with PI reduction (r = -0.28, p = 10(-17)) and Hb change largely attenuated the association between the ITPA variants and PI reduction in regression models. No common genetic variants were associated with pegIFN-induced neutropenia or leucopenia.Conclusions: Two ITPA variants were associated with thrombocytopenia; this was largely explained by a thrombocytotic response to RBV-induced HA attenuating IFN-related thrombocytopenia. No genetic determinants of pegIFN-induced neutropenia were identified. (C) 2011 Published by Elsevier B.V. on behalf of the European Association for the Study of the Liver.

Boceprevir (BOC) added to peginterferon alfa-2b (PegIFN) and ribavirin (RBV) significantly increases sustained virologic response (SVR) rates over PegIFN/RBV alone in previously untreated adults with chronic hepatitis C genotype 1. We evaluate the relationship of incident anemia with triple therapy. A total of 1,097 patients received a 4-week lead-in of PegIFN/RBV followed by: (1) placebo plus PegIFN/RBV for 44 weeks (PR48); (2) BOC plus PegIFN/RBV using response-guided therapy (BOC/RGT); and (3) BOC plus PegIFN/RBV for 44 weeks (BOC/PR48). The management of anemia (hemoglobin [Hb] <10 g/dL) included RBV dose reduction and/or erythropoietin (EPO) use. A total of 1,080 patients had 1 Hb measurement during treatment. The incidence of anemia was 50% in the BOC arms combined (363/726) and 31% in the PR48 arm (108/354, P < 0.001). Among BOC recipients, lower baseline Hb and creatinine clearance were associated with incident anemia. In the BOC-containing arms, anemia was managed by the site investigators as follows: EPO without RBV dose reduction, 38%; RBV dose reduction without EPO, 8%; EPO with RBV dose reduction, 40%; and neither RBV dose reduction nor EPO, 14%. SVR rates were not significantly affected by management strategy (70%-74%), and overall patients with anemia had higher rates of SVR than those who did not develop anemia (58%). Serious and life-threatening adverse events (AEs) and discontinuations due to AEs among BOC-treated patients did not differ by EPO use. Conclusion: With BOC/PR therapy, SVR rates in patients with incident anemia were higher than nonanemic patients and did not vary significantly according to the investigator-selected approach for anemia management. Prospective studies are needed to confirm this observation. (HEPATOLOGY 2013)

The recovery of detailed and continuous paleoclimate records from the interior of the African continent has long been of interest for understanding climate dynamics of the tropics, and also for constraining the environmental backdrop to the evolution and spread of early Homo sapiens. In 2005 an international team of scientists collected a series of scientific drill cores from Lake Malawi, the first long and continuous, high-fidelity records of tropical climate change from interior East Africa. The paleoclimate records, which include lithostratigraphic, geochemical, geophysical and paleobiological observations documented in this special issue of Palaeo3, indicate an interval of high-amplitude climate variability between 145,000 and ~60,000years ago, when several severe arid intervals reduced Lake Malawi's volume by more than 95%. These intervals of pronounced tropical African aridity in the early Late Pleistocene around Lake Malawi were much more severe than the Last Glacial Maximum (LGM), a well-documented period of drought in equatorial and Northern Hemisphere tropical east Africa. After 70,000years ago climate shifted to more humid conditions and lake levels rose. During this latter interval however, wind patterns shifted rapidly, and perhaps synchronously with high-latitude shifts and changes in thermohaline circulation. This transition to wetter, more stable conditions coincided with diminished orbital eccentricity, and a reduction in precession-dominated climatic extremes. The observed climate mode switch to decreased environmental variability is consistent with terrestrial and marine records from in and around tropical Africa.

Black Americans are disproportionally infected with hepatitis C virus (HCV) and are less likely than whites to respond to treatment with peginterferon (PEG-IFN) plus ribavirin (RBV). The impact of race on HCV treatment eligibility is unknown. We therefore performed a retrospective analysis of a phase 3B multicenter clinical trial conducted at 118 United States community and academic medical centers to evaluate the rates of and reasons for HCV treatment ineligibility according to self-reported race. In all, 4,469 patients were screened, of whom 1,038 (23.2%) were treatment ineligible. Although blacks represented 19% of treated patients, they were more likely not to be treated due to ineligibility and/or failure to complete required evaluations (40.2%) than were nonblack patients (28.5%; P < 0.001). After the exclusion of persons not treated due to undetectable HCV RNA or nongenotype 1 infection, blacks were 65% less likely than nonblacks to be eligible for treatment (28.1% > 17.0%; relative risk, 1.65; 95% confidence interval, 1.46-1.87; P < 0.001). Blacks were more likely to be ineligible due to neutropenia (14% versus 3%, P < 0.001), anemia (7% versus 4%, P = 0.02), elevated glucose (8% versus 3%, P < 0.001), and elevated creatinine (5% versus 1%, P < 0.001). Conclusion: Largely due to a higher prevalence of neutropenia and uncontrolled medical conditions, blacks were significantly less likely to be eligible for HCV treatment. Increased access to treatment may be facilitated by less conservative neutrophil requirements and more effective care for chronic diseases, namely, diabetes and renal insufficiency. (HEPATOLOGY 2011;54:70-78)

BACKGROUND:Peginterferon-ribavirin therapy is the current standard of care for chronic infection with hepatitis C virus (HCV). The rate of sustained virologic response has been below 50% in cases of HCV genotype 1 infection. Boceprevir, a potent oral HCV-protease inhibitor, has been evaluated as an additional treatment in phase 1 and phase 2 studies.METHODS:We conducted a double-blind study in which previously untreated adults with HCV genotype 1 infection were randomly assigned to one of three groups. In all three groups, peginterferon alfa-2b and ribavirin were administered for 4 weeks (the lead-in period). Subsequently, group 1 (the control group) received placebo plus peginterferon-ribavirin for 44 weeks; group 2 received boceprevir plus peginterferon-ribavirin for 24 weeks, and those with a detectable HCV RNA level between weeks 8 and 24 received placebo plus peginterferon-ribavirin for an additional 20 weeks; and group 3 received boceprevir plus peginterferon-ribavirin for 44 weeks. Nonblack patients and black patients were enrolled and analyzed separately.RESULTS:A total of 938 nonblack and 159 black patients were treated. In the nonblack cohort, a sustained virologic response was achieved in 125 of the 311 patients (40%) in group 1, in 211 of the 316 patients (67%) in group 2 (P<0.001), and in 213 of the 311 patients (68%) in group 3 (P<0.001). In the black cohort, a sustained virologic response was achieved in 12 of the 52 patients (23%) in group 1, in 22 of the 52 patients (42%) in group 2 (P=0.04), and in 29 of the 55 patients (53%) in group 3 (P=0.004). In group 2, a total of 44% of patients received peginterferon-ribavirin for 28 weeks. Anemia led to dose reductions in 13% of controls and 21% of boceprevir recipients, with discontinuations in 1% and 2%, respectively.CONCLUSIONS:The addition of boceprevir to standard therapy with peginterferon-ribavirin, as compared with standard therapy alone, significantly increased the rates of sustained virologic response in previously untreated adults with chronic HCV genotype 1 infection. The rates were similar with 24 weeks and 44 weeks of boceprevir. (Funded by Schering-Plough [now Merck]; SPRINT-2 ClinicalTrials.gov number, NCT00705432.).

Preface to the Second Edition Preface to the First Edition Part I. Plants and Energy: 1. Photosynthesis: the leitmotiv of life 2. Plant respiration: breathing without lungs References Part II. Plant Nutrition: 3. Plants are cool, but why? 4. Nutrition for the healthy lifestyle 5. Nitrogen, nitrogen, everywhere ... 6. Transport of delights References Part III. Growth and Development: 7. Growth: the long and the short of it 8. The time of their lives 9. A dash of seasoning 10. Dormancy: a matter of survival 11. Color, fragrance, and flavor References Part IV. Stress, Defense, and Decline: 12. Stressful tranquility 13. Chemical warfare 14. Senescence and death References Part V. Plants and the Environment: 15. Elemental cycles 16. The human touch Appendix. Genetic engineering in a rapidly changing world References Epilogue Index.

PRESENTATIONSand randomized (1:1:1) to receive placebo (A); GS-9450, 10 mg QD (B); or GS-9450, 40 mg QD (C) for 24 weeks.The primary outcome was pre-specified histologic response (≥2-point decrease in Knodell necroinflammation score with no worsening in fibrosis score) between study groups from pre-treatment and Week 24 liver biopsies.Results: 307 subjects were randomized and treated [n = 103 (A), 101 (B), and 103 (C)].70% were male, 81% were Caucasian, mean age was 53, mean baseline (BL) ALT was 107 IU/mL, mean BL HAI and fibrosis scores were 8.0 and 2.8, and 9% were cirrhotic.Median ALT in GS-9450 groups improved at Week 4, with normalization in 46%, and was maintained through Week 20 in a majority.Adverse events led to treatment discontinuation in 1.9% (A), 5.0% (B) and 4.9% (C) of patients.During treatment, Grade 3 or 4 treatment emergent (TE) ALT elevations occurred in 6.8% (A), 5.0% (B), and 7.8% (C) of subjects.Notably, three subjects receiving GS-9450 developed marked simultaneous marked simultaneous ALT (7, 8, 28 × BL) and bilirubin (4.3, 6.8, 11.0 mg/dL) elevation by Week 8-12, and two others developed marked marked ALT elevation alone (11, 18 ×BL), resulting in study termination by the sponsor for possible drug-induced livery injury (DILI).Two placebo recipients also developed simultaneous elevation of ALT (2, 3 ×BL) and bilirubin (1.9, 3.3 mg/dL).50% of study subjects received study medication through Week 20, and 87 paired liver biopsies were obtained.Histologic improvement by pre-defined criteria occurred in 10/27 (37%), 5/28 (18%) and 5/32 (16%) of Group A, B, and C subjects, respectively.Conclusions: GS-9450 induced ALT improvement in patients with chronic HCV infection previously failing PEG/RBV, but was associated with presumptive DILI.The histology data do not support the concept of therapeutic caspase inhibition in chronic HCV infection.

With growing use of numerical models to forecast lake conditions under future climates and other stressors, paleo-events in the history of the Great Lakes have greater potential for relevance. Past events and history may extend records of observations, provide estimates of the sensitivity of the lake system to stressing conditions, and contribute scenarios for model validation. Here we describe four examples that hold promise for improving understanding of the present and future Great Lakes: 1) using an event of lake closure to derive climate-hydrology sensitivity, 2) extending the record of lake-level history by examining beach ridge sequences, 3) investigating sedimentary black bands to indicate past anoxia at the lakebed in deep basins, and 4) deriving evidence of lake process teleconnections with atmospheric circulation.