Urban lizards had reduced limb lengths and toe lengths consistent with how they used microhabitats and other habitat characteristics (e.g., percent impervious surface cover). Urban lizards also had fewer dorsal scales, which might be associated with changes in ambient temperature (e.g., urban heat island effect), given that lizards with fewer and larger scales typically have reduced evaporative water loss. Our results uniquely differ from past studies on lizard responses to urbanization, indicating that work on diverse taxa is necessary to assess the potential varied pathways of morphological adaptations to urban environments.Structural equation modeling (SEM) provides an extensive toolbox to analyze the multivariate interrelations of directly observed variables and latent constructs. Multilevel SEM integrates mixed effects to examine the covariances between observed and latent variables across many levels of analysis. However, while it is necessary to consider model fit, traditional indices are largely insufficient to analyze model fit at each level of analysis. Ko143 The present paper reviews i) the partially-saturated model fit approach first suggested by Ryu and West (2009) and ii) an alternative model parameterization that removes the multilevel data structure. We next describe the implementation of an algorithm to compute partially-saturated model fit for 2-level structural equation models in the open source SEM package, OpenMx, including verification in a simulation study. Finally, an example empirical application evaluates leading theories on the structure of affect from ecological momentary assessment data collected thrice daily for two weeks from 345 participants.

The purpose of this study was to examine if the longitudinal associations between father-adolescent conflict and both externalizing and internalizing symptoms in youth were moderated by fathers‘ residential status (i.e., whether or not he lived in the home) and type of residential father (i.e., biological or step).

Adolescents (

= 146) completed a measure about conflict with their father or stepfather in 8

and 9

grade. At the same time points, mothers completed measures about the youths‘ externalizing and internalizing symptoms.

The association between 8

grade conflict and 9

grade externalizing symptoms was moderated by fathers‘ residential status. Conflict with fathers in 8

grade was positively associated with 9

grade externalizing symptoms when youths resided with their father (biological and stepfathers were included); in contrast, higher levels of father-adolescent conflict were associated with lower levels of subsequent externalizing symptoms when fathers did not live with the youth. Externalizing symptoms in 8

grade did not significantly predict father-adolescent conflict in grade 9. Regarding internalizing symptoms, the association between father-adolescent conflict in 8

grade and internalizing symptoms in 9

grade was moderated by father’s residential status; conflict predicted higher levels of internalizing symptoms when the biological father lived elsewhere. Higher levels of 8

grade internalizing symptoms also significantly predicted greater conflict between adolescents and their fathers in 9

grade for residential fathers only.

The associations among adolescent emotional and behavioral outcomes and paternal-child relationship qualities vary with symptom type and family structures and, thus, warrant further comprehensive study.

The associations among adolescent emotional and behavioral outcomes and paternal-child relationship qualities vary with symptom type and family structures and, thus, warrant further comprehensive study.Motivated by the shortcoming of current hospital scheduling and capacity planning methods which often model different units in isolation, we introduce the first dynamic multi-day scheduling model that integrates information about capacity usage at more than one location in a hospital. In particular, we analyze the first dynamic model that accounts for patients‘ length-of-stay and downstream census in scheduling decisions. Via a simple and innovative variable transformation, we show that the optimal number of patients to be allowed in the system is increasing in the state of the system and in the downstream capacity. Moreover, the total system cost exhibits decreasing marginal returns as the capacity increases at any location independently of another location. Through numerical experiments on realistic data, we show that there is substantial value in making integrated scheduling decisions. In contrast, localized decision rules that only focus on a single location of a hospital can result in up to 60% higher expenses.Objective Patients at risk of lymphedema following pelvic lymph-node dissection for gynecologic cancers (PLND) often receive prophylactic risk-reducing advice and compression stockings to wear for 6 months, without clear supportive evidence or evaluation of the impact. This study explored if these measures affected lymphedema development 1 year after PLND. Materials and Methods Relevant data of patients who had undergone PLND over a 10-year period were allocated into 2 groups Group A had data on patients who received prophylactic lymphedema risk-reduction advice and compression stockings for to wear for 6 months. Group B had data on patients who did not receive prophylactic lymphedema risk-reduction advice or prophylactic compression stockings. Exclusion criteria were preexisting swelling, medication that increased edema, symptom management during end-of-life care. Data were analyzed for statistical significance between the groups. Results Of 108 patients, 19/60 patients (35%) in Group A and 6/48 (12.5%) patients in Group B developed lymphedema. There was no statistical difference between the groups for the presence of lymphedema. Conclusions This study did not show that prophylactic compression stockings reduced the development of lymphedema but suggested an increased awareness of the signs and symptoms of lymphedema among patients who received risk-reducing education and the compression garments. These results should be tested in a prospective, controlled trial, and suggest that a change in current clinical practice is appropriate. (J GYNECOL SURG 36198).We propose an evolutionary state space model (E-SSM) for analyzing high dimensional brain signals whose statistical properties evolve over the course of a non-spatial memory experiment. Under E-SSM, brain signals are modeled as mixtures of components (e.g., AR(2) process) with oscillatory activity at pre-defined frequency bands. To account for the potential non-stationarity of these components (since the brain responses could vary throughout the entire experiment), the parameters are allowed to vary over epochs. Compared with classical approaches such as independent component analysis and filtering, the proposed method accounts for the entire temporal correlation of the components and accommodates non-stationarity. For inference purpose, we propose a novel computational algorithm based upon using Kalman smoother, maximum likelihood and blocked resampling. The E-SSM model is applied to simulation studies and an application to a multi-epoch local field potentials (LFP) signal data collected from a non-spatial (olfactory) sequence memory task study. The results confirm that our method captures the evolution of the power for different components across different phases in the experiment and identifies clusters of electrodes that behave similarly with respect to the decomposition of different sources. These findings suggest that the activity of different electrodes does change over the course of an experiment in practice; treating these epoch recordings as realizations of an identical process could lead to misleading results. In summary, the proposed method underscores the importance of capturing the evolution in brain responses over the study period.

The incidence of intestinal NK/T cell lymphoma (NKTCL) is extremely low, and the clinical symptoms are atypical, which makes it difficult to distinguish this disorder from Crohn’s disease (CD), T lymphocyte proliferative disease, and other immune disorders. The misdiagnosis rate is high, and the patient’s prognosis is poor.

In this case, the patient had repeated high fever, colonoscopy revealed multiple ulcers, and the initial diagnosis was CD. The patient’s condition did not improve after treatment with hormones and infliximab, and she eventually died. Positron emission tomographic-computed tomographic and B-ultrasound were performed in our hospital and showed that multiple lymph nodes were enlarged. Immunohistochemi-stry showed that CD3 and Epstein-Barr virus encoded RNA expression was positive. Colonoscopy, tissue biopsy, and histopathology showed intestinal focal mucosal infiltration of heterotypic lymphocytes with an abnormal immune phenotype. On the basis of the patient’s medical history, auxiliary examination, and pathological findings, digestive physicians and pathologists gave the diagnosis of NKTCL.

Clinicians need to improve their comprehensive knowledge of NKTCL, and combination of clinical symptoms, histological characteristics, as well as colonoscopy biopsies should be considered to improve the diagnosis and thereby reduce misdiagnosis.

Clinicians need to improve their comprehensive knowledge of NKTCL, and combination of clinical symptoms, histological characteristics, as well as colonoscopy biopsies should be considered to improve the diagnosis and thereby reduce misdiagnosis.

Transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) have shown promising local benefits for advanced hepatocellular carcinoma (HCC). S-1, a composite preparation of a 5-fluorouracil prodrug, has proven to be a convenient oral chemotherapeutic agent with definite efficacy against advanced HCC.

To evaluate the efficacy and safety of TACE followed by HAIC with or without oral S-1 for treating advanced HCC.

In this single-center, open-label, prospective, randomized controlled trial, 117 participants with advanced HCC were randomized to receive TACE followed by oxaliplatin-based HAIC either with (TACE/HAIC + S-1,

= 56) or without (TACE/HAIC,

= 61) oral S-1 between December 2013 and September 2017. Two participants were excluded from final analysis for withdrawing consent. The primary endpoint was progression-free survival (PFS) and secondary endpoints included overall survival (OS), objective response rate, disease control rate and safety.

In total, 115 participants (100 males and 15 females; mean age, 57.7 years ± 11.9) were analyzed. The median PFS and OS were 5.0 mo (0.4-58.6 mo) (95% confidence interval (CI) 3.82 to 6.18)

4.4 mo (1.1-54.4 mo) (95%CI 2.54 to 6.26;

= 0.585) and 8.4 mo (0.4-58.6 mo) (95%CI 6.88 to 9.92)

8.3 mo (1.4-54.4 m) (95%CI 5.71 to 10.96;

= 0.985) in the TACE/HAIC + S-1 and TACE/HAIC groups, respectively. The objective response rate and disease control rate were 30.9%

18.4% and 72.7%

56.7% in the TACE/HAIC + S-1 and TACE/HAIC groups, respectively. Grade 3/4 adverse events had a similar frequency in both treatment groups.

No improvements in tumor response rates, PFS or OS were observed with the addition of S-1 to TACE/HAIC in advanced HCC. Both treatment regimens had a similar safety profile.

No improvements in tumor response rates, PFS or OS were observed with the addition of S-1 to TACE/HAIC in advanced HCC. Both treatment regimens had a similar safety profile.