Stony Brook School

Emergent literacy consists of the skills, knowledge, and attitudes that are developmental precursors to reading and writing. This article offers a preliminary typology of children's emergent literacy skills, a review of the evidence that relates emergent literacy to reading, and a review of the evidence for linkage between children's emergent literacy environments and the development of emergent literacy skills. We propose that emergent literacy consists of at least two distinct domains: inside-out skills (e.g., phonological awareness, letter knowledge) and outside-in skills (e.g., language, conceptual knowledge). These different domains are not the product of the same experiences and appear to be influential at different points in time during reading acquisition. Whereas outside-in skills are associated with those aspects of children's literacy environments typically measured, little is known about the origins of inside-out skills. Evidence from interventions to enhance emergent literacy suggests that relatively intensive and multifaceted interventions are needed to improve reading achievement maximally. A number of successful preschool interventions for outside-in skills exist, and computer-based tasks designed to teach children inside-out skills seem promising. Future research directions include more sophisticated multidimensional examination of emergent literacy skills and environments, better integration with reading research, and longer-term evaluation of preschool interventions. Policy implications for emergent literacy intervention and reading education are discussed.

The propensity of metals to form irregular and nonplanar electrodeposits at liquid-solid interfaces has emerged as a fundamental barrier to high-energy, rechargeable batteries that use metal anodes. We report an epitaxial mechanism to regulate nucleation, growth, and reversibility of metal anodes. The crystallographic, surface texturing, and electrochemical criteria for reversible epitaxial electrodeposition of metals are defined and their effectiveness demonstrated by using zinc (Zn), a safe, low-cost, and energy-dense battery anode material. Graphene, with a low lattice mismatch for Zn, is shown to be effective in driving deposition of Zn with a locked crystallographic orientation relation. The resultant epitaxial Zn anodes achieve exceptional reversibility over thousands of cycles at moderate and high rates. Reversible electrochemical epitaxy of metals provides a general pathway toward energy-dense batteries with high reversibility.

The distribution volume ratio (DVR), which is a linear function of receptor availability, is widely used as a model parameter in imaging studies. The DVR corresponds to the ratio of the DV of a receptor-containing region to a nonreceptor region and generally requires the measurement of an arterial input function. Here we propose a graphical method for determining the DVR that does not require blood sampling. This method uses data from a nonreceptor region with an average tissue-to-plasma efflux constant k2 to approximate the plasma integral. Data from positron emission tomography studies with [11C]raclopride (n = 20) and [11C]d-threo-methylphenidate ([11C]dMP) (n = 8) in which plasma data were taken and used to compare results from two graphical methods, one that uses plasma data and one that does not. k2 was 0.163 and 0.051 min-1 for [11C]raclopride and [11C]dMP, respectively. Results from both methods were very similar, and the average percentage difference between the methods was -0.11% for [11C]raclopride and 0.46% for [11C]dMP for DVR of basal ganglia (BG) to cerebellum (CB). Good agreement between the two methods was also achieved for DVR images created by both methods. This technique provides an alternative method of analysis not requiring blood sampling that gives equivalent results for the two ligands studied. It requires initial studies with blood sampling to determine the average kinetic constant and to test applicability. In some cases, it may be possible to neglect the k2 term if the BG/CB ratio becomes reasonably constant for a sufficiently long period of time over the course of the experiment.

BACKGROUND: Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs. METHOD: General population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. Survival analysis was carried out to examine associations of sociodemographic characteristics and prior traumatic events with subsequent exposure. RESULTS: Over 70% of respondents reported a traumatic event; 30.5% were exposed to four or more. Five types - witnessing death or serious injury, the unexpected death of a loved one, being mugged, being in a life-threatening automobile accident, and experiencing a life-threatening illness or injury - accounted for over half of all exposures. Exposure varied by country, sociodemographics and history of prior traumatic events. Being married was the most consistent protective factor. Exposure to interpersonal violence had the strongest associations with subsequent traumatic events. CONCLUSIONS: Given the near ubiquity of exposure, limited resources may best be dedicated to those that are more likely to be further exposed such as victims of interpersonal violence. Identifying mechanisms that account for the associations of prior interpersonal violence with subsequent trauma is critical to develop interventions to prevent revictimization.

Involvement of the central nervous system (CNS) is common in patients with advanced disease due to human immunodeficiency virus (HIV). Symptoms range from lethargy and apathy to coma, incoordination and ataxia to hemiparesis, loss of memory to severe dementia, and focal to major motor seizures. Involvement may be closely associated with HIV infection per se, as in the AIDS dementia complex, but is frequently caused by opportunistic pathogens such as Toxoplasma gondii and Cryptococcus neoformans or malignancies such as primary lymphoma of the CNS. The clinical presentations of attendant and direct CNS involvement are remarkably non-specific and overlapping, yet a correct diagnosis is critical to successful intervention. Toxoplasmic encephalitis is one of the most common and most treatable causes of AIDS-associated pathology of the CNS. A great deal has been learned in the last 10 years about its unique presentation in the HIV-infected patient with advanced disease. Drs. Benjamin J. Luft of the State University of New York at Stony Brook and Jack S. Remington of the Stanford University School of Medicine and Palo Alto Medical Foundation's Research Institute have studied T. gondii for many years and are two of the leading experts in the field. This commentary comprises an update of their initial review (J Infect Dis 1988;157:1-6) and a presentation of the current approaches to diagnosing and managing toxoplasmic encephalitis in HIV-infected patients.

BACKGROUND: Cardiovascular events occur most frequently in the morning hours. We prospectively studied the association between the morning blood pressure (BP) surge and stroke in elderly hypertensives. METHODS AND RESULTS: We studied stroke prognosis in 519 older hypertensives in whom ambulatory BP monitoring was performed and silent cerebral infarct was assessed by brain MRI and who were followed up prospectively. The morning BP surge (MS) was calculated as follows: mean systolic BP during the 2 hours after awakening minus mean systolic BP during the 1 hour that included the lowest sleep BP. During an average duration of 41 months (range 1 to 68 months), 44 stroke events occurred. When the patients were divided into 2 groups according to MS, those in the top decile (MS group; MS > or =55 mm Hg, n=53) had a higher baseline prevalence of multiple infarcts (57% versus 33%, P=0.001) and a higher stroke incidence (19% versus 7.3%, P=0.004) during the follow-up period than the others (non-MS group; MS <55 mm Hg, n=466). After they were matched for age and 24-hour BP, the relative risk of the MS group versus the non-MS group remained significant (relative risk=2.7, P=0.04). The MS was associated with stroke events independently of 24-hour BP, nocturnal BP dipping status, and baseline prevalence of silent infarct (P=0.008). CONCLUSIONS: In older hypertensives, a higher morning BP surge is associated with stroke risk independently of ambulatory BP, nocturnal BP falls, and silent infarct. Reduction of the MS could thus be a new therapeutic target for preventing target organ damage and subsequent cardiovascular events in hypertensive patients.

This consensus statement presents a comprehensive and evidence-based set of guidelines for the care of postoperative nausea and vomiting (PONV) in both adult and pediatric populations. The guidelines are established by an international panel of experts under the auspices of the American Society of Enhanced Recovery and Society for Ambulatory Anesthesia based on a comprehensive search and review of literature up to September 2019. The guidelines provide recommendation on identifying high-risk patients, managing baseline PONV risks, choices for prophylaxis, and rescue treatment of PONV as well as recommendations for the institutional implementation of a PONV protocol. In addition, the current guidelines focus on the evidence for newer drugs (eg, second-generation 5-hydroxytryptamine 3 [5-HT3] receptor antagonists, neurokinin 1 (NK1) receptor antagonists, and dopamine antagonists), discussion regarding the use of general multimodal PONV prophylaxis, and PONV management as part of enhanced recovery pathways. This set of guidelines have been endorsed by 23 professional societies and organizations from different disciplines (Appendix 1).Guidelines currently available include the 3 iterations of the consensus guideline we previously published, which was last updated 6 years ago; a guideline published by American Society of Health System Pharmacists in 1999; a brief discussion on PONV management as part of a comprehensive postoperative care guidelines; focused guidelines published by the Society of Obstetricians and Gynecologists of Canada, the Association of Paediatric Anaesthetists of Great Britain & Ireland and the Association of Perianesthesia Nursing; and several guidelines published in other languages.The current guideline was developed to provide perioperative practitioners with a comprehensive and up-to-date, evidence-based guidance on the risk stratification, prevention, and treatment of PONV in both adults and children. The guideline also provides guidance on the management of PONV within enhanced recovery pathways.The previous consensus guideline was published 6 years ago with a literature search updated to October 2011. Several guidelines, which have been published since, are either limited to a specific populations or do not address all aspects of PONV management. The current guideline was developed based on a systematic review of the literature published up through September 2019. This includes recent studies of newer pharmacological agents such as the second-generation 5-hydroxytryptamine 3 (5-HT3) receptor antagonists, a dopamine antagonist, neurokinin 1 (NK1) receptor antagonists as well as several novel combination therapies. In addition, it also contains an evidence-based discussion on the management of PONV in enhanced recovery pathways. We have also discussed the implementation of a general multimodal PONV prophylaxis in all at-risk surgical patients based on the consensus of the expert panel.

Periodontitis is a common disorder affecting >40% of adults in the United States. Globally, the severe form of the disease has a prevalence of 11%. In advanced cases, periodontitis leads to tooth loss and reduced quality of life. The aetiology of periodontitis is multifactorial. Subgingival dental biofilm elicits a host inflammatory and immune response, ultimately leading to irreversible destruction of the periodontium (i.e. alveolar bone and periodontal ligament) in a susceptible host. In order to successfully manage periodontitis, dental professionals must understand the pathogenesis, primary aetiology, risk factors, contributing factors and treatment protocols. Careful diagnosis, elimination of the causes and reduction of modifiable risk factors are paramount for successful prevention and treatment of periodontitis. Initial non-surgical periodontal therapy primarily consists of home care review and scaling and root planing. For residual sites with active periodontitis at periodontal re-evaluation, a contemporary regenerative or traditional resective surgical therapy can be utilised. Thereafter, periodontal maintenance therapy at a regular interval and long-term follow-ups are also crucial to the success of the treatment and long-term retention of teeth. The aim of this review is to provide current concepts of diagnosis, prevention and treatment of periodontitis. Both clinical and biological rationales will be discussed.

To facilitate the systematic description of catatonic signs, we developed a catatonia rating examination, rating scale and screening instrument. We constructed a 23-item rating scale and a truncated 14-item screening instrument using operationalized definitions of signs ascribed to catatonia in published sources. Inter-rater reliability was tested in 44 simultaneous ratings of 28 cases defined by the presence of > or = 2 signs on the 14-item screen. Inter-rater reliability for total score on the rating scale was 0.93, and mean agreement of items was 88.2% (SD 9.9). Inter-rater reliability for total score on the screening instrument was 0.95, and mean agreement of items was 92.7% (SD 4.9). Diagnostic agreement was high based on criteria for catatonia put forth by other authors. Seven per cent (15/215) of consecutively admitted patients to an academic psychiatric in-patient facility met criteria for catatonia. It is concluded that catatonia is a distinct, moderately prevalent neuropsychiatric syndrome. The rating scale and screening instrument are reliable and valid. Their use facilitates diagnosis, treatment protocols, and cross-study comparisons.

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumor-infiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment.

Abstract An investigation has been made of the relations among porosity, permeability, and texture of artificially mixed and packed sand, to determine the approximate porosity and permeability values to be expected for unconsolidated sand of eight grain-size subclasses and six sorting groups. The sand samples were prepared so that the weight fractions were distributed normally about the median grain size. Porosity values were determined for two packings, designated as “dry-loose” and “wet-packed.” Porosity data for “wet-packed” sand samples remain about the same for changes in grain size of a given sorting, but decrease from an average of 42.4 percent for extremely well-sorted sand to 27.9 percent for very poorly sorted sand. These experimental data agree within 5 porosity percent with framework porosity values obtained for natural packing of 25 Holocene barrier-Island sand samples of a limited size-sorting range, and appear to be representative of minimum porosities expected for natural packing of most unconsolidated, clay-free sand. The 48 artificially mixed and wet-packed experimental sands selected for porosity measurement also were used to determine permeability. Inasmuch as there are some irregularities in the experimental data caused by the inability to pack each sample uniformly, an average adjusted permeability value has been calculated. The average adjusted permeability values become progressively lower with decreasing grain size and poorer sorting, and agree well with permeability values computed by the Krumbein and Monk formula for most grain-size and sorting classes. Reference photographs or visual textural comparators enable a rapid estimation of grain shape, roundness, size, and sorting. Grain-size-sorting comparators, representing photomicrographs of thin sections of the porosity and permeability test samples, are especially useful in estimating original textural parameters form thin sections of severely compacted and silica-cemented sandstones.

CONTEXT: Nonpharmacological treatments with little patient cost or risk are useful supplements to pharmacotherapy in the treatment of patients with chronic illness. Research has demonstrated that writing about emotionally traumatic experiences has a surprisingly beneficial effect on symptom reports, well-being, and health care use in healthy individuals. OBJECTIVE: To determine if writing about stressful life experiences affects disease status in patients with asthma or rheumatoid arthritis using standardized quantitative outcome measures. DESIGN: Randomized controlled trial conducted between October 1996 and December 1997. SETTING: Outpatient community residents drawn from private and institutional practice. PATIENTS: Volunteer sample of 112 patients with asthma (n = 61) or rheumatoid arthritis (n = 51) received the intervention; 107 completed the study, 58 in the asthma group and 49 in the rheumatoid arthritis group. INTERVENTION: Patients were assigned to write either about the most stressful event of their lives (n = 71; 39 asthma, 32 rheumatoid arthritis) or about emotionally neutral topics (n = 41; 22 asthma, 19 rheumatoid arthritis) (the control intervention). MAIN OUTCOME MEASURES: Asthma patients were evaluated with spirometry and rheumatoid arthritis patients were clinically examined by a rheumatologist. Assessments were conducted at baseline and at 2 weeks and 2 months and 4 months after writing and were done blind to experimental condition. RESULTS: Of evaluable patients 4 months after treatment, asthma patients in the experimental group showed improvements in lung function (the mean percentage of predicted forced expiratory volume in 1 second [FEV1] improved from 63.9% at baseline to 76.3% at the 4-month follow-up; P<.001), whereas control group patients showed no change. Rheumatoid arthritis patients in the experimental group showed improvements in overall disease activity (a mean reduction in disease severity from 1.65 to 1.19 [28%] on a scale of 0 [asymptomatic] to 4 [very severe] at the 4-month follow-up; P=.001), whereas control group patients did not change. Combining all completing patients, 33 (47.1%) of 70 experimental patients had clinically relevant improvement, whereas 9 (24.3%) of 37 control patients had improvement (P=.001). CONCLUSION: Patients with mild to moderately severe asthma or rheumatoid arthritis who wrote about stressful life experiences had clinically relevant changes in health status at 4 months compared with those in the control group. These gains were beyond those attributable to the standard medical care that all participants were receiving. It remains unknown whether these health improvements will persist beyond 4 months or whether this exercise will prove effective with other diseases.

Many problems in comparative biology and biological anthropology require meaningful definitions of “relative size” and “shape.” Here we review the distinguishing features of ratios and residuals and their relationships to other methods of “size-adjustment” for continuous data. Eleven statistical techniques are evaluated in reference to one broadly interspecific data set (craniometries of adult Old World monkeys) and one narrowly intraspecific data set (anthropometries of adult Native American males). Three different types of residuals are compared to three versions of shape ratios, and these are contrasted to “cscores,” Penrose shape, and multivariate adjustments based on the first principal component of the logged variance-covariance matrix; all methods are also compared to raw and logged raw data. In order to help us identify appropriate; methods for size-adjustment, geometrically similar or “isometric” versions of the male vervet and the Inuit male were created by scalar multiplication of all variables. The geometric mean of all variables is used as overall “size” throughout this investigation, but our conclusions would be the same for most other size variables. Residual adjustments failed to correctly identify individuals of the same shape in both sampkles. Like residuals, cscores are also sample-specific and incorrectly attribute different shape values to individuals known to be identical in shape. Multivariate “residuals” (e.g., discarding the first principal component and Burnaby's method) are plagued by similar problems. If one of the goals of an analysis is to identify individuals (OTUs) of the same shape after accounting for overalll size differences, then none of these methods can be recommended. We also reject the assertion that size-adjusted variables should be unciorrelated with size of “size-free”; rather, whether or not shape covaries with size is an important empirical determination in any analysis. Without explicit similarity criteria, “lines of subtraction” can be very misleading. Only variables in the Mosimann family of shape rations allowed us to identify sized individuals of the same shape (“Iso-OUTs”). Residuals from isometric lines in logarithmic space, projections of logged data to a plane orthogonal to an isometric vector, and Penrose shape distance based on logged data are also part of this shape family. Shape defined in this manner can be significantly correlated with size in allometric data sets (e.g., guenon craniometrics); ratio shape differences may be largely independent of size in narrowly intraspecific or intrasexual data sets (e.g., Native American anthropometrics). Log-transformations of shape variables are not always necessary or desirable. We hope our findings enciourage other workers to question the assumptions and utility of residuals as size-adjusted data and to explore shape and relative size within Mosimann's explicitly geometric framework. © 1995 Wiley-Liss, Inc.

raise global mean temperature over the next century by 1.0–3.5 °C (Houghton et al. 1995, 1996). Ecologists from around the world have begun experiments to investigate the effects of global warming on terrestrial ecosystems, the aspect of global climate change that attracts the most public attention (Woodwell and McKenzie 1995, Walker and Steffen 1999). The effort to understand response to warming builds on a history of investigations of the effects of elevated CO 2 on plants and ecosystems (Koch and Mooney 1996, Schulze et al. 1999). There are important differences, however, between increases in atmospheric CO 2 and temperature change, both in the temporal and spatial patterns of change and in how they affect ecosystems. The scientists involved in temperature change research have had to face new technical and conceptual challenges in designing and interpreting their experiments (Schulze et al. 1999). In this paper we describe these challenges and present a conceptual framework for interpreting experimental results and predicting effects of warming on ecosystems.

remarkable convergence between geography and philosophy has become increasingly manifest in the past two decades. It is as if Strabo’s celebrated opening claim in his Geographia had finally become true two millennia later: “The science of Geography, which I now propose to investigate, is, I think, quite as much as any other science, a concern of the philosopher” (Strabo I, 3). What is new (and not in Strabo) is the growing conviction that philosophy is the concern of the geographer as well, or more exactly that philosophy and geography now need each other—and profit from this mutual need. Collaboration between the two fields has been evident ever since concerted attention to place began to emerge just over twenty years ago in, e.g., Edward Relph’s Place and Placelessness (1976) and Yi-Fu Tuan’s Space and Place (1976). Because of their emphasis on the experiential features of place—its “subjective” or “lived” aspects— such works were natural allies of phenomenology, a form of philosophy that attempts to give a direct description of first-person experience. Both geography and phenomenology have come to focus on place as experienced by human beings, in contrast to space, whose abstractness discourages experiential explorations. In the case of geography, a primary task has been to do justice to the indispensability of place in geographic theory and practice. So much is this the case that Robert David Sack (1997, 34, 30), a more recent proponent of the importance of place, can claim unhesitatingly that “[in geography] the truly important factor is place and its relationship to space.” 1

A seminal experiment involving a germ-free rat model of connective tissue breakdown (followed soon thereafter by a series of in vitro studies) identified an unexpected non-antimicrobial property of tetracyclines (TCs). This ability of TCs to inhibit matrix metalloproteinases (MMPs) such as collagenase was found to reflect multiple direct and indirect mechanisms of action, and to be therapeutically useful in a variety of dental (e.g., adult periodontitis) and medical (e.g., arthritis, osteoporosis, cancer) diseases. The site on the TC molecule responsible for its MMP-inhibitory activity was identified which led to the development of a series of chemically modified non-antimicrobial analogs, called CMTs, which also have therapeutic potential but do not appear to induce antibiotic side-effects. Longitudinal double-blind studies on humans with adult periodontitis have demonstrated that a sub-antimicrobial dose of doxycycline (previously reported to suppress collagenase activity in the periodontal pocket) is safe and effective and has recently been approved by the FDA as an adjunct to scaling and root planing.

Toward National Well-Being Accounts by Daniel Kahneman, Alan B. Krueger, David Schkade, Norbert Schwarz and Arthur Stone. Published in volume 94, issue 2, pages 429-434 of American Economic Review, May 2004

A wide variety of research studies suggest that breakdowns in the diagnostic process result in a staggering toll of harm and patient deaths. These include autopsy studies, case reviews, surveys of patient and physicians, voluntary reporting systems, using standardised patients, second reviews, diagnostic testing audits and closed claims reviews. Although these different approaches provide important information and unique insights regarding diagnostic errors, each has limitations and none is well suited to establishing the incidence of diagnostic error in actual practice, or the aggregate rate of error and harm. We argue that being able to measure the incidence of diagnostic error is essential to enable research studies on diagnostic error, and to initiate quality improvement projects aimed at reducing the risk of error and harm. Three approaches appear most promising in this regard: (1) using 'trigger tools' to identify from electronic health records cases at high risk for diagnostic error; (2) using standardised patients (secret shoppers) to study the rate of error in practice; (3) encouraging both patients and physicians to voluntarily report errors they encounter, and facilitating this process.

Abstract Recent observational and theoretical studies of the global properties of small‐scale atmospheric gravity waves have highlighted the global effects of these waves on the circulation from the surface to the middle atmosphere. The effects of gravity waves on the large‐scale circulation have long been treated via parametrizations in both climate and weather‐forecasting applications. In these parametrizations, key parameters describe the global distributions of gravity‐wave momentum flux, wavelengths and frequencies. Until recently, global observations could not define the required parameters because the waves are small in scale and intermittent in occurrence. Recent satellite and other global datasets with improved resolution, along with innovative analysis methods, are now providing constraints for the parametrizations that can improve the treatment of these waves in climate‐prediction models. Research using very‐high‐resolution global models has also recently demonstrated the capability to resolve gravity waves and their circulation effects, and when tested against observations these models show some very realistic properties. Here we review recent studies on gravity‐wave effects in stratosphere‐resolving climate models, recent observations and analysis methods that reveal global patterns in gravity‐wave momentum fluxes and results of very‐high‐resolution model studies, and we outline some future research requirements to improve the treatment of these waves in climate simulations. Copyright © 2010 Royal Meteorological Society and Crown in the right of Canada

The sympathetic skin response (SSR) was measured in 33 patients with peripheral neuropathies and in 30 normal control subjects. Abnormalities of the response were correlated with clinical, pathologic, and EMG observations. The response was usually absent in axonal neuropathies, but present in demyelinating disorders. Abnormalities of the sympathetic skin response did not correlate well with clinical evidence of dysautonomia, but were a reliable indicator of disorders affecting unmyelinated axons.