Identification of the Incisive Branch of the Inferior Alveolar Nerve of Edentulous Mandibles Using Cone-Beam Computerized Tomography.

This study explored the average length of the incisive branch (IB) of the inferior alveolar nerve on cone-beam computerized tomography (CBCT) with regard to patient demographics in patients with edentulous mandibles. CBCT was used in a retrospective study of edentulous mandibles to assess the presence and anatomical variation for the IB. Three independent observers measured bilateral IB lengths. In addition to demographics, IB length and port of exit data were obtained. A 1-way analysis of variance was used to test whether IB length varied by sex or port of exit, and a standard Pearson correlation was used to test for IB length and age significance, with a significance level of P < .05. Intraclass correlation coefficients showed significant agreement in IB length across all observers. No significant difference was noted between the exit port and IB length. An important effect was reported for sex, indicating women have generally shorter IB lengths (9.43 ± 3.99 vs 10.55 ± 3.92). There was a significant correlation with age, but the relationship was weak. Edentulous mandibles have an altered anatomic landscape, and establishing predictive IB dimensions aids practitioners in surgical planning.

Identification of the Incisive Branch of the Inferior Alveolar Nerve of Edentulous Mandibles Using Cone Beam Computed Tomography.

This study explored the average length of the incisive branch of the inferior alveolar nerve on cone-beam computed tomography (CBCT) regarding patient demographics in patients with edentulous mandibles. CBCT was utilized in a retrospective study of edentulous mandibles to assess the presence and anatomical variation for the incisive branch (IB). Three independent observers measured bilateral IB lengths. In addition to demographics, IB length and port of exit data were obtained. A one-way ANOVA was used to test IB length varied by sex or port of exit, and a standard Pearson's correlation was used to test for IB length and age significance with a significance level of a p-value<0.05. Intraclass correlation coefficients show significant agreement in IB length across all observers. No significant difference was noted between the exit port and IB length. An important effect was reported for sex, indicating women have generally shorter IB lengths (9.43 ± 3.99 vs 10.55 ± 3.92). There was a significant correlation with age, but the relationship was weak. Edentulous mandibles have an altered anatomic landscape and establishing predictive incisive branch dimensions aids practitioners in surgical planning.

How well does your e-nose detect cancer? Application of artificial breath analysis for performance assessment.

Comparing electronic nose (e-nose) performance is a challenging task because of a lack of standardised method. This paper proposes a method for defining and quantifying an indicator of the effectiveness of multi-sensor systems in detecting cancers by artificial breath analysis. To build this method, an evaluation of the performances of an array of metal oxide sensors built for use as a lung cancer screening tool was conducted. Breath from 20 healthy volunteers has been sampled in fluorinated ethylene propylene sampling bags. These healthy samples were analysed with and without the addition of nine volatile organic compound (VOC) cancer biomarkers, chosen from literature. The concentration of the VOC added was done in increasing amounts. The more VOC were added, the better the discrimination between 'healthy' samples (breath without additives) and 'cancer' samples (breath with additives) was. By determining at which level of concentration the e-nose fails to reliably discriminate between the two groups, we estimate its ability to well predict the presence of the disease or not in a realistic situation. In this work, a home-made e-nose is put to the test. The results underline that the biomarkers need to be about 5.3 times higher in concentration than in real breath for the home-made nose to tell the difference between groups with a sufficient confidence.

Circulating tumor DNA-based molecular residual disease detection for treatment monitoring in advanced melanoma patients.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have substantially improved overall survival in patients with advanced melanoma; however, the lack of biomarkers to monitor treatment response and relapse remains an important clinical challenge. Thus, a reliable biomarker is needed that can risk-stratify patients for disease recurrence and predict response to treatment. METHODS: A retrospective analysis using a personalized, tumor-informed circulating tumor DNA (ctDNA) assay on prospectively collected plasma samples (n = 555) from 69 patients with advanced melanoma was performed. Patients were divided into three cohorts: cohort A (N = 30), stage III patients receiving adjuvant ICI/observation; cohort B (N = 29), unresectable stage III/IV patients receiving ICI therapy; and cohort C (N = 10), stage III/IV patients on surveillance after planned completion of ICI therapy for metastatic disease. RESULTS: In cohort A, compared to molecular residual disease (MRD)-negative patients, MRD-positivity was associated with significantly shorter distant metastasis-free survival (DMFS; hazard ratio [HR], 10.77; p = .01). Increasing ctDNA levels from the post-surgical or pre-treatment time point to after 6 weeks of ICI were predictive of shorter DMFS in cohort A (HR, 34.54; p < .0001) and shorter progression-free survival (PFS) in cohort B (HR, 22; p = .006). In cohort C, all ctDNA-negative patients remained progression-free for a median follow-up of 14.67 months, whereas ctDNA-positive patients experienced disease progression. CONCLUSION: Personalized and tumor-informed longitudinal ctDNA monitoring is a valuable prognostic and predictive tool that may be used throughout the clinical course of patients with advanced melanoma.

An earlier role for intent in children's partner choice versus punishment.

Among the many factors that influence our moral judgments, two are especially important: whether the person caused a bad outcome and whether they intended for it to happen. Notably, the weight accorded to these factors in adulthood varies by the type of judgment being made. For punishment decisions, intentions and outcomes carry relatively equal weight; for partner choice decisions (i.e., deciding whether or not to interact with someone again), intentions are weighted much more heavily. These behavioral differences in punishment and partner choice judgments may also reflect more fundamental differences in the cognitive processes supporting these decisions. Exploring how punishment and partner choice emerge in development provides important and unique insight into these processes as they emerge and mature. Here, we explore the developmental emergence of punishment and partner choice decisions in 4- to 9-year-old children. Given the importance of intentions for partner choice decisions-from both theoretical and empirical perspectives-we targeted the sensitivity of these two responses to others' intentions as well as outcomes caused. Our punishment results replicate past work: Young children are more focused on outcomes caused and become increasingly sensitive to intentions with age. In contrast, partner choice judgments exhibit sensitivity to intentions at an earlier age than punishment judgments, manifesting as earlier partner choice in cases of attempted violations. These results reveal distinct developmental trajectories for punishment and partner choice judgments, with implications for our understanding of the processes underlying these two responses as well as the development of moral judgment more broadly. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

They should have known better: The roles of negligence and outcome in moral judgements of accidental actions.

Two experiments were conducted to investigate the relative influence of agents' negligence and their actions' unintended outcomes on moral judgements. In Study 1, 343 participants were asked in an online questionnaire about a driver whose level of negligence, and the severity of the outcome, were varied systematically. Each judged how much punishment and blame the driver deserved, and rated her negligence, causal responsibility, and intentionality. In Study 2, 341 participants completed the same questionnaire, and also judged the driver's wrongness and the outcome's severity. In both studies, judgements were strongly influenced by negligence; blame was also affected by causal responsibility, and wrongness by intention, but the relatively slight outcome effect on blame and wrongness was largely mediated by negligence. In contrast, both negligence and outcome had substantial effects on punishment judgements; most participants assigned high levels of punishment when, and only when, the outcome was negative and the agent was negligent. These findings shed light on the intriguing phenomenon of moral luck, and indicate that it applies more to punishment judgements than to blame and wrongness. They also indicate that when no negligence information is provided in the description of accidents (as in many previous studies), participants often attribute negligence to agents and judge them accordingly. It seems that the effect of outcome on moral judgements has often been overestimated by researchers, and that of negligence underestimated.

Signaling benefits of partner choice decisions.

When deciding whom to choose for a cooperative interaction, two features of prospective partners are especially relevant: ability to provide benefits, and willingness to provide those benefits. Often, these traits are correlated. But, when ability and willingness are in conflict, people often indicate that they value willingness over ability, even when doing so results in immediate losses. Why would such behavior be favored by natural selection acting at the level of the individual? Across nine experimental studies (seven preregistered) and a mathematical model we explore one way of explaining this costly choice, demonstrating that choosing a willing over an able partner affords one a moral reputation and makes one more likely to be chosen as a cooperation partner. In fact, even people who choose an able over a willing partner for themselves prefer others who choose a willing over an able partner. Crucial to our model, we find that valuing willingness over ability is an honest signal of both higher levels of generosity in an economic game and lower levels of trait Machiavellianism. These findings provide the first extensive exploration of the signaling benefits of partner choice decisions. Furthermore, this work provides one explanation for why we choose those who are willing over those who are able, even at a cost to ourselves: By doing so, we in turn look like good potential partners. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Simultaneous open fracture and rattlesnake bite on the same extremity.

Open fractures and rattlesnake envenomations are two emergencies that each require emergent intervention and treatment. While each is common, when they occur simultaneously on the same extremity, it creates a syndrome that is quintessential Central Texas. We present the case of a 13-year-old boy who sustained a lower-extremity rattlesnake envenomation with concomitant open tibia and fibula fractures after being thrown from an all-terrain vehicle. The envenomation from the snake bite compelled us to first treat his developing coagulopathy with a delayed operative management of his fractures.

Third-party punishment promotes fairness in children.

Third-party punishment can promote fair behavior. However, the mechanisms by which this happens are unclear. Third-party punishment may increase fair behavior by providing direct feedback, helping shape the behavior of those punished, or through an influence on reputation, by encouraging the transgressor to behave appropriately before a third-party audience. Investigating whether and how third-party punishment leads to fairness in children during middle childhood-a key developmental period in the emergence of fairness-presents an ideal context in which to explore these 2 mechanisms. Six to nine-year-old children (N = 121) allocated resources between themselves and a partner in a forced-choice dictator game. In the Direct Feedback condition, a third party punished if the child chose the less fair option. In the Reputation condition, a third party merely observed the child. In the Baseline condition, no third party was present. We find that the Direct Feedback condition increased fairness relative to the other conditions, especially among younger children. These results highlight an important link between third-party punishment and fairness in children and, more broadly, help clarify the mechanisms through which third-party punishment can influence fair behavior and thereby human cooperation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

"Internally Wicked": Investigating How and Why Essentialism Influences Punitiveness and Moral Condemnation.

Kant argued that individuals should be punished "proportional to their internal wickedness," and recent work has demonstrated that essentialism-the notion that observable characteristics reflect internal, biological, unchanging "essences"-influences moral judgment. However, these efforts have yielded conflicting results: essentialism sometimes increases and sometimes decreases moral condemnation. To resolve these discrepancies, we investigated the mechanisms by which essentialism influences moral judgment, focusing on perceptions of actors' control over their behavior, the target of essentialism (particular behaviors vs. actors' character), and the component of essentialism (biology vs. immutability). Participants punished people described as having a criminal essence more than those with a non-criminal essence or no essence. Probing potential mechanisms underlying this effect, we found a mediating role for perceptions of control and weak influences of essentialism focus (behavior vs. character) and component of essentialism (biology vs. immutability). These results extend prior work on essentialism and moral cognition, demonstrating a causal link between perceptions of "internal wickedness" and moral judgment. Our findings also resolve discrepancies in past work on the influence of essentialism on moral judgment, highlighting the role that perceptions of actors' control over their behavior play in moral condemnation.

The Effect of Cognitive Load on Intent-Based Moral Judgment.

When making a moral judgment, people largely care about two factors: Who did it (causal responsibility), and did they intend to (intention)? Since Piaget's seminal studies, we have known that as children mature, they gradually place greater emphasis on intention, and less on mere bad outcomes, when making moral judgments. Today, we know that this developmental shift has several signature properties. Recently, it has been shown that when adults make moral judgments under cognitive load, they exhibit a pattern similar to young children; that is, their judgments become notably more outcome based. Here, we show that all of the same signature properties that accompany the outcome-to-intent shift in childhood characterize the "intent-to-outcome" shift obtained under cognitive load in adults. These findings hold important implications for current theories of moral judgment.

The Value of Detecting Pathological Changes During Clot Formation in Early Disease Treatment-Naïve Breast Cancer Patients.

Breast cancer (BC) is one of the most prevalent forms of cancer in women worldwide. Clinical research indicates that BC patients are at an increased risk for thrombotic events, drastically decreasing their quality-of-life and treatment outcomes. There is ample evidence of this in the literature, but it is mainly focused on metastatic BC. Therefore, coagulopathies of nonmetastatic BC are understudied and require in-depth investigation. In this study, clot kinetics and ultrastructure were used to investigate treatment-naïve, nonmetastatic BC patients using scanning electron microscopy, Thromboelastography®, and confocal laser scanning microscopy. It was demonstrated that nonmetastatic BC patients exhibit minimal ultrastructural alterations of the clot components and no changes in the clot kinetics. However, BC patients presented changes to fibrinogen protein structure, compared to matched controls, using an amyloid-selective stain. Together, these findings suggest that coagulation dysfunction(s) in BC patients with early disease manifest at the microlevel, rather than the macrolevel. This study presents novel insights to a method that are more sensitive to coagulation changes in this specific patient group, emphasizing that the coagulation system may react in different forms to the disease, depending on the progression of the disease itself.

Punishment is Organized around Principles of Communicative Inference.

Humans use punishment to influence each other's behavior. Many current theories presume that this operates as a simple form of incentive. In contrast, we show that people infer the communicative intent behind punishment, which can sometimes diverge sharply from its immediate incentive value. In other words, people respond to punishment not as a reward to be maximized, but as a communicative signal to be interpreted. Specifically, we show that people expect harmless, yet communicative, punishments to be as effective as harmful punishments (Experiment 1). Under some situations, people display a systematic preference for harmless punishments over more canonical, harmful punishments (Experiment 2). People readily seek out and infer the communicative message inherent in a punishment (Experiment 3). And people expect that learning from punishment depends on the ease with which its communicative intent can be inferred (Experiment 4). Taken together, these findings demonstrate that people expect punishment to be constructed and interpreted as a communicative act.

Hydraulic traits of co-existing conifers do not correlate with local hydroclimate condition: a case study in the northern Rocky Mountains, U.S.A.

In this study, we examined the inter- and intra-specific variation of hydraulic traits of three conifers of the Northern Rockies: Pinus ponderosa, Picea engelmannii, and Pseudotsuga menziesii to understand the mechanisms that allow different plant species to co-exist across a watershed. We quantified differences in plant xylem water potential (ψx), xylem tissue vulnerability to cavitation (P50, or ψ causing 50% loss of hydraulic conductivity), and safety margins for co-occurring trees from low and high elevations. We then investigated xylem vulnerability to cavitation with rooting depth. We found that xylem vulnerability to cavitation did not correspond to where tree species were found in the landscape. For example, P. ponderosa grew in more xeric locations, while P. engelmannii were largely confined to more mesic locations, yet P. engelmannii had more negative P50 values. P. menziesii had the lowest P50 value, but displayed little variation in vulnerability to cavitation across the hydroclimatic gradient. These patterns were also reflected in the safety margins; P. menziesii had the widest safety margin, P. engelmannii was intermediate, and P. ponderosa displayed the narrowest safety margin. All three species were also using water sources deeper than 30 cm in depth, allowing them to persist throughout the mid-summer drought. Overall, species-specific hydraulic traits did not necessarily follow a predictable response to the environment; instead, a combination of physiological and morphological traits likely allow trees to persist across a broader hydroclimatic gradient than would be otherwise expected from hydraulic trait measurements alone.

Why do children punish? Fair outcomes matter more than intent in children's second- and third-party punishment.

Humans punish fairness violations both as victims and as impartial third parties, which can maintain cooperative behavior. However, it is unknown whether similar motivations underlie punishment of unfairness in these two contexts. Here we approached this question by focusing on how both types of punishment develop in children, asking the question: What motivates young children to punish in response to fairness norm violations? We explored two potential factors: the direct experience of unfair outcomes and a partner's fair versus unfair intentions. The participants, 5- and 7-year-olds, were given the chance to engage in both second- and third-party punishment in response to either intended or unintended fairness norm violations in a single paradigm. In both age-groups, children were more likely to punish when they were directly affected by the allocation (second-party punishment) than when they were an uninvolved third party (third-party punishment). Reliable third-party punishment was shown only in the older age-group. Moreover, children's punishment was driven by outcome rather than intent, with equal rates of punishment when unequal outcomes were either the result of chance or the intentional act of another child. These findings suggest that younger children may be mainly motivated to create equal outcomes between themselves and others, whereas older children are motivated to enforce fairness norms as a general principle.

Increased drought severity tracks warming in the United States' largest river basin.

Across the Upper Missouri River Basin, the recent drought of 2000 to 2010, known as the "turn-of-the-century drought," was likely more severe than any in the instrumental record including the Dust Bowl drought. However, until now, adequate proxy records needed to better understand this event with regard to long-term variability have been lacking. Here we examine 1,200 y of streamflow from a network of 17 new tree-ring-based reconstructions for gages across the upper Missouri basin and an independent reconstruction of warm-season regional temperature in order to place the recent drought in a long-term climate context. We find that temperature has increasingly influenced the severity of drought events by decreasing runoff efficiency in the basin since the late 20th century (1980s) onward. The occurrence of extreme heat, higher evapotranspiration, and associated low-flow conditions across the basin has increased substantially over the 20th and 21st centuries, and recent warming aligns with increasing drought severities that rival or exceed any estimated over the last 12 centuries. Future warming is anticipated to cause increasingly severe droughts by enhancing water deficits that could prove challenging for water management.

Estimates of Prenatal HIV, Hepatitis B Virus, and Hepatitis C Virus Testing Among Pregnant People Enrolled in Wisconsin Medicaid, 2011-2015.

BACKGROUND: The opioid epidemic and rising rates of injection drug use are increasing the risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections among pregnant people. According to national clinical guidelines, pregnant people should be universally tested for HIV and HBV, and risk-based tested for HCV. The aim of this study was to determine the proportion and characteristics of prenatal HIV, HBV, and HCV testing and diagnosis among pregnant people with Wisconsin Medicaid coverage between 2011 and 2015. METHODS: Wisconsin birth certificates and Medicaid enrollment data were used to identify the sample. Standard billing and diagnosis codes were used to assess study variables. Data for each pregnancy were analyzed to describe the proportion of pregnancies that had evidence of testing, diagnoses, and yearly trends. RESULTS: Of the 78,917 pregnancies, prenatal testing estimates were 67% for HIV, 73% for HBV, and 6% for HCV. The estimated rate of infections during the study period was 1.82 for HIV, 2.09 for HBV, and 3.52 for HCV per 1000 pregnancies. Compared to the other race/ethnicity groups, pregnant people who were Black were most likely to be tested for HIV (78%) and HBV (80%), and pregnant people who were White were most likely to be tested for HCV (7%). CONCLUSIONS: Clinical testing guidelines have not been effectively translated to practice. Additionally, compared to HIV and HBV, HCV infections during pregnancy are becoming more prevalent, yet current national HCV screening guidelines are the least comprehensive.

When do we punish people who don't?

People often punish norm violations. In what cases is such punishment viewed as normative-a behavior that we "should" or even "must" engage in? We approach this question by asking when people who fail to punish a norm violator are, themselves, punished. (For instance, a boss who fails to punish transgressive employees might, herself, be fired.) We conducted experiments exploring the contexts in which higher-order punishment occurs, using both incentivized economic games and hypothetical vignettes describing everyday situations. We presented participants with cases in which an individual fails to punish a transgressor, either as a victim (second party) or as an observer (third party). Across studies, we consistently observed higher-order punishment of non-punishing observers. Higher-order punishment of non-punishing victims, however, was consistently weaker, and sometimes non-existent. These results demonstrate the selective application of higher-order punishment, provide a new perspective on the psychological mechanisms that support it, and provide some clues regarding its function.

Risks of hydroclimatic regime shifts across the western United States.

Paleohydrologic reconstructions of water-year streamflow for 105 sites across the western United States (West) were used to compute the likelihood (risk) of regime (wet/dry state) shifts given the length of time in a specific regime and for a specified time in the future. The spatial variability of risks was examined and indicates that regime shift risks are variable across the West. The Pacific-Northwest region is associated with low risks of regime shifts, indicating persistence controlled by prevalent low frequency variability in flow (periods above 64 years). Other areas in the West indicate higher risks compared to the Pacific-Northwest due to flow variability in the mid-to-high frequencies (periods of 32 to 16 years). Understanding risks of regime shifts provides critical information for improved management of water supplies, particularly during periods of extended low flows. The method presented here has global applicability as a decision-making framework for risk-based planning and management.