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de Souza N, Esopenko C, Jia Y, Parrott JS, Merkley T, Dennis E, Hillary F, Velez C, Cooper D, Kennedy J, Lewis J, York G, Menefee D, McCauley S, Bowles AO, Wilde E, Tate DF. Discriminating Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Using Latent Neuroimaging and Neuropsychological Profiles in Active-Duty Military Service Members. J Head Trauma Rehabil 2023; 38:E254-E266. [PMID: 36602276 PMCID: PMC10264548 DOI: 10.1097/htr.0000000000000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly occur among military Service Members and Veterans and have heterogenous, but also overlapping symptom presentations, which often complicate the diagnoses of underlying impairments and development of effective treatment plans. Thus, we sought to examine whether the combination of whole brain gray matter (GM) and white matter (WM) structural measures with neuropsychological performance can aid in the classification of military personnel with mTBI and PTSD. METHODS Active-Duty US Service Members ( n = 156; 87.8% male) with a history of mTBI, PTSD, combined mTBI+PTSD, or orthopedic injury completed a neuropsychological battery and T1- and diffusion-weighted structural neuroimaging. Cortical, subcortical, ventricular, and WM volumes and whole brain fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated. Latent profile analyses were performed to determine how the GM and WM indicators, together with neuropsychological indicators, classified individuals. RESULTS For both GM and WM, respectively, a 4-profile model was the best fit. The GM model identified greater ventricular volumes in Service Members with cognitive symptoms, including those with a diagnosis of mTBI, either alone or with PTSD. The WM model identified reduced FA and elevated RD in those with psychological symptoms, including those with PTSD or mTBI and comorbid PTSD. However, contrary to expectation, a global neural signature unique to those with comorbid mTBI and PTSD was not identified. CONCLUSIONS The findings demonstrate that neuropsychological performance alone is more robust in differentiating Active-Duty Service Members with mTBI and PTSD, whereas global neuroimaging measures do not reliably differentiate between these groups.
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Affiliation(s)
- N.L. de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - C. Esopenko
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - Y. Jia
- Department of Interdisciplinary Studies, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - J. S. Parrott
- Department of Interdisciplinary Studies, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - T.L. Merkley
- Department of Psychology & Neuroscience Center, Brigham Young University, Provo, UT, USA
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - E.L. Dennis
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
| | - F.G. Hillary
- Department of Psychology, Pennsylvania State University, University Park, PA 16802, United States
- Social Life and Engineering Sciences Imaging Center, University Park, PA 16802, United States
| | - C. Velez
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - D.B. Cooper
- San Antonio VA Polytrauma Rehabilitation Center, San Antonio, TX
- Departments of Rehabilitation Medicine and Psychiatry, UT Health San Antonio, TX
| | - J. Kennedy
- General Dynamics Information Technology (GDIT) contractor for the Traumatic Brain Injury Center of Excellence (TBICoE), Neurology Service, Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX, USA
| | - J. Lewis
- Neurology Clinic, Wright Patterson Air Force Base, Wright Patterson AFB, Ohio
| | - G. York
- Alaska Radiology Associates, Anchorage, AK
| | - D.S. Menefee
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
| | - S.R. McCauley
- Department of Neurology, Baylor College of Medicine, Houston, TX USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
| | - A. O. Bowles
- Brain Injury Rehabilitation Service, Department of Rehabilitation Medicine, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX, US
| | - E.A. Wilde
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX USA
| | - D. F. Tate
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
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Kerr K, Valladares A, Kilgore K, Sulo S, McCauley S, Partridge J. Improving Nutrition Care Processes and 30-day Readmissions Through Malnutrition Quality Improvement Initiatives. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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McCauley S, Mezynski J, Mcaleese J. Oligometastases in extensive disease-small cell lung cancer. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30180-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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McCauley S, O'Connell B, Lyons C, Evans R. EP-1309 Are OAR dose constraints for radical 3DCRT breast plans achievable? A one-year retrospective review. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31729-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Naing A, Infante J, Wong D, Korn W, Aljumaily R, Papadopoulos K, Autio K, Pant S, Bauer T, Drakaki A, Daver N, Hung A, Verma R, Ratti N, McCauley S, Van Vlasselaer P, Tannir M, Oft M. Overall responses and survival in RCC on pegilodecakin with anti-PD-1. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Khan M, McCauley S, Pratt K, Whitmire M, Blancato R. ADVANCING PATIENT-CENTERED MALNUTRITION CARE TRANSITIONS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Khan
- Academy of Nutrition and Dietetics
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Ratti N, Shifrin N, McCauley S, Verma R, Van Vlasselaer P, Oft M, Leveque J. Combination of pegilodecakin and docetaxel shows synergy in tumor rejection in immune resistant TNBC model. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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McCauley S, Tumelty K, Eakin R, Harney J, Young L, McAleese J, Hanna G. EP-1398: Isolated Nodal Failure rates following curative intent radiotherapy in a modern cohort. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31707-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McCauley S, Tumelty K, Hanna G, Eakin R, Harney J, Johnston R, McAleese J. Rate of marginal relapse following curative intent radiotherapy in a modern cohort. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30181-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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McCauley S, Khan M. Learning Collaborative 2.0: Achieving Optimal Malnutrition Care. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Buelsing D, Khan M, McCauley S. Evaluating the Standards of Excellence Metric Tool. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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McCauley S, McCloskey P, Lyons C, Brown K, Rooney K, Houghton F. Should all oropharyngeal squamous cell carcinomas be stratified by HPV p16 status? Clin Oncol (R Coll Radiol) 2017. [DOI: 10.1016/j.clon.2017.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McCauley S, McCloskey P, Lyons C, Brown K, Rooney K, Houghton F. PO-105: Is there justification for age bias in HPV p16 testing for Oropharyngeal Squamous Cell Carcinoma? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30239-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Khan M, McCauley S. Advancing the Academy’s Quality Initiatives. J Acad Nutr Diet 2016. [DOI: 10.1016/j.jand.2016.06.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Khan M, McCauley S. Building The Academy’s Quality Initiatives. J Acad Nutr Diet 2015. [DOI: 10.1016/j.jand.2015.06.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Price J, Kent S, Antine S, Cox S, Klein C, McCauley S, Byrne C. Standards of Excellence in Nutrition and Dietetics for Organizations. J Acad Nutr Diet 2013. [DOI: 10.1016/j.jand.2013.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Moretti P, McCauley S, Wilde E, Levin H, Clifton G. Predictive Validity and Sensitivity to Change of the Neurological Outcome Scale for Traumatic Brain Injury (S49.002). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s49.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Soury S, Mazaux JM, Lambert J, De Seze M, Joseph PA, Lozes-Boudillon S, McCauley S, Vanier M, Levin HS. [The neurobehavioral rating scale-revised: assessment of concurrent validity]. ACTA ACUST UNITED AC 2005; 48:61-70. [PMID: 15748770 DOI: 10.1016/j.annrmp.2004.08.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2004] [Accepted: 08/26/2004] [Indexed: 11/29/2022]
Abstract
UNLABELLED Cognitive and behavioral impairment are a major source of disability in daily living of patients with traumatic brain injury (TBI). The Neurobehavioral Rating Scale-Revised (NRS-R) is a short, easy-to administer interview tool developed to improve assessment by clinicians. Data are available on its criterion validity and reliability, but the concurrent validity of the French NRS-R was not yet documented. OBJECTIVE To assess the concurrent validity of the NRS-R with current psychometric tests. METHOD One hundred and four patients with TBI enrolled in a community adjustment program underwent concurrent examination with the NRS-R, cognitive tests assessing memory, attention, and executive functions, and scales of anxiety (STAI) and depressive mood (CES-D). Intercorrelations were undertaken between these variables and the five factors of the NRS-R: F1, intentional behavior; F2, lowered emotional state; F3, survival-oriented behaviour/hightened emotional state; F4, arousal state; and F5, language. Patients were 82 men and 22 women, the mean age was 28.5 years, and 70% had severe TBI (Glasgow coma score [GCS] below 8 on admission). They were assessed 52 months on average after their injury. RESULTS Factor F1 was correlated with results on the GCS (P<0.05), the Tower of London test (TL, P<0.01), the Trail Making Test (TMT, P<0.01), divided attention (DA) and inhibition (IN) subscales of the Zimmermann and Fimm's Attention battery (TEA) (P<0.01) and reverse digit span (DS, P<0.05). Factor F2 was positively related to age at injury, time since injury (TSI) (P<0.05) and CESD and STAI scores (P<0.001). Factor F3 was related to DA (P<0.01) TL scores and TSI (P<0.05). Factor F4 was related to TL, TMT, DA, flexibility, DS (P<0.05), TSI, duration of post-traumatic amnesia, CES-D score (P<0.05) and STAI scores (P<0.01). Factor F5 was related to GCS, DA (P<0.05), and reaction time on the subscales IN and Go/nogo (GO) of the TEA battery (P<0.01). The NRS-R total score was related to CESD, STAI scores, TMT score, DA (P<0.01) and TL score, IN and GO scores and TSI (P<0.05). DISCUSSION As McCauley et al found with the English version of the NRS-R, significant relationships were found between NRS-R factor scores, cognitive tests and emotional scales. Relationships were also found between factor scores and indicators of injury severity and time since injury. These data suggest fair concurrent validity of the NRS-R.
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Affiliation(s)
- S Soury
- Unité UEROS, service MP réadaptation, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France
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Lo Y, Mardirossian G, Cicchetti G, McCauley S, Fisher G, FitzGerald T. Dose coverage evaluation and comparison between 2D and 3D planning for patients with breast cancer. Int J Radiat Oncol Biol Phys 2002. [DOI: 10.1016/s0360-3016(02)03470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR, Muizelaar JP, Wagner FC, Marion DW, Luerssen TG, Chesnut RM, Schwartz M. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 2001; 344:556-63. [PMID: 11207351 DOI: 10.1056/nejm200102223440803] [Citation(s) in RCA: 857] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Induction of hypothermia in patients with brain injury was shown to improve outcomes in small clinical studies, but the results were not definitive. To study this issue, we conducted a multicenter trial comparing the effects of hypothermia with those of normothermia in patients with acute brain injury. METHODS The study subjects were 392 patients 16 to 65 years of age with coma after sustaining closed head injuries who were randomly assigned to be treated with hypothermia (body temperature, 33 degrees C), which was initiated within 6 hours after injury and maintained for 48 hours by means of surface cooling, or normothermia. All patients otherwise received standard treatment. The primary outcome measure was functional status six months after the injury. RESULTS The mean age of the patients and the type and severity of injury in the two treatment groups were similar. The mean (+/-SD) time from injury to randomization was 4.3+/-1.1 hours in the hypothermia group and 4.1+/-1.2 hours in the normothermia group, and the mean time from injury to the achievement of the target temperature of 33 degrees C in the hypothermia group was 8.4+/-3.0 hours. The outcome was poor (defined as severe disability, a vegetative state, or death) in 57 percent of the patients in both groups. Mortality was 28 percent in the hypothermia group and 27 percent in the normothermia group (P=0.79). The patients in the hypothermia group had more hospital days with complications than the patients in the normothermia group. Fewer patients in the hypothermia group had high intracranial pressure than in the normothermia group. CONCLUSIONS Treatment with hypothermia, with the body temperature reaching 33 degrees C within eight hours after injury, is not effective in improving outcomes in patients with severe brain injury.
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Affiliation(s)
- G L Clifton
- Vivian L Smith Center for Neurologic Research, Department of Neurosurgery, University of Texas-Houston Medical School, 77030, USA.
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Kalin RM, Hamilton JT, Harper DB, Miller LG, Lamb C, Kennedy JT, Downey A, McCauley S, Goldstein AH. Continuous flow stable isotope methods for study of delta(13)C fractionation during halomethane production and degradation. Rapid Commun Mass Spectrom 2001; 15:357-363. [PMID: 11241767 DOI: 10.1002/rcm.219] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Gas chromatography/mass spectrometry/isotope ratio mass spectrometry (GC/MS/IRMS) methods for delta(13)C measurement of the halomethanes CH(3)Cl, CH(3)Br, CH(3)I and methanethiol (CH(3)SH) during studies of their biological production, biological degradation, and abiotic reactions are presented. Optimisation of gas chromatographic parameters allowed the identification and quantification of CO(2), O(2), CH(3)Cl, CH(3)Br, CH(3)I and CH(3)SH from a single sample, and also the concurrent measurement of delta(13)C for each of the halomethanes and methanethiol. Precision of delta(13)C measurements for halomethane standards decreased (+/-0.3, +/-0.5 and +/-1.3 per thousand) with increasing mass (CH(3)Cl, CH(3)Br, CH(3)I, respectively). Given that carbon isotope effects during biological production, biological degradation and some chemical (abiotic) reactions can be as much as 100 per thousand, stable isotope analysis offers a precise method to study the global sources and sinks of these halogenated compounds that are of considerable importance to our understanding of stratospheric ozone destruction.
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Affiliation(s)
- R M Kalin
- Environmental Engineering Research Centre, School of Civil Engineering, The Queen's University of Belfast, Belfast BT9 5AG, UK.
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Abstract
Quartz grains that appear to have been shock-metamorphosed occur within three closely spaced shale beds from the uppermost Triassic ("Rhaetian") Calcare a Rhaetavicula in the Northern Apennines of Italy. The upper shale coincides with the abrupt termination of the distinctive, uppermost Triassic Rhaetavicula fauna and is overlain by the Hettangian (Lower Jurassic) Calcare Massiccio; no extinctions appear to be associated with the two lower layers, which occur 1.2 and 2.4 meters below the boundary shale. Approximately 5 to 10% of the quartz grains within these layers exhibit one or more sets of planar deformational features whose orientations cluster around the rational crystallographic planes (basal, omega, and pi) most commonly observed in shocked quartz. Textural and stratigraphic observations support an interpretation of at least three closely spaced impacts at the end of the Triassic.
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McCauley S. Part-time nursing service in small industry. Am Assoc Ind Nurses J 1967; 15:7-12. [PMID: 6031094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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