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Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites [Grushka 2002]. Vitamin B complex deficiencies have been associated with BMS, including B1 (thiamine) [Lamey 1988]. Replacement with thiamine and other B vitamins was noted to cause relief of BMS in 34 of 150 patients [Lamey 1988]. BMS secondary to vitamin deficiencies have been discussed; however, hemicolectomy and hyperalimentation associated thiamine deficiency inducing chronic BMS has not heretofore been described.
Case Study: A 63 year old female presents with a two year history of BMS pain, two weeks following a hemicolectomy from terminal ileum to transverse colon and five days of hyperalimentation. She describes it as a burning pain, 8/10 in severity, localized to both lips, anterior tongue, and middle tongue. It is aggravated with eating and drinking, increasing to 10/10 on the pain scale. Alleviation of pain is seen when ice, Blistex, or lidocaine-mouthwash is used, decreasing the pain to 4/10. Diurnal variation was noted, wherein the pain is exacerbated later in the evening.
Abnormalities in neurological examination: Motor Examination: abductor pollicis brevis 4/5 bilaterally. Drift testing with bilateral cerebellar spooning and bilateral abductor digiti minimi signs. Cerebellar Examination: rapid alternating movements are decreased in the left upper extremity. Reflex Examination: Deep Tendon Reflexes: Brachioradialis: 3+ bilaterally. Biceps: 3+ bilaterally. Triceps: 3+ bilaterally. Ankle Jerk: 2+ bilaterally with delayed return. Hoffman reflex: positive bilaterally. Serum Thiamine level: 66 nmol/L (normal 70-180 nmol/L).
Although, BMS can be seen with thiamine deficiency [Lamey 1988], it has yet to be described status-post hemicolectomy and hyperalimentation. Thiamine is absorbed systemically in the upper jejunum, as well as in duodenum and ileum in conjunction with folate [Friedamann 1948]. Thiamine deficiency is associated with Wernicke-Korsakoff Syndrome and Wet/Dry Beri-Beri; however, these abnormalities are associated with a significant decrease of serum vitamin B1 [Martin 2004]. Even with near normal levels of thiamine, her BMS pain may be a prodromal syndrome which may act as a biological marker of dietary vitamin deficiency.
BMS is highly prevalent in postmenopausal women, wherein trigeminal nerve sensitivity may amplify and worsen pain, given a decrease in estrogen and progesterone [Martin 2007], indirectly influencing her BMS pain. Salivary output and composition can alter due to a drop in estrogen and progesterone as well, allowing baseline reduction of proprioceptive input on the tongue. Ergo, acting through Melzack and Wall’s Gate Control Theory of Pain to disinhibit small C-fibers, it may be perceived as burning pain [Melzack 1965]. Given this case, in those who undergo abdominal surgery or hyperalimentation, query regarding BMS symptoms is warranted.
The cat flea, Ctenocephalides felis, is a major pest species on companion animals thus of significant importance to the animal health industry. The aim of this study was to develop sampling and storage protocols and identify stable reference genes for gene expression studies to fully utilize the growing body of molecular knowledge of C. felis. RNA integrity was assessed in adult and larvae samples, which were either pierced or not pierced and stored in RNAlater at ambient temperature. RNA quality was maintained best in pierced samples, with negligible degradation evident after 10 days. RNA quality from non-pierced samples was poor within 3 days. Ten candidate reference genes were evaluated for their stability across four group comparisons (developmental stages, genders, feeding statuses and insecticide-treatment statuses). Glyceraldehyde 3 phosphate dehydrogenase (GAPDH), 60S ribosomal protein L19 (RPL19) and elongation factor-1α (Ef) were ranked highly in all stability comparisons, thus are recommended as reference genes under similar conditions. Employing just two of these three stable reference genes was sufficient for accurate normalization. Our results make a significant contribution to the future of gene expression studies in C. felis, describing validated sample preparation procedures and reference genes for use in this common pest.
We have measured the relative radial velocity of Arcturus using the HF absorption cell technique on 43 occasions from 1981 through 1985. The range of our velocities is 500 m s-1, which is much larger than our estimated internal errors (typically 10 m s-1). This confirms the radial velocity variability of Arcturus that has been previously reported by our group and others based on shorter observational time spans.
Variation in human cognitive ability is of consequence to a large number of health and social outcomes and is substantially heritable. Genetic linkage, genome-wide association, and copy number variant studies have investigated the contribution of genetic variation to individual differences in normal cognitive ability, but little research has considered the role of rare genetic variants. Exome sequencing studies have already met with success in discovering novel trait-gene associations for other complex traits. Here, we use exome sequencing to investigate the effects of rare variants on general cognitive ability. Unrelated Scottish individuals were selected for high scores on a general component of intelligence (g). The frequency of rare genetic variants (in n = 146) was compared with those from Scottish controls (total n = 486) who scored in the lower to middle range of the g distribution or on a proxy measure of g. Biological pathway analysis highlighted enrichment of the mitochondrial inner membrane component and apical part of cell gene ontology terms. Global burden analysis showed a greater total number of rare variants carried by high g cases versus controls, which is inconsistent with a mutation load hypothesis whereby mutations negatively affect g. The general finding of greater non-synonymous (vs. synonymous) variant effects is in line with evolutionary hypotheses for g. Given that this first sequencing study of high g was small, promising results were found, suggesting that the study of rare variants in larger samples would be worthwhile.
Macroevolutionary and macroecological studies must account for biases in the fossil record, especially when questions concern the relative abundance and diversity of taxa that differ in preservation and sampling potential. Using Cenozoic marine mollusks from a temperate setting (New Zealand), we find that much of the long-term temporal variation in gastropod versus bivalve occurrences is correlated with the stage-level sampling probabilities of aragonitic versus calcitic taxa. Average sampling probabilities are higher for calcitic species, but this contrast is time-varying in a predictable way, being concentrated in stages with widespread carbonate deposition.
To understand these results fully, we link them with analyses at the level of individual point occurrences. Doing so reveals that aragonite bias is effectively absent in terrigenous clastic sediments. In limestones, by contrast, calcitic species have at least twice the odds of sampling as aragonitic species. This result is most pronounced during times of widespread carbonate deposition, where the difference in the per-collection odds of sampling species is a factor of eight. During carbonate-rich intervals, calcitic taxa also have higher odds of sampling in clastics. At first glance this result may suggest simple preservational bias against aragonite. However, comparing relative odds of aragonitic versus calcitic sampling with absolute sampling rates shows that the positive calcite bias during carbonate-rich times reflects higher than average occurrence rates for calcitic taxa (rather than lower rates for aragonitic taxa) and that the negative aragonite bias in limestones reflects lower than average occurrence rates for aragonitic taxa (rather than higher rates for calcitic taxa).
Our results therefore indicate a time-varying interplay of two main factors: (1) taphonomic loss of aragonitic species in carbonate sediments, with no substantial bias in terrigenous clastics; and (2) an ecological preference of calcitic taxa for environments characteristic of periods with pervasive carbonate deposition, irrespective of lithology per se.
In 2006, legislative changes were made to the Australian Family Law Act 1975. These changes included a revision of the matters that must be considered when determining children's best interests following parental separation, at Section 60CC. This section lists two ‘primary considerations’, which relate to the child's having a ‘meaningful relationship’ with both parents and ensuring that children are safe in their interactions with their parents and others in their lives. The first of the ‘Additional considerations’ under Section 60CC concerns ‘any views expressed by the child and any factors (such as the child's maturity or level of understanding) that the court thinks are relevant to the weight it should give to the child's views’. This consideration differs from that in the pre-2006 Act, which referred to a child's ‘wishes’ rather than her/his ‘views’. There is evidence, however, that those working in the family law system may not yet have made the shift towards understanding what these changes may entail.
In this article I explore the differences between the concepts of ‘wishes’ and ‘views’ as they relate to children in family law matters. I argue that these concepts are qualitatively different, and that children's ‘views’ are far more encompassing than their ‘wishes’. Moving to a far broader understanding of children and their ability to understand issues that directly affect their lives may lead to the development of more comprehensive decisions about their futures.
This article reports on a study of parents’ and children's responses to the service they received at two Family Relationship Centres (FRCs) in Perth, Western Australia. Family members who had attended either the Mandurah or Joondalup FRCs sponsored by AnglicareWA between 2010 and 2012 were invited to complete a survey that asked them for their views on the services they had received. A total of 74 parents, representing 139 children, completed the survey. Findings indicated significant satisfaction with the two-hour group session that introduces the work of the FRCs, with parents reporting they could remember the main messages from the session. A surprising finding, and one that has not been reported elsewhere, is that parents expressed an unwillingness to invite their own children to participate in the work of the Centres, although the majority of the respondents agreed in principle that children should take part. The implications of this finding are briefly discussed.
The aims of the present study were to determine compliance with current advice on vitamin D and to assess the influence of season, dietary intake, supplement use and deprivation on vitamin D status in pregnant mothers and newborns in the north of Scotland where sunlight exposure is low. Pregnant women (n 1205) and their singleton newborns were studied in the Aberdeen Maternity Hospital (latitude 57°N) between 2000 and 2006. Plasma 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3 were measured at 19 weeks of gestation in mothers and at delivery in newborns. During pregnancy, 21·0 (95 % CI 18·5, 23·5) % of women took vitamin D supplements. The median intake was 5 μg/d and only 0·6 (95 % CI 0·1, 1·0) % took the recommended 10 μg/d. Supplement use, adjusted for season, dietary intake and deprivation, significantly increased maternal 25-hydroxyvitamin D (25(OH)D) by 10·5 (95 % CI 5·7, 15·2) nmol/l (P< 0·001); however, there was no significant effect on cord 25(OH)D (1·4 (95 % CI − 1·8, 4·5) nmol/l). The biggest influence on both maternal and cord 25(OH)D was season of birth (P< 0·001). Compared with the least deprived women (top three deciles), the most deprived pregnancies (bottom three deciles) were characterised by a significantly lower seasonally adjusted 25(OH)D ( − 11·6 (95 % CI − 7·5, − 15·7) nmol/l in the mother and − 5·8 (95 % CI − 2·3, − 9·4) nmol/l in the cord), and a lower level of supplement use (10 (95 % CI 4, 17) v. 23 (95 % CI 20, 26) %). More should be done to promote vitamin D supplement use in pregnancy but the critical importance of endogenous vitamin D synthesis, and known adaptations of fat metabolism specific to pregnancy, suggest that safe sun advice may be a useful additional strategy, even at high latitude.
In view of the challenge posed by climate change and the need to reduce dependence on fossil fuels, The Royal Society of Edinburgh Inquiry (2011) examined the barriers making it difficult for Scotland to change to a low-carbon society. The single most important finding is that, whilst widely desired, change is held back by the lack of coherence and integration of policy at different levels of governance. There is activity at the level of the EU, UK Government, Scottish Government, local authorities, local communities, households and civil society, but there is often a disconnection between policies at different levels. This impedes progress and also leads to mistrust among the general public. This paper brings together the background to ten primary recommendations featured in the Inquiry addressing the principal barriers. Above all, it is important to integrate the activities within city regions and to exploit opportunities in local communities. Reflecting on the Inquiry findings, we stress the economic, social and environmental opportunities to be gained from a low-carbon society and outline the step changes that need to take place within governance, city regions and local authorities and civil society.
Land use and the management of our natural resources such as soils and water offer great opportunities to sequester carbon and mitigate the effects of climate change. Actions on forestry, soil carbon and damaged peatlands each have the potential to reduce Scottish emissions in 2020 by hundreds of thousands of tonnes. Most actions to reduce emissions from land use have beneficial effects on other ecosystem services, so if we can cut emissions we can in many circumstances improve the environment. The cost of reducing emissions through land use change can be low in relation to other means of cutting emissions. The Scottish Land Use Strategy and the Ecosystem Approach it calls for, employing the concept of ecosystem services, offers a way of balancing environmental, social and economic demands on the land. Scotland's land, soils, forests and waters are all likely to be significantly altered by future climate change. Each of these components of the land-based environment offers opportunities for mitigation and adaptation to climate change. The emerging new imperatives for securing food, water and energy at a global level are equally important for Scotland, and interact with the need for environmental security and for dealing with climate change.
Coherent anti-Stokes Raman spectroscopy (CARS) is a powerful analysis approach for nonintrusive temperature and species measurements in hostile environments. Widely utilized in combustion, it may be able to significantly impact materials processing research. CARS is described and its applications to combustion and plasma process environments are reviewed and contrasted.
PACVD techniques for depositing protective coatings are an emerging field in plasma processing technology. Technology transfer is limited by a lack of understanding of the basic mechanisms involved in the gas phase plasma chemistry. The aspects of plasma species concentration and distribution and plasma gas temperature are fragmentary and unclear. Laser diagnostic techniques represent a critical starting point for providing some of this needed information. The techniques are in-situ, nonintrusive, and give excellent spatial and temporal resolution. Numerous diagnostic techniques for detailed coating characterization are available, but a correlation of the PACVD parameters with some of the key coating properties is required. Thus, a predictive capability that is lacking in the present science base can be established together with important phenomenological aspects needed for efficient deposition of high quality protective coatings. As the mechanisms become better understood, use of remote sensors and A.I may then be introduced. This paper will review selected diagnostic techniques available for characterizing these nonequilibrium reactive plasmas and the coatings.
Background: Consensus recommends early recognition of memory problems through multi-disciplinary assessment in memory clinics; however, little is known about the experiences of people accessing such services. The aim of this review was to synthesis empirical evidence on patient and carer experiences in the transition to dementia.
Methods: This review updates an earlier review (Bamford et al., 2004) on the topic of disclosure of the diagnosis of dementia. Key electronic databases were searched including OVID Medline, CINAHL, Web of Science, EMBASE, and Sociological Abstracts; this was supplemented by hand searching of reference lists and contact with experts in the field. Only papers published after 2003 were included.
Results: Of the 35 papers included in the review, only one study observed the process of disclosure and only two papers explored the effects on the person with dementia's health. The vast majority of people with dementia wished to know their diagnosis. The key challenges for the person with dementia were coming to terms with losses on multiple levels. Although there may be short-term distress, the majority of people with dementia do not appear to experience long-term negative effects on their psychological health. For family carers, becoming the main decision-maker and adjusting to increased responsibility were common concerns.
Conclusions: There is still little empirical research observing the process of diagnostic disclosure in dementia. Studies exploring the views of patients and their families suggest this should be an ongoing process with the provision of support and information tailored to individual needs. The term “Alzheimer's disease” appears to have more negative connotations than the word “dementia”.
Titanium nitride (TiN) is a candidate material for hard and wear resistant coatings on metallic substrates such as titanium (Ti), stainless steel and aluminum. Coating processes include chemical vapor deposition, ion implantation, plasma and thermal nitriding under vacuum and controlled environments. The motivation for the present research is to develop a laser plasma process for high rate formation of TiN coatings on Ti substrates at near-atmospheric pressures. Laser induced plasma generated by a pulsed CO2 laser was used to excite a Ti substrate. The species in the vapor plume were characterized by optical emission spectroscopy. Spatially and temporally resolved spectral characterization was performed as a function of laser power, position of the substrate relative to the focal plane, pulse parameters, and shielding gases. These experiments are a first step in understanding laser assisted plasma deposition of nitride/oxy-nitride coatings on titanium metal under atmospheric conditions. Results indicate a window of optimal process parameters for developing titanium nitride coatings.