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To determine the association between in-vivo spectroscopy metabolite data, the local connectome, and markers of initial injury severity (I.e., history of loss of consciousness; LoC) in traumatic brain injury (TBI), in a heterogenous sample of Veterans and non-Veterans with a history of remote mild-to-moderate TBI (I.e., >6 months).
Participants and Methods:
Participants with complete PRESS magnetic resonance spectroscopy (MRS) and diffusion weighted imaging (DWI) data (N = 41) were sampled from a larger multisite study of chronic mild-to-moderate TBI (Nmiid = 38; Nmoderate = 3; 54% with LoC; 46% with multiple TBI). The sample was predominantly male (76%) with ages ranging from 23-59 (M = 36.9, SD = 10.1), with 98% holding at least a high school degree (M = 14.5 years of education, SD = 2.4). Fully tissue-and-relaxation-corrected metabolite concentration estimates in the dorsal anterior cingulate (30x30x30mm voxel) were modeled using Osprey 2.4.0. Total creatine (tCr), total choline (tCho), total N-acetylaspartate (tNAA), glutamate/glutamine (Glx), and myo-inositol (mI) were analyzed. Logistic regression was used to measure the association between metabolites and history of TBI with LoC. Correlational connectometry using the normalized spin distribution function was performed for metabolites associated with LoC, to characterize the local connectome associated with metabolites of interest, controlling for age and sex, and correcting for multiple comparisons (FDR < .050 with 4000 permutations). A profile approach was used to interpret diffusion metrics, contrasting quantitative anisotropy (QA) with fractional anisotropy (FA). Local connectome tracks were then clustered to identify the larger white matter tract.
Results:
Glx (p = .008) and tCr (p = .032) were significantly associated with history of TBI with LoC. Increased Glx was associated with increased QA in 11,001 tracks, accounting for 1.4% of the total white matter tracks in the brain. 90% of tracks were identified in bilateral cingulum (33%), bilateral thalamic (13%), bilateral corticospinal (13%), corpus callosum (12%), left arcuate fasciculus (9%), left frontoparietal aslant tracts (6%), and bilateral inferior fronto-occipital fasciculus (4%) tracts. In contrast, FA was not associated with Glx. The same pattern emerged for tCr, with 10,542 tracks identified predominantly in bilateral cingulum (29%), corpus callosum (21%), bilateral corticospinal (15%), bilateral corticostriatal (7%), bilateral medial lemniscus (7%), left cortico-pontine (3%), left thalamic (2%), and bilateral superior longitudinal fasciculus (2%) tracts. Post-hoc exploratory analyses of mean QA across regions of cingulum found that increased QA was associated with self-report measures of headache intensity, fatigue, and perceived change in executive functioning.
Conclusions:
Results provided evidence that multimodal imaging can identify subtle markers of initial TBI severity years after injury. Neurometabolite concentrations were associated with diffuse changes in the local connectome; the pattern of discrepancy between FA and QA was suggestive of reduced potential for neuroplasticity. Exploratory analyses further indicated that variability in white matter density in the cingulum, an important connection for limbic regions, was associated with a range of problems commonly reported in clinical settings, which may be informative for diagnosis and treatment planning.
Field studies were conducted at three locations to evaluate glyphosate-resistant (GR) cotton response, weed control, and cotton lint yields to two formulations of glyphosate (diammonium salt– glyphosate and isopropylamine salt–glyphosate) and trifloxysulfuron applied early postemergence (EPOST) alone or to tank mixtures of trifloxysulfuron with each glyphosate formulation, with and without a late postemergence-directed (LAYBY) treatment of prometryn plus MSMA. Trifloxysulfuron and both formulations of glyphosate controlled common lambsquarters and pitted morningglory. Both glyphosate formulations provided equivalent control of common lambsquarters, goosegrass, pitted morningglory, prickly sida, and smooth pigweed. Trifloxysulfuron controlled smooth pigweed better than either glyphosate formulation but did not control goosegrass or prickly sida. Prometryn plus MSMA LAYBY improved late-season control of common lambsquarters, goosegrass, large crabgrass, and pitted morningglory for all EPOST systems and improved late-season smooth pigweed control for EPOST systems that did not include trifloxysulfuron. Cotton injury was 2% or less from both glyphosate formulations, while trifloxysulfuron injured ‘Deltapine 5415RR’ 7 to 16% at two locations. At a third location, trifloxysulfuron injured ‘Paymaster 1218RR/BG’ 24%, and when applied in mixture with either glyphosate formulation, injury increased to at least 72%. Cotton injury was transient at the first two locations and was not visually apparent 3 to 5 wk later. Cotton yield at the third location was reduced. High cotton yields reflected high levels of weed control.
The antiquarian and topographer John Britton (1771–1857) is best remembered for his multi-volume series of The Beauties of England and Wales. A self-taught author and scholar, he was attracted by the work of John Aubrey (1626–97), who was born in the same Wiltshire village as him, and had very similar interests as an antiquarian and biographer, famous for his Brief Lives and for his surveys of and writings on Avebury and Stonehenge. Britton's research on Aubrey's life induced him to write a fresh account, using surviving manuscripts as well as printed sources, which would clear up the contradictions and errors of earlier versions. This 1845 book is a fascinating portrait of a sickly child who ended up a pauper because of family debts and lawsuits, but was a diligent and intelligent scholar, scientist and occultist, and a close friend of Thomas Hobbes and Robert Hooke.
The goal of this brief review is to address the role of the ageing gut in the genesis of malnutrition in the elderly. We assess the burden of malnutrition in the elderly, exploring the role of comorbid conditions and neurohumoral changes that take place to contribute towards the process of anorexia associated with ageing. Following this, the review assesses physiological changes that occur in each part of the gastrointestinal (GI) tract and what implication they may have in clinical practice. In the oropharynx and the oesophagus, changes in swallowing and oesophageal motility associated with ageing can be demonstrated using physiological testing. However, in the absence of comorbid disease, they often have little, if any, clinical significance. In the stomach, reduced fundal compliance may contribute to early satiety; however, the primary change is hypochlorhydria, which may predispose to malabsorption or bacterial overgrowth further along the GI tract. Almost uniquely, the small bowel, particularly its absorptive function, is unaffected by age and we review the literature demonstrating this. In the colon, there is evidence of a prolonged transit time related to a reduction in both neurotransmitters and receptors. Although this may cause symptoms, this aspect is unlikely to contribute to malnutrition. In addition, we assess the potential changes in the gut microbiome and how this may interact with the immune system in the process of ‘inflamm-ageing’. We conclude by summarising the main changes and their impact for the clinician along with recommendations for future areas of research.
Despite considerable international activity in tobacco control, including shaping the Framework Convention on Tobacco Control (FCTC), comprehensive national legislation has been a struggle to achieve in Ghana. Accordingly, the most recent tobacco control efforts in Ghana, including the African Tobacco Situation Analysis (ATSA) initiative, have focused on advocating for national comprehensive legislation. Unfortunately, the legislation has been stalled for more than fi ve years. It is not clear how much support there is for the legislation in either the new cabinet or the national legislature. High-level changes in the health ministry have complicated these efforts, so the advocacy community has been once again regrouping to assess the potential for high-level support. In the interim, the tobacco control community has identifi ed other goals that may be more feasible in the short term. With comparatively low prevalence rates (approximately 5 percent) and a public generally compliant with informal tobacco control norms – particularly smoke-free public places of various sorts (e.g. hospitals, educational institutions, public transport, etc.) – a formalization of existing rules and regulations with an emphasis on enforcement could be sought concurrent to the pursuit of the broader legislation.
The Research and Development Division (RDD, formerly the Health Research Unit of the Ghana Health Service (GHS)) has been the principal leader of the ATSA team. While this unit is well-poised to conduct health research (it has strong ties to the Universities of Ghana and Nottingham) and public education, it has limitations, as an offi cial government entity, in advocating effectively for policy change.
Smoking is closely linked to severe mental illness and has a major detrimental impact on individuals' lives. Despite this and the recent societal ‘de-normalisation’ of smoking, the historic ‘smoking culture’ still prevails within mental health settings. Change is urgently required to prevent a widening of existing health gaps.
This volume brings together extensive recollections of authors, publishers, auctioneers and booksellers from 1779 to 1853, based on the author's personal acquaintance with the prominent writers, artists and book publishers of the period. The book is in three sections, each one concentrating on a given area of London and the literary scene centred upon it. They are Paternoster Row, Fleet Street and The Strand. Attention is paid to different forms of publication, such as the early magazines, in which books were published by instalments, and to key personalities. There is also detailed background to some of the most important publishing houses, such as Longman, and works which were considered pivotal to their success, such as 'Rees' Cyclopaedia' and the 'Annual Review'. Engagingly written from a personal perspective, this book will be of value to historians of literature and publishing, and others interested in London's literary past.
Mental health units in England had to become smoke-free by law from July
2008. Concerns regarding the implementation and enforcement of smoke-free
policies in these settings have been raised.
Aims
To study difficulties and challenges associated with smoke-free policy
implementation in English National Health Service (NHS) mental health
settings.
Method
Questionnaire survey of all 72 English NHS trusts providing mental health
in-patient services and facilities, supplemented by semi-structured
telephone interviews at a systematic sample of 7 trusts and site visits
at a convenience sample of 5 trusts.
Results
Questionnaires were returned by 79% of the trusts, all of whom had
implemented smoke-free policies. Most respondents (91%) believed that
mental health settings faced particular challenges, arising from the high
smoking prevalence among patients (81%), related safety risks (70%),
adverse effects on the clinician–patient relationship (36%), and
potential interactions with antipsychotic medication (34%). Interviews
indicated that sustained policy enforcement was perceived as difficult,
but that despite challenges and concerns, the impact of the policy was
regarded as beneficial, with some evidence of positive behavioural
changes occurring in people.
Conclusions
Many mental health trusts across England have implemented comprehensive
smoke-free policies but the majority state that they are facing specific
difficulties. Challenges and concerns need to be explored in depth and
addressed to ensure that smoke-free policies implemented under the terms
of the Health Act in July 2008 are not undermined.
The British dominated the world's submarine cable business over the second half of the nineteenth century, but they encountered significant challenges in the 1880s and 1890s—especially from James Scrymser, an upstart entrepreneur from New York. Scrymser exploited a strategic gap in the cable system in the Western Hemisphere and became locked in a confrontation along the west coast of South America with John Pender, the leading British cable magnate. Scrymser gained the upper hand in Chile by outmaneuvering Pender and used this victory to expand his operations with the telegraph network that linked South America, North America, and Europe.
There are few validated methods of measuring dietary fatty acid intake that are suitable for epidemiological research. The purpose of the present study was to develop and validate a food-frequency questionnaire (FFQ) developed to measure individual dietary fatty acid intakes against 7d weighed dietary records, in a sample of thirty-one healthy adult volunteers. The FFQ was based on a previously validated questionnaire (DIETQ; Tinuviel Software, Warrington, Ches., UK), adapted to include greater detail on those foods from which the majority of dietary fatty acids are obtained. The FFQ and weighed records were analysed using food nutrient data from McCance and Widdowson's Food Composition Tables, supplemented with a food fatty acid content database (Foodbase, London, UK). Results from the two dietary assessment methods were compared by correlation coefficients and limits of agreement. The mean intake of individual fatty acids tended to be lower when assessed by FFQ. Correlation coefficients comparing unadjusted individual fatty acid intakes assessed by FFQ and weighed records ranged from 0·29 for 18:1n−9 to 0·71 for 20:4n−6. Adjusting for energy intake tended to increase the correlation coefficients between saturated fatty acids and decrease those between unsaturated fatty acids. In conclusion, this food-frequency method provides reliable estimates of dietary intake of many individual fatty acids for use in epidemiological studies.
The aim of Working Group 5 is to develop and coordinate education and support networks for individuals and organizations undertaking or using assessment of health interventions and to identify needs in the field and assist in the establishment of new provisions.
While feed-forward mechanisms may be ubiquitous in biological systems that form the substrates of Pavlovian conditioning, the control system proposed by Domjan, Cusato & Villarreal seems too elaborate for Pavlovian conditioning of simple skeletal muscle responses. We discuss here how the known neural substrates of classical eyeblink conditioning can be described in feed-forward terms, but argue that the monitor/comparator part of the system is not necessary and perhaps could even be detrimental to simple, nonsocial forms of Pavlovian conditioning.
This paper investigates all aspects of the orthography of the Ormulum in relation to the phonology of the late twelfth-century south Lincolnshire dialect which Orm's spelling system was designed to reflect. We show that Orm's adaptations of what he found in existing orthographic systems provided a set of graphic symbols that was fully capable of representing phonological contrasts in the vocabulary of the dialect and which thus in many respects resembled the inventory that an analysis on phonemic principles might provide. However, Orm's system has more orthographic symbols than an analysis of distinctive oppositions in speech would have required. All of these additions are in some measure attributable to following precedent. In this aspect of his spelling system, as in his innovations, nearly all of which also have parallels within the English orthographic tradition, we discern a spelling reformer who, in due consideration of transparency of the system as perceived by the reader, took pains to depart as little as possible from the familiar.