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Birth weight and early growth have been associated with later blood pressure. However, not all studies consistently find a significant reduction in blood pressure with an increase in birth weight. In addition, the relative importance of birth weight and of other lifestyle and environmental factors is often overlooked and the association is rarely studied in adolescents. We investigated early life predictors, including birth weight, of adolescent blood pressure in the Gateshead Millennium Study (GMS). The GMS is a cohort of 1029 individuals born in 1999–2000 in Gateshead in Northern England. Throughout infancy and early childhood, detailed information were collected, including birth weight and measures of height and weight. Assessments of 491 returning participants at age 12 years included measures of body mass and blood pressure. Linear regression and path analysis were used to determine predictors and their relative importance on blood pressure. Birth weight was not directly associated with blood pressure at the age of 12. However, after adjustment for contemporaneous body mass index (BMI), an inverse association of standardized birth weight on systolic blood pressure was significant. The relative importance of birth weight on later systolic blood pressure was smaller than other contemporaneous body measures (height and BMI). There was no independent association of birth weight on blood pressure seen in this adolescent population. Contemporaneous body measures have an important role to play. Lifestyle factors that influence body mass or size, such as diet and physical activity, where interventions are directed at early prevention of hypertension should be targeted.
The aim of this retrospective review was to assess the overall burden and trend in spinal tuberculosis (TB) at tertiary hospitals in the Western Cape Province of South Africa. All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical records of each case assessed. Cases were subsequently classified as bacteriologically confirmed or clinically diagnosed and reported with accompanying clinical and demographic information. Odds ratios (OR) for severe spinal disease and corrective surgery in child vs. adult cases were calculated. A total of 393 cases were identified (319 adults, 74 children), of which 283 (72%) were bacteriologically confirmed. Adult cases decreased year-on-year (P = 0.04), however there was no clear trend in child cases. Kyphosis was present in 60/74 (81%) children and 243/315 (77%) adults with available imaging. Corrective spinal surgery was performed in 35/74 (47%) children and 80/319 (25%) adults (OR 2.7, 95% confidence interval 1.6–4.5, P = 0.0003). These findings suggest that Western Cape tertiary hospitals have experienced a substantial burden of spinal TB cases in recent years with a high proportion of severe presentation, particularly among children. Spinal TB remains a public health concern with increased vigilance required for earlier diagnosis, especially of child cases.
Background: The natural history of small unruptured intracranial aneurysms (UIAs) <7mm is 0 to 1.3% per year. Our centre provides cerebrovascular care for the entire province allowing for long-term follow-up. We studied the safety of observation for aneurysms <7mm. Methods: We performed a retrospective chart review of patients with intracranial aneurysm referred to our centre between July 2008 and April 2015. Aneurysm characteristics and current status (followed, treated, not followed), were collected along with patient factors. Follow-up duration for each aneurysm was used to calculate total follow-up in aneurysm-years. Statistical evaluation consisted of multivariate analysis and logistic regression analysis. Results: 428 patients harbouring 497 aneurysms <7mm were identified. 67 presented with rupture. Of the remaining 430 aneurysms, there was a 9.3% treatment rate. 2 cases of rupture occurred in those patients who were followed, creating a 0.5% rupture rate. 325 aneurysms were followed for 631.3 total cumulative aneurysm-years, an average of 1.9 aneurysm-years. Smoking status and hypertension associated with presence of aneurysm (p≈0.009,0.026, respectively). Conclusions: In our selected patient group there is a low yearly rate of aneurysm rupture, and observation of aneurysms <7mm is safe. Hypertension and smoking were associated with the development of aneurysm. 9.3% of patients were treated, likely leading to a reduced natural history risk.
Good education requires student experiences that deliver lessons about practice as well as theory and that encourage students to work for the public good—especially in the operation of democratic institutions (Dewey 1923; Dewy 1938). We report on an evaluation of the pedagogical value of a research project involving 23 colleges and universities across the country. Faculty trained and supervised students who observed polling places in the 2016 General Election. Our findings indicate that this was a valuable learning experience in both the short and long terms. Students found their experiences to be valuable and reported learning generally and specifically related to course material. Postelection, they also felt more knowledgeable about election science topics, voting behavior, and research methods. Students reported interest in participating in similar research in the future, would recommend other students to do so, and expressed interest in more learning and research about the topics central to their experience. Our results suggest that participants appreciated the importance of elections and their study. Collectively, the participating students are engaged and efficacious—essential qualities of citizens in a democracy.
The physiological demands of weight-pulling dogs have yet to be investigated. Two groups of competitive weight-pulling dogs both underwent two identical pull series 3 h apart. The control group (n 8) was compared with a group fed a rapidly digestible carbohydrate and protein supplement after the first pull series (n 9). Blood was drawn before and after each pull series as well as at 15 and 30 min after the first pull series finished. Biochemistry values remained unremarkable throughout the study in both groups regardless of supplementation or exercise over time. Lactic acid showed mild significant increases post-exercise (2·1 (sd 1·2) mmol/l) compared with baseline (1·4 (sd 0·3) mmol/l; P = 0·03) after the initial pull series. When examining the effects of time there was a significant increase in insulin from baseline (median of 10·8 (range 6·8–17·4) μIU/ml) compared with 30 min after supplementation (17·0 (range 8·1–33·0) μIU/ml) and at 3 h after supplementation (19·2 (range 9·7–53·4) μIU/ml). In the treatment group there was also a time effect, with glucagon being elevated from baseline (median of 100 (range 79–115) pg/ml) compared with 30 min after supplementation (114 (range 90–183) pg/ml) and after the second pull series (131 (range 107–152) pg/ml). Evaluation of each dog's ability to pull the same or greater amount of weight on the second pull series revealed no significant differences. In conclusion, weight-pulling dogs have mild elevations in lactate reflecting little anaerobic metabolism compared with other canine sprinting athletes; hormonal changes associated with carbohydrate absorption are reflected within the treatment group, and supplementation had no effect on performance.
The current project seeks to integrate literatures on personality risk for antisocial behavior (ASB) by examining how callous–unemotional traits relate to (a) the development of disinhibited traits and (b) the association between disinhibited traits and ASB. In Study 1, using a nationally representative sample of youth (N > 7,000), we examined whether conduct problems and lack of guilt assessed during ages 4–10 years predicted levels of and changes in disinhibited traits over the course of adolescence, and moderated associations between these traits and ASB. High levels of childhood conduct problems were associated with higher levels of impulsivity, sensation seeking, and ASB in early adolescence, whereas lack of guilt was associated with lower levels of sensation seeking. Neither conduct problems nor lack of guilt significantly predicted changes in impulsivity or sensation seeking, and associations among changes in sensation seeking, impulsivity, and ASB were also consistent across levels of conduct problems and lack of guilt. In Study 2, using a cross-sectional sample of adolescents (N = 970), we tested whether callous–unemotional traits moderated associations between disinhibited traits and ASB. Consistent with the results of Study 1, associations between disinhibited personality and ASB were consistent across a continuous range of callous–unemotional traits.
Cortisol is the primary output of the hypothalamic–pituitary–adrenal (HPA) axis and is central to the biological stress response, with wide-ranging effects on psychiatric health. Despite well-studied biological pathways of glucocorticoid function, little attention has been paid to the role of genetic variation. Conventional salivary, urinary and serum measures are strongly influenced by diurnal variation and transient reactivity. Recently developed technology can be used to measure cortisol accumulation over several months in hair, thus indexing chronic HPA function.
In a socio-economically diverse sample of 1070 twins/multiples (ages 7.80–19.47 years) from the Texas Twin Project, we estimated effects of sex, age and socio-economic status (SES) on hair concentrations of cortisol and its inactive metabolite, cortisone, along with their interactions with genetic and environmental factors. This is the first genetic study of hair neuroendocrine concentrations and the largest twin study of neuroendocrine concentrations in any tissue type.
Glucocorticoid concentrations increased with age for females, but not males. Genetic factors accounted for approximately half of the variation in cortisol and cortisone. Shared environmental effects dissipated over adolescence. Higher SES was related to shallower increases in cortisol with age. SES was unrelated to cortisone, and did not significantly moderate genetic effects on either cortisol or cortisone.
Genetic factors account for sizable proportions of glucocorticoid variation across the entire age range examined, whereas shared environmental influences are modest, and only apparent at earlier ages. Chronic glucocorticoid output appears to be more consistently related to biological sex, age and genotype than to experiential factors that cluster within nuclear families.
After a little more than forty years of work related to the interplanetary plasma and the heliosphere the IAU's Commission 49 was formally discontinued in 2015. The commission started its work when the first spacecraft were launched to measure the solar wind in–situ away from Earth orbit, both inward and outward from 1 AU. It now hands over its activities to a new commission during an era of space research when Voyager 1 measures in–situ the parameters of the local interstellar medium at the edge of the heliosphere. The commission will be succeeded by C.E3 with a similar area of responsibility but with more focused specific tasks that the community intends to address during the coming several years. This report includes a short description of the motivation for this commission and of the historical context. It then describes work from 2012 to 2015 during the present solar cycle 24 that has been the weakest in the space era so far. It gave rise to a large number of studies on solar energetic particles and cosmic rays. Other studies addressed e.g. the variation of the solar wind structure and energetic particle fluxes on long time scales, the detection of dust in the solar wind and the Voyager measurements at the edge of the heliosphere. The research is based on measurements from spacecraft that are at present operational and motivated by the upcoming Solar Probe + and Solar Orbiter missions to explore the vicinity of the Sun. We also report here the progress on new and planned radio instruments and their importance for heliospheric studies. Contributors to this report are Carine Briand, Yoichiro Hanaoka, Eduard Kontar, David Lario, Ingrid Mann, John D. Richardson.
Proteins are the workhorses of the cell (Figure 4.1): They provide structural support in the cytoskeleton, facilitate communication with other cells by acting as receptors, neutralize foreign pathogens, generate contraction forces in muscle, and most ubiquitously catalyze chemical reactions. Proteins are abundant in biological systems, such as eggs (Figure 4.2). Proteins are one of the major macronutrients in the human diet (Figure 4.3).
Some recombinant proteins now serve as therapeutic drugs for treatment or prevention of disease. Biomedical engineers also use recombinant proteins, such as growth factors, to promote growth and differentiation of cells in engineered tissues. Some biomedical engineers have been using techniques of protein engineering to design new biomaterials for use in tissue engineering, drug-delivery systems, or other medical applications. Biomedical engineers working in the area of systems biology are developing models for the function of signaling networks in cells: these signaling networks are interconnected sets of biochemical reactions, which happen inside cells and which are controlled largely by intracellular proteins.
This chapter describes the structure and function of proteins and also includes a brief introduction to some of the techniques used to determine protein structure, chiefly nuclear magnetic resonance (NMR) and x-ray crystallography. Researchers in the pharmaceutical industry use these protein structures in structure-guided drug design. Chemicals that interfere with protein function have long been used as drugs, but traditionally these chemical-protein interactions have been discovered empirically (or by accident). Now, chemical agents can be designed rationally, based on a detailed knowledge of the protein's structure, to interact with enzymes or receptors and enhance or inhibit their function. Because the structure of a protein determines its function, and because chemicals that interact with specific structural units within proteins can be useful as drugs, biomedical engineers and computer scientists are developing computer programs that will help predict the three-dimensional structure of a protein based on its primary amino acid sequence.
Resilience is the capacity of individuals to resist mental disorders despite exposure to stress. Little is known about its neural underpinnings. The putative variation of white-matter microstructure with resilience in adolescence, a critical period for brain maturation and onset of high-prevalence mental disorders, has not been assessed by diffusion tensor imaging (DTI). Lower fractional anisotropy (FA) though, has been reported in the corpus callosum (CC), the brain's largest white-matter structure, in psychiatric and stress-related conditions. We hypothesized that higher FA in the CC would characterize stress-resilient adolescents.
Three groups of adolescents recruited from the community were compared: resilient with low risk of mental disorder despite high exposure to lifetime stress (n = 55), at-risk of mental disorder exposed to the same level of stress (n = 68), and controls (n = 123). Personality was assessed by the NEO-Five Factor Inventory (NEO-FFI). Voxelwise statistics of DTI values in CC were obtained using tract-based spatial statistics. Regional projections were identified by probabilistic tractography.
Higher FA values were detected in the anterior CC of resilient compared to both non-resilient and control adolescents. FA values varied according to resilience capacity. Seed regional changes in anterior CC projected onto anterior cingulate and frontal cortex. Neuroticism and three other NEO-FFI factor scores differentiated non-resilient participants from the other two groups.
High FA was detected in resilient adolescents in an anterior CC region projecting to frontal areas subserving cognitive resources. Psychiatric risk was associated with personality characteristics. Resilience in adolescence may be related to white-matter microstructure.
Our previous work identified deficits in interference processing and learning/memory in past suicide attempters who were currently depressed and medication-free. In this study, we extend this work to an independent sample studied at various stages of illness and treatment (mild symptoms, on average) to determine if these deficits in past suicide attempters are evident during a less severe clinical state.
A total of 80 individuals with a past history of major depression and suicide attempt were compared with 81 individuals with a history of major depression and no lifetime suicide attempts on a battery of neurocognitive measures assessing attention, memory, abstract/contingent learning, working memory, language fluency and impulse control.
Past attempters performed more poorly in attention, memory and working memory domains, but also in an estimate of pre-morbid intelligence. After correction for this estimate, tests that had previously distinguished past attempters – a computerized Stroop task and the Buschke Selective Reminding Test – remained significantly worse in attempters. In a secondary analysis, similar differences were found among those with the lowest levels of depression (Hamilton Depression Rating Scale score <10), suggesting that these deficits may be trait markers independent of current symptomatology.
Deficits in interference processing and learning/memory constitute an enduring defect in information processing that may contribute to poor adaptation, other higher-order cognitive impairments and risk for suicidal behavior.
It has been suggested that in addition to genetic factors, fetal and post-natal growth influence cognition in early adulthood. However, most studies have been in developed populations, so it is unclear if the same findings would be seen in other, less developed, settings, and have used testing tools not applicable to an Australia Aboriginal population. This study investigated the relationships between cognitive function in early adulthood and birth weight and contemporary height. Simple reaction time (SRT), choice reaction time (CRT) and working memory (WM) were assessed using the CogState battery. A significant association was seen between birth weight and SRT in early adulthood, but not with the other two cognitive measures. Urban dwellers had significantly shorter SRT and CRT than their remote counterparts. Contemporary body mass index and maternal age were associated with CRT. Only fetal growth restriction was associated with WM, with greater WM in those with restricted growth. No associations were seen with contemporary height. These results suggest that fetal growth may be more important than the factors influencing post-natal growth in terms of cognition in early adulthood in this population, but that the associations may be inconsistent between cognitive outcomes. Further research is required to identify whether similar associations are seen in other, similar, populations and to assess why differences in cognitive outcome measures are seen.