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Objectives: Craniopharyngioma survivors experience cognitive deficits that negatively impact quality of life. Aerobic fitness is associated with cognitive benefits in typically developing children and physical exercise promotes recovery following brain injury. Accordingly, we investigated cognitive and neural correlates of aerobic fitness in a sample of craniopharyngioma patients. Methods: Patients treated for craniopharyngioma [N=104, 10.0±4.6 years, 48% male] participated in fitness, cognitive and fMRI (n=51) assessments following surgery but before proton radiation therapy. Results: Patients demonstrated impaired aerobic fitness [peak oxygen uptake (PKVO2)=23.9±7.1, 41% impaired (i.e., 1.5 SD<normative mean)], motor proficiency [Bruininks-Oseretsky (BOT2)=38.6±9.0, 28% impaired], and executive functions (e.g., WISC-IV Working Memory Index (WMI)=96.0±15.3, 11% impaired). PKVO2 correlated with better executive functions (e.g., WISC-IV WMI r=.27, p=.02) and academic performance (WJ-III Calculation r=.24, p=.04). BOT2 correlated with better attention (e.g., CPT-II omissions r=.26, p=.04) and executive functions (e.g., WISC-IV WMI r=.32, p=.01). Areas of robust neural activation during an n-back task included superior parietal lobule, dorsolateral prefrontal cortex, and middle and superior frontal gyri (p<.05, corrected). Higher network activation was associated with better working memory task performance and better BOT2 (p<.001). Conclusions: Before adjuvant therapy, children with craniopharyngioma demonstrate significantly reduced aerobic fitness, motor proficiency, and working memory. Better aerobic fitness and motor proficiency are associated with better attention and executive functions, as well as greater activation of a well-established working memory network. These findings may help explain differential risk/resiliency with respect to acute cognitive changes that may portend cognitive late effects. (JINS, 2019, 25, 413–425)
Introduction: Overuse of acute care services, particularly emergency department (ED) use, is an important topic for healthcare providers and policy makers within Canada and abroad. Prior work has shown that frail elderly patients with complex medical needs and limited personal and social resources are heavy users of ED services and are often admitted when they present to the ED. Updated information on the most effective strategies to avert ED presentation and hospital admission focused specifically on elderly patients is needed. Methods: This systematic review addressed the question: what interventions have demonstrated effectiveness in decreasing ED use and hospital admissions in elderly patients? Comprehensive literature searches were conducted in databases including Ovid Medline, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials with no language or date restrictions. Citations were limited to interventional studies. Grey literature and reference list searches, as well as communication with experts in the field were performed. Consensus or a third reviewer resolved any disagreements. Original research regarding interventions conducted in populations 65 years or older with acute illness, either living in community or facility-living were included. Primary outcomes were ED visits and hospital admissions. Secondary outcomes included: mortality, cost, and patient-reported outcomes such as health-related quality of life and functional status. Results: Forty-three relevant studies were identified including 22 randomized controlled trials (RCT), 2 cluster-RCT, 2 trials with non-random allocation, 4 before-after studies, 6 quasi-experimental studies, and 7 cohort studies. Intervention settings included: home visits (22), long-term care (7), outpatient or primary care clinics (8), and ED (3) or inpatient (3). Data characterization revealed that home-based, outpatient and/or primary care-based strategies reduced ED visits and hospitalizations, particularly those which included comprehensive geriatric assessments, home visits or regular face-to-face contact and interdisciplinary teams. Hospital-based models generally showed no difference in ED or inpatient service utilization. There was, however, considerable variability across individual studies with respect to reporting of outcomes, statistical analyses performed, and overall risk of bias. Conclusion: Various interventional strategies have been studied to avert ED presentation and hospital admission for frail elderly patients. More rigorous methodology and standardization of outcome measures is needed to quantitatively assess the effects of these programs.
I review the data-driven approach to spectroscopy, The Cannon, which is a method for deriving fundamental diagnostics of galaxy formation of precise chemical compositions and stellar ages, across many stellar surveys that are mapping the Milky Way. With The Cannon, the abundances and stellar parameters from the multitude of stellar surveys can be placed directly on the same scale, using stars in common between the surveys. Furthermore, the information that resides in the data can be fully extracted, this has resulted in higher precision stellar parameters and abundances being delivered from spectroscopic data and has opened up new avenues in galactic archeology, for example, in the determination of ages for red giant stars across the Galactic disk. Coupled with Gaia distances, proper motions, and derived orbit families, the stellar age and individual abundance information delivered at the precision obtained with the data-driven approach provides very strong constraints on the evolution of and birthplace of stars in the Milky Way. I will review the role of data-driven spectroscopy as we enter the era where we have both the data and the tools to build the ultimate conglomerate of galactic information as well as highlight further applications of data-driven models in the coming decade.
Recent increases in mechanisation, larger dairy units and financial pressure on dairy farmers result in a reduction in labour and time available to spend with stock. Cattle are innately fearful of humans and this fear has been found to have a substantial impact on their productivity. This survey compliments experimental work conducted at Newcastle University on approach behaviour (see companion paper). The objective was to gather information from dairy farmers on commercial heifer rearing systems; establish the different levels of human interaction and familiarity with stockpersons, explore on-farm indicators of fear and solicit farmers’ views on the subject.
Recent increases in mechanisation, a trend towards larger dairy units and current financial pressure on dairy farmers all combine to result in a reduction in labour and therefore time available to spend with the animals. increasing numbers of stock per attendant allowing them less time and opportunity to spend with their animals. If we view the reduction in human-animal interaction in routine husbandry tasks as positive because it frees up more quality time to spend with the stock; how will this best be spent to enhance the animal-worker bond, is it feasible in a practical situation and can we back this ideal up with monetary values and benefits to the different interested parties of the industry? This survey was designed to compliment some experimental work being carried out at Newcastle University (see companion paper). The objective was to gather information from dairy farmers on the heifer rearing systems currently in use; establish the different levels of human interaction the heifer experiences during rearing in commercial practice and explore whether this relates to other indices of welfare and production.
Dietary intake of PUFA has been associated with colorectal neoplasm risk; however, results from observational studies have been inconsistent. Most prior studies have utilised self-reported dietary measures to assess fatty acid exposure which might be more susceptible to measurement error and biases compared with biomarkers. The purpose of this study was to determine whether erythrocyte phospholipid membrane PUFA percentages are associated with colorectal adenoma risk. We included data from 904 adenoma cases and 835 polyp-free controls who participated in the Tennessee Colorectal Polyp Study, a large colonoscopy-based case–control study. Erythrocyte membrane PUFA percentages were measured using GC. Conditional logistic regression was used to calculate adjusted OR for risk of colorectal adenomas with erythrocyte membrane PUFA. Higher erythrocyte membrane percentages of arachidonic acid was associated with an increased risk of colorectal adenomas (adjusted OR 1·66; 95 % CI 1·05, 2·62, Ptrend=0·02) comparing the highest tertile to the lowest tertile. The effect size for arachidonic acid was more pronounced when restricting the analysis to advanced adenomas only. Higher erythrocyte membrane EPA percentages were associated with a trend towards a reduced risk of advanced colorectal adenomas (Ptrend=0·05). Erythrocyte membrane arachidonic acid percentages are associated with an increased risk of colorectal adenomas.
Starvation arouses evolved protective mechanisms including binge eating and increased metabolic efficiency and fat storage. When aroused by dieting, the experiences of out-of-control eating, increased appetite, and increased fat storage arouse greater fears of obesity, spurring renewed attempts to restrict intake severely. The resulting positive feedback cycle escalates into bulimia for many, and anorexia in a few.
The Galactic bulge of the Milky Way is made up of stars with a broad range of metallicity, –3.0 < [Fe/H] < 1 dex. The mean of the metallicity distribution function decreases as a function of height z from the plane and, more weakly, with galactic radius RGC. The most metal-rich stars in the inner Galaxy are concentrated to the plane and the more metal-poor stars are found predominantly further from the plane, with an overall vertical gradient in the mean of the metallicity distribution function of about − 0.45 dex kpc−1. This vertical gradient is believed to reflect the changing contribution with height of different populations in the innermost region of the Galaxy. The more metal-rich stars of the bulge are part of the boxy/peanut structure and comprise stars in orbits which trace out the underlying X-shape. There is still a lack of consensus on the origin of the metal-poor stars ([Fe/H] < −0.5) in the region of the bulge. Some studies attribute the more metal-poor stars of the bulge to the thick disk and stellar halo that are present in the inner region, and other studies propose that the metal-poor stars are a distinct ‘old spheroid’ bulge population. Understanding the origin of the populations that make up the metallicity distribution function of the bulge, and identifying if there is a unique bulge population which has formed separately from the disk and halo, has important consequences for identifying the relevant processes in the formation and evolution of the Milky Way.
Cultural group selection helps explain human cooperation, but social selection offers a complementary, more powerful explanation. Just as sexual selection shapes extreme traits that increase matings, social selection shapes extreme traits that make individuals preferred social partners. Self-interested partner choices create strong and possibly runaway selection for prosocial traits, without requiring group selection, kin selection, or reciprocity.
The relation of solar active regions to the large-scale sector structure of the interplanetary field is discussed. In the winter of 1963–64 (observed by the satellite IMP-1) the plage density was greatest in the leading portion of the sectors and lesser in the trailing portion of the sectors. The boundaries of the sectors (places at which the direction of the interplanetary magnetic field changed from toward the Sun to away from the Sun, or vice versa) were remarkably free of plages. The very fact that since the first observations in 1962 the average interplanetary field has almost always had the property of being either toward the Sun or away from the Sun (along the Archimedean spiral angle) continuously for several days must be considered in the discussion of large-scale evolution of active regions. Using the observed interplanetary magnetic field at 1 AU and a set of reasonable assumptions the magnetic configuration in the ecliptic from 0·4 AU to 1·2 AU has been reconstructed. In at least one case a pattern emerges which appears to be related to the evolution of an active region from an early stage in which the magnetic lines closely couple the preceding and following halves of the region to a later stage in which the two halves of the region are more widely separated.
We study the stellar content of three galactic bulges with the high resolution gratings (R=7000) of the WiFeS integral field unit in order to better understand their formation and evolution. In all cases we find that at least 50% of the stellar mass already existed 12 Gyrs ago, more than currently predicted by simulations. A younger component (age between ∼1 to ∼8 Gyrs) is also prominent and its present day distribution seems to be much more affected by morphological structures, especially bars, than the older one. This in-depth analysis supports the notion of increasing complexity in bulges which cannot be achieved by mergers alone, but requires a non-negligible contribution from secular evolution.
For diagnostic purposes, the nine symptoms that compose the DSM-5 criteria for major depressive disorder (MDD) are assumed to be interchangeable indicators of one underlying disorder, implying that they should all have similar risk factors. The present study investigates this hypothesis, using a population cohort that shifts from low to elevated depression levels.
We assessed the nine DSM-5 MDD criterion symptoms (using the Patient Health Questionnaire; PHQ-9) and seven depression risk factors (personal and family MDD history, sex, childhood stress, neuroticism, work hours, and stressful life events) in a longitudinal study of medical interns prior to and throughout internship (n = 1289). We tested whether risk factors varied across symptoms, and whether a latent disease model could account for heterogeneity between symptoms.
All MDD symptoms increased significantly during residency training. Four risk factors predicted increases in unique subsets of PHQ-9 symptoms over time (depression history, childhood stress, sex, and stressful life events), whereas neuroticism and work hours predicted increases in all symptoms, albeit to varying magnitudes. MDD family history did not predict increases in any symptom. The strong heterogeneity of associations persisted after controlling for a latent depression factor.
The influence of risk factors varies substantially across DSM depression criterion symptoms. As symptoms are etiologically heterogeneous, considering individual symptoms in addition to depression diagnosis might offer important insights obfuscated by symptom sum scores.
Fulfilling the need for reproducible Quantum Dots (QDs) with certain spectroscopic features, high stability and luminescence we have established synthetic routes for the production of CdSe core as well as CdSe/shell particles in a continuous flow (cf) system. Our method features the deviation between nucleation and growth in two different parts of the system to mimic the well-known and often-used hot injection method for the synthesis of nanoparticles in organic solvents.
The 2009 celebrations of Darwin's birth and the publication of The Origin of Species were grand not only because his discoveries changed biology, but also because they are continuing to benefit society. Nowhere is this more evident than in medicine and public health. You might think that Darwin's discoveries would have been fully applied long ago, but a deep fracture in the intellectual landscape has prevented medicine from making full use of evolutionary biology. This is changing fast. Scientists are now recognising that diseases need evolutionary explanations as well as explanations based only on the body's mechanisms.
The field that tries to understand why natural selection has left the body vulnerable to diseases is called Darwinian medicine. Also called evolutionary medicine, it applies every aspect of evolutionary biology to every problem in medicine and public health. It has grown quickly since 1991 (Williams and Nesse, 1991). Major edited volumes have illustrated the opportunity in areas from infectious disease epidemiology to genetics, anatomy and physiology. The most significant ones are already in second editions (Stearns and Koella, 2007; Trevathan et al., 2007). They are being widely read and studied except, it seems, by physicians. Most doctors never take a course in evolutionary biology before medical school, and evolution is not part of the usual medical curriculum.
To examine the associations between maternal education level and diet in 10-year-old children.
Three-day diet diaries (child completed with parental help) were collected. Height and weight were measured in research clinics. Maternal education level was derived from a questionnaire completed during pregnancy and classified into low, medium or high. One-way ANOVA was undertaken to compare maternal education groups for nutrient intakes and the Kruskal–Wallis test used for food consumption.
Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK.
Children (n 7474) who provided dietary data at age 10 years.
A large proportion (60 %) of the sample was classified as plausible reporters, with under-reporting accounting for 36 %. No clear differences were found for intakes of energy or macronutrients between maternal education groups for plausible reporters. However, there were marked differences in micronutrient intakes especially for vitamin C, retinol equivalents and folate, highlighting lower diet quality with lower maternal education level. Intakes of fruit and vegetables showed a positive gradient with increasing maternal education (57 % v. 79 % consumed fresh fruit in low and high educational groups, respectively). A trend towards higher intake in the lower educated group was shown for less healthy foods (meat pies P < 0·001; sausages, burgers and kebabs P < 0·001).
The quality of children's diet at 10 years was related to maternal education level. Lower maternal education was associated with less healthy food choices that could be detrimental to health. Further research is needed to establish if these associations can be explained by other socio-economic factors.
A series of boron carbide materials was hot pressed with 0-7% excess carbon. The strength of each material was determined by four point bending, and found to decrease from about 600MPa to 300MPa as the carbon content increased from 0% to 7%. Diamond indentation yielded hardness values that decreased from 28.3 to 25.OGPa and toughness values that increased from 3.5 to 4.5 MPa√mover the same carbon range. Each sample was fractured in situ in ultrahigh vacuum (UHV) and examined by scanning Auger microanalysis (SAM) and XPS to determine both the elemental and chemical state distributions. For the samples with excess carbon, localized carbonrich regions are observed on fracture surfaces by SAM. XPS reveals a 50% enhancement of excess carbon on the fracture surface compared to the bulk for the sample with 7% excess carbon. A correlation was observed between surface carbon composition and the bulk toughness and hardness. The C(ls) XPS spectra were utilized to determine the nature of carbon in B4C on freshly fractured and Ne+ bombarded surfaces. Two distinct peaks were observed in the C(ls) region. Low dose ion bombardment resulted in a single broad C(ls) peak at the midpoint of the two initial peaks. It can be inferred from this data that there are C-C-C intericosahedral linkages in B4C.
Previous research suggests that n-3 PUFA may play a role in bone health. The present analysis aimed to investigate the impact of n-3 PUFA supplementation on bone resorption in adult men and women. Serum samples from 113 mild–moderately depressed individuals (twenty-six males and eighty-seven females, aged 18–67 years) randomised to receive 1·48 g EPA+DHA/d (n 53) or placebo (n 60) for 12 weeks as part of a large recent randomised controlled trial were assayed for n-3 PUFA status and a bone resorption marker, C-terminal cross-linking telopeptide of type 1 collagen (β-CTX). Regression analyses revealed that n-3 PUFA status following supplementation was associated with randomisation (placebo/n-3 PUFA) (B = 3·25, 95 % CI 2·60, 3·91, P < 0·01). However, β-CTX status following supplementation was not associated with randomisation (B = − 0·01, 95 % CI − 0·03, 0·04). Change in β-CTX status was also not associated with change in n-3 PUFA status (B = − 0·002, 95 % CI − 0·01, 0·01). These findings provide no evidence for an association between n-3 PUFA supplementation (1·48 g EPA+DHA/d) for 12 weeks and bone resorption in humans assessed by β-CTX, and suggest that n-3 PUFA supplementation may be unlikely to be of benefit in preventing bone loss.