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Lithium has been used in the successful treatment of bipolar disorders since the 1950's. Advancements in neuroscience show that it has neuroprotective properties suggesting a possible efficacy in stroke, Alzheimer's and dementia. There is also evidence showing lithium protection of neurologic injury by changing GSK-3 inhibition in animals.
The Lithium Archives Project research design is a retrospective, random paper based chart review of patients with mood disorders. The charts are examined for over 100 variables including demographic, symptom, mood, biochemical, neurologic, and medical items. The current sample of over 700 charts was analyzed by a skilled statistician using standard SPSS statistical software. Mean, standard deviation and significance of cerebrovascular disease, myocardial infarction, brain tumors, stroke, seizures, and eye diseases of patients treated with lithium and patients treated without lithium were compared and analyzed. Multivariate analysis was performed to analyze group (lithium/no lithium) and incidence of disease. The means of disease incidence in the lithium versus non-lithium groups were then charted.
The Multivariate Analysis of Variance of the current data shows that group is a significant variable in the incidence of diseases analyzed (Pillai's Trace F = 2.926, df = 11,416, p=.004). The patients treated with lithium show less incidence of cerebrovascular disease (p=.053), myocardial infarction (p=.012), seizures (p=.091), eye diseases (p=.011), stroke (p=.014) and brain tumors (p=.072).
The current analysis is very promising and indicates that in this patient population, lithium may have played a role in protection from these diseases.
The aim of this project was to investigate the cognitive abnormalities in healthy individuals (No Axis I or II disorders) at risk for bipolar disorder (BD) and schizophrenia (SZ)
Materials and Methods:
Participants were 17 BD-R and 15 SZ-R and 23 controls. All participants underwent assessment of IQ, inhibition, verbal fluency, planning and cognitive set shifting. Lack of lifetime Axis I and II disorders was screened using Structured Clinical Interview for DSM-IV and symptomatology was assessed with the Brief Psychiatric Rating Scale (BPRS).
No difference was found in IQ. Loss of inhibition was found in both SZ-R and BD-R compared to controls whereas SZ-R had slower initiation times. SZ-R also failed to inhibit relatively fast erroneous responses, leading to an effect on error rates but not in reaction times. SZ-R and BD-R produced fewer words compared to controls whereas the former group made more errors. BD-R achieved both comparable number of categories to controls and made equal number of errors whereas SZ-R underperformed compared to former groups in both measures. Effect of BPRS total score was found only for BD-R across all measures apart from inhibition.
Genetic predisposition to SZ may be mediated by deficits in both the Ventral and Dorsal Prefrontal Cortex (VPFC) and (DPFC). In BD-R impairment was limited in the VPFC whereas the DPFC function was preserved. The two disorders share inhibition deficits associated with the VPFC.
Whilst cannabis use appears to be a causal risk factor for the development of schizophrenia-related psychosis, associations with mania remain relatively unknown.
This review aimed to examine the impact of cannabis use on the incidence of manic symptoms and on their occurrence in those with pre-existing bipolar disorder
A systematic review of the scientific literature using the PRISMA guidelines. PsychINFO, Cochrane, Scopus, Embase and MEDLINE databases were searched for prospective studies.
Six articles met inclusion criteria. These sampled 2,391 individuals who had experienced mania symptoms. The mean length of follow up was 3.9 years. Studies support an association between cannabis use and the exacerbation of manic symptoms in those with previously diagnosed bipolar disorder. Furthermore, a meta-analysis of two studies suggests that cannabis use is associated with an approximately 3-fold (Odds Ratio: 2.97; 95% CI: 1.80 to 4.90) increased risk for the new onset of manic symptoms.
Our findings whilst tentative, suggest that cannabis use may worsen the occurrence of manic symptoms in those diagnosed with bipolar disorder and may also act as a causal risk factor in the incidence of manic symptoms. This underscores the importance of discouraging cannabis use among youth and those with bipolar disorder to help prevent chronic psychiatric morbidity. More high quality prospective studies are required to fully elucidate how cannabis use may contribute to the development of mania over time.
The Asian elephant Elephas maximus is at risk of extinction as a result of anthropogenic pressures, and remaining populations are often small and fragmented remnants, occupying a fraction of the species' former range. Once widely distributed across China, only a maximum of 245 elephants are estimated to survive across seven small populations. We assessed the Asian elephant population in Nangunhe National Nature Reserve in Lincang Prefecture, China, using camera traps during May–July 2017, to estimate the population size and structure of this genetically important population. Although detection probability was low (0.31), we estimated a total population size of c. 20 individuals, and an effective density of 0.39 elephants per km2. Social structure indicated a strong sex ratio bias towards females, with only one adult male detected within the population. Most of the elephants associated as one herd but three adult females remained separate from the herd throughout the trapping period. These results highlight the fragility of remnant elephant populations such as Nangunhe and we suggest options such as a managed metapopulation approach for their continued survival in China and more widely.
Surgery for CHD has been slow to develop in parts of the former Soviet Union. The impact of an 8-year surgical assistance programme between an emerging centre and a multi-disciplinary international team that comprised healthcare professionals from developed cardiac programmes is analysed and presented.
Material and methods
The international paediatric assistance programme included five main components – intermittent clinical visits to the site annually, medical education, biomedical engineering support, nurse empowerment, and team-based practice development. Data were analysed from visiting teams and local databases before and since commencement of assistance in 2007 (era A: 2000–2007; era B: 2008–2015). The following variables were compared between periods: annual case volume, operative mortality, case complexity based on Risk Adjustment for Congenital Heart Surgery (RACHS-1), and RACHS-adjusted standardised mortality ratio.
A total of 154 RACHS-classifiable operations were performed during era A, with a mean annual case volume by local surgeons of 19.3 at 95% confidence interval 14.3–24.2, with an operative mortality of 4.6% and a standardised mortality ratio of 2.1. In era B, surgical volume increased to a mean of 103.1 annual cases (95% confidence interval 69.1–137.2, p<0.0001). There was a non-significant (p=0.84) increase in operative mortality (5.7%), but a decrease in standardised mortality ratio (1.2) owing to an increase in case complexity. In era B, the proportion of local surgeon-led surgeries during visits from the international team increased from 0% (0/27) in 2008 to 98% (58/59) in the final year of analysis.
The model of assistance described in this report led to improved adjusted mortality, increased case volume, complexity, and independent operating skills.
In product design engineering (PDE), ideation involves the generation of technical behaviours and physical structures to address specific functional requirements. This differs from generic creative ideation tasks, which emphasise functional and technical considerations less. To advance knowledge about the neural basis of PDE ideation, we present the first fMRI study on professional product design engineers practising in industry. We aimed to explore brain activation during ideation, and compare activation in open-ended and constrained tasks. Imagery manipulation tasks were contrasted with ideation tasks in a sample of 29 PDE professionals. The key findings were: (1) PDE ideation is associated with greater activity in left cingulate gyrus; (2) there were no significant differences between open-ended and constrained tasks; and (3) a preliminary association with activity in the right superior temporal gyrus was also observed. The results are consistent with existing fMRI work on generic creative ideation, suggesting that PDE ideation may share a number of similarities at the neural level. Future work includes: functional connectivity analysis of open-ended and constrained ideation to further investigate potential differences; investigating the effects of aspects of design expertise/training on processing; and the use of novelty measures directly linked to the designer’s internal processing in fMRI analysis.
We demonstrate a suspended graphene-(poly(methyl methacrylate) (PMMA) polymer angular displacement actuator enabled by variable elastic modulus of the perforated stacked structure. Azimuthal flexures support a central disc-shaped membrane, and compression of the membrane can be used to control the rotation of the entire structure. Irradiating the PMMA on graphene stack with 5 kV electrons in a convention scanning electron microscope reduces the elastic modulus of the PMMA and allows graphene’s built in strain to dominate and compress the flexures, thus rotating the actuator.
In this report, we demonstrate the use of helium ion milling for the controllable fabrication of nanostructures in few-layer hexagonal boron nitride (h-BN). Using the direct-write lithographic capabilities of a scanning helium ion microscope (HIM), nanopores with diameters as small as 4 nm and nanoribbons with widths of 3 – 10 nm are etched from suspended h-BN sheets. This ability to pattern h-BN sheets with high-throughput and sub-10 nm precision paves the way for future studies that make use of atomically-thin, nanostructured insulators such as those needed for nanopore sequencing and patterned van der Waals heterostructures.
The chromosphere is a complex region that acts as an intermediary between the magnetic flux emergence in the photosphere and the magnetic features seen in the corona. Large eruptions in the chromosphere of flares and filaments are often accompanied by ejections of coronal mass off the sun. Several studies have observed fast-moving progressive trains of compact bright points (called Sequential Chromospheric Brightenings or SCBs) streaming away from chromospheric flares that also produce a coronal mass ejection (CME). In this work, we review studies of SCBs and search for commonalties between them. We place these findings into a larger context with contemporary chromospheric and coronal observations. SCBs are fleeting indicators of the solar atmospheric environment as it existed before their associated eruption. Since they appear at the very outset of a flare eruption, SCBs are good early indication of a CME measured in the chromosphere.
Replacing dairy components from milk replacer (MR) with vegetable products has been previously associated with decreased protein and fat digestibility in milk-fed calves resulting in lower live weight gain. In this experiment, the major carbohydrate source in MR, lactose, was partly replaced with gelatinized corn starch (GCS) to determine the effect on protein and fat digestibility in milk-fed calves. In total, 16 male Holstein-Friesian calves received either MR with lactose as the carbohydrate source (control) or 18% GCS at the expense of lactose. In the adaptation period, calves were exposed to an increasing dose of GCS for 14 weeks. The indigestible marker cobalt ethylenediaminetetraacetic acid was incorporated into the MR for calculating apparent nutrient digestibility, whereas a pulse dose of chromium (Cr) chloride was fed with the last MR meal 4 h before slaughter as an indicator of passage rates. The calves were anesthetized and exsanguinated at 30 weeks of age. The small intestine was divided in three; small intestine 1 and 2 (SI1 and SI2, respectively) and the terminal ileum (last ~100 cm of small intestine) and samples of digesta were collected. Small intestinal digesta was analysed for α-amylase, lipase and trypsin activity. Digestibility of protein was determined for SI1, SI2, ileum and total tract, whereas digestibility of fat was determined for SI1, SI2 and total tract. Apparent protein digestibility in the small intestine did not differ between treatments but was higher in control calves at total tract level. Apparent crude fat digestibility tended to be increased in SI1 and SI2 for GCS calves, but no difference was found at total tract level. Activity of α-amylase in SI2 and lipase in both SI1 and SI2 was higher in GCS calves. Activity of trypsin tended to be higher in control calves and was higher in SI1 compared with SI2. A lower recovery of Cr in SI2 and a higher recovery of Cr in the large intestine suggest an increased rate of passage for GCS calves. Including 18% of GCS in a milk replacer at the expense of lactose increased passage rate and decreased apparent total tract protein digestibility. In the small intestine, protein digestion did not decrease when feeding GCS and fat digestion even tended to increase. Overall, effects on digestion might be levelled when partially replacing lactose with GCS, because starch digestion is lower than that of lactose but fat digestion may be slightly increased when feeding GCS.
Selection of animals for improved feed efficiency can affect sustainability of animal production because the most efficient animals may face difficulties coping with challenges. The objective of this study was to determine the effects of an inflammatory challenge (using an intravenous injection of complete Freund’s adjuvant – CFA) in piglets from two lines of pigs divergently selected during the fattening period for a low (RFI−) or a high (RFI+) residual feed intake (RFI; difference between actual feed intake and theoretical feed requirements). Nitrogen and energy balances (including heat production – HP – and its components: activity-related HP – AHP, thermic effect of feeding, and resting HP) were measured individually in thirteen 20-kg BW castrated male piglets (six and seven from RFI+ and RFI− line, respectively) fed at the same level (1.72 MJ ME/kg BW0.60 per day) from 3 days before to 3 days after CFA injection. Dynamics of dietary U-13C-glucose oxidation were estimated from measurements of 13CO2 production on the day before and 3 days after the CFA injection. Oxidation of dietary nutrients and lipogenesis were calculated based on HP and O2 consumption and CO2 production. The data were analyzed as repeated measurements within piglets in a mixed model. Before CFA injection, RFI− piglets had a lower resting energy expenditure than RFI+ piglets, which tended to increase energy retention because of a higher energy retention as fat. The CFA injection did not affect feed intake from the day following CFA injection onwards but it increased energy retention (P=0.04). Time to recover 50% of 13C from dietary glucose as expired 13CO2 was higher in RFI+ piglets before inducing inflammation but decreased after to the level of RFI− piglets (P<0.01). Oxidation of U-13C-glucose tended to slightly increased in RFI− piglets and to decreased in RFI+ piglets (P=0.10) because of CFA. Additionally, RFI− piglets had a lower respiratory quotient during the 1st day following the CFA injection whereas RFI+ piglets tended to have a higher respiratory quotient. In conclusion, selection for RFI during the fattening period also affected the energy metabolism of pigs during earlier stages of growth. The effects of CFA injection were moderated in both lines but the most efficient animals (RFI−) exhibited a marked re-orientation of nutrients only during the 1st day after CFA, and seemed to recover thereafter, whereas the less efficient piglets expressed a more prolonged alteration of their metabolism.
The deadliest outburst flood from an englacial cavity occurred on Glacier de Tête Rousse in the Mont Blanc area, French Alps, in 1892. A subglacial reservoir was discovered in the same glacier in 2010 and drained artificially in 2010, 2011 and 2012 to protect the 3000 inhabitants downstream. The mechanism leading to the spontaneous refilling of the cavity following these pumping operations has been analyzed. For this purpose, the subglacial water volume changes between 2010 and 2013 were reconstructed. The size of the cavity following the pumping was found to have decreased from 53500 m3 in 2010 to 12 750 m3 in 2013. Creep and the partial collapse of the cavity roof explain a large part of the volume loss. Analysis of cavity filling showed a strong relationship between measured surface melting and the filling rate, with a time delay of 4–6 hours. A permanent input of 15 m3 d−1, not depending on surface melt, was also found. The meltwater and rain from the surface is conveyed to bedrock through crevasses and probably through a permeable layer of rock debris at the glacier bed. The drainage pathway permeability was estimated at 0.054 ms−1 from water discharge measurements and dye-tracing experiments.
Sodalite (Na8[AlSiO4]6Cl2), a naturally occurring Cl-containing mineral, has long been regarded as a potential immobilization matrix for the chloride salt wastes arising from pyrochemical reprocessing operations, as it allows for the conditioning of the waste salt as a whole without the need for any pre-treatment. Here the consolidation and densification of Sm-doped sodalite (as an analogue for AnCl3) has been investigated with the aim of producing fully dense (i.e. > 95 % t.d.) ceramic monoliths via conventional cold-press-and-sinter techniques at temperatures of < 1000 °C. Microstructural analysis of pressed and sintered sodalite powders under these conditions is shown to produce poorly sintered, porous, inhomogeneous pellets. However, by the addition of a sodium aluminophosphate glass sintering aid, fully dense Sm-sodalite ceramic monoliths can successfully be produced by sintering at temperatures as low as 800 °C.
Apatites are often seen as good potential candidates for the immobilization of halide-rich wastes. In particular, phosphate apatites have received much attention in recent years, however, their synthesis often produces complicated multi-phase systems, with a number of secondary phases forming [1.2]. Calcium vanadinite (Ca5(VO4)3Cl) demonstrates a much simpler phase system, with only a single Ca2V2O7 secondary phase which can easily be retarded by the addition of excess CaCl2. However, when doping with SmCl3 (as an inactive analogue for AnCl3) the Sm forms a wakefieldite (SmVO4) phase rather than being immobilized within the vanadinite, a result of having to form an energetically unfavourable Ca vacancy in order for the lattice to remain neutral overall. It has been postulated that charge-balancing the lattice via co-substitution of a monovalent cation will be less disfavoured and therefore help stabilise formation of a (Ca5-2xSmxAx)(VO4)3Cl solid solution (A = monovalent cation). This has been investigated using a combined modelling and experimental approach. Static lattice calculations performed using Li+, Na+ and K+ as charge-balancing species have shown the energy cost to be less than half that of charge-balancing via formation of a Ca vacancy. As a result, solid state synthesis of (Ca5-2xSmxLix)(VO4)3Cl, (Ca5−2xSmxNax)(VO4)3Cl and (Ca5-2xSmxKx)(VO4)3Cl solid solutions have been trialled, and analysis of the resulting products has shown a significant reduction in both the SmVO4 and Ca2V2O7 secondary phases across all dopant levels.
Calcium chlorosilicate (Ca3(SiO4)Cl2) is seen as a potential host phase for the immobilization of Cl-rich wastes arising from pyrochemical reprocessing, a waste stream often containing a mix of both di- and trivalent cations. Substitution of trivalent cations into the lattice requires some form of charge compensation to ensure the lattice remains charge neutral overall. Whilst previous work has only examined this through the formation of Ca vacancies, this study investigates the feasibility of charge-balancing via the substitution of a monovalent cation onto the Ca sites of the lattice. To that end, a series of static lattice calculations were performed to determine the site selectivity of monovalent cations of differing size when substituted onto the Ca sites of the calcium chlorosilicate lattice and the solution energies for the overall substitution processes compared with those for charge compensation via vacancy formation. In all cases the monovalent charge-balancing species shows a clear preference for substitution onto the Ca1 site in the calcium chlorosilicate lattice. The solution energy of the substitution process increases with the increasing ionic radii of both the mono- and trivalent species as the steric stresses associated with substitution of larger cations than the Ca2+ host increase. As such, only charge-balancing using Li+, Na+ or K+ is more favourable than via formation of a Ca vacancy.
The quiet Sun observed in polarized light exhibits a rich and complex magnetic structuring which is still not fully resolved nor understood. The present work is intended to contribute to the debate about the origin of the quiet sun magnetic fields, in relation or not to the global solar dynamo. We present analysis of center-to-limb polarization measurements obtained with the SOT/SP spectropolarimeter onboard the Hinode satellite outside active regions, in 2007 and 2013, i.e. at a minimum and a maximum of the solar cycle, respectively. We compare the spatial fluctuation Fourier spectra of unsigned circular and linear polarization images after corrections for polarization bias and focus variations between the two data sets. The decay of active regions is clearly a source of magnetic fields in the quiet Sun. It leads to a global increase of the polarization fluctuation power spectrum in 2013 in the network. In the internetwork, we observe no variation of the polarization fluctuation power at mesogranular and granular scales, whereas it increases at sub-granular scales. We interpret these results in the following way. At the mesogranular and granular scales very efficient mechanisms of magnetic field removal are operating in the internetwork, that leads to a dissipation or a concentration of magnetic fields on smaller scales. So the cycle-invariant magnetic signal that we detect at mesogranular and granular scales must be continuously created by a dynamo mechanism which is independent of the solar cycle.
To establish how people with psoriasis in the United Kingdom today experience living with their condition including diagnosis, treatment, healthcare provision and impact on daily life.
Psoriasis is a debilitating long-term inflammatory skin disease which can result in severe itching, discomfort and soreness, and may be associated with problems beyond the specific symptoms related to the skin. For many it is accompanied by difficult-to-manage treatment regimes, emotional distress and a negative impact on their quality of life and psychosocial functioning. To date there is little published information about the health experiences of people in the United Kingdom with psoriasis.
A postal self-administered questionnaire was completed by members of the Psoriasis Association and the responses analysed (n=1564).
The findings suggest some similarities to surveys in other nations, but specifically highlighted that patients feel under-informed and are dissatisfied with current treatment regimes. Responses provided an insight into aspects of the condition that treatments should be targeting. Specific areas of negative impact on psychosocial functioning were identified, including the lack of available support for those experiencing emotional distress. The research provides important information about how the care of patients with psoriasis can be improved, especially at primary care level. This includes: improved training in psoriasis knowledge and awareness at general practitioner level and greater use of dermatology specialist nurses in primary care settings; more effective and manageable treatment regimes that target visible areas and general well-being; greater support for emotional distress and psychosocial functioning.