To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Higher cardiorespiratory fitness (CRF) induces neuroprotective effects in the hippocampus, a key brain region for memory and learning. We investigated the association between CRF and functional connectivity (FC) of the hippocampus in healthy young adults. We also examined the association between hippocampal FC and neurocognitive function. Lastly, we tested whether hippocampal FC mediates the association between 2-Min Walk Test (2MWT) and neurocognitive function.
913 young adults (28.7 ± 3.7 years) from the Human Connectome Project were included in the analyses. The 2MWT performance result was used as a proxy for cardiovascular endurance. Fluid and crystalized composite neurocognitive scores were used to assess cognition. Resting-state functional MRI data were processed to measure hippocampal FC. Linear regression was used to examine the association between 2MWT, hippocampal FC, and neurocognitive outcomes after controlling for age, sex, years of education, body mass index, systolic blood pressure, and gait speed.
Better 2MWT performance was associated with greater FC between the anterior hippocampus and right posterior cingulate and left middle temporal gyrus. No associations between 2MWT and posterior hippocampal FC, whole hippocampal FC, and caudate FC (control region) were observed. Greater anterior hippocampal FC was associated with better crystalized cognition scores. Lastly, greater FC between the anterior hippocampus and right posterior cingulate mediated the association between better 2MWT scores and higher crystalized cognition scores.
Anterior hippocampal FC may be one underlying neurophysiological mechanism that promotes the association between 2MWT performance and crystalized composite cognitive function in healthy young adults.
Medical language – like all forms of living language – is subject to change. The ‘scientific currency’ (de Almeida 1991: 13) of the late eighteenth and early nineteenth centuries differs from our own. One word in English that had special meanings at the time, as identified by Professor Alberto Tanturri, is excitability, and the linked terms excite, excitant, and so on, which in the late eighteenth century came to develop specifically physiological meanings. This usage seems to derive from the writings of John Brown (1735–88), an Edinburgh physician of the Scottish Enlightenment whose biography is conveniently available in the Oxford Dictionary of National Biography (Lawrence 2004; see also Beddoes 1795; Bynum & Porter 1988). Brown, the founder of an eponymous innovative nosographic system known as Brunonianism, held that excitability was the fundamental feature of living bodies, being triggered by interaction with the environment to produce excitement; that is, the life force. Brunonianism thus pointed forward to Vitalist and Romantic notions of the operation of the body, going beyond the dominant earlier eighteenth-century conception that living bodies could be understood as the outcome of mathematical or physical laws alone.
Written by an interdisciplinary team of scholars, this book offers novel perspectives on the history of medical writing and scientific thought-styles by examining patterns of change and reception in genres, discourse, and lexis in the period 1500-1820. Each chapter demonstrates in detail how changing textual forms were closely tied to major multi-faceted social developments: industrialisation, urbanisation, expanding trade, colonialization, and changes in communication, all of which posed new demands on medical care. It then shows how these developments were reflected in a range of medical discourses, such as bills of mortality, medical advertisements, medical recipes, and medical rhetoric, and provides an extensive body of case studies to highlight how varieties of medical discourse have been targeted at different audiences over time. It draws on a wide range of methodological frameworks and is accompanied by numerous relevant illustrations, making it essential reading for academic researchers and students across the human sciences.
This introductory chapter discusses the contents of the volume with its focus on genres and text traditions of medical discourse in a diachronic perspective. Variability of medical language with its conventions and traditions of writing is a leading theme in several chapters and surfaces in others as well. The social and cultural contexts of production and use as well as meaning-making processes of written texts as communicative events receive attention. All contributions take context in textual production and use into account. Another point of emphasis is variation in discourse forms in texts that were removed from the original settings and repurposed for new readerships. Texts circulating in Britain are at centre stage, but medical discourses reflecting common ideological assumptions had a broad currency and English writers shared profoundly in the pan-European medical culture.
New resources have led to new insights into the history of English vocabulary. The appearance of machine-readable corpora has made it possible to contextualise particular idiolectal usages much more comprehensively than was possible until recently. Such developments have allowed, through the harnessing of the large bodies of data to be found in the Oxford English Dictionary and other resources, a much better understanding of intertextual engagement: what might be called authorial invention, the focus of this chapter. The chapter focuses on authorial invention during the Romantic period, with reference to three writers whose imaginative outputs drew profoundly on their understanding of medicine: Samuel Taylor Coleridge (1772–1834), Mary Shelley (1797–1851), and John Keats (1795–1821). As Richard Holmes has argued, Romanticism drew profoundly on its scientific inheritance, in the cases analysed here derived from direct or indirect encounters with thinkers such as Thomas Beddoes (1760–1808), Astley Cooper (1768–1841), William Cullen (1710–1790), and Erasmus Darwin (1731–1802). However, they transformed this inheritance through what Holmes terms ‘imaginative intensity’.
To increase inclusivity, diversity, equity and accessibility in Antarctic science, we must build more positive and inclusive Antarctic field work environments. The International Thwaites Glacier Collaboration (ITGC) has engaged in efforts to contribute to that goal through a variety of activities since 2018, including creating an open-access ‘Field and Ship Best Practices’ guide, engaging in pre-field season team dynamics meetings, and surveying post-field season reflections and experiences. We report specific actions taken by ITGC and their outcomes. We found that strong and supported early career researchers brought new and important perspectives regarding strategies for transforming culture. We discovered that engaged and involved senior leadership was also critical for expanding participation and securing funding to support efforts. Pre-field discussions involving all field team members were particularly helpful for setting expectations, improving sense of belonging, describing field work best practices, and co-creating a positive work culture.
Electroanatomic mapping systems are increasingly used during ablations to decrease the need for fluoroscopy and therefore radiation exposure. For left-sided arrhythmias, transseptal puncture is a common procedure performed to gain access to the left side of the heart. We aimed to demonstrate the radiation exposure associated with transseptal puncture.
Data were retrospectively collected from the Catheter Ablation with Reduction or Elimination of Fluoroscopy registry. Patients with left-sided accessory pathway-mediated tachycardia, with a structurally normal heart, who had a transseptal puncture, and were under 22 years of age were included. Those with previous ablations, concurrent diagnostic or interventional catheterisation, and missing data for fluoroscopy use or procedural outcomes were excluded. Patients with a patent foramen ovale who did not have a transseptal puncture were selected as the control group using the same criteria. Procedural outcomes were compared between the two groups.
There were 284 patients in the transseptal puncture group and 70 in the patent foramen ovale group. The transseptal puncture group had a significantly higher mean procedure time (158.8 versus 131.4 minutes, p = 0.002), rate of fluoroscopy use (38% versus 7%, p < 0.001), and mean fluoroscopy time (2.4 versus 0.6 minutes, p < 0.001). The acute success and complication rates were similar.
Performing transseptal puncture remains a common reason to utilise fluoroscopy in the era of non-fluoroscopic ablation. Better tools are needed to make non-fluoroscopic transseptal puncture more feasible.
Copy number variants (CNVs) have been associated with the risk of schizophrenia, autism and intellectual disability. However, little is known about their spectrum of psychopathology in adulthood.
We investigated the psychiatric phenotypes of adult CNV carriers and compared probands, who were ascertained through clinical genetics services, with carriers who were not. One hundred twenty-four adult participants (age 18–76), each bearing one of 15 rare CNVs, were recruited through a variety of sources including clinical genetics services, charities for carriers of genetic variants, and online advertising. A battery of psychiatric assessments was used to determine psychopathology.
The frequencies of psychopathology were consistently higher for the CNV group compared to general population rates. We found particularly high rates of neurodevelopmental disorders (NDDs) (48%), mood disorders (42%), anxiety disorders (47%) and personality disorders (73%) as well as high rates of psychiatric multimorbidity (median number of diagnoses: 2 in non-probands, 3 in probands). NDDs [odds ratio (OR) = 4.67, 95% confidence interval (CI) 1.32–16.51; p = 0.017) and psychotic disorders (OR = 6.8, 95% CI 1.3–36.3; p = 0.025) occurred significantly more frequently in probands (N = 45; NDD: 39[87%]; psychosis: 8[18%]) than non-probands (N = 79; NDD: 20 [25%]; psychosis: 3[4%]). Participants also had somatic diagnoses pertaining to all organ systems, particularly conotruncal cardiac malformations (in individuals with 22q11.2 deletion syndrome specifically), musculoskeletal, immunological, and endocrine diseases.
Adult CNV carriers had a markedly increased rate of anxiety and personality disorders not previously reported and high rates of psychiatric multimorbidity. Our findings support in-depth psychiatric and medical assessments of carriers of CNVs and the establishment of multidisciplinary clinical services.
Patients with CHD can be exposed to high levels of cumulative ionising radiation. Utilisation of electroanatomic mapping during catheter ablation leads to reduced radiation exposure in the general population but has not been well studied in patients with CHD. This study evaluated the radiation sparing benefit of using three-dimensional mapping in patients with CHD.
Data were retrospectively collected from the Catheter Ablation with Reduction or Elimination of Fluoroscopy multi-institutional registry. Patients with CHD were selected. Those with previous ablations, concurrent diagnostic or interventional catheterisation and unknown arrhythmogenic foci were excluded. The control cohort was matched for operating physician, arrhythmia mechanism, arrhythmia location, weight and age. The procedure time, rate of fluoroscopy use, fluoroscopy time, procedural success, complications, and distribution of procedures per year were compared between the two groups.
Fifty-six patients with congenital heart disease and 56 matched patients without CHD were included. The mean total procedure time was significantly higher in patients with CHD (212.6 versus 169.5 minutes, p = 0.003). Their median total fluoroscopy time was 4.4 minutes (compared to 1.8 minutes), and their rate of fluoroscopy use was 23% (compared to 13%). The acute success and minor complication rates were similar and no major complications occurred.
With the use of electroanatomic mapping during catheter ablation, fluoroscopy use can be reduced in patients with CHD. The majority of patients with CHD received zero fluoroscopy.