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Subthreshold post-traumatic stress disorder (PTSD) is more prevalent than PTSD, yet its role as a potential risk factor for PTSD is unknown. To address this gap, we analysed data from a 7-year, prospective national cohort of USA veterans. Of veterans with subthreshold PTSD at wave 1, 34.3% developed PTSD compared with 7.6% of trauma-exposed veterans without subthreshold PTSD (relative risk ratio 6.4). Among veterans with subthreshold PTSD, specific PTSD symptoms, greater age, cognitive difficulties, lower dispositional optimism and new-onset traumas predicted incident PTSD. Results suggest that preventive interventions targeting subthreshold PTSD and associated factors may help mitigate risk for PTSD in USA veterans.
The Crusades have always been a focus of historical attention. William of Tyre (c.1130–86) wrote a great history of the crusades in Latin which was so well received that in the early thirteenth century it was translated into French and extended in many versions to cover the period after 1186. The French version was so popular that the Renaissance scholar, Francesco Pipino, unaware of the original, translated it back into Latin, while Caxton produced an English version in the fifteenth century.1 Many of the earlier crusader chronicles, notably Robert the Monk’s account of the First Crusade, were also very popular in the Middle Ages and were edited very early in the age of print, notably in the great collection by Jacques Bongars in 1611.2 In modern times the crusades have always been a contentious subject, as President George Bush discovered when he referred to a ‘crusade against terrorism’ shortly after 9/11.
Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare tumor-like lesion with unknown pathogenesis. It is likely under-reported due to diagnostic challenges including the nonspecific radiographic features, lack of diagnostic markers, and often asymptomatic nature of the lesions.
We performed detailed examination of 11 CAPNON specimens diagnosed by histopathology, with the help of electron microscopy and immunohistochemistry.
Electron microscopy revealed the presence of fibrillary materials consistent with neurofilaments. In addition to some entrapped axons at the periphery of CAPNONs, we discovered that all specimens stained positive for neurofilament-light (NF-L) within the granular amorphous cores, but not neurofilament-phosphorylated (NF-p). CAPNONs also showed variable infiltration of CD8+ T-cells and a decreased ratio of CD4/CD8+ T-cells, suggesting an immune-mediated process in the pathogenesis of CAPNON.
NF-L and CD4/CD8 immunostains may serve as diagnostic markers for CAPNON and shed light on its pathogenesis.
GILBERT'S CHRONICLE COVERS the history of the county of Hainaut from 1071, when it came under the rule of an ousted branch of the house of Flanders, to 1196. By 1169 Gilbert was a chaplain at the court of Baldwin IV, count of Hainaut (1120–71), then court chaplain to Count Baldwin V (1171–95), whose chancellor he became by 1178. He held many offices under Baldwin V but none under Baldwin VI, count of Flanders and Hainaut (1195–1205). Gilbert served as an envoy to the court of the Emperor Frederick Barbarossa (1152–89) and his son Henry at least eight times, and on one occasion acted as a judge at the request of the emperor. He also mentions that he acted as an envoy to the count of Champagne. He was familiar with neighboring powers England and France. As a cleric he was richly rewarded with ecclesiastical offices, being especially devoted to the abbey of St Waudru of Mons of which he was Provost. Gilbert wrote his work in the years 1195–96 and had access to documents and memories of the past. His narrative before the late 1160s is uneven especially on military matters. Thus we are told Baldwin IV and his wife resisted “continual assaults of war” from Thierry of Flanders with no details. But he is often very detailed for the same and even more remote periods on matters that would have been in his records, like noble inheritances. Gilbert's work is invaluable for the prosopography of the Low Countries and is notably useful for identifying noble women though he is occasionally inaccurate. As a cleric deeply enmeshed in court affairs and diplomacy, he is comparable to Roger of Howden, whose chronicle is also very useful for the study of warfare.
The work must be understood in the context in which it was written. Hainaut was one of a group of small powers sandwiched between the county of Flanders, the German Empire and the kingdom of France. The dukes of Brabant, the counts of Namur, the counts of Looz, the counts of Guelders, the counts of Vermandois, of Holland and of Champagne all had family and tenurial connections.
After the collapse of Rome Europe was dominated by relatively small powers. Its development, therefore, was different from that of China or some of the powers of the Middle East. Lacking continuous existence and permanent facilities armies depended on native skills which recruits brought with them. The retinues of the powerful, who could train and buy equipment, were at an advantage. In time they became predominantly mounted warriors, the knights. Infantry were never a negligible force, but without training they lacked the coherence to make their mass effective. In the later Middle Ages standing armies in Europe grew out of rising prosperity, the improving structures of a few states and the demands of continuous warfare. By contrast Mamluk Egypt developed a standing army by about 1240, while China always had one. The Mongols, by virtue of their way of life with its ‘native skills’, constituted a permanent army. Although improved metallurgy increased the supply of better weapons and armour, and experience in stonework led to better fortifications, the technology of war changed little. War remained up close and personal, an affair of plundering and, when battle became necessary, close-order formations fighting at close-quarters. Gunpowder, therefore, was a major challenge whose impact on war before the mid 15th century was limited.