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 email@example.com
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.
We previously reported that bipolar disorder (BD) patients with clinically significant weight gain (CSWG; ⩾7% of baseline weight) in the 12 months after their first manic episode experienced greater limbic brain volume loss than patients without CSWG. It is unknown whether CSWG is also a risk factor for progressive neurochemical abnormalities.
We investigated whether 12-month CSWG predicted greater 12-month decreases in hippocampal N-acetylaspartate (NAA) and greater increases in glutamate + glutamine (Glx) following a first manic episode. In BD patients (n = 58) and healthy comparator subjects (HS; n = 34), we measured baseline and 12-month hippocampal NAA and Glx using bilateral 3-Tesla single-voxel proton magnetic resonance spectroscopy. We used general linear models for repeated measures to investigate whether CSWG predicted neurochemical changes.
Thirty-three percent of patients and 18% of HS experienced CSWG. After correcting for multiple comparisons, CSWG in patients predicted a greater decrease in left hippocampal NAA (effect size = −0.52, p = 0.005). CSWG also predicted a greater decrease in left hippocampal NAA in HS with a similar effect size (−0.53). A model including patients and HS found an effect of CSWG on Δleft NAA (p = 0.007), but no diagnosis effect and no diagnosis × CSWG interaction, confirming that CSWG had similar effects in patients and HS.
CSWG is a risk factor for decreasing hippocampal NAA in BD patients and HS. These results suggest that the well-known finding of reduced NAA in BD may result from higher body mass index in patients rather than BD diagnosis.
Background: Ketorolac has long been used to manage pain in the Emergency Department and has the advantage of being the only parenteral NSAID formulation. Despite multiple studies demonstrating an analgesic ceiling dose of 10mg for intravenous ketorolac, higher doses (30-60mg) are commonly ordered. Use of optimal doses of ketorolac (10mg) has the advantage of lower side effects and cost. Aim Statement: The aim of this project was to increase the usage of the optimal dose parenteral ketorolac (10mg) without increasing the use of additional, concomitant or rescue opioids (balancing measures). Measures & Design: This pre-/post-intervention comparison study (May 1, 2016 to April 30, 2018) included all patients ≥18 years of age that received parenteral ketorolac at one of 4 EDs in the Calgary zone. All data was captured via administrative data records. Stakeholders (ED leadership, analgesia committee, nursing and pharmacy) provided feedback and support for the project. Our multi-modal intervention included modifying all ED computerized order sets such that the default parenteral ketorolac dose was 10mg (post-intervention) from 30mg (pre-intervention), education (dissemination of evidence to support the changes to clinicians) and our pharmacy securing 10mg vials of ketorolac. At their discretion, physicians’ were still able to order other doses of ketorolac. Evaluation/Results: During the 2 year study period, 19290 patient records were identified where parenteral ketorolac was administered during the ED visit. Baseline characteristics were similar between the pre/post periods. Prior to the change in default dosing, 10.5% of orders were for ketorolac 10mg compared to 87% in the post-intervention period (p < 0.000). Statistical process charts support the above results and demonstrate that the changes have been sustained. There were no differences in patients receiving ketorolac as the only analgesic between the pre/post periods (42% vs 42%, p = 0.396), nor where there significant changes in concomitant opioid usage (46% vs 46%, p = 0.817), or rescue analgesia (11% vs 12%, p = 0.097). Discussion/Impact: In this large cohort, our multi-modal intervention, resulted in a significant increase in optimal ketorolac parenteral dosing without a significant change in additional opioid use. The results support the utility of computerized order set changes as the cornerstone of an effective and rapid knowledge translation strategy to align physician practice with best evidence.
Recent commercialization of auxin herbicide–based weed control systems has led to increased off-target exposure of susceptible cotton cultivars to auxin herbicides. Off-target deposition of dilute concentrations of auxin herbicides can occur on cotton at any stage of growth. Field experiments were conducted at two locations in Mississippi from 2014 to 2016 to assess the response of cotton at various growth stages after exposure to a sublethal 2,4-D concentration of 8.3 g ae ha−1. Herbicide applications occurred weekly from 0 to 14 weeks after emergence (WAE). Cotton exposure to 2,4-D at 2 to 9 WAE resulted in up to 64% visible injury, whereas 2,4-D exposure 5 to 6 WAE resulted in machine-harvested yield reductions of 18% to 21%. Cotton maturity was delayed after exposure 2 to 10 WAE, and height was increased from exposure 6 to 9 WAE due to decreased fruit set after exposure. Total hand-harvested yield was reduced from 2,4-D exposure 3, 5 to 8, and 13 WAE. Growth stage at time of exposure influenced the distribution of yield by node and position. Yield on lower and inner fruiting sites generally decreased from exposure, and yield partitioned to vegetative or aborted positions and upper fruiting sites increased. Reductions in gin turnout, micronaire, fiber length, fiber-length uniformity, and fiber elongation were observed after exposure at certain growth stages, but the overall effects on fiber properties were small. These results indicate that cotton is most sensitive to low concentrations of 2,4-D during late vegetative and squaring growth stages.
The introduction of auxin herbicide weed control systems has led to increased occurrence of crop injury in susceptible soybeans and cotton. Off-target exposure to sublethal concentrations of dicamba can occur at varying growth stages, which may affect crop response. Field experiments were conducted in Mississippi in 2014, 2015, and 2016 to characterize cotton response to a sublethal concentration of dicamba equivalent to 1/16X the labeled rate. Weekly applications of dicamba at 35 g ae ha−1 were made to separate sets of replicated plots immediately following planting until 14 wk after emergence (WAE). Exposure to dicamba from 1 to 9 WAE resulted in up to 32% visible injury, and exposure from 7 to 10 WAE delayed crop maturity. Exposure from 8 to 10 and 13 WAE led to increased cotton height, while an 18% reduction in machine-harvested yield resulted from exposure at 6 WAE. Cotton exposure at 3 to 9 WAE reduced the seed cotton weight partitioned to position 1 fruiting sites, while exposure at 3 to 6 WAE also reduced yield in position 2 fruiting sites. Exposure at 2, 3, and 5 to 7 WAE increased the percent of yield partitioned to vegetative branches. An increase in percent of yield partitioned to plants with aborted terminals occurred following exposure from 3 to 7 WAE and corresponded with reciprocal decreases in yield partitioned to positional fruiting sites. Minimal effects were observed on fiber quality, except for decreases in fiber length uniformity resulting from exposure at 9 and 10 WAE.
Tonsillectomy is a common procedure with significant post-operative pain. This study was designed to compare post-operative pain, returns to a normal diet and normal activity, and duration of regular analgesic use in Coblation and bipolar tonsillectomy patients.
A total of 137 patients, aged 2–50 years, presenting to a single institution for tonsillectomy or adenotonsillectomy were recruited. Pain level, diet, analgesic use, return to normal activity and haemorrhage data were collected.
Coblation tonsillectomy was associated with significantly less pain than bipolar tonsillectomy on post-operative days 1 (p = 0.005), 2 (p = 0.006) and 3 (p = 0.010). Mean pain scores were also significantly lower in the Coblation group (p = 0.039). Coblation patients had a significantly faster return to normal activity than bipolar tonsillectomy patients (p < 0.001).
Coblation tonsillectomy is a less painful technique compared to bipolar tonsillectomy in the immediate post-operative period and in the overall post-operative period. This allows a faster return to normal activity and decreased analgesic requirements.
Ketamine has emerged as a novel therapeutic agent for major depressive episodes, spurring interest in its potential to augment electroconvulsive therapy (ECT).
We sought to update our preliminary systematic review and meta-analysis, focusing on randomised controlled trials (RCTs) involving an index course of ECT, and testing the hypothesis that lack of efficacy is due to barbiturate anaesthetic co-administration.
We searched EMBASE, CENTRAL and Medline to identify RCTs examining the efficacy of ketamine during a course of ECT. Data were synthesised from ten trials (ketamine group n = 333, comparator group n = 269) using pooled random effects models.
Electroconvulsive therapy with ketamine was not associated with greater improvements in depressive symptoms or higher rates of clinical response or remission, nor did it result in pro-cognitive effects. This held true when limiting analysis to trials without barbiturate anaesthetic co-administration. Increased rates of confusion were reported.
Overall, our analyses do not support using ketamine over other induction agents in ECT.
Greenhouse and laboratory studies were conducted to confirm and quantify glyphosate resistance, quantify pyrithiobac resistance, and investigate interaction between flumiclorac and glyphosate mixtures on control of Palmer amaranth from Mississippi. The GR50 (herbicide dose required to cause a 50% reduction in plant growth) values for two glyphosate-resistant biotypes, C1B1 and T4B1, and a glyphosate-susceptible (GS) biotype were 1.52, 1.3, and 0.09 kg ae ha−1 glyphosate, respectively. This indicated that the C1B1 and T4B1 biotypes were 17- and 14-fold resistant to glyphosate, respectively, compared with the GS biotype. The C1B1 and T4B1 biotypes were also resistant to pyrithiobac, an acetolactate synthase (ALS) inhibitor, with GR50 values of 0.06 and 0.07 kg ai ha−1, respectively. This indicated that the C1B1 and T4B1 biotypes were 7- and 8-fold, respectively, more resistant to pyrithiobac compared with the GS biotype, which had a GR50 value of 0.009 kg ha−1. Flumiclorac was antagonistic to glyphosate by reducing glyphosate translocation. The C1B1 and T4B1 absorbed less glyphosate 48 h after treatment (HAT) compared with the GS biotype. The majority of the translocated glyphosate accumulated in the shoot above the treated leaf (that contains the apical meristem) in the GS biotype and in the shoot below the treated leaf in the resistant biotypes, C1B1 and T4B1, by 48 HAT. The C1B1 biotype accumulated negligible shikimate levels, whereas the T4B1 and GS biotypes recorded elevated levels of shikimate. Metabolism of glyphosate to aminomethylphosphonic acid was not detected in either of the resistant biotypes or the susceptible GS biotype. The above results confirm multiple resistance to glyphosate and pyrithiobac in Palmer amaranth biotypes from Mississippi and indicate that resistance to glyphosate is partly due to reduced absorption and translocation of glyphosate.
Managing glyphosate-resistant (GR) horseweed in no-till cotton continues to be a serious challenge for midsouthern producers. Field studies were conducted in 2008 and 2009 to evaluate spring burndown applications of saflufenacil on GR horseweed prior to planting cotton. Saflufenacil controlled GR horseweed at least 94% up to 7 d before planting (DBP) without causing significant cotton injury. Saflufenacil applied at 7 or 14 DBP controlled GR horseweed while still providing residual control until planting. Moreover, saflufenacil, on silt loam soil evaluated in this study, showed no more injury than dicamba applied 7 or more DBP. Results indicated that saflufenacil is an option in cotton for controlling GR horseweed much closer to cotton planting than 42 DBP (current saflufenacil label). At 25 g ha−1, which is the standard labeled rate in cotton, saflufenacil provided > 90% control of GR horseweed. Saflufenacil as a GR horseweed burndown, could replace the current dicamba standard every other year to reduce the probability of horseweed developing resistance to dicamba or salflufenacil.
A new form of Xenungulata Paula Couto, 1952 from red levels of the Peñas Coloradas Formation in a locality near Puerto Visser (45°17'S, 67°01'W), Chubut province, Argentina, is represented by a fragmentary left jaw with the m3 (MPEF-PV 1871). Notoetayoa gargantuai n. gen. and n. sp. is the first ever found in direct association with Carodnia feruglioi Simpson, 1935a which characterizes the incompletely known homonymous zone of the late Paleocene of Patagonia. A preliminary phylogenetic analysis, including representatives of “Condylarthra,” Litopterna, Notoungulata, Pyrotheria, Xenungulata and Astrapotheria, plus the characters that could be scored in the new taxon, was performed using TNT software. A single most parsimonious tree was obtained. Notoetayoa gargantuai has a closer phylogenetic relationship with the Xenungulate Etayoa bacatensis Villarroel, 1987 from the ?middle Paleocene of Colombia than with any other Tertiary ungulate group of South America. Notoetayoa gargantuai fills an important gap in the knowledge of the mammalian faunas from the Paleocene of Patagonia, particularly of the poorly known pre-Itaborian times.
Sublethal injuries recorded in the shells of five Upper Mississippian ammonoid species from the Imo Formation of northwest Arkansas are manifested as repaired shell breaks, which can be categorized as minor, moderate, massive, deep-acute, or as perforations. Overall, 15% of the ammonoids exhibit some form of repaired break. The injuries are distributed as follows: Anthracoceras discus 9%; Fayettevillea bransoni 13%; Fayettevillea friscoense 21%; Rhadinites miseri 24%; Richardsonites mapesi 38%. These figures are substantially lower than in living Nautilus, in which more than one-half of adult specimens exhibit repaired shell breaks. The different frequencies of injuries may reflect species-selective predation, differential abilities to sustain and to repair shell damage, or they may be due to interspecific differences in physical parameters such as shell thickness and body chamber length. The most likely possible perpetrators of the injuries include sharks, other fishes, and cephalopods.
Numerous studies describe the occurrence of post-traumatic stress disorder following disasters, but less is known about the risk of major depression.
To review the risk of depressive disorder in people surviving disasters and in soldiers returning from military deployment.
A systematic literature search combined with reference screening identified 23 controlled epidemiological studies. We used random effects models to compute pooled odds ratios (ORs).
The average OR was significantly elevated following all types of exposures: natural disaster OR = 2.28 (95% CI 1.30–3.98), technological disaster OR = 1.44 (95% CI 1.21–1.70), terrorist acts OR = 1.80 (95% CI 1.38–2.34) and military combat OR = 1.60 (95% CI 1.09–2.35). In a subset of ten high-quality studies OR was 1.41 (95% CI 1.06–1.87).
Disasters and combat experience substantially increase the risk of depression. Whether psychological trauma per se or bereavement is on the causal path is unresolved.
We previously reported that patients with early-stage bipolar disorder,
but not healthy comparison controls, had body mass index (BMI)-related
volume reductions in limbic brain areas, suggesting that the structural
brain changes characteristic of bipolar disorder were more pronounced
with increased weight.
To determine whether the most consistently reported neurochemical
abnormality in bipolar disorder, increased glutamate/glutamine (Glx), was
also more prominent with higher BMI.
We used single-voxel proton magnetic resonance spectroscopy to measure
hippocampal Glx in 51 patients with first-episode mania (mean BMI = 24.1)
and 28 healthy controls (mean BMI = 23.3).
In patients, but not healthy controls, linear regression demonstrated
that higher BMI predicted greater Glx. Factorial ANCOVA showed a
significant BMI×diagnosis interaction, confirming a distinct effect of
weight on Glx in patients.
Together with our volumetric studies, these results suggest that higher
BMI is associated with more pronounced structural and neurochemical
limbic brain changes in bipolar disorder, even in early-stage patients
with low obesity rates.
BW of replacement heifers is rarely measured on commercial farms, making it difficult to evaluate the success of management practices related to calf growth. Our aims were to describe variability among commercial farms in Holstein heifer BW, determine how BW differences varied with management and propose a method of estimating calf growth based upon single measurement. Heart girth circumference was used to estimate BW of 576 heifers 48 to 70 weeks of age on 33 different farms (on average 11±6 heifers/farm) in British Columbia, Canada. Regression analysis showed a linear relationship of BW with age (BW (kg)=116+5×age (weeks)). Residuals from this regression were averaged across heifers within each farm to identify farms where heifers were heavier or lighter than would be predicted on the basis of their age; farm average residuals ranged from −54 to 72 kg. Farms with heifers showing the highest residual BW also had the highest rates of gain for pre-weaned calves. These results indicate that farms able to rear faster growing calves before weaning were also rearing faster growing heifers at breeding, and suggest that management of milk-fed calves is a particularly important component of replacement heifer management.
There is growing interest in glutamatergic agents in depression, particularly ketamine, a glutamate N-methyl-d-aspartate (NMDA) receptor antagonist. We aimed to assess the efficacy of ketamine in major depressive episodes.
We searched EMBASE, PsycINFO, CENTRAL, and Medline from 1962 to January 2014 to identify double-blind, randomized controlled trials with allocation concealment evaluating ketamine in major depressive episodes. Clinical remission, response and depressive symptoms were extracted by two independent raters. The primary outcome measure was clinical remission at 24 h, 3 days and 7 days post-treatment. Analyses employed a random-effects model.
Data were synthesized from seven RCTs employing an intravenous infusion and one RCT employing intranasal ketamine, representing 73 subjects in parallel arms and 110 subjects in cross-over designs [n = 34 with bipolar disorder (BD), n = 149 with major depressive disorder (MDD)]. Ketamine was associated with higher rates of clinical remission relative to comparator (saline or midazolam) at 24 h [OR 7.06, number needed to treat (NNT) = 5], 3 days (OR 3.86, NNT = 6), and 7 days (OR 4.00, NNT = 6), as well as higher rates of clinical response at 24 h (OR 9.10, NNT = 3), 3 days (OR 6.77, NNT = 3), and 7 days (OR 4.87, NNT = 4). A standardized mean difference of 0.90 in favor of ketamine was observed at 24 h based on depression rating scale scores, with group comparisons revealing greater efficacy in unipolar depression compared to bipolar depression (1.07 v. 0.68). Ketamine was associated with transient psychotomimetic effects, but no persistent psychosis or affective switches.
Our meta-analysis suggests that single administrations ketamine are efficacious in the rapid treatment of unipolar and bipolar depression. Additional research is required to determine optimal dosing schedules, route, treatment schedules, and the potential efficacy of other glutamatergic agents.
PILOT (the Pathfinder for an International Large Optical Telescope) is a proposed 2.5-m optical/infrared telescope to be located at Dome C on the Antarctic plateau. The atmospheric conditions at Dome C deliver a high sensitivity, high photometric precision, wide-field, high spatial resolution, and high-cadence imaging capability to the PILOT telescope. These capabilities enable a unique scientific potential for PILOT, which is addressed in this series of papers. The current paper presents a series of projects dealing with the nearby Universe that have been identified as key science drivers for the PILOT facility. Several projects are proposed that examine stellar populations in nearby galaxies and stellar clusters in order to gain insight into the formation and evolution processes of galaxies and stars. A series of projects will investigate the molecular phase of the Galaxy and explore the ecology of star formation, and investigate the formation processes of stellar and planetary systems. Three projects in the field of exoplanet science are proposed: a search for free-floating low-mass planets and dwarfs, a program of follow-up observations of gravitational microlensing events, and a study of infrared light-curves for previously discovered exoplanets. Three projects are also proposed in the field of planetary and space science: optical and near-infrared studies aimed at characterising planetary atmospheres, a study of coronal mass ejections from the Sun, and a monitoring program searching for small-scale Low Earth Orbit satellite debris items.
PILOT (the Pathfinder for an International Large Optical Telescope) is a proposed 2.5-m optical/infrared telescope to be located at Dome C on the Antarctic plateau. Conditions at Dome C are known to be exceptional for astronomy. The seeing (above ∼30 m height), coherence time, and isoplanatic angle are all twice as good as at typical mid-latitude sites, while the water-vapour column, and the atmosphere and telescope thermal emission are all an order of magnitude better. These conditions enable a unique scientific capability for PILOT, which is addressed in this series of papers. The current paper presents an overview of the optical and instrumentation suite for PILOT and its expected performance, a summary of the key science goals and observational approach for the facility, a discussion of the synergies between the science goals for PILOT and other telescopes, and a discussion of the future of Antarctic astronomy. Paper II and Paper III present details of the science projects divided, respectively, between the distant Universe (i.e. studies of first light, and the assembly and evolution of structure) and the nearby Universe (i.e. studies of Local Group galaxies, the Milky Way, and the Solar System).