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Obesity is highly prevalent and disabling, especially in individuals with severe mental illness including bipolar disorders (BD). The brain is a target organ for both obesity and BD. Yet, we do not understand how cortical brain alterations in BD and obesity interact.
We obtained body mass index (BMI) and MRI-derived regional cortical thickness, surface area from 1231 BD and 1601 control individuals from 13 countries within the ENIGMA-BD Working Group. We jointly modeled the statistical effects of BD and BMI on brain structure using mixed effects and tested for interaction and mediation. We also investigated the impact of medications on the BMI-related associations.
BMI and BD additively impacted the structure of many of the same brain regions. Both BMI and BD were negatively associated with cortical thickness, but not surface area. In most regions the number of jointly used psychiatric medication classes remained associated with lower cortical thickness when controlling for BMI. In a single region, fusiform gyrus, about a third of the negative association between number of jointly used psychiatric medications and cortical thickness was mediated by association between the number of medications and higher BMI.
We confirmed consistent associations between higher BMI and lower cortical thickness, but not surface area, across the cerebral mantle, in regions which were also associated with BD. Higher BMI in people with BD indicated more pronounced brain alterations. BMI is important for understanding the neuroanatomical changes in BD and the effects of psychiatric medications on the brain.
Psychopathological signs reflect general and significant phenomenon, the whole “extract” of a particular historical time, consisting of a bizarre set of events, influential characters twisted in an individual history of a patient. Except detailed “real” clinical picture reflecting socio-political events, authors consider formatting mechanisms of “unreal” content of hallucinatory-delusional symptoms. In such cases, main heroes are mythological characters for example gins or intimidating heroes of modern movies like vampires and zombies. Events in the social sets, such as Facebook and Instagram are also reflected in experiences of patients. Authors focus their attention on a paradox of logical reflection of events in the context of delusional symptoms versus paralogical interpretations. Research is based on clinical cases, and shows up a spectrum of mechanisms of how events are either included or ignored in the forming a content of psychopathological experiences.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Non-tuberculous mycobacterium encephalitis is rare. Since 2013, a global outbreak of Mycobacterium chimaera infection has been attributed to point-source contamination of heater cooler units used in cardiac surgery. Disseminated M. chimaera infection has presented many unique challenges, including non-specific clinical presentations with delays in diagnosis, and a high mortality rate among predominantly immunocompetent adults. Here, we describe three patients with fatal disseminated Mycobacterium chimaera infection showing initially non-specific, progressively worsening neurocognitive decline, including confusion, delirium, depression and apathy. Autopsy revealed widespread granulomatous encephalitis of the cerebrum, brain stem and spinal cord, along with granulomatous chorioretinitis. Cerebral involvement and differentiation between mycobacterial granulomas and microangiopathic changes can be assessed best on MRI with contrast enhancement. The prognosis of M. chimaera encephalitis appears to be very poor, but might be improved by increased awareness of this new syndrome and timely antimicrobial treatment.
This presentation will enable the learner to:
1. Describe the clinical, radiological and neuropathological findings of Mycobacterium chimaera encephalitis
2. Be aware of this rare form of encephalitis, and explain its diagnosis, prognosis and management
The objective of this study was to evaluate the impact of a brief parenting intervention, ‘Parents Make the Difference‘(PMD), on parenting behaviors, quality of parent-child interactions, children's cognitive, emotional, and behavioral wellbeing, and malaria prevention behaviors in rural, post-conflict Liberia.
A sample of 270 caregivers of children ages 3–7 were randomized into an immediate treatment group that received a 10-session parent training intervention or a wait-list control condition (1:1 allocation). Interviewers administered baseline and 1-month post-intervention surveys and conducted child-caregiver observations. Intent-to-treat estimates of the average treatment effects were calculated using ordinary least squares regression. This study was pre-registered at ClinicalTrials.gov (NCT01829815).
The program led to a 55.5% reduction in caregiver-reported use of harsh punishment practices (p < 0.001). The program also increased the use of positive behavior management strategies and improved caregiver–child interactions. The average caregiver in the treatment group reported a 4.4% increase in positive interactions (p < 0.05), while the average child of a caregiver assigned to the treatment group reported a 17.5% increase (p < 0.01). The program did not have a measurable impact on child wellbeing, cognitive skills, or household adoption of malaria prevention behaviors.
PMD is a promising approach for preventing child abuse and promoting positive parent-child relationships in low-resource settings.
An outbreak of cryptosporidiosis occurred in the Isle of Thanet during December 1990 and January 1991. A total of 47 cases ranging in age from 2 months to 85 years were identified in residents from the Margate, Broadstairs and Ramsgate areas, with dates of onset of illness from 3 December to 14 January. A case-control study demonstrated a strong statistical association between illness and the consumption of unboiled tap water from a particular source, with evidence of a dose–response relationship. Although no cryptosporidial oocysts were identified in samples of untreated or treated water taken during the investigation, the results were consistent with the view that the source of infection was treated river water which was used to supplement borehole water.
The voluntary food intake (VFI) and apparent digestibility of chopped timothy hay by six Scottish Blackface (BF), Shetland (SH) and Dorset Horn (DH) non-breeding ewes were assessed in summer and winter. In two experiments VFI was higher in summer than in winter but did not differ between the breeds. In Expt 1, the seasonal difference in VFI was greater in BF and SH than in DH ewes and the apparent digestibility of dry matter (DM), organic matter (OM) and total nitrogen was consistently higher in all three breeds in summer than in winter. The higher digestibility of DM of the hay in summer than in winter was confirmed in Expt 2, in which the whole tract mean retention time (MRT) of the undigested residues was measured using 103ruthenium-phenanthroline as a marker. The MRT was lower in all three breeds in summer than in winter. In a third experiment, following at least 6 months ad libitum feeding on the hay, for all three breeds the contents of DM and liquid in the reticulorumen were smaller in summer, and the liquid fraction formed a greater proportion in summer than in winter. The results contrast with the expectation that intake and digestibility within a given forage type are negatively correlated. Although an increase in digestibility may facilitate a higher VFI in summer (BF and SH) it does not necessarily do so (DH).
In this study, 82 sex offenders incarcerated at the Massachusetts Treatment Center were administered a brief structured clinical interview focusing on caregiver and institutional history up to age 18. Interview data were examined along with archival information coded from the clinical files. Four factors were derived from principal components analysis and were entered into a series of multiple regression analyses. There were two noteworthy results. First, sexual and nonsexual aggression in adulthood each were related to distinct aspects of developmental history. Whereas caregiver inconstancy and sexual deviation in the family wére related to the severity of sexual aggression, childhood and juvenile institutional history and physical abuse and neglect were associated with severity of nonsexual aggression. Second, contrary to previous studies of other criminal populations, the severity of aggression rather than frequency of crimes was predicted by developmental history. The results of the study suggest that childhood experiences with and disruption of caregiver relationships may be important to understanding sexual aggression in adulthood.
A number of authors have suggested that surgery for suspected perilymph fistula is effective in preventing deterioration of hearing and in improving hearing in some cases in the short term. We present long-term hearing outcome data from 35 children who underwent exploration for presumed perilymph fistula at The Children's Hospital, Sydney, Australia, between 1985 and 1992.
The pre-operative audiological data (mean of 500, 1000, 2000 and 4000 Hz results) were compared with the most recently available data (range two to 15 years) and the six-month post-operative data.
The short-term results showed no significant change in hearing at six months, with a subsequent, statistically significant progression of hearing loss in both operated and non-operated ears (Wilcoxon signed rank test: operated ear, p < 0.017; non-operated ear, p < 0.009).
In this case series, exploratory surgery for correction of suspected perilymph fistula did not prevent progression of long-term hearing loss.
To interpret the concentrations of the products measured in Titan's atmosphere and to better understand the associated chemistry, many theoretical models have been developed so far. Unfortunately, large discrepancies are still found between theoretical and observational data. A critical examination of the chemical scheme included in these models points out some problems regarding the reliability of the description of critical reaction pathways as well as the accuracy of kinetic parameters. Laboratory experiments can be used to reduce these two sources of uncertainty. It can be:
i) experimental simulations: in our laboratory (LISA), representative Titan's simulation experiments are planned to be carried out in a reactor where the initial gas mixture will be exposed, for the first time, to both electrons and photons. Thus, the chemistry between N atoms and CH3, CH2, CH fragments, issued from electron dissociation of N2 and photo-dissociation of CH4 respectively, will be initiated. Thank to a time resolved technique, we will be able to analyse “in situ”, qualitatively and quantitatively, the stable species as well as the short life intermediates. Then, the implied chemistry will be determined precisely, and consequently, its description will be refined in theoretical models. The current status of this program will be given.
ii) specific experiments: they are devoted, for example, to determine kinetic rate constants and low temperature VUV spectra that will be used to feed models and to interpret observational data. Such experiments performed in LISA and in Rennes' laboratory concern polyynes and cyanopolyynes as these compounds could link the gaseous and the solid phase in planetary atmosphere. Results concerning C4H+ hydrocarbons kinetic rate constants and VUV cross section of HC3N and HC5N will be detailed.
Progress on mid-infrared photodetectors fabricated by the liquid phase epitaxial growth of GaInAsSb, InAsSbP, and AlGaAsSb on GaSb and InAs substrates is reported. GaInAsSb p/n and p-i-n detectors, InAsSbP p/n detectors and AlGaAsSb/GaInAsSb avalanche photodiode (APD) structures were fabricated. Preliminary results indicate that these devices can have higher detectivity with lower cooling requirements than commercially available detectors in the same wavelength range. Infrared p/n junction detectors made from GaInAsSb and InAsSbP showed cut-off wavelengths of 2.3.μm and 2.8. μm respectively. Room temperature background noiselimited detectivity (D*BLIP) of 4 × 1010 cmHz1/2/W for GaInAsSb detectors and 4 × 108 cmHz1/2/W for InAsSbP was measured. Room-temperature avalanche multiplication gain of 20 was measured on AlGaAsSb/GaInAsSb avalanche photodiodes.
Over 3 years, a flock of Scottish Blackface ewes was managed so that one-third of the ewes received a high level of nutrition during the last 100 days of pregnancy (P), one-third received a high level of nutrition during the first 100 days of lactation (L) and one-third received a low level of nutrition as derived from a hill grazing over the same two periods (C). From these ewes, 496 ewe lambs were retained at weaning (19 to 22 weeks of age), balanced for treatment, year and birth type. At 6 months of age half of the lambs, similarly balanced, were transferred to an upland grazing system (U) for three breeding years. The other half was retained on the same hill grazing as their mothers for the same period (H). At the end of the study, all ewes were fed to reduce the range in body condition at a synchronized mating and ovulation rates were determined at slaughter.
Differences in live weight of ewes due to treatment between groups P, L and C had disappeared by 18 months. There were no pre-mating differences between treatments in live weight or body condition score except that ewes in group P had higher live weights than those in group C at condition scores greater than 2·75. There was little effect of grazing system on the differences between treatments in live weight or body condition score at 30 and 42 months but H ewes were heavier and fatter at 18 months of age. Ewe mortality was consistently less in group L than in groups P and C and on system H than on system U, although the differences were not statistically significant. Group L had fewer barren ewes than groups P and C, and barrenness was significantly greater in the U than the H system. Group C had proportionally more single than multiple births than either groups P or L.
At the end of the study there were no differences between the treatments in the proportion of ewes successfully mated at the final mating nor in their ovulation rates in relation to pre-mating body condition.
It is concluded that nutrition during either the lactation period or late pregnancy period can influence subsequent lifetime reproductive performance and that this was expressed through an effect on embryo or foetal loss since there were neither residual differences apparent in live weight or condition score nor in ovulation rate potential.
Voluntary food intake (VFI) of chopped timothy hay and metabolic rate were each measured in each month of the year in six non-breeding ewes of each of three breeds. Metabolic rate was measured using indirect calorimetry over a range of food intakes and adjusted for intake to an estimated maintenance metabolic rate (MMR). The breeds compared were the Dorset Horn (DT), Scottish Blackface (BF) and Shetland (SH), the first being less seasonal in reproductive and other characteristics than the other two which are hill or northern latitude breeds. There was significant overall variation between months in VFI which was higher in the summer (July to September) than in the winter (December to February) months (P < 0·001). There was a significant breed × month interaction (P < 0·01), the seasonal effect being most strongly observed in the BF and SH ewes, whose VFI in summer was proportionately 0-1 greater than the year-round mean but was 0-1 lower in the winter. The DT ewes showed much less seasonal variation in VFI. There was no overall difference in VFI between breeeds (DT: 43-7; BF: 49-5; SH: 48-1 g dry matter per M075 live weight per day, P > 0·1). Although MMR varied significantly between months (P < 0·001), there was no systematic variation between summer and winter. There was no significant breed × month interaction, but the MMR differed significantly (P < 0·001) between breeds giving a high overall MMR in BF (DT: 322-7; BF: 356-6; SH: 324-5 kf/kg M0·75 per day). No significant correlation existed (P > 0·05) between the monthly mean MMR and VFI in any of the breeds. The causal relationship between seasonal cycles of basal metabolic rate and VFI is questioned.
The effects on herbage intake of changes of herbage mass associated with different stocking rates were studied in Greyface (Border Leicester × Scottish Blackface) ewes in the autumn. Intake was measured in 5-day periods in late September (PI), late October (P2) and late November (P3) on two established, perennial ryegrass/white clover swards (SI and S2). Both swards had previously been variably stocked to produce areas with a range in herbage masses, some of which were grazed continuously (G) at stocking rates declining from 18 to 6 ewes per ha.
Intake was also measured in P2 and P3 on other areas of the swards which were ungrazed for 6 weeks in September and October (C) and then stocked at 18 ewes per ha. Intakes of dry matter, organic matter and digestible organic matter were 16 g, 10 g and 7·5 g/kg live weight, respectively. Organic matter digestibility was 075 in PI and P2 but declined in P3.
Differences in herbage intake and digestibility arose largely because of differences between the swards in herbage mass, sward height and sward density. Ewes in condition scores > 3·00 in early September had lower intakes at all times than did thinner ewes. Changes in sward management associated with different strategies of use had little long-term effect on herbage intake. Keywords: digestibility, herbage, sheep, stocking rate.
The effects of high-low (HL) and low-high (LH) patterns of nutrition during the 5 weeks prior to a synchronized mating were studied on the reproductive performance of 115 Welsh Mountain and 114 Brecknock Cheviot ewes in a range of body condition at the start of treatment. For 2 months prior to treatment imposition, ewes were grazed in a systematic way at different stocking rates on different sward heights to obtain a range of body condition scores. Target score groupings were 2·00 to 2·25, 2·50 to 2·75 and 3·00 to 3·25 and although scores of 1·50 to 3·25 were obtained, most lay in the 2·00 to 2·75 range. Two treatment groups, balanced for live weight and body condition score, received high and low levels of nutrition for 16 days from mid October, achieved, respectively, by a low stocking rate on a sward with a high surface height plus ad libitum concentrate and a high stocking rate on a sward with a low surface height plus 200 g hay per head per day. Treatments were then reversed for the 17 days prior to mating. Live-weight and body condition-score changes were recorded and reproductive performance at first mating was measured from counts of corpora lutea and viable embryos at slaughter either at return to service or at 4 weeks after first mating. There were no differences due to nutritional pattern in live weight or body condition score at mating. The LH treatment significantly increased the rates of ovulation, conception, multiple ova survival and potential lambing per ewe pregnant and per ewe mated in the Welsh Mountain breed but significantly increased only the rates of ovulation and potential lambing per ewe pregnant in the Brecknock Cheviot breed compared with the HL treatment. The relatively poorer response in the latter breed was partially due to a lower ovulation rate potential coupled with non-significantly lower rates of conception and survival of single-shed ova associated with the LH treatment. Much of this relatively poorer reproductive performance in the Brecknock Cheviot breed was in ewes with body condition scores 3= 2·75. Reproductive performance increased with increasing body condition at the start of treatment over the range of scores =≤ 2·25 to 2·50 in both breeds and, while continuing to improve in scores above 2·50 in the Welsh Mountain breed, in the Brecknock Cheviot breed it started to decline. Ewes with a body condition score of 2·50 in both breeds showed the greatest response in potential lambing rate to the LH treatment.
Over 4 years, a flock of mature North Country Cheviot ewes was grazed on different swards between weaning in August and mid October to achieve a range of condition scores at 5 weeks before mating (post-weaning period). During the subsequent 5 weeks before a synchronized mating (pre-mating period), all ewes were grazed on a perennial ryegrass/white clover sward, provided at high (H) or low (L) herbage masses (1600 to 2100 or 1200 to 1400 kg dry matter (DM) per ha, respectively). Ovulation rate was derived from the number of corpora lutea in 101 ewes slaughtered after first mating. Conception and lambing rates were derived from the number of lambs born to first mating of 406 ewes. In 2 out of the 4 years, 79 ewes were used to estimate herbage intake.
There was no effect of post-weaning management on reproductive performance. Herbage intake and reproductive performance were examined in relation to the body condition of the ewes at 5 weeks before mating. On an H herbage mass pre-mating, herbage intake in the period immediately prior to mating was greatest in ewes in low body condition and declined significantly with increasing condition. On an L herbage mass pre-mating, herbage intake did not vary significantly with condition. Ovulation rate was low in ewes in low body condition (scores =≤·25) at 5 weeks before mating, increased significantly with increasing condition up to scores 2·50/2·75 but did not change significantly above such intermediate scores. Conception and lambing rates increased significantly with increasing body condition up to scores 2·50/2·75 and then decreased significantly as condition increased above these levels. These effects of body condition were greater on an L herbage mass pre-mating than they were on an H herbage mass. Ewes in the intermediate body condition scores of 2·50 and 2·75 at 5 weeks before mating had a low sensitivity to contemporary nutrition pre-mating. Such condition levels are therefore considered to be above the range of condition in the North Country Cheviot breed within which reproductive response is affected by contemporary nutrition pre-mating.
The lower reproductive performance of ewes in high body condition (scores 3=3·00) at 5 weeks before mating was related to an increase in estimated ova and embryo loss and may be associated with a reduced herbage intake.
In a 2 × 2 × 2 × 2 factorial experiment, the effects on reproductive performance of active immunization against androstenedione and of two sward heights in two periods, August to October (period 1) and October to November (period 2), were investigated in 144 Beulah Speckled-face and 146 Brecknock Cheviot ewes. Sward heights of either 5 to 6 cm (2200 kg dry matter (DM) per ha) (high) or 2 to 3 cm (650 kg DM per ha) (low) were achieved by adjustment of stocking rate during period 1. Two groups of ewes were balanced for body condition score across breed and sward height and the ewes of one group were actively immunized against androstenedione by injection with Fecundin® at 8 and 5 weeks before mating at the second synchronized oestrus after progestagen pessary withdrawal. Ewes were reallocated to the high (at 15 ewes per ha) and low (at 20 ewes per ha) swards at the start of period 2 by breed and immunization treatment, balanced for live weight, body condition score and sward height in period 1. After mating in mid November, all ewes were run at 19 ewes per ha on the residual pasture of the high sward until slaughtered either at return to service or at 4 weeks after first mating when corpora lutea and embryos were counted.
There were no effects or interactions due to sward height in period 1 on the reproductive responses to sward height in period 2. Ovulation and potential lambing rates were greater in the Beulah breed than in the Cheviot, and on the high sward than on the low in period 2. Ovulation rates were higher in immunized ewes than in control ewes but the effects of immunization and sward height on potential lambing rate were not independent. Potential lambing rates were higher in immunized ewes than in control ewes at the low sward height but not at the high sward height.
Adjustment of stocking rate during period 1 served to increase the range in ewe body condition at the start of period 2 in mid October. Reproductive response to body condition at this time differed between the breeds, the relationship being strongly positive in the more prolific Beulah control ewes but less so in the less prolific Cheviot control ewes. The response to immunization in both breeds was relatively greater at lower levels of body condition, thereby reducing the effect of body condition in immunized ewes.
The use of Fecundin® is therefore unlikely to produce much advantage when pre-mating nutrition or body condition are high but there may be some advantage in using it when nutritional resources are limited in the autumn, particularly in ewes in poorer body condition.
The need for structural materials that can withstand severe environments up to 4000°F has promulgated the investigation of sol-gel derived ceramic and composite coatings on carbon/carbon composite materials. Alumina and zirconia sols have been deposited via thermophoresis on carbon/carbon substrates.
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