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This study aimed to examine the predictors of cognitive performance in patients with pediatric mild traumatic brain injury (pmTBI) and to determine whether group differences in cognitive performance on a computerized test battery could be observed between pmTBI patients and healthy controls (HC) in the sub-acute (SA) and the early chronic (EC) phases of injury.
203 pmTBI patients recruited from emergency settings and 159 age- and sex-matched HC aged 8–18 rated their ongoing post-concussive symptoms (PCS) on the Post-Concussion Symptom Inventory and completed the Cogstate brief battery in the SA (1–11 days) phase of injury. A subset (156 pmTBI patients; 144 HC) completed testing in the EC (∼4 months) phase.
Within the SA phase, a group difference was only observed for the visual learning task (One-Card Learning), with pmTBI patients being less accurate relative to HC. Follow-up analyses indicated higher ongoing PCS and higher 5P clinical risk scores were significant predictors of lower One-Card Learning accuracy within SA phase, while premorbid variables (estimates of intellectual functioning, parental education, and presence of learning disabilities or attention-deficit/hyperactivity disorder) were not.
The absence of group differences at EC phase is supportive of cognitive recovery by 4 months post-injury. While the severity of ongoing PCS and the 5P score were better overall predictors of cognitive performance on the Cogstate at SA relative to premorbid variables, the full regression model explained only 4.1% of the variance, highlighting the need for future work on predictors of cognitive outcomes.
As I write, it is late April. Spring this year is warm, anxious, sunny and uncertain. It is unusually quiet in our village. The constant ebb and flow of commuter traffic has stopped: it has been like this for weeks since the lockdown. There is much less pollution, the skies are bluer than normal. There is a path near our small, terraced house that goes down to an old wood covered in a sea of bluebells. We are allowed one walk outside a day, not to be taken near others. This path, like all others now, is measured strictly in units of two metres. But the path is rarely busy, so I can follow it down to the wood.
Standing in this sea of blue, it is hard not to reflect on the duality of nature, on its ability to be both deadly and sublime. Today the death toll from COVID-19 is almost 800. I feel powerless, calm, vulnerable. In a week or two, this wood will have changed, the blue will be gone. But nothing will have changed. The crisis will not have passed. We will still be confined and isolated. The feeling that each next step will be taken in an ocean of uncertainty will remain.
Not all crises cause change. About 17 years ago, I survived a category four hurricane. Hurricanes of this magnitude are extremely dangerous. We were living in Bermuda at the time and had two very young children. The islands took a direct hit. Bermuda is tiny, the remains of a long-extinct volcano, isolated in the vastness of the Atlantic Ocean about 600 miles from the nearest landmass and with only a fragile coral reef for protection. Our children were thankfully too young to understand what nature was about to unleash. The emergency radio station went dead two hours into the storm and there was no contact with the outside world. The night that followed was terrifying. I remember most stepping outside the morning after the hurricane passed. It was warm, sunny and eerily calm. We would have no power or water for a month.
It was Hannah Arendt who once famously said that most evil is done by those who never make up their minds to be good or evil. In the Richard IIIs, Edmunds, Iagos and Don Johns we can readily recognize malice and intent. Indeed, they may even tell us they want ‘to prove a villain’. Arendt is talking about a different kind of villain: those who do not think, those who do not reflect on the meaning or consequences of their actions, or inactions. Those who choose not to choose.
Innovation can be defined in many ways, but for me the key thing is that it is about creating futures, in sometimes profound and disruptive ways. Innovation is a powerful thing, but it also has the propensity to be tragically banal. Think about all its promise, potential and power and then think about what it is actually being used for. At a time of great danger for our planet and the people and non-people who inhabit it, think about the futures innovation could create, and the ones innovation is actually creating. We desperately need innovation to help us secure a future on this planet that is sustainable, flourishing, just and equitable, but that is not what we are getting. Not all innovation, to be sure. But a great deal, and that is the sad truth.
With innovation I suggest the time has come to choose to choose. What kind of futures do we want (or rather need), and want innovation to help create? How can we collectively and substantively engage with those futures? And what does that mean for the re-framing and practice of innovation now? These for me are the departure points for taking responsibility for the future and for responsible innovation.
Responsible innovation, or at least the version I am familiar with, has always been cognisant and critical about the economic and political contexts within which it sits (I won't go on about second order reflexivity here, other than to stress its importance). This is a book that goes further. After reflecting on this context, the authors have made a choice. They contend that innovation is trapped in its ‘feed-the-market’ ties as the engine of an unsustainable, growth-led economic order.
Schmidt-hammer exposure-age dating (SHD) of boulders on cryoplanation terrace treads and associated bedrock cliff faces revealed Holocene ages ranging from 0 ± 825 to 8890 ± 1185 yr. The cliffs were significantly younger than the inner treads, which tended to be younger than the outer treads. Radiocarbon dates from the regolith of 3854 to 4821 cal yr BP (2σ range) indicated maximum rates of cliff recession of ~0.1 mm/yr, which suggests the onset of terrace formation before the last glacial maximum. Age, angularity, and size of clasts, together with planation across bedrock structures and the seepage of groundwater from the cliff foot, all support a process-based conceptual model of cryoplanation terrace development in which frost weathering leads to parallel cliff recession and, hence, terrace extension. The availability of groundwater during autumn freezeback is viewed as critical for frost wedging and/or the growth of segregation ice during prolonged winter frost penetration. Permafrost promotes cryoplanation by providing an impermeable frost table beneath the active layer, focusing groundwater flow, and supplying water for sediment transport by solifluction across the tread. Snow beds are considered an effect rather than a cause of cryoplanation terraces, and cryoplanation is seen as distinct from nivation.
Studies involving clinically recruited samples show that genetic liability to schizophrenia overlaps with that for several psychiatric disorders including bipolar disorder, major depression and, in a population study, anxiety disorder and negative symptoms in adolescence.
We examined whether, at a population level, association between schizophrenia liability and anxiety disorders continues into adulthood, for specific anxiety disorders and as a group. We explored in an epidemiologically based cohort the nature of adult psychopathology sharing liability to schizophrenia.
Schizophrenia polygenic risk scores (PRSs) were calculated for 590 European-descent individuals from the Christchurch Health and Development Study. Logistic regression was used to examine associations between schizophrenia PRS and four anxiety disorders (social phobia, specific phobia, panic disorder and generalised anxiety disorder), schizophrenia/schizophreniform disorder, manic/hypomanic episode, alcohol dependence, major depression, and – using linear regression – total number of anxiety disorders. A novel population-level association with hypomania was tested in a UK birth cohort (Avon Longitudinal Study of Parents and Children).
Schizophrenia PRS was associated with total number of anxiety disorders and with generalised anxiety disorder and panic disorder. We show a novel population-level association between schizophrenia PRS and manic/hypomanic episode.
The relationship between schizophrenia liability and anxiety disorders is not restricted to psychopathology in adolescence but is present in adulthood and specifically linked to generalised anxiety disorder and panic disorder. We suggest that the association between schizophrenia liability and hypomanic/manic episodes found in clinical samples may not be due to bias.
The longstanding association between the major histocompatibility complex (MHC) locus and schizophrenia (SZ) risk has recently been accounted for, partially, by structural variation at the complement component 4 (C4) gene. This structural variation generates varying levels of C4 RNA expression, and genetic information from the MHC region can now be used to predict C4 RNA expression in the brain. Increased predicted C4A RNA expression is associated with the risk of SZ, and C4 is reported to influence synaptic pruning in animal models.
Based on our previous studies associating MHC SZ risk variants with poorer memory performance, we tested whether increased predicted C4A RNA expression was associated with reduced memory function in a large (n = 1238) dataset of psychosis cases and healthy participants, and with altered task-dependent cortical activation in a subset of these samples.
We observed that increased predicted C4A RNA expression predicted poorer performance on measures of memory recall (p = 0.016, corrected). Furthermore, in healthy participants, we found that increased predicted C4A RNA expression was associated with a pattern of reduced cortical activity in middle temporal cortex during a measure of visual processing (p < 0.05, corrected).
These data suggest that the effects of C4 on cognition were observable at both a cortical and behavioural level, and may represent one mechanism by which illness risk is mediated. As such, deficits in learning and memory may represent a therapeutic target for new molecular developments aimed at altering C4’s developmental role.
The impact of flexible assertive community treatment (FACT) has been observed in people previously supported by assertive community treatment (ACT) teams, but its effect on those previously with a community mental health team (CMHT) has not been studied in the UK. An observational study was conducted of 380 people from 3 CMHTs and 95 people from an ACT team, all with a history of psychosis, following service reconfiguration to 3 FACT teams.
People previously with a CMHT required less time in hospital when the FACT model was introduced. A smaller reduction was observed in people coming from the ACT team. Both groups required less crisis resolution home treatment (CRHT) team input.
FACT may be a better model than standard CMHT care for people with a history of psychosis, as a result of reduced need for acute (CRHT and inpatient) services.
The existing theories on the evolution of senescence assume that senescence is inevitable in all organisms. However, recent studies have shown that this is not necessarily true. A better understanding of senescence and its underlying mechanisms could have far-reaching consequences for conservation and eco-evolutionary research. This book is the first to offer interdisciplinary perspectives on the evolution of senescence in many species, setting the stage for further developments. It brings together new insights from a wide range of scientific fields and cutting-edge research done on a multitude of different animals (including humans), plants and microbes, giving the reader a complete overview of recent developments and of the controversies currently surrounding the topic. Written by specialists from a variety of disciplines, this book is a valuable source of information for students and researchers interested in ageing and life history traits and populations.