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B.6 Long-term risk of subsequent stroke after transient ischemic attack or minor stroke: a systematic review and meta-analysis
- F Khan, V Yogendrakumar, R Lun, A Ganesh, V Lioutas, N Vinding, A Algra, C Weimar, J Ögren, J Edwards, R Swartz, A Ois, E Giralt-Steinhauer, H Bae, M Kamouchi, F de Leeuw, J Verhoeven, T Uehara, K Minematsu, S Fandler-Höfler, M Foschi, W Whiteley, F Purroy, J Jing, Y Wang, M Baik, Y Kim, M Spampinato, F Ildstad, Y Hasegawa, K Perera, H Park, D Dutta, P Barber, S Coutts, M Hill
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 51 / Issue s1 / June 2024
- Published online by Cambridge University Press:
- 24 May 2024, p. S6
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Background: After a transient ischemic attack (TIA) or minor stroke, the long-term risk of subsequent stroke is uncertain. Methods: Electronic databases were searched for observational studies reporting subsequent stroke during a minimum follow-up of 1 year in patients with TIA or minor stroke. Unpublished data on number of stroke events and exact person-time at risk contributed by all patients during discrete time intervals of follow-up were requested from the authors of included studies. This information was used to calculate the incidence of stroke in individual studies, and results across studies were pooled using random-effects meta-analysis. Results: Fifteen independent cohorts involving 129794 patients were included in the analysis. The pooled incidence rate of subsequent stroke per 100 person-years was 6.4 events in the first year and 2.0 events in the second through tenth years, with cumulative incidences of 14% at 5 years and 21% at 10 years. Based on 10 studies with information available on fatal stroke, the pooled case fatality rate of subsequent stroke was 9.5% (95% CI, 5.9 – 13.8). Conclusions: One in five patients is expected to experience a subsequent stroke within 10 years after a TIA or minor stroke, with every tenth patient expected to die from their subsequent stroke.
Impact of health educational programmes on the prevalence of enterobiasis in schoolchildren in Thailand
- C. Nithikathkul, N. Akarachantachote, S. Wannapinyosheep, W. Pumdonming, M. Brodsky, Y. Sukthana
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- Journal of Helminthology / Volume 79 / Issue 1 / March 2005
- Published online by Cambridge University Press:
- 12 April 2024, pp. 61-65
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Enterobiasis is a worldwide prevalent disease particularly in low income areas. The budget needed for the prevention, treatment and eradication of the disease has thus far frustrated the limited budgets of global public health systems. A study was undertaken to determine if education in addition to medical treatment of enterobiasis could make a difference to the rates of infection. A total of 777 children (399 male and 378 female) from 11 elementary schools in five districts of Samut Prakan Province, Thailand were examined between December 2000 and March 2002. In five of the 11 schools studied, medical treatments were applied, followed by a programme of educating the children in the prevention of infection. Children in the remaining six schools received medical treatment only. The study showed a decrease in infections among children who received supplementary education. This decrease was significant in comparison to the decrease shown among children who received medical treatment only. The study therefore showed that educating high risk individuals played a key role in the prevention of enterobiasis.
Diagnostic value of IgG isotype responses against Brugia malayi antifilarial antibodies in the clinical spectrum of brugian filariasis
- S. Wongkamchai, C. Rochjanawatsiriroj, N. Monkong, H. Nochot, S. Loymek, C. Jiraamornnimit, S. Hunnangkul, W. Choochote
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- Journal:
- Journal of Helminthology / Volume 80 / Issue 4 / December 2006
- Published online by Cambridge University Press:
- 12 April 2024, pp. 363-367
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To study the diagnostic significance of antifilarial IgG subclasses in the clinical spectrum of brugian filariasis, IgG1, IgG3 and IgG4 antifilarial antibodies were determined in an exposed population comprising 74 asymptomatic amicrofilaraemics, 30 microfilaraemics, 20 lymphangitis and 16 elephantiasis patients resident in Narathiwart province, an area endemic for Brugia malayi lymphatic filariasis in southern Thailand. The dominant isotype of antifilarial antibody was IgG4. A significantly higher percentage of individuals were positive for IgG1 in the microfilaraemic and lymphangitis groups compared with the elephantiasis and endemic normal patients, while a significantly higher positive rate of IgG3 was found in those with lymphangitis. The possible role of these isotypes for diagnostic purposes and the pattern of antibody response in various clinically manifesting groups are discussed.
Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition
- Jarrod J Homer, Stuart C Winter, Elizabeth C Abbey, Hiba Aga, Reshma Agrawal, Derfel ap Dafydd, Takhar Arunjit, Patrick Axon, Eleanor Aynsley, Izhar N Bagwan, Arun Batra, Donna Begg, Jonathan M Bernstein, Guy Betts, Colin Bicknell, Brian Bisase, Grainne C Brady, Peter Brennan, Aina Brunet, Val Bryant, Linda Cantwell, Ashish Chandra, Preetha Chengot, Melvin L K Chua, Peter Clarke, Gemma Clunie, Margaret Coffey, Clare Conlon, David I Conway, Florence Cook, Matthew R Cooper, Declan Costello, Ben Cosway, Neil J A Cozens, Grant Creaney, Daljit K Gahir, Stephen Damato, Joe Davies, Katharine S Davies, Alina D Dragan, Yong Du, Mark R D Edmond, Stefano Fedele, Harriet Finze, Jason C Fleming, Bernadette H Foran, Beth Fordham, Mohammed M A S Foridi, Lesley Freeman, Katherine E Frew, Pallavi Gaitonde, Victoria Gallyer, Fraser W Gibb, Sinclair M Gore, Mark Gormley, Roganie Govender, J Greedy, Teresa Guerrero Urbano, Dorothy Gujral, David W Hamilton, John C Hardman, Kevin Harrington, Samantha Holmes, Jarrod J Homer, Deborah Howland, Gerald Humphris, Keith D Hunter, Kate Ingarfield, Richard Irving, Kristina Isand, Yatin Jain, Sachin Jauhar, Sarra Jawad, Glyndwr W Jenkins, Anastasios Kanatas, Stephen Keohane, Cyrus J Kerawala, William Keys, Emma V King, Anthony Kong, Fiona Lalloo, Kirsten Laws, Samuel C Leong, Shane Lester, Miles Levy, Ken Lingley, Gitta Madani, Navin Mani, Paolo L Matteucci, Catriona R Mayland, James McCaul, Lorna K McCaul, Pádraig McDonnell, Andrew McPartlin, Valeria Mercadante, Zoe Merchant, Radu Mihai, Mufaddal T Moonim, John Moore, Paul Nankivell, Sonali Natu, A Nelson, Pablo Nenclares, Kate Newbold, Carrie Newland, Ailsa J Nicol, Iain J Nixon, Rupert Obholzer, James T O'Hara, S Orr, Vinidh Paleri, James Palmer, Rachel S Parry, Claire Paterson, Gillian Patterson, Joanne M Patterson, Miranda Payne, L Pearson, David N Poller, Jonathan Pollock, Stephen Ross Porter, Matthew Potter, Robin J D Prestwich, Ruth Price, Mani Ragbir, Meena S Ranka, Max Robinson, Justin W G Roe, Tom Roques, Aleix Rovira, Sajid Sainuddin, I J Salmon, Ann Sandison, Andy Scarsbrook, Andrew G Schache, A Scott, Diane Sellstrom, Cherith J Semple, Jagrit Shah, Praveen Sharma, Richard J Shaw, Somiah Siddiq, Priyamal Silva, Ricard Simo, Rabin P Singh, Maria Smith, Rebekah Smith, Toby Oliver Smith, Sanjai Sood, Francis W Stafford, Neil Steven, Kay Stewart, Lisa Stoner, Steve Sweeney, Andrew Sykes, Carly L Taylor, Selvam Thavaraj, David J Thomson, Jane Thornton, Neil S Tolley, Nancy Turnbull, Sriram Vaidyanathan, Leandros Vassiliou, John Waas, Kelly Wade-McBane, Donna Wakefield, Amy Ward, Laura Warner, Laura-Jayne Watson, H Watts, Christina Wilson, Stuart C Winter, Winson Wong, Chui-Yan Yip, Kent Yip
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- Journal:
- The Journal of Laryngology & Otology / Volume 138 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 14 March 2024, pp. S1-S224
- Print publication:
- April 2024
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Crystal structure of ractopamine hydrochloride, C18H24NO3Cl
- Colin W. Scherry, Nicholas C. Boaz, James A. Kaduk, Anja Dosen, Thomas N. Blanton
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- Powder Diffraction , First View
- Published online by Cambridge University Press:
- 29 February 2024, pp. 1-11
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The crystal structure of ractopamine hydrochloride has been solved and refined using synchrotron X-ray powder diffraction data, and optimized using density functional theory techniques. Ractopamine hydrochloride crystallizes in space group Pbca (#61) with a = 38.5871(49), b = 10.7691(3), c = 8.4003(2) Å, V = 3490.75(41) Å3, and Z = 8. The ractopamine cation contains two chiral centers, and the sample consists of a mixture of the S,S/R,R/S,R and R,S forms. Models for the two diastereomers S,S and S,R were refined, and yielded equivalent residuals, but the S,R form is significantly lower in energy. The crystal structure consists of layers of molecules parallel to the bc-plane. In each structure one of the H atoms on the protonated N atom acts as a donor in a strong discrete N–H⋯Cl hydrogen bond. Hydroxyl groups act as donors in O–H⋯Cl and O–H⋯O hydrogen bonds. Both the classical and C–H⋯Cl and C–H⋯O hydrogen bonds differ between the forms, helping to explain the large microstrain observed for the sample. The powder pattern has been submitted to ICDD® for inclusion in the Powder Diffraction File™ (PDF®).
Functional neuroimaging biomarkers of anhedonia response to escitalopram plus adjunct aripiprazole treatment for major depressive disorder
- Sophie R. Vaccarino, Shijing Wang, Sakina J. Rizvi, Wendy Lou, Stefanie Hassel, Glenda M. MacQueen, Keith Ho, Benicio N. Frey, Raymond W. Lam, Roumen V. Milev, Susan Rotzinger, Arun V. Ravindran, Stephen C. Strother, Sidney H. Kennedy
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- Journal:
- BJPsych Open / Volume 10 / Issue 1 / January 2024
- Published online by Cambridge University Press:
- 05 January 2024, e18
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Background
Identifying neuroimaging biomarkers of antidepressant response may help guide treatment decisions and advance precision medicine.
AimsTo examine the relationship between anhedonia and functional neurocircuitry in key reward processing brain regions in people with major depressive disorder receiving aripiprazole adjunct therapy with escitalopram.
MethodData were collected as part of the CAN-BIND-1 study. Participants experiencing a current major depressive episode received escitalopram for 8 weeks; escitalopram non-responders received adjunct aripiprazole for an additional 8 weeks. Functional magnetic resonance imaging (on weeks 0 and 8) and clinical assessment of anhedonia (on weeks 0, 8 and 16) were completed. Seed-based correlational analysis was employed to examine the relationship between baseline resting-state functional connectivity (rsFC), using the nucleus accumbens (NAc) and anterior cingulate cortex (ACC) as key regions of interest, and change in anhedonia severity after adjunct aripiprazole.
ResultsAnhedonia severity significantly improved after treatment with adjunct aripiprazole.
There was a positive correlation between anhedonia improvement and rsFC between the ACC and posterior cingulate cortex, ACC and posterior praecuneus, and NAc and posterior praecuneus. There was a negative correlation between anhedonia improvement and rsFC between the ACC and anterior praecuneus and NAc and anterior praecuneus.
ConclusionsEight weeks of aripiprazole, adjunct to escitalopram, was associated with improved anhedonia symptoms. Changes in functional connectivity between key reward regions were associated with anhedonia improvement, suggesting aripiprazole may be an effective treatment for individuals experiencing reward-related deficits. Future studies are required to replicate our findings and explore their generalisability, using other agents with partial dopamine (D2) agonism and/or serotonin (5-HT2A) antagonism.
Arsenic-Bearing Serpentine-Group Minerals: Mineral Synthesis with Insights for the Arsenic Cycle
- P. C. Ryan, F.J. Huertas, L. N. Pincus, W. Painter
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- Journal:
- Clays and Clay Minerals / Volume 67 / Issue 6 / December 2019
- Published online by Cambridge University Press:
- 01 January 2024, pp. 488-506
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When present at elevated levels in drinking water, arsenic is toxic, and magnesian clays are gaining recognition as a source of elevated arsenic in groundwater. In the crust and upper mantle of Earth, arsenic incorporation into clay minerals is influenced by geochemical conditions associated with hydrothermal fluids and metamorphic processes (e.g. serpentinization), meaning that As is a useful tracer of fluid-flow in the deep Earth. To improve understanding of arsenic speciation in groundwater, sediments, soils, and hydrothermal-metamorphic systems, the present study examined arsenic incorporation into magnesian clays by synthesis of serpentine minerals (200oC, 10 d) with varied concentrations of Si, Al, As5+, and As3+. The synthesis experiments produced two distinct crystal types, tubular and platy serpentines, each with 10–15% randomly interstratified talc layers. X-ray absorption spectroscopy indicated that As5+ and As3+ occurred in the tetrahedral sheet. Single-crystal analysis revealed that tubular crystals contained up to 1 wt.% arsenic [Mg2.8(Si1.8As0.2)O5(OH)4] (mean 0.2 wt.% As). The mean composition of platy, high-Al crystals is (Mg1.8Al0.7)(Si2.0)O5(OH)4, and that of platy, medium-Al crystals with As3+ is (Mg2.07Al0.52) (Si1.97As3+0.03)O5(OH)4. Charge, geometry, and radius of tetrahedral AsO43– oxyanions are similar to tetrahedral SiO44–, and this facilitates fixation of As5+ into the tetrahedral sheet of clay minerals. The geometry and size of the larger As3+ in tetrahedral sites (as a pyramidal AsO33– oxyanion) may limit incorporation relative to As5+. Arsenic-bearing Mg clays crystallize in alkaline environments where AsO43– or AsO33– are the dominant As species and where high pH accompanies crystallization of serpentine, talc, chlorite, or Mg-smectite. The presence of tetrahedral As in these clays raises the possibility of tetrahedral As in other Mg clays (e.g. sepiolite or kerolite) as well.
Kaolinite and Halloysite Derived from Sequential Transformation of Pedogenic Smectite and Kaolinite-Smectite in a 120 ka Tropical Soil Chronosequence
- P. C. Ryan, F. J. Huertas, F. W. C. Hobbs, L. N. Pincus
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- Journal:
- Clays and Clay Minerals / Volume 64 / Issue 5 / October 2016
- Published online by Cambridge University Press:
- 01 January 2024, pp. 639-667
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Tropical soils range from nutrient-depleted lateritic soils rich in halloysite or kaolinite to Inceptisols rich in interstratified kaolinite-smectite (K-S), smectite, or related 2:1 clays. Given the strong influence of clay minerals on tropical soil quality, better understanding of factors influencing their occurrence is important for modeling and managing tropical environments. This study examines the alteration of smectite to kaolinite by way of intermediate K-S and halloysite in a 120 ka moist tropical chronosequence. Iron-rich smectite (11.6 ± 2.2% Fe2O3) is the dominant mineral in Holocene soils (1–8 ka) originating from sediments rich in plagioclase and clinopyroxene. The cation exchange capacity (CEC) of smectite is 54–84 cmolc/kg and pH is 6.1 to 7.4. Within 50 ka, smectite fixes Al-hydroxy complexes into interlayers, K+ is retained preferentially over Ca2+, and 2:1 layers are stripped of tetrahedral sheets; the resulting K-S inherits flaky smectite crystal habit and the 2:1 layers — which only expand partially — include Al-hydroxy smectite and some illite-like layers. After 50 ka, the dominant mineral is K-S, the CEC is 18–28 cmolc/kg, and the pH is 5.3. Flaky Fe-kaolinite with ~10% residual smectite layers and halloysite (7.4% Fe2O3) also occur in 50 ka soil. The 120 ka soils are dominated by flaky Fe-kaolinite (<10% residual smectite layers) and halloysite (4.9% Fe2O3), and Fe-poor hexagonal kaolinite also occurs (5–10% of soil). The CEC is 11–16 cmolc/kg and the pH is 4.7–5.3.
Changes in crystal chemistry of the soil clays (decreasing Fe, Mg, Ca, and K; increasing Al) over time reflects two reaction mechanisms: (1) cell-preserved transformation of smectite layers to kaolinite layers that accompanies conversion of smectite to K-S and eventually kaolinite; this results in the formation of flaky Fe-rich kaolinites after 50 ka; and (2) dissolution of K-S followed by crystallization of halloysite. Neoformation of hexagonal kaolinite and/or halloysite with low Fe (<3% Fe2O3) follows dissolution of Fe-kaolinite or halloysite after 100 ka. This sequence is probably common in moist tropical soils and these findings may inform modeling of soil composition in tropical landscapes where tectonic, volcanic, or geomorphic activity periodically exposes unweathered parent material, producing a range of soil ages.
4 Evaluating Plasma GFAP for the Detection of Alzheimer’s Disease Dementia
- Madeline Ally, Henrik Zetterberg, Kaj Blennow, Nicholas J. Ashton, Thomas K. Karikari, Hugo Aparicio, Michael A. Sugarman, Brandon Frank, Yorghos Tripodis, Ann C. McKee, Thor D. Stein, Brett Martin, Joseph N. Palmisano, Eric G. Steinberg, Irene Simkina, Lindsay Farrer, Gyungah Jun, Katherine W. Turk, Andrew E. Budson, Maureen K. O’Connor, Rhoda Au, Wei Qiao Qiu, Lee E. Goldstein, Ronald Killiany, Neil W. Kowall, Robert A. Stern, Jesse Mez, Michael L. Alosco
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 408-409
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Objective:
Blood-based biomarkers represent a scalable and accessible approach for the detection and monitoring of Alzheimer’s disease (AD). Plasma phosphorylated tau (p-tau) and neurofilament light (NfL) are validated biomarkers for the detection of tau and neurodegenerative brain changes in AD, respectively. There is now emphasis to expand beyond these markers to detect and provide insight into the pathophysiological processes of AD. To this end, a reactive astrocytic marker, namely plasma glial fibrillary acidic protein (GFAP), has been of interest. Yet, little is known about the relationship between plasma GFAP and AD. Here, we examined the association between plasma GFAP, diagnostic status, and neuropsychological test performance. Diagnostic accuracy of plasma GFAP was compared with plasma measures of p-tau181 and NfL.
Participants and Methods:This sample included 567 participants from the Boston University (BU) Alzheimer’s Disease Research Center (ADRC) Longitudinal Clinical Core Registry, including individuals with normal cognition (n=234), mild cognitive impairment (MCI) (n=180), and AD dementia (n=153). The sample included all participants who had a blood draw. Participants completed a comprehensive neuropsychological battery (sample sizes across tests varied due to missingness). Diagnoses were adjudicated during multidisciplinary diagnostic consensus conferences. Plasma samples were analyzed using the Simoa platform. Binary logistic regression analyses tested the association between GFAP levels and diagnostic status (i.e., cognitively impaired due to AD versus unimpaired), controlling for age, sex, race, education, and APOE e4 status. Area under the curve (AUC) statistics from receiver operating characteristics (ROC) using predicted probabilities from binary logistic regression examined the ability of plasma GFAP to discriminate diagnostic groups compared with plasma p-tau181 and NfL. Linear regression models tested the association between plasma GFAP and neuropsychological test performance, accounting for the above covariates.
Results:The mean (SD) age of the sample was 74.34 (7.54), 319 (56.3%) were female, 75 (13.2%) were Black, and 223 (39.3%) were APOE e4 carriers. Higher GFAP concentrations were associated with increased odds for having cognitive impairment (GFAP z-score transformed: OR=2.233, 95% CI [1.609, 3.099], p<0.001; non-z-transformed: OR=1.004, 95% CI [1.002, 1.006], p<0.001). ROC analyses, comprising of GFAP and the above covariates, showed plasma GFAP discriminated the cognitively impaired from unimpaired (AUC=0.75) and was similar, but slightly superior, to plasma p-tau181 (AUC=0.74) and plasma NfL (AUC=0.74). A joint panel of the plasma markers had greatest discrimination accuracy (AUC=0.76). Linear regression analyses showed that higher GFAP levels were associated with worse performance on neuropsychological tests assessing global cognition, attention, executive functioning, episodic memory, and language abilities (ps<0.001) as well as higher CDR Sum of Boxes (p<0.001).
Conclusions:Higher plasma GFAP levels differentiated participants with cognitive impairment from those with normal cognition and were associated with worse performance on all neuropsychological tests assessed. GFAP had similar accuracy in detecting those with cognitive impairment compared with p-tau181 and NfL, however, a panel of all three biomarkers was optimal. These results support the utility of plasma GFAP in AD detection and suggest the pathological processes it represents might play an integral role in the pathogenesis of AD.
4 Risk Factor and Biomarker Correlates of FLAIR White Matter Hyperintensities in Former American Football Players
- Monica T Ly, Fatima Tuz-Zahra, Yorghos Tripodis, Charles H Adler, Laura J Balcer, Charles Bernick, Elaine Peskind, Megan L Mariani, Rhoda Au, Sarah J Banks, William B Barr, Jennifer V Wethe, Mark W Bondi, Lisa Delano-Wood, Robert C Cantu, Michael J Coleman, David W Dodick, Michael D McClean, Jesse Mez, Joseph N Palmisano, Brett Martin, Kaitlin Hartlage, Alexander P Lin, Inga K Koerte, Jeffrey L Cummings, Eric M Reiman, Martha E Shenton, Robert A Stern, Sylvain Bouix, Michael L Alosco
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 608-610
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Objective:
White matter hyperintensity (WMH) burden is greater, has a frontal-temporal distribution, and is associated with proxies of exposure to repetitive head impacts (RHI) in former American football players. These findings suggest that in the context of RHI, WMH might have unique etiologies that extend beyond those of vascular risk factors and normal aging processes. The objective of this study was to evaluate the correlates of WMH in former elite American football players. We examined markers of amyloid, tau, neurodegeneration, inflammation, axonal injury, and vascular health and their relationships to WMH. A group of age-matched asymptomatic men without a history of RHI was included to determine the specificity of the relationships observed in the former football players.
Participants and Methods:240 male participants aged 45-74 (60 unexposed asymptomatic men, 60 male former college football players, 120 male former professional football players) underwent semi-structured clinical interviews, magnetic resonance imaging (structural T1, T2 FLAIR, and diffusion tensor imaging), and lumbar puncture to collect cerebrospinal fluid (CSF) biomarkers as part of the DIAGNOSE CTE Research Project. Total WMH lesion volumes (TLV) were estimated using the Lesion Prediction Algorithm from the Lesion Segmentation Toolbox. Structural equation modeling, using Full-Information Maximum Likelihood (FIML) to account for missing values, examined the associations between log-TLV and the following variables: total cortical thickness, whole-brain average fractional anisotropy (FA), CSF amyloid ß42, CSF p-tau181, CSF sTREM2 (a marker of microglial activation), CSF neurofilament light (NfL), and the modified Framingham stroke risk profile (rFSRP). Covariates included age, race, education, APOE z4 carrier status, and evaluation site. Bootstrapped 95% confidence intervals assessed statistical significance. Models were performed separately for football players (college and professional players pooled; n=180) and the unexposed men (n=60). Due to differences in sample size, estimates were compared and were considered different if the percent change in the estimates exceeded 10%.
Results:In the former football players (mean age=57.2, 34% Black, 29% APOE e4 carrier), reduced cortical thickness (B=-0.25, 95% CI [0.45, -0.08]), lower average FA (B=-0.27, 95% CI [-0.41, -.12]), higher p-tau181 (B=0.17, 95% CI [0.02, 0.43]), and higher rFSRP score (B=0.27, 95% CI [0.08, 0.42]) were associated with greater log-TLV. Compared to the unexposed men, substantial differences in estimates were observed for rFSRP (Bcontrol=0.02, Bfootball=0.27, 994% difference), average FA (Bcontrol=-0.03, Bfootball=-0.27, 802% difference), and p-tau181 (Bcontrol=-0.31, Bfootball=0.17, -155% difference). In the former football players, rFSRP showed a stronger positive association and average FA showed a stronger negative association with WMH compared to unexposed men. The effect of WMH on cortical thickness was similar between the two groups (Bcontrol=-0.27, Bfootball=-0.25, 7% difference).
Conclusions:These results suggest that the risk factor and biological correlates of WMH differ between former American football players and asymptomatic individuals unexposed to RHI. In addition to vascular risk factors, white matter integrity on DTI showed a stronger relationship with WMH burden in the former football players. FLAIR WMH serves as a promising measure to further investigate the late multifactorial pathologies of RHI.
5 Antemortem Plasma GFAP Predicts Alzheimer’s Disease Neuropathological Changes
- Madeline Ally, Henrik Zetterberg, Kaj Blennow, Nicholas J. Ashton, Thomas K. Karikari, Hugo Aparicio, Michael A. Sugarman, Brandon Frank, Yorghos Tripodis, Brett Martin, Joseph N. Palmisano, Eric G. Steinberg, Irene Simkina, Lindsay Farrer, Gyungah Jun, Katherine W. Turk, Andrew E. Budson, Maureen K. O’Connor, Rhoda Au, Wei Qiao Qiu, Lee E. Goldstein, Ronald Killiany, Neil W. Kowall, Robert A. Stern, Jesse Mez, Bertran R. Huber, Ann C. McKee, Thor D. Stein, Michael L. Alosco
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 409-410
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Objective:
Blood-based biomarkers offer a more feasible alternative to Alzheimer’s disease (AD) detection, management, and study of disease mechanisms than current in vivo measures. Given their novelty, these plasma biomarkers must be assessed against postmortem neuropathological outcomes for validation. Research has shown utility in plasma markers of the proposed AT(N) framework, however recent studies have stressed the importance of expanding this framework to include other pathways. There is promising data supporting the usefulness of plasma glial fibrillary acidic protein (GFAP) in AD, but GFAP-to-autopsy studies are limited. Here, we tested the association between plasma GFAP and AD-related neuropathological outcomes in participants from the Boston University (BU) Alzheimer’s Disease Research Center (ADRC).
Participants and Methods:This sample included 45 participants from the BU ADRC who had a plasma sample within 5 years of death and donated their brain for neuropathological examination. Most recent plasma samples were analyzed using the Simoa platform. Neuropathological examinations followed the National Alzheimer’s Coordinating Center procedures and diagnostic criteria. The NIA-Reagan Institute criteria were used for the neuropathological diagnosis of AD. Measures of GFAP were log-transformed. Binary logistic regression analyses tested the association between GFAP and autopsy-confirmed AD status, as well as with semi-quantitative ratings of regional atrophy (none/mild versus moderate/severe) using binary logistic regression. Ordinal logistic regression analyses tested the association between plasma GFAP and Braak stage and CERAD neuritic plaque score. Area under the curve (AUC) statistics from receiver operating characteristics (ROC) using predicted probabilities from binary logistic regression examined the ability of plasma GFAP to discriminate autopsy-confirmed AD status. All analyses controlled for sex, age at death, years between last blood draw and death, and APOE e4 status.
Results:Of the 45 brain donors, 29 (64.4%) had autopsy-confirmed AD. The mean (SD) age of the sample at the time of blood draw was 80.76 (8.58) and there were 2.80 (1.16) years between the last blood draw and death. The sample included 20 (44.4%) females, 41 (91.1%) were White, and 20 (44.4%) were APOE e4 carriers. Higher GFAP concentrations were associated with increased odds for having autopsy-confirmed AD (OR=14.12, 95% CI [2.00, 99.88], p=0.008). ROC analysis showed plasma GFAP accurately discriminated those with and without autopsy-confirmed AD on its own (AUC=0.75) and strengthened as the above covariates were added to the model (AUC=0.81). Increases in GFAP levels corresponded to increases in Braak stage (OR=2.39, 95% CI [0.71-4.07], p=0.005), but not CERAD ratings (OR=1.24, 95% CI [0.004, 2.49], p=0.051). Higher GFAP levels were associated with greater temporal lobe atrophy (OR=10.27, 95% CI [1.53,69.15], p=0.017), but this was not observed with any other regions.
Conclusions:The current results show that antemortem plasma GFAP is associated with non-specific AD neuropathological changes at autopsy. Plasma GFAP could be a useful and practical biomarker for assisting in the detection of AD-related changes, as well as for study of disease mechanisms.
Causalgia: A Review of Nerve Resection, Amputation, Immunotherapy, and Amputated Limb CRPS II Pathology
- C. Peter N. Watson, Rajiv Midha, Denise W. Ng
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- Canadian Journal of Neurological Sciences , First View
- Published online by Cambridge University Press:
- 25 July 2023, pp. 1-6
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Background:
Causalgia and complex regional pain syndrome (CRPS) type II with nerve injury can be difficult to treat. Surgical peripheral nerve denervation for causalgia has been largely abandoned by pain clinicians because of a perception that this may aggravate a central component (anesthesia dolorosa).
Methods:We selectively searched Pubmed, Cochrane, MEDLINE, EMBASE, CINAHL Plus, and Scopus from 1947 for articles, books, and book chapters for evidence of surgical treatments (nerve resection and amputation) and treatment related to autoimmunity and immune deficiency with CRPS.
Results:Reviews were found for the treatment of causalgia or CRPS type II (n = 6), causalgia relieved by nerve resection (n = 6), and causalgia and CRPS II treated by amputation (n = 8). Twelve reports were found of autoimmunity with CRPS, one paper of these on associated immune deficiency and autoimmunity, and two were chosen for discussion regarding treatment with immunoglobulin and one by plasma exchange. We document a report of a detailed and unique pathological examination of a CRPS type II affected amputated limb and related successful treatment with immunoglobulin.
Conclusions:Nerve resection, with grafting, and relocation may relieve uncomplicated causalgia and CRPS type II in some patients in the long term. However, an unrecognized and treatable immunological condition may underly some CRPS II cases and can lead to the ultimate failure of surgical treatments.
Caregiver burden in parents of children with neurological impairement and its relation with depression
- A. Mellouli, S. Zouari, N. Smaoui, W. Bouchaala, I. Gassara, O. Jallouli, R. Feki, S. Ben Ncir, F. Kamoun, M. Maâlej, C. Charfi Triki
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S826
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Introduction
Caregiving negatively affects the psychological and physical health of the caregivers, especially in parents of children with neurological impairement (NI).Furthermore, the behavior and demands of the patient make the caregivers encounter increased stress levels and negative thoughtsabout the future that may lead to depression in caregivers.
ObjectivesTo assess the relationship between caregiver burden and symptoms of depression in parents of children with NI.
MethodsA total of 33 caregivers of children with NI, participated in this cross-sectional, descriptive and analytical study, carried out in Child Neurology Department of the University Hospital in Sfax (Tunisia), between February and April 2021.
The Zarit-Caregiver-Burden-Scale (Zarit-CBS) and the Beck Depression Scale were administered.
ResultsThe average age of the caregivers (27 mothers and 6 fathers) was 38,33 years ± 6,53 years. Among the parents, 81,81% didn’t exceed the secondary educational level and75,75% of them had an irregular occupation.
The average age of the children (21 boys and 12 girls) was 7,58±4,29 years.Near to the half of them (51,51%) had intellectual disability.Over 54.54% of the children had a functional independence, while 21.21% required help in walking and 24.24% were unable to walk.
The intervention was based on motor rehabilitation (57,57%), adequate equipment (24,24%), ergotherapy (45,45%) and speech therapy (60,6%).After the intervention, 63,63% of children had an improvement and 30,3% had a stationary state.
The mean score of Zarit-CBS was 52,45±14,26. The caregiver burden was noted in 96,96%.
The mean score of Beck was 9,33±5,48. The depression was noted in 78,78%.
The total Zarit-CBS score had positive correlation with Beck scores (p=0.038).
ConclusionsThere is a positive relationship between the caregiver burden and depression symptoms. Thus, effort should be made to relieve caregiver burden in parents of children with NI.
Disclosure of InterestNone Declared
Culturally adapted psychoeducation for bipolar disorder in a low-resource setting: protocol for a multicentre randomized controlled trial
- I. Husain, M. Umer, M. Asif, A. Bukhsh, T. Kiran, M. Ansari, H. Aslam, M. Bhatia, F. Dogar, O. Husain, H. A. Khan, A. A. Mufti, B. Mulsant, F. Naeem, H. A. Naqvi, C. De Oliveria, S. Siddiqui, A. Tamizuddin, W. Wang, J. Zaheer, N. Husain, N. Chaudhry, I. Chaudhry
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S384
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Introduction
Bipolar disorder (BD) is a source of marked disability, morbidity, and premature death. There is a paucity of research on personalized psychosocial interventions for BD, especially in lowresource settings. A previously published pilot randomized controlled trial (RCT) of a Culturally adapted PsychoEducation (CaPE) intervention for BD in Pakistan reported higher patient satisfaction, enhanced medication adherence, knowledge and attitudes towards BD, and improvement in mood symptom scores and health-related quality of life measures compared to treatment-as-usual (TAU).
ObjectivesThis protocol describes a larger multicentre RCT to confirm the clinical and cost-effectiveness of CaPE in Pakistan.
MethodsA multicentre individual, parallel arm, RCT of CaPE in 300Pakistani adults with BD. Participants over the age of 18, with adiagnosis of bipolar I and II and who are currently euthymic, will berecruited from seven sites including Karachi, Lahore, Multan, Rawalpindi,Peshawar, Hyderabad and Quetta. Time to recurrence will be the primaryoutcome assessed using Longitudinal Interval Follow-up Evaluation(LIFE). Secondary measures will include mood symptomatology, qualityof life and functioning, adherence to psychotropic medications, andknowledge and attitudes towards BD.
ResultsFull ethics approval has been received from National Bioethics Committee (NBC) of Pakistan and Centre for Addiction and Mental Health (CAMH), Toronto, Canada. The study has completed sixty-five screening across the seven centres, of which forty-eight participants have been randomised.
ConclusionsA successful trial will lead to rapid implementation of CaPE in clinical practice, not only in Pakistan, but also in other low-resource settings including those in high-income countries, to improve clinical outcomes, social and occupational functioning, and quality of life in South Asian and other minority patients with BD.
Disclosure of InterestNone Declared
Predictors of caregiver burden among parents of children with neurological impairement
- A. Mellouli, S. Zouari, N. Smaoui, O. Jallouli, S. Omri, W. Bouchaala, I. Gassara, S. Ben Nsir, F. Kamoun, M. Maâlej, C. Charfi Triki
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S947-S948
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Introduction
Many neurological, sensory and behavioural deficits, are linked with significant limitations in the overall functioning not only of the child but also his/her closest family, and poses a great challenge for the primary parental caregivers.
ObjectivesTo assess the caregiver burden in parents of children with neurological impairement (NI), and itsrelated factors.
MethodsA total of33 caregivers of children with NI participated in this cross-sectional, descriptive and analytical study, carried out in Child Neurology Department of the University Hospital in Sfax (Tunisia), between February and April 2021.
The Zarit-Caregiver-Burden-Scale (Zarit-CBS) was administered.
ResultsThe average age of the caregivers (27 mothers and 6 fathers) was 38,33 ± 6,53 years. Among the parents, 17.14% had another disabled child and 30.3% had a mediocre health status. Mother caregivers constitutes the majority of caregiving (82.85%).
The average of the number of children in the family was 1.97±1.18 and the average age of the children (21 boys and 12 girls) was 7,58±4,29 years. Near to the half of them (51,51%) had intellectual disability.Over 54.54% of the children had a functional independence, while 21.21% required help in walking and 24.24% were unable to walk. The intervention was based on motor rehabilitation (57,57%), adequate equipment (24,24%), ergotherapy (45,45%) and speech therapy (60,6%).After the intervention, 63,63% of children had an improvement and 30,3% had a stationary state.
The mean score of Zarit-CBS was 52,45±14,26. The caregiver burden was noted in 96,96%.
The total Zarit-CBS score was associated with the number of children in the family (p=0.047).
There was no significant relationship between Zarit-CBS and the severity of impairement (p=0.418).
ConclusionsGiven the variety of factors affecting caregiver burden, specific interventions may promote parental caregivers’well-being, and consequently lead to improved quality of care provided to children with NI.
Disclosure of InterestNone Declared
Exploring Decision-Making Strategies in the IOWA Gambling Task and Rat Gambling Task
- C. Hultman, N. Tjernström, S. Vadlin, M. Rehn, K. W. Nilsson, E. Roman, C. Åslund
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S106-S107
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Introduction
Impairments in decision-making processes are believed to play an important role in both substance use disorders and behavioral addictions. Clinical and pre-clinical experimental testing provide complimentary insights on the psychobiological mechanisms of decision-making. The IOWA Gambling Task (IGT) assesses decision-making under ambiguity and risk, in which individuals are faced with four card choices associated with varying monetary reinforcer/loss contingencies. The rat Gambling Task is a pre-clinical version using palatable reinforcers as wins and timeouts mimicking losses. However, studies with interspecies comparisons in these tasks are lacking, but important to facilitate translation of information that may help unravel the complex processes of decision-making and generate clinical advances.
ObjectivesThis study explores decision-making strategies among humans and rats performing the IGT and rGT.
MethodsA total of 270 young human adults performed a computerized version of the IGT, and 72 adult outbread male Lister Hooded rats performed the rGT. Performance was assessed and explored by normative scoring approaches and subgroup formations based on individual choices.
ResultsResults showed that most humans and rats learned to favor the advantageous choices, but the overall level of performance differed considerably. Humans displayed both exploration and learning as the task progressed, while rats showed relatively consistent pronounced preferences for the advantageous choices throughout the task. Nevertheless, variability in individual choice preferences during end performance were evident in both species.
ConclusionsResults are discussed in relation to procedural differences impacting performance and potential to study different aspects of decision-making. This is a first attempt to provide formal evaluation of similarities and differences regarding decision-making processes in the IGT and rGT from an explorative perspective.
Disclosure of InterestNone Declared
The use of new technology in prevention and treatment of psychiatric diseases - preliminary results
- A. Häussl, F. Fellendorf, E. Fleischmann, S. Guggemos, E. Schönthaler, T. Stross, I. Zwigl, D. Albert, J. Mosbacher, K. Stix, S. Draxler, G. Lodron, T. Orgel, M. Pszeida, S. Russegger, M. Schneeberger, M. Uray, W. Weiss, M. Fellner, T. Fruhmann, R. Hartmann, P. Hauptmann, R. Pfiszter, G. Pötz, U. Prattner, N. Saran, S. Spat, E. Zweytik, T. Lutz, S. Lindner-Rabl, R. Roller-Wirnsberger, S. Schüssler, J. Zuschnegg, K. Ceron, M. Danilov, C. Grossegger, M. Macher, O. Sokolov, S. Egger-Lampl, B. Roszipal, L. Paletta, M. Lenger, N. Dalkner, E. Reininghaus
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S853-S854
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Introduction
The COVID-19 outbreak is a serious global public health issue with wide-ranging negative effects on people’s lives, which is reflected in steadily rising mental health problems. In order to appropriately respond to the increased occurrence of psychiatric illness, protect mental health and strengthen resilience it is necessary to include new technologies, such as extended reality (XR) or socially assistive robots (SAR) in not only psychiatric treatment but also in the prevention of psychiatric diseases. In this context, the use of new technologies offers innovative ways to strengthen resilience, self-efficacy and stress coping skills and plays an important role in improving psychological wellbeing.
ObjectivesPreliminary results from studies at the Clinical Department of Psychiatry and Psychotherapeutic Medicine in Graz, Austria, dealing with new technologies in psychiatry, show new options for psychiatric settings.
MethodsProject AMIGA: The aim of this study is to test the effectiveness of a cognitive training session, conducted with the SAR named Pepper. In this randomized controlled trial, the effectiveness of SAR on depressive symptoms and correlates is evaluated in a sample of 60 individuals with major depression. While the intervention group will receive cognitive training with the SAR Pepper, the control group will receive “treatment-as-usual” therapy with a common PC software. Participants will receive 30 minutes of training 2 times per week over a period of 3 weeks.
Project XRes4HEALTH: The aim of this study is to develop an XR resilience training to increase resilience and stress coping mechanisms in healthcare workers. A total of 40 people will be included. To test the effectiveness of the resilience training, 3 XR training sessions of 15 minutes each will be held. A pre-post measurement will test the effectiveness of the training on wellbeing and stress levels as well as the acceptance and satisfaction with the training.
Project AI-REFIT: The overall goal of this study is to explore key information to increase resilience in healthy individuals who are at increased risk for mental health problems. Through a usability study, the artificial intelligence-based prototype app of the resilience training will be tested for acceptance, usability, functionality, and efficiency. During the resilience training, participants are wearing a smartwatch which measures psychophysiological parameters. Conclusions about the success of the therapy can be drawn based on digital data acquisition.
ResultsNew technologies including XR and SAR support classical psychiatric treatment in the topics of resilience and cognitive training as an add-on therapy in times of reduced availability of healthcare workers.
ConclusionsThe rapid development of new technologies holds a lot of potential in the treatment of psychiatric disorders, which is why it is important to scientifically evaluate those innovative tools.
Disclosure of InterestNone Declared
A Holocene pollen-inferred climate reconstruction for Vermont, USA
- Laurie D. Grigg, Ioana C. Stefanescu, Bryan N. Shuman, W. Wyatt Oswald
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- Quaternary Research / Volume 116 / November 2023
- Published online by Cambridge University Press:
- 03 July 2023, pp. 60-77
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A 13.0 cal ka BP pollen record from Twin Ponds, Vermont, provides new insights into the climate history of the northeastern United States. Modern analogs were used to produce qualitative and quantitative climate reconstructions for Twin Ponds. The Twin Ponds record was compared with nearby Knob Hill Pond to develop a Vermont reconstruction that was compared with reconstructions from two sites at a similar latitude. Postglacial warming at 11.5 cal ka BP followed a cool, wet Younger Dryas and was the largest temperature change of the record. The warmest, driest conditions occurred at ca. 9.0 cal ka BP, followed by an increase in moisture. Latitudinal and elevational shifts in the location of modern analogs from 5.7 to 4.0 cal ka BP were used to infer cooling and increased moisture during the Tsuga canadensis decline. Analysis of the timing of pollen events between the two Vermont sites suggests a more rapid decline in T. canadensis at the more northern Knob Hill Pond and further supports the possibility that colder temperatures contributed to this event. The other northern sites show similar trends until 2.5 cal ka BP, when precipitation in the easternmost site diverges, indicating the establishment of modern climatic gradients.
Accelerated protons with energies up to 70 MeV based on the optimized SG-II Peta-watt laser facility
- H. H. An, W. Wang, J. Xiong, C. Wang, X. Pan, X. P. Ouyang, S. Jiang, Z. Y. Xie, P. P. Wang, Y. L. Yao, N. Hua, Y. Wang, Z. C. Jiang, Q. Xiao, F. C. Ding, Y. T. Wan, X. Liu, R. R. Wang, Z. H. Fang, P. Q. Yang, Y. E. Jiang, P. Z. Zhang, B. Q. Zhu, J. R. Sun, B. Qiao, A. L. Lei, J. Q. Zhu
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- High Power Laser Science and Engineering / Volume 11 / 2023
- Published online by Cambridge University Press:
- 30 June 2023, e63
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The target backsheath field acceleration mechanism is one of the main mechanisms of laser-driven proton acceleration (LDPA) and strongly depends on the comprehensive performance of the ultrashort ultra-intense lasers used as the driving sources. The successful use of the SG-II Peta-watt (SG-II PW) laser facility for LDPA and its applications in radiographic diagnoses have been manifested by the good performance of the SG-II PW facility. Recently, the SG-II PW laser facility has undergone extensive maintenance and a comprehensive technical upgrade in terms of the seed source, laser contrast and terminal focus. LDPA experiments were performed using the maintained SG-II PW laser beam, and the highest cutoff energy of the proton beam was obviously increased. Accordingly, a double-film target structure was used, and the maximum cutoff energy of the proton beam was up to 70 MeV. These results demonstrate that the comprehensive performance of the SG-II PW laser facility was improved significantly.
WALLABY pilot survey: The diversity of HI structural parameters in nearby galaxies
- T. N. Reynolds, B. Catinella, L. Cortese, N. Deg, H. Dénes, A. Elagali, B.-Q. For, P. Kamphuis, D. Kleiner, B. S. Koribalski, K. Lee-Waddell, C. Murugeshan, W. Raja, J. Rhee, K. Spekkens, L. Staveley-Smith, J. M. van der Hulst, J. Wang, T. Westmeier, O. I. Wong, F. Bigiel, A. Bosma, B. W. Holwerda, D. A. Leahy, M. J. Meyer
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- Publications of the Astronomical Society of Australia / Volume 40 / 2023
- Published online by Cambridge University Press:
- 08 June 2023, e032
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We investigate the diversity in the sizes and average surface densities of the neutral atomic hydrogen (H i) gas discs in $\sim$280 nearby galaxies detected by the Widefield ASKAP L-band Legacy All-sky Blind Survey (WALLABY). We combine the uniformly observed, interferometric H i data from pilot observations of the Hydra cluster and NGC 4636 group fields with photometry measured from ultraviolet, optical, and near-infrared imaging surveys to investigate the interplay between stellar structure, star formation, and H i structural parameters. We quantify the H i structure by the size of the H i relative to the optical disc and the average H i surface density measured using effective and isodensity radii. For galaxies resolved by $>$$1.3$ beams, we find that galaxies with higher stellar masses and stellar surface densities tend to have less extended H i discs and lower H i surface densities: the isodensity H i structural parameters show a weak negative dependence on stellar mass and stellar mass surface density. These trends strengthen when we limit our sample to galaxies resolved by $>$2 beams. We find that galaxies with higher H i surface densities and more extended H i discs tend to be more star forming: the isodensity H i structural parameters have stronger correlations with star formation. Normalising the H i disc size by the optical effective radius (instead of the isophotal radius) produces positive correlations with stellar masses and stellar surface densities and removes the correlations with star formation. This is due to the effective and isodensity H i radii increasing with mass at similar rates while, in the optical, the effective radius increases slower than the isophotal radius. Our results are in qualitative agreement with previous studies and demonstrate that with WALLABY we can begin to bridge the gap between small galaxy samples with high spatial resolution H i data and large, statistical studies using spatially unresolved, single-dish data.