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To examine the association of posttraumatic headache (PTH) type with postconcussive symptoms (PCS), pain intensity, and fluid cognitive function across recovery after pediatric concussion.
Methods:
This prospective, longitudinal study recruited children (aged 8–16.99 years) within 24 hours of sustaining a concussion or mild orthopedic injury (OI) from two pediatric hospital emergency departments. Based on parent-proxy ratings of pre- and postinjury headache, children were classified as concussion with no PTH (n = 18), new PTH (n = 43), worse PTH (n = 58), or non-worsening chronic PTH (n = 19), and children with OI with no PTH (n = 58). Children and parents rated PCS and children rated pain intensity weekly up to 6 months. Children completed computerized testing of fluid cognition 10 days, 3 months, and 6- months postinjury. Mixed effects models compared groups across time on PCS, pain intensity, and cognition, controlling for preinjury scores and covariates.
Results:
Group differences in PCS decreased over time. Cognitive and somatic PCS were higher in new, chronic, and worse PTH relative to no PTH (up to 8 weeks postinjury; d = 0.34 to 0.87 when significant) and OI (up to 5 weeks postinjury; d = 0.30 to 1.28 when significant). Pain intensity did not differ by group but declined with time postinjury. Fluid cognition was lower across time in chronic PTH versus no PTH (d = −0.76) and OI (d = −0.61) and in new PTH versus no PTH (d = −0.51).
Conclusions:
Onset of PTH was associated with worse PCS up to 8 weeks after pediatric concussion. Chronic PTH and new PTH were associated with moderately poorer fluid cognitive functioning up to 6 months postinjury. Pain declined over time regardless of PTH type.
Women with polycystic ovary syndrome (PCOS) experience higher rates of depression and anxiety. There is limited research relating to perinatal mental health in women with PCOS. Studies suggest PCOS is associated with a higher prevalence of perinatal mental health disorders. Perinatal guidelines currently do not recognise PCOS as a risk factor for perinatal mental health disorders. We aimed to prospectively assess the prevalence of mental health disorders in pregnant women with PCOS.
Methods:
Consenting pregnant women, with and without PCOS, were invited to participate. Standardised validated questionnaires were carried out including Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS).
Results:
Fifty-one with PCOS and 49 without PCOS responded. Pregnant women with PCOS had a higher mean (SD) anxiety score (GAD-7) than those without PCOS (8.2 [6.7] vs. 5.89 [4.7], p = 0.04). Pregnant women with PCOS had higher mean (SD) depression scores than those without PCOS on EPDS (9.1 [6.4] vs. 6.4 [4.5], p = 0.02) but not PHQ-9 score (median (IQR) 4 (3–9) vs. 4 (2–7.5), p = 0.25). Women with PCOS were more likely to experience moderate/severe anxiety (PCOS 34%, control 20%) and moderate/severe depression (PCOS 34%, control 20%) symptoms than women without PCOS. Twenty-nine percent of pregnant women with PCOS had an EPDS score >13 showing significantly higher rates of severe depression (PCOS 29%, control 12%, p = 0.03).
Conclusion:
Our findings suggest a higher prevalence of perinatal depression and anxiety in women with PCOS. Our findings may suggest increased need for screening for mental health disorders in women with PCOS.
Palmer amaranth (Amaranthus palmeri S. Watson) was first reported in Iowa in 2013 and has continued to spread across the state over the last decade. Amaranthus palmeri is widely recognized as one of the more economically important weeds in production agriculture. The presence of A. palmeri in Iowa is concerning as the species has evolved resistance to ten herbicide sites of action, however, no formal characterization has been conducted on Iowa populations. Therefore, herbicide assays were conducted on an A. palmeri population collected in Harrison County, IA, in 2023 (Southwest Palmer Amaranth [SWPA]) and a known herbicide-susceptible population collected from Nebraska in 2001 (Palmer Amaranth Susceptible [PAS]). The two populations were treated with preemergence and postemergence herbicides commonly used in Iowa. The treatments included preemergence applications of atrazine, metribuzin, and mesotrione and postemergence applications of atrazine, imazethapyr, glyphosate, lactofen, mesotrione, glufosinate, 2,4-D, and dicamba at 1× and 4× the labeled rates. Survival frequency of SWPA was >90% when treated postemergence with 1× rates of imazethapyr, atrazine, glyphosate, and mesotrione compared with ≤6% for PAS. Both SWPA and PAS had 0% survival when treated with lactofen, glufosinate, 2,4-D, and dicamba at the 1× or 4× rates. Plant population density reduction for SWPA was 53% and 40% in response to 1× rates of preemergence-applied mesotrione and atrazine, respectively. Metribuzin applied preemergence reduced SWPA plant population density by >90% at both rates. Dose–response experiments revealed the 50% effective doses (ED50) of mesotrione, glyphosate, imazethapyr, and atrazine for SWPA were 9.5-,8.5-, 71-, and 40-fold greater than for PAS, respectively. The results confirm that SWPA is four-way multiple-herbicide resistant. Amaranthus palmeri infestations are likely to continue to spread within Iowa; therefore, diversified weed management programs that include early detection, rapid response, and effective multi-tactic management strategies will be required for control.
Rapid Onset Obesity with Hypoventilation, Hypothalamic Dysfunction, Autonomic Dysregulation (ROHHAD) is a rare and often progressive syndrome with unknown etiology and only 100 cases reported to date. The syndrome is characterized by generally normal development followed by rapid onset of pain, muscle weakness, personality changes, and developmental regression. Associated chronic pain and fatigue result in difficulty concentrating, slow information processing, and executive function challenges. Only one study has examined the neuropsychological profile of pediatric patients with this syndrome.
Participants and Methods:
Our patient was a 10-year-old, right-handed male with a history of ROHHAD syndrome, focal epilepsy, mild neurocognitive disorder, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) who underwent two comprehensive neuropsychological evaluations at our medical center.
Results:
Findings across multiple evaluations showed solid verbal skills and difficulty processing visual-spatial and nonverbal information, as well as problems with attention, executive functioning, and adaptive skills, and psychosocial functioning consistent with his diagnoses of ADHD and ASD. He exhibited fine-and gross-motor challenges associated with hypotonia. Chronic fatigue contributed to his challenges with attention and information processing. These findings are generally consistent with previous research examining the neuropsychological profile associated with ROHHAD syndrome.
Conclusions:
Results from our case study highlight the complexity and challenges associated with ROHHAD syndrome. Consistent with available information, etiology of our patients’ neuropsychological weakness and functional decline is unclear. Yearly neuropsychological evaluations are recommended for these patients to update interventions based on their variable abilities. More research is needed to firmly establish the neuropsychological profile in youth of varying ages afflicted with this syndrome.
A rich literature exists on cognitive changes related to focal injury in the adult brain. In contrast, the developing brains of children are less understood. In contrast to adult cases, 20% to 25% of perinatal strokes result in language disorder regardless of lesion lateralization. Existing literature suggests children with perinatal stroke may present with a range of executive functioning and visuospatial processing difficulties. Gross and fine motor challenges are also likely to occur. Furthermore, these children have an increased prevalence of autism spectrum disorder (ASD) and carry the highest risk for epilepsy. Despite growing research on neurodevelopmental profiles in patients with perinatal stroke, published literature is limited.
Participants and Methods:
Our study examines neurodevelopment of a 2-year-old, right-handed male with a history of perinatal ischemic right middle cerebral artery (MCA) stroke, infantile spasms, and left hemiparesis following right hemispherectomy for seizure management who underwent two neurodevelopmental evaluations at our medical center over approximately 3 years.
Results:
Findings from the patient’s evaluation with the Mullen Scales of Early Learning revealed overall cognitive ability in the low average range (SS = 89, 23rd percentile); however, notable variability was seen in his performance. His receptive language was average (SS = 98, 45th %tile) and consistent with previous evaluation results, and he has made gains in visual reception (from SS = 75, 5th %tile to SS = 91, 27th %tile) and expressive language (from SS = 55, 0.1st %tile to SS = 70, 2nd %tile). In addition, his gross motor was exceptionally low (SS = 55, 0.1st %tile) and consistent with previous evaluation results. Fine motor was low average (SS = 84, 14th %tile).
Conclusions:
Our patient showed cognitive gains in language and visual reception since his prior evaluation despite history of right MCA stroke and right hemispherectomy. Improvements are likely due to a combination of early brain plasticity and intensive therapies he has received. Consistent with published findings in this population, he experienced seizures associated with his stroke. Our results add to the limited literature on neurodevelopmental challenges associated with perinatal stroke and progress that can be made when appropriate supports are provided early and consistently.
Epilepsy includes recurrent, unprovoked seizures and affects 470,000 children in the US, of which 7% have drug-resistant epilepsy due to failing two or more antiseizure medication trials. For some patients with drug-resistant epilepsy, surgery has been successful in reducing seizure burden. Functional MRI (fMRI) and intracranial mapping of neurocognitive functions, especially language, are increasingly done to assess potential functional loss from epilepsy surgery. However, these procedures vary by medical institute. The purpose of this review was to examine published literature on fMRI and intracranial mapping procedures for pediatric epilepsy surgery workup toward development of a standardized protocol that can be used across institutes as a guide to standard-of-care best practices for predicting loss of function associated with epilepsy surgery.
Participants and Methods:
Our literature review includes information from 8 electronic databases for peer-reviewed, English language studies of evaluation for pediatric epilepsy surgery candidacy. Thirty-one studies were selected based on inclusion criteria. Only studies including fMRI and intracranial mapping conducted with pediatric patients being worked up for epilepsy surgery were selected.
Results:
Our review revealed that the most common task used in fMRI and intracranial mapping procedures is visual-object naming, but type of naming tasks and the way they are administered varies widely across medical institutes and includes published measures and those created on site. Variability makes examining findings across studies and designing best practice for these procedures challenging.
Conclusions:
Creating gold-standard procedures for fMRI and intracranial mapping administration for epilepsy surgery evaluations is critical in optimizing treatment and functional outcomes for our pediatric patients. Our review is an initial step in this process.
Estimates suggest that 1 in 100 people in the UK live with facial scarring. Despite this incidence, psychological support is limited.
Aims
The aim of this study was to strengthen the case for improving such support by determining the incidence and risk factors for anxiety and depression disorders in patients with facial scarring.
Method
A matched cohort study was performed. Patients were identified via secondary care data sources, using clinical codes for conditions resulting in facial scarring. A diagnosis of anxiety or depression was determined by linkage with the patient's primary care general practice data. Incidence was calculated per 1000 person-years at risk (PYAR). Logistic regression was used to determine risk factors.
Results
Between 2009 and 2018, 179 079 patients met the study criteria and were identified as having a facial scar, and matched to 179 079 controls. The incidence of anxiety in the facial scarring group was 10.05 per 1000 PYAR compared with 7.48 per 1000 PYAR for controls. The incidence of depression in the facial scarring group was 16.28 per 1000 PYAR compared with 9.56 per 1000 PYAR for controls. Age at the time of scarring, previous history of anxiety or depression, female gender, socioeconomic status and classification of scarring increased the risk of both anxiety disorders and depression.
Conclusions
There is a high burden of anxiety disorders and depression in this patient group. Risk of these mental health disorders is very much determined by factors apparent at the time of injury, supporting the need for psychological support.
Wortupaite (IMA2022–107) is a new hydrated magnesium nickel tellurite mineral with a zemannite-like structure, described from the Wortupa gold mine, South Australia, Australia. Wortupaite forms needles up to 25 μm in length, generally clustered and sometimes in blocky masses of shorter (10‒15 μm) crystals. Wortupaite is found growing on melonite, from which the component nickel and tellurium are derived, and is associated with calcite. The strongest powder diffraction lines are [dobsÅ(Iobs)(hkl)]: 8.059 (93) (100), 4.034 (92) (200), 2.832 (43) (211 and 121), 2.769 (100) (202) and 1.920 (45) (213 and 123). The empirical formula of wortupaite as determined by electron probe microanalysis is (Mg0.57Ni0.39Mn0.04)Σ1(Ni2+1.87Fe3+0.13)Σ2(Te4+O3)3⋅3H2O, simplified to the ideal formula of MgNi2+2(Te4+O3)3⋅3H2O with H2O content calculated from the crystal structure. The average crystal structure of wortupaite was determined by single-crystal X-ray diffraction with synchrotron radiation (R1 = 0.0558 for 100 independent reflections). Wortupaite is hexagonal, crystallising in the space group P63/m, with a = 9.2215(13) Å, c = 7.5150(15) Å, V = 553.43(19) Å3 and Z = 2. Wortupaite has a microporous structure, with the negatively charged zemannite-like framework formed by Te4+O3 trigonal pyramids and Ni2+O6 octahedra. For charge balance, Mg2+ and Ni2+ dominant sites are assumed to be located on central sites in the channels, coordinated by 6 H2O groups. An OW site was refined around the Mg2+ dominant site, but OW position(s) were not locatable around the Ni2+ dominant site. A discussion of the different models for crystallographic arrangement of channel species is provided, taking into account possible Fourier truncation effects. Unlike the other four minerals with zemannite-like structures which have a near 50% split of divalent and trivalent framework cations, wortupaite is the first natural phase to have only divalent cations in the framework sites.
This paper uses the Current Population Survey to study older workers' transitions out of employment and into retirement during the first year of the pandemic. We find that, among workers ages 55 to 79, the likelihood of leaving employment over the course of a year rose by 6.7 percentage points, a 43-percent increase over baseline. Workers without a college degree, Asian–Americans, those whose jobs were not amenable to social distancing, and part-time workers saw disproportionate impacts. In contrast, the likelihood of retiring increased by 1 percentage point, and there was no immediate retirement boom for full-time workers under 70.
Competition between genotypes within a plant population can result in the displacement of the least competitive by more competitive genotypes. Although evolutionary processes in plants may occur over thousands and millions of years, it has been suggested that changes in key fitness traits could occur in as little as decades, with herbicide resistance being a common example. However, the rapid evolution of complex traits has not been proven in weeds. We hypothesized that changes in weed growth and competitive ability can occur in just a few years because of selection in agroecosystems. Seed of multiple generations of a single natural population of the grassy weed giant foxtail (Setaria faberi Herrm.) were collected during 34 yr (i.e., 1983 to 2017). Using a “resurrection” approach, we characterized life-history traits of the different year-lines under noncompetitive and competitive conditions. Replacement-series experiments comparing the growth of the oldest year-line (1983) versus newer year-lines (1991, 1996, 1998, 2009, and 2017) showed that plant competitive ability decreased and then increased progressively in accordance with oscillating selection. The adaptations in competitive ability were reflected in dynamic changes in leaf area and biomass when plants were in competition. The onset of increased competitive ability coincided with the introduction of herbicide-resistant crops in the landscape in 1996. We also conducted a genome-wide association study and identified four loci that were associated with increased competitive ability over time, confirming that this trait changed in response to directional selection. Putative transcription factors and cell wall–associated enzymes were linked to those loci. This is the first study providing direct in situ evidence of rapid directional evolution of competitive ability in a plant species. The results suggest that agricultural systems can exert enough pressure to cause evolutionary adaptations of complex life-history traits, potentially increasing weediness and invasiveness.
Burnout is well characterised in physicians and residents but not in paediatric cardiology fellows, and few studies follow burnout longitudinally. Training-specific fears have been described in paediatric cardiology fellows but also have not been studied at multiple time points. This study aimed to measure burnout, training-specific fears, and professional fulfilment in paediatric cardiology fellows with the attention to time of year and year-of-training.
Methods:
This survey-based study included the Professional Fulfillment Index and the Impact of Events Scale as well as an investigator-designed Fellow Fears Questionnaire. Surveys were distributed at three-time points during the academic year to paediatric cardiology fellows at a large Midwestern training programme. Fellow self-reported gender and year-of-training were collected. Descriptive analyses were performed.
Results:
10/17 (59%) of fellows completed all surveys; 60% were female, 40% in the first-year class, 40% in the second-year class, and 20% in the third-year class. At least half of the fellows reported burnout at each survey time point, with lower mean professional fulfilment scores. The second-year class, who rotate primarily in the cardiac ICU, had higher proportions of burnout than the other two classes. At least half of fellows reported that they “often” or “always” worried about not having enough clinical knowledge or skills and about work–life balance.
Conclusions:
Paediatric cardiology fellows exhibit high proportions of burnout and training-specific fears. Interventions to mitigate burnout should be targeted specifically to training needs, including during high-acuity rotations.
The prevention of unnecessary suffering at slaughter is considered to be an imperative and, as such, the majority of animals slaughtered under industrial conditions are stunned prior to slaughter by mechanical, electrical or gas inhalation means. However, many Orthodox Jewish and Muslim communities do not accept pre-slaughter stunning. Those Jewish and Muslim communities that do accept pre-slaughter stunning require that any such stun is fully reversible in order to meet the requirements of their religious laws. Head-only electrical stunning is widely used in sheep, as it is a reversible method of stunning, but in cattle, the stun duration can be so short that the animal may regain consciousness during exsanguination. The concept of using electromagnetic radiation to induce insensibility has been proposed. Early attempts to induce insensibility and death in laboratory species were successful, but the technology to apply the technique to larger animals was not available at that time. More recently, however, technological advances have led to new work in the areas of transcranial magnetic stimulation and microwave irradiation, both of which are potential methods of inducing a recoverable stun in larger species.
Stunning prior to slaughter is commonly used to render the animal insensible to pain. However, for certain markets, stunning is disallowed, unless the animal can fully recover if not slaughtered. There are very few available methods of inducing a fully recoverable stun. This preliminary study investigates the potential for microwave energy application to be used to induce a recoverable stun in sheep. Cadaver heads were used to demonstrate that brain temperature could be raised to a point at which insensibility would be expected to occur (44°C). Trials on four anaesthetised sheep confirmed this finding in a live animal model where brain temperatures between 43 and 48°C were achieved with 20 s of microwave energy application. Although the applicator and process variables require some further development, this technology seems eminently suitable for use as an alternative method of inducing a recoverable stun.
Strong lensing galaxy clusters provide a powerful observational test of Cold Dark Matter (CDM) structure predictions derived from simulation. Specifically, the shape and relative alignments of the dark matter halo, stars, and hot intracluster gas tells us the extent to which theoretical structure predictions hold for clusters in various dynamical states. We measure the position angles, ellipticities, and locations/centroids of the brightest cluster galaxy (BCG), intracluster light (ICL), the hot intracluster medium (ICM), and the core lensing mass for a sample of strong lensing galaxy clusters from the SDSS Giant Arcs Survey (SGAS). We use iterative elliptical isophote fitting methods and GALFIT modeling on HST WFC3/IR imaging data to extract ICL and BCG information and use CIAO’s Sherpa modeling on Chandra ACIS-I X-ray data to make measurements of the ICM. Using this multicomponent approach, we attempt to constrain the physical state of these strong lensing clusters and evaluate the different observable components in terms of their ability to trace out the gravitational potential of the cluster.
This article offers insights into the character and composition of world order. It does so by focusing on how world order is made and revealed through seemingly disorderly events. We examine how societies struggle to interpret and respond to disorderly events through three modes of treatment: tragedy, crisis, and scandal. These, we argue, are the dominant modes of treatment in world politics, through which an account of disorder is articulated and particular political responses are mobilised. Specifically, we argue that each mode provides a particular way of problematising disorder, locating responsibility, and generating political responses. As we will demonstrate, these modes instigate the ordering of disorder, but they also agitate and reveal the contours of order itself. We argue, therefore, that an attentiveness to how we make sense of and respond to disorder offers the discipline new opportunities for interrogating the underlying forces, dynamics, and structures that define contemporary world politics.
Risk factors for salivary gland carcinoma are poorly understood. Although links between background radiation, smoking and obesity have been previously suggested, no studies have so far established any significant results. This study aimed to establish correlations between common environmental and lifestyle risk factors and different subtypes of salivary gland carcinoma.
Method
A study of population data in Wales spanning 27 years was conducted; 2 national databases were used to identify 356 cases of primary salivary gland carcinoma over this period. Histological subtype of cancer and geographical location of each case was recorded. Public health data was used to establish radon levels, smoking, obesity and activity levels of populations in each geographical location. A population matched multivariate analysis of variance analysis was performed using histological subtype and risk factor data for each geographical location.
Results
A significantly higher incidence of mucoepidermoid cancer in populations with higher background radon levels (p = 0.006), epithelial-myoepithelial cancer in populations with higher smoking levels (p = 0.029) and adenoid cystic cancer in populations with higher obesity levels (p = 0.028) was found.
Conclusion
To the authors’ knowledge, this is the first study to establish significant links between background radiation, smoking and obesity with different subtypes of salivary gland carcinoma.
The metabolic syndrome is common in older adults and may be modified by the diet. The aim of this study was to examine associations between a posteriori dietary patterns and the metabolic syndrome in an older New Zealand population. The REACH study (Researching Eating, Activity, and Cognitive Health) included 366 participants (aged 65–74 years, 36 % male) living independently in Auckland, New Zealand. Dietary data were collected using a 109-item FFQ with demonstrated validity and reproducibility for assessing dietary patterns using principal component analysis. The metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III. Associations between dietary patterns and the metabolic syndrome, adjusted for age, sex, index of multiple deprivation, physical activity, and energy intake were analysed using logistic regression analysis. Three dietary patterns explained 18 % of dietary intake variation – ‘Mediterranean style’ (salad/leafy cruciferous/other vegetables, avocados/olives, alliums, nuts/seeds, shellfish and white/oily fish, berries), ‘prudent’ (dried/fresh/frozen legumes, soya-based foods, whole grains and carrots) and ‘Western’ (processed meat/fish, sauces/condiments, cakes/biscuits/puddings and meat pies/hot chips). No associations were seen between ‘Mediterranean style’ (OR = 0·75 (95 % CI 0·53, 1·06), P = 0·11) or ‘prudent’ (OR = 1·17 (95 % CI 0·83, 1·59), P = 0·35) patterns and the metabolic syndrome after co-variate adjustment. The ‘Western’ pattern was positively associated with the metabolic syndrome (OR = 1·67 (95 % CI 1·08, 2·63), P = 0·02). There was also a small association between an index of multiple deprivation (OR = 1·04 (95 % CI 1·02, 1·06), P < 0·001) and the metabolic syndrome. This cross-sectional study provides further support for a Western dietary pattern being a risk factor for the metabolic syndrome in an older population.
Insect crop pests are a major threat to food security in sub-Saharan Africa. Configuration of semi-natural habitat within agricultural landscapes has the potential to enhance biological pest control, helping to maintain yields whilst minimising the negative effects of pesticide use. Fall armyworm (Spodoptera frugiperda, J. E. Smith) is an increasingly important pest of maize in sub-Saharan Africa, with reports of yield loss between 12 and 45%. We investigated the patterns of fall armyworm leaf damage in maize crops in Ghana, and used pitfall traps and dummy caterpillars to assess the spatial distribution of potential fall armyworm predators. Crop damage from fall armyworm at our study sites increased significantly with distance from the field edge, by up to 4% per m. We found evidence that Araneae activity, richness and diversity correspondingly decreased with distance from semi-natural habitat, although Hymenoptera richness and diversity increased. Our preliminary findings suggest that modifying field configuration to increase the proximity of maize to semi-natural habitat may reduce fall armyworm damage and increase natural enemy activity within crops. Further research is required to determine the level of fall armyworm suppression achievable through natural enemies, and how effectively this could safeguard yields.