Whether genetic factors influence the associations of fatty acids with the risk of sudden cardiac arrest (SCA) is largely unknown. To investigate possible gene–fatty acid interactions on SCA risk, we used a case-only approach and measured fatty acids in erythrocyte samples from 1869 SCA cases in a population-based repository with genetic data. We selected 191 SNP in ENCODE-identified regulatory regions of fifty-five candidate genes in fatty acid metabolic pathways. Using linear regression and additive genetic models, we investigated the association of the selected SNP with erythrocyte levels of fatty acids, including DHA, EPA and trans-fatty acids among the SCA cases. The assumption of no association in non-cases was supported by analysis of publicly available datasets containing over 8000 samples. None of the SNP–fatty acid associations tested among the cases reached statistical significance after correction for multiple comparisons. One SNP, rs4654990 near PLA2G2A, with an allele frequency of 0·33, was nominally associated with lower levels of DHA and EPA and higher levels of trans-fatty acids. The strongest association was with DHA levels (exponentiated coefficient for one unit (1 % of total fatty acids), 0·90, 95 % CI 0·85, 0·97; P = 0·003), indicating that for subjects with a coded allele, the OR of SCA associated with one unit higher DHA is about 90 % what it is for subjects with one fewer coded allele. These findings suggest that the associations of circulating n-3 and trans-fatty acids with SCA risk may be more pronounced in carriers of the rs4654990 G allele.

Despite decades of research aimed at identifying the causes of postpartum depression (PPD), PPD remains common, and the causes are poorly understood. Many have attributed the onset of PPD to the rapid perinatal change in reproductive hormones. Although a number of human and nonhuman animal studies support the role of reproductive hormones in PPD, several studies have failed to detect an association between hormone concentrations and PPD. The purpose of this review is to examine the hypothesis that fluctuations in reproductive hormone levels during pregnancy and the postpartum period trigger PPD in susceptible women. We discuss and integrate the literature on animal models of PPD and human studies of reproductive hormones and PPD. We also discuss alternative biological models of PPD to demonstrate the potential for multiple PPD phenotypes and to describe the complex interplay of changing reproductive hormones and alterations in thyroid function, immune function, hypothalamic–pituitary–adrenal (HPA) axis function, lactogenic hormones, and genetic expression that may contribute to affective dysfunction. There are 3 primary lines of inquiry that have addressed the role of reproductive hormones in PPD: nonhuman animal studies, correlational studies of postpartum hormone levels and mood symptoms, and hormone manipulation studies. Reproductive hormones influence virtually every biological system implicated in PPD, and a subgroup of women seem to be particularly sensitive to the effects of perinatal changes in hormone levels. We propose that these women constitute a “hormone-sensitive” PPD phenotype, which should be studied independent of other PPD phenotypes to identify underlying pathophysiology and develop novel treatment targets.

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a recently described and underdiagnosed entity that typically affects young, previously healthy individuals. Patients usually present in phases, which may include refractory seizures, psychosis, unresponsiveness, and autonomicinstability. The diagnosis of anti-NMDAR encephalitis is challenging; however, prompt diagnosis and early treatment can lead to complete recovery. The incidence of anti-NMDAR encephalitis may be as high as four times that of encephalitis from herpes simplex, varicella-zoster, and West Nile viruses; however, it remains an underrecognized disorder. Early initiation of immunotherapy in anti-NMDAR encephalitis has been found to improve patient outcomes. Because of this, emergency physicians must be vigilant and consider this diagnosis in patients with altered mental status in whom a toxicologic or other etiology is not suspected. Early consideration of this diagnosis can facilitate urgent neurology consultation and prevent diagnostic delays arising from psychiatric referrals. It is essential to consider this diagnosis in suspicious emergency department presentations, particularly young patients who present with altered mental status, psychosis, or new-onset seizure activity when other obvious causes are ruled out. Emergency physicians should discuss the possibility of empirical intravenous immunoglobulin administration with neurology consultants if anti-NMDAR encephalitis is suspected. We describe the case of a 20-year-old man with anti-NMDAR encephalitis who presented to the emergency department with status epilepticus.

Owing to the entry of Japan into the war it is essential that agar should be used as economically as possible. Since October 1941, we have, in this laboratory, reclaimed used agar by the following simple method, which is a modification of the procedure described by Huang, Shen & Tang (1941).

Our group recently reported that smoking a regular cigarette (1.2–1.4 mg nicotine) resulted in 88% occupancy of brain α4β2* nicotinic acetylcholine receptors (nAChRs). However, this study did not determine whether nicotine inhalation or the many other pharmacological and behavioural factors that occur during smoking resulted in this receptor occupancy. If nicotine is solely responsible for α4β2* nAChR occupancy from smoking, then (as estimated from our previous data) smoking a denicotinized (0.05 mg nicotine) or a low-nicotine (0.6 mg nicotine) cigarette (commonly used for research and clinical purposes) would result in substantial 23% and 78% α4β2* nAChR occupancies, respectively, and a plasma nicotine concentration of 0.87 ng/ml would result in 50% α4β2* nAChR occupancy (EC50). Twenty-four positron emission tomography sessions were performed on tobacco-dependent smokers, using 2-[F-18]fluoro-A-85380 (2-FA), a radiotracer that binds to α4β2* nAChRs. 2-FA displacement was determined from before to 3.1 hours after either: no smoking, smoking a denicotinized cigarette, or smoking a low-nicotine cigarette. Analysis of this PET data revealed that smoking a denicotinized and a low-nicotine cigarette resulted in 26% and 79% α4β2* nAChR occupancies, respectively, across three regions of interest. The EC50 determined from this dataset was 0.75 ng/ml. Given the consistency of findings between our previous study with regular cigarettes and the present study, nicotine inhalation during smoking appears to be solely responsible for α4β2* nAChR occupancy, with other factors (if present at all) having either short-lived or very minor effects. Furthermore, smoking a denicotinized cigarette resulted in substantial nAChR occupancy.

Loneliness and isolation can be a major cause of unhappiness and can contribute towards depression and mental illness in older age. These associations are recognised by academics, policy makers and older people's representative organisations alike in several countries, and many corrective ad hoc and country-specific initiatives have been supported. This study examines the opinions of the users of a local home-visiting befriending service in the United Kingdom. The befrienders are volunteers, and most users were introduced to the service by female relatives or health service professionals. Positive opinions of the service predominated, and users placed a high value on the reliability of their befrienders. The service provided the users with an opportunity to develop a new bond, and many reported friendly reciprocity, which they recognised as an ingredient of ‘real’ friendship. These friendships sometimes developed beyond the agreed rules and remits of the ‘formal’ service, and incorporated various forms of supplementary assistance and social activities. The paper demonstrates the value of befriending services and examines carefully the aspects of their implementation that required exceptional sensitivity.

This comment on the whole agrees with Eric Arnesen's critique of the whiteness historical scholarship. It suggests, however, that Arnesen insufficiently credits David R. Roediger's The Wages of Whiteness: Race and the Making of the American Working Class (New York, 1991) for its achievement as a kind of charismatic history and insufficiently distinguishes between Roediger's book and the work of his emulators. The latter are the source of the multiple meanings of whiteness that Arnesen rightly criticizes, and likewise for the hardening of Roediger's suggestive notions about “becoming white” into a new dogma of American immigration history. This comment concludes by noting that in his book Roediger neglected the language of whiteness and suggests that by attending to that question he would find a response to Arnesen's pessimism over the usefulness of whiteness as an analytical concept.

The January 3, 1900, edition of the popular, New York City newspaper the World contains an advertisement for a new edition of The Century Dictionary & Cyclopedia & Atlas (Figure 1). The strength of this reference guide, according to the full-page advertisement, is the volume's war maps. The presentation of battle cartography “enable[s] one to trace instantly the movements of every important campaign on land or sea, the routes of invading armies, raids, etc., placing and dating on the maps the battles, sieges and blockades not only of ancient and medieval times, but also those of the year just ended – and this without any complexity in the maps themselves.” In case the reader needed to be reminded about recent wars, the advertisement has enormous graphic representations of “Africa” and the “Philippine Is.” The map of the Philippines would have immediately signified the Spanish-American (1898) and Philippine-American (1899–1902) Wars to readers, conflicts that the pages of the mass media covered widely.

Spectrum scans at 10 A resolution have been obtained for four likely clusters in the field of the giant elliptical galaxy NGC 4486 (M87), using the IPCS at the 4-metre Anglo-Australian Telescope. A wavelength range of 3500–7000 A was covered, with the objects having brightnesses from V=19.5 to V=19.8 mag. Preliminary analysis suggests that one of these objects is comparable to the metal-richest known Galactic globular clusters, while the other three seem to be even more metal-rich. Alternative explanations, such as gross differences in the stellar mix within the M87 clusters compared to those in our own Galaxy, may account for the observed spectroscopic differences; quantitative analysis is just beginning.

The education of the imbecile is an enterprise the inception of which dates from a very recent period. The generation has not yet passed away, which frankly insinuated that the idea of teaching the idiot could only enter the brain of one somewhat closely related to the class. It is now everywhere recognised as an important and imperative duty which cannot be neglected without shame and loss; yet for efficient practical effort, it is still but the day of small things.