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To examine relationships between history of mild traumatic brain injury (mTBI), neuropsychological measures of executive function, and lifetime history of criminal justice (CJ) involvement among combat-exposed Veterans and Service Members (V/SM).
Participants and Methods:
Participants were combat-exposed V/SM who completed a baseline assessment for the multicenter Long-term Impact of Military-Relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium study (N=1,341) and had adequate engagement/symptom reporting on measures of performance and symptom validity (i.e., Medical Symptom Validity Test and Mild Brain Injury Atypical Symptoms Scale). Neuropsychological battery included the Trail Making Test (A and B), Wechsler Adult Intelligence Scale-IV (WAIS-IV) Digit Span subtest, and the National Institute of Health (NIH) Toolbox Flanker subtest. Lifetime history of brain injury, criminal justice involvement, and demographics were collected. Participants were 87% male, 72% white, with a mean age of 40 years (SD=9.67). Eighty-one percent had at least some college education. Nineteen percent were active duty. Eighty percent of Veterans and 86% of Service Members reported a history of >1 mTBI, and of these 31% and 47% respectively experienced 3+ mTBIs.
Results:
Three groups were composed based on level of involvement with the CJ system: 1.) No history of arrests or incarcerations (3+ mTBIs: 64%), 2.) A lifetime history of arrest but no felony incarceration (3+ mTBIs: 34%), and 3.) A lifetime history of felony incarceration (3+ mTBIs: 2%). Ordinal regression analyses revealed that performance on a working memory task (Digit Span; b= 0.024, p= .041; OR= 1.024) was significantly associated with increased CJ involvement after adjusting for age, education, service status, and mTBIs. Performance on measures of processing speed (Trails A), set-shifting (Trails B), and inhibition (Flanker) were not significantly associated with CJ involvement. Number of mTBIs was significantly and positively associated with level of CJ involvement in all four models; Digit Span (p= .016), Trails A (p= .016), Trails B (p= .020), and Flanker (p= .008).
Conclusions:
Performance on most measures of executive functioning was not significantly associated with CJ involvement in this large, representative sample of V/SM who served in combat. Although performance on a working memory task was significantly associated with CJ involvement, the size of the effect was small and the association was in the opposite direction as expected. Number of mTBIs was significantly associated with level of CJ involvement, indicating that sustaining multiple mTBI may be linked to greater risk of CJ involvement. These findings suggest that social and psychological factors beyond executive dysfunction may better explain the relationship between history mTBIs and CJ involvement. Some aspects of military service and veteran status, such as interdisciplinary treatment for brain injury and physical, mental, and psychosocial health needs, may be protective against previously identified risk factors for arrest (e.g., deficits in executive functioning). Contextualizing mTBI within the larger behavioral health profile of V/SM, with emphasis placed on intervention for related co-morbidities, may reduce the impact of previous arrest on wellbeing and/or reduce the risk of future CJ involvement.
Advance Clinical and Translational Research (Advance-CTR) serves as a central hub to support and educate clinical and translational researchers in Rhode Island. Understanding barriers to clinical research in the state is the key to setting project aims and priorities.
Methods:
We implemented a Group Concept Mapping exercise to characterize the views of researchers and administrators regarding how to increase the quality and quantity of clinical and translational research in their settings. Participants generated ideas in response to this prompt and rated each unique idea in terms of how important it was and feasible it seemed to them.
Results:
Participants generated 78 unique ideas, from which 9 key themes emerged (e.g., Building connections between researchers). Items rated highest in perceived importance and feasibility included providing seed grants for pilot projects, connecting researchers with common interests and networking opportunities. Implications of results are discussed.
Conclusions:
The Group Concept Mapping exercise enabled our project leadership to better understand stakeholder-perceived priorities and to act on ideas and aims most relevant to researchers in the state. This method is well suited to translational research enterprises beyond Rhode Island when a participatory evaluation stance is desired.
Increasing emphasis is given on involving patients in health technology assessment (HTA). While this is mainly done at the level of regional and national HTA agencies, this tendency is also emerging in local HTA units. In this study, we provide the results of a survey conducted in local HTA units in the province of Quebec, Canada. The aim of the survey was to provide an overview of local HTA unit practices to involve patients, users, caregivers, and citizens in their process, their interest in doing so, and their information needs for this.
Methods
The survey was conducted in 2017 with a response rate of eleven units over a possibility of twelve.
Results
Three units out of eleven (27.3 percent) never involved patients or members of the public in their processes and all indicated that they will involve them in the next few years. The three most important needs for support identified in the HTA units were in: recruiting and selecting patients; integrating experiential knowledge; and knowing and implementing the best methods and practices for partnership.
Conclusion
Patient involvement in local HTA units is quickly evolving and that is why they urgently need tools to involve more effectively patients and members of the public in their process.
Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset, using a large, international database.
Methods:
The database includes 4037 patients with a diagnosis of bipolar I disorder, previously collected at 36 collection sites in 23 countries. Generalized estimating equations (GEE) were used to adjust the data for country median age, and in some models, birth cohort. Model-based clustering (mixture analysis) was then performed on the age of onset data using the residuals. Clinical variables in subgroups were compared.
Results:
There was a strong birth cohort effect. Without adjusting for the birth cohort, three subgroups were found by clustering. After adjusting for the birth cohort or when considering only those born after 1959, two subgroups were found. With results of either two or three subgroups, the youngest subgroup was more likely to have a family history of mood disorders and a first episode with depressed polarity. However, without adjusting for birth cohort (three subgroups), family history and polarity of the first episode could not be distinguished between the middle and oldest subgroups.
Conclusion:
These results using international data confirm prior findings using single country data, that there are subgroups of bipolar I disorder based on the age of onset, and that there is a birth cohort effect. Including the birth cohort adjustment altered the number and characteristics of subgroups detected when clustering by age of onset. Further investigation is needed to determine if combining both approaches will identify subgroups that are more useful for research.
Postoperative cognitive impairment is among the most common medical complications associated with surgical interventions – particularly in elderly patients. In our aging society, it is an urgent medical need to determine preoperative individual risk prediction to allow more accurate cost–benefit decisions prior to elective surgeries. So far, risk prediction is mainly based on clinical parameters. However, these parameters only give a rough estimate of the individual risk. At present, there are no molecular or neuroimaging biomarkers available to improve risk prediction and little is known about the etiology and pathophysiology of this clinical condition. In this short review, we summarize the current state of knowledge and briefly present the recently started BioCog project (Biomarker Development for Postoperative Cognitive Impairment in the Elderly), which is funded by the European Union. It is the goal of this research and development (R&D) project, which involves academic and industry partners throughout Europe, to deliver a multivariate algorithm based on clinical assessments as well as molecular and neuroimaging biomarkers to overcome the currently unsatisfying situation.
The DELTA parallel robot, designed by an EPFL (Ecole Polytechnique Fédérale de Lausanne) research team, is a mechanical structure which has the advantage of parallel robots and ease of serial robots modeling. This paper presents solutions for a complete modeling of the DELTA parallel robot (direct and inverse kinematics, inverse statics, inverse dynamics), with few arithmetic and trigonometric operations. Our method is based on a satisfactory choice of kinematic parameters and on a few restricting hypotheses for the static and dynamic models. We give some details of each model, we present some computation results and we put the emphasis on some particular points, showing the capabilities of this mechanical structure.
Pattern analysis has emerged as a tool to depict the role of multiple nutrients/foods in relation to health outcomes. The present study aimed at extracting nutrient patterns with respect to breast cancer (BC) aetiology.
Design
Nutrient patterns were derived with treelet transform (TT) and related to BC risk. TT was applied to twenty-three log-transformed nutrient densities from dietary questionnaires. Hazard ratios (HR) and 95 % confidence intervals computed using Cox proportional hazards models quantified the association between quintiles of nutrient pattern scores and risk of overall BC, and by hormonal receptor and menopausal status. Principal component analysis was applied for comparison.
Setting
The European Prospective Investigation into Cancer and Nutrition (EPIC).
Subjects
Women (n 334 850) from the EPIC study.
Results
The first TT component (TC1) highlighted a pattern rich in nutrients found in animal foods loading on cholesterol, protein, retinol, vitamins B12 and D, while the second TT component (TC2) reflected a diet rich in β-carotene, riboflavin, thiamin, vitamins C and B6, fibre, Fe, Ca, K, Mg, P and folate. While TC1 was not associated with BC risk, TC2 was inversely associated with BC risk overall (HRQ5 v. Q1=0·89, 95 % CI 0·83, 0·95, Ptrend<0·01) and showed a significantly lower risk in oestrogen receptor-positive (HRQ5 v. Q1=0·89, 95 % CI 0·81, 0·98, Ptrend=0·02) and progesterone receptor-positive tumours (HRQ5 v. Q1=0·87, 95 % CI 0·77, 0·98, Ptrend<0·01).
Conclusions
TT produces readily interpretable sparse components explaining similar amounts of variation as principal component analysis. Our results suggest that participants with a nutrient pattern high in micronutrients found in vegetables, fruits and cereals had a lower risk of BC.
In the original publication of ‘Riding the Orange Wave: Leadership, Values, Issues and the 2011 Canadian Election’ (published online January 10, 2014), an error appeared. The caption for Figure 1 appears incorrectly; it should read, “Campaign Dynamics of Vote Intensions.” The publisher regrets this error.
La mesure précise des champs de contraintes autour de précipités inclus dans une matricecristalline est nécessaire à la compréhension de l’interaction entre les dislocations etles précipités de matériaux structurellement durcis. Ces interactions contrôlent lemouvement des dislocations, et donnent donc des informations sur les propriétés mécaniquesdes matériaux. Les champs de contraintes autour des précipités de petite taille peuventêtre obtenus à partir d’images de microscopie électronique en transmission en hauterésolution (METHR) en utilisant la méthode des phases géométrique (GPA). Cette méthode estutilisable de façon générale pour caractériser les contraintes à l’échelle nanométriqueautour des précipités de structure complexe ou inconnue et est appliquée ici dans les casde l’alliage d’aluminium 2198. Dans ce matériau, il est montré que les champs dedéformation autour d’un nanoprécipité en forme de disque et d’épaisseur faible peuventêtre modélisés par ceux d’une dislocation dissociée.
The United States Army is concerned that its installations face multiple resource issues, including water security. Critical water issues include supply, cost, and quality. Strategies are needed to mitigate any adverse affects. To develop these strategies, information was gathered from national watershed screenings and regional water budgets, including supply and demand data from regions containing Army installations. The information was then used to develop installation water-demand projections that look beyond the boundaries of an installation and out 30 years into the future to identify the potential for water scarcity. Fort Bragg, North Carolina, and Fort Bliss, Texas–New Mexico, were used as specific examples to illustrate the critical role that water plays in the future of Army installations. Fort Bragg is not likely to have water availability issues out to 2030, because it will be accessing municipal water supplies. Fort Bliss will likely face water availability issues because the aquifer from which it draws its potable water is being used by more and more other parties.
A number of Hfr strains have been studied as to the action of radiations on the transmission of their genetic material to female cells. They form two classes, one in which irradiation produces only lesions that prevent transfer, and one in which new modes of chromosome transfer seem to be induced. One group of strains, derived from a common F+ male, appears to give rise to the same induced mode of transfer, while no correlation could be found in the other Hfr's studied.
Subcritical cracking of thin glass films caused by stress-corrosion phenomena cannot be neglected when it comes to application and manufacturing processes that involve exposure to aqueous environments. A protocol is introduced to allow for a quantitative study of stress corrosion through channel cracking experiments. By this method, an exponential dependence of the crack propagation rate on the pH of the aqueous environment is revealed. Therefore, this behavior should be accounted for through the use of an appropriate pre-exponential factor in the expression of channel cracking rate. This factor should reflect the reduced crack resistance of the glass film caused by the weakening of the silica bonds behind the crack tip in the aqueous environment. A direct comparison between commercial slurries and reference solutions confirms that the crack resistance is a function of the pH of the ambient.
Generation IV fission and future fusion reactors envisage development of more efficient high temperature concepts where materials performances under creep-fatigue hold the key to success. This paper presents extended experimental results obtained from creep, fatigue and creep-fatigue tests on the main structural materials retained for these concepts, namely: stainless steel type 316L(N), the conventional Modified 9Cr-1Mo martensitic steel and its low activation derivatives such as Eurofer steel, and their more advanced grades strengthened by oxide dispersion. It shows that the existing recommendations made in design codes adequately cover individual damage due to creep or fatigue but often fall short under combined creep-fatigue interaction. This is partly due to the difficulties of reproducing service conditions in laboratory. In this paper, results from tests performed on components removed from reactor, after long service, are used to refine code recommendations.
Using the above combined assessment, it is concluded that there is good confidence in predicting creep-fatigue damage for austenitic stainless steels. For the martensitic steels the effects of cyclic softening and microstructure coarsening throughout the fatigue life need more consideration in creep-fatigue recommendation. In the long-term development of ferritic/martensitic oxide dispersion strengthened grades with stable microstructure and no cyclic softening, appears promising provided problems associated with their fabrication and embrittlement are resolved.
Intensive chemical treatments have led to the development of a number of insecticide resistance mechanisms in the peach–potato aphid Myzus persicae (Sulzer). Some of these mechanisms are known to be associated with negative pleiotropic effects (resistance costs). Molecular and biochemical methods were used to determine the genotypes or phenotypes associated with four insecticide resistance mechanisms in single aphids from sexually-reproducing populations in southern France. The mechanisms considered were E4 and FE4 carboxylesterase overproduction, modified acetycholinesterase, and kdr and rdl resistance-associated mutations. A new method for determining individual kdr genotypes is presented. Almost all resistant individuals overproduced FE4 carboxylesterase, whereas modified acetylcholinesterase was rare. Both the kdr and rdl resistance mutations were present at high frequencies in French sexually-reproducing populations. The frequencies of insecticide resistance genes were compared before and after sexual reproduction in one peach orchard at Avignon to evaluate the potential impact of selection on the persistence of resistance alleles in the over-wintering phase. The frequencies of the kdr and rdl mutations varied significantly between autumn and spring sampling periods. The frequency of the kdr mutation increased, probably due to pyrethroid treatments at the end of the winter. Conversely, the frequency of the rdl mutation decreased significantly during winter, probably because of a fitness cost associated with this mutation.
Background and objective: The ease of endotracheal intubation has been recently shown to affect the incidence of laryngeal injury. There remains controversy as to whether or not a muscle relaxant is routinely required for tracheal intubation. This study examined conditions of intubation in our routine practice, which employs a relaxant-sparing approach. Methods: All adult patients scheduled for surgery with general anaesthesia were prospectively included. A muscle relaxant was used to facilitate intubation when it was required for the surgical procedure and/or otherwise regarded as necessary by the anaesthesiologist. In the remaining patients, a relaxant-free intubation was performed. Intubating conditions were evaluated in all the patients as well as the post-intubation laryngeal symptoms. Results: Between March and July 2003, 612 patients were consecutively included. A muscle relaxant was used in 32% of patients and no relaxant in the remaining patients (68%). Clinically acceptable intubating scores were observed in 98.4% overall with no significant difference between the two groups. Excellent conditions occurred more frequently in the relaxant group as compared to the relaxant-free group, 87% vs. 72%, P = 0.005. Laryngeal symptoms occurred in 184 (33%) patients with no difference between the two groups. Conclusions: Our relaxant-sparing approach did not increase the incidence of poor conditions of intubation nor laryngeal symptoms. However, excellent conditions occurred more frequently in the relaxant group. A more flexible approach to the issue of the need for neuromuscular blockade prior to intubation is proposed.
Within the scope of a joint IRSN/EDF research program, it is possible to present a first status of free water tritium and organically bound tritium levels in the French coastal marine environment, from Concarneau to Gravelines. Seasonal sampling was conducted over two years, 2001 and 2002. The matrices selected for this specific survey include water, seaweed, molluscs, crustaceans and fish. The background concentration, estimated from the results obtained at two sites, Concarneau and Roscoff, remote from industrial sources, is close to the detection limit of 1,2 Bq.l-1. Along the Channel coast and the entrance of the North Sea, tritium is released in seawater by four nuclear power plants (14 reactors) and mainly by the reprocessing plant of La Hague. The concentrations measured are in good agreement with activities calculated with the hydrodynamic model of dispersion TRANSMER. The results confirm a dilution factor of two between the north Cotentin area and the Straits of Dover for soluble radionuclides. The concentrations are in the range of 2 to 20 Bq.l-1 for free and organically bound tritium in biota. Although isotopic fractionation is theoretically expected to be slight, the available results indicate a ratio between tritium bound to organic matter and tritium in free water greater than one.
Besides being an indispensable amino acid for protein synthesis, arginine (Arg) is also involved in a number of other physiological functions. Available data on the quantitative requirement for Arg in different teleosts appear to show much variability. So far, there are very limited data on the maintenance requirements of indispensable amino acids (IAA) in fish. In the present study, we compared N and Arg requirements for maintenance and growth of four finfish species: rainbow trout (Oncorhynchus mykiss), turbot (Psetta maxima), gilthead seabream (Sparus aurata) and European seabass (Dicentrarchus labrax). Groups of fish having an initial body weight close to 5–7 g were fed semi-purified diets containing graded levels of N (0 to 8 % DM) and Arg (0 to 3 % DM) over 4 to 6 weeks. For each species, N and Arg requirements for maintenance and for growth were calculated regressing daily N gain against daily N or Arg intakes. N requirement for maintenance was estimated to be 37·8, 127·3, 84·7 and 45·1 mg/kg metabolic body weight per d and 2·3, 2·2, 2·6 and 2·5 g for 1 g N accretion, in rainbow trout, turbot, gilthead seabream and European seabass respectively. The four species studied appear to have very low or no dietary Arg requirements for maintenance. Arg requirement for g N accretion was calculated to be 0·86 g in rainbow trout and between 1·04–1·11 g in the three marine species. Turbot required more N for maintenance than the other three species, possibly explaining its reputedly high overall dietary protein requirement. Data suggest a small but sufficient endogenous Arg synthesis to maintain whole body N balance and differences between freshwater and marine species as regards Arg requirement. It is worth verifying this tendency with other IAA.
When the UNESCO research programme on Man and the Biosphere was launched in 1971, aquatic ecosystems immediately became the subject of a special project due to the important changes that can be produced in them by human activities. In the beginning, attention was focused on the consequences of intensification of agriculture: erosion and sedimentation, groundwater pollution, eutrophication, and other adverse events.
After 15 years, the first phase of the project was concluded with a final meeting devoted to the use of scientific information in understanding the impact of land use on aquatic ecosystems. It highlighted the major role of interfaces (ecotones) between terrestrial and aquatic ecosystems in the regulation of biogeochemical cycles and in the structuring of landscape mosaics. Viewing aquatic systems as a collection of resource patches separated by ecotones allows to determine the relative importance of upstream – downstream linkages, lateral linkages and vertical linkages to be examined, and provides a conceptual framework for the understanding of factors regulating the exchange of energy and materials between identifiable resource patches.
Therefore, it was recommanded by this meeting that UNESCO's future work on ecosystems should emphasize the in-depth study of ecotones, their management and restoration. Thus the Ecotone project was established under the double responsability of the International Hydrological Programme and the Man and Biosphere Programme with a general objective to determine the management options for the conservation and restoration of the land/inland water ecotones through increased understanding of ecological processes.