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Background: Climate change, and fossil fuel combustion threaten the health of children globally through direct and indirect mechanisms,1 such as the exacerbation of ambient air pollution.1,2 Increased ambient air pollutant concentrations are associated with emergency department (ED) visits for episodic and paroxysmal neurologic conditions in adults in the Toronto region of Canada.4,5 We hypothesize that, in Calgary, Alberta, increased ambient air pollutants will be positively associated with the daily burden of pediatric ED presentations for migraine and seizures, and that a greater effect size may be present due to increased regional variability in ambient PM2.5 concentrations.3,4 Methods: Emergency records from the National Ambulatory Care Reporting System, comprising 17552 primary seizure and headache cases between 0-18 years of age and presenting to Calgary-region emergency departments between January 2012-December 2021, will be included. Quasi-Poisson regression modeling incorporating ambient air pollutants, seasonality and meteorological covariates will estimate relative risk and 95% confidence intervals of ED visit counts relative to increases in air pollutants. Results: Results currently pending and will be available for presentation. Conclusions: Significant results may inform further inquiry into the impact of air pollutants on children with neurological conditions and identify potential contributions of air quality to healthcare service demand in the Calgary region.
Quality of life (QoL) is an abstract construct that has been formally recognised and widely used in human medicine. In recent years, QoL has received increasing attention in animal and veterinary sciences, and the measurement of QoL has been a focus of research in both the human and animal fields. Lord Kelvin said “When you cannot measure it, when you cannot express it in numbers — you have scarcely in your thoughts, advanced to a stage of science, whatever the matter may be” (Lord Kelvin 1893). So are we able to measure animal QoL? The psychometric measurement principles for abstract constructs such as human intelligence have been well rehearsed and researched. Application of traditional and newer psychometric approaches is becoming more widespread as a result of increasing human and animal welfare expectations which have brought a greater emphasis on the individual. In recent decades the field of human medicine has developed valid measures of experienced pain and QoL of individuals, including those who are not capable of self-report. More recently, researchers who are interested in the measurement of animal pain and QoL have begun to use similar methodologies. In this paper, we will consider these methodologies and the opportunities and difficulties they present.
A reproductive population of the Asian longhorned beetle, Anoplophora glabripennis (Motschulsky) (Coleoptera: Cerambycidae), an adventive insect from Asia, was discovered in 2003 in an urban landscape in Ontario, Canada. This polyphagous beetle, which attacks maples, Acer spp. (Sapindaceae), had the potential to seriously and permanently alter the composition and structure of forests in eastern North America. The Canadian Food Inspection Agency (CFIA) developed and implemented an eradication programme, with partners from various agencies in both Canada and the United States of America. Surveys were used to delineate the infestation and establish a regulated area around it. Treatment consisted of removing and destroying both trees with signs of A. glabripennis injury and trees assumed at high risk of being injured within the regulated area. After nine years of monitoring the regulated area, the CFIA declared A. glabripennis eradicated on 5 April 2013. Herein, we detail the response undertaken, summarise lessons learned, and provide preliminary observations and results pertaining to the arrival, establishment, and spread of A. glabripennis in Ontario.
Screening tools for delirium are being used more consistently in pediatric critical care. However, screening is not universal, and delirium may be underdiagnosed, misdiagnosed, or undocumented in hospitalized patients. We evaluated the identification and documentation of delirium in pediatric oncology and bone marrow transplant patients.
Method
A retrospective chart review on all hospitalized pediatric oncology and bone marrow transplant patients admitted to an Academic Cancer center between 2013 and 2016. Patients aged less than 21 years of age with active cancer were included. Patients with major psychiatric conditions, developmental delays, or autism were excluded. Data were collected to characterize documentation concerning the identification and diagnosis of delirium.
Results
Of 201 hospitalization records, 54 (26.9%) admissions from 109 unique patients had documentation of delirium. The overall documented incidence of delirium was 3.2% of hospitalizations or 8.2% of unique patients. Patients prescribed opioids and benzodiazepines were more likely to have documentation of delirium. ICD coding under-reported delirium while physician documentation was inaccurate in 26% (53/201) when compared with the chart review.
Significance of results
Delirium was frequently undocumented or miscoded. Implementing a validated, universal screening tool for delirium may improve identification and clinical outcomes.
It is clinically imperative to better understand the relationship between trauma, auditory hallucinations and dissociation. The personal narrative of trauma has enormous significance for each individual and is also important for the clinician, who must use this information to decide on a diagnosis and treatment approach.
Aims
To better understand whether dissociation contributes in a significant way to hallucinations in individuals with and without trauma histories.
Method
Three groups of participants with auditory hallucinations were recruited, with diagnoses of: schizophrenia (without trauma) (n = 18), post-traumatic stress disorder (PTSD, n = 27) and comorbid schizophrenia and PTSD (SCZ+PTSD), n = 26). Clinician-administered measures included the PTSD Symptoms Scale Interview (PSSI-5), the Clinician-Administered Dissociative States Scale (CADSS) and the Psychotic Symptom Rating Scales (PSYRATS).
Results
Dissociative symptoms were significantly higher in participants with trauma histories (PTSD and SCZ+PTSD groups) and significantly correlated with hallucinations in trauma-exposed participants, but not in participants with schizophrenia (without trauma history). Hallucination severity was correlated with the CADSS amnesia subscale score, but depersonalisation and derealisation were not.
Conclusions
Dissociation may be a mechanism in trauma-exposed individuals who hear voices, but it does not explain all hallucinatory experiences. The SCZ+PTSD group were in an intermediary position between schizophrenia and PTSD on dissociative and hallucination measures. The PTSD and SCZ+PTSD groups experienced dissociative phenomena much more frequently than the schizophrenia group, with a significant trend towards the amnesia subtype of dissociation.
Climate change is one of the biggest challenges facing the world. Scientific research points out that it is predominately driven by human activity. There are three different types of risks that arise from this change. These have been broadly grouped into physical, transition and liability risks. These risks can impact general insurers to different degrees, depending on their business areas and investment strategies. These may pose different strategic, investment, market, operational and reputational risks. This paper provides General Insurance Practitioners with an overview of different aspects of insurance operations that may be affected by climate change. It highlights the impact of these risks on pricing and underwriting, reserving, reinsurance, catastrophe modelling, investment, risk management and capital management processes.
Philip Melanchthon is undoubtedly one of the most significant figures to emerge from the Reformation. However, his legacy is frequently overshadowed by Martin Luther and John Calvin – in large part because of his close relationship with both. Because of this, Melanchthon has infrequently been the focus of historical research, functioning much more frequently as a footnote to Luther or a sounding board for Calvin. Yet Melanchthon’s work and writings shaped the religious landscape of Europe and he left an indelible influence on both Lutheranism and the Reformed tradition – particularly through his biblical scholarship and Loci Communes. The overlooking of Melanchthon is, to some extent, explained by the final years of his life, during which he was almost universally disdained for his perceived betrayal of Lutheran principles at the Leipzig Interim. Because of this, Melanchthon has frequently been disregarded or maligned in confessional histories of Lutheranism and the Reformed faith. In more recent years, however, the significance of Melanchthon’s Loci Communes, his contributions to early modern biblical scholarship, his role in the political developments of the German Reformation, and his relationship with Calvin have come to be recognized as formative influences on the history of the early modern world.
Blunt neck trauma can cause serious morbidity and mortality rates of up to 40 per cent, but there is a paucity of literature on the topic.
Method
A retrospective case note review was performed for all blunt neck trauma cases managed at the Queen Elizabeth Hospital Birmingham between 1st January 2011 and 31st December 2017.
Results
Seventeen cases were managed, with no mortality and limited morbidity. Most patients were male (70.6 per cent) and road traffic accidents were the most common cause of injury (41.2 per cent). The median age of patients was 40.6 years (range, 21.5–70.3 years). Multidetector computed tomography angiography of the neck was performed in 9 patients (52.9 per cent) with ‘hot’ reports made by on-duty radiology staff matching consultant reports in all but 1 case. Six patients underwent operative exploration yielding a negative exploration rate of 33.3 per cent. Imaging reports matched operative findings in 3 cases (60 per cent).
Conclusion
Blunt neck trauma is uncommon but usually presents in polytrauma. Imaging has inaccuracies when compared with operative findings, regardless of radiological experience.
In 2013, a task force was developed to discuss the future of the Canadian pediatric neurology workforce. The consensus was that there was no indication to reduce the number of training positions, but that the issue required continued surveillance. The current study provides a 5-year update on Canadian pediatric neurology workforce data.
Methods:
Names, practice types, number of weekly outpatient clinics, and dates of certification of all physicians currently practicing pediatric neurology in Canada were obtained. International data were used to compute comparisons between countries. National data sets were used to provide information about the number of residency positions available and the number of Canadian graduates per year. Models for future projections were developed based on published projected population data and trends from the past decade.
Results:
The number of pediatric neurologists practicing in Canada has increased 165% since 1994. During this period, wait times have not significantly shortened. There are regional discrepancies in access to child neurologists. The Canadian pediatric neurology workforce available to see outpatient consultations is proportionally less than that of USA. After accounting for retirements and emigrations, the number of child neurologists being added to the workforce each year is 4.9. This will result in an expected 10-year increase in Canadian pediatric neurologists from 151 to 200.
Conclusions:
Despite an increase in the number of Canadian child neurologists over the last two decades, we do not predict that there will be problems with underemployment over the next decade.
Background: Stroke is a rare neurological disease in children, with an annual incidence of 2 - 13/100,000 children per year. Pediatric stroke is associated with significant morbidity and mortality lasting many decades. Diagnosis of pediatric stroke is challenging and often delayed, limiting options for acute intervention, and the pharmacological and mechanical recanalization strategies that have revolutionized adult stroke remain undefined in children. Clinicians are left to draw conclusions from other retrospective cohort studies or case reports and extrapolate adult guidelines to the pediatric population. The TIPS trial eligibility criteria are often used in clinical practice, despite not being validated for this purpose. We present here the case of a healthy 14 year old male who was treated with intravenous tissue plasminogen activator (IV tPA) for a presumed arterial ischemic stroke without large vessel occlusion on neuroimaging. Methods: Retrospective chart review Results: Not applicable Conclusions: Following the administration of IV tPA, the patient made a full recovery. While we do not recommend the routine use of IV tPA for treatment of presumed large vessel or small vessel in children, we suggest that the decision to proceed with IV tPA be considered on a case-by-case basis.
Downy brome (Bromus tectorum L.) is a common impediment to ecological restoration, because its seedbank remains viable after repeated treatment with herbicides. Soil solarization has been used in ecological restoration to control seedbanks of invasive plants. Here we test the efficacy of soil solarization to reduce B. tectorum cover and establish native plants at a site in B. tectorum’s core invasive range with a long history of disturbance and infestation. Solarization raised soil temperatures by as much as 13 C and reduced B. tectorum densities by approximately 20-fold. In 30 plots solarized for 0 to 101 d, B. tectorum emerged in inverse abundance to treatment duration. Broadleaf weeds were less abundant than B. tectorum before treatment, and diminished under solarization, but their response to solarization was weaker than B. tectorum’s, and they emerged in greater numbers than B. tectorum 2 to 3 yr after treatment. When seeded after solarization, a native perennial bunchgrass, squirreltail [Elymus elymoides (Raf.) Swezey], did not differ in abundance between solarized and control plots. Solarization may facilitate B. tectorum control on a small scale without jeopardizing the establishment of native plants, but only if treatment durations are long and subsequent management of broadleaf weeds and remnant B. tectorum is planned.
For livestock production systems to play a positive role in global food security, the balance between their benefits and disbenefits to society must be appropriately managed. Based on the evidence provided by field-scale randomised controlled trials around the world, this debate has traditionally centred on the concept of economic-environmental trade-offs, of which existence is theoretically assured when resource allocation is perfect on the farm. Recent research conducted on commercial farms indicates, however, that the economic-environmental nexus is not nearly as straightforward in the real world, with environmental performances of enterprises often positively correlated with their economic profitability. Using high-resolution primary data from the North Wyke Farm Platform, an intensively instrumented farm-scale ruminant research facility located in southwest United Kingdom, this paper proposes a novel, information-driven approach to carry out comprehensive assessments of economic-environmental trade-offs inherent within pasture-based cattle and sheep production systems. The results of a data-mining exercise suggest that a potentially systematic interaction exists between ‘soil health’, ecological surroundings and livestock grazing, whereby a higher level of soil organic carbon (SOC) stock is associated with a better animal performance and less nutrient losses into watercourses, and a higher stocking density with greater botanical diversity and elevated SOC. We contend that a combination of farming system-wide trials and environmental instrumentation provides an ideal setting for enrolling scientifically sound and biologically informative metrics for agricultural sustainability, through which agricultural producers could obtain guidance to manage soils, water, pasture and livestock in an economically and environmentally acceptable manner. Priority areas for future farm-scale research to ensure long-term sustainability are also discussed.
Previous research has shown relatively diminished medial prefrontal cortex activation and heightened psychophysiological responses during the recollection of personal events in post-traumatic stress disorder (PTSD), but the origin of these abnormalities is unknown. Twin studies provide the opportunity to determine whether such abnormalities reflect familial vulnerabilities, result from trauma exposure, or are acquired characteristics of PTSD.
Methods
In this case–control twin study, 26 male identical twin pairs (12 PTSD; 14 non-PTSD) discordant for PTSD and combat exposure recalled and imagined trauma-unrelated stressful and neutral life events using a standard script-driven imagery paradigm during functional magnetic resonance imaging and concurrent skin conductance measurement.
Results
Diminished activation in the medial prefrontal cortex during Stressful v. Neutral script-driven imagery was observed in the individuals with PTSD, relative to other groups.
Conclusions
Diminished medial prefrontal cortex activation during Stressful v. Neutral script-driven imagery may be an acquired characteristic of PTSD. If replicated, this finding could be used prospectively to inform diagnosis and the assessment of treatment response.
Efficacy of soil and/or foliage applications of the sodium salt of chloramben (3-amino-2,5-dichlorobenzoic acid) was compared, and the influence of growth stage and oil base within adjuvants on chloramben efficacy was evaluated on velvetleaf (Abutilon theophrasti Medic. # ABUTH). In greenhouse experiments, soil applications reduced growth of velvetleaf treated at the six- to seven-leaf stage (15-cm height) more than did foliage applications. Simulated rainfall applied 48 h after chloramben was applied to foliage significantly increased chloramben activity. Chloramben plus an oil concentrate applied at 3.4 kg ae/ha plus 2.3 L/ha reduced fresh and dry weight less as growth stage advanced in both greenhouse and field experiments. Origin of oil present in the oil concentrate did not influence the activity of chloramben plus oil concentrate in either the greenhouse or in the field. Chloramben plus oil concentrate reduced seed capsule (boll) production 70% or more in velvetleaf plants treated at each of three growth stages in one year and reduced capsule production 90, 90, and 28% in plants treated at early vegetative, late vegetative, and flowering stages, respectively, in the second year. Viability of seed was less from plants treated at a vegetative stage compared to the flowering stage.
There are multiple recent reports of an association between anxious/depressed (A/D) symptomatology and the rate of cerebral cortical thickness maturation in typically developing youths. We investigated the degree to which anxious/depressed symptoms are tied to age-related microstructural changes in cerebral fiber pathways. The participants were part of the NIH MRI Study of Normal Brain Development. Child Behavior Checklist A/D scores and diffusion imaging were available for 175 youths (84 males, 91 females; 241 magnetic resonance imagings) at up to three visits. The participants ranged from 5.7 to 18.4 years of age at the time of the scan. Alignment of fractional anisotropy data was implemented using FSL/Tract-Based Spatial Statistics, and linear mixed model regression was carried out using SPSS. Child Behavior Checklist A/D was associated with the rate of microstructural development in several white matter pathways, including the bilateral anterior thalamic radiation, bilateral inferior longitudinal fasciculus, left superior longitudinal fasciculus, and right cingulum. Across these pathways, greater age-related fractional anisotropy increases were observed at lower levels of A/D. The results suggest that subclinical A/D symptoms are associated with the rate of microstructural development within several white matter pathways that have been implicated in affect regulation, as well as mood and anxiety psychopathology.
Discovery of the non-native Anoplophora glabripennis Motschulsky (Coleoptera: Cerambycidae) in Ontario, Canada, in 2003 led to the implementation of an eradication programme. The plan consisted of removing all infested trees and all trees belonging to a genus considered suitable for complete development of this wood-borer that were found within 400 m of an infested tree; however, many of the trees within that 400 m belonged to genera for which suitability for development of A. glabripennis was questionable or unknown. We visually inspected over 3000 such trees annually for the three years following removal of infested trees. All but one tree were unattacked: an ash (Fraxinus excelsior Linnaeus (Oleaceae)) tree had signs of oviposition and early-instar development, but not of adult emergence. Before that survey, we had found only one other species with questionable suitability, a little leaf linden (Tilia cordata Miller (Malvaceae)) that had many signs of oviposition, but no evidence of full development, suggesting resistance to A. glabripennis. Both of these trees were within 200 m of the most heavily infested maple (Acer platanoides Linnaeus (Sapindaceae)) tree found in that infestation, suggesting that colonisation of trees with questionable or unknown suitability might occur mostly where population pressure is high.