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Spirometra is a genus of zoonotic cestodes with an ambiguous species-level taxonomic history. Previously, Spirometra mansonoides was considered the only species present in North America. However, recent molecular data revealed the presence of at least three distinct species in the USA: Spirometra sp. 2 and 3, and Spirometra mansoni. This study aimed to elucidate the diversity and potential host associations of Spirometra species among companion animals in the USA. Samples (N = 302) were examined from at least 13 host species, including mammals, amphibians and reptiles. Sample types included eggs isolated from faeces (n = 222), adult specimens (n = 71) and plerocercoids (n = 9) from 18 different states and 2 territories across the USA. Extracted genomic DNA was subjected to PCR targeting a fragment of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Generated sequences (n = 136) were included in a phylogenetic analysis. Spirometra mansoni was detected in domestic cats (n = 76), dogs (n = 12), a White’s tree frog (n = 1), a Cuban knight anole (n = 1), a green iguana (n = 1) and a serval (n = 1) across 15 states and Puerto Rico. Spirometra sp. 2 was found only in dogs (n = 3) from Florida and Spirometra sp. 3 was found only in cats (n = 41) from 17 states. All plerocercoid samples were consistent with S. mansoni. The results confirm that at least three distinct Spirometra species are present and established in companion animals, such as dogs and cats, and likely are using various native and exotic species as paratenic hosts within the USA.
As COVID-19 continues to spread worldwide, severe disease and mortality have been observed in obese patients. We discuss how obesity and obesity-associated factors such as ‘meta-flammation’, dietary fat intake and paradoxical suppression of the innate immune response within the pulmonary compartment may be crucial determinants in the host response to a novel viral pathogen. Modulation of immune cell bioenergetics and metabolic potential plays a central role in the innate immune response to infection, and as we strive to combat this new global health threat, immunometabolism of the innate immune system warrants attention.
Carers’ expressed emotion (EE) and patients’ cannabis misuse are two of the most robust predictors of psychotic relapse. We aimed to examine the temporal relationship between EE and cannabis misuse. Sixty-three key carers of young people with first-episode psychosis (FEP) were assessed at baseline and 7-month follow-up. EE was measured in carers using the Family Questionnaire (FQ) and cannabis misuse in patients using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Correlational and hierarchical logistic regression analyses were conducted to examine the temporal relationship between EE components (i.e. criticism and emotional over involvement) and cannabis misuse. Carers’ criticism at baseline significantly predicted cannabis misuse according to the ASSIST at 7-month follow-up. The association remained significant after controlling for baseline symptom severity and social functioning (B = 0.15, P = .02). Conversely, baseline cannabis misuse was not associated with carers’ criticism at 7-month follow-up. Patients in families with high criticism showed a tendency to increase cannabis misuse over time whereas the opposite trend was observed in those with carers with low criticism. A family environment characterized by high criticism may become a key risk factor for worsening cannabis misuse over time in young people with FEP. Further studies should investigate the potential mechanisms (e.g., patient's anxiety or perceived stress) through which criticism increases cannabis misuse in FEP.
Cognitive impairment impacts on patient outcomes [1] but is under-recognised in acute hospitals [2]. Data on rates and degree of impairment among hospital inpatients remain sparse. This information is vital for strategic planning of health services as the European population ages.
Objectives
To examine the rates and degree of cognitive impairment among patients aged 65 and older who were admitted to an acute general hospital and to assess its impact on patient outcomes.
Methods
All patients aged over 65 who were admitted over a 2-week period were invited to participate. Those who met the inclusion criteria were screened for delirium then underwent a cognitive screening battery. Normative values for age and level of education were obtained from the TILDA study [3]. Demographic and outcome data were obtained from medical records.
Results
One hundred and forty-eight patients underwent cognitive screening. Thirty-nine over 148 (26%) met the DSM-IV criteria for dementia of whom only 16 (41%) had a previously-documented impairment. Thirty over 148 (20%) had evidence of cognitive impairment that did not meet criteria for dementia, only 3 (10%) of whom were previously documented. Seventy-three over 148 (49%) were normal. Six over 148 (4%) were not classifiable. The impact of cognitive status on length of hospital stay, number of readmissions in 6 months and discharge destination was investigated. Impact on length of stay was significant (P = 0.017) but significance was not achieved against number of readmissions or discharge destination.
Conclusions
Cognitive impairment is pervasive and under-recognised in the acute hospital and impacts on length of hospital stay. Longer interval analysis is necessary to investigate further implications.
References 1–3 available upon request.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Recent observations of the radio-frequency flux spectrum of Jupiter in the frequency range 80-10 000 MHz suggest that the synchrotron component is not independent of frequency as has been generally accepted. Rather, the flux decreases at frequencies below 300 MHz and above 3000 MHz. In this paper we show that extensions and variations of the well-known dipolar model for this emission can account for the modified spectrum.
In this paper we model mathematically the propagation of galactic cosmic-rays in the solar cavity and study the effects of changing the physical parameters; in particular the radius of the cavity. We assume spherical symmetry with heliocentric distance r, momentum p and work in terms of F0(r, p) the mean distribution function with respect to momentum; it is related to JT the mean differential intensity w.r.t. energy by JT = p2F0. The boundary is at r = rb beyond which the galactic spectrum prevails; there is free escape of particles incident on rb from within, and the distribution is steady state.
The purpose of this paper is to provide a new expression for < ṗ > the average time-rate-of-change of momentum of cosmic-ray particles propagating in the interplanetary region. The expression derived replaces the previously used adiabatic deceleration formula and it is arrived at by a rearrangement and reinterpretation of the well known equation of transport for cosmic-rays. Thus, although we provide a new expression for < ṗ > we maintain the equation of transport and do not render invalid results for differential intensity and differential current density of cosmic-ray particles obtained by its solution (Jokipii 1971; Gleeson 1972).
This paper is a preliminary account of the calculation of the circularly polarized synchrotron radiation received from a distribution of electricallycharged particles confined to a thin shell in the magnetic field of a dipole. Calculations of the total radiation and the degree of linear polarization have previously been carried out, and these calculations are duplicated in part.
In this paper we study the steady-state interplanetary propagation of solar cosmic-rays by means of analytic solutions of the equation of transport. The cosmic-rays are released monoenergetically from a fixed heliocentric radius and redistribute in energy as they propagate. Previous investigations by Goldstein et al. (1970), Urch and Gleeson (1971,1972), and Parker (1965, 1966), were either not general enough or used numerical solutions which could not deal with strictly monoenergetic initial injection nor maintain accuracy over a wide range of particle energies. We use the analytic solutions of Gleeson and Webb (1973) and show the energy changes, the redistribution in energy (or momentum) and the characteristics of the particle flow or streaming.
Recently (Gleeson (1972), Quenby (1973), Gleeson and Webb (1974, 1978)) it has been shown that the mean rate of change of momentum of cosmic rays reckoned for a volume fixed in the solar system is
where G = (1/Up)(∂Up/∂r)si the cosmic-ray density gradient with Up, the differential number density with respect to momentum p at position r. (cf also the integral form of (1) by Jokipii and Parker 1967).
With prevention and treatment of mental disorders a challenge for primary care and increasing capability of electronic medical records (EMRs) to facilitate research in practice, we aim to determine the prevalence and treatment of mental disorders by using routinely collected clinical data contained in EMRs.
Methods
We reviewed EMRs of patients randomly sampled from seven general practices, by piloting a study instrument and extracting data on mental disorders and their treatment.
Results
Data were collected on 690 patients (age range 18–95, 52% male, 52% GMS-eligible). A mental disorder (most commonly anxiety/stress, depression and problem alcohol use) was recorded in the clinical records of 139 (20%) during the 2-year study period. While most patients with the common disorders had been prescribed medication (i.e. antidepressants or benzodiazepines), a minority had been referred to other agencies or received psychological interventions. ‘Free text’ consultation notes and ‘prescriptions’ were how most patients with disorders were identified. Diagnostic coding alone would have failed to identify 92% of patients with a disorder.
Conclusions
Although mental disorders are common in general practice, this study suggests their formal diagnosis, disease coding and access to psychological treatments are priorities for future research efforts.
By
Tanja Bueltmann, Lecturer in History at Northumbria University.,
David T. Gleeson, Gleeson is Reader in History at Northumbria University where he teaches American history.,
Donald M. MacRaild, Professor of History and Associate Dean for Research at Northumbria University.
From the early seventeenth century, when sustained migrations began a process of re-peopling in the emerging colonies of settlement, emigrants from the British and Irish Isles outnumbered those from any other European nation. Methods of counting frustrate the historian of the English: over the four centuries from the earliest migrations until the outbreak of the Second World War, those living in the colonies or the United States who had been born in England or were of English extraction exceeded those from Scotland and Ireland, but it is impossible to disentangle the English from the British. This remained a problem in the second half of the nineteenth century, and was compounded by the fact that many who left from English ports were not English themselves. But indicative emigration rates point to the continued importance of English people as a source for New World populations. While in the period from 1881 to 1910 Scotland was losing between seven and ten people per thousand of population, and Ireland between seven and fourteen, the much larger population of England was producing more emigrants, albeit at the lower rate of between five and six per thousand. Yet while the significance of the English has been noticed by historians of emigration, it is not acknowledged by historians of ethnicity: scholars recognize the English as a key population source in the Anglophone world but say relatively little about their contribution as immigrant communities.
In the United States, Charlotte Erickson studied the English but ultimately labelled them ‘invisible’. Bernard Bailyn consciously overlooked them since they did not qualify as marginal in the first British Empire. Carl Wittke also chose to leave them out. Oscar Handlin, who saw migration as a disturbing ‘uprooting’ process, simply ignored them. The idea that the English might, like every other settler group, be an ethnic community is ignored or refuted.
In recent years there has been increasing interest in functional recovery in the early phase of schizophrenia. Concurrently, new remission criteria have been proposed and several studies have examined their clinical relevance for prediction of functional outcome in first-episode psychosis (FEP). However, the longitudinal interrelationship between full functional recovery (FFR) and symptom remission has not yet been investigated. This study sought to: (1) examine the relationships between FFR and symptom remission in FEP over 7.5 years; (2) test two different models of the interaction between both variables.
Method
Altogether, 209 FEP patients treated at a specialized early psychosis service were assessed at baseline, 8 months, 14 months and 7.5 years to determine their remission of positive and negative symptoms and functional recovery. Multivariate logistic regression and path analysis were employed to test the hypothesized relationships between symptom remission and FFR.
Results
Remission of both positive and negative symptoms at 8-month follow-up predicted functional recovery at 14-month follow-up, but had limited value for the prediction of FFR at 7.5 years. Functional recovery at 14-month follow-up significantly predicted both FFR and remission of negative symptoms at 7.5 years, irrespective of whether remission criteria were simultaneously met. The association remained significant after controlling for baseline prognostic indicators.
Conclusions
These findings provided support for the hypothesis that early functional and vocational recovery plays a pivotal role in preventing the development of chronic negative symptoms and disability. This underlines the need for interventions that specifically address early psychosocial recovery.
We report a case of an arteriovenous malformation within the internal auditory meatus and cerebellopontine angle, and we discuss its imaging appearances and management.
Case report:
A 50-year-old man presented with a two-year history of vertigo. Magnetic resonance imaging and magnetic resonance angiography demonstrated a lesion consisting of multiple ‘high flow’ vessels within the left internal auditory meatus and cerebellopontine angle. Transarterial embolisation was performed, with obliteration of the arteriovenous malformation.
Conclusion:
Arteriovenous malformations of the internal auditory meatus and cerebellopontine angle are exceedingly rare. It is important that a pre-treatment diagnosis is made, as the management of arteriovenous malformation differs from that of other, more common lesions at this site.
To present a rare cause of facial pain, and the differential diagnosis of a lesion of the mandibular division of the trigeminal nerve.
Case report:
A 19-year-old woman presented to a tertiary referral skull base centre with right periorbital pain and a progressive, right-sided deficit of the mandibular division of the trigeminal nerve. Clinical examination revealed right-sided hypoaesthesia in the mandibular division of the trigeminal nerve dermatome, mild trismus and some wasting of the right masseter muscle. Computed tomography and magnetic resonance imaging scans revealed a small area of mildly enhancing soft tissue centred within the foramen ovale, with concentric enlargement. Surgery was undertaken via an infratemporal fossa (Fisch) type D approach. A vascular lesion was found filling the foramen ovale, with no obvious nerve separate from the lesion. The lesion was removed en bloc. Histopathological analysis demonstrated a venous haemangioma within the nerve.
Conclusion:
Facial pain is common, and may be wrongly attributed to trigeminal neuralgia. A thorough clinical examination must be performed to identify subtle neurological abnormalities, and appropriate imaging undertaken to exclude rare causes, such as this venous haemangioma of the mandibular division of the trigeminal nerve.
Myxosporean parasites are significant parasites of fishes not only for their apparent high diversity but also for their potential impact on fish health and/or marketability. Regardless, our knowledge of most myxosporeans, especially those found in elasmobranch hosts, is superficial. A study of multivalvulidan diversity in a range of elasmobranchs from Queensland, Western Australia and the Northern Territory (Australia) was conducted to address this knowledge gap. Specimens were collected from a total of 3 orders, 9 families and 31 species of elasmobranchs. Myxosporean infections referable to the genus Kudoa were discovered in host muscle and characterized morphologically and genetically. Both small subunit (SSU) and large subunit (LSU) rDNA sequences were used in molecular phylogenetic analyses. Kudoa spp. infected 27 of the 31 species of elasmobranchs examined, representing new records of this parasite genus in 26, of the 27, host species. Kudoids were observed in all 3 orders, and 7 out of the 9 families of elasmobranchs investigated. This paper reports the first 2 multivalvulidan species to be formally described from elasmobranchs, Kudoa hemiscylli n.sp. characterized from Hemiscyllium ocellatum (and 8 other host species) and Kudoa carcharhini n. sp. characterized from Carcharhinus cautus (and 2 other host species). Phylogenetic analyses revealed that kudoids from elasmobranchs form a separate lineage to those of teleosts, but are anchored within the overall kudoid clade.
Jugular foramen schwannomas are rare skull base tumours which typically have a variable clinical presentation. Glossopharyngeal syncope syndrome is an unusual clinical presentation; in the following case report, it was the sole presentation of an extracranial jugular foramen tumour.
Methods:
The presentation of a patient with glossopharyngeal neuralgia syncope syndrome is reviewed and the pathophysiology, clinical features and treatment discussed.
Results:
A 45-year-old woman presented with unilateral throat pain, bradycardia and hypotension leading to episodes of impaired consciousness when lying on her left side or turning her head to the left. Imaging detected a left-sided extracranial jugular foramen schwannoma. The tumour was excised, and the patient had no more syncopal attacks.
Conclusion:
Glossopharyngeal neuralgia syncope syndrome can be the sole presentation of a jugular foramen schwannoma. Although this syndrome may be treated with anti-dysrhythmic drugs, cardiac pacing or nerve section, in the presented patient excision of the jugular foramen schwannoma was successful in preventing further episodes of syncope.