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Repetitive transcranial magnetic stimulation (TMS) is an evidenced based treatment for adults with treatment resistant depression (TRD). The standard clinical protocol for TMS is to stimulate the left dorsolateral prefrontal cortex (DLPFC). Although the DLPFC is a defining region in the cognitive control network of the brain and implicated in executive functions such as attention and working memory, we lack knowledge about whether TMS improves cognitive function independent of depression symptoms. This exploratory analysis sought to address this gap in knowledge by assessing changes in attention before and after completion of a standard treatment with TMS in Veterans with TRD.
Participants and Methods:
Participants consisted of 7 Veterans (14.3% female; age M = 46.14, SD = 7.15; years education M = 16.86, SD = 3.02) who completed a full 30-session course of TMS treatment and had significant depressive symptoms at baseline (Patient Health Questionnaire-9; PHQ-9 score >5). Participants were given neurocognitive assessments measuring aspects of attention [Wechsler Adult Intelligence Scale 4th Edition (WAIS-IV) subtests: Digits Forward, Digits Backward, and Number Sequencing) at baseline and again after completion of TMS treatment. The relationship between pre and post scores were examined using paired-samples t-test for continuous variables and a linear regression to covary for depression and posttraumatic stress disorder (PTSD), which is often comorbid with depression in Veteran populations.
Results:
There was a significant improvement in Digit Span Forward (p=.01, d=-.53), but not Digit Span Backward (p=.06) and Number Sequencing (p=.54) post-TMS treatment. Depression severity was not a significant predictor of performance on Digit Span Forward (f(1,5)=.29, p=.61) after TMS treatment. PTSD severity was also not a significant predictor of performance on Digit Span Forward (f(1,5)=1.31, p=.32).
Conclusions:
Findings suggested that a standard course of TMS improves less demanding measures of working memory after a full course of TMS, but possibly not the more demanding aspects of working memory. This improvement in cognitive function was independent of improvements in depression and PTSD symptoms. Further investigation in a larger sample and with direct neuroimaging measures of cognitive function is warranted.
This volume of the Haskins Society Journal brings together a rich and interdisciplinary collection of articles. Topics range from the politics and military organization of northern worlds of the Anglo-Normans and Angevins in the twelfth and thirteenth centuries, to the economic activity of women in Catalonia and political unrest in thirteenth-century Tripoli. Martin Millett's chapter on thesignificance of rural life in Roman Britain for the early Middle Ages continues the Journal's commitment to archaeological approaches to medieval history, while contributions on �lfric's complex use of sources in his homilies, Byrhtferth of Ramsey's reinterpretation of the Alfredian past, and the little known History of Alfred of Beverly engage with crucial questions of sources andhistoriographical production within Anglo-Saxon and Anglo-Norman England. Pieces on the political meaning of the Empress Helena and Constantine I for Angevin political ambitions and the role of relicssuch as the Holy Lance in strategies of political legitimation in Anglo-Saxon England and Ottonian Germany in the tenth century complete the volume.
Contributors: David Bachrach, Mark Blincoe, Katherine Cross, Sarah Ifft Decker, Joyce Hill, Katherine Hodges-Kluck, Jesse Izzo, Martin Millett, John Patrick Slevin, Oliver Stoutner, Laura Wangerin.
Thirty-four states, the District of Columbia, and Puerto Rico have legalized medical cannabis. While no two state medical cannabis programs are alike, public health concerns related to advertising, packaging and labeling, pesticide use, scientific research, and the role of medical cannabis in the opioid crisis are emerging across the country. This article examines these issues, the policy approaches states are adopting to protect patients and the public, and an assessment of the underlying federal legal landscape.
Since its inception in 2010, the Network for Public Health Law (Network) has aligned with federal, state, tribal, and local public health practitioners to assess how law can promote and protect the public’s health. In 2013, Network authors illustrated major trends in public health laws and policies emanating from an internal assessment of thousands of requests for technical assistance nationally. More recently, the Robert Wood Johnson Foundation (RWJF) has invited the Network and other partners to consider new ideas and strategies toward building a “culture of health.” Per Figure 1, RWJF’s conception of a culture of health emphasizes key action areas essential to the promotion of health across all sectors and diverse populations.
Optical coherence tomography (OCT) - measured retinal nerve fiber layer (RNFL) values may represent a surrogate biomarker for axonal integrity in multiple sclerosis (MS). The purpose of this study was to determine whether RNFL measurements obtained within two years of an optic neuritis (ON) event distinguish patients at increased risk of developing clinically-definite MS (CDMS).
Methods:
Fifty consecutively sampled patients who experienced a single ON event were followed prospectively for a mean period of 34 months with OCT testing. Values of RNFL in clinically-affected and non-affected eyes were compared between patients who developed CDMS and those that did not develop MS after ON.
Findings:
Twenty-one patients (42%) developed CDMS during the course of the study, with a mean conversion time of 27 months. Mean RNFL values were thinner in the clinically - affected eyes of non - MS patients than CDMS eyes after one year (p = 0.0462) due to more severe ON events in the former. By year two, CDMS patients manifested more recurrent ON events and RNFL thinning than non - MS patients. Temporal RNFL values were thinner in the non-affected eyes of CDMS patients with a trend towards significance (p = 0.1302).
Interpretation:
Our results indicate that RNFL thickness does not reliably distinguish patients at higher risk of converting to CDMS after ON. The severity of ON has a greater effect on RNFL thickness than risk of CDMS at one year. The CDMS patients demonstrate progressive RNFL thinning likely due to recurrent sub-clinical ON events, which may help differentiate them from non - MS patients over time.
All four major southern pines can be killed by the southern pine beetle, but loblolly and shortleaf are much more susceptible than longleaf and slash. Oleoresin from more than 50 trees of each species was tested for composition and amount of monoterpenes and resin acids, viscosity, flow (rate, duration, and amount), and rate of crystallization. Discriminant function analyses were used to classify the loblolly and shortleaf trees as to probable resistance. The best classification used physical properties (total flow, flow rate, viscosity, time to crystallization). Supposedly resistant and susceptible trees were subjected to controlled attack, and the chemical and physical properties of four loblolly pines that survived natural attack were measured. Resistance is strongly related to the physical properties of the oleoresin, and can be predicted by these properties. Loblolly and shortleaf trees with “average” properties usually succumb to 100 or more attacks per sq. m of bark surface. Several trees classified as resistant survived a much higher rate of attack.
We present a new method for finding associations of young stars in M31 using broadband WFPC2 data from the HST data archive. Applying our identification method to 13 WFPC2 fields, covering an area of ∼60 arcmin2, has revealed 80 new candidate young star clusters in these portions of the M31 disk. Most of these clusters are small (≳5 pc) young (∼10–200 Myr) star groups located within large OB associations. We have estimated the reddening values and the ages of each candidate individually by fitting isochrones to the stellar photometry. We provide a catalogue of the candidates including rough approximations of their reddenings and ages.
We present a photometric study of the stars in ionizing star clusters embedded in several giant H II regions of M33 (CC93, IC 142, NGC 595, MA2, NGC 604 and NGC 588). Our photometry is based on the HST-WFPC2 images of these clusters. Color-magnitude diagrams and color-color diagrams of these clusters are obtained and are used for estimating the reddenings and ages of the clusters. The luminosity functions (LFs) and initial mass functions (IMFs) of the massive stars in these clusters are also derived. The slopes of the IMFs range from Γ = −0.5 to −2.1. Interestingly, it is found that the IMFs get steeper with increasing galactocentric distance and with decreasing [O/H] abundance.
Extragalactic HII regions and their ionizing star clusters are the most prominent signposts of recent starbirth activity in galaxies. In this paper, we present optical measurements of nearby extragalactic HII regions with the aim of investigating possible relationships between the newborn ionizing clusters and their dynamical environment. Evidence for variations in the measured HII region properties (size, Hα luminosity, and Hα equivalent width) are presented as a function of galaxy type and of position within individual galaxies. These variations, in turn, are compared with the corresponding kinematic and dynamical variations. The apparent sensitivity of the ionizing activity to the dynamical environment suggests that the total masses and upper stellar mass limits of the ionizing clusters are somehow constrained by the ambient tidal stresses and shear flows within the galaxies. We speculate that regions of high tidal stress and kinematic shearing tend to suppress the formation and maintenance of giant molecular clouds, thereby hindering the creation of giant clusters and massive stars therein.