Examining the effects of adjuvant chemotherapy on cognition and the impact of any cognitive impairment on quality of life in colorectal cancer patients: study protocol

Background: Research suggests that chemotherapy can cause deficits in both patients’ objectively measured and self-reported cognitive abilities which can in turn affect their quality of life (QoL). The majority of research studies have used post-treatment retrospective designs or have not included a control group in prospective cohorts. This has limited the conclusions that can be drawn from the results. There have also been a disproportionate number of studies focussed on women with breast cancer, which has limited the generalisability of the results to other cancer populations. Aim: This study aims to identify the extent and impact of chemotherapy-induced cognitive decline in colorectal cancer patients. Possible associations with poorer QoL will also be explored. Design: This will be a longitudinal controlled cohort study. Questionnaires measuring subjective cognitive functioning, QoL, fatigue and mood, and neuropsychological assessments of objective cognitive function will be collected pre-, mid- and post- chemotherapy treatment from a consecutive sample of 78 colorectal cancer patients from five London NHS Trusts. A further 78 colorectal cancer surgery only patients will be assessed at equivalent time points; this will allow the researchers to compare the results of patients undergoing surgery, but not chemotherapy against those receiving both treatments. Pre- and post-chemotherapy difference scores will be calculated to detect subtle changes in cognitive function as measured by the objective neuropsychological assessments and the self-reported questionnaires. A standardised zscore will be computed for every patient on each neuropsychological test, and for each test at each time point. The post-chemotherapy score will then be subtracted from the pre-chemotherapy score to produce a relative difference score for each patient. ANCOVA will be used to compare mean difference z-scores between the chemotherapy and surgery-only groups while controlling for the effects of gender, age, depression, anxiety, fatigue and education. Discussion: The result from this study will indicate whether a decline in cognitive functioning can be attributed to chemotherapy or to disease, surgical or some other confounding factor. Identification of risk factors for cognitive deficits may be used to inform targeted interventions, in order to improve QoL and help patients’ cope

Interpretation of hyperchromic nerve cells relative significance of the type of fixative used, of the osmolarity of the cytoplasm and the surrounding fluid in the production of cell shrinkage

No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/49986/1/901210110_ftp.pd

Interactions between sleep, stress, and metabolism: From physiological to pathological conditions

AbstractPoor sleep quality due to sleep disorders and sleep loss is highly prevalent in the modern society. Underlying mechanisms show that stress is involved in the relationship between sleep and metabolism through hypothalamic–pituitary–adrenal (HPA) axis activation. Sleep deprivation and sleep disorders are associated with maladaptive changes in the HPA axis, leading to neuroendocrine dysregulation. Excess of glucocorticoids increase glucose and insulin and decrease adiponectin levels. Thus, this review provides overall view of the relationship between sleep, stress, and metabolism from basic physiology to pathological conditions, highlighting effective treatments for metabolic disturbances

Co-creating a trigger model for cholera anticipatory action in Cameroon

Anticipatory action (AA) refers to actions taken by humanitarian actors and governments to reduce the humanitarian impacts of a forecasted hazard before it occurs. To date, most AA initiatives have focused on hydrometeorological events, but initiatives for in particular climate-sensitive diseases are gaining traction. Acting ahead of a disease outbreak or controlling an epidemic early on can significantly reduce the impacts. Cameroon has experienced recurrent cholera epidemics since 1971. The Cameroon Red Cross has been working with the French Red Cross, technical partners (510 an initiative of the Netherlands Red Cross and EHESP), and in-country actors such as the Ministry of Health to co-create an Early Action Protocol (EAP) for cholera. An EAP contains a model that triggers early actions once a certain forecast or observation reaches a threshold that indicates there could be severe negative impacts corresponding to a one-in-five-year return period. Cholera is a water-borne disease, where climatic, environmental, and socio-economic factors contribute to its risk. The development of a trigger model requires historical data on these factors, but this data is often difficult to obtain or not available with sufficient spatial and temporal resolution. Also, for an operational trigger model, the input data of the trigger model has to be available in near-real time. A data-sharing agreement with the Ministry of Health was put in place to get access to the sensitive cholera incidence data. Correlation analyses between daily rainfall (as floods impact WASH infrastructure) and cholera case data were done for delays between 7 to 14 days, as it is known from the literature that the first cholera cases usually occur after a few days of flooding. However, only very weak correlations were found. A moving average of rainfall over 50 mm/day for four consecutive days did correspond to a significant number of cholera cases. The trigger model proposed relies only on observed data and consists of two parts. Trigger 1 is a climatic trigger that triggers when a district experiences flooding with over 2000 people affected or when it experiences 4 days with an average daily rainfall of at least 50 mm. Trigger 2 goes off whenever at least 5 suspected cases or 1 confirmed cholera case are identified through community-based or national surveillance systems. To activate trigger 2, trigger 1 must already have been activated. The next steps will include gaining experience with activations with this protocol, while also, from a research point of view, evolving the trigger model once more data on the cholera risk factors becomes available

Studies on the Diencephalon of the virginia Opossum. Part i. The nuclear pattern in the adult

No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/49920/1/900710203_ftp.pd

The development and general morphology of the telencephalon of actinopterygian fishes: synopsis, documentation and commentary

The Actinopterygii or ray-finned fishes comprise, in addition to the large superorder of teleosts, four other superorders, namely the cladistians, the chondrosteans, the ginglymodes, and the halecomorphs, each with a limited number of species. The telencephalon of actinopterygian fishes differs from that in all other vertebrates in that it consists of a pair of solid lobes. Lateral ventricles surrounded by nervous tissue are entirely lacking. At the end of the nineteenth century, the theory was advanced that the unusual configuration of the forebrain in actinopterygians results from an outward bending or eversion of its lateral walls. This theory was accepted by some authors, rejected or neglected by others, and modified by some other authors. The present paper is based on the data derived from the literature, complemented by new observations on a large collection of histological material comprising specimens of all five actinopterygian superorders. The paper consists of three parts. In the first, a survey of the development of the telencephalon in actinopterygian fishes is presented. The data collected show clearly that an outward bending or eversion of the pallial parts of the solid hemispheres is the principal morphogenetic event in all five actinopterygian superorders. In all of these superorders, except for the cladistians, eversion is coupled with a marked thickening of the pallial walls. In the second part, some aspects of the general morphology of the telencephalon in mature actinopterygians are highlighted. It is pointed out that (1) the degree of eversion varies considerably among the various actinopterygian groups; (2) eversion leads to the transformation of the telencephalic roof plate into a wide membrane or tela choroidea, which is bilaterally attached to the lateral or ventrolateral aspect of the solid hemispheres; (3) the lines of attachment or taeniae of the tela choroidea form the most important landmarks in the telencephalon of actinopterygians, indicating the sites where the greatly enlarged ventricular surface of the hemispheres ends and its reduced meningeal surface begins; (4) the meningeal surface of the telencephalon shows in most actinopterygians bilaterally a longitudinally oriented sulcus externus, the depth of which is generally positively correlated with the degree of eversion; (5) a distinct lateral olfactory tract, occupying a constant topological position close to the taenia, is present in all actinopterygians studied; and (6) this tract is not homologous to the tract of the same name in the evaginated and inverted forebrains of other groups of vertebrates. In the third and final section, the concept that the structural organization of the pallium in actinopterygians can be fully explained by a simple eversion of its walls, and the various theories, according to which the eversion is complicated by extensive shifts of its constituent cell groups, are discussed and evaluated. It is concluded that there are no reasons to doubt that the pallium of actinopterygian fishes is the product of a simple and complete eversion

From phenomenology to a neurophysiological understanding of hallucinations in children and adolescents

Typically reported as vivid, multisensory experiences which may spontaneously resolve, hallucinations are present at high rates during childhood. The risk of associated psychopathology is a major cause of concern. On the one hand, the risk of developing further delusional ideation has been shown to be reduced by better theory of mind skills. On the other hand, ideas of reference, passivity phenomena, and misidentification syndrome have been shown to increase the risk of self-injury or heteroaggressive behaviors. Cognitive psychology and brain-imaging studies have advanced our knowledge of the mechanisms underlying these early-onset hallucinations. Notably, specific functional impairments have been associated with certain phenomenological characteristics of hallucinations in youths, including intrusiveness and the sense of reality. In this review, we provide an update of associated epidemiological and phenomenological factors (including sociocultural context, social adversity, and genetics, considered in relation to the psychosis continuum hypothesis), cognitive models, and neurophysiological findings concerning hallucinations in children and adolescents. Key issues that have interfered with progress are considered and recommendations for future studies are provided

The alterations of tonus and movements through the interplay between the cerebral hemispheres and the cerebellum

This paper deals with the experimental production of involuntary movenients and abnormal tonus in macaques ( Macacu mulatta ) and their alterations in these animals and in children with cerebral palsy and other cerebral lesions. The first major subdivision of the paper has three parts. The first part describes the effects of lesions in the macaque cerebral hemispheres, ranging from a small destructive lesion in area 4 to an essentially complete bicortectomy. The case histories of a few patients document some of the results. The second part reports the effects of lesions in the macaque cerebellum ranging from small vermal injuries to complete cerebellectomies. The third part is concerned with successive lesions in the cerebellum and cerebral hemispheres of macaques and with planned cerebellar lesions in a few children with grave hypertonicity and marked involuntary movements. This subdivision is illustrated with photographs of the monkeys and the children at various stages of the procedures, photographs of many monkey brains at postmortem, and some photomicrographs showing lesions. The second major subdivision has a discussion of the anatomic and the physiologic bases for the experimental results obtained and for the operations on the children. It correlates the material presented with data from the literature and is illustrated with photomicrographs of degenerated tracts and with diagrams. The paper stresses the balancing of cerebral hemisphere and cerebellar discharges in the regulation of tonus and in the stabilizing of movements. It discusses the possibility of producing more effective tonus by making carefully planned lesions in cerebellar areas of animals or of children with highly handicapping hypertonicity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/49991/1/901270502_ftp.pd