Network Analysis Reveals Distinct Clinical Syndromes Underlying Acute Mountain Sickness

Acute mountain sickness (AMS) is a common problem among visitors at high altitude, and may progress to life-threatening pulmonary and cerebral oedema in a minority of cases. International consensus defines AMS as a constellation of subjective, non-specific symptoms. Specifically, headache, sleep disturbance, fatigue and dizziness are given equal diagnostic weighting. Different pathophysiological mechanisms are now thought to underlie headache and sleep disturbance during acute exposure to high altitude. Hence, these symptoms may not belong together as a single syndrome. Using a novel visual analogue scale (VAS), we sought to undertake a systematic exploration of the symptomatology of AMS using an unbiased, data-driven approach originally designed for analysis of gene expression. Symptom scores were collected from 292 subjects during 1110 subject-days at altitudes between 3650 m and 5200 m on Apex expeditions to Bolivia and Kilimanjaro. Three distinct patterns of symptoms were consistently identified. Although fatigue is a ubiquitous finding, sleep disturbance and headache are each commonly reported without the other. The commonest pattern of symptoms was sleep disturbance and fatigue, with little or no headache. In subjects reporting severe headache, 40% did not report sleep disturbance. Sleep disturbance correlates poorly with other symptoms of AMS (Mean Spearman correlation 0.25). These results challenge the accepted paradigm that AMS is a single disease process and describe at least two distinct syndromes following acute ascent to high altitude. This approach to analysing symptom patterns has potential utility in other clinical syndromes

Sonic diaspora, vibrations and rhythm: thinking through the sounding of the Jamaican dancehall session

The propagation of vibrations may provide a better way of understanding diasporic spread than the conventional focus on the circulation of products (Hall 1980, Appadurai 1986, 1996, Gilroy 1993a, Brah 1996). Jamaican sound systems operate as a broadcast medium and a source of CDs, DVDs and other commercial products (Henriques 2007a). But the dancehall sound system session also propagates a broad spectrum of frequencies diffused through a range of media and activities - described as “sounding” (following Small’s 1998 concept of “musicking”). These include the material vibrations of the signature low-pitched auditory frequencies of Reggae as a bass culture (Johnson 1980), at the loudness of “sonic dominance” (Henriques 2003). Secondly a session propagates the corporeal vibrations of rituals, dance routines and bass-line “riddims” (Veal 2007). Thirdly it propagates the ethereal vibrations (Henriques 2007b), “vibes” or atmosphere of the sexually charged popular subculture by which the crowd (audience) appreciate each dancehall session as part of the Dancehall scene (Cooper 2004). The paper concludes that thinking though vibrating frequencies makes it easier to appreciate how audiences with no direct or inherited connection with a particular music genre can be energetically infected and affected - to form a sonic diaspora

Identification of common genetic risk variants for autism spectrum disorder

Autism spectrum disorder (ASD) is a highly heritable and heterogeneous group of neurodevelopmental phenotypes diagnosed in more than 1% of children. Common genetic variants contribute substantially to ASD susceptibility, but to date no individual variants have been robustly associated with ASD. With a marked sample-size increase from a unique Danish population resource, we report a genome-wide association meta-analysis of 18,381 individuals with ASD and 27,969 controls that identified five genome-wide-significant loci. Leveraging GWAS results from three phenotypes with significantly overlapping genetic architectures (schizophrenia, major depression, and educational attainment), we identified seven additional loci shared with other traits at equally strict significance levels. Dissecting the polygenic architecture, we found both quantitative and qualitative polygenic heterogeneity across ASD subtypes. These results highlight biological insights, particularly relating to neuronal function and corticogenesis, and establish that GWAS performed at scale will be much more productive in the near term in ASD.Peer reviewe

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

The benefits of climate change mitigation in integrated assessment models: The role of the carbon cycle and climate component

Integrated Assessment Models (IAMs) are an important tool to compare the costs and benefits of different climate policies. Recently, attention has been given to the effect of different discounting methods and damage estimates on the results of IAMs. One aspect to which little attention has been paid is how the representation of the climate system may affect the estimated benefits of mitigation action. In that respect, we analyse several well-known IAMs, including the newest versions of FUND, DICE and PAGE. Given the role of IAMs in integrating information from different disciplines, they should ideally represent both best estimates and the ranges of anticipated climate system and carbon cycle behaviour (as e. g. synthesised in the IPCC Assessment reports). We show that in the longer term, beyond 2100, most IAM parameterisations of the carbon cycle imply lower CO 2 concentrations compared to a model that captures IPCC AR4 knowledge more closely, e. g. the carbon-cycle climate model MAGICC6. With regard to the climate component, some IAMs lead to much lower benefits of mitigation than MAGICC6. The most important reason for the underestimation of the benefits of mitigation is the failure in capturing climate dynamics correctly, which implies this could be a potential development area to focus on

The benefits of climate change mitigation in integrated assessment models: The role of the carbon cycle and climate component

Integrated Assessment Models (IAMs) are an important tool to compare the costs and benefits of different climate policies. Recently, attention has been given to the effect of different discounting methods and damage estimates on the results of IAMs. One aspect to which little attention has been paid is how the representation of the climate system may affect the estimated benefits of mitigation action. In that respect, we analyse several well-known IAMs, including the newest versions of FUND, DICE and PAGE. Given the role of IAMs in integrating information from different disciplines, they should ideally represent both best estimates and the ranges of anticipated climate system and carbon cycle behaviour (as e. g. synthesised in the IPCC Assessment reports). We show that in the longer term, beyond 2100, most IAM parameterisations of the carbon cycle imply lower CO 2 concentrations compared to a model that captures IPCC AR4 knowledge more closely, e. g. the carbon-cycle climate model MAGICC6. With regard to the climate component, some IAMs lead to much lower benefits of mitigation than MAGICC6. The most important reason for the underestimation of the benefits of mitigation is the failure in capturing climate dynamics correctly, which implies this could be a potential development area to focus on

The benefits of climate change mitigation in integrated assessment models: The role of the carbon cycle and climate component

Integrated Assessment Models (IAMs) are an important tool to compare the costs and benefits of different climate policies. Recently, attention has been given to the effect of different discounting methods and damage estimates on the results of IAMs. One aspect to which little attention has been paid is how the representation of the climate system may affect the estimated benefits of mitigation action. In that respect, we analyse several well-known IAMs, including the newest versions of FUND, DICE and PAGE. Given the role of IAMs in integrating information from different disciplines, they should ideally represent both best estimates and the ranges of anticipated climate system and carbon cycle behaviour (as e. g. synthesised in the IPCC Assessment reports). We show that in the longer term, beyond 2100, most IAM parameterisations of the carbon cycle imply lower CO 2 concentrations compared to a model that captures IPCC AR4 knowledge more closely, e. g. the carbon-cycle climate model MAGICC6. With regard to the climate component, some IAMs lead to much lower benefits of mitigation than MAGICC6. The most important reason for the underestimation of the benefits of mitigation is the failure in capturing climate dynamics correctly, which implies this could be a potential development area to focus on

Effects of food and fire on the demography of a nectar-feeding marsupial: A field experiment

Animals that specialize on nectar can be expected to face shortages of energy at times or in places where floral resources fade. Using a nectar-feeding marsupial, the eastern pygmy-possum Cercartetus nanus as a model, we predicted that animals would respond rapidly to an artificial energy supplement by showing improved body condition and increased local abundance. We also tested the hypothesis that responses would be more pronounced in burnt than in unburnt habitats due to the expectation that food would be limiting after fire. Energy was added in the form of sugar solution to two burnt and two unburnt woodland sites on the New South Wales coast, but not to two sets of equivalent control sites. The responses of pygmy-possums were compared between sites a month before and a month after supplementation during early autumn when flowers were diminishing. The energy supplement increased on-site immigration and a tail-fat index of body condition, but had no overall effect on the abundance or mean body mass of pygmy-possums. There was no effect of habitat; floral abundance was equal across sites. The results show that C. nanus responded rapidly to the energy supplement, and indicate that animals monitor shifts in the resource base continuously. Similar resource tracking abilities have been demonstrated previously in more mobile nectar-feeders, such as honeyeaters and bats. We suggest that such abilities should be generally advantageous in any species that depend on ephemeral resources