Prophylaxis pharmacotherapy to prevent the onset of post traumatic brain injury depression: a systematic review

YesBackground: Depression is a common psychiatric problem following traumatic brain injury (TBI) with reported prevalence rates of 30-77% in the first year post-TBI. Given the negative influence of post-TBI depression on cognition, interpersonal, social, physical and occupational functioning; early initiation of pharmacotherapy to prevent post-TBI depression has been considered. This systematic review will synthesize the available evidence from published studies on the effectiveness and harms of pharmacotherapy for the secondary prevention of post-TBI depression. Method: Studies published before November 2017 were reviewed. Six databases were searched, with additional searching of key additional documents. Studies meeting inclusion criteria were evaluated for methodological quality. Results: Six articles addressing five studies met inclusion criteria. Study designs included three randomised controlled trials (RCT), two retrospective cohorts and one case-control. Prophylactic pharmacotherapy included antidepressants, beta-blockers and statins. In one RCT, the number-needed-to-treat with sertraline to prevent one case of depression post-TBI at 24 weeks was 5.9 (95%CI: 3.1-71.1). Prescribing beta-blockers prior to TBI reduced the depression risk regardless of the specific brain trauma. TBI patients with pre-existing hyperlipidemia not treated with statins had an increased depression risk compared to those without hyperlipidemia. Conclusion: Early initiation of sertraline prophylaxis in nondepressed TBI patients shows promise to reduce the odds of post-TBI depression developing. However, in the absence of rigorous study of tolerability, existing data are insufficient to recommend sertraline prophylaxis. Optimal timing and treatment duration with identification of patients most likely to benefit from prophylaxis require further consideration. Dedicated prospective studies assessing the effects of beta-blockers and statins on post-TBI depression are required.The Transport Accident Commission (TAC), through the Institute for Safety, Compensation and Recovery Research (ISCRR) at Monash University, provided funding for this review

Transfer of motor and perceptual skills from basketball to darts

The quiet eye is a perceptual skill associated with expertise and superior performance; however, little is known about the transfer of quiet eye across domains. We attempted to replicate previous skill-based differences in quiet eye and investigated whether transfer of motor and perceptual skills occurs between similar tasks. Throwing accuracy and quiet eye duration for skilled and less-skilled basketball players were examined in basketball free throw shooting and the transfer task of dart throwing. Skilled basketball players showed significantly higher throwing accuracy and longer quiet eye duration in the basketball free throw task compared to their less-skilled counterparts. Further, skilled basketball players showed positive transfer from basketball to dart throwing in accuracy but not in quiet eye duration. Our results raise interesting questions regarding the measurement of transfer between skills

Herschel-ATLAS/GAMA: A difference between star formation rates in strong-line and weak-line radio galaxies

We have constructed a sample of radio-loud objects with optical spectroscopy from the Galaxy and Mass Assembly (GAMA) project over the Herschel Astrophysical Terahertz Large Area Survey (Herschel-ATLAS) Phase 1 fields. Classifying the radio sources in terms of their optical spectra, we find that strong-emission-line sources ('high-excitation radio galaxies') have, on average, a factor of ~4 higher 250-μm Herschel luminosity than weak-line ('lowexcitation') radio galaxies and are also more luminous than magnitude-matched radio-quiet galaxies at the same redshift. Using all five H-ATLAS bands, we show that this difference in luminosity between the emission-line classes arises mostly from a difference in the average dust temperature; strong-emission-line sources tend to have comparable dust masses to, but higher dust temperatures than, radio galaxies with weak emission lines. We interpret this as showing that radio galaxies with strong nuclear emission lines are much more likely to be associated with star formation in their host galaxy, although there is certainly not a one-to-one relationship between star formation and strong-line active galactic nuclei (AGN) activity. The strong-line sources are estimated to have star formation rates at least a factor of 3-4 higher than those in the weak-line objects. Our conclusion is consistent with earlier work, generally carried out using much smaller samples, and reinforces the general picture of high-excitation radio galaxies as being located in lower-mass, less evolved host galaxies than their low-excitation counterparts.Peer reviewe

A novel compartment, the 'subqpical stem' of the aerial hyphae, is the location of a sigN-dependent, developmentally distinct transcription in Streptomyces coelicolor.

Streptomyces coelicolor has nine SigB-like RNA polymerase sigma factors, several of them implicated in morphological differentiation and/or responses to different stresses. One of the nine, SigN, is the focus of this article. A constructed sigN null mutant was delayed in development and exhibited a bald phenotype when grown on minimal medium containing glucose as carbon source. One of two distinct sigN promoters, sigNP1, was active only during growth on solid medium, when its activation coincided with aerial hyphae formation. Transcription from sigNP1 was readily detected in several whi mutants (interrupted in morphogenesis of aerial mycelium into spores), but was absent from all bld mutants tested, suggesting that sigNP1 activity was restricted to the aerial hyphae. It also depended on sigN, thus sigN was autoregulated. Mutational and transcription studies revealed no functional significance to the location of sigN next to sigF, encoding another SigB-like sigma factor. We identified another potential SigN target, nepA, encoding a putative small secreted protein. Transcription of nepA originated from a single, aerial hyphae-specific and sigN-dependent promoter. While in vitro run-off transcription using purified SigN on the Bacillus subtilis ctc promoter confirmed that SigN is an RNA polymerase sigma factor, SigN failed to initiate transcription from sigNP1 and from the nepA promoter in vitro. Additional in vivo data indicated that further nepA upstream sequences, which are likely to bind a potential activator, are required for successful transcription. Using a nepA–egfp transcriptional fusion we located nepA transcription to a novel compartment, the ‘subapical stem’ of the aerial hyphae. We suggest that this newly recognized compartment defines an interface between the aerial and vegetative parts of the Streptomyces colony and might also be involved in communication between these two compartments

Herschel*-ATLAS: correlations between dust and gas in local submm-selected galaxies

We present an analysis of CO molecular gas tracers in a sample of 500 μ m-selected Herschel -ATLAS galaxies at z < 0 . 05 ( cz < 14990 km s − 1 ). Using 22 − 500 μ m photom- etry from WISE , IRAS and Herschel , with H i data from the literature, we investigate correlations between warm and cold dust, and tracers of the gas in different phases. The correlation between global CO(3–2) line fluxes and FIR–submm fl uxes weakens with increasing IR wavelength ( λ & 60 μ m), as a result of colder dust being less strongly associated with dense gas. Conversely, CO(2–1) and H i line fluxes both ap- pear to be better correlated with longer wavelengths, suggesting that cold dust is more strongly associated with diffuse atomic and molecular gas phases, co nsistent with it being at least partially heated by radiation from old stellar populations . The increased scatter at long wavelengths implies that sub-millimetre fluxes are a po orer tracer of SFR. Fluxes at 22 and 60 μ m are also better correlated with diffuse gas tracers than dense CO(3–2), probably due to very-small-grain emission in the diffu se interstellar medium, which is not correlated with SFR. The FIR/CO luminosity ratio a nd the dust mass/CO luminosity ratio both decrease with increasing luminosit y, as a result of either correlations between mass and metallicity (changing CO/H 2 ) or between CO luminosity and excitation [changing CO(3–2)/CO(1–0)].Web of Scienc

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Dissolved iron(II) ligands in river and estuarine water

We present the first evidence of Fe(II) complexation by natural organic ligands in estuarine waters. Across five diverse river/estuary systems we find evidence of terrestrially derived ligands with binding constants (log KFe(II)L) mainly in the range 6–8. These Fe(II) ligands were stable over short time periods (1–2 days), generally equivalent to, or in excess of, ambient freshwater Fe(II) concentrations (which ranged from 12 to 3600 nM) and had similar binding constants to ligands that were leached by water from vegetation and detritus (log KFe(II)L 7–8). A class of terrestrially derived ligands may therefore be important in stabilising Fe(II) concentrations in freshwater systems. However, in coastal seawater the impact of these ligands upon Fe(II) speciation is likely to be diminished due to a combination of dilution, loss of humic material during flocculation and increased ionic strength.The temperate and sub-tropical river systems studied included the Beaulieu (England), Itchen (England), Cape Fear (North Carolina, USA), Winyah Bay (South Carolina, USA) and Loch Etive (Scotland). Freshwaters in each system possessed a broad range of dissolved organic carbon (DOC, 200–1300 ?M), labile dissolved Fe (LDFe, Fe &lt; 0.2 ?m available to ferrozine after reduction with ascorbic acid, 100 nM–20 ?M) and pH (5.5–8.5). In the Itchen estuary, where anthropogenic discharge constitutes &gt; 10% of freshwater input, ligand binding constants were elevated (up to log KFe(II)L 11) and the expected decrease in LDFe with increasing salinity along the estuary was not observed (LDFe and DOC both peaked at a salinity of 7) due to effluent inputs

Evaluating the efficacy of acupuncture in defined aspects of stroke recovery: a randomised, placebo controlled single blind study

Objective To investigate the efficacy of acupuncture on stroke recovery compared to an inert placebo. Design Placebo-controlled, randomised, clinical trial. Setting Post-stroke rehabilitation wards in five NHS hospitals in the UK. Subjects Patients between 4 and 10 days after their first stroke. Interventions and outcome measures The patients received 12 acupuncture or placebo treatments over four weeks. Acupuncture with electrical stimulation was compared with mock TENS, and assessments continued for 12 months after entry. Primary outcome was the Barthel Index (BI). Secondary outcomes were muscle power, Motricity Index (MI), mood, Nottingham Health Profile (NHP) and treatment credibility. Results 92 patients completed data sets. Data were analysed using both t tests and a structural equation based on longitudinal analysis of both BI and MI, using generalised estimating equations with an exchangeable correlation structure. While both acupuncture and placebo (mock TENS) appeared to have had an equal effect on stroke recovery, there is no significant difference between the two interventions at 12 (p = 0.737, 95 % CI –2.00 to 2.81) and 52 weeks (p = 0.371, 95 % CI –3.48 to1.32). An apparently accelerated improvement in the MI scores in the acupuncture group at 3 weeks (p = 0.009, 95 % CI 1.55 to 10.77) is interesting. Conclusions Acupuncture did not demonstrate specific efficacy over placebo and both groups did as well as normally expected with this condition

Glacial meltwater from Greenland is not likely to be an important source of Fe to the North Atlantic

Recent work has shown that glaciers are a globally significant source of the micronutrient Fe to the ocean. Polar regions are particularly susceptible to climate change and have been subject to pronounced warming in the past few decades. In response to this warming, the volume of glacial meltwater runoff from Greenland has increased. This meltwater has a relatively high particulate and dissolved Fe content. Seasonal Fe limitation of marine ecosystems has been found in parts of the North Atlantic, so it has been proposed that increasing fluxes of Fe rich meltwater from Greenland to the North Atlantic could alleviate this Fe limitation and thereby increase marine primary production. However, here we use a synthesis of biogeochemical and physical oceanography studies to suggest that the physical circulation around Greenland does not favour direct export of dissolved or particulate Fe from inshore to offshore waters. The Fe budget in surface waters of the North Atlantic may therefore be insensitive to increasing meltwater fluxes from Greenland.<br/

Strain- and age-associated variation in viral persistence and antibody response to mouse parvovirus 1 in experimentally infected mice

The effect of mouse strain and age at infection on viral replication and concurrent antibody response to mouse parvovirus 1 (isolate MPV1f) was evaluated for 305 d after inoculation in 4 strains of mice. The results confirmed previous reports that mouse strain and age at infection are significant factors in viral persistence and antibody development and detection. Randombred Arc:Arc(s) mice originally bred from CD1 stock inoculated as juveniles (4 wk) or adults (8 wk) developed persistent viral infection for 152 d after inoculation and an antibody response that persisted for 295 d. Mice of C57BL/6J background inoculated as juveniles had detectable viral DNA in large intestinal content and tissues for 24 d after inoculation and an antibody response that persisted for 288 d. However, viral DNA was not detected in tissues of C57BL/6J mice inoculated as adults, although an antibody was detected for 111 d after inoculation; these results suggest probable viral replication in adult C57BL/6J mice but at levels below the limits of detection. BALB/cArc mice inoculated as juveniles or adults had detectable virus DNA in tissues for 108 to 242 d after inoculation, but no antibody was detected. Similarly, BALB/c-Foxn1 nu/ArC mice had detectable levels of viral DNA in tissues for 98 to 131 d but no measurable antibody. The difficulty of detecting antibody in mice with a BALB/c background indicates they are unsuitable for routine surveillance of MPV1f infection