Anterior Thalamic High Frequency Band Activity Is Coupled with Theta Oscillations at Rest

Cross-frequency coupling (CFC) between slow and fast brain rhythms, in the form of phase–amplitude coupling (PAC), is proposed to enable the coordination of neural oscillatory activity required for cognitive processing. PAC has been identified in the neocortex and mesial temporal regions, varying according to the cognitive task being performed and also at rest. PAC has also been observed in the anterior thalamic nucleus (ATN) during memory processing. The thalamus is active during the resting state and has been proposed to be involved in switching between task-free cognitive states such as rest, in which attention is internally-focused, and externally-focused cognitive states, in which an individual engages with environmental stimuli. It is unknown whether PAC is an ongoing phenomenon during the resting state in the ATN, which is modulated during different cognitive states, or whether it only arises during the performance of specific tasks. We analyzed electrophysiological recordings of ATN activity during rest from seven patients who received thalamic electrodes implanted for treatment of pharmacoresistant focal epilepsy. PAC was identified between theta (4–6 Hz) phase and high frequency band (80–150 Hz) amplitude during rest in all seven patients, which diminished during engagement in tasks involving an external focus of attention. The findings are consistent with the proposal that theta–gamma coupling in the ATN is an ongoing phenomenon, which is modulated by task performance

Contextualising Apartheid at the End of Empire: Repression, ‘Development’ and the Bantustans

This article examines the global dynamics of late colonialism and how these informed South African apartheid. More specifically, it locates the programmes of mass relocation and bantustan ‘self-government’ that characterised apartheid after 1959 in relation to three key dimensions. Firstly, the article explores the global circulation of idioms of ‘development’ and trusteeship in the first half of the twentieth century and its significance in shaping segregationist policy; secondly, it situates bantustan ‘selfgovernment’ in relation to the history of decolonisation and the partitions and federations that emerged as late colonial solutions; and, thirdly, it locates the tightening of rural village planning in the bantustans after 1960 in relation to the elaboration of anti-colonial liberation struggles, repressive southern African settler politics and the Cold War. It argues that, far from developing policies that were at odds with the global ‘wind of change’, South African apartheid during the 1960s and 1970s reflected much that was characteristic about late colonial strategy

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

Ehud Yairi: Reflections on a Career.

This is the second in a series of papers that provides an historical record in this journal of contributions made by the most influential researchers in the field of fluency disorders. The present paper reflects on the long and productive career of Ehud Yairi, outlining his many contributions to the field of stuttering, and his outstanding achievements and accomplishments. The paper is based on interviews with him during 2020, after the conclusion of his research career. His visionary, lifetime work has advanced our understanding of the nature, origins, and epidemiology of this disorder

Barry Guitar: Reflections on a career.

This is the third in a series of papers that provides an historical record in this journal of contributions made by the most influential figures in the field of fluency disorders. The paper reflects on the long and productive career of Barry Guitar, documenting his outstanding achievements. The paper is based on interviews with him during 2022. Like no one else in our field, Barry Guitar has an understanding of the experience of stuttering and how to cope with it, and, throughout his career, he has used that understanding to inspire others to cope with it

After the RESTART trial: six guidelines for clinical trials of early stuttering intervention

© 2019 Royal College of Speech and Language Therapists Background: The Rotterdam Evaluation Study of Stuttering Therapy randomized trial (RESTART) was seminal, comparing the Lidcombe Program with RESTART Demands and Capacities Model-based treatment (RESTART-DCM) for pre-school age children who stutter. Aims: To critique the methods of the RESTART trial to develop guidelines for its systematic replication and extension. Beyond that, to contribute to the refinement of existing methodological guidelines for early stuttering intervention. Method: The discussion is organized around methodological issues of primary outcomes, treatment completion, clinician allegiance, treatment fidelity, age exclusions and no-treatment control reasoning. Main Contribution: We recommend six methodological guidelines to guide future clinical trials comparing the Lidcombe Program with RESTART-DCM, which can be applied to clinical trials of other early stuttering intervention methods: (1) incorporate a continuous measure of primary outcome; (2) ensure that all children in clinical trials have completed treatment; (3) eliminate potential bias due to clinician allegiance; (4) establish treatment fidelity within and beyond the clinic; (5) include children younger than 3 years in clinical trials; and (6) establish an estimate of treatment effect size at some stage of treatment development. Conclusion: In addition to guiding future clinical research comparing RESTART-DCM and Lidcombe Program treatment, these recommendations may extend to influence positively other treatment developments for early stuttering

Temperament and early stuttering intervention: Two perspectives.

PURPOSE:To discuss clinical applications of research findings about temperament and early stuttering. METHOD:A "1000-bytes" format (Onslow & Millard, 2012) was used to provide readers with contemporaneous observation of a "conversation" between the authors. The conversation is proceeded by a prologue and followed by concluding statements from each author. RESULTS:One author contended that comprehensive, multidimensional assessment of temperament domains is essential during clinical management of early stuttering, and the results of that assessment are best incorporated into a multifactorial treatment approach. The other author contested that view, arguing that such an approach is not empirically justifiable at present. CONCLUSIONS:The authors agree about the salience of research on temperament and early stuttering but have different perspectives about the topic when applied to providing health care for early stuttering