The pathogenesis of the anaerobic corynebacterium diphtheriae, anaerobic diphtheroid, and anaerobic leptothrix infections in relation to the psychoses, neuroses, and neurotoxic states, compared with 260 cases of symptomatic physical disorder (illustrated by 17 tables)

The subject of this thesis is the outcome of what might be termed a 'hereditary interest' in the complex problem of the relationship of chronic infections to the psychoses and allied mental disorders. Circumstances enabled me, while still a student, to undertake very humbly the continuation of my father's researches in the Scottish Asylums' Laboratory at a point where his illness and death mic:ht have proved the closing of a long and arduous chapter. That this would have been so is, as far as I know, borne out by the fact that up to the present no work directly bearing on his later bacteriological studies has been published. The researches I have undertaken during the past six rears have been an attempt to elucidate more clearly what exactly are the bacteriological factors at work, and, further, in what manner they attach the economy generally, and with what result. In my endeavour to verify and extend Ford Robertson's views I have been singularly fortunate.After nearly two years in the Laboratory of the Scottish Asylums' I had the opportunity as honorary Bacteriologist and Pathologist to the Southport Infirmary and assistant to Dr E. Cronin Lowe, (consulting pathologist and director of the Southport Infirmary laboratory) of studying a large number of private and hospital patients during the course of two years work. In addition to undertaking bacteriological research by anaerobic methods, it fell to me to organise a pathological clinique, the object of which was to aid the physician in the diagnosis and treatment of obscure physical disorders by the method of a "diagnostic survey". The scheme evolved necessitated a sz stematic study of each patient by haematological an biochemical tests including functional efficiency tests such as the glucose tolerance and fractional test meal. Each case was also studied with a view to discovering if possible some underlying bacteriological infective condition which might have a bearing upon the state of the patient. In the course of undertaking a large number of patients by this method of approach some fifteen mental and borderland cases came under review. In many instances I was much struck by their similarity to control patients in the underlying physical disturbance found, and, while in this respect there was something in common, it was striking to note in some of the borderland, and certainly in those who were definitely, mental, the absence of clinical symptomatology, in spite of the fact that they showed more gross functional physical disorder on the average than did the non-mental cases. In gastric disorders for example non-mental patients, almost without exception, gave a clear clinical history referrible to that organ. In two mental patient however no such evidence past or present was ascertainable, although both were found to be suffering from severe gastritis and disordered secretory function. Exceptional as these two cases may appear to b this experience, which has been by no means confined to the gastric mechanism, has been enormously amplified by the work I have carried out since then. In the study of the bacteriological flora, especially of the intestine, there were bacterial elements common to the majority of the fifteen cases which, on the other hand, were relatively infrequently met with in ordinary hospital patients. This fact further impressed itself upon me when it had to be realised that these additional infective factors were in every respect similar to those so commonly seen in the course of routine bacteriological work at the Scottish Asylums Laboratory. This evidence I believed at the time formed a valuable link which, if opportunity offered, might result in a chain of facts establishing the importance of this group of bacteria.Early in November, 1927, the New Reception hospital, (Wantage House), of St Andrews, Northampton, was opened, and I was offered the opportunity of organising the very work which had been begun amongst cases of mental disorder at the Southport Infirmary. It is not often one is fortunate enough to start from the foundation a scheme of research with a limited number of patients whose whole care clinically and scientifically comes within one's own province. Further, the facilities afforded in each department are those of the best equipped modern general hospital in miniature, a fact which has very materially contributed, not only to the extension of research, but to the correlation as far as my knowledge has permitted, of the wide range of facts and observations that have been collected in the course of nearly three years.By experience of the value both scientific and therapeutic of the diagnostic survey method of research led me to adopt it in an extended. form on all cases admitted to ':Vantage House. The following is a brief outline of t' :e scheme of research which up to the present has been undertaken on 155 patients, 137 of whom presented definite mental disorders.(1) Systematic physical examination including blood pressure, central nervous system, teeth, etc. (2) Examination of upper respirator- passages for evidence of focal infection. (3) Laboratory tests. a. Cytology of the blood. b. Biochemical examination of the blood. Non-protein nitrogen, CO₂, calcium, Van-den-Bergh, and phosphates. c. Gastric analysis by fractional method. d. Glucose tolerance. e. Urine, 24 hrs. sample. Biochemical qualitative and quantitative: examinations and cytological. f. Intestinal content. Chemical and microscopical. g. Cerebro-spinal fluid. Cytological, biochemical qualitative and quantitative in about 1/4 of the cases. (4) Bacteriological examinations of the foci throughout the alimentary canal in all cases by the anaerobic methods given in this thesis. Pelvic organs and accessory sinuses in some. (5) Radiography. Teeth and accessory sinuses in all cases, and gastro-intestinal tract in some. (6) The study of the psychological aspects past and present of each case, especially in relation to heredity, environment, and past physical disorder The above tests have been repeated as circumstances demanded and, with the exception of the gastric analysis and glucose tolerance, are carried out again case it has been possible,under ideal circumstances of observation and control, to study and where possible correlate the mental symptoms with the underlying physical disorders. The main outlines of this scheme and the circumstances that led up to its inception have been mentioned so that those whose position it is to criticise and judge should know that the basis of this thesis has been a wide one and that the views expressed therein have been given without conscious bias and in the hope that others may be stimulated to carry out similar researches

Researches upon the pathology of subdural membrane formation

Preliminary note | Literature upon subdural membranes | Review of literature upon subdural membranes | Note on the structure and functions of the dura mater | Description of the naked-eye and microscopic appearances presented by the dura mater in a series of asylum and general hospital cases | Author's conclusions | I. The naked-eye anatomy of subdural membranes and allied conditions. | II. The morbid appearances which may be observed in superficial horizontal sections of the dura mater. | 1. Morbid changes in the endothelial elemerits'of the dura. | 2. Phenomena following effusion of blood upon the internal surface of the dura. | 3. Morbid changes in the superficial vessels of the dura. | 4. Hyaline changes. | 5. Concentric bodies. | 6. Mulberry bodies. | 7. Granular patches in the fibrous tissue, | 8. Granulations. | III. The morbid processes concerned in subdural membrane formation. | Illustrations. | Description of the illustrations. | Microscopic specimens

Top ten risk factors for morbidity and mortality in patients with chronic systolic heart failure and elevated heart rate: the SHIFT risk model

Aims We identified easily obtained baseline characteristics associated with outcomes in patients with chronic heart failure (HF) and elevated heart rate (HR) receiving contemporary guideline-recommended therapy in the SHIFT trial, and used them to develop a prognostic model. Methods We selected the 10 best predictors for each of four outcomes (cardiovascular death or HF hospitalisation; all-cause mortality; cardiovascular mortality; and HF hospitalisation). All variables with p &#60; 0.05 for association were entered into a forward stepwise Cox regression model. Our initial analysis excluded baseline therapies, though randomisation to ivabradine or placebo was forced into the model for the composite endpoint and HF hospitalisation. Results Increased resting HR, low ejection fraction, raised creatinine, New York Heart Association class III/IV, longer duration of HF, history of left bundle branch block, low systolic blood pressure and, for three models, age were strong predictors of all outcomes. Additional predictors were low body mass index, male gender, ischaemic HF, low total cholesterol, no history of hyperlipidaemia or dyslipidaemia and presence of atrial fibrillation/flutter. The c-statistics for the four outcomes ranged from 67.6% to 69.5%. There was no evidence for lack of fit of the models with the exception of all-cause mortality (p = 0.017). Similar results were found including baseline therapies. Conclusion The SHIFT Risk Model includes simple, readily obtainable clinical characteristics to produce important prognostic information in patients with chronic HF, systolic dysfunction, and elevated HR. This may help better calibrate management to individual patient risk.</p

Long-term impact on healthcare resource utilization of statin treatment, and its cost effectiveness in the primary prevention of cardiovascular disease: a record linkage study

Aims: To assess the impact on healthcare resource utilization, costs, and quality of life over 15 years from 5 years of statin use in men without a history of myocardial infarction in the West of Scotland Coronary Prevention Study (WOSCOPS).&lt;p&gt;&lt;/p&gt; Methods: Six thousand five hundred and ninety-five participants aged 45–54 years were randomized to 5 years treatment with pravastatin (40 mg) or placebo. Linkage to routinely collected health records extended follow-up for secondary healthcare resource utilization to 15 years. The following new results are reported: cause-specific first and recurrent cardiovascular hospital admissions including myocardial infarction, heart failure, stroke, coronary revascularization and angiography; non-cardiovascular hospitalization; days in hospital; quality-adjusted life years (QALYs); costs of pravastatin treatment, treatment safety monitoring, and hospital admissions.&lt;p&gt;&lt;/p&gt; Results: Five years treatment of 1000 patients with pravastatin (40 mg/day) saved the NHS £710 000 (P &#60; 0.001), including the cost of pravastatin and lipid and safety monitoring, and gained 136 QALYs (P = 0.017) over the 15-year period. Benefits per 1000 subjects, attributable to prevention of cardiovascular events, included 163 fewer admissions and a saving of 1836 days in hospital, with fewer admissions for myocardial infarction, stroke, heart failure and coronary revascularization. There was no excess in non-cardiovascular admissions or costs (or in admissions associated with diabetes or its complications) and no evidence of heterogeneity of effect over sub-groups defined by baseline cardiovascular risk.&lt;p&gt;&lt;/p&gt; Conclusion: Five years' primary prevention treatment of middle-aged men with a statin significantly reduces healthcare resource utilization, is cost saving, and increases QALYs. Treatment of even younger, lower risk individuals is likely to be cost-effective.&lt;p&gt;&lt;/p&gt

Effect of visit-to-visit variation of heart rate and systolic blood pressure on outcomes in chronic systolic heart failure: results from the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT) trial

Background: Elevated resting heart rate (HR) and low systolic blood pressure (SBP) are related to poor outcomes in heart failure (HF). The association between visit-to-visit variation in SBP and HR and risk in HF is unknown. Methods and Results: In Systolic Heart Failure Treatment with the If inhibitor ivabradine Trial (SHIFT) patients, we evaluated relationships between mean HR, mean SBP, and visit-to-visit variations (coefficient of variation [CV]=SD/mean×100%) in SBP and HR (SBP-CV and HR-CV, respectively) and primary composite endpoint (cardiovascular mortality or HF hospitalization), its components, all-cause mortality, and all-cause hospitalization. High HR and low SBP were closely associated with risk for primary endpoint, all-cause mortality, and HF hospitalization. The highest number of primary endpoint events occurred in the highest HR tertile (38.8% vs 16.4% lowest tertile; P&lt;0.001). For HR-CV, patients at highest risk were those in the lowest tertile. Patients in the lowest thirds of mean SBP and SBP-CV had the highest risk. The combination of high HR and low HR-CV had an additive deleterious effect on risk, as did that of low SBP and low SBP-CV. Ivabradine reduced mean HR and increased HR-CV, and increased SBP and SBP-CV slightly. Conclusions: Beyond high HR and low SBP, low HR-CV and low SBP-CV are predictors of cardiovascular outcomes with additive effects on risk in HF, but with an unknown effect size. Beyond HR reduction, ivabradine increases HR-CV. Low visit-to-visit variation of HR and SBP might signal risk of cardiovascular outcomes in systolic HF. Clinical Trial Registration: URL: http://www.isrctn.com/. Unique identifier: ISRCTN70429960

The Center for Adventist Research at Andrews University

The Center for Adventist Research (CAR), an Andrews University and General Conference of Seventh-day Adventist organization, seeks to promote an understanding and appreciation of the heritage and mission of the Seventh-day Adventist Church (SDA). It combines the resources of the James White Library’s Adventist Heritage Center and the Ellen G. White Estate Branch Office to provide the most extensive collection of Adventist-related resources in the world, both physically and digitally. An introduction to the background, collections, and activities of CAR is presented. Of particular interest are the digitization projects

Most Americans are now opposed to laws against interracial marriage, but their behavior does not yet reflect these attitudes

Recent decades have seen a dramatic fall in the number of people that support laws which prohibit interracial marriages, and an increase in the number of these marriages. But why does the rate of interracial marriages remain so low, when compared to same-race marriages? Using national data from the past three decades, Ginny E. Garcia, Richard Lewis Jr., and Joanne Ford-Robertson show that while attitudes towards interracial marriages have changed, many groups still have negative attitudes towards Black-White unions. They find that those who perceive social and economic competition with Blacks, such as those with lower levels of education, were more likely to support laws that prohibit interracial marriages and engage in behaviors that prevent Black’s wider participation in society

Psychometric and Faciometric Support for Observable Facial Feminization in Gay Men

Though male homosexuality appears to be evolutionarily paradoxical, phenotypic feminization has been offered as a route for three current models positing a genetic basis for male homosexuality. We tested whether facial feminization is observable in gay men in two studies. In Study 1, using two composite images of gay and of heterosexual men, naive participants (N = 308) rated the ‘gay’ face more highly on stereotypically feminine traits and actual femininity and the ‘heterosexual’ face more highly on stereotypically masculine traits and actual masculinity. In Study 2, faciometrics of 428 internet images of gay (N = 219) and heterosexual men were analyzed along six, sexually dimorphic ratios. The faciometrics of gay men were more feminine, both in gestalt terms, and for five of the six individual traits. The studies offer objective support for a more feminized facial phenotype in gay males that is difficult to explain through cultural or behavioral cues

An Empirically Derived Three-Dimensional Laplace Resonance in the Gliese 876 Planetary System

We report constraints on the three-dimensional orbital architecture for all four planets known to orbit the nearby M dwarf Gliese 876 based solely on Doppler measurements and demanding long-term orbital stability. Our dataset incorporates publicly available radial velocities taken with the ELODIE and CORALIE spectrographs, HARPS, and Keck HIRES as well as previously unpublished HIRES velocities. We first quantitatively assess the validity of the planets thought to orbit GJ 876 by computing the Bayes factors for a variety of different coplanar models using an importance sampling algorithm. We find that a four-planet model is preferred over a three-planet model. Next, we apply a Newtonian MCMC algorithm to perform a Bayesian analysis of the planet masses and orbits using an n-body model in three-dimensional space. Based on the radial velocities alone, we find that a 99% credible interval provides upper limits on the mutual inclinations for the three resonant planets ($\Phi_{cb}<6.20^\circ$ for the "c" and "b" pair and $\Phi_{be}<28.5^\circ$ for the "b" and "e" pair). Subsequent dynamical integrations of our posterior sample find that the GJ 876 planets must be roughly coplanar ($\Phi_{cb}<2.60^\circ$ and $\Phi_{be}<7.87^\circ$), suggesting the amount of planet-planet scattering in the system has been low. We investigate the distribution of the respective resonant arguments of each planet pair and find that at least one argument for each planet pair and the Laplace argument librate. The libration amplitudes in our three-dimensional orbital model supports the idea of the outer-three planets having undergone significant past disk migration.Comment: 19 pages, 11 figures, 8 tables. Accepted to MNRAS. Posterior samples available at https://github.com/benelson/GJ87

Ideology and disease identity : the politics of rickets, 1929-1982

How can we assess the reciprocal impacts of politics and medicine in the contemporary period? Using the example of rickets in twentieth century Britain, I will explore the ways in which a preventable, curable non-infectious disease came to have enormous political significance, first as a symbol of socioeconomic inequality, then as evidence of racial and ethnic health disparities. Between the 1920s and 1980s, clinicians, researchers, health workers, members of Parliament and later Britain's growing South Asian ethnic communities repeatedly confronted the British state with evidence of persistent nutritional deficiency among the British poor and British Asians. Drawing on bitter memories of the ‘Hungry Thirties’, postwar rickets—so often described as a ‘Victorian’ disease—became a high-profile sign of what was variously constructed as a failure of the Welfare State; or of the political parties charged with its protection; or of ethnically Asian migrants and their descendants to adapt to British life and norms. Here I will argue that rickets prompted such consternation not because of its severity, the cost of its treatment, or even its prevalence; but because of the ease with which it was politicised. I will explore the ways in which this condition was envisioned, defined and addressed as Britain moved from the postwar consensus to Thatcherism, and as Britain's diverse South Asian communities developed from migrant enclaves to settled multigenerational ethnic communities