An Investigation of Neurological soft signs as a discriminating factor between Veterans with Post-traumatic Stress Disorder, mild Traumatic Brain Injury, and co-occurring Post-traumatic Stress Disorder and mild Traumatic Brain Injury

While multiple Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans suffer from mild Traumatic Brain Injury (mTBI), Post-traumatic Stress Disorder (PTSD), and co-morbid mTBI and PTSD, there remains difficulty disentangling the specific symptoms associated with each disorder using self-report and neurocognitive assessments. We propose that neurological soft signs (NSS), which are tasks associated with general neurologic compromise, may prove useful in this regard. Based on our review of the literature we hypothesized that individuals with PTSD would present with a greater number of NSS than controls or individuals with mTBI. Further, we hypothesized a synergistic effect, such that individuals with mTBI + PTSD would present with the greatest number of NSS. To test these hypotheses, we analyzed a subset of individuals (N=238) taken from a larger study of neurocognitive functioning in veterans. Participants completed a battery of neuropsychological measures, which included the Behavioral Dyscontrol Scale (BDS), the current study’s measure of NSS. A subset of other neuropsychological measures were also included to examine the utility of NSS over and above traditional neuropsychological measures. Individuals were removed from the study if they sustained a moderate/severe TBI or did not meet validity criteria on the Green’s Word Memory Test or the Negative Impression Management subscale of the Personality Assessment Inventory. Binomial logistic and multinomial logistic regression were used to examine the ability of NSS to discriminate between the study groups, first by themselves and then after the variance explained by the traditional neuropsychological measures was accounted for. Exploratory cluster analyses were performed on neuropsychological measures and NSS to identify profiles of cognitive performance in the data set. Results indicated that individuals in the mTBI and/or PTSD group had more NSS compared to controls. Of the individual NSS items only a go/no-go task of the BDS discriminated between groups, with worse performance among individuals in the mTBI, PTSD, and mTBI + PTSD group compared to controls. In contrast, the overall BDS score and individual NSS, in general, did not discriminate between the mTBI, PTSD, and mTBI + PTSD group. Overall, the current study suggests that, when eliminating participants who do not meet validity criteria, NSS do not aid in discriminating between individuals with mTBI, PTSD, and mTBI + PTSD

Revisionism Misplaced: Why This is Not the Time to Bury Autonomy

For the past twenty years, bioethics has exerted a profound influence on American medicine. Although its full impact cannot be precisely measured, one need only speak to European physicians and clinical investigators to grasp the full extent of the change. Americans may debate the sufficiency of the information that physicians share with their patients, but hear a European doctor exclaim angrily that it is criminal to ask a woman to decide whether to have a radical mstectomy or lumpectomy, and you know that bioethics has made a significant difference in the United States. So too, Americans, far more intensely than Europeans, will fiercly contest any proposed exception to informed consent in research protocols, and our Institutional Review Boards (IRBs) are unmatched for the protections they provide human subjects. Not only foreign comparisons but daily events point to the difference that bioethics has made: consider the newspaper space devoted to bioethical considerations, whether the case be multiple births, AIDS testing in Africa, cloning, or organ donation, to choose recent examples; or the readiness of lawyers to have clients sign an advanced directive and proxy assignment; or the intensity of public debate on physician-assisted suicide. Bioethics has clearly become the stuff of referendum campaigns and dinner-table discussions

The Effect of Pre-Deployment Physiology as a Predictor of Post-Traumatic Stress Disorder Among a Sample of United States Army National Guard and Reserve Soldiers

Potential risk factors for development of Post-Traumatic Stress Disorder (PTSD) are still unclear. One potential risk factor for the development of PTSD is an individual’s cardiovascular reactivity and recovery in response to stressor tasks. The current study was conducted with 763 Army National Guard and Army Reserve soldiers. Participants completed a stressful induction along with self-report measures prior to deployment. Post-deployment, self-report measures were completed to assess PTSD symptomatology and experiences related to deployment and combat. Multiple regression was used to determine the ability of blood pressure response to stress to predict PTSD symptoms immediately and one-year after return from deployment. Results indicated that soldiers who had a less reactive systolic blood pressure response to and recovery from stressor tasks reported more PTSD symptomatology immediately after and one year after return from deployment. These results suggest that soldiers who develop PTSD after deployment have less pre-deployment emotion regulation ability

miRNA-140-5p: new avenue for pulmonary arterial hypertension drug development?

Pulmonary arterial hypertension (PAH) is a rare but fatal disease. Pathologically, PAH is characterised by sustained vasoconstriction and progressive obliteration of small pulmonary arteries through a process of medial thickening, intimal fibrosis and the formation of angioproliferative lesions. Current treatments target the sustained vasoconstriction via either the prostacyclin, endothelin or nitric oxide pathway but do little to address the underlying progressive proliferative vascular disease. Dysregulated expression of microRNA (miR) has been identified in PAH and we have recently highlighted reduced miR-140-5p in patients with PAH. Replacement of miR-140-5p attenuated disease in animal models with the regulation of Smurf1, a E3 ubiquitin ligase targeting BMPR2 as one identified mechanism. These data highlight Smurf1 inhibition as a treatment for PAH

Channel Network Scaling Laws in Submarine Basins

Fluvial drainage basin area is often related to channel length and local slope through power law relationships and the relatively small range of exponents observed in these relationships is thought to result from physical mechanisms. Proposed mechanisms assume that the observed correlation between drainage area and fluid discharge is caused by precipitation. Using high resolution DEMs of channelized continental slope settings offshore Monterey, CA and Brunei Darussalam we extracted submarine channel profiles and drainage area statistics from five basins. In-situ and remote observations suggest discharge in these oceanic settings is determined by boundary conditions at the shelf-edge. In spite of substantial differences in environment and physical process, the data yield submarine scaling exponents within the range of terrestrial (fluvial) observations. The convergence in scaling relationships from two very different settings supports theoretical arguments that channel network structure results from the aggregation of random walks

The Relationship Between Promise and Performance in State Intervention in Family Life

JUDGE MIDONICK: We have a fantastic representation of our alumni here and we\u27ve overdone our 10:00 starting time and we\u27re supposed to stop at 12:00 promptly in order for us to go to the Low Memorial Library for lunch, for those who are having lunch with us. In order to be on time for this afternoon\u27s extravaganza we really ought to begin now. You must understand this program is entirely unrehearsed and therefore will be more interesting. We have with us today a panel of four whom I will introduce as they are to speak. The first speaker will speak for about forty-five minutes and he has a paper to present; and then we will have the others. At the end of that time, there will be a forty minute fun and games period when everyone here is entitled to make remarks. We are fortunate to have with us Dean Monrad Paulsen of the University of Virginia School of Law whom we hadn\u27t expected and who will be able not only to ask questions but give answers during the last forty minute period. I myself am eagerly awaiting an answer or two. Now, to begin, the paper which is to be given on the subject of the relationship between promise and performances in state intervention in family life will be given by Peter L. Strauss, Associate Professor of Law, Columbia Law School. His background is Harvard \u2761 in physics and chemistry, strangely, and so we have a person who is very well rounded and his law degree comes from Yale in 1964. He was editor-in-chief of the Yale Law Journal – he clerked as a law assistant for not only the Chief Judge of the Court of Appeals in the District of Columbia, David Bazelon, who is a great expert on child problems in the court himself, but Professor Strauss clerked after that for United States Supreme Court Justice William Brennan. He taught criminal law for two years at the Haile Sellassie I University in Addis Ababa, Ethiopia, and for three years was assistant to the Solicitor General of the United States. He joined Columbia\u27s faculty this fall, so be very gentle with him

Far Infrared and Submillimeter Emission from Galactic and Extragalactic Photo-Dissociation Regions

Photodissociation Region (PDR) models are computed over a wide range of physical conditions, from those appropriate to giant molecular clouds illuminated by the interstellar radiation field to the conditions experienced by circumstellar disks very close to hot massive stars. These models use the most up-to-date values of atomic and molecular data, the most current chemical rate coefficients, and the newest grain photoelectric heating rates which include treatments of small grains and large molecules. In addition, we examine the effects of metallicity and cloud extinction on the predicted line intensities. Results are presented for PDR models with densities over the range n=10^1-10^7 cm^-3 and for incident far-ultraviolet radiation fields over the range G_0=10^-0.5-10^6.5, for metallicities Z=1 and 0.1 times the local Galactic value, and for a range of PDR cloud sizes. We present line strength and/or line ratio plots for a variety of useful PDR diagnostics: [C II] 158 micron, [O I] 63 and 145 micron, [C I] 370 and 609 micron, CO J=1-0, J=2-1, J=3-2, J=6-5 and J=15-14, as well as the strength of the far-infrared continuum. These plots will be useful for the interpretation of Galactic and extragalactic far infrared and submillimeter spectra observable with ISO, SOFIA, SWAS, FIRST and other orbital and suborbital platforms. As examples, we apply our results to ISO and ground based observations of M82, NGC 278, and the Large Magellenic Cloud.Comment: 54 pages, 20 figures, accepted for publication in The Astrophysical Journa