Contracting on the Web: Collegiate Athletes and Sports Agents Confront a New Hurdle in Closing the Deal

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Functional Imaging Studies of Speech and Verbal Memory in Healthy Adults and Patients with Alzheimer’s Disease

Alzheimer’s disease (AD) results in a diffuse, but characteristic impairment of cognitive function, with early involvement of verbal episodic memory. A prodromal phase of amnestic mild cognitive impairment (MCI) consists of patients with a mild, isolated impairment of episodic memory. In this thesis, I have described experiments performed on these patients and healthy volunteers using functional magnetic resonance imaging (fMRI). I aimed to investigate changes in neural activity associated with the breakdown in verbal episodic memory. Initially, I established the feasibility of using fMRI to investigate spoken responses in a study of speech production in healthy volunteers. This was important for investigating spoken retrieval of episodic memory. I also demonstrated integration of perceptual feedback and motor feedforward responses during propositional speech production within the medial planum temporale, associated with suppression of activity in secondary somatosensory cortex within the parietal operculum. In the verbal memory study, I demonstrated that successful encoding of heard sentences was associated with greater activity in cortical regions associated with semantic processing, but lower activity within early auditory cortex; implying a “top-down” effect on early perceptual cortex, related to sustained auditory attention. Patients with AD did not show this top-down effect. In addition, less activity was observed during encoding in AD patients, compared to MCI patients or controls, in regions associated with motivation. In the medial temporal lobes, there was less activity in AD compared to controls, but higher activity in MCI, consistent with previous reports. During retrieval, there was less activity in frontal executive control systems in AD compared to controls. This was seen in both performance-matched comparisons and in the neural response to a reduction in retrieval performance. MCI patients showed early changes in parietal lobe retrieval performance-related activity. Overall, the reduced verbal encoding performance in AD was related to impairments in the function of both MTL memory-related systems and sustained auditory attention, and was associated with reduced motivation. During free recall, lower performance in AD was associated with impairment of frontal cognitive control. Therefore, I have shown that verbal episodic memory impairment in AD is the consequence of altered activity in multiple cognitive networks, in addition to the well-recognised impairments in the MTL-memory network. These results have implications for future therapeutic interventions to improve memory function in this patient group, highlighting the potential use of drugs that enhance attention, motivation and frontal executive function

Case report: Managing profound circulatory collapse post-atrial fibrillation ablation: a methodical approach

BACKGROUND: Circulatory collapse during/post-pulmonary vein (PV) isolation by cryo-balloon ablation is a Cardiology emergency that has multiple potential causes and requires a methodical investigative approach. Some of the complications that can arise include cardiac tamponade, bleeding/vascular injury, anaphylaxis, Addisonian crisis, acute pulmonary embolism, acute PV stenosis, oesophageal injury, and vagal reaction. CASE SUMMARY: Here, we present a case of a 76-year-old lady who developed profound circulatory collapse during an elective pulmonary vein isolation by cryo-balloon ablation for symptomatic paroxysmal atrial fibrillation (AF). Cardiac tamponade, bleeding/vascular injury, and other less common causes were excluded. She only responded transiently to fluid resuscitation and developed intermittent bradyarrhythmias and hypotension which responded to isoprenaline. She was discharged home at Day 3 post-AF ablation after remaining well and continued to do so at follow-up. DISCUSSION: Circulatory collapse during/post-PV cryo-balloon ablation is a Cardiology emergency that has multiple potential causes. The ganglionate plexi form part of the cardiac intrinsic autonomic nervous system (ANS) and are located close to the left atrial–PV junctions. The presence of vagal response has been observed to be a marker of ANS modulation although its significance on the long-term outcome post-ablation has yet to be elucidated. The true cause of our patient’s profound circulatory collapse is uncertain but a vital learning point in this case is the systematic exclusion of common and potentially life-threatening complications following AF ablation. A persistent vagal reaction secondary to PV cryo-balloon ablation can usually be managed with supportive medical therapy as demonstrated in our case

Primary percutaneous coronary intervention for acute myocardial infarction in a patient with dextrocardia

Dextrocardia is a rare cardiac anomaly in which the heart is located in the right hemithorax. This developmental irregularity can occur in isolation as situs solitus, or in association with situs inversus or situs ambiguous. Although there are reports of coronary angiography in patients with dextrocardia, there are very few reported cases of mechanical intervention. We report a patient with dextrocardia and situs inversus who presented with an ST segment elevation myocardial infarction and was successfully treated with primary percutaneous coronary intervention

Formal Learning About the Past in Schools in England

This paper explains how archaeology has been used to teach history to children in English schools, museums and heritage sites. We describe six successful schools-linked projects then focuses on the Young Archaeologists’ Club, which has over the past 40 years nurtured many members of today’s archaeology professionals. Finally, we consider how archaeology education practitioners can use what has been learnt in those projects to plan for a sustainable future

The visual word form system in context

According to the “modular” hypothesis, reading is a serial feedforward process, with part of left ventral occipitotemporal cortex the earliest component tuned to familiar orthographic stimuli. Beyond this region, the model predicts no response to arrays of false font in reading-related neural pathways. An alternative “connectionist” hypothesis proposes that reading depends on interactions between feedforward projections from visual cortex and feedback projections from phonological and semantic systems, with no visual component exclusive to orthographic stimuli. This is compatible with automatic processing of false font throughout visual and heteromodal sensory pathways that support reading, in which responses to words may be greater than, but not exclusive of, responses to false font. This functional imaging study investigated these alternative hypotheses by using narrative texts and equivalent arrays of false font and varying the hemifield of presentation using rapid serial visual presentation. The “null” baseline comprised a decision on visually presented numbers. Preferential activity for narratives relative to false font, insensitive to hemifield of presentation, was distributed along the ventral left temporal lobe and along the extent of both superior temporal sulci. Throughout this system, activity during the false font conditions was significantly greater than during the number task, with activity specific to the number task confined to the intraparietal sulci. Therefore, both words and false font are extensively processed along the same temporal neocortical pathways, separate from the more dorsal pathways that process numbers. These results are incompatible with a serial, feedforward model of reading

Calcium Silicide - Methods of production and their technological consideration

Three industrial methods of production of calcium silicide have been discussed with their merits and demerits along with technological considerations. Calcium silicide was produced at NML in 500 KVA submerged arc furnace using partial charging method. Based on the results and observations of the smelting trials carried out a model has been proposed to explain the mechanism of form-ation of calcium silicide. Inoculation trials with calcium silicide produced at NML compares favourably with those obtained from abroad

Research and Development work on Substitute Nickel-Free Austenitic Stainless Steels

THE demands of austenitic stainless steel as what is termed as `non-magnetic' in the Indian market in sheet, plate, tube and rod forms have been multiplying during each successive Five-Year Plan.Due to severe import restrictions, acute and chronic shortage of foreign exchange, the actual import figures tend to taper off and do not represent the actual requirements of the country including stainless sheet used specifically for engineering, chemical and dairy industries incl- uding utensil-making and household hardware. The engi-neering uses of the stainless steel have also multi-plied with the rising tempo of industrial growth. Likewise, stainless steel finished items and assembled components of composite equipment etc. represent an `invisible' demand for heavy imports in one form or the other. About a decade back, the import of stain- less sheet alone represented about Rs 7-8 crores (Rs 70-80 million) of import bill in foreign exchange annually. This figure will double or treble itself, were import restrictions to be removed

The impact of mosaicism in preimplantation genetic diagnosis (PGD): approaches to PGD for dominant disorders in couples without family history

OBJECTIVES: Mosaicism in certain dominant disorders may result in a 'non-Mendelian' transmission for the causative mutation. Preimplantation genetic diagnosis (PGD) is available for patients with inherited disorders to achieve an unaffected pregnancy. We present our experience for two female patients with different dominantly inherited autosomal disorders; neurofibromatosis type 1 (NF1) and tuberous sclerosis complex type 2 (TSC2). METHODS: PGD protocol development was carried out using single cells from the patients. PGD was carried out on polar bodies and different embryonic cells. RESULTS: Protocol development for NF1 using lymphocytes from the patient suggested mosaicism for the mutation. This was supported further by quantitative fluorescent-PCR performed on genomic DNA. During PGD, polar bodies and blastomeres lacked the mutation that probably was absent or present at very low levels in the patient's germline. Single lymphocyte analysis during protocol development for TSC2 did not indicate mosaicism; however, analysis of single buccal cells and multiple embryo biopsies across two consecutive IVF/PGD cycles confirmed gonosomal mosaicism. CONCLUSIONS: The trend in PGD is for blastocyst biopsy followed by whole genome amplification, eliminating single cell analysis. In the case of certain dominantly inherited disorders, pre-PGD single cell analysis is beneficial to identify potential mosaicism that ensures robust protocols. © 2016 John Wiley & Sons, Ltd