Extended electrocardiographic monitoring in patients on chronic haemodialysis and after renal transplantation

Background Chronic Kidney Disease (CKD) and chronic haemodialysis are associated with cardiovascular disease. Despite the increased risk of sudden cardiac death, few studies to date have described the burden of arrhythmias in this population. The aim of this study was to determine the prevalence, type and timing of arrhythmias by means of implantable loop recorder (ILR) monitoring in patients with CKD on chronic haemodialysis. Methods In this prospective cohort study, ILR's were implanted in twenty patients with CKD on the Renal Replacement Programme at Groote Schuur Hospital in Cape Town. Clinical, electrocardiographic and echocardiographic parameters were collected. We reviewed ILR recordings obtained between August 2015 and July 2018 and analysed arrhythmic events in relation to clinical parameters and temporal relation to dialysis sessions. Results In this cohort of 17/20 patients (1 died prior to ILR download and 2 lost to follow-up), the median age was 38 years (IQR 27.5 – 45) and left ventricular ejection fraction (LVEF) 62% (48 – 73). Clinically significant arrhythmias included atrioventricular (AV) block (n=24), atrial fibrillation (n=12) and non-sustained ventricular tachycardia (n=2). Most (57.4%) arrhythmic events occurred in the long interdialytic period between dialysis sessions. One patient with high degree AV block detected by ILR received a permanent pacemaker. Arrhythmic events were less prevalent after renal transplantation (6/17 during study period). Conclusion We have demonstrated that there is potential clinical utility of ILR monitoring in this population, which have a high risk of largely asymptomatic, clinically significant arrythmias. Larger studies are required to validate our findings

Neuropsychological and functional outcomes in recent-onset major depression, bipolar disorder and schizophrenia-spectrum disorders: a longitudinal cohort study

Functional disability is the lead contributor to burden of mental illness. Cognitive deficits frequently limit functional recovery, although whether changes in cognition and disability are longitudinally associated in recent-onset individuals remains unclear. Using a prospective, cohort design, 311 patients were recruited and assessed at baseline. One hundred and sixty-seven patients met eligibility criteria (M = 21.5 years old, s.d. = 4.8) and returned for follow-up (M = 20.6 months later, s.d. = 7.8). Two-hundred and thirty participants were included in the final analysis, comprising clinically stable patients with major depression (n = 71), bipolar disorder (BD; n = 61), schizophrenia-spectrum disorders (n = 35) and 63 healthy controls. Neuropsychological functioning and self-rated functional disability were examined using mixed-design, repeated-measures analysis, across diagnoses and cognitive clusters, covarying for relevant confounds. Clinical, neuropsychological and functional changes did not differ between diagnoses (all P40.05). Three reliable neuropsychological subgroups emerged through cluster analysis, characterized by psychomotor slowing, improved sustained attention, and improved verbal memory. Controlling for diagnosis and changes in residual symptoms, clusters with improved neuropsychological functioning observed greater reductions in functional disability than the psychomotor slowing cluster, which instead demonstrated a worsening in disability (Po0.01). Improved sustained attention was independently associated with greater likelihood of follow-up employment (Po0.01). Diagnosis of BD uniquely predicted both follow-up employment and independent living. Neuropsychological course appears to be independently predictive of subjective and objective functional outcomes. Importantly, cognitive phenotypes may reflect distinct pathophysiologies shared across major psychiatric conditions, and be ideal targets for personalized early intervention

Servants of the Republic: Patrician lawyers in Quattrocento Venice.

Lawyers have widely been recognized as playing a role in the transition from the medieval to the modem state. Their presence in Renaissance Venetian politics, however, remains largely unexplored. Relying primarily on a prosopographical analysis, the thesis explores the various roles played by lawyers, dividing those roles into three main categories: diplomats, territorial governors, and domestic legislators. What emerges is a clear pattern of significant involvement by legally trained patricians in the Venetian political system. Noble lawyers were most often ambassadors, serving in many of the principal courts inside and outside of Italy as Venice was extending her influence on the Italian peninsula. They also served as administrators of Venetian rule throughout the Venetian terraferma (mainland) state. Lastly, their domestic political officeholding further confirms their continuing participation, as they held many of the most important domestic offices throughout the Quattrocento. The thesis ends with short biographies of each of the nearly three-dozen lawyers who make up this study, as well as chronologies of the offices they held. These chronologies include archival references for each office

Sovereignty, intervention, and social order in revolutionary times

This article has been accepted for publication and will appear in a revised form, subsequent to peer review and/or editorial input by Cambridge University Press, in Review of International Studies / Volume 39 / Issue 05 / December 2013, pp 1149 - 1167 Copyright © British International Studies Association 2013 DOI: http://dx.doi.org/10.1017/S026021051300025

Attentional modulation of the carry over of eye-movements between tasks

Task demands that influence scanning behaviour in one task can cause that behaviour to persist to a second unrelated task (carry over). This can also affect performance on a second task (e.g., hazard perception ratings), and has been attributed to a process of attentional bias that is modulated by top-down influences (Thompson & Crundall, 2011). In a series of experiments we explored how these top-down influences impact upon carry over. In all experiments, participants searched letters that were presented horizontally, vertically, or in a random array. They were then presented with a driving scene and rated the hazardousness of the scene. Carry over of eye-movements from the letter search to the scene was observed in all experiments. Furthermore, it was demonstrated that this carry over effect influenced hazard perception accuracy. The magnitude of carry over was correlated with task switching abilities, attentional conflicting, and attentional orienting (Experiment 1), and was affected by predictability of the primary task (Experiment 2). Furthermore, direct current stimulation of the left dorsolateral prefrontal cortex and parietal areas affected the magnitude of the effect (Experiment 3). These results indicate that carry over is modulated by the specific ability to orient attention and disengage from this orientation. Over orienting leads to increased carry over and insufficient task switching is detrimental to task performance. As a result the current experiments provide evidence that the carry over effect is strongly influenced by attentional processes, namely orienting, inhibition, and task switching

Changes in salivary estradiol predict changes in women’s preferences for vocal masculinity

Although many studies have reported that women’s preferences for masculine physical characteristics in men change systematically during the menstrual cycle, the hormonal mechanisms underpinning these changes are currently poorly understood. Previous studies investigating the relationships between measured hormone levels and women’s masculinity preferences tested only judgments of men’s facial attractiveness. Results of these studies suggested that preferences for masculine characteristics in men’s faces were related to either women’s estradiol or testosterone levels. To investigate the hormonal correlates of within-woman variation in masculinity preferences further, here we measured 62 women’s salivary estradiol, progesterone, and testosterone levels and their preferences for masculine characteristics in men’s voices in five weekly test sessions. Multilevel modeling of these data showed that changes in salivary estradiol were the best predictor of changes in women’s preferences for vocal masculinity. These results complement other recent research implicating estradiol in women’s mate preferences, attention to courtship signals, sexual motivation, and sexual strategies, and are the first to link women’s voice preferences directly to measured hormone levels

Changes in salivary estradiol predict changes in women’s preferences for vocal masculinity

Although many studies have reported that women’s preferences for masculine physical characteristics in men change systematically during the menstrual cycle, the hormonal mechanisms underpinning these changes are currently poorly understood. Previous studies investigating the relationships between measured hormone levels and women’s masculinity preferences tested only judgments of men’s facial attractiveness. Results of these studies suggested that preferences for masculine characteristics in men’s faces were related to either women’s estradiol or testosterone levels. To investigate the hormonal correlates of within-woman variation in masculinity preferences further, here we measured 62 women’s salivary estradiol, progesterone, and testosterone levels and their preferences for masculine characteristics in men’s voices in five weekly test sessions. Multilevel modeling of these data showed that changes in salivary estradiol were the best predictor of changes in women’s preferences for vocal masculinity. These results complement other recent research implicating estradiol in women’s mate preferences, attention to courtship signals, sexual motivation, and sexual strategies, and are the first to link women’s voice preferences directly to measured hormone levels

A Critical Examination of the X-Wind Model for Chondrule and Calcium-rich, Aluminum-rich Inclusion Formation and Radionuclide Production

Meteoritic data, especially regarding chondrules and calcium-rich, aluminum-rich inclusions (CAIs), and isotopic evidence for short-lived radionuclides (SLRs) in the solar nebula, potentially can constrain how planetary systems form. Intepretation of these data demands an astrophysical model, and the "X-wind" model of Shu et al. (1996) and collaborators has been advanced to explain the origin of chondrules, CAIs and SLRs. It posits that chondrules and CAIs were thermally processed < 0.1 AU from the protostar, then flung by a magnetocentrifugal outflow to the 2-3 AU region to be incorporated into chondrites. Here we critically examine key assumptions and predictions of the X-wind model. We find a number of internal inconsistencies: theory and observation show no solid material exists at 0.1 AU; particles at 0.1 AU cannot escape being accreted into the star; particles at 0.1 AU will collide at speeds high enough to destroy them; thermal sputtering will prevent growth of particles; and launching of particles in magnetocentrifugal outflows is not modeled, and may not be possible. We also identify a number of incorrect predictions of the X-wind model: the oxygen fugacity where CAIs form is orders of magnitude too oxidizing; chondrule cooling rates are orders of magnitude lower than those experienced by barred olivine chondrules; chondrule-matrix complementarity is not predicted; and the SLRs are not produced in their observed proportions. We conclude that the X-wind model is not relevant to chondrule and CAI formation and SLR production. We discuss more plausible models for chondrule and CAI formation and SLR production.Comment: Accepted for publication in The Astrophysical Journa