Findings of the International Subarachnoid Aneurysm Trial and the National Study of Subarachnoid Haemorrhage in context.

Concern has been expressed about the applicability of the findings of the International Subarachnoid Aneurysm Trial (ISAT) with respect to the relative effects on outcome of coiling and clipping. It has been suggested that the findings of the National Study of Subarachnoid Haemorrhage may have greater relevance for neurosurgical practice. The objective of this paper was to interpret the findings of these two studies in the context of differences in their study populations, design, execution and analysis. Because of differences in design and analysis, the findings of the two studies are not directly comparable. The ISAT analysed all randomized patients by intention-to-treat, including some who did not undergo a repair, and obtained the primary outcome for 99% of participants. The National Study only analysed participants who underwent clipping or coiling, according to the method of repair, and obtained the primary outcome for 91% of participants. Time to repair was also considered differently in the two studies. The comparison between coiling and clipping was susceptible to confounding in the National Study, but not in the ISAT. The two study populations differed to some extent, but inspection of these differences does not support the view that coiling was applied inappropriately in the National Study. Therefore, there are many reasons why the two studies estimated different sizes of effect. The possibility that there were real, systematic differences in practice between the ISAT and the National Study cannot be ruled out, but such explanations must be seen in the context of other explanations relating to chance, differences in design or analysis, or confounding

A history of the provision of treatment for mental health in nineteenth-century Surrey

The thesis presents a study of the provision of resources for the care and treatment of the insane in nineteenth-century Surrey. It covers the period between the mid 1770s until 1900 but focuses particular attention on the period 1830 - 1890. It examines the establishment of private asylums, county lunatic asylums and other institutions providing accommodation for the mentally ill, and, so far as possible, the care of single patients in their homes or other residences designated for that purpose. It traces the growth of legislation aimed at regulating the operation and conduct of asylums including their licensing, inspection and maintenance of records. It examines the impact of such legislation in the county with particular regard to the duties and responsibilities which fell upon those concerned with its implementation and administration at the local level. This examination includes the monitoring of private asylums and the processes by which the need for public asylums was established, their building and commissioning, staffing and subsequent asylum management. It examines the relationship between the requirements of the poor law and lunacy legislation for the care of pauper lunatics, and, therefore, includes within its purview the accommodation of the mentally ill in poor law institutions. It also examines, therefore, the roles of the local justices and poor law officials in the provisions made for the care and treatment of the insane poor. The study draws to a conclusion in the late 1880s coincidental with the reform of local government boundaries which resulted in a change of administrative responsibilities in Surrey and the newly created London local authorities

Interactive batch process schedule optimization and decision-making using multiobjective genetic algorithms

A multiobjective genetic algorithm (MOGA) is applied to a test batch scheduling problem to optimize five objectives simultaneously. The design of the MOGA allows an emphasis on human interaction with the optimization process, including the ability to change priorities of preferences and plant data interactively, and to allow the MOGA to make decisions regarding batch size and the rule task allocation. Experimental results demonstrate the development of this technique, allowing the combination of human expertise and MOGA optimization power to provide scheduling solutions to a highly complex problem

Reactive Polymorphic Nanoparticles: Preparation via Polymerization-Induced Self-Assembly and Postsynthesis Thiol-para-Fluoro Core Modification

The use of 2,3,4,5,6-pentafluorobenzyl methacrylate (PFBMA) as a core-forming monomer in ethanolic reversible addition-fragmentation chain transfer dispersion polymerization formulations is presented. Poly[poly(ethylene glycol) methyl ether methacrylate] (pPEGMA) macromolecular chain transfer agents were chain-extended with PFBMA leading to nanoparticle formation via polymerization-induced self-assembly (PISA). pPEGMA-pPFBMA particles exhibited the full range of morphologies (spheres, worms, and vesicles), including pure and mixed phases. Worm phases formed gels that underwent a thermo-reversible degelation and morphological transition to spheres (or spheres and vesicles) upon heating. Postsynthesis, the pPFBMA cores were modified through thiol-para-fluoro substitution reactions in ethanol using 1,8-diazabicyclo[5.4.0]undec-7-ene as the base. For monothiols, conversions were 64% (1-octanethiol) and 94% (benzyl mercaptan). Spherical and worm-shaped nano-objects were core cross-linked using 1,8-octanedithiol, which prevented their dissociation in nonselective solvents. For a temperature-responsive worm sample, cross-linking additionally resulted in the loss of the temperature-triggered morphological transition. The use of the reactive monomer PFBMA in PISA formulations presents a simple method to prepare well-defined nano-objects similar to those produced with nonreactive monomers (e.g., benzyl methacrylate) and to retain morphologies independent of solvent and temperature

High prevalence of malignancy in HIV-positive patients with mediastinal lymphadenopathy: A study in the era of antiretroviral therapy.

Mediastinal lymphadenopathy (MLN) in human immunodeficiency virus (HIV) infection has a wide spectrum of aetiologies with different prognoses and treatments. The decision to pursue a histopathological diagnosis represents a clinical challenge as patients present with non-specific symptoms. This study aimed to determine the aetiology and predictive factors of MLN in a cohort of HIV-infected patients in the combination antiretroviral therapy (cART) era

Lipid droplet remodelling and reduced muscle ceramides following sprint interval and moderate-intensity continuous exercise training in obese males.

BACKGROUND: In obesity, improved muscle insulin sensitivity following exercise training has been linked to the lowering of diacylglycerol (DAG) and ceramide concentrations. Little is known, however, about how improved insulin action with exercise training in obese individuals relates to lipid droplet (LD) adaptations in skeletal muscle. In this study we investigated the hypothesis that short-term sprint interval training (SIT) and moderate intensity continuous training (MICT) in obese individuals would increase perilipin (PLIN) expression, increase the proportion of LDs in contact with mitochondria and reduce muscle concentrations of DAGs and ceramides. METHODS: Sixteen sedentary obese males performed 4 weeks of either SIT (4-7 × 30 s sprints at 200% Wmax, 3 days.week(-1)) or MICT (40-60 min cycling at ~65% VO2peak, 5 days.week(-1)), and muscle biopsies were obtained pre- and post-training. RESULTS: Training increased PLIN2 (SIT 90%, MICT 68%) and PLIN5 (SIT 47%, MICT 34%) expression in type I fibres only, and increased PLIN3 expression in both type I (SIT 63%, MICT 67%) and type II fibres (SIT 70%, MICT 160%) (all P<0.05). Training did not change LD content but increased the proportion of LD in contact with mitochondria (SIT 12%, MICT 21%, P<0.01). Ceramides were reduced following training (SIT -10%, MICT -7%, P<0.05), but DAG was unchanged. No training × group interactions were observed for any variables. CONCLUSIONS: These results confirm the hypothesis that SIT and MICT results in remodelling of LDs and lowers ceramide concentrations in skeletal muscle of sedentary obese males.International Journal of Obesity accepted article preview online, 24 July 2017. doi:10.1038/ijo.2017.170

Functional significance may underlie the taxonomic utility of single amino acid substitutions in conserved proteins

We hypothesized that some amino acid substitutions in conserved proteins that are strongly fixed by critical functional roles would show lineage-specific distributions. As an example of an archetypal conserved eukaryotic protein we considered the active site of ß-tubulin. Our analysis identified one amino acid substitution—ß-tubulin F224—which was highly lineage specific. Investigation of ß-tubulin for other phylogenetically restricted amino acids identified several with apparent specificity for well-defined phylogenetic groups. Intriguingly, none showed specificity for “supergroups” other than the unikonts. To understand why, we analysed the ß-tubulin Neighbor-Net and demonstrated a fundamental division between core ß-tubulins (plant-like) and divergent ß-tubulins (animal and fungal). F224 was almost completely restricted to the core ß-tubulins, while divergent ß-tubulins possessed Y224. Thus, our specific example offers insight into the restrictions associated with the co-evolution of ß-tubulin during the radiation of eukaryotes, underlining a fundamental dichotomy between F-type, core ß-tubulins and Y-type, divergent ß-tubulins. More broadly our study provides proof of principle for the taxonomic utility of critical amino acids in the active sites of conserved proteins

In the shadow of coal: How large-scale industries contributed to present-day regional differences in personality and well-being

Recent research has identified regional variation of personality traits within countries but we know little about the underlying drivers of this variation. We propose that the Industrial Revolution, as a key era in the history of industrialized nations, has led to a persistent clustering of well-being outcomes and personality traits associated with psychological adversity via processes of selective migration and socialization. Analyzing data from England and Wales, we examine relationships between the historical employment share in large-scale coal-based industries (coal mining and steam-powered manufacturing industries that used this coal as fuel for their steam engines) and today’s regional variation in personality and well- being. Even after controlling for possible historical confounds (historical energy supply, education, wealth, geology, climate, population density), we find that the historical local dominance of large-scale coal-based industries predicts today’s markers of psychological adversity (lower Conscientiousness [and order facet scores], higher Neuroticism [and anxiety and depression facet scores], lower activity [an Extraversion facet], and lower life satisfaction and life expectancy). An instrumental variable analysis, using the historical location of coalfields, supports the causal assumption behind these effects (with the exception of life satisfaction). Further analyses focusing on mechanisms hint at the roles of selective migration and persisting economic hardship. Finally, a robustness check in the U.S. replicates the effect of the historical concentration of large-scale industries on today’s levels of psychological adversity. Taken together, the results show how today’s regional patterns of personality and well-being may have their roots in major societal changes underway decades or centuries earlier

Reliability and Validity of a Medicine Ball-Contained Accelerometer for Measuring Upper-Body Neuromuscular Performance

Roe, G, Shaw, W, Darrall-Jones, J, Phibbs, PJ, Read, D, Weakley, JJ, Till, K, and Jones, B. Reliability and validity of a medicine ball-contained accelerometer for measuring upper-body neuromuscular performance. J Strength Cond Res 32(7): 1915-1918, 2018-The aim of the study was to assess the between-day reliability and validity of a medicine ball-contained accelerometer (MBA) for assessing upper-body neuromuscular performance during a throwing task. Ten professional rugby union players partook in the study. Between-day reliability was assessed from the best score attained during 2 sets of 3 throws, on 2 testing occasions separated by 7 days. Validity was assessed against a criterion measure (Optioelectronic system) during 75 throws from a subgroup of 3 participants. The MBA exhibited a small between-day error of 2.2% (90% confidence intervals; 2.0-4.6%) and an almost perfect relationship with a criterion measure (r = 0.91 [90% CIs; 0.87-0.94]). However, the mean bias and standard error were moderate (7.9% [90% CIs; 6.6-9.2%] and 4.9% [90% CIs; 4.2-5.7%], respectively). Practitioners using an MBA to assess neuromuscular performance of the upper body must take into account the overestimation and error associated with such assessment with respect to a criterion measure. However, as the error associated with between-day testing was small and testing is easy to implement in applied practice, an MBA may provide a useful tool for monitoring upper-body neuromuscular performance over time

Younger age of onset in familial amyotrophic lateral sclerosis is a result of pathogenic gene variants, rather than ascertainment bias.

OBJECTIVE: Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease of motor neurons with a median survival of 2 years. Familial ALS has a younger age of onset than apparently sporadic ALS. We sought to determine whether this younger age of onset is a result of ascertainment bias or has a genetic basis. METHODS: Samples from people with ALS were sequenced for 13 ALS genes. To determine the effect of genetic variation, age of onset was compared in people with sporadic ALS carrying a pathogenic gene variant and those who do not; to determine the effect of family history, we compared those with genetic sporadic ALS and familial ALS. RESULTS: There were 941 people with a diagnosis of ALS, 100 with familial ALS. Of 841 with apparently sporadic ALS, 95 carried a pathogenic gene variant. The mean age of onset in familial ALS was 5.3 years younger than for apparently sporadic ALS (p=6.0×10-5, 95% CI 2.8 to 7.8 years). The mean age of onset of genetic sporadic ALS was 2.9 years younger than non-genetic sporadic ALS (p=0.011, 95% CI 0.7 to 5.2 years). There was no difference between the mean age of onset in genetic sporadic ALS and familial ALS (p=0.097). CONCLUSIONS: People with familial ALS have an age of onset about 5 years younger than those with apparently sporadic ALS, and we have shown that this is a result of Mendelian gene variants lowering the age of onset, rather than ascertainment bias