Long-term health outcomes after exposure to repeated concussion in elite level: rugby union players

Background: There is continuing concern about effects of concussion in athletes, including risk of the neurodegenerative disease chronic traumatic encephalopathy. However, information on long-term health and wellbeing in former athletes is limited. Method: Outcome after exposure to repeated brain injury was investigated in 52 retired male Scottish international rugby players (RIRP) and 29 male controls who were similar in age and social deprivation. Assessment included history of playing rugby and traumatic brain injury, general and mental health, life stress, concussion symptoms, cognitive function, disability and markers of chronic stress (allostatic load). Results: The estimated number of concussions in RIRP averaged 14 (median=7; IQR 5-40). Performance was poorer in RIRP than controls on a test of verbal learning (p=0.022) and of fine co-ordination of the dominant hand (p=0.038) and not significantly different on other cognitive tests (p>0.05). There were no significant associations between number of concussions and performance on cognitive tests. Other than a higher incidence of cardiovascular disease in controls, no group differences were detected in general or mental health or estimates of allostatic load. In RIRP, persisting symptoms attributed to concussion were more common if reporting more than nine concussions (p=0.028), although these symptoms were not perceived to affect social or work functioning. Conclusions: Despite a high number of concussions in RIRP, differences in mental health, social or work functioning were not found late after injury. Subtle group differences were detected on two cognitive tests, the cause of which is uncertain. Prospective group comparison studies on representative cohorts are required

The primary visual system of adult lizards demonstrates that neurogenesis is not obligatorily linked to central nerve regeneration but may be a prerequisite for the restoration of maps in the brain

AbstractFollowing optic nerve crush in the adult lizard Ctenophorus ornatus, most retinal ganglion cells regrow their axons into visual brain centres: however, the regenerated projections lack retinotopic order and the animals are blind via the experimental eye. Here we have used 3H-thymidine autoradiography to demonstrate that cell division is no longer taking place in the retina of normal adult lizards. We conclude that the optic nerve can regenerate in lizard even though cells are no longer being added to the retina, However, continued retinal neurogenesis may be linked to the ability to restore topographic maps

Development and evaluation of a de-identification procedure for a case register sourced from mental health electronic records

Background: Electronic health records (EHRs) provide enormous potential for health research but also present data governance challenges. Ensuring de-identification is a pre-requisite for use of EHR data without prior consent. The South London and Maudsley NHS Trust (SLaM), one of the largest secondary mental healthcare providers in Europe, has developed, from its EHRs, a de-identified psychiatric case register, the Clinical Record Interactive Search (CRIS), for secondary research. Methods: We describe development, implementation and evaluation of a bespoke de-identification algorithm used to create the register. It is designed to create dictionaries using patient identifiers (PIs) entered into dedicated source fields and then identify, match and mask them (with ZZZZZ) when they appear in medical texts. We deemed this approach would be effective, given high coverage of PI in the dedicated fields and the effectiveness of the masking combined with elements of a security model. We conducted two separate performance tests i) to test performance of the algorithm in masking individual true PIs entered in dedicated fields and then found in text (using 500 patient notes) and ii) to compare the performance of the CRIS pattern matching algorithm with a machine learning algorithm, called the MITRE Identification Scrubber Toolkit – MIST (using 70 patient notes – 50 notes to train, 20 notes to test on). We also report any incidences of potential breaches, defined by occurrences of 3 or more true or apparent PIs in the same patient’s notes (and in an additional set of longitudinal notes for 50 patients); and we consider the possibility of inferring information despite de-identification. Results: True PIs were masked with 98.8% precision and 97.6% recall. As anticipated, potential PIs did appear, owing to misspellings entered within the EHRs. We found one potential breach. In a separate performance test, with a different set of notes, CRIS yielded 100% precision and 88.5% recall, while MIST yielded a 95.1% and 78.1%, respectively. We discuss how we overcome the realistic possibility – albeit of low probability – of potential breaches through implementation of the security model. Conclusion: CRIS is a de-identified psychiatric database sourced from EHRs, which protects patient anonymity and maximises data available for research. CRIS demonstrates the advantage of combining an effective de-identification algorithm with a carefully designed security model. The paper advances much needed discussion of EHR de-identification – particularly in relation to criteria to assess de-identification, and considering the contexts of de-identified research databases when assessing the risk of breaches of confidential patient information

Linear Field Dependence of the Normal-State In-Plane Magnetoresistance of Sr2RuO4

The transverse and longitudinal in-plane magnetoresistances in the normal state of superconducting Sr2RuO4 single crystals have been measured. At low temperatures, both of them were found to be positive with a linear magnetic-field dependence above a threshold field, a result not expected from electronic band theory. We argue that such behavior is a manifestation of a novel coherent state characterized by a spin pseudo gap in the quasi-particle excitation spectrum in Sr2RuO4.Comment: 4 pages + 5 figure

Light-Front Approach for Heavy Pentaquark Transitions

Assuming the two diquark structure for the pentaquark state as advocated in the Jaffe-Wilczek model, there exist exotic parity-even anti-sextet and parity-odd triplet heavy pentaquark baryons. The theoretical estimate of charmed and bottom pentaquark masses is quite controversial and it is not clear whether the ground-state heavy pentaquark lies above or below the strong-decay threshold. We study the weak transitions of heavy pentaquark states using the light-front quark model. In the heavy quark limit, heavy-to-heavy pentaquark transition form factors can be expressed in terms of three Isgur-Wise functions: two of them are found to be normalized to unity at zero recoil, while the third one is equal to 1/2 at the maximum momentum transfer, in accordance with the prediction of the large-Nc approach or the quark model. Therefore, the light-front model calculations are consistent with the requirement of heavy quark symmetry. Numerical results for form factors and Isgur-Wise functions are presented. Decay rates of the weak decays Theta_b+ to Theta_c0 pi+ (rho+), Theta_c0 to Theta+ pi- (rho-), Sigma'_{5b}+ to Sigma'_{5c}0 pi+ (rho+) and Sigma'_{5c}0 to N_8+ pi- (rho-) with Theta_Q, Sigma'_{5Q} and N_8 being the heavy anti-sextet, heavy triplet and light octet pentaquarks, respectively, are obtained. For weakly decaying Theta_b+ and Theta_c0, the branching ratios of Theta_b+ to Theta_c0 pi+, Theta_c0 to Theta+ pi- are estimated to be at the level of 10^{-3} and a few percents, respectively.Comment: 33 pages, 3 figures, version to be published in Phys. Rev.

D*-->Dpi and D*-->Dgamma decays: Axial coupling and Magnetic moment of D* meson

The axial coupling and the magnetic moment of D*-meson or, more specifically, the couplings g(D*Dpi) and g(D*Dgamma), encode the non-perturbative QCD effects describing the decays D*-->Dpi and D*-->Dgamma. We compute these quantities by means of lattice QCD with Nf=2 dynamical quarks, by employing the Wilson ("clover") action. On our finer lattice (a=0.065 fm) we obtain: g(D*Dpi)=20 +/- 2, and g(D0*D0gamma)=[2.0 +/- 0.6]/GeV. This is the first determination of g(D0*D0gamma) on the lattice. We also provide a short phenomenological discussion and the comparison of our result with experiment and with the results quoted in the literature.Comment: 22 pages, 3 figure

Dual Vortex Theory of Strongly Interacting Electrons: Non-Fermi Liquid to the (Hard) Core

As discovered in the quantum Hall effect, a very effective way for strongly-repulsive electrons to minimize their potential energy is to aquire non-zero relative angular momentum. We pursue this mechanism for interacting two-dimensional electrons in zero magnetic field, by employing a representation of the electrons as composite bosons interacting with a Chern-Simons gauge field. This enables us to construct a dual description in which the fundamental constituents are vortices in the auxiliary boson fields. The resulting formalism embraces a cornucopia of possible phases. Remarkably, superconductivity is a generic feature, while the Fermi liquid is not -- prompting us to conjecture that such a state may not be possible when the interactions are sufficiently strong. Many aspects of our earlier discussions of the nodal liquid and spin-charge separation find surprising incarnations in this new framework.Comment: Modified dicussion of the hard-core model, correcting several mistake

Small intestinal polyp burden in pediatric Peutz–Jeghers syndrome assessed through capsule endoscopy: a longitudinal study

The management of pediatric Peutz–Jeghers Syndrome (PJS) focuses on the prevention of intussusception complicating small intestinal (SI) polyposis. This hinges on the accurate appraisal of the polyp burden to tailor therapeutic interventions. Video Capsule Endoscopy (VCE) is an established tool to study SI polyps in children, but an in-depth characterization of polyp burden in this population is lacking. Methods: We performed a retrospective longitudinal cross-sectional analysis of VCE studies in pediatric PJS patients at our institution (CMKC) from 2010 to 2020. Demographic, clinical, and VCE findings reported by three reviewers in tandem were accrued. Polyp burden variables were modeled as functions of patient and study characteristics using linear mixed models adjusted for clustering. Results: The cohort included 15 patients. The total small bowel polyp count and largest polyp size clustered under 30 polyps and <20 mm in size. Luminal occlusion correlated closely with the estimated polyp size. Polyp distribution favored proximal (77%) over distal (66%) small bowel involvement. The adjusted largest polyp size was greater in males. Double Balloon Enteroscopy was associated with a decreased polyp burden. Conclusions: The polyp burden in pediatric PJS patients favors the proximal third of the small intestine, with relatively small numbers and a polyp size amenable to resection through enteroscopy. Male gender and older age were related to an increased polyp burden

Assessment of Trinidad community stakeholder perspectives on the use of yeast interfering RNA-baited ovitraps for biorational control of Aedes mosquitoes

Dengue, Zika, chikungunya and yellow fever viruses continue to be a major public health burden. Aedes mosquitoes, the primary vectors responsible for transmitting these viral pathogens, continue to flourish due to local challenges in vector control management. Yeast interfering RNA-baited larval lethal ovitraps are being developed as a novel biorational control tool for Aedes mosquitoes. This intervention circumvents increasing issues with insecticide resistance and poses no known threat to non-target organisms. In an effort to create public awareness of this alternative vector control strategy, gain stakeholder feedback regarding product design and acceptance of the new intervention, and build capacity for its potential integration into existing mosquito control programs, this investigation pursued community stakeholder engagement activities, which were undertaken in Trinidad and Tobago. Three forms of assessment, including paper surveys, community forums, and household interviews, were used with the goal of evaluating local community stakeholders' knowledge of mosquitoes, vector control practices, and perceptions of the new technology. These activities facilitated evaluation of the hypothesis that the ovitraps would be broadly accepted by community stakeholders as a means of biorational control for Aedes mosquitoes. A comparison of the types of stakeholder input communicated through use of the three assessment tools highlighted the utility and merit of using each tool for assessing new global health interventions. Most study participants reported a general willingness to purchase an ovitrap on condition that it would be affordable and safe for human health and the environment. Stakeholders provided valuable input on product design, distribution, and operation. A need for educational campaigns that provide a mechanism for educating stakeholders about vector ecology and management was highlighted. The results of the investigation, which are likely applicable to many other Caribbean nations and other countries with heavy arboviral disease burdens, were supportive of supplementation of existing vector control strategies through the use of the yeast RNAi-based ovitraps

Earth system justice needed to identify and live within Earth system boundaries

Living within planetary limits requires attention to justice as biophysical boundaries are not inherently just. Through collaboration between natural and social scientists, the Earth Commission defines and operationalizes Earth system justice to ensure that boundaries reduce harm, increase well-being, and reflect substantive and procedural justice. Such stringent boundaries may also affect ‘just access’ to food, water, energy and infrastructure. We show how boundaries may need to be adjusted to reduce harm and increase access, and challenge inequality to ensure a safe and just future for people, other species and the planet. Earth system justice may enable living justly within boundaries