bluuebunny/crossref_metadata_2025 huggingface dataset:
MMT and policy assignment in an open economy context: Simplicity is useful, oversimplification not so much
Authors: Razmi Arslan
Published: December 2022

Modern Monetary Theory (MMT) has recently received significant attention in academic and policy circles. Critics question the sustainability of MMT‐prescribed approaches to fiscal and monetary policy, especially over extended periods of time, in the presence of international financial markets, and for developing country governments that borrow in foreign currency. I formalize some of these arguments using a dynamic, open economy, Tobin‐Markowitz portfolio balance environment that takes into account: (1) the role of expectations in the foreign exchange market and the feedback mechanisms between these and the exchange rate and inflation, and (2) interactions between the current account, debt accumulation, and the goods market. I show that continuous monetary accommodation of fiscal policy by a consolidated authority that operates along MMT‐prescribed lines is likely to generate instability and make it hard to maintain full employment with stable inflation. Importantly, this is true even in the absence of rational forward‐looking expectations or sovereign foreign indebtedness.
Bacterial filaments recover by successive and accelerated asymmetric divisions that allow rapid post‐stress cell proliferation
Authors: Cayron Julien , Dedieu‐Berne Annick , Lesterlin Christian
Published: December 2022

Filamentation is a reversible morphological change triggered in response to various stresses that bacteria might encounter in the environment, during host infection or antibiotic treatments. Here we re‐visit the dynamics of filament formation and recovery using a consistent framework based on live‐cells microscopy. We compare the fate of filamentous Escherichia coli induced by cephalexin that inhibits cell division or by UV‐induced DNA‐damage that additionally perturbs chromosome segregation. We show that both filament types recover by successive and accelerated rounds of divisions that preferentially occur at the filaments' tip, thus resulting in the rapid production of multiple daughter cells with tightly regulated size. The DNA content, viability and further division of the daughter cells essentially depends on the coordination between chromosome segregation and division within the mother filament. Septum positioning at the filaments' tip depends on the Min system, while the nucleoid occlusion protein SlmA regulates the timing of division to prevent septum closure on unsegregated chromosomes. Our results not only recapitulate earlier conclusions but provide a higher level of detail regarding filaments division and the fate of the daughter cells. Together with previous reports, this work uncovers how filamentation recovery allows for a rapid cell proliferation after stress treatment.
Lack of difference between amyloid‐beta burden at gyral crests and sulcal depths in diverse neurodegenerative diseases
Authors: Ichimata Shojiro , Kim Ain , Nishida Naoki , Kovacs Gabor G.
Published: December 2022

Aims

The aim of this study is to clarify whether there is a difference in amyloid‐beta burden between gyral crests (GCs) and sulcal depths (SDs) in different neurodegenerative proteinopathies.

Methods

We analysed the burden and distribution of amyloid‐beta deposition in post‐mortem brain samples from 138 autopsies, including Alzheimer's disease (n = 30), Down's syndrome (n = 11), Lewy body disease (LBD; n = 53), multiple system atrophy (n = 8) and progressive supranuclear palsy (n = 36). We applied quantitative amyloid‐beta burden analysis to compare amyloid‐beta deposition in both GCs and SDs. We also evaluated the prevalence of amyloid‐beta plaques in both regions in samples exhibiting high or low amounts of amyloid‐beta pathology.

Results

Amyloid‐beta burden was evaluated in 67 and 84 samples of the frontal and temporal cortices, respectively. We did not find significant differences in the amyloid‐beta burden between GCs and SDs in these regions in any examined disease. In addition, amyloid‐beta plaques were almost evenly distributed in both regions in cases with low amounts of amyloid‐beta pathology. Females in the LBD group showed significantly higher amyloid‐beta burden than males (temporal cortex, p < 0.01). Furthermore, only one LBD case showed SD‐predominant deposition associated with the coarse‐grained plaques.

Conclusions

We have shown that amyloid‐beta is almost evenly distributed in both GCs and SDs in the frontal and temporal lobes from the early stage, in diverse neurodegenerative diseases. Sex may contribute to differences in the amyloid‐beta burden. The coarse‐grained plaque may show SD‐predominant neuritic tau deposition that must be carefully distinguished from chronic traumatic encephalopathy‐related SD tau pathology.
Christ, Image of the Father. On the Lasting Importance of the Christology of Thomas Aquinas
Authors: Schoot Henk J.M.
Published: December 2022

This contribution discusses the expression ‘Image of the Father’ as a case in point to Aquinas's approach of naming Christ: Christology and Trinitarian theology, as well as the discussion of analogical naming in divinis, need to be taken together. ‘Image’ and ‘Father’ are predicated differently of Christ and God the Father than of human beings. Moreover, God is ‘Father’ in a different way towards the Son than regarding human beings. Christ is the unique image of the Father: the invisible image of the invisible Father.
Revisiting the relationship between turgor pressure and plant cell growth
Authors: Ali Olivier , Cheddadi Ibrahim , Landrein Benoit , Long Yuchen
Published: December 2022

Growth is central to plant morphogenesis. Plant cells are encased in rigid cell walls, and they must overcome physical confinement to grow to specific sizes and shapes. Cell wall tension and turgor pressure are the main mechanical components impacting plant cell growth. Cell wall mechanics has been the focus of most plant biomechanical studies, and turgor pressure was often considered as a constant and largely passive component. Nevertheless, it is increasingly accepted that turgor pressure plays a significant role in plant growth. Numerous theoretical and experimental studies suggest that turgor pressure can be both spatially inhomogeneous and actively modulated during morphogenesis. Here, we revisit the pressure–growth relationship by reviewing recent advances in investigating the interactions between cellular/tissular pressure and growth.
Short‐term variation in leaf‐level water use efficiency in a tropical forest
Authors: Davidson Kenneth J. , Lamour Julien , Rogers Alistair , Ely Kim S. , Li Qianyu , McDowell Nate G. , Pivovaroff Alexandria L. , Wolfe Brett T. , Wright S. Joseph , Zambrano Alfonso , Serbin Shawn P.
Published: December 2022

The representation of stomatal regulation of transpiration and CO2 assimilation is key to forecasting terrestrial ecosystem responses to global change. Given its importance in determining the relationship between forest productivity and climate, accurate and mechanistic model representation of the relationship between stomatal conductance (gs) and assimilation is crucial.

We assess possible physiological and mechanistic controls on the estimation of the g1 (stomatal slope, inversely proportional to water use efficiency) and g0 (stomatal intercept) parameters, using diurnal gas exchange surveys and leaf‐level response curves of six tropical broadleaf evergreen tree species.

g1 estimated from ex situ response curves averaged 50% less than g1 estimated from survey data. While g0 and g1 varied between leaves of different phenological stages, the trend was not consistent among species. We identified a diurnal trend associated with g1 and g0 that significantly improved model projections of diurnal trends in transpiration.

The accuracy of modeled gs can be improved by accounting for variation in stomatal behavior across diurnal periods, and between measurement approaches, rather than focusing on phenological variation in stomatal behavior. Additional investigation into the primary mechanisms responsible for diurnal variation in g1 will be required to account for this phenomenon in land‐surface models.
Prevalence of mental health symptoms in children and adolescents during the COVID‐19 pandemic: A meta‐analysis
Authors: Deng Jiawen , Zhou Fangwen , Hou Wenteng , Heybati Kiyan , Lohit Simran , Abbas Umaima , Silver Zachary , Wong Chi Yi , Chang Oswin , Huang Emma , Zuo Qi Kang , Moskalyk Myron , Ramaraju Harikrishnaa Ba , Heybati Shayan
Published: December 2022

The COVID‐19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta‐analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross‐sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit‐transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics.
Childhood obesity trends: Association with same‐day hospital admission in a National Outpatient Surgical Population
Authors: Tram Nguyen K. , Mpody Christian , Owusu‐Bediako Kwaku , Murillo‐Deluquez Marcelino E. , Tobias Joseph D. , Nafiu Olubukola O.
Published: December 2022

Background

Although the prevalence of obesity in the general population and its perioperative implications among children undergoing inpatient surgeries are well known, little is known about obesity prevalence among children scheduled for ambulatory surgery.

Aims

Here, we report the trends of obesity and severe obesity among children who underwent ambulatory surgery across multiple centers in the United States and explore the association of obesity status with admission following elective ambulatory surgery.

Materials and Methods

Using data from the American College of Surgeons National Surgical Quality Improvement Program‐Pediatric (2012–2019), we selected children 2–18 years old who underwent outpatient surgical procedures under general anesthesia and had documented height, weight, and body mass index (BMI) data. We estimated the prevalence of overweight, obesity (class 1), and severe obesity (class 2 and class 3) patients and explored their association with same‐day hospital admission, defined as hospital length of stay ≥1 day.

Results

Data from 152 918 children (mean age: 9.7 ± 4.7 years) were analyzed. Of these, 16.4% (n = 25 007) were overweight, 13.8% (n = 21 085) were class 1 obese, 5.2% (n = 7879) were class 2 obese, and 3.0% (n = 4623) were class 3 obese. From 2012 to 2019, class 2 or 3 obesity prevalence increased by 26.7% and 32.5%, respectively. Overweight and obese children had relatively higher odds of same‐day hospital admission compared to healthy weight children (overweight odds ratio [95% confidence interval]: 1.05 [1.02, 1.08]; class 1 obesity: 1.04 [1.00, 1.07]; class 2 obesity: 1.09 [1.02, 1.16]; class 3 obesity: 1.20 [1.11, 1.30]).

Discusion and Conclusion

The burden of obesity continues to increase in children scheduled for ambulatory surgery. Children with class 2 and class 3 obesity have higher rates of same‐day hospital admission following elective ambulatory surgery compared to healthy weight children, a factor that should be considered in scheduling these patients.
Acute phase proteins in cattle and swine: A review
Authors: Saco Yolanda , Bassols Anna
Published: December 2022

The major acute phase proteins (APPs) in cattle are haptoglobin (Hp) and serum amyloid A (SAA), and in swine, are Hp, SAA, C‐reactive protein (CRP), and Pig major acute phase protein (Pig‐MAP). Many methodologic assays are presently available to measure these parameters, which are still being improved to increase their specificity, sensitivity, user‐friendliness, and economic availability. In cattle, the main applications are the diagnosis and monitoring of frequent diseases such as mastitis and metritis in dairy cows and respiratory problems in young calves. In pigs, APPs are useful in the control of bacterial and viral infections, and they may be used at the slaughterhouse to monitor subclinical pathologies and improve food safety. The utility of APP in animal production must not be forgotten; optimization of protocols to improve performance, welfare, and nutrition may benefit from the use of APPs. Other sample types besides serum or plasma have potential uses; APP determination in milk is a powerful tool in the control of mastitis, saliva is a non‐invasive sample type, and meat juice is easily obtained at the slaughterhouse. Increasing our knowledge of reference intervals and the influence of variables such as age, breed, sex, and the season is important. Finally, worldwide harmonization and standardization of analytical procedures will help to expand the use of APPs.
Communicative and Linguistic Characteristics of the Comic Discourse (on the Material of English-Language Belles-Lettres Works)
Authors: Blynova Iryna
Published: December 2022

The article deals with the investigation of the communicative and linguistic features of the comic discourse on the basis of the English-language fictional works by M. Spark, R. Dahl, K. Vonnegut Jr, I. Shaw, R. Carver and K. Barry. The author represents the description of a comic discourse in terms of Linguistic Pragmatics. Extra-linguistic components of the literary text creating and actualizing, which include pragmatic characteristics, social and cultural factors, psychological peculiarities, cognitive component and paralinguistic supplement, are described. The article also provides a detailed classification of comic discourse linguistic components on the material of belles-letters communication in the works of aforementioned writers. All linguistic characteristics within five groups, according to the violation/lack/incompleteness of the discourse certain communicative qualities disclosure, are distinguished. Besides, there is a thorough analysis of the presupposition as a constituent part in the comic discourse definition. The article dwells on the interlocutors’ micro and macro presuppositions introducing, the absence of which leads to non-cooperative communication with, predominantly, a comic effect. The results of the experiment show that the participants’ (readers’ particularly) background knowledge helps them interpret a literary discourse. The article continues the study of special special means and techniques of comic effect producing that provides a further understanding of the authors’ individual styles.
Semantics and Creation of Eponyms in the English-Speaking World
Authors: Kovalchuk Olena
Published: December 2022

The relevance of the topic of the article is determined by the importance of researching derivational processes in the modern English-speaking world, in particular using the example of eponyms, with the aim of tracking the transition of proper names to common names, creating occasional vocabulary and its unification and codification at the national or international level. The purpose of the article is the structural-linguistic analysis of eponymous units with regard to the sphere of everyday life in different contexts (medical, political, social), the study of various derivational models functioning in the English-speaking environment. The main method is a comparative study of various productive word-forming classes on the example of the development of the English language system, a historical-typological study of the mechanisms of adding elements to its derivational composition. This article reveals the main word-formation models that are most characteristic for the formation of eponymous vocabulary (conversion, suffixation, composition, blending, acronymization), analyzes the metaphorical and metonymic features of figurative reinterpretation during the transition of a linguistic unit from the composition of its own vocabulary to general use, points out the grammatical nature of eponyms (noun, adjective, verb, adverb), highlights productive suffix morphemes, indicates the linguistic potential of various means of word formation, the main lexical-semantic transformations as a result of the implementation of derivational models, and special attention is paid to suffixation as the main way of forming new eponyms. The materials presented in this paper will further help in the study of various language systems in view of the derivational, lexical-grammatical, structural features of a separate national language, the study of global influences on the linguistic culture of creating occasional vocabulary and its standardization and codification in the national language space.
Gender Discourse – Representation of Ideas about the Distribution of Gender Roles
Authors: Novosad Yuliia , Tsepeniuk Tetiana , Golovatska Yuliia , Yarema Oksana , Сhumak Halyna
Published: December 2022

The relevance of the study is conditioned by the insufficient level of investigation of gender discourse, in particular, in translation studies, understanding the feminine and masculine aspects when analysing the content of the text through the use of linguistic tools and techniques. The purpose of the study is a comparative analysis of two translations at the level of phonetic, morphological, grammatical, syntactic, and stylistic means, analysis of translation strategy in such aspects as the accuracy (adequacy) of reproduction of folk realia, the use of emotional and evaluative vocabulary, metaphorical and aphoristic thinking, the use of techniques of foreignization and domestication of language resources. The main method is a theoretical approach to understanding the concepts of gender, gender stereotypes, cultural turn, postcolonial development of literature and feminist discourse, and a comparative linguistic analysis of the linguistic tools used in both translations. This paper focuses on the intralingual and extralingual means of gender identity, reveals the main aspects of the study of masculine and feminine discourse through the use of various mechanisms at the language level to convey national realia, and examines the key aspects of the communication strategy of male and female translators. The materials presented in this paper would facilitate further research of gender issues in the context of the modern reading of literary texts, analysis of world influences on cultural space and language adaptation of translation with the selection of full and incomplete correspondences, and understanding the possibilities of a particular national language to reproduce the content and form of a literary work made in the original.
The effect of allophonic variability on L2 contrast perception: Evidence from perception of English vowels
Authors: Zhou Alexis , Dmitrieva Olga , Olson Daniel J.
Published: December 2022

Current frameworks of L2 phonetic acquisition remain largely underspecified with respect to the role of L1 allophonic variability in acquisition. Examining the role of L1 allophonic variability, the current study compared the perceptual discrimination of English /i-ɪ/ and /ɛ-æ/ by L1 Korean and L1 Mandarin speakers. Korean and Mandarin vowel inventories differ in that Mandarin employs significantly greater allophonic variation of the mid-region /E/ vowel. Results demonstrated worse perceptual accuracy by L1 Mandarin speakers for the /ɛ-æ/ contrast than L1 Korean speakers. These results suggest that both L1 phonemic inventories and allophonic variation play a role in L2 phonetic acquisition.
Epidemiological Investigation of Hospital Transmission of Corynebacterium striatum Infection by Core Genome Multilocus Sequence Typing Approach
Authors: Kang Yutong , Chen Shenglin , Zheng Beijia , Du Xiaoli , Li Zhenpeng , Tan Zhizhou , Zhou Haijian , Huang Jia , Tian Leihao , Zhong Jiaxin , Ma Xueli , Li Fang , Yao Jiang , Wang Yu , Zheng Meiqin , Li Zhenjun
Published: December 2022

Recently, WGS of many human and animal pathogens has been successfully used to investigate microbial outbreaks. The cgMLST schema are powerful genotyping tools that can be used to investigate potential epidemics and provide classification of the strains precise and reliable.
Sensitization of KPC and NDM Klebsiella pneumoniae To Rifampicin by the Human Lactoferrin-Derived Peptide hLF1-11
Authors: Morici Paola , Rizzato Cosmeri , Ghelardi Emilia , Rossolini Gian Maria , Lupetti Antonella
Published: December 2022

The present study describes a synergistic effect between rifampicin, an impermeable hydrophobic antibiotic with an intracellular target, and an hLF1-11, an antimicrobial peptide derived from human lactoferrin, against multidrug-resistant
Klebsiella pneumoniae
. Carbapenem-resistant
K. pneumoniae
has recently caused an outbreak in Tuscany, Italy, thus pressing the need for the development of new treatment options.
Paleozoic vegetation increased fine sediment in fluvial and tidal channels: Evidence from secular changes to the mudrock content of ancient point bars
Authors: McMahon William J. , Davies Neil S. , Kleinhans Maarten G. , Mitchell Ria L.
Published: December 2022

The amount of mudrock preserved globally in alluvium increased in stratigraphic synchrony with the Paleozoic evolution of land plants. This observation has been explained by vegetation promoting both the retention of mud through baffling, stabilization, and flocculation, and the production of mud through chemical weathering. However, the latter explanation has been challenged on the basis that it is perceived to require imbalance in the long-term global carbon cycle. We present a compendium of empirical evidence that is supportive of increased global fine sediment supply, and thus the contention that land plants did, in fact, promote the production of mud on the continents. We refine previous broad-brush analyses of Paleozoic mudrock content by specifically tracking shifts in the mudrock content of regions of alluvial and tidal landscapes that remained locally unvegetated even after the greening of the continents, namely inclined heterolithic stratification (IHS) that records submerged in-channel bars. We show that the Paleozoic mudrock increase was pronounced even within these areas, away from any biomechanical binding and baffling effects of plants. Precambrian and Cambrian IHS are composed almost exclusively of sandstone, whereas Silurian through to Carboniferous examples show a steady increase in total mudrock content. This progressive rise in the mudrock component of channel bars cannot alone be explained by physical retention of mud by vegetation and requires heightened fine sediment concentrations from the hinterland, which suggests that plants increased the volume of mud available at source. The muddying of Earth’s preserved IHS serves as a proxy that suggests evolving Paleozoic land plants triggered a global increase in the production and supply of fine-grained sediment.
Hypotony in uveitis: an overview of medical and surgical management
Authors: Testi Ilaria , Calcagni Antonio , Barton Keith , Gooch James , Petrushkin Harry
Published: December 2022

Hypotony is a well-recognised, sight-threatening complication of uveitis. It can also be the final common endpoint for a multitude of disease entities. Multiple mechanisms underlie hypotony, and meticulous clinical history alongside ocular phenotyping is necessary for choosing the best intervention and therapeutic management. In this narrative review, a comprehensive overview of medical and surgical treatment options for the management of non-surgically induced hypotony is provided. Management of ocular hypotony relies on the knowledge of the aetiology and mechanisms involved. An understanding of disease trajectory is vital to properly educate patients. Both anatomical and functional outcomes depend on the underlying pathophysiology and choice of treatment.
Digital disparities among healthcare workers in typing speed between generations, genders, and medical specialties: cross sectional study
Authors: Schuurman Alex R , Baarsma M E , Wiersinga W Joost , Hovius Joppe W
Published: December 2022

Objective

To investigate the typing skills of healthcare professionals.

Design

Cross sectional study.

Setting

Two large tertiary medical centres in Amsterdam, the Netherlands.

Participants

2690 hospital employees working in patient care, research, or medical education.

Main outcome measures

Participants completed a custom built, web based, Santa themed, typing test in 60 seconds and filled out an associated questionnaire. The primary outcome was corrected typing speed, defined as crude typing speed (words per minute) multiplied by accuracy (correct characters as a percentage of total characters in the final transcribed text). Feelings towards administrative tasks scored on the Visual Analogue Scale to Weigh Respondents’ Internalised Typing Enjoyment (VAS-WRITE), in which 0 represents the most negative and 100 the most positive feelings towards administration, were also recorded.

Results

Between 18 and 21 May 2021, a representative cohort of 2690 study participants was recruited (1942 (72.2%) were younger than 40 years; 2065 (76.8%) were women). Respondents’ mean typing speed was 60.1 corrected words per minute (standard deviation 20.8; range 8.0-136.6) with substantial differences between professions and specialties, in which physicians in internal medicine were the fastest among the medical professionals. Typing speed decreased significantly with every age decade (rho −0.51, P<0.001), and people with a history of completing a typing course were more than 20% faster than those who had not (mean difference 12.1 words (standard error 0.8), (95% confidence interval 10.6 to 13.6), P<0.001). The corrected typing speed did not differ between genders (0.5 (0.9) words, (−1.4 to 2.4), P=0.61). Women were less negative towards administration than were men (mean difference VAS-WRITE score 7.68 (standard error 1.17), (95% confidence interval 5.33 to 10.03), P<0.001). Of all professional groups, medical staff reported the most negative feelings towards administration (mean VAS-WRITE score of 33.5 (standard deviation 22.9)).

Conclusions

Important differences were reported in typing proficiency between age groups, professions, and medical specialties. Specific groups are at a disadvantage in an increasingly digitalised healthcare system, and these data could inform the implementation of training modules and alternative methods of data entry to level the playing field.
Study protocol for the BRAIN Training Trial: a randomised controlled trial of Balance, Resistance, And INterval training on cognitive function in older adults with mild cognitive impairment
Authors: Valenzuela Trinidad , Coombes Jeff S , Liu-Ambrose Teresa , Mavros Yorgi , Kochan Nicole , Sachdev Perminder S , Hausdorff Jeffrey , Smith Emily C , Hollings Matthew , Hawkins Tess C , Ashley Nicholas J , Feter Natan , Wilson Guy C , Shih Isabel Hui En , Guerrero Yareni , Jiang Jiyang , Wen Wei , Bailey Tom , Stensvold Dorthe , Wisløff Ulrik , Falck Ryan S , Fiatarone Singh Maria
Published: December 2022

Introduction

Epidemiological evidence suggests that both poor cardiovascular fitness and low muscle mass or strength markedly increase the rate of cognitive decline and incident dementia in older adults. Results from exercise trials for the improvement of cognition in older adults with mild cognitive impairment (MCI) have reported mixed results. This is possibly due to insufficient exercise intensities. The aim of the Balance, Resistance, And INterval (BRAIN) Training Trial is to determine the effects of two forms of exercise, high-intensity aerobic interval training (HIIT) and high-intensity power training (POWER) each compared with a sham exercise control group on cognition in older adults with MCI.

Methods and analysis

One hundred and sixty community-dwelling older (≥ 60 years) people with MCI have been randomised into the trial. Interventions are delivered supervised 2–3 days per week for 12 months. The primary outcome measured at baseline, 6 and 12 months is performance on a cognitive composite score measuring the executive domain calculated from a combination of computerised (NeuroTrax) and paper-and-pencil tests. Analyses will be performed via repeated measures linear mixed models and generalised linear mixed models of baseline, 6-month and 12-month time points, adjusted for baseline values and covariates selected a priori. Mixed models will be constructed to determine the interaction of GROUP × TIME.

Ethics and dissemination

Ethical approval was obtained from the University of Sydney (HREC Ref.2017/368), University of Queensland (HREC Ref. 2017/HE000853), University of British Columbia (H16-03309), and Vancouver Coastal Health Research Institute (V16-03309) Human Research Ethics. Dissemination will be via publications, conference presentations, newsletter articles, social media, talks to clinicians and consumers and meetings with health departments/managers.

It is expected that communication of results will allow for the development of more effective evidence-based exercise prescription guidelines in this population while investigating the benefits of HIIT and POWER on subclinical markers of disease.

Trial registration number

ACTRN12617001440314 Australian New Zealand Clinical Trials Registry.
Outcomes of a telemedicine smoking cessation programme for heated tobacco product users in Japan: a retrospective cohort study
Authors: Nomura Akihiro , Ikeda Takaaki , Fujimoto Toshiki , Morita Yusaku , Taniguchi Chie , Ishizawa Tetsuro , Tabuchi Takahiro
Published: December 2022

Objectives

Japan is one of the largest markets for heated tobacco products (HTPs), and the number of HTP users, including dual users, is growing. However, it is not yet clear whether a telemedicine smoking cessation programme is effective for nicotine-dependent HTP users to quit smoking. We assessed the outcomes of a telemedicine smoking cessation programme in terms of continuous smoking cessation among smokers who had used HTPs compared with those who used exclusively cigarettes.

Design

A retrospective cohort study to assess the outcomes of the telemedicine smoking cessation programme provided by Linkage, Japan, comparing the success rates of smoking cessation between exclusively cigarette group (as reference) and HTP user groups (exclusively HTPs or dual use of both cigarettes and HTPs).

Setting

Linkage telemedicine smoking cessation programme database, covering programme participants in Japan.

Participants

Programme participants from between August 2018 and October 2020.

Outcome measures

Continuous abstinence rates (CARs) from 9 to 24 weeks (CAR9–24) and 9 to 52 weeks (CAR9–52). Adjusted ORs (aORs) with 95% CIs for CAR were calculated to compare the exclusively cigarette group with exclusively HTP and dual use groups.

Results

We analysed 733 telemedicine smoking cessation programme participants. Exclusively HTP users had higher CARs than the exclusively cigarette group for CAR9–24 (aOR 1.12, 95% CI 1.02 to 1.23; p=0.02) and CAR9–52 (1.09, 0.99 to 1.19; p=0.08). Conversely, dual users had lower CARs than the exclusively cigarette group for CAR9–24 (0.85, 0.76 to 0.95; p=0.004) and CAR9–52 (0.88, 0.79 to 0.97; p=0.01).

Conclusions

Exclusive HTP users achieved higher CARs, whereas dual users had lower CARs than exclusively cigarette users over short-term and long-term periods. A telemedicine smoking cessation programme may be a reasonable option for exclusive HTP users.
1 Neuropsychiatry mavericks
Authors: David Anthony S
Published: December 2022

Professor David is among Britain’s preeminent psychiatrists and academics. His research in recent times has focused on schizophrenia, neuropsychiatry, medically unexplained syndromes and neuroimaging. He has particular interest and expertise in the concept and nature of ‘insight’ in schizophrenia, and its relation to treatment compliance and an individual’s decision-making capacity. Professor David is Director of the UCL Institute of Mental Health.

Professor David is a widely published author in influential peer-reviewed academic journals. He recently published his latest book, the acclaimed Into the Abyss: A Neuropsychiatrist’s Notes on Troubled Minds. Dr David has co-edited several books, including The Self in Neuroscience and Psychiatry and Insight and Psychosis. He is the co-editor of the journal Cognitive Neuropsychiatry.

Professor David is a founding member of both the British Neuropsychological Society and the British Neuropsychiatry Association – he was Chair of the latter organization between 2004 and 2007. In 2018, he delivered the inaugural lecture as part of the Kings Lectures series.

A maverick is an outsider who has rare qualities which may be highly valued in many areas of society. Empirical research has validated ‘maverickism’ as a recognisable personality type. Medicine and psychiatry have always attracted mavericks – neuropsychiatry in particular. Over the last 150 years there have been several notable examples who have a few key characteristics in common, but their contribution has been mostly negative, sometimes disastrously so. Modern mavericks continue to flourish perhaps aided by the loosening of bounds on science communication and governance but also because of the difficulty mainstream neuropsychiatry has in communicating the biopsychosocial approach in a way that satisfies some sufferers. The question is whether they can be a useful stimulus.
10 What can we learn from the nervous sequelae of past pandemics?
Authors: Honigsbaum Mark
Published: December 2022

Dr Mark Honigsbaum, medical historian and senior lecturer, City University of London. A regular contributor to The Observer & The Lancet, the author of five books including The Pandemic Century: One Hundred Years of Panic, Hysteria, and Hubris (New York and London: Norton; Hurst, 2019), The Fever Trail: In Search of the Cure for Malaria (Farrar Straus Giroux, 2002), and Living With Enza: The Forgotten Story of Britain and the Great Flu Pandemic of 1918 (Macmillan, 2009), which was longlisted for the Royal Society science book of the year in 2009. A specialist in the history of pandemics and infectious disease, his academic work combines insights from the medical and environmental humanities and the philosophy and sociology of science. His current research focuses on the phenomenon of ‘vaccine hesitancy’. Through case studies of recent vaccine controversies he seeks to understand the role that the media and partial or incomplete scientific knowledge of vaccines plays in suspicion of this valuable medical technology. He is also developing a project interrogating the phenomenon of pandemic remembrance and the tension between narrative framings of Covid-19 as a ‘crisis’ and collective experiences of grief and loss enabled by connective digital technologies.

Pandemics of respiratory disease have long been associated with peculiar fatigue states and an array of neurological conditions. However, in the absence of compelling biological evidence, in practice it has proved difficult to differentiate these post-viral syndromes from wider epidemiological signals and medical syndromes.

Focussing on the ‘Russian influenza’ pandemic of the 1890s, this talk examines the way in which Victorian nerve doctors sought to make sense of the peculiar nervous sequelae that trailed the pandemic. These sequels included nerve exhaustion, psychosis, insomnia and fatigue and, as with Long Covid, provoked disquisitions and disputes inThe Lancetand other medical journals.

Unlike Long Covid, however, men were more likely to fall prey to these syndromes than women. The result was that rather than stigmatizing male sufferers as malingerers, Victorian neurologists provided a functional diagnosis, the ‘psychoses of influenza’. Drawing on notions of ‘overwork’ and ‘overworry’ and theories of entropy, the psychoses closely resembled neurasthenia and, I argue, provided a similarly acceptable label for a spectrum of somatic and psychosomatic disorders.
12 Neuromodulation of intracranial physiological recordings and behaviour
Authors: Voon Valerie
Published: December 2022

Valerie runs research groups across Cambridge and Shanghai and holds professorships at Cambridge University and Fudan University. She is the current president of the BNPA. She focuses on interventional psychiatry anchored on mechanisms underlying self-control and repetitive behaviours relevant to addictions and compulsivity. Her research group focuses on identifying anatomical and functional biomarkers sensitive to invasive and non-invasive leading towards precision neuromodulation.

Deep brain stimulation is effective for treatment of refractory movement disorders and obsessive compulsive disorder with increasing interest in targeting neuropsychiatric disorders. This talk asks how we might optimize stimulation parameters and targeting to shift behavioural outcomes. I discuss physiological substrates underlying negative emotional processing, anticipation of reward and loss, and risk taking recorded using intracranial electrodes across a network from deep brain stimulation and stereotactic electroencephalography. I address how stimulation at specific frequencies might influence behavioural measures. These studies provide insight underlying the physiological network of these cognitive processes and ultimately leading towards optimizing neuromodulation parameters to treat clinical psychiatric disorders.
15 Attenuated heart-brain integration predicts functional non-epileptic seizures
Authors: Elkommos Samia , Martin-Lopez David , Koreki Akihiro , Jolliffe Claire , Mula Marco , Critchley Hugo , Edwards Mark , Garfinkel Sarah , Richardson Mark P , Yogarajah Mahinda
Published: December 2022

Objectives/Aims

Patients with functional seizures (FS) can experience dissociation (depersonalisation) before their seizures. Depersonalisation encompasses a feeling of disembodiment, putatively caused by reduced afferent visceral mapping, that is, changes in interoceptive processing. The heartbeat-evoked potential (HEP) is an electroencephalographic (EEG) index of synchronised neural responses to individual heartbeats, and a marker interoceptive representation. HEP amplitude is reported to be reduced in patients with depersonalisation-derealisation disorder. The objective of this study was to assess whether alterations in interoceptive processing indexed by the HEP occur prior to FSs, and compare this with epileptic seizures (ES).

Methods

HEP amplitudes were calculated from EEG during video-EEG monitoring in 25 patients with FS and 19 patients with ES, and compared between interictal and preictal states. HEP amplitudes were calculated at frontal and central EEG electrodes. HEP amplitude difference was calculated as a composite measure of preictal HEP amplitude minus interictal HEP amplitude. A Receiver Operating Characteristic (ROC) curve analysis was later used to evaluate the diagnostic performance of the HEP amplitude difference measure in discriminating functional cases from epilepsy cases.

Results

The FS group demonstrated a significant reduction in HEP amplitude between interictal and preictal states at F8 (effect size rB=0.612, p=0.006) and C4 (rB=0.600, p=0.007). No differences in HEP amplitude were found between interictal and preictal states in the ES group. Between diagnostic groups, HEP amplitude difference was significantly different between the FS and ES group at C4 (rB=0.457, p=0.009) and F8 (rB=0.423, p=0.017). These findings were not related to heart rate, mean ECG or QRS amplitudes, which did not differ between interictal/preictal states, or groups. There was no difference in age between FS and ES groups, however there were a greater proportion of females compared to males in the FS group as compared to the ES group. Using HEP amplitude difference at frontal and central electrodes plus sex as variables, the ROC curve demonstrated an area under the curve (AUC) of 0.893, with sensitivity=0.840 and specificity=0.842 (p=0.000).

Conclusions

Our data support the notion that aberrant interoception underpins disembodiment prior to dissociative FS. Changes in HEP amplitude may therefore reflect a neurophysiological biomarker of FS. HEP amplitude difference between interictal and preictal states may have diagnostic utility in differentiating FS and ES.
19 Group psychotherapy/guided self help for patients with FNSD awaiting in-patient MDT programme treatment: a pilot study
Authors: Boico Vasile , Humblestone Susan , Moutoussis Michael , Selai Caroline
Published: December 2022

Background

The 4-week in-patient Multi-Disciplinary Team Service at Queen Square for patients with Functional Neurological Symptom Disorder (FNSD) has input from Neuropsychiatrists, Occupational Therapists, Physiotherapists, Cognitive Behavioural Therapists, and specialist nursing staff.

The Queen Square Guided Self-Help (QGSH) was developed as a brief therapeutic intervention, which aims to ensure that, prior to admission, the patient understands (a) the diagnosis of FNSD and how their own diagnosis has been reached; (b) rehabilitation therapy, both physical and psychological, and (c) the use of goal setting in rehabilitation.

The QGSH is a course of Internet-based guided self-help. It runs for up to 12 weeks and includes original videos and patient worksheets, as well as signposting to existing published resources. It involves therapists guiding the patient to use a range of psychoeducational resources and facilitating therapy activities, supported by one-to-one contact via email or phone-calls.

With the emergence of the covid pandemic and the first lockdown (March 2020) plus the growing patient waiting lists, we decided to offer the QGSH (i) remotely via zoom (ii) to groups of patients instead of individuals. This required a complete review of the QGSH goals, format, aims and objectives which resulted in a number of modifications including extensive revisions to the current materials.

Aim of this study

We present a service evaluation of the first 8 months of running QGSH therapy groups remotely on zoom.

Results

(1) We present the modifications we made to the existing QGSH materials which were finalised in April 2021.

(2) In the period 11-May-2021 to 31-Jan-2022 we ran three groups with a total of 16 participants.

(3) We present challenges and advantages from the perspective of the patients and from the perspective of the QGSH therapists.

(4) Drawing on the published literature (Rogers, Yalom) plus our experiences as senior therapists, we outline the specialist knowledge, skills and competencies required to run a therapeutic group with patients with FNSD.

Discussion

Feedback from the patients who participated in the groups was overwhelmingly positive. From the patients’ comments, the group furnished 8/11 of Yalom’s curative factors. We outline our plans for the future development of the QGSH preparatory therapy and a new initiative: the development of a ‘stand-alone’ group therapy for patients with FNSD.
27 Prevalence of lower urinary tract dysfunction in consecutive patients attending a tertiary referral functional neurological disorders clinic in Edinburgh
Authors: Wittingham Charlotte , Hoeritzauer Ingrid , Barr Megan
Published: December 2022

Objectives/Aims

Functional neurological disorders are the second most common reason for outpatient review by a neurologist. The frequency of lower urinary tract symptoms in functional neurological disorders has not been described.

Our aim was to carry out a deep phenotyping of patients diagnosed with functional motor and/or dissociative symptoms and to record the prevalence of lower urinary tract dysfunction.

Methods

A retrospective notes review was undertaken involving consecutive patients attending a specialist functional neurological disorders clinic in Edinburgh between October 2019-February 2020 for non-urological presentation.

Results

In a one hundred and fifty-eight patient cohort, 78% of patients were female (n=123) and the mean age was 42. When categorising predominant functional symptoms, 52% of patients had a purely motor disorder (n=82), 17% of patients had a dissociative disorder alone (n=27) and 31% a mixed motor and dissociative disorder (n=49). Fifty percent of patients reported urinary symptoms (n=79). In total, 28% reported storage symptoms (n=45), 9% voiding symptoms (n=15), and 9% had mixed storage and voiding symptoms (n=15).

15% of patients attended a specialist clinic regarding their urinary symptoms (n= 23).

Patients with a motor disorder had the highest prevalence of lower urinary tract dysfunction (56%) and the dissociative group the lowest (26%). Storage symptoms were the most prevalent symptom (35% in motor, 15% in dissociative, 24% in mixed) and patients with storage or mixed LUTS were most likely to have a motor disorder (n=29, 64%; n=12, 80%), whereas those with voiding symptoms were more likely to have mixed functional neurological symptoms (n=10, 67%).

20% of patients reported urinary retention and/or voiding dysfunction (n = 32). 100% of these patients had motor or mixed symptoms.

11% of patients reported urinary retention (n=17) comprising 14 females and 3 men, with an average age of 36.4. 59% of patients with urinary retention were on opioid medication.

Conclusions

50% of patients with functional neurological disorders report lower urinary tract dysfunction however just 15% of patients attended a specialist clinic regarding their urinary symptoms.

This research has provided an insight into the potential associations between urological symptoms and functional neurology and may impact or change future management.