Oxley (United Kingdom)

Abstract Understanding the neural processes governing the human gut-brain connection has been challenging due to the inaccessibility of the body’s interior. Here, we investigated neural responses to gastrointestinal sensation using a minimally invasive mechanosensory probe by quantifying brain, stomach, and perceptual responses following the ingestion of a vibrating capsule. Participants successfully perceived capsule stimulation under two vibration conditions (normal and enhanced), as evidenced by above chance accuracy scores. Perceptual accuracy improved significantly during the enhanced relative to normal stimulation, which was associated with a more rapid detection of the stimulation and reduced reaction time variability. Stomach stimulation induced early and late neural responses in parieto-occipital leads near the midline. Moreover, these ‘gastric evoked potentials’ showed intensity-dependent increases in amplitude and were significantly correlated with perceptual accuracy. These findings highlight a unique form of enterically-focused sensory monitoring within the human brain, with implications for understanding gut-brain interactions in healthy and clinical populations.

Introduction: Endovascular therapy (EVT) has become the standard of care for treatment of emergent large vessel occlusion (ELVO) in ischemic stroke. It is a time sensitive procedure that has previously only been performed at comprehensive stroke centers (CSC). Transfer was required for patients presenting at a primary stroke center (PSC). PSCs with interventional capacity (PSCI) have emerged to increase access to EVT. We have developed a Mobile Interventional Stroke Team (MIST) model, in which a MIST transfers from a CSC to PSCI to perform EVT. Hypothesis: The delivery of care by the MIST at PSCIs is more time efficient and leads to improved clinical outcomes in comparison to transferring patients from a PSC to PSCI or CSC and comparable to direct presentation to a CSC. Methods: Analysis of prospectively collected data from 228 patients who received EVT for ELVO at a CSC or 4 PSCIs between June 2016 - December 2018 was performed. The cohorts include: Mothership with patient presentation to CSC (n=20), Drip-and-Ship with patient transfer from PSC or PSCI to CSC (DS) (n=114), MIST and patient presentation to PSCI (n=64), and DS with patient transfer from PSC to PSCI and MIST (DS/MIST) (n=30). The primary outcome was initial door-to-recanalization. Secondary outcomes measured other time intervals and clinical outcomes at discharge and 3 months. Results: MIST had a faster mean initial door-to-recanalization time than DS by 83 minutes (p < 0.05). MIST and Mothership had similar median times of 192 minutes and 181 minutes, respectively (p = 0.84). A greater proportion of patients reached a discharge NIHSS of 0 or 1 in MIST compared to DS (34% vs. 17%; p < 0.01). MIST led to 53% with a mRS of ≤ 2 at 3 months compared to 39% in DS, although not statistically significant (p = 0.10). Conclusions: MIST has led to significantly faster initial door-to-recanalization times compared to DS. This decrease in time has translated into improved short-term outcomes and a trend towards improved long-term outcomes.

This paper aims to analyze Portugal's structures of legality and corruption avoidance with a special look on compliance methods, its regulatory frameworks and challenges within a global corporate scenario that increasingly values government efficient tools.In order to achieve such purpose, it will be studied some international risk mitigation legal frameworks, such as the Greenbury report (1995), the Sarbenas Oxley Act ( 2004), and the Brazilian law n.12.846 (2013).Once overcomed the historical -normative scope, it will be questioned whether Portugal is in fact aligned with the international system of compliance and corporate governance.

Abstract BackgroundMajor depressive disorder (MDD) is associated with an increased risk of brain atrophy, aging-related diseases, and mortality. We examined potential advanced brain aging in MDD patients, and whether this process is associated with clinical characteristics in a large multi-center international dataset.MethodsWe performed a mega-analysis by pooling brain measures derived from T1-weighted MRI scans from 29 samples worldwide. Normative brain aging was estimated by predicting chronological age (10-75 years) from 7 subcortical volumes, 34 cortical thickness and 34 surface area, lateral ventricles and total intracranial volume measures separately in 1,147 male and 1,386 female controls from the ENIGMA MDD working group. The learned model parameters were applied to 1,089 male controls and 1,167 depressed males, and 1,326 female controls and 2,044 depressed females to obtain independent unbiased brain-based age predictions. The difference between predicted “brain age” and chronological age was calculated to indicate brain predicted age difference (brain-PAD).FindingsOn average, MDD patients showed a higher brain-PAD of +0.90 (SE 0.21) years (Cohen’s d=0.12, 95% CI 0.06-0.17) compared to controls. Relative to controls, first-episode and currently depressed patients showed higher brain-PAD (+1.2 [0.3] years), and the largest effect was observed in those with late-onset depression (+1.7 [0.7] years). In addition, higher brain-PAD was associated with higher self-reported depressive symptomatology (b=0.05, p=0.004).InterpretationThis highly powered collaborative effort showed subtle patterns of abnormal structural brain aging in MDD. Substantial within-group variance and overlap between groups were observed. Longitudinal studies of MDD and somatic health outcomes are needed to further assess the predictive value of these brain-PAD estimates.FundingThis work was supported, in part, by NIH grants U54 EB020403 and R01 MH116147.

The invasive Red Imported Fire Ant (Solenopsis invicta Buren) is well established at two locations in the Brisbane area, and we report a patient with anaphylaxis after a sting. The potential for anaphylactic events in Australia due to S. invicta will be greater than for native ants because of its unusual venom, its habit of forming supercolonies in grassy areas, and its aggressive group territorial defence, which can result in multiple stings.

Inventories of Ancient, Long-established, and Semi-natural, Woodland for Scotland. (Research and Survey in Nature Conservation, No 22.) Nature Conservancy Council, Northminster House, Peterborough, England, UK: 63 pp., 29.5 × 20.8 × 0.4 cm, 29 figs, 18 tables, card covers, £5.50, 1989. - Volume 17 Issue 4

Birds, Bogs and Forestry—The Peatlands of Caithness and Sutherland, by D.A. Stroud, T.M. Reed, M.W. Pienkowski & R.A. Lindsay. Nature Conservancy Council, Northminster House, Peterborough, England, UK: 121 pp., 29.5 × 20.8 × 1.0 cm, 28 photographic colour plates, 10 text figures, 17 maps, 10 tables, card covers, £10, 1987. - Volume 15 Issue 1

Institute of Terrestrial Ecology: Annual Report 1983. Natural Environment Research Council, 68 Hills Road, Cambridge, England, UK: 137 pp., 69 figures, 30 plates (23. in colour), 29 tables, 30 × 21 × 1.1 cm, stiff paper cover, £6, 1984. - Volume 12 Issue 2

A simple technique is described that enables the physical detail of an incandescent object to be photographed by using ultraviolet illumination.