Color categories are not universal: replications and new evidence from a stone-age culture

The authors sought to replicate and extend the work of E. Rosch Heider (1972) on the Dani with a comparable group from Papua, New Guinea, who speak Berinmo, which has 5 basic color terms. Naming and memory for highly saturated focal, non-focal, and low-saturation stimuli from around the color space were investigated. Recognition of desaturated colors was affected by color vocabulary. When response bias was controlled, there was no recognition advantage for focal stimuli. Paired-associate learning also failed to show an advantage for focal stimuli. Categorical Perception effects for both English and Berinmo were found, but only at the boundaries of existing linguistic categories. It is concluded that possession of linguistic categories facilitates recognition and influences perceptual judgments.

Stress hormone and blood glucose response following acute stroke in the elderly

We studied the relation of reactive hyperglycemia, stress hormone response, and outcome in 23 consecutive elderly patients (median age 80 [range 75-92] years) following an acute first stroke. The median delay from the onset of the stroke to the first blood sample (day 0) was 9 (range 4-22) hours. Subsequent blood samples were taken, after fasting, for the determination of blood glucose, cortisol, catecholamine, insulin, C-peptide, glucagon, and lactate concentrations on days 1, 2, 3, 7, 14, 30, and 90. For all 23 patients, a significant relation was found between the blood glucose concentration and survival (p = 0.03) and the blood glucose concentration decreased with time (p less than 0.001). There was also a significant relation between blood glucose concentration and outcome (p = 0.02). For the 15 patients with complete data, the major determinants of the blood glucose concentration were the cortisol, insulin, and glucagon concentrations (all p less than 0.001), which accounted for 42% of the variance. When all the indexes were analyzed together by logistic regression, only the cortisol concentration was related to outcome (p = 0.02). Hyperglycemia following a stroke probably reflects the intensity of the stress hormone response. We have confirmed that hyperglycemia is a predictor of outcome in persons with stroke.

A randomised controlled trial and cost analysis of problem-solving treatment for emotional disorders given by community nurses in primary care

BACKGROUND

We set out to investigate whether community nurses could be trained in problem-solving therapy and, once trained, how effective they would be in treating emotional disorders in primary care.

METHOD

Seventy patients with an emotional disorder in primary care were randomly allocated to receive either problem-solving therapy from a trained community nurse or treatment as usual from their general practitioner. Interview and self-rated assessments of clinical and economic outcome were made pretreatment, at eight weeks and at 26 weeks after treatment.

RESULTS

There was no difference in clinical outcome between patients who received problem-solving treatment and patients who received the general practitioner's usual treatment. However, patients who received problem-solving treatment had fewer disability days and fewer days off work. The health care cost of problem-solving was greater than that of the general practitioner's usual treatment but this was more than offset by savings in the cost of days off work.

CONCLUSIONS

Problem-solving treatment can be given by trained community nurses. The clinical effectiveness and cost-benefit of the treatment will depend on the selection of appropriate patients.

A British Society of Paediatric Gastroenterology, Hepatology and Nutrition survey of the effectiveness and safety of adalimumab in children with inflammatory bowel disease

BACKGROUND

Adalimumab is efficacious therapy for adults with Crohn's disease (CD).

AIM

To summarise the United Kingdom and Republic of Ireland paediatric adalimumab experience.

METHODS

British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) members with Inflammatory Bowel Disease (IBD) patients <18 years old commencing adalimumab with at least 4 weeks follow-up. Patient demographics and details of treatment were then collected. Response and remission was assessed using the Paediatric Crohn's Disease Activity Index (PCDAI)/Physicians Global Assessment (PGA).

RESULTS

Seventy-two patients [70 CD, 1 ulcerative colitis (UC), 1 IBD unclassified (IBDU)] from 19 paediatric-centres received adalimumab at a median age of 14.8 (IQR 3.1, range 6.1-17.8) years; 66/70 CD (94%) had previously received infliximab. A dose of 80 mg then 40 mg was used for induction in 41(59%) and 40 mg fortnightly for maintenance in 61 (90%). Remission rates were 24%, 58% and 41% at 1, 6 and 12 months, respectively. Overall 43 (61%) went into remission at some point, with 24 (35%) requiring escalation of therapy. Remission rates were higher in those on concomitant immunosuppression cf. those not on immunosuppression [34/46 (74%) vs. 9/24 (37%), respectively, (χ(2) 8.8, P=0.003)]. There were 15 adverse events (21%) including four (6%) serious adverse events with two sepsis related deaths in patients who were also on immunosuppression and home parenteral nutrition (3% mortality rate).

CONCLUSIONS

Adalimumab is useful in treatment of refractory paediatric patients with a remission rate of 61%. This treatment benefit should be balanced against side effects, including in this study a 3% mortality rate.

Age changes in the human female urethra: a morphometric study

Aging in the human female urethra can contribute towards urinary problems. To our knowledge the effect of age on urethral tissues has not been quantified previously. Histological sections were prepared from 8 regions along the length of the urethra from 26 women between 19 and 88 years old. Using quantitative morphological techniques the relative volume fractions of various tissue components were determined. As age increased there was a decrease in the relative volume of striated muscle and blood vessels, and an increase in the relative volume of connective tissue. There was no change in the smooth muscle components. These age changes in the human female urethra may lead to impairment of urethral function.

Color categories are not universal: replications and new evidence from a stone-age culture

The authors sought to replicate and extend the work of E. Rosch Heider (1972) on the Dani with a comparable group from Papua, New Guinea, who speak Berinmo, which has 5 basic color terms. Naming and memory for highly saturated focal, non-focal, and low-saturation stimuli from around the color space were investigated. Recognition of desaturated colors was affected by color vocabulary. When response bias was controlled, there was no recognition advantage for focal stimuli. Paired-associate learning also failed to show an advantage for focal stimuli. Categorical Perception effects for both English and Berinmo were found, but only at the boundaries of existing linguistic categories. It is concluded that possession of linguistic categories facilitates recognition and influences perceptual judgments.

Plasma arginine vasopressin in dehydrated elderly patients

Plasma arginine vasopressin was assessed by radioimmunoassay in dehydrated elderly patients and healthy young and elderly control subjects. The elderly control subjects' AVP levels were higher than the young control subjects (Kruskal-Wallis rank sums z = 3.29; P less than 0.001). Despite similar plasma osmolalities, after correction for the osmotic contribution of urea, the patients' AVP levels were higher than the elderly controls (z = 4.16; P less than 0.001) and were in the range reported to evoke a maximal antidiuretic response. It is concluded that the dehydration which often accompanies acute illness in the elderly is not primarily a consequence of inadequate AVP release.

Age-associated alterations in thirst and arginine vasopressin in response to a water or sodium load

We have examined simultaneous changes in thirst, plasma osmolality and arginine vasopressin, after oral water loading or hypertonic saline infusion. The studies were carried out in the same subjects, comprising young controls aged 26.8 years (SD 4.8, n = 10) and health status-defined elderly people aged 72.1 years (SD 3.1, n = 10). Water loading caused significant falls in plasma osmolality (p < 0.001) and thirst (p < 0.001), but there was no variation with age. Infusion with 462 mmol/l of sodium chloride increased plasma osmolality significantly (p < 0.001), but there was no variation with age (p = 0.12). The perception of thirst during the osmotic loading experiment was recorded differently by the two age groups (p < 0.0001). However, linear regression analysis showed no age difference in the relationship between thirst and plasma osmolality during osmotic loading. During osmotic loading the relationship between the plasma concentration of arginine vasopressin in response to increasing plasma osmolality varied significantly (slope: p = 0.02; intercept: p = 0.02). Plasma arginine vasopressin rose more rapidly with increasing plasma osmolality in old subjects.

Multiple somatic symptoms predict impaired health status in functional somatic syndromes

BACKGROUND

The relationship between functional somatic syndromes and multiple somatic symptoms is unclear.

PURPOSE

We assessed whether the number of somatic symptoms is a predictor of health status in three functional somatic syndromes (FSS).

METHODS

In a population-based study of 990 UK adults we assessed chronic widespread pain (CWP), chronic fatigue (CF) and irritable bowel syndrome (IBS) by questionnaire and medical record data. We assessed health status (Short Form 12 and EQ-5D), number of somatic symptoms (Somatic Symptom Inventory) and anxiety/depression (Hospital Anxiety and Depression Scale) both at baseline and at follow-up 1 year later.

RESULTS

The proportion of people with an FSS who also have multiple somatic symptoms (52-55 %) was similar in the three functional syndromes. The presence of multiple somatic symptoms was associated with more impaired health status both at baseline and at follow-up. This finding was not explained by severity of FSS. In the absence of multiple somatic symptoms, the health status of the FSS was fair or good. In multiple regression analysis, the number of somatic symptoms, the presence of a functional syndrome (CWP or CF) and anxiety/depression were predictors of EQ-5D thermometer at follow-up after adjustment for confounders.

CONCLUSIONS

Multiple somatic symptoms in people with an FSS are associated with impaired health status and this cannot be explained by more severe functional syndrome or the presence of anxiety and depression.

Reduced survival with increasing plasma osmolality in elderly continuing-care patients

The results reported here are from a 2-year follow-up study of 58 elderly patients in a continuing-care unit. Most of these patients were in a hyperosmolar state at the time of entry (mean plasma osmolality 304 +/- 8 mOsmol/kg). The survival of those patients with the highest osmolality (greater than 308 mOsmol/kg) was significantly reduced (p = 0.025), with an increased mortality at 2 years (15/20 patients, p = 0.053). There was no correlation between age and plasma osmolality (r = 0.02) and the effect of osmolality on survival was independent of age. Hyperosmolality was either a marker for, or a cause of, increased mortality in this group of frail elderly patients.

Cardiovascular haemodynamics and the response of vasopressin, aldosterone, plasma renin activity and plasma catecholamines to head-up tilt in young and old healthy subjects

Increasing age impairs the regulation of blood pressure during posture change. The neuro-humoral and cardiovascular responses to head-up tilt were analysed in carefully-screened young and healthy elderly individuals. Mean blood pressure was significantly higher in the elderly but there were no differences in total peripheral resistance, heart rate, stroke volume and cardiac index. Age-related interactions were observed in the control of mean blood pressure, heart rate and stroke volume. Total peripheral resistance increased and cardiac index decreased but there was no difference in their control in the young and old. Noradrenaline, vasopressin, plasma renin activity and aldosterone all increased in response to the tilt. These observations indicate differences in the neuroendocrine responses and cardiovascular haemodynamics of young and old healthy individuals to head-up tilt and are particularly important because of all observations were made simultaneously in the same subject. It is suggested that a similar approach should be adopted in the investigation of patients with postural hypotension.

The effect of lipofuscin on cellular function

The neurons of the supraoptic nucleus of male C57BL/Icrfat mice at 6 or 28 months of age were examined from normally hydrated, osmotically loaded and osmotically loaded-rehydrated animals. Using quantitative morphological techniques, a reduction in the concentration of lipofuscin in the neurons was observed in osmotically loaded mice at both ages, and these levels were restored to control values during rehydration. In addition, there was a significant difference in the pattern of response of lipofuscin levels between the two age groups during the experiment. The concentration of hormone containing neurosecretory granules in the neurons of the supraoptic nucleus did not differ significantly between the two age groups during the experiment. However, the surface area of rough endoplasmic reticulum per unit volume of the supraoptic nucleus cell did differ significantly between the two age groups over the course of the experiment. It is concluded that increasing concentrations of lipofuscin do not affect the ability of the cell to control the concentration of neurosecretory granules or rough endoplasmic reticulum. The simplistic view that lipofuscin accumulates with age to the detriment of cell function must be revised.

The influence of age on the hypothalamo-neurohypophyseal system of the mouse: a quantitative ultrastructural analysis of the supraoptic nucleus

A quantitative study of various morphological parameters in endocrine cells of the neuroendocrine region of the laboratory mouse was carried out. The supraoptic nucleus of the hypothalamo-neurohypophyseal system synthesises the hormones vasopressin and, to a lesser extent, oxytocin, and transports them to the posterior pituitary. Female C57BL/Icrfat mice at 8 and 26 months of age, free of macroscopic pathology, were sampled when in a physiologically defined resting state. No significant differences in the volume fractions of most cell and subcellular components could be detected at the two ages studied; however, significant increases in the volume fractions of hormone-containing granules and lipofuscin (aging pigment) were demonstrated in older animals. These observations are similar to those made on rat endocrine pancreas also in the resting state. The notion that these hormone-secreting cells are "protected" to some extent from the aging process, and may have some of the qualities of "pace-maker" cells, is discussed.

Circulating ghrelin exists in both lipoprotein bound and free forms

Introduction

Ghrelin is a gastric peptide that has been implicated in the development of obesity and cardiovascular disease. It has been reported that ghrelin binds to lipoproteins, although the different binding patterns of acylated ghrelin (AG) and unacylated ghrelin (UAG) are still to be determined.

Methods

Lipoprotein fractions were generated using a self-generating iodixanol gradient. AG and UAG were measured using specific enzyme immunoassays.

Results

AG bound to all lipoproteins in approximately equal concentrations (VLDL 26%, LDL 22%, HDL 23%) and was present as a plasma protein (27%). UAG bound more specifically to HDL (49%) and was present as a plasma protein (48%).

Conclusions

The different binding patterns of AG and UAG may have significant implications for their biological effects, including roles in energy metabolism, the development of obesity and potentially in the modulation of cardiovascular disease.

Oedema and glial cell involvement in the aged mouse brain after permanent focal ischaemia

This study examines the effect of age on oedema and brain swelling, and associated glial cell involvement on the size of the lesion in two models of permanent, focal cerebral ischaemia. Ischaemia was induced in male C57BL/Icrfat mice (4-6 and 26-31-month-old) by middle cerebral artery (MCA) occlusion using either electrocoagulation after craniotomy (MCA/craniotomy), or by an intraluminal filament through the carotid artery (MCA/icf). Twenty-four hours after inducing ischaemia, brain swelling and lesion size were measured in young and aged mice, and cerebral oedema by wet/dry brain weights. Histopathology and immunocytochemistry were performed on a separate set of perfusion fixed brains. The MCA/icf technique produced a significantly larger lesion than MCA/craniotomy in both age groups. The percentage of water taken into the brain was significantly greater after MCA/icf, with aged mice showing the greatest increase. When lesion size was corrected for brain swelling there was no age-related increase in the size of the lesion. The numbers of microglia and astroglia increased significantly in the parietal cortex of aged control animals, and there were qualitative differences in the glial response between the two stroke models. This study emphasizes the importance of age in models of permanent focal ischaemia, with oedema clearly being a significant factor. Differ-ences in the responsiveness of the glial cell population with age may be of fundamental importance in the progress of ischaemic brain damage.

Perceptual learning of stereoacuity

It has often been noted that with repeated exposure to random-dot stereograms the time required to perceived depth decreases. Further, with extensive practice, stereoacuity thresholds have been shown to decrease. For both types of learning some researchers have reported specificity of the improvements to retinal location, and have thus suggested that the learning may be localised at early levels of visual processing, such as in primary visual cortex. However, these studies have not adequately ruled out the possibility that the specificity shown may be due to the operation of selective-spatial-attention mechanisms. In the present study this possibility was examined by training observers to judge the relative depth of a pair of stereograms presented equally often in two spatial locations, but stimuli were only presented with one direction of disparity (ie crossed or uncrossed) in any one location. Results indicated that, as expected, observers' judgements improved with practice. However, this improvement transferred completely to stimuli presented with the other direction of disparity in each location. Thus, it is argued that previous findings of retinal-location-specific improvements in stereoacuity may well be due to selective-spatial-attention mechanisms, rather than to learning localised at an early level of visual processing.

The influence of age and dementia of the neurone population of the mammillary bodies

In a study on the influence of age and senile dementia on the mammillary bodies, the medial mammillary nucleus was examined in 15 brains from young (control), normal aged and demented females. Neurone populations, volumes and cell densities were estimated. Individual variation was high in all the groups studied. Normal ageing and dementia were accompanied by a substantial loss of volume but no significant loss of neurones, resulting in a considerable increase in cell density. No significant differences were detectable between the normal aged group and the demented group. These findings are in agreement with other investigators who have found no neuronal loss with age in discrete nuclear structures.

Fluid balance in elderly patients following acute stroke

We studied the relationship between plasma osmolality, arginine vasopressin (AVP), and fluid input in patients during the acute phase of a first stroke. Fifteen consecutive patients were studied (median age 79) and their blood sampled on days 0, 1, 2, 3, 7 and 14. Plasma osmolality was related to fluid input over days 0-3 (p = 0.0013) and AVP over 14 days (p less than 0.001). Patients with a poor outcome had higher AVP concentrations (p = 0.02). Those on intravenous fluids received a higher volume (p less than 0.01) and had a lower plasma osmolality (p = 0.04). The results of this preliminary study indicate that a standard regime for fluid input is inappropriate.

Wildfires, fuel treatment and risk mitigation in Australian eucalypt forests: insights from landscape-scale simulation

Wildfires pose significant risks to people and human infrastructure worldwide. The treatment of fuel in landscapes may alter these risks but the magnitude of this effect on risk is poorly understood. Evidence from Australian Eucalyptus forests suggests that mitigation of risk using prescribed burning as a fuel treatment is partial because weather and fuel dynamics are conducive to regular high intensity fires. We further examine the response of risk to treatment in eucalypt forests using landscape simulation modelling. We model how five key measures of wildfire activity that govern risk to people and property may respond to variations in rate and spatial pattern of prescribed fire. We then model effects of predicted climate change (2050 scenarios) to determine how the response of risk to treatment is likely to be altered in the future. The results indicate that a halving of risk to people and property in these forests is likely to require treatment rates of 7-10% of the area of the landscape per annum. Projections of 2050 weather conditions under climate change further substantially diminished the effect of rate of treatment. A large increase in rates of treatment (i.e. circa. 50% over current levels) would be required to counteract these effects of climate change. Such levels of prescribed burning are unlikely to be financially feasible across eucalypt dominated vegetation in south eastern Australia. Despite policy imperatives to expand fuel treatment, a reduction rather than an elimination of risk will result. Multi-faceted strategies will therefore be required for the management of risk.

Impact of Schmallenberg virus on British sheep farms during the 2011/2012 lambing season

British sheep farmers were invited to complete a questionnaire about the impact of Schmallenberg virus (SBV) on animal health, welfare and their own emotional wellbeing during the 2011–2012 lambing season, through Defra and Farming Industry websites, letters to farmers who had requested SBV laboratory tests and advertisement at Sheep 2012. The 494 responders included SBV confirmed (positive by RT-PCR) (n=76), SBV suspected by farmer (n=140) or SBV not suspected (n=278). Percentage of barren ewes was similar across SBV groups, however, lamb and ewe losses were higher on responder farms where SBV was confirmed or suspected. The median percentages of all lambs born (and lambs born deformed ) that died within one week of birth was 10.4 per cent (5.5 per cent), 7.0 per cent (2.9 per cent) and 5.3 per cent (0 per cent), respectively, on SBV confirmed, suspected and not suspected farms (P<0.001). Eight to 16 per cent of SBV confirmed or suspected farms reported lamb mortality of ≥40 per cent. Farmer perceived impact was greater where SBV was confirmed or suspected (P<0.001): 25 per cent reported a high impact on emotional wellbeing (4 per cent of SBV not suspected), 13 per cent reported a high impact on flock welfare and financial performance and 6 per cent were less likely to farm sheep next year because of SBV (<2 per cent in SBV not suspected). Overall, SBV impact has been large relative to reported sheep loss.

Cardiovascular response to graded lower body negative pressure in young and elderly man

Lower body negative pressure (LBNP) reduces central venous pressure (CVP) and cardiac output. The elderly are reported to have a limited capacity to increase cardiac output by increasing heart rate (HR), are especially dependent on end diastolic volume to maintain stroke volume and therefore should be especially vulnerable to LBNP. The present study compared the effects of LBNP in the young and old. Stroke volume was assessed non-invasively as stroke distance (SD) by aortovelography. Two groups of healthy male volunteers were studied: eight young (29.7 +/- 2.0 years, mean +/- S.E.M.) and nine old (70.1 +/- 0.9 years). LBNP was applied progressively at 17.5, 35 and 50 mmHg in 20 min steps, with measurements taken during each steady state. There were similar, significant, falls in CVP in both groups. SD fell significantly in both groups from respective control values of 24.8 +/- 1.6 and 16.6 +/- 0.9 cm to 12.5 +/- 1.3 and 8.9 +/- 0.4 cm at a LBNP of 50 mmHg. Although SD in the elderly was significantly lower than in the young, the LBNP-induced changes were not different between groups. Both groups produced similar significant increases in vascular resistance, HR, plasma vasopressin (AVP) and noradrenaline. Mean arterial blood pressure (MBP) and plasma adrenaline did not change significantly. Therefore healthy old men respond to LBNP in a similar manner to the young, although MBP and SD are regulated around different baselines in the two groups.