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Rosenbaum RS, Halilova JG, Agnihotri S, D'Angelo MC, Winocur G, Ryan JD, Moscovitch M. Dramatic changes to well-known places go unnoticed. Neuropsychologia 2024; 196:108818. [PMID: 38355037 DOI: 10.1016/j.neuropsychologia.2024.108818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
How well do we know our city? It turns out, much more poorly than we might imagine. We used declarative memory and eye-tracking techniques to examine people's ability to detect modifications to real-world landmarks and scenes in Toronto locales with which they have had extensive experience. Participants were poor at identifying which scenes contained altered landmarks, whether the modification was to the landmarks' relative size, internal features, or relation to surrounding context. To determine whether an indirect measure would prove more sensitive, we tracked eye movements during viewing. Changes in overall visual exploration, but not to specific regions of change, were related to participants' explicit endorsement of scenes as modified. These results support the contention that very familiar landmarks are represented at a global or gist level, but not local or fine-grained, level. These findings offer a unified view of memory for gist across verbal and spatial domains, and across recent and remote memory, with implications for hippocampal-neocortical interactions.
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Affiliation(s)
- R S Rosenbaum
- York University, Toronto, ON, Canada; Rotman Research Institute, Baycrest, Toronto, ON, Canada.
| | | | - S Agnihotri
- York University, Toronto, ON, Canada; University of Toronto, ON, Canada
| | - M C D'Angelo
- Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | - G Winocur
- Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | - J D Ryan
- Rotman Research Institute, Baycrest, Toronto, ON, Canada; University of Toronto, ON, Canada
| | - M Moscovitch
- Rotman Research Institute, Baycrest, Toronto, ON, Canada; University of Toronto, ON, Canada
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Maharaj T, Fitzgerald N, Gilligan E, Quirke M, MacHale S, Ryan JD. Alcohol-related emergency department presentations and hospital admissions around the time of minimum unit pricing in Ireland. Public Health 2024; 227:38-41. [PMID: 38103275 DOI: 10.1016/j.puhe.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/22/2023] [Accepted: 11/08/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Minimum unit pricing (MUP) was recently introduced in Ireland to reduce alcohol-related harms. The size of the impact of alcohol on hospital emergency departments (EDs) in Ireland is poorly understood due to inconsistent alcohol screening and documentation. AIMS We sought to systematically characterise the volume, timing, and nature of alcohol-related presentations and admissions to a busy urban ED in Dublin, Ireland. METHOD Patients presenting to the ED were assessed by a dedicated clinician during selected time periods before (Nov-Dec 2021) and after (Feb-Apr 2022) the introduction of MUP. A total of 725 interviews were conducted over 168 h in the ED. FINDINGS Alcohol consumption was a factor in 19.4% of ED presentations and in 17.3% of hospital admissions across the entire study period. A reduction in overall alcohol-related ED presentations was noted in the period following MUP, although it is not possible to conclude a direct effect. CONCLUSION Alcohol-related harm places a significant strain on EDs and hospitals, and the impact of MUP on hospital burden in Ireland merits further evaluation. Effective measures at local and population levels are urgently required to address this burden.
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Affiliation(s)
- T Maharaj
- RCSI University of Medicine and Health Sciences, Dublin, Ireland; Hepatology Unit, Beaumont Hospital Dublin, Ireland.
| | - N Fitzgerald
- University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - E Gilligan
- Department of Liaison Psychiatry, Beaumont Hospital Dublin, Ireland
| | - M Quirke
- Emergency Department, Beaumont Hospital Dublin, Ireland
| | - S MacHale
- RCSI University of Medicine and Health Sciences, Dublin, Ireland; Department of Liaison Psychiatry, Beaumont Hospital Dublin, Ireland
| | - J D Ryan
- RCSI University of Medicine and Health Sciences, Dublin, Ireland; Hepatology Unit, Beaumont Hospital Dublin, Ireland
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Mitchnick KA, Ahmad Z, Mitchnick SD, Ryan JD, Rosenbaum RS, Freud E. Damage to the human dentate gyrus impairs the perceptual discrimination of complex, novel objects. Neuropsychologia 2022; 172:108238. [PMID: 35513066 DOI: 10.1016/j.neuropsychologia.2022.108238] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/25/2022] [Accepted: 04/07/2022] [Indexed: 11/19/2022]
Abstract
The hippocampus (HPC), and the dentate gyrus (DG) subregion in particular, is purported to be a pattern separator, orthogonally representing similar information so that distinct memories may be formed. The HPC may also be involved in complex perceptual discrimination. It is unclear if this role is limited to spatial/scene stimuli or extends to the discrimination of objects. Also unclear is whether the DG itself contributes to pattern separation beyond memory. BL, an individual with bilateral DG lesions, was previously shown to have poor discrimination of similar, everyday objects in memory. Here, we demonstrate that BL's deficit extends to complex perceptual discrimination of novel objects. Specifically, BL was presented with closely matched possible and impossible objects, which give rise to fundamentally different 3D perceptual representations despite being visually similar. BL performed significantly worse than controls when asked to select an odd object (e.g., impossible) amongst three identical counterpart objects (e.g., possible) presented at different rotations. His deficit was also evident in an atypical eye fixation pattern during this task. In contrast, BL's performance was indistinguishable from that of controls on other tasks involving the same objects, indicating that he could visually differentiate the object pairs, that he perceived the objects holistically in 3D, and that he has only a mild weakness in categorizing object possibility. Furthermore, his performance on standardized neuropsychological measures indicated intact mental rotation, visual-spatial attention, and working memory (visual and auditory). Collectively, these results provide evidence that the DG is necessary for complex perceptual discrimination of novel objects, indicating that the DG might function as a generic pattern separator of a wide range of stimuli within high-level perception, and that its role is not limited to memory.
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Affiliation(s)
- K A Mitchnick
- York University, Toronto, Canada; Rotman Research Institute at Baycrest Hospital, Toronto, Canada.
| | - Z Ahmad
- York University, Toronto, Canada
| | | | - J D Ryan
- Rotman Research Institute at Baycrest Hospital, Toronto, Canada
| | - R S Rosenbaum
- York University, Toronto, Canada; Rotman Research Institute at Baycrest Hospital, Toronto, Canada.
| | - E Freud
- York University, Toronto, Canada.
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Catháin DN, Ryan JD. Vocal Cord Icterus in Acute Liver Failure. Clin Gastroenterol Hepatol 2021; 19:A30. [PMID: 32712390 DOI: 10.1016/j.cgh.2020.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 02/07/2023]
Affiliation(s)
| | - John Denis Ryan
- Hepatology Unit, Beaumont Hospital, Dublin, Ireland; Royal College of Surgeons, Ireland
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Lowry D, Burke T, Galvin Z, Ryan JD, Russell J, Murphy A, Hegarty J, Stewart S, Crowe J. Is psychosocial and cognitive dysfunction misattributed to the virus in hepatitis C infection? Select psychosocial contributors identified. J Viral Hepat 2016; 23:584-95. [PMID: 27167497 DOI: 10.1111/jvh.12544] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 03/29/2016] [Indexed: 02/06/2023]
Abstract
Chronic hepatitis C is associated with health-related quality of life and cognitive impairments, even in mild disease. Recent evidence demonstrating hepatitis C virus (HCV) neurotropism has strengthened a neuropathophysiological hypothesis. However, sample heterogeneity confounds study outcomes. A uniquely homogeneous cohort of Irish women, following an iatrogenic HCV outbreak, offers a rare opportunity to control for HCV chronicity and the virus' purported impact on quality of life and cognition. A multi site, three-group, cross-sectional design was employed. Noncirrhotic, iatrogenically infected women, developing either acute or chronic infection, were recruited from prospective tertiary-care liver clinics and the community. Well-matched healthy controls were also recruited. All participants completed a psychosocial survey and were invited to undergo a comprehensive neuropsychological test battery. Significantly distressed psychosocial symptom profiles were observed in those with an iatrogenic HCV exposure history, which was independent of viral chronicity. Chronic and cleared HCV cohorts were not differentiated from each other. Two distinct subgroups, demarcated along 'impaired' vs 'nonimpaired' quality-of-life reports, were clearly identified and logistic regression analysis identified depressed mood and cognitive fatigue, rather than viral status, as statistically significant predictors of group membership. Compared with matched controls, significant cognitive impairments were not observed in either HCV cohort. Our findings provide strong evidence of nonviral factors accounting for quality of life impairment in chronic HCV and they also appear to question existing reports of cognitive dysfunction in mild disease. Depressed mood and cognitive fatigue appear to be critical psychosocial mediators of reduced quality-of-life and we hypothesize that metabolite abnormalities reported in HCV samples may also be confounded by these factors, given the associated literature.
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Affiliation(s)
- D Lowry
- Liver Centre, Mater Misericordiae University Hospital, Dublin 7, Ireland.,Cognitive and Behavioural Neuroscience Research Group, School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - T Burke
- Cognitive and Behavioural Neuroscience Research Group, School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland.,School of Nursing and Human Sciences, Dublin City University, Dublin 9, Ireland
| | - Z Galvin
- Liver Centre, Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - J D Ryan
- Liver Centre, Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - J Russell
- Liver Centre, Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - A Murphy
- Liver Unit, St. Vincent's University Hospital, Dublin 4, Ireland
| | - J Hegarty
- Liver Unit, St. Vincent's University Hospital, Dublin 4, Ireland
| | - S Stewart
- Liver Centre, Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - J Crowe
- Liver Centre, Mater Misericordiae University Hospital, Dublin 7, Ireland
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Ryan JD, Altamura S, Muckenthaler M, Crowe J. Reply: To PMID 22334511. Hepatology 2014; 59:1648-9. [PMID: 24122806 DOI: 10.1002/hep.26764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 09/19/2013] [Indexed: 12/07/2022]
Affiliation(s)
- John Denis Ryan
- Center for Liver Disease Mater Misericordiae, University Hospital Dublin, Ireland
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Bernstein CN, Ryan JD, Graff LA, Xu W. Commentary: predicting complicated Crohn's disease and surgery--phenotypes, genetics, serology and psychological characteristics of a population-based cohort--authors' reply. Aliment Pharmacol Ther 2013; 38:556-7. [PMID: 23937465 DOI: 10.1111/apt.12423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 07/01/2013] [Indexed: 12/29/2022]
Affiliation(s)
- C N Bernstein
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada.
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Ryan JD, Silverberg MS, Xu W, Graff LA, Targownik LE, Walker JR, Carr R, Clara I, Miller N, Rogala L, Bernstein CN. Predicting complicated Crohn's disease and surgery: phenotypes, genetics, serology and psychological characteristics of a population-based cohort. Aliment Pharmacol Ther 2013; 38:274-83. [PMID: 23725363 DOI: 10.1111/apt.12368] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 02/20/2013] [Accepted: 05/16/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Predictors of complicated Crohn's disease (CD), defined as stricturing or penetrating behaviour, and surgery have largely been derived from referral centre populations. AIM To investigate whether serological markers, susceptibility genes or psychological characteristics are associated with complicated CD or surgery in a population-based cohort. METHODS One hundred and eighty-two members of the Manitoba IBD Cohort with CD phenotyped using the Montreal classification underwent genetic and serological analysis at enrolment and after 5 years. One hundred and twenty-seven had paired sera at baseline and 5 years later and their data were used to predict outcomes at a median of 9.3 years. Serological analysis consisted of a seven antibody panel, and DNA was tested for CD-associated NOD2 variants (rs2066845,rs2076756,rs2066847), ATG16L1 (rs3828309, rs2241880) and IL23R (rs11465804). Psychological characteristics were assessed using semi-structured interviews and validated survey measures. RESULTS Sixty-five per cent had complicated CD and 42% underwent surgery. Multivariate analysis indicated that only ASCA IgG-positive serology was predictive of stricturing/penetrating behaviour (OR = 3.01; 95% CI: 1.28-7.09; P = 0.01) and ileal CD (OR = 2.2; 95% CI: 1.07-4.54, P = 0.03). Complicated CD behaviour was strongly associated with surgery (OR = 5.6; 95% CI: 2.43-12.91; P < 0.0001), whereas in multivariate analysis, only ASCA IgG was associated (OR = 2.66; 95% CI, 1.40-5.06, P = 0.003). ASCA titre results were similar at baseline and follow-up. Psychological characteristics were not significantly associated with disease behaviour, serological profile or genotype. CONCLUSIONS ASCA IgG at baseline was significantly associated with stricturing/penetrating disease at 9-10 years from diagnosis. Stricturing/penetrating disease was significantly associated with surgery. In a model including serology, the genotypes assessed did not significantly associate with complicated disease or surgery.
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Affiliation(s)
- J D Ryan
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
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Ryan JD, Joyce MR, Pierce C, Brannigan A, O'Connell PR. Haematoma in a hydrocele of the canal of Nuck mimicking a Richter's hernia. Hernia 2011; 13:643-5. [PMID: 19301083 DOI: 10.1007/s10029-009-0493-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2008] [Accepted: 02/23/2009] [Indexed: 11/24/2022]
Abstract
We report a haematoma in a hydrocele of the canal of Nuck in a 69-year-old female. She presented with a right-sided groin swelling, the differential for which included an irreducible inguinal hernia or haematoma given her aspirin and clopidegrel use. Successful treatment involved evacuation of the haematoma with excision of the sac. Despite a high index of suspicion for a haematoma, these swellings should ideally be explored given the potential for co-existence of a hernia.
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Affiliation(s)
- J D Ryan
- Department of Surgery, Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland
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Blayney MR, Ryan JD, Malins AF. Propofol target-controlled infusions for sedation--a safe technique for the non-anaesthetist? Br Dent J 2003; 194:450-2; discussion 443. [PMID: 12778100 DOI: 10.1038/sj.bdj.4810031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2002] [Accepted: 10/03/2002] [Indexed: 11/09/2022]
Abstract
OBJECTIVE As an alternative to general anaesthesia for dentistry.attention has been focused on other, apparently safer, methods of pain and anxiety control. We have undertaken a study to evaluate the safety and efficacy of intravenous sedation using propofol target-controlled infusions. DESIGN We describe a retrospective observational analysis of propofol conscious sedation as an adjunct to local anaesthesia for patients undergoing simple or surgical exodontia. All the patients were assessed,selected and treated according to standardized hospital sedation protocols. Experienced anaesthetists used a standard regimen, with ECG, pulse oximetry and non-invasive blood pressure monitoring. A standard sedation record was completed for each patient. The initial target plasma propofol concentration was set at 1.5 microg ml(-1), adjusted thereafter to achieve the desired level of sedation. Any adverse events were recorded. SETTING Birmingham Dental Hospital. SUBJECTS Three hundred consecutive sedation episodes in adult dental phobic patients requiring exodontia under local anaesthesia. RESULTS Sedation and treatment were satisfactorily completed in 297 patients. The mean target propofol concentration required was 2.1 microg ml(-1), (SD = 0.47 microg ml(-1), range 1 - 4 microg ml(-1)). General anaesthesia occurred in two cases (target concentration (TC) 2 microg ml(-1)), over sedation in 11 cases(TC 1 - 3 microg ml(-1)), and transient hypoxaemia in 7 cases (TC 1.8 - 2.5 microg ml(-1)). CONCLUSION Intravenous sedation with target-controlled propofol infusions is effective. However, significant adverse effects may occur at target concentrations below 2.1 microg ml(-1). Only anaesthetists working in an appropriate environment should practise this technique.
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Affiliation(s)
- M R Blayney
- Department of Anaesthesia, Noble's Isle of Man Hospital, Douglas, Isle of Man, Brisish Isles IM1 4QA.
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Abstract
Eye movements were monitored to assess memory for scenes indirectly (implicitly). Two eye movement-based memory phenomena were observed: (a) the repetition effect, a decrease in sampling of previously viewed scenes compared with new scenes, reflecting memory for those scenes, and (b) the relational manipulation effect, an increase in viewing of the regions where manipulations of relations among scene elements had occurred. In normal control subjects, the relational manipulation effect was expressed only in the absence of explicit awareness of the scene manipulations. Thus, memory representations of scenes contain information about relations among elements of the scenes, at least some of which is not accessible to verbal report. But amnesic patients with severe memory impairment failed to show the relational manipulation effect. Their failure to show any demonstrable memory for relations among the constituent elements of scenes suggests that amnesia involves a fundamental deficit in relational (declarative) memory processing.
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Affiliation(s)
- J D Ryan
- University of Illinois at Urbana-Champaign, USA
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Maness NO, Ryan JD, Mort AJ. Determination of the degree of methyl esterification of pectins in small samples by selective reduction of esterified galacturonic acid to galactose. Anal Biochem 1990; 185:346-52. [PMID: 2339791 DOI: 10.1016/0003-2697(90)90306-t] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A procedure for the determination of the degree of methyl esterification of pectin in virtually any sample is described. Samples were dissolved or suspended in 1 M imidazole buffer, pH 7.0, cooled on ice, and reduced with sodium borohydride. Quantitative reduction of samples was accomplished after 1 h using at least 20 mg sodium borohydride/mg sample. The degree of methyl esterification was determined by either the increase in galactose content as determined by GLC of the sugar or by the change in galacturonic acid content by colorimetric uronic acid analyses. Sample requirements were at least as low as 100 micrograms per determination by GLC or 2 to 3 mg per determination by colorimetric uronic acid analysis compared to 5 mg or more per determination for other published procedures. The degrees of methyl esterification determined by the methods described have compared very favorably with those determined by established methods.
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Affiliation(s)
- N O Maness
- Department of Biochemistry, Oklahoma State University, Stillwater 74078-0454
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