Showing papers by "University College London published in 2001"

Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis

Abstract: The International Panel on MS Diagnosis presents revised diagnostic criteria for multiple sclerosis (MS). The focus remains on the objective demonstration of dissemination of lesions in both time and space. Magnetic resonance imaging is integrated with dinical and other paraclinical diagnostic methods. The revised criteria facilitate the diagnosis of MS in patients with a variety of presentations, including "monosymptomatic" disease suggestive of MS, disease with a typical relapsing-remitting course, and disease with insidious progression, without clear attacks and remissions. Previously used terms such as "clinically definite" and "probable MS" are no longer recommended. The outcome of a diagnostic evaluation is either MS, "possible MS" (for those at risk for MS, but for whom diagnostic evaluation is equivocal), or "not MS."

Current concepts in mild cognitive impairment.

Abstract: The field of aging and dementia is focusing on the characterization of the earliest stages of cognitive impairment. Recent research has identified a transitional state between the cognitive changes of normal aging and Alzheimer's disease (AD), known as mild cognitive impairment (MCI). Mild cognitive impairment refers to the clinical condition between normal aging and AD in which persons experience memory loss to a greater extent than one would expect for age, yet they do not meet currently accepted criteria for clinically probable AD. When these persons are observed longitudinally, they progress to clinically probable AD at a considerably accelerated rate compared with healthy age-matched individuals. Consequently, this condition has been recognized as suitable for possible therapeutic intervention, and several multicenter international treatment trials are under way. Because this is a topic of intense interest, a group of experts on aging and MCI from around the world in the fields of neurology, psychiatry, geriatrics, neuropsychology, neuroimaging, neuropathology, clinical trials, and ethics was convened to summarize the current state of the field of MCI. Participants reviewed the world scientific literature on aging and MCI and summarized the various topics with respect to available evidence on MCI. Diagnostic criteria and clinical outcomes of these subjects are available in the literature. Mild cognitive impairment is believed to be a high-risk condition for the development of clinically probable AD. Heterogeneity in the use of the term was recognized, and subclassifications were suggested. While no treatments are recommended for MCI currently, clinical trials regarding potential therapies are under way. Recommendations concerning ethical issues in the diagnosis and the management of subjects with MCI were made.

The causes of land-use and land-cover change: moving beyond the myths

Abstract: Common understanding of the causes of land-use and land-cover change is dominated by simplifications which, in turn, underlie many environment-development policies. This article tracks some of the major myths on driving forces of land-cover change and proposes alternative pathways of change that are better supported by case study evidence. Cases reviewed support the conclusion that neither population nor poverty alone constitute the sole and major underlying causes of land-cover change worldwide. Rather, peoples’ responses to economic opportunities, as mediated by institutional factors, drive land-cover changes. Opportunities and

An Energy Budget for Signaling in the Grey Matter of the Brain

Abstract: Anatomic and physiologic data are used to analyze the energy expenditure on different components of excitatory signaling in the grey matter of rodent brain. Action potentials and postsynaptic effects of glutamate are predicted to consume much of the energy (47% and 34%, respectively), with the resting potential consuming a smaller amount (13%), and glutamate recycling using only 3%. Energy usage depends strongly on action potential rate--an increase in activity of 1 action potential/cortical neuron/s will raise oxygen consumption by 145 mL/100 g grey matter/h. The energy expended on signaling is a large fraction of the total energy used by the brain; this favors the use of energy efficient neural codes and wiring patterns. Our estimates of energy usage predict the use of distributed codes, with

Adverse events in british hospitals: preliminary retrospective record review

Abstract: Objectives: To examine the feasibility of detecting adverse events through record review in British hospitals and to make preliminary estimates of the incidence and costs of adverse events. Design: Retrospective review of 1014 medical and nursing records. Setting: Two acute hospitals in Greater London area. Main outcome measure: Number of adverse events. Results: 110 (10.8%) patients experienced an adverse event, with an overall rate of adverse events of 11.7% when multiple adverse events were included. About half of these events were judged preventable with ordinary standards of care. A third of adverse events led to moderate or greater disability or death. Conclusions: These results suggest that adverse events are a serious source of harm to patients and a large drain on NHS resources. Some are major events; others are frequent, minor events that go unnoticed in routine clinical care but together have massive economic consequences

Trait emotional intelligence: Psychometric investigation with reference to established trait taxonomies.

Abstract: This paper sets out the theoretical foundation of emotional intelligence (EI) as a constellation of traits and self‐perceived abilities. The discriminant validity of trait EI is explored in two stu...

ALSPAC--the Avon Longitudinal Study of Parents and Children. I. Study methodology.

Abstract: ALSPAC (The Avon Longitudinal Study of Parents and Children, formerly the Avon Longitudinal Study of Pregnancy and Childhood) was specifically designed to determine ways in which the individual's genotype combines with environmental pressures to influence health and development. To date, there are comprehensive data on approximately 10,000 children and their parents, from early pregnancy until the children are aged between 8 and 9. The study aims to continue to collect detailed data on the children as they go through puberty noting, in particular, changes in anthropometry, attitudes and behaviour, fitness and other cardiovascular risk factors, bone mineralisation, allergic symptoms and mental health. The study started early during pregnancy and collected very detailed data from the mother and her partner before the child was born. This not only provided accurate data on concurrent features, especially medication, symptoms, diet and lifestyle, attitudes and behaviour, social and environmental features, but was unbiased by parental knowledge of any problems that the child might develop. From the time of the child's birth many different aspects of the child's environment have been monitored and a wide range of phenotypic data collected. By virtue of being based in one geographic area, linkage to medical and educational records is relatively simple, and hands-on assessments of children and parents using local facilities has the advantage of high quality control. The comprehensiveness of the ALSPAC approach with a total population sample unselected by disease status, and the availability of parental genotypes, provides an adequate sample for statistical analysis and for avoiding spurious results. The study has an open policy in regard to collaboration within strict confidentiality rules.

Extension of Life-Span by Loss of CHICO, a Drosophila Insulin Receptor Substrate Protein

Abstract: The Drosophila melanogaster gene chico encodes an insulin receptor substrate that functions in an insulin/insulin-like growth factor (IGF) signaling pathway. In the nematode Caenorhabditis elegans, insulin/IGF signaling regulates adult longevity. We found that mutation of chico extends fruit fly median life-span by up to 48% in homozygotes and 36% in heterozygotes. Extension of life-span was not a result of impaired oogenesis in chico females, nor was it consistently correlated with increased stress resistance. The dwarf phenotype of chico homozygotes was also unnecessary for extension of life-span. The role of insulin/IGF signaling in regulating animal aging is therefore evolutionarily conserved.

Human hypertension caused by mutations in WNK kinases

Abstract: Hypertension is a major public health problem of largely unknown cause. Here, we identify two genes causing pseudohypoaldosteronism type II, a Mendelian trait featuring hypertension, increased renal salt reabsorption, and impaired K+ and H+ excretion. Both genes encode members of the WNK family of serine-threonine kinases. Disease-causing mutations in WNK1 are large intronic deletions that increase WNK1 expression. The mutations in WNK4 are missense, which cluster in a short, highly conserved segment of the encoded protein. Both proteins localize to the distal nephron, a kidney segment involved in salt, K+, and pH homeostasis. WNK1 is cytoplasmic, whereas WNK4 localizes to tight junctions. The WNK kinases and their associated signaling pathway(s) may offer new targets for the development of antihypertensive drugs.

Development of the Children's Eating Behaviour Questionnaire

Abstract: Individual differences in several aspects of eating style have been implicated in the development of weight problems in children and adults, but there are presently no reliable and valid scales that assess a range of dimensions of eating style. This paper describes the development and preliminary validation of a parent-rated instrument to assess eight dimensions of eating style in children; the Children's Eating Behaviour Questionnaire (CEBQ). Constructs for inclusion were derived both from the existing literature on eating behaviour in children and adults, and from interviews with parents. They included reponsiveness to food, enjoyment of food, satiety responsiveness, slowness in eating, fussiness, emotional overeating, emotional undereating, and desire for drinks. A. large pool of items covering each of these: constructs was developed. The number of items was then successively culled through analysis of responses from three samples of families of young children (N = 131; N = 187, N = 218), to produce a 35-item instrument with eight scales which were internally valid and had good test-retest reliability. Investigation of variations by gender and age revealed only minimal gender differences in any aspect of eating style. Satiety responsiveness and slowness in eating diminished from age 3 to 8. Enjoyment of food and food responsiveness increased over this age range. The CEBQ should provide a useful measure of eating style for research into the early precursors of obesity or eating disorders. This is especially important in relation to the growing evidence for the heritability of obesity, where good measurement of the associated behavioural phenotype will be crucial in investigating the contribution of inherited variations in eating behaviour to the process of weight gain.

Spin ice state in frustrated magnetic pyrochlore materials.

Abstract: A frustrated system is one whose symmetry precludes the possibility that every pairwise interaction (“bond”) in the system can be satisfied at the same time. Such systems are common in all areas of physical and biological science. In the most extreme cases, they can have a disordered ground state with “macroscopic” degeneracy; that is, one that comprises a huge number of equivalent states of the same energy. Pauling9s description of the low-temperature proton disorder in water ice was perhaps the first recognition of this phenomenon and remains the paradigm. In recent years, a new class of magnetic substance has been characterized, in which the disorder of the magnetic moments at low temperatures is precisely analogous to the proton disorder in water ice. These substances, known as spin ice materials, are perhaps the “cleanest” examples of such highly frustrated systems yet discovered. They offer an unparalleled opportunity for the study of frustration in magnetic systems at both an experimental and a theoretical level. This article describes the essential physics of spin ice, as it is currently understood, and identifies new avenues for future research on related materials and models.

Interleukin-1β-mediated induction of Cox-2 in the CNS contributes to inflammatory pain hypersensitivity

Abstract: Inflammation causes the induction of cyclooxygenase-2 (Cox-2), leading to the release of prostanoids, which sensitize peripheral nociceptor terminals and produce localized pain hypersensitivity. Peripheral inflammation also generates pain hypersensitivity in neighbouring uninjured tissue (secondary hyperalgesia), because of increased neuronal excitability in the spinal cord (central sensitization), and a syndrome comprising diffuse muscle and joint pain, fever, lethargy and anorexia. Here we show that Cox-2 may be involved in these central nervous system (CNS) responses, by finding a widespread induction of Cox-2 expression in spinal cord neurons and in other regions of the CNS, elevating prostaglandin E2 (PGE2) levels in the cerebrospinal fluid. The major inducer of central Cox-2 upregulation is interleukin-1beta in the CNS, and as basal phospholipase A2 activity in the CNS does not change with peripheral inflammation, Cox-2 levels must regulate central prostanoid production. Intraspinal administration of an interleukin-converting enzyme or Cox-2 inhibitor decreases inflammation-induced central PGE2 levels and mechanical hyperalgesia. Thus, preventing central prostanoid production by inhibiting the interleukin-1beta-mediated induction of Cox-2 in neurons or by inhibiting central Cox-2 activity reduces centrally generated inflammatory pain hypersensitivity.

A Review of Studies on the Effect of Iron Deficiency on Cognitive Development in Children

Abstract: Studies on the effect of iron deficiency on children's cognition and behavior are selectively reviewed, looking for evidence of a causal relationship. Most correlational studies have found associations between iron-deficiency anemia and poor cognitive and motor development and behavioral problems. Longitudinal studies consistently indicate that children anemic in infancy continue to have poorer cognition, school achievement, and more behavior problems into middle childhood. However, the possible confounding effects of poor socioeconomic backgrounds prevent causal inferences from being made. In anemic children 2 y old, the evidence from RCT is reasonably convincing but not conclusive. RCT of iron treatment are warranted especially in younger children.

Psychology Culture Shock

Abstract: Foreword. Part I: The Psychology of Intercultural Contact. Introduction and Overview: Setting the Scene. Social Systems as Inputs, Throughputs and Outputs. Culture Contact within and between Societies. Intercultural Contact: Processes and Outcomes. Groups in Intercultural Contact. Dimensions of Intercultural Contact. Outcomes of Contact. Theoretical Perspectives on Intercultural Contact. Intercultural Contact and Adaptation. A Model of the Acculturation Process. Chapter Summary. Part II: Theoretical Approaches to "Culture Shock". Culture Learning. Social Interaction. The Social Psychology of the Cross-cultural Encounter. Cross-cultural Differences in How People Communicate. Intercultural Communication Theory: Integrating the Communication Elements. Social Relations in Multicultural Societies. Cross-cultural Transition and Social Difficulty. Chapter Summary. Stress, Coping and Adjustment. The Stress and Coping Framework. Factors Affecting Stress, Coping and Adjustment. Social Identification Theories. Theoretical Perspectives. Identity, Acculturation and Intercultural Contact. Intergroup Perceptions and Relations. Social Identification Theories and Multicultural Ideology. Chapter Summary. Part III: Varieties of Culture Travellers. Tourists. The Tourist Experience. Tourism and Intercultural Contact. Chapter Summary. Sojourners: International Students. Historical Perspectives. Empirical Research on Student Sojourners. Chapter Summary. Sojourners: International Business People. Cultural Distance, Work Performance and Adaptation of Business Sojourners. Expatriate Adjustment. Women in International Management. Repatriation and Inpatriation. Chapter Summary. Immigrants. Social and Political Influences on Immigrant Acculturation. Migrant Adaptation. Perspectives on Immigrant Youth. Chapter Summary. Refugees. Refugee Status and Mental Health. Pre- and Post-Migration Experiences and Adjustment over Time. Stress, Coping and Adjustment. Acculturation, Identity and Intercultural Relations. Chapter Summary. Part IV: Applications and Conclusions. Culture Training. Training Principles, Issues and Aims. Cross-cultural Preparation in Historical Perspective. Sojourner Training. Training for Multicultural Living. Chapter Summary. Conclusion. The ABCs of "Culture Shock". Intercultural Interactions: Then and Now. The Future. Final Remarks. References.

Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes.

Abstract: We aimed to examine the mortality rates, excess mortality and causes of death in diabetic patients from ten centres throughout the world. A mortality follow-up of 4713 WHO Multinational Study of Vascular Disease in Diabetes (WHO MSVDD) participants from ten centres was carried out, causes of death were ascertained and age-adjusted mortality rates were calculated by centre, sex and type of diabetes. Excess mortality, compared with the background population, was assessed in terms of standardised mortality ratios (SMRs) for each of the 10 cohorts. Cardiovascular disease was the most common underlying cause of death, accounting for 44 % of deaths in Type I (insulin-dependent) diabetes mellitus and 52 % of deaths in Type II (non-insulin-dependent) diabetes mellitus. Renal disease accounted for 21 % of deaths in Type I diabetes and 11 % in Type II diabetes. For Type I diabetes, all-cause mortality rates were highest in Berlin men and Warsaw women, and lowest in London men and Zagreb women. For Type II diabetes, rates were highest in Warsaw men and Oklahoma women and lowest in Tokyo men and women. Age adjusted mortality rates and SMRs were generally higher in patients with Type I diabetes compared with those with Type II diabetes. Men and women in the Tokyo cohort had a very low excess mortality when compared with the background population. This study confirms the importance of cardiovascular disease as the major cause of death in people with both types of diabetes. The low excess mortality in the Japanese cohort could have implications for the possible reduction of the burden of mortality associated with diabetes in other parts of the world. [Diabetologia (2001) 44 [Suppl 2]: S 14–S 21]

Competition, Imitation and Growth with Step-by-Step Innovation

Abstract: Is more intense product market competition and imitation good or bad for growth? This question is addressed in the context of an endogenous growth model with "step-by-step" innovations, in which technological laggards must first catch up with the leading-edge technology before battling for technological leadership in the future. In contrast to earlier Schumpeterian models in which innovations are always made by outsider firms who earn no rents if they fail to innovate and become monopolies if they do innovate, here we find: first, that the usual Schumpeterian effect of more intense product market competition (PMC) is almost always outweighed by the increased incentive for firms to innovate in order to escape competition, so that PMC has a positive effect on growth; second, that a little imitation is almost always growth-enhancing, as it promotes more frequent neck-and-neck competition, but too much imitation is unambiguously growth-reducing. The model thus points to complementary roles for competition (anti-trust) policy and patent policy.

Export of organic carbon from peat soils

Abstract: Warmer conditions may be to blame for the exodus of peatland carbon to the oceans.

Dyslexia: cultural diversity and biological unity.

Abstract: The recognition of dyslexia as a neurodevelopmental disorder has been hampered by the belief that it is not a specific diagnostic entity because it has variable and culture-specific manifestations. In line with this belief, we found that Italian dyslexics, using a shallow orthography which facilitates reading, performed better on reading tasks than did English and French dyslexics. However, all dyslexics were equally impaired relative to their controls on reading and phonological tasks. Positron emission tomography scans during explicit and implicit reading showed the same reduced activity in a region of the left hemisphere in dyslexics from all three countries, with the maximum peak in the middle temporal gyrus and additional peaks in the inferior and superior temporal gyri and middle occipital gyrus. We conclude that there is a universal neurocognitive basis for dyslexia and that differences in reading performance among dyslexics of different countries are due to different orthographies.

The role of sleep in learning and memory.

Abstract: Sleep has been implicated in the plastic cerebral changes that underlie learning and memory. Indications that sleep participates in the consolidation of fresh memory traces come from a wide range of experimental observations. At the network level, reactivations during sleep of neuronal assemblies recently challenged by new environmental circumstances have been reported in different experimental designs. These neuronal assemblies are proposed to be involved in the processing of memory traces during sleep. However, despite this rapidly growing body of experimental data, evidence for the influence of sleep discharge patterns on memory traces remains fragmentary. The underlying role of sleep in learning and memory has yet to be precisely characterized.

The Reflection Grating Spectrometer on board XMM-Newton

Abstract: The ESA X-ray Multi Mirror mission, XMM-Newton, carries two identical Reflection Grating Spectrometers (RGS) behind two of its three nested sets of Wolter I type mirrors. The instrument allows high-resolution (E/(Delta)E = 100 to 500) measurements in the soft X-ray range (6 to 38 A or 2.1 to 0.3 keV) with a maximum effective area of about 140 sq cm at 15 A. Its design is optimized for the detection of the K-shell transitions of carbon, nitrogen, oxygen, neon, magnesium, and silicon. as well as the L shell transitions of iron. The present paper gives a full description of the design of the RGS and its operational modes. We also review details of the calibrations and in-orbit performance including the line spread function, the wavelength calibration, the effective area, and the instrumental background.

The Role of Working Memory in Visual Selective Attention

Abstract: The hypothesis that working memory is crucial for reducing distraction by maintaining the prioritization of relevant information was tested in neuroimaging and psychological experiments with humans. Participants performed a selective attention task that required them to ignore distractor faces while holding in working memory a sequence of digits that were in the same order (low memory load) or a different order (high memory load) on every trial. Higher memory load, associated with increased prefrontal activity, resulted in greater interference effects on behavioral performance from the distractor faces, plus increased face-related activity in the visual cortex. These findings confirm a major role for working memory in the control of visual selective attention.