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BackgroundStudies have reported elevated rates of dissociative symptoms and comorbid dissociative disorders in functional neurological disorder (FND); however, a comprehensive review is lacking.AimsTo systematically review the severity of dissociative symptoms and prevalence of comorbid dissociative disorders in FND and summarise their biological and clinical associations.MethodWe searched Embase, PsycInfo and MEDLINE up to June 2021, combining terms for FND and dissociation. Studies were eligible if reporting dissociative symptom scores or rates of comorbid dissociative disorder in FND samples. Risk of bias was appraised using modified Newcastle–Ottawa criteria. The findings weresynthesised qualitatively and dissociative symptom scores were included in a meta-analysis (PROSPERO CRD42020173263).ResultsSeventy-five studies were eligible (FND n = 3940; control n = 3073), most commonly prospective case–control studies (k = 54). Dissociative disorders were frequently comorbid in FND. Psychoform dissociation was elevated in FND compared with healthy (g = 0.90, 95% CI 0.66–1.14, I2 = 70%) and neurologicalcontrols (g = 0.56, 95% CI 0.19–0.92, I2 = 67%). Greater psychoform dissociation was observed in FND samples with seizure symptoms versus healthy controls (g = 0.94, 95% CI 0.65–1.22, I2 = 42%) and FND samples with motor symptoms (g = 0.40, 95% CI −0.18 to 1.00, I2 = 54%). Somatoform dissociation was elevated in FND versus healthy controls (g = 1.80, 95% CI 1.25–2.34,I2 = 75%). Dissociation in FND was associated with more severe functional symptoms, worse quality of life and brain alterations.ConclusionsOur findings highlight the potential clinical utility of assessing patients with FND for dissociative symptomatology. However, fewer studies investigated FND samples with motor symptoms and heterogeneity between studies and risk of bias were high. Rigorous investigation of the prevalence, features and mechanistic relevance of dissociation in FND is needed.

Functional jerky movements (or functional myoclonus) are commonly seen in patients with functional movement disorder. Positive features both from history and clinical examination are important for the diagnosis. However, due to their heterogeneous and paroxysmal nature a home-made video-recording of the jerky movements can be essential to make the diagnose by a movement disorder specialist. Supportive clinical clues include abrupt symptom onset often triggered by a physical event, whereas entrainment and distractibility are supportive signs during physical examination. Localization of the jerky movements, especially proximal localization, is supportive, and can also be helpful in distinguishing functional jerks from tics and myoclonus, which are the most important differential diagnostic considerations. Additional neurophysiological tests include polymyography and electroencephalography-electromyography (EEG-EMG) co-registration in order to demonstrate a readiness potential (RP). Management includes disease education and specialized physical therapy.

BackgroundNeurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome.MethodsWe conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models.ResultsWe included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67-82]), than encephalopathy (54% [42-65]). Intensive care use was high (38% [35-41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27-32]. The hazard of death was comparatively lower for patients in the WHO European region.InterpretationNeurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different

Functional jerky movements (or functional myoclonus) are commonly seen in patients with functional movement disorder. Positive features both from history and clinical examination are important for the diagnosis. However, due to their heterogeneous and paroxysmal nature a home-made video-recording of the jerky movements can be essential to make the diagnose by a movement disorder specialist. Supportive clinical clues include abrupt symptom onset often triggered by a physical event, whereas entrainment and distractibility are supportive signs during physical examination. Localization of the jerky movements, especially proximal localization, is supportive, and can also be helpful in distinguishing functional jerks from tics and myoclonus, which are the most important differential diagnostic considerations. Additional neurophysiological tests include polymyography and electroencephalography-electromyography (EEG-EMG) co-registration in order to demonstrate a readiness potential (RP). Management includes disease education and specialized physical therapy.

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In providing a more imperial theoretical paradigm, highlighting earlier and more informal intervention by T.E.A. and Peace Corps volunteers and addressing their successes and failures, this article demonstrates the complexities created by new transnational connections and interactions between young Americans and East African students and their importance specifically in Tanzania. It delves into the conflicts with the T.E.A. and Peace Corps and the departing British colonial teachers worried about their declining influence, the American volunteers and the Tanzanian government, as well as organizational conflict between the T.E.A. and the new Peace Corps.

Despite the rhizotoxicity of aluminum (Al) being identified over 100 years ago, there is still no consensus regarding the mechanisms whereby root elongation rate is initially reduced in the approximately 40% of arable soils worldwide that are acidic. We used high-resolution kinematic analyses, molecular biology, rheology, and advanced imaging techniques to examine soybean (Glycine max) roots exposed to Al. Using this multidisciplinary approach, we have conclusively shown that the primary lesion of Al is apoplastic. In particular, it was found that 75 µm Al reduced root growth after only 5 min (or 30 min at 30 µm Al), with Al being toxic by binding to the walls of outer cells, which directly inhibited their loosening in the elongation zone. An alteration in the biosynthesis and distribution of ethylene and auxin was a second, slower effect, causing both a transient decrease in the rate of cell elongation after 1.5 h but also a longer term gradual reduction in the length of the elongation zone. These findings show the importance of focusing on traits related to cell wall composition as well as mechanisms involved in wall loosening to overcome the deleterious effects of soluble Al.

In an attempt to generate supramolecular assemblies able to function as self-healing hydrogels, a novel ureido-pyrimidinone (UPy) monomer, 2-(N ′-methacryloyloxyethylureido)-6-(1-adamantyl)-4[1H]-pyrimidinone, was synthesized and then copolymerized with N,N-dimethylacrylamide at four different feed compositions, using a solution of lithium chloride in N,N-dimethylacetamide as the polymerization medium. The assembling process in the resulting copolymers is based on crosslinking through the reversible quadruple hydrogen bonding between side-chain UPy modules. The adamantyl substituent was introduced in order to create a “hydrophobic pocket” that may protect the hydrogen bonds against the disruptive effect of water molecules. Upon hydration to equilibrium, all copolymers generated typical hydrogels when their concentration in the hydrated system was at least 15%. The small-deformation rheometry showed that all hydrated copolymers were hydrogels that maintained a solid-like behavior, and that their extrusion through a syringe needle did not affect significantly this behavior, suggesting a self-healing capacity in these materials. An application as injectable substitutes for the eye's vitreous humor was proposed

beta-Glucan is one of the most studied soluble dietary fibres, and is known for its positive effects on human health such as lowering glycemic responses and reducing serum cholesterol levels. Viscosity and diffusion phenomena are thought to play an important role in imparting these beneficial effects through interactions with digestive enzymes and bile salt micelles in the digestive tract. Correlations between viscosity, probe diffusivity, and molecular structure for three barley beta-glucans are studied here to enhance understanding of the molecular basis for these nutritional effects. Fluorescence recovery after photobleaching (FRAP) is used to measure the diffusion coefficients of a dextran probe similar in size to both digestive enzymes and bile salt micelles in beta-glucan solutions. Diffusion coefficients are found to decrease with an increase in the viscosity, but showed systematic deviations from Stokes-Einstein behaviour, similar to those found for cereal arabinoxylans, and thus indicating that bulk viscosity measurements cannot be reliably used as sole indicator of diffusion processes, due to local aggregation and microviscosity effects. The diffusion coefficient values are 10-100 times slower than predicted for diffusion in the absence of beta-glucan, consistent with a functional role in retarding digestion and absorption processes in the small intestine., QC 20120127

Non-starch polysaccharides such as arabinoxylans have important roles in the human diet, resulting in potential benefits such as increased microbial fermentation, promotion of beneficial microflora, prevention of re-absorption of bile acids leading to lower plasma cholesterol, and retardation of starch digestion. The latter two beneficial effects may arise from viscosity and/or diffusion phenomena in the gastrointestinal tract. To study this, measurements of the viscosity and diffusion coefficients of a polymer probe similar in size to both bile salt micelles and alpha-amylase were carried out for water solutions of three arabinoxylans with differing viscosities. Diffusion coefficients were obtained using fluorescence recovery after photobleaching (FRAP). The concentration dependence of both viscosity and diffusion coefficients followed the usual behaviour of polymers for each of three arabinoxylan samples. However, at a given concentration, the sample with the highest viscosity also had the highest probe diffusion coefficient: the reverse of what would be expected for homogeneous solutions. This apparent anomaly is ascribed to differences in polymer structure between the three samples giving rise to varying levels of local polymer aggregation and consequent microvoids. These differences are verified using characterisation with multiple-detection size-exclusion chromatography. Deviations from simple Stokes-Einstein behaviour are ascribed to the existence of aggregates in solution. The results show that studies of the role of arabinoxylans in human nutrition cannot assume that the diffusion coefficients of species with sizes in the range important for digestive processes in a series of samples will increase with decreasing viscosity at a given concentration: diffusion coefficient and viscosity must be measured independently., QC 20120127

We report experimental measurements on the drawing behaviour of a pre-swollen drawn sample of ultra-high molecular weight polyethylene (UHMWPE). X-ray information is expressed in terms of an orientation function P2(θ), and the increase in both P2 and the tensile modulus are determined as a function of draw ratio. Scanning electron microscopy is used to follow the structural changes in the material. The experimental results are compared with a numerical simulation of the deformation and from these we suggest that early stages of deformation involve crystal orientation followed by subsequent chain extension at higher draw ratios.