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This consensus guidance statement reflects input from patient communities and the authors thank the following organizations and individuals for their input during the Collaborative writing process: the Patient-Led Research Collaborative, Angela Meriquez Vazquez, MSW, Long Covid Patient and Advocate, and Lauren Nichols, Long Covid Patient and Chronic Illness Advocate. For example, patients with MS may be on disease modifying therapy (DMT), and both the MS and the DMT may put them at higher risk for COVID-19 acute infections as well as more severe course, though in a recent systematic review these were not consistent findings.58 The review included more than 80 reports involving 2493 MS patients and 37 Neuromyelitis Optica Spectrum Disorder patients with COVID-19. Larger number of beds and location in an area with high COVID-19 prevalence were the strongest and most consistent predictors of facilities having more COVID-19 cases and deaths.56 This multicenter cohort study showed that delirium was the sixth most common of all presenting symptoms and signs of acute COVID-19 infection, and factors associated with delirium were age older than 75 years, living in a nursing home or assisted living, vision impairment, hearing impairment, stroke, and Parkinson disease.57Though the studies in children are evolving, long COVID is recognized and should be considered at all ages. Patients with GBS/MFS benefit further from intravenous immunoglobulin and plasma exchange.[7] Most patients with isolated cranial neuropathies have a favorable outcome with supportive care compared to patients with multiple cranial neuropathies with GBS, who may achieve partial recovery and experience longer symptom duration. [Extracted from the article]

Objective: The concussion team at The University of Kansas Health System outpatient rehabilitation spine center is comprised of experienced multi-disciplinary experts including physical therapists and a speech language pathologist. The team set forth with a purpose of creating and organizing an internal physical therapy clinical recommendation protocol for initial evaluations and subsequent treatments for the concussed patient. The aim of this paper is to share these recommendation protocols with other therapy teams and provide a foundational layout for treating the patient with post-concussion symptoms in an outpatient physical therapy clinical setting. Study design: Clinical recommendation protocol provides guidance for patients ages 10+ from initial evaluation through discharge with emphasis on evidence-based research in the areas of: oculomotor, cervical, vestibular, post-concussion migraine influence, mood disorders(such as anxiety and depression), exertion, and cognitive communicative dysfunction. Results: Finding a written, comprehensive clinical resource protocol for post-concussion outpatient evaluation(s) and treatment strategies can be difficult. This document serves as a resource for other outpatient concussion rehabilitation clinics, providing rationale, and objective measurement tools, for assessing and treating concussion patients. To the authors' knowledge, no other research has produced a practical, efficient evaluation tool to be utilized at bed side, condensing evidence-based research into an easy-to-use form. Conclusion: The University of Kansas Health System outpatient concussion rehabilitation center developed clinical recommendation protocols for concussion care. The intent was to standardize assessment and treatment for concussion patients and to share these objective measurement tools and procedures, focused on a team approach of concussion providers, as a clinical outline for both the novice and seasoned clinician specializing in the field of concussion work in an outpatient rehabilitation setting. [ABSTRACT FROM AUTHOR]

Meat production creates high greenhouse gas emissions while consumption of wild game meat presumably has lower greenhouse gas impacts. We estimated the amount of meat legally harvested in the United States for animals with state or federal harvest data and determined caloric value and the greenhouse gas impact (emissions savings) of these harvests. Hunting of reported game accounts for approximately 487 billion Kcal, about 3% of U.S. annual meat consumption, although the total is probably higher if non-reported (small game) are included. Wild game consumption may equal more than two billion kg of avoided CO2 emissions, equivalent to more than $120 million USD in annual carbon avoidance societal benefits. Our results suggest that wild game harvests contribute a relatively small, but not irrelevant, greenhouse gas savings. Wildlife conservation organizations could use the positive climate attributes of wild game harvesting as a public relations tool to encourage hunting and subsequent emissions reductions. [ABSTRACT FROM AUTHOR]

The article discusses how the United States v. Windsor civil right court case affects the Maritime law. Topics discussed include wrongful death beneficiaries for Maritime claims under the Jones Act, the U.S. supreme court case Moragne v. States Marine League, Inc., and mentions the section 3 of the Defense of Marriage Act.

This article discusses the need for establishing a federally run, full-time, resident, self-contained national academy: the U.S. Homeland Security Intelligence Academy (HSIA). At HSIA, students will earn an undergraduate degree in homeland security and intelligence studies. This program will provide students with homeland security and intelligence-related practical and tactical skills as well as relevant leadership capabilities. It is the goal of HSIA to produce tier-one education and training for future homeland security and intelligence-focused agents and other professionals. [ABSTRACT FROM AUTHOR]

Generalized whole brain volume loss is well documented in moderate to severe traumatic brain injury. Whether this atrophy occurs in the thalamus and brainstem has not been systematically studied in children. Magnetic resonance imaging (MRI) quantitative analysis was used to investigate brain volume loss in the thalamus and brainstem in 16 traumatic brain injury subjects (age range 9-16 years) compared with 16 age and demographically matched controls. Based on multiple analysis of covariance, controlling for age and head size, reduced volume in the thalamus and the midbrain region of the brainstem were found. General linear model analyses revealed a relation between processing speed on a working memory task and midbrain and brain stem volumes. Reduced volume in thalamic and brainstem structures were associated with traumatic brain injury. Reduction in midbrain and thalamic volume is probably a reflection of the secondary effects of diffuse axonal injury and reduction in cortical volume from brain injury. [ABSTRACT FROM AUTHOR]

Broccoli sprouts are a convenient and rich source of the glucosinolate, glucoraphanin, which can generate the chemopreventive agent, sulforaphane, an inducer of glutathione S-transferases (GST) and other cytoprotective enzymes. A broccoli sprout-derived beverage providing daily doses of 600 μmol glucoraphanin and 40 μmol sulforaphane was evaluated for magnitude and duration of pharmacodynamic action in a 12-week randomized clinical trial. Two hundred and ninety-one study participants were recruited from the rural He-He Township, Qidong, in the Yangtze River delta region of China, an area characterized by exposures to substantial levels of airborne pollutants. Exposure to air pollution has been associated with lung cancer and cardiopulmonary diseases. Urinary excretion of the mercapturic acids of the pollutants, benzene, acrolein, and crotonaldehyde, were measured before and during the intervention using liquid chromatography tandem mass spectrometry. Rapid and sustained, statistically significant (P ≤ 0.01) increases in the levels of excretion of the glutathione-derived conjugates of benzene (61%), acrolein (23%), but not crotonaldehyde, were found in those receiving broccoli sprout beverage compared with placebo. Excretion of the benzene-derived mercapturic acid was higher in participants who were GSTT1-positive than in the null genotype, irrespective of study arm assignment. Measures of sulforaphane metabolites in urine indicated that bioavailability did not decline over the 12-week daily dosing period. Thus, intervention with broccoli sprouts enhances the detoxication of some airborne pollutants and may provide a frugal means to attenuate their associated long-term health risks., (©2014 American Association for Cancer Research.)

A detailed morphometric analysis of the cerebellum in autism with and without macrocephaly. Four subject groups (N = 65; male; IQs > or = 65; age 7 to 26 years) were studied with quantitative MRI; normocephalic and macrocephalic individuals with autism without mental retardation were compared to normocephalic and benign macrocephalic typically developing individuals. Total cerebellum volumes and surface areas of four lobular midsagittal groups were measured. Independent t-tests between autism and control subjects matched for head size revealed no significant differences. Multivariate analyses of variance were also performed, using the diagnostic group as the fixed factor, cerebellar measures as the dependent variables and total intracranial volume, total brain volume, age, verbal IQ, and performance IQ as covariates. No significant differences were found; however, a trend was noted in which macrocephalic individuals with autism consistently exhibited slightly smaller cerebellar volume or surface area when compared to individuals with benign macrocephaly. In autism, with and without macrocephaly, cerebellar structures were found to be proportional to head size and did not differ from typically developing subjects.

In vivo MRI volumetric analysis enables investigators to evaluate the extent of tissue loss following traumatic brain injury (TBI). However, volumetric studies of pediatric TBI are sparse, and there have been no volumetric studies to date in children examining specific subregions of the prefrontal and temporal lobes. In this study, MRI volumetry was used to evaluate brain volume differences in the whole brain, and prefrontal, temporal, and posterior regions of children following moderate to severe TBI as compared to uninjured children of similar age and demographic characteristics. The TBI group had significantly reduced whole brain, and prefrontal and temporal regional tissue volumes as well as increased cerebrospinal fluid (CSF). Confidence interval testing further revealed group differences on gray matter (GM) and white matter (WM) in the superior medial and ventromedial prefrontal regions, WM in the lateral frontal region, and GM, WM, and CSF in the temporal region. Whole brain volume and total brain GM were reduced, and total ventricular volume, total CSF volume, and ventricle-to-brain ratio (VBR) were increased in the TBI group. Additional analyses comparing volumetric data from typically developing children and subgroups of TBI patients with and without regional focal lesions suggested that GM loss in the frontal areas was primarily attributable to focal injury, while WM loss in the frontal and temporal lobes was related to both diffuse and focal injury. Finally, volumetric measures of preserved frontotemporal tissue were related to functional recovery as measured by the Glasgow Outcome Scale (adapted for children) with greater tissue preservation predicting better recovery.