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Multinodular and vacuolating neuronal tumor (MVNT) is a new pattern of neuronal tumour included in the recently revised WHO 2016 classification of tumors of the CNS. There are 15 reports in the literature to date. They are typically associated with late onset epilepsy and a neoplastic vs. malformative biology has been questioned. We present a series of ten cases and compare their pathological and genetic features to better characterized epilepsy‐associated malformations including focal cortical dysplasia type II (FCDII) and low‐grade epilepsy‐associated tumors (LEAT). Clinical and neuroradiology data were reviewed and a broad immunohistochemistry panel was applied to explore neuronal and glial differentiation, interneuronal populations, mTOR pathway activation and neurodegenerative changes. Next generation sequencing was performed for targeted multi‐gene analysis to identify mutations common to epilepsy lesions including FCDII and LEAT. All of the surgical cases in this series presented with seizures, and were located in the temporal lobe. There was a lack of any progressive changes on serial pre‐operative MRI and a mean age at surgery of 45 years. The vacuolated cells of the lesion expressed mature neuronal markers (neurofilament/SMI32, MAP2, synaptophysin). Prominent labelling of the lesional cells for developmentally regulated proteins (OTX1, TBR1, SOX2, MAP1b, CD34, GFAPδ) and oligodendroglial lineage markers (OLIG2, SMI94) was observed. No mutations were detected in the mTOR pathway genes, BRAF, FGFR1 or MYB. Clinical, pathological and genetic data could indicate that MVNT aligns more with a malformative lesion than a true neoplasm with origin from a progenitor neuro‐glial cell type showing aberrant maturation.

Background: Mental health is a difficult topic to discuss in Nepal. This makes it hard for front-line maternity-care providers to start a discussion about mental health issues with women. As Nepal has not yet recognised midwifery as a profession, this UK-funded programme (THET) aims to train community health workers i.e. Auxiliary Nurse Midwives (ANMs) on mental health issues related to pregnancy. Purpose/Objective: This needs assessment, of all ANMs working in one district, assesses knowledge of perinatal mental health issues and future training needs. Method: This quantitative study used a structure questionnaire in Nepali at the start of the training of ANMs. The questions covered knowledge, views on mental health and illness and previous training on the topic. Ethical approval was granted by the Nepal Health Research Council (NHRC). Key Findings: In total 74 questionnaires were returned (out of 76). With 97% of ANMSs reporting they never had specific training issues around perinatal mental health. Their knowledge on perinatal mental health is poor, half of them are not aware that pregnancy and childbirth can cause mental illness. People do not talk openly about mental health problem in their local community. Most ANM thought specialised training on perinatal mental health would be useful. Discussion: Mental health in pregnancy/childbirth is often ignored especially in low-income countries like Nepal. In a country without recognised midwives there is a great need to improve attitudes and skills among community-based maternity workers who lacking training on maternity-related mental health issues. There is a great need for a national curriculum to facilitate relevant training.

© 2016 Taylor & Francis. Huntington disease (HD) is a neurodegenerative condition with prominent motor (including oculomotor), cognitive, and psychiatric effects. While neuropsychological deficits are present in HD, motor impairments may impact performance on neuropsychological measures, especially those requiring a speeded response, as has been demonstrated in multiple sclerosis and schizophrenia. The current study is the first to explore associations between oculomotor functions and neuropsychological performance in HD. Participants with impaired oculomotor functioning performed worse than those with normal oculomotor functioning on cognitive tasks requiring oculomotor involvement, particularly on psychomotor speed tasks, controlling for covariates. Consideration of oculomotor dysfunction on neuropsychological performance is critical, particularly for populations with motor deficits.

Objective: Although Huntington disease (HD) is caused by an autosomal dominant mutation, its phenotypic presentation differs widely. Variability in clinical phenotypes of HD may reflect the existence of disease subtypes. This hypothesis was tested in prodromal participants from the longitudinal Neurobiological Predictors of Huntington Disease (PREDICT-HD) study. Method: We performed clustering using longitudinal data assessing motor, cognitive, and depression symptoms. Using data from 521 participants with 2,716 data points, we fit growth mixture models (GMM) that identify groups based on multivariate trajectories. Results: In various GMM, different phases of disease progression were partitioned by progression trajectories of motor and cognitive signs, and by overall level of depression symptoms. More progressed motor signs were accompanied by more progressed cognitive signs, but not always by higher levels of depressive symptoms. In several models, there were at least 2 groups with similar trajectories for motor and cognitive signs that showed different levels for depression symptoms- one with a very low level of depression and the other with a higher level of depression. Conclusions: Findings indicate that at least intermediate HD progression might be associated with different levels of depression. Depression is one of the few symptoms that is treatable in HD and has implications for clinical care. Identification of potential depression subtypes may also help to select appropriate patients for clinical trials.

© 2015 Wiley Periodicals, Inc. Huntington disease (HD) is most widely known for its selective degeneration of striatal neurons but there is also growing evidence for white matter (WM) deterioration. The primary objective of this research was to conduct a large-scale analysis using multisite diffusion-weighted imaging (DWI) tractography data to quantify diffusivity properties along major prefrontal cortex WM tracts in prodromal HD. Fifteen international sites participating in the PREDICT-HD study collected imaging and neuropsychological data on gene-positive HD participants without a clinical diagnosis (i.e., prodromal) and gene-negative control participants. The anatomical prefrontal WM tracts of the corpus callosum (PFCC), anterior thalamic radiations (ATRs), inferior fronto-occipital fasciculi (IFO), and uncinate fasciculi (UNC) were identified using streamline tractography of DWI. Within each of these tracts, tensor scalars for fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity coefficients were calculated. We divided prodromal HD subjects into three CAG-age product (CAP) groups having Low, Medium, or High probabilities of onset indexed by genetic exposure. We observed significant differences in WM properties for each of the four anatomical tracts for the High CAP group in comparison to controls. Additionally, the Medium CAP group presented differences in the ATR and IFO in comparison to controls. Furthermore, WM alterations in the PFCC, ATR, and IFO showed robust associations with neuropsychological measures of executive functioning. These results suggest long-range tracts essential for cross-region information transfer show early vulnerability in HD and may explain cognitive problems often present in the prodromal stage.

© 2015 The Authors. Background: It is well known in Huntington's disease that cytosine-adenine-guanine expansion and age at study entry are predictive of the timing of motor diagnosis. The goal of this study was to assess whether additional motor, imaging, cognitive, functional, psychiatric, and demographic variables measured at study entry increased the ability to predict the risk of motor diagnosis over 12 years. Methods: One thousand seventy-eight Huntington's disease gene-expanded carriers (64% female) from the Neurobiological Predictors of Huntington's Disease study were followed up for up to 12 y (mean=5, standard deviation=3.3) covering 2002 to 2014. No one had a motor diagnosis at study entry, but 225 (21%) carriers prospectively received a motor diagnosis. Analysis was performed with random survival forests, which is a machine learning method for right-censored data. Results: Adding 34 variables along with cytosine-adenine-guanine and age substantially increased predictive accuracy relative to cytosine-adenine-guanine and age alone. Adding six of the common motor and cognitive variables (total motor score, diagnostic confidence level, Symbol Digit Modalities Test, three Stroop tests) resulted in lower predictive accuracy than the full set, but still had twice the 5-y predictive accuracy than when using cytosine-adenine-guanine and age alone. Additional analysis suggested interactions and nonlinear effects that were characterized in a post hoc Cox regression model. Conclusions: Measurement of clinical variables can substantially increase the accuracy of predicting motor diagnosis over and above cytosine-adenine-guanine and age (and their interaction). Estimated probabilities can be used to characterize progression level and aid in future studies' sample selection.

A cross-platform field campaign, OP3, was conducted in the state of Sabah in Malaysian Borneo between April and July of 2008. Among the suite of observations recorded, the campaign included measurements of NOx and O3 – crucial outputs of any model chemistry mechanism. We describe the measurements of these species made from both the ground site and aircraft. We then use the output from two resolutions of the chemistry transport model p-TOMCAT to illustrate the ability of a global model chemical mechanism to capture the chemistry at the rainforest site. The basic model performance is good for NOx and poor for ozone. A box model containing the same chemical mechanism is used to explore the results of the global model in more depth and make comparisons between the two. Without some parameterization of the nighttime boundary layer – free troposphere mixing (i.e. the use of a dilution parameter), the box model does not reproduce the observations, pointing to the importance of adequately representing physical processes for comparisons with surface measurements. We conclude with a discussion of box model budget calculations of chemical reaction fluxes, deposition and mixing, and compare these results to output from p-TOMCAT. These show the same chemical mechanism behaves similarly in both models, but that emissions and advection play particularly strong roles in influencing the comparison to surface measurements.

Analysis of diurnal patterns of surface ozone (O3) at multiple urban sites in the UK shows the occurrence of prominent nocturnal enhancements during the winter months (November-March). Whilst nocturnal surface ozone (NSO) enhancement events have been observed at other locations, this is the first time that such features have been demonstrated to occur in the UK and the second location globally. The observed NSO enhancement events in the UK were found to be so prevalent that they are clearly discernible in monthly diurnal cycles averaged over several years of data. Long-term (2000-2010) analysis of hourly surface ozone data from 18 urban background stations shows a bimodal diurnal variation during the winter months with a secondary nighttime peak around 0300 hours along with the primary daytime peak. For all but one site, the daily maxima NSO concentrations during the winter months exceeded 60 ?g/m3 on >20 % of the nights. The highest NSO value recorded was 118 ?g/m3. During the months of November, December, and January, the monthly averaged O3 concentrations observed at night (0300 h) even exceeded those observed in the daytime (1300 h). The analysis also shows that these NSO enhancements can last for several hours and were regional in scale, extending across several stations simultaneously. Interestingly, the urban sites in the north of the UK exhibited higher NSO than the sites in the south of the UK, despite their daily maxima being similar. In part, this seems to be related to the sites in the north typically having lower concentrations of nitrogen oxides.Analysis of diurnal patterns of surface ozone (O3) at multiple urban sites in the UK shows the occurrence of prominent nocturnal enhancements during the winter months (November-March). Whilst nocturnal surface ozone (NSO) enhancement events have been observed at other locations, this is the first time that such features have been demonstrated to occur in the UK and the second location globally. The observed NSO enhancement events in the UK were found to be so prevalent that they are clearly discernible in monthly diurnal cycles averaged over several years of data. Long-term (2000-2010) analysis of hourly surface ozone data from 18 urban background stations shows a bimodal diurnal variation during the winter months with a secondary nighttime peak around 0300 hours along with the primary daytime peak. For all but one site, the daily maxima NSO concentrations during the winter months exceeded 60 ?g/m3 on >20 % of the nights. The highest NSO value recorded was 118 ?g/m3. During the months of November, December, and January, the monthly averaged O3 concentrations observed at night (0300 h) even exceeded those observed in the daytime (1300 h). The analysis also shows that these NSO enhancements can last for several hours and were regional in scale, extending across several stations simultaneously. Interestingly, the urban sites in the north of the UK exhibited higher NSO than the sites in the south of the UK, despite their daily maxima being similar. In part, this seems to be related to the sites in the north typically having lower concentrations of nitrogen oxides.

In one of the most exhaustive evidence reviews into high streets, town centres and consumer habits ever conducted in Britain, researchers at the University of Southampton have highlighted that seismic shifts in consumer behaviour, combined with significant technological innovations, are having a deep and profound impact on the evolution of UK high streets.Funded by the Economic and Social Research Council (ESRC) and commissioned by the Government’s advisory group The Future High Streets Forum, this report comes at a time when radical shifts in consumer culture and practices are becoming increasingly apparent and widely discussed in public debate on what is changing UK town centres and high streets.This review offers an important resource for many groups with stakes in British town centres and high streets. It reflects the fact that reversing the decline of Britain’s high streets can only be achieved through research and informed discussion and by harnessing the goodwill and common purpose which has recently been displayed by the many stakeholders in the retail, hospitality, property and leisure sectors in working together to understand and address those challenges.

The RONOCO (ROle of Nighttime chemistry in controlling the Oxidising Capacity of the AtmOsphere) aircraft campaign during July 2010 and January 2011 made observations of OH, HO2, NO3, N2O5 and a number of supporting measurements at night over the UK, and reflects the first simultaneous airborne measurements of these species. We compare the observed concentrations of these short-lived species with those calculated by a box model constrained by the concentrations of the longer lived species using a detailed chemical scheme. OH concentrations were below the limit of detection, consistent with model predictions. The model systematically underpredicts HO2 by ~200% and overpredicts NO3 and N2O5 by around 80 and 50%, respectively. Cycling between NO3 and N2O5 is fast and thus we define the NO3x (NO3x=NO3+N2O5) family. Production of NO3x is overwhelmingly dominated by the reaction of NO2 with O3, whereas its loss is dominated by aerosol uptake of N2O5, with NO3+VOCs (volatile organic compounds) and NO3+RO2 playing smaller roles. The production of HOx and ROx radicals is mainly due to the reaction of NO3 with VOCs. The loss of these radicals occurs through a combination of HO2+RO2 reactions, heterogeneous processes and production of HNO3 from OH+NO2, with radical propagation primarily achieved through reactions of NO3 with peroxy radicals. Thus NO3 at night plays a similar role to both OH and NO during the day in that it both initiates ROx radical production and acts to propagate the tropospheric oxidation chain. Model sensitivity to the N2O5 aerosol uptake coefficient (γN2O5) is discussed and we find that a value of γN2O5=0.05 improves model simulations for NO3 and N2O5, but that these improvements are at the expense of model success for HO2. Improvements to model simulations for HO2, NO3 and N2O5 can be realised simultaneously on inclusion of additional unsaturated volatile organic compounds, however the nature of these compounds is extremely uncertain.