Missouri Citizen Perceptions: Giving Second Amendment Preservation Legislation a Second Look

In June 2021, Missouri passed the "Second Amendment Preservation Act" (SAPA). Though SAPA passed easily and had gubernatorial support, many Missouri law enforcement agencies, including the Missouri Sheriff's Association, oppose it. Missing from this policy conversation, and deserving of analysis, is the voice of Missouri citizens. Using qualitative interview data and survey data, we explored what if anything Missouri gun owners knew about SAPA and what they perceived its effects would be on gun-related murders, suicides, gun thefts, and mass shootings. Most Missouri gun owners had not heard about SAPA and were ambivalent about its potential effect on gun safety outcomes. Our findings also indicate that respondents' attitudes toward SAPA and the impact of such policy on safety is driven by gun ownership (i.e., primary versus living in a household with firearms), partisan identification, and attitudes toward government firearm regulation.

Impact of Long COVID on health and quality of life

Background: The aim of this study was to measure the impact of post-acute sequelae of COVID-19 (PASC) on quality of life, mental health, ability to work and return to baseline health in an Irish cohort.

Methods: We invited individuals with symptoms of COVID-19 lasting more than 14 days to participate in an anonymous online questionnaire. Basic demographic data and self-reported symptoms were recorded. Internationally validated instruments including the patient health questionnaire somatic, anxiety and depressive symptom scales (PHQ-SADS), the Patient Health Questionnaire-15 (PHQ-15) and Chadler fatigue scale (CFQ) were used.

Results: We analysed responses from 988 participants with self-reported confirmed (diagnostic/antibody positive; 81%) or suspected (diagnostic/antibody negative or untested; 9%) COVID-19. The majority of respondents were female (88%), white (98%), with a median age of 43.0 (range 15 – 88 years old) and a median BMI of 26.0 (range 16 – 60). At the time of completing this survey, 89% of respondents reported that they have not returned to their pre-COVID-19 level of health. The median number of symptoms reported was 8 (range 0 to 33 symptoms), with a median duration of 12 months (range 1 to 20 months) since time of acute infection. A high proportion of PASC patients reported that they have a moderate or severe limitation in their ability to carry out their usual activities, 38% report their ability to work is severely limited and 33% report a moderate, or higher, level of anxiety or depression.

Conclusion: The results of this survey of an Irish cohort with PASC are in line with reports from other settings, and we confirm that patients with PASC reported prolonged, multi-system symptoms which can significantly impact quality of life, affect ability to work and cause significant disability. Dedicated multidisciplinary, cross specialty supports are required to improve outcomes of this patient group.

Construction and validation of the chronic acquired polyneuropathy patient-reported index (CAP-PRI): A disease-specific, health-related quality-of-life instrument

INTRODUCTION

Generic health-related quality-of-life (HRQOL) patient-reported outcome measures have been used in patients with chronic immune-mediated polyneuropathies. We have created a disease-specific HRQOL instrument.

METHODS

The chronic acquired polyneuropathy patient-reported index (CAP-PRI) was developed and validated in multiple steps. Items were initially generated through patient and specialist input. The performance of the preliminary 20 items was analyzed via a prospective, 5-center study involving chronic immune-mediated polyneuropathy patients.

RESULTS

Data analysis suggested modification to a 15-item scale with 3 response categories rather than 5. The final CAP-PRI was validated in another prospective, 5-center study. The CAP-PRI appeared to be a unidimensional outcome measure that fit the Rasch model in our multicenter cohort. It correlated appropriately with outcome measures commonly used in this patient population.

CONCLUSIONS

The CAP-PRI is a simple disease-specific HRQOL measure that appears to be useful for clinical care and possibly also for clinical trials. Muscle Nerve 54: 9-17, 2016.

Autonomic Neuropathy

Autonomic nerve fibers are affected in most generalized peripheral neuropathies. Although this involvement is often mild or subclinical, there are a group of peripheral neuropathies in which the small or unmyelinated fibers are selectively or prominently targeted. These include the autonomic neuropathies associated with diabetes and amyloid, immune-mediated autonomic neuropathies including those associated with a paraneoplastic syndrome, inherited autonomic neuropathies, autonomic neuropathies associated with infectious diseases, and toxic autonomic neuropathies. The presenting features include impairment of cardiovascular, gastrointestinal, urogenital, thermoregulatory, sudomotor, and pupillomotor function. The accurate diagnosis of the autonomic neuropathies has been enhanced by the availability of physiological tests that measure autonomic function, and more recently, structural studies of the autonomic cutaneous innervation. With the help of these investigations and the judicious use of laboratory testing, many autonomic neuropathies can be accurately diagnosed and their clinical progression monitored.

Metastatic meningioma: positron emission tomography CT imaging findings

The imaging findings of a case of metastasing meningioma are described. The case illustrates a number of rare and interesting features. The patient presented with haemoptysis 22 years after the initial resection of an intracranial meningioma. CT demonstrated heterogeneous masses with avid peripheral enhancement without central enhancement. Blood supply to the larger lesion was partially from small feeding vessels from the inferior pulmonary vein. These findings correlate with a previously published case in which there was avid uptake of fluoro-18-deoxyglucose peripherally with lesser uptake centrally. The diagnosis of metastasing meningioma was confirmed on percutaneous lung tissue biopsy.

Parasol and midget ganglion cells of the human retina

Golgi-impregnated ganglion cells were studied in two flat-mounted human retinas. A number of different morphologic forms were observed, and those showing a thickly branching dendritic field with terminals that stratified within a narrow zone of the inner plexiform layer were selected for further investigation. When the dendritic field diameter of these cells was plotted against distance from the fovea, the scatter diagram showed two distinct clusters. At any given eccentricity, there was no overlap between the cell group with large dendritic fields and the group with small dendritic fields. Those with the larger dendritic fields also tended to have larger somas and thicker axons than the group with the smaller dendritic fields. The dendritic fields of both groups tended to be elongated, and the orientation and degree of this elongation were quantified by determining the best-fitting ellipse for each dendritic field. The degree of elongation was independent of eccentricity. The orientation of the dendritic field (major axis of the ellipse) of a cell did not appear to be independent of its position on the retina. To test whether the major axes tended to be directed toward any particular point on the retina, the positions of the cells on the retinal flat mount were transformed to relative positions on the retinal hemisphere, and the orientations of the dendritic fields were expressed in a spherical coordinate system for this hemisphere. A search was made for the position on the hemisphere which minimized the mean square deviation of the orientations from this point. The group with the large dendritic fields showed a significant tendency to be radially oriented toward a specific location on the retinal hemisphere, and that location lay within a few degrees of the fovea. Leventhal and Schall ('83) have reported a similar finding for ganglion cells of the cat retina. For the group with small dendritic fields, the retinal location that minimized the mean square deviation was also near the fovea; however, the set of orientations showed no greater tendency for mutual alignment than did a randomized set. The cell group with the large dendritic fields appears to correspond to Dogiel's (1891) type II cells, to Polyak's ('41) parasol cells, to the A cells of the monkey retina described by Leventhal et al. ('81), observed following HRP injection to the magnocellular layer of the LGN, and to the P alpha cells of the monkey retina, observed by Perry and Cowey ('81), following HRP uptake by cut axons of the optic nerve.(ABSTRACT TRUNCATED AT 400 WORDS)

Alterations of retinal inputs following striate cortex removal in adult monkey

The morphology of the retina and central retino-recipient nuclei was studied in two monkeys that had undergone total bilateral striate cortex removal as adults. These animals had been behaviorally tested for two years after lesioning and had demonstrated significant recovery of pattern vision. Light and electron microscopy and autoradiography were done on the central retino-recipient nuclei following a monocular intravitreal injection of 3H-proline. Light microscopic analysis of retinal ganglion cell number showed a 30% loss in the parafoveal retina due to retrograde trans-synaptic degeneration. The most striking central change in retinal axon distribution was in the dorsal lateral geniculate nucleus (dLGN) where the parvocellular but not the magnocellular region showed a marked reduction in retinal input. Despite the loss of almost all dLGN neurons through retrograde degeneration, at the EM level both parvocellular and magnocellular regions contained islands of neuropil made up of retinal and several other types of synaptic terminals as well as small dendrites and pale unidentified processes. Approximately equal numbers of retinal terminals were identified by EM autoradiography in both regions of dLGN, which did not explain the apparent differences in labeling between the two regions seen in the light microscope. A second change in central retinal pathways was found in the olivary pretectal nucleus where a significant loss of retinal input also occurred. A third change, but in the opposite direction, was found in the pregeniculate nucleus (PGN) where the area of retinal terminals appeared enlarged. The remaining central retino-recipient nuclei had the same distribution of retinal input as the control animals.

The primate visual system after bilateral removal of striate cortex. Survival of complex pattern vision

This study examined the strategies used by monkeys lacking striate cortex to perform visual pattern discriminations. Complete bilateral removal of area 17 initially produced severe visual impairment with recovery of even rudimentary visual capacities (e. g., flux discrimination) dependent on gradually retraining the monkeys through a set of increasingly more complex pattern discriminations. After extended periods of postoperative testing, however, three of five monkeys lacking striate cortex were able to discriminate a number of complex visual patterns even when such local stimulus cues as amount of contour and number of elements were equal. Further testing demonstrated that these animals could distinguish a pattern's spatial organization. They were also able to transfer good performance to tasks with novel patterns.

Relationship of age and hypertension to neuropsychological test performance

Young adult (X- = 29) and middle aged (X- =50) hypertensive and normotensive subjects were compared with respect to seven neuropsychological test scores derived from tests on the Halstead-Reitan battery. Age main effects, with inferior performance for the middle aged subjects, were observed for the localization and time portions of the Tactile Performance Test (TPT) and for the Trail Making A test. The multivariate age effect was significant for the composite of seven scores. A multivariate blood pressure main effect was obtained and main effect blood pressure was significant for the category test; hypertensives made more errors than normotensives. A blood pressure by age interaction was observed for finger tapping scores and the TPT-Memory scores with larger differences between hypertensives and normotensives for the younger than for the middle aged group. Results were discussed in terms of previous studies of age and hypertension with the WAIS, the Primary Mental Abilities Test and serial reaction time measures. The poor prediction of hypertensive status from individual neuropsychological test scores was emphasized and readers were cautioned not to conclude that essential hypertensives, as a group, can be characterized as brain damaged.

Effects of altered responsibility, congnitive set, and modeling on physical aggression and deindividuation

This laboratory investigation using 64 college students as subjects assessed the role of three disinhibiting variables in producing both physical aggression and an internal state of deindividuation. Altered responsibility, congnitive set, and modeling were manipulated in a factorial design, and all three variables significantly increased physical aggression. No interaction produced significant results. The increase due to altered responsibility and varying cognitions supports Zimbardo's theory of deindividuation which relates certain input variables to wild, impulsive behavior. Questionnaire data indicated that the increase in aggression was not accompanied by internal mediational factors such as reduced self-awareness. It appears that disinhibiting forces may produce increases in antisocial behavior without necessarily producing a deindividuated internal state.