Cohort profile for the STratifying Resilience and Depression Longitudinally (STRADL) study: A depression-focused investigation of Generation Scotland, using detailed clinical, cognitive, and neuroimaging assessments

STratifying Resilience and Depression Longitudinally (STRADL) is a population-based study built on the Generation Scotland: Scottish Family Health Study (GS:SFHS) resource. The aim of STRADL is to subtype major depressive disorder (MDD) on the basis of its aetiology, using detailed clinical, cognitive, and brain imaging assessments. The GS:SFHS provides an important opportunity to study complex gene-environment interactions, incorporating linkage to existing datasets and inclusion of early-life variables for two longitudinal birth cohorts. Specifically, data collection in STRADL included: socio-economic and lifestyle variables; physical measures; questionnaire data that assesses resilience, early-life adversity, personality, psychological health, and lifetime history of mood disorder; laboratory samples; cognitive tests; and brain magnetic resonance imaging. Some of the questionnaire and cognitive data were first assessed at the GS:SFHS baseline assessment between 2006-2011, thus providing longitudinal measures relevant to the study of depression, psychological resilience, and cognition. In addition, routinely collected historic NHS data and early-life variables are linked to STRADL data, further providing opportunities for longitudinal analysis. Recruitment has been completed and we consented and tested 1,188 participants.

Cohort profile for the STratifying Resilience and Depression Longitudinally (STRADL) study: A depression-focused investigation of Generation Scotland, using detailed clinical, cognitive, and neuroimaging assessments

STratifying Resilience and Depression Longitudinally (STRADL) is a population-based study built on the Generation Scotland: Scottish Family Health Study (GS:SFHS) resource. The aim of STRADL is to subtype major depressive disorder (MDD) on the basis of its aetiology, using detailed clinical, cognitive, and brain imaging assessments. The GS:SFHS provides an important opportunity to study complex gene-environment interactions, incorporating linkage to existing datasets and inclusion of early-life variables for two longitudinal birth cohorts. Specifically, data collection in STRADL included: socio-economic and lifestyle variables; physical measures; questionnaire data that assesses resilience, early-life adversity, personality, psychological health, and lifetime history of mood disorder; laboratory samples; cognitive tests; and brain magnetic resonance imaging. Some of the questionnaire and cognitive data were first assessed at the GS:SFHS baseline assessment between 2006-2011, thus providing longitudinal measures relevant to the study of depression, psychological resilience, and cognition. In addition, routinely collected historic NHS data and early-life variables are linked to STRADL data, further providing opportunities for longitudinal analysis. Recruitment has been completed and we consented and tested 1,188 participants.

Clinical laboratory practices for detection and reporting of Cryptosporidium in community cases of diarrhoea in the United Kingdom, 2008

To identify procedures employed by publicly funded clinical diagnostic laboratories in the United Kingdom (UK) for the detection of Cryptosporidium in community cases of diarrhoea, a telephone survey was conducted between August 2008 and January 2009 of all such laboratories that test stools from community-based patients. All 200 laboratories responded: 145 (72.5%) tested all stool samples for Cryptosporidium, while 55 (27.5%) applied selection criteria. There were country and regional differences in the proportion of laboratories selectively testing stools, which were significantly correlated with Cryptosporidium report rates to national surveillance (Spearman's rank correlation coefficient (rs)=0.61, degrees of freedom (df)=11, p=0.03). Understanding of laboratory practice is fundamental to interpreting trends in surveillance data, estimating disease burden and identifying outbreaks, as well as providing important background information against which changes and effects of new public health regulations can be measured.

Intrapartum ultrasound estimation of total bladder volume

OBJECTIVE

To determine whether real-time ultrasound measurement of multiple linear dimensions of the bladder could be used to estimate total bladder volumes of women in labour.

AIM

To create a simple reproducible formula using ultrasound techniques to help estimate total bladder volumes of women in labour. This may prevent unnecessary catheterisation and conversely, avoid failure to catheterise when indicated, thereby reducing the complications associated with catheterisation and bladder overdistension.

DESIGN

Prospective, observational study of women in labour.

SETTING

Delivery Suite, Obstetric Hospital, University College London Hospitals.

POPULATION

Forty-nine women in labour recommended for catheterisation by their attending midwives.

METHOD

A real-time ultrasound scanner was used to measure bladder diameters in two planes: transverse width and height, and sagittal width and height. A Foley's catheter was inserted and the bladder drained into a graduated bowl under sterile conditions. These values and urine volumes were recorded and a formula for detecting bladder volumes above 300 mL was developed using linear regression methods and the Bland-Altman limits of agreement.

MAIN OUTCOME MEASURE

Sensitivity and specificity of derived formulae in predicting bladder volume from ultrasound measurements. Correctly predicted volumes greater than 300 mL.

RESULTS

Among the 49 women, 36 were nulliparous and 13 were multiparous. All had full-term pregnancies with cephalic presentation and were in active labour with cervical dilatations ranging from 3 to 10 cm. There were no previous caesarean sections among the multiparous women. Thirty-nine women had epidural analgesia. Indications for catheterisation included a palpable bladder per abdomen, or the interval from last urine voided. The catheterised volumes ranged from 30 to 720 mL with a median of 150 mL. The new equation (0.68 x h x d x w) had a sensitivity of 77% (95% CI 46-95%) and specificity of 86% (95% CI 71-95%) for detecting bladder volumes greater than 300 mL. In order to ensure that about 95% of women in need of catheterisation are detected, the above equation was improved using the Bland-Altman limits of agreement. The sensitivity of this final equation (1.74 x h x d x w) was 100% (95% CI 75-100%) and the specificity dropped to 36% (95% CI 21-54%).

CONCLUSION

It is possible to use real-time ultrasound in estimation of total bladder volumes of women in labour. The implications are that all of those normally selected as being in need of catheterisation could be detected, while about a quarter of those women would avoid unnecessary catheterisation.

Alkaloids and triterpenoids from Ammocharis coranica (Amaryllidaceae)

The bulbs of Ammocharis coranica yielded eight alkaloids: lycorine, acetylcaranine and crinamine, which have been reported previously from A. coranica, 1-O-acetyllycorine, hippadine, 6 alpha-hydroxypowelline and hamayne, which have been reported from other members of the Amaryllidaceae, 1-O-acetyl-9-O-demethylpuviine, which has not been described previously, and the known cycloartane compounds: 24-methylenecycloartan-3 beta-ol, cycloeucalenol, cycloeucalenone and also 24-methylenepollinastanone, which has not been described previously.

Bovine-associated mucoprotein: I. Distribution among adult and fetal bovine tissues and body fluids

Bovine-associated mucoprotein (BAMP), solubilized with water from the delipidated membranes of bovine milk fat globules, is not restricted to fat globules or to the alveolar epithelial cells from which they are formed. BAMP also has a widespread distribution on other bovine glandular epithelial cells and on undifferentiated cells in lymphoid germinal centers and in several fetal tissues. Free BAMP is present in bovine colostrum, milk, other secretory fluids, and in fetal serum but is absent from adult and colostrum-deprived calf sera. In bronchoalveolar fluids, BAMP is preferentially found in the mucus-rich fraction. BAMP is antigenically distinct from all adult serum proteins, free secretory component, beta 2-microglobulin, lactoferrin, alpha-lactalbumin, beta-lactoglobulin, and five different caseins. BAMP as a free protein constitutes one-sixth of the total amount of BAMP present in milk. The BAMP-related component of fetal serum lacks antigenic determinants present on the BAMP of milk as demonstrated by immunoprecipitation and partial blocking of immunofluorescence. The fetal component is not fetuin or alpha 1-fetoprotein. These data suggest that BAMP may be useful in studies of the membranes of proliferating or differentiating epithelial cells.