I'm so excited to announce that my first book signing for 2014 will be in Peru!!
It's a place I've always wanted to visit, and I can't even begin to express how excited I am!
I know it's a little off the beaten path, but for my Peruvian readers, I really hope to see YOU there!!
After a lovely Thanksgiving Day in Reims, France, touring the Champagne caves, I'm looking forward to a leisurely day exploring Paris, before tomorrow's signing at the Children's Book Fair in Montreuil.
I'll be there on Saturday, November 30, from 14h - 16h, at the Michel Lafon Booth D38 on the 1st Floor…Really hope to see YOU there!!!
Just wanted to send out a big, warm, sparkly Bonjour to all my French readers!! I'm currently in Paris, getting ready for my signings at the Children's Book Fair today (Wednesday) and Saturday, and really hope to see YOU at one (or both!) of the events!
Readers of THE SOUL SEEKERS know that Daire and Dace are guided by Raven and Horse—did you ever wonder what Ever and Damen's Spirit Animals are?
Ever is guided by Butterfly. Butterfly represents change, metamorphosis, transformation, and has an innate understanding of the cycles of life, death, and rebirth. Those guided by Butterfly bring color, beauty, and joy wherever they go.
Damen is guided by Owl. Owl represents magic, mystery, prophecy, wisdom, and night vision. Those guided by Owl are generally old souls with an ability to foretell the future and see that which remains hidden from most. Owl brings awareness, wisdom, and sensitivity to any situation.
Wondering which Spirit Animal might be guiding you? Check out some of these descriptions HERE and see which one fits!
Just wanted to thank all of my lovely readers along with the amazing staff at Alamosa Books for celebrating the HORIZON release with me! The Soul Seekers is a series that is dear to my heart, and I really appreciate all of you going on Dace and Daire's journey with me--I couldn't have done it without you!
After that, I'll be hard at work on a brand new project that I hope to announce soon! But until then, THANK YOU again for supporting THE SOUL SEEKERS--I'm so grateful to have you as readers!
The fourth and final installment in the bestselling SOUL SEEKERS series.
In stores now- wherever books are sold.
Tuesday, November 19, 7:00 p.m.
For information on the series, events, Soul Seekers news and updates, visit the website HERE!
Wearing my dreamcatcher earrings today in anticipation of HORIZON hitting stores tomorrow!
Just a few more days until HORIZON hits the stores, but in the meantime you can read this free short story I wrote about Daire Santos from THE SOUL SEEKERS meeting Ever Bloom from THE IMMORTALS. Worlds Collide!! Details HERE!
THEIR DESTINY IS ON THE HORIZON.
My husband and I collect masks from all over the world--all of which are placed on a 2-story wall that faces the entry and also my office. I didn't even realize where I'd gotten the idea for Cade's transformation until I took a writing break one day, wandered over to the mask wall, and realized I'd been staring at it all along!
And speaking of HORIZON, I'll be signing copies next Tuesday, November 19 at 6:00 PM at Alamosa Books in Albuquerque, NM. Hope to see YOU there!!
Also, if you haven't done so already, be sure to enter for your chance to win one of 100 pairs of Raven inspired feather earrings that we're giving away to celebrate the HORIZON release. Click HERE for details!
In less than a week HORIZON will be in stores! To celebrate, we're giving away 100 pairs of Official SOUL SEEKERS earrings, inspired by Daire's Spirit Animal, Raven!
For your chance to win, click HERE!!
Everything that went down in the previous books, FATED, ECHO, & MYSTIC , has been leading up to this moment...and I hope you enjoy the explosive ending as much as I enjoyed writing it!
In the meantime, you can get a sneak peek at the first two chapters HERE!!
Also, over on THE SOUL SEEKERS Facebook page, we'll be making some fun posts as part of our daily countdown, so be sure to check by daily!
And, lastly, I'm so excited to be headed back to Alamosa Books, in Albuquerque, New Mexico to celebrate the finale of the series--same place I celebrated the release of FATED last year!
If you can't make that signing, maybe you can visit me in Paris! I'll be making a couple of appearances in Paris, France at the annual Children's Book Fair (can't wait!)!!
I'm so excited that HORIZON-- the final installment in THE SOUL SEEKERS series -- will be hitting the shelves in just 10 days! I can't believe how quickly this series has gone by!
We'll be posting some fun pics, inside info, and giveaways over on THE SOUL SEEKERS Facebook page, so be sure to check in daily so you don't miss out on the fun!
But before things get too crazy in the land of book promo, I wanted to take a moment to THANK ALL OF YOU for your kindness, generosity, and support over the last eight years since my debut novel, FAKING 19, was published! I always say I have THE BEST READERS EVER--and not a day goes by that it's not proven true!
I've got a few signings coming up and I really hope you can make one (or all!) of the events!
On Tuesday, November 19, I'll be celebrating HORIZON's release at the place where it all started last year with FATED-- I'm returning to Alamosa Books in Albuquerque, New Mexico!
Shortly after, I'll make a couple of appearances in Paris, France at the annual Children's Book Fair (can't wait!)!!
As always, you can keep up on all of the latest news on the FREE Alyson Noel App!
And you can almost always find me over on Twitter, Facebook, or Pinterest!
I have some exciting news I hope to announce soon-- but until then, I really hope you enjoy HORIZON--and THANK YOU- THANK YOU- THANK YOU- for being soooo awesome!
Book Signing in Manila & Cebu!!!
I'm soooo excited to finally announce that I'm headed back to The Philippines in September for some book signing events with the amazing Melissa delaCruz and Margaret Stohl!
Thanks to National Book Store and all of YOU, my signing in Manila last year was amazing, and I can't wait to return with two wonderful authors and good friends in tow!
Hope you can meet us at one (or all) of the events!
Well, MYSTIC has been in stores for a couple weeks now and I just wanted to thank you for your kind words and support. I'm so happy to know that so many of you are enjoying the series as much as I enjoyed writing it, and are looking forward to the final installment, HORIZON, in stores 11.12.13!
But, well before then, I'm headed for Norway on book tour next week and I can hardly wait to get there!
I just received my schedule a moment ago, and wanted to share it with you in hopes that you can make one (or more!) of the events!
I'm really looking forward to seeing Norway in the spring (last time I was there it was one of the coldest winters on record!), and would love to see YOU at one of the events! Hope you can make it!
That's all for now -- have a great day, everyone!
The MYSTIC trailer is here!!!
I'm so excited about the release of MYSTIC today and to share the trailer with you!!
Without further ado--here it is.....Enjoy!!
Well, it's been nearly two months since I last blogged or checked in on my social networks, and I want to thank you all for your patience during this difficult time.
But as things are beginning to stabilize, I thought I'd pop in and say hello and tell you how much I've missed all of you!
And while I apologize for the earlier events that I wasn't able to attend, I wanted you to know that I'm really excited about the release of MYSTIC tomorrow, May 7, and to celebrate its release I'll be signing copies in Los Angeles, this coming Sunday, May 13, 2013 at 5:00 pm, alongside the amazing, Margaret Stohl, Marie Lu, Tahereh Mafi, Ransom Riggs and Kami Garcia!
"The plot development is positively divine in Mystic, and I am more excited than ever for the finale in this series. Much like Echo, the plot is going, going, going ... and just around every plot twist is another mystery to be unraveled. If you haven't started the Soul Seekers series, go pick up some copies now. You won't regret it, I promise!"
And speaking of signings, I'm headed to Norway at the end of May for events in both Oslo as well as the Lillehammer literary festival! I had such a great time in Norway when I signed there two years ago, and I can't wait to return and see it in the spring (last time I was there was the coldest winter on record!)!
Again, I really want to thank all of you for your kindness and support during a difficult time-and I really hope to see you in L.A. or Norway--and, barring that, there's always Twitter and Facebook, right?!


On To Paris! uses a wargame system adapted from Victory Games' "The Civil War" to simulate the grand events of the Franco Prussian war (1870-71) and challenge players to control the leadership, organization and military operations of Armies and Corps during the later 19th century.
The Franco Prussian war was fought using Napoleonic tactics but with weapons of almost World War One lethality that included breech loading rifles, artillery and an early version of the machine gun. The Franco Prussian war developed many key concepts for the control and movement of large formations in warfare as well as tactical combat.
At a time when the French army was considered the best in the world, the armies of Prussia and her German allies invaded France and in less than 3 months defeated the armies of Napoleon III. Despite German success, the French refused to surrender and as a result German forces laid siege to the French capital. For 5 long months, Paris, a city of about 2 million inhabitants, was starved into submission while surrounded by German armies that had to maintain a long supply line back to Germany, all the time fending off desperate French attempts to break the siege.
On To Paris! simulates both phases of the Franco Prussian war; the German invasion of France in 1870 and the German conquest of France in 1871. Designed for two players, On To Paris! is also suitable for solitaire play. Nine scenarios include an 'early start' plus a full length campaign game. Players can also pick any scenario as a starting point and determine their own period of the conflict to simulate.
On To Paris! is a fast moving competitive one map game where players do their best to control their forces and where every decision creates excitement and tension. The game system features interactive game play with flexible initiative and variable turn length as well as extensive defensive player reaction ability. The game puts players in charge of all the famous Corps and Army leaders of the Franco Prussian war which are all rated for their individual leadership qualities and occasional unique characteristics like resistance to following orders.
Before it ended, the Franco Prussian war caused an overall casualty rate over twice that of the American Civil War fought only 5 years earlier and it was the last war where both armies wore uniforms designed for the parade ground. Special rules include the evolution of German Infantry and French Artillery tactics throughout the war, the political stability of the French 2nd Empire, Franc Tireurs, the brilliance of von Moltke and the German General staff, cavalry, German Landwehr and French Mobiles, Fortresses, Forts, siege artillery, rail supply and more.
On To Paris! is a straightforward, intricate and interactive fast playing game that covers the entire Franco Prussian war with Individual Army and Corps level Leaders that are rated for their tactical and battle leadership abilities and to react to enemy forces. The game focuses on the operation of Corps and Armies and individual strength points that represent brigades and the abiltiies of the Leaders that command them. Players decide where to focus their operations then alternate commanding their units in a series of game phases.  Each phase, the amount of initiative represents the relative ability of each player to conduct operations. Commands to units expend different amounts of available command and initiative and Corps and Armies let you organize and move larger number of strength points more efficiently.  The more initiative you have, the more you can do. But remember, the other player is able to react with their forces and will be able to move second while you react to them! A simple combat and siege process, rail/sea transport and supply rules and many optional rules create in depth historical flavour of the Franco Prussian war and signficiant replayability.


According to experts, it will take years to reconstruct Rgn and other towns as all infrastructures are collapsed now.
It will take at least 40 days to reinstall electrical lines.
Main water supply system is damaged and the whole city cannot get any water now. A bottle of water cost 800 kts and there is no more stock now.
Fuel price is 10,000 kts per gal tonight. Bus fare from downtown to Insein is 2000 kts.
An egg cost 300 kts, and all food and commodities cannot be bought easily.
About half of housings are damaged in Rangoon. Hlaingtharyar, Shwepyithar and Dagon (New Settlite Towns) are most hard hit. Some quarters were blown away completely. But there are very few information available, as people cannot move around even in your own quarter.
In Phyarpone, Pyinsi village out of 3000 villagers, only 700 left behind. They lost the rest. In Hainegyi, there are 95,000 homeless on the town alone. No relief assistance is available. I think hundreds of thousands of people's life are at stake, if no rescue program start in time. Kyaiklatt and Lapputta are the hardest hit, it is said. Many villages are still under flood and no food or water is available.
In Rangoon, all the roads are still blocked with fallen trees. There is no public conveyance system. Almost all phone systems are dead, except very few CDMA lines which are reconnected this evening.
All trees from U Wisarra road are uprooted. All big pagodas are damaged. Only Kabaaye road is cleaned today. Prome road is still closed. No news from Daw Suu compound yet. NLD signboard is blown away. No NLD Ec start working yet.
All advertisement signboards were fallen and all satellite antennas fall down from roofs.
There are news that hall no 1, Insein jail was burnt down to ground during the storm. Cannot confirm yet, as everyone is still busy repairing their own house and try to make their way out. The whole city is totally paralyzed and people are panic of extensive looting in the coming days. There is no hope to get food for majority of the population. There is not even enough candles to buy.
All hospitals are hit hard too and medical personnel cannot attend the patients.
SPDC refuse some aid offers. They will not rebuilt Rgn but encourage people to move to Naypyidaw. It is unthinkable to survive with no food, no water, no medecine,no roof, no electricity, no phones, no transport, no fuel or candle, ( No job, no money, no hope) and no help.


With this 20 DVD set train your meployees from the ground up providing a solid safety foundation for employees working in construction.
Train your construction crew from the ground up with the solid safety foundation provided by these courses. All of the courses in this set can help raise safety awareness, ultimately reducing injuries and costs. Topics include common equipment functions and procedures, important OSHA regulations, seasonal conditions, and instructions for preventing and treating worksite incidents involving injury.


GREE Forum > Forums > Kingdom Age > General > What do you think the next Event will be?
View Full Version : What do you think the next Event will be?
I'm guessing it will be a PvP fights won tournament, only because they've run them before. Anybody have any ideas?
It's going to be the same thing as the rune box event. Just with a different item to gather 10 of, and the prize will be a 20% reduction in upgrade time.
For MW wasn't the 20% energy renewal before the upgrade cost one? Or am I getting confused?
I know for a fact the upgrade reduction was the 2nd one because that was the event I went all out on just to have my hopes and dreams pooped on by funzio.
Likewise. Only got 8 and went all out, spent about 200 gold, levelled up loads. Finished on 8 on several other events without really bothering, never managed any more than 8.
For me the upgrade time reduction is the biggest prize available in these games.
Here is a list of MW event prizes. Tournaments is anyone's guess.
1st event = Ambulance, 20% reduction in casualties.
2st = Helicopter, buildings upgrade 20% faster.
4th = Fighter Jet, Energy replenish +67 % faster (ie. 5 points instead of 3).
5th = Speed Boat, building upgrade costs reduced by -30%.
6th = Boat, +40 % extra Valor from each won combat.
7th = Tank, +30 % more money from Missions.
That's fantastic Freekizh. We only need the CC events too to start to bet on them. Maybe some polls just as Bigflan likes a lot.
Don't mention flan. He's in the doghouse - he made HK really angry and sad. Right now the MW forum is one really angry and weird place.
Ok, sorry, as i am new never knew about how were MW and i usually read more in KA because is the game that got me hooked.
Got nothing to be sorry about bro. Fannie is in the poo.
I stopped playing MW..it's like a distant memory, and it was for the buddies there, but seems like an angry mob over there now...maybe too many of the events wearing people down like ghost says. People always come onto forums just to rant about the event and casualty rates. Same old same old.


text:
info@icschool-uae.com
ICS PTA AL FALAH CITY
EXECUTIVE MEMBERS ROLES
WELCOME TO ICS AL FALAH CITY CAMPUS
"He who does not know his past cannot make the best of his present and future, for it is from the past that we learn." Sheikh Zayed bin Sultan Al Nahyan
The International Community School – ICS Al Falah City Campus (BRanch 2) is part of a private K-12 group of schools offering the American Curriculum. ICS Al Falah City is the fourth campus of International Community Schools to open in the Emirate of Abu Dhabi. As a new campus, we opened in the Academic Year 2020 - 2021 with students from KG1 to Grade 5. In the AY 2021-2022, we plan to open Grades 6, Grade 7, and Grade 8 to grow and develop our student body to be sensitive to the plight of others and confident in themselves to learn, develop, and assist others.
ICS Al Falah City ensures our commitment to creating value-added learning through fun-filled interesting learning opportunities in STEAM classes. Our class teachers are all native speakers and create higher-order thinking lessons that empower students to be innovative thinkers, creative problem-solvers filled with self-confidence.
ICS school systems are known for offering outstanding holistic educational opportunities and boasts an enviable reputation for providing high-quality academic programs enriched and extended by a broad range of co-curricular and extra-curricular activities. Resources and facilities at ICS are of the highest standard. Accomplished ICS graduates leave the school as dynamic and impactful citizens, fully prepared for success at university.
Subscribe to our mailing list for updates on ICS Al Falah.
Ph: 026338181
Al Farah St, Al Falah
Abu Dhabi - United Arab Emirates
Email: alfalahadmissions@icschool-uae.com

redpajama_set_name: RedPajamaCommonCrawl


text:
Del Potro, Monfils And Goffin Withdraw From Indian Wells
by Tom Gainey | March 9th, 2015, 3:25 pm
A trio of men withdrew from this week's Indian Wells Masters on Monday. Injury-riddled Juan Martin del Potro returned his wildcard back to the tournament where he reached the finals in 2013 as the Argentine's ailing left wrist is still not ready.
The tournament announced that rising star Thanasi Kokkinakis will take del Potro's available wildcard.
Gael Monfils and David Goffin, who both played Davis Cup over the weekend, also withdrew. Monfils cited a knee injury while the Goffin who won the fifth rubber for Belgium yesterday is out with a bad rib.
"I felt a slight pain on my rib during my Davis Cup match, so I decided to withdraw from the Indian Wells tournament to cure myself," Goffin wrote on Facebook. "I will be back to competition in Miami where I will be 100% physically."
Last week, Jo-Wilfried Tsonga and Petra Kvitova announced their withdrawals from the first Masters 1000 event of the season.
While players have withdrawn, several are expected to make their 2015 debuts including Marin Cilic, Jack Sock, Tommy Haas and Laura Robson.
The Indian Wells women's draw will be released at 6pm ET today. The men's draw will be made at 6pm Tuesday.
Sadly, Here's Who Won't Be At Indian Wells
Roger Federer to Withdraw From Indian Wells?
Jo-Wilfried Tsonga, Petra Kvitova Withdraw From Indian Wells
Serena Williams Pulls Out Of Indian Wells And Miami
2-Time Champion Maria Sharapova Withdraws From Indian Wells
Read more stories about: Indian Wells
Tags: David Goffin, Gael Monfils, Juan Martin Del Potro
11 Comments for Del Potro, Monfils And Goffin Withdraw From Indian Wells
Hippy Chick Says:
Sorry about Goffin and Monflis,but there was never any cast iron certainty that Delpo would be competeing anyway,so not that surprised about his withdrawal,not that you can call it that when the guy aint played hardly this year?….
Okiegal Says:
This doesn't sound good for DelPo…..I'm sorry to say. His wrist is not healing. I don't see how it would if he continues with the hard hitting. It will never be OK, imo. This is so sad for him. But in all reality, how will it be possible for him to change his playing style? Knocking the cover off the ball is what he does best. Hope something can help him, but atm it's looking dismal.
RZ Says:
What a shame. I would have liked to see all the players who withdrew out at IW.
I think I've jinxed David Goffin with injury woes. I put him in my year-end top 10 in the Tennis-X challenge based on his results at the end of last year. Since I did that, he's been plagued by injury.
@RZ…….You better shape up. With friends like you, who needs enemies!! Lol. Kidding of course. I just hate it when injuries interfere with these players careers. It's a real bummer!! :(
chris ford1 Says:
Hope we see Delpo helping field a strong DC squad against Novak and the Serbs. Will be a week after Wimbledon, Jul 7-9. I root for Nole and Zim and Viktor because I think those guys were robbed in 2013 by the Tipsarevic injury and the unfairly long suspension Troicki suffered.
Had Viktor or Janko been there, if would have been 50-50 in the Finals with the Czechs.
But at the same time, who hates Juan Martin? Anyone?? Argentina has never won DC, but they have been doing it since 1923 and have some great players over the years.
Yes, lots of talk about Andy and the Brits. How it's been since 1936 for the UK to win DC…..but Argentina has waited longer for the dream.
And on paper, they could have a top team. Delpo, Monaco, Mayer maybe, Delbonis, a good doubles squad.
I wonder if theres any news on Rafa and Roger,or the Spanish and Swiss DC teams??
Um, you need to do a better job managing your news feed. The item about Federer withdrawing from Indian Wells is from 2010, yet it's mixed in with all the current news!
Aarontennis Says:
I am happy that Tommy Haas and Jack Sock are returning and hope that they stay injury free. I am the least optimistic about Del Potro. I think that he needs to sit out at least another six months without hitting a ball. It kind of reminds me of Tommy Haas' original shoulder injury in the early 2000s. He eventually was able to hit without pain after he sort of game up tennis for awhile and fell off the map. Del Potro might want to plan on a 2016 comeback.
@Aarontennis – I read a tweet yesterday that Tommy Haas has pulled out of IW. :-( I was looking forward to his return too.
Sad to think that we'll never see again the del Potro that won the 2009 US Open or the del Potro that gave the top 3 guys a run for their money. I hope he had his wrists insured. I wonder if the top tennis guys have insurance against sports injuries. Anthony Kim (golf) stands to get more than $10M if he never plays professional golf again.
what comments are these. Delpo must stop hitting hard!
We know one thing and that is when he stops hitting as hard as hè does then he is finished as a toplevel professional player.
he will not make top 30 if he eases in his groundstrokes. Besides that his window is closing.


text:
Bābā Sheydollāh (persiska: بابا شيداللّه) är en ort i Iran.   Den ligger i provinsen Kurdistan, i den nordvästra delen av landet,  km väster om huvudstaden Teheran. Bābā Sheydollāh ligger  meter över havet och antalet invånare är .

Terrängen runt Bābā Sheydollāh är platt åt nordost, men åt sydväst är den kuperad. Den högsta punkten i närheten är  meter över havet,  km norr om Bābā Sheydollāh. Runt Bābā Sheydollāh är det ganska tätbefolkat, med  invånare per kvadratkilometer. Närmaste större samhälle är Delbarān,  km nordväst om Bābā Sheydollāh. Trakten runt Bābā Sheydollāh består i huvudsak av gräsmarker.

Ett varmt stäppklimat råder i trakten. Årsmedeltemperaturen i trakten är  °C. Den varmaste månaden är juli, då medeltemperaturen är  °C, och den kallaste är februari, med  °C. Genomsnittlig årsnederbörd är  millimeter. Den regnigaste månaden är november, med i genomsnitt  mm nederbörd, och den torraste är augusti, med  mm nederbörd.

Kommentarer

Källor

Orter i Kurdistan (Iran)

redpajama_set_name: RedPajamaWikipedia


Below is a collection of special mindful children and young adult books by some of my favorite authors that are sure to enlighten. If you see any that might be of interest to you, just click on the Amazon image for an overview.
The Kind Hearted Princess and The Mighty Spirited Prince is now available for purchase.
Want to join Lexi and Grier on their adventures? Just click on the book below for more information.
"Teaches children 7 lessons that will help lead them to a happy successful life."
"Do I have a soul? How do wishes come true? What is the supreme force in the universe? How can I change the world?"
"At every age we all need to know what life is really all about. Not just on the surface, but deep down. Teenagers are no exception."
"If you could ask God any question, what would it be?"
A Children's Parable adapted from Conversations with God. "Once upon a time there was a Little Soul who said to God, " I know who I am!" And God said, "That's wonderful! Who are you?" And the Little Soul shouted, "I am the light!"
The little soul's journey of a return to Earth in order to "experience who he really is."
Addresses the concepts of: Money doesn't define who you are, it doesn't matter what others have and abundance comes in many forms.
Teaches valuable lessons in the value of taking risks, dealing with stress and anxiety and learning to enjoy each moment.
Follows a boy with a seemingly impossible dream who almost lets excuses get in his way. He discovers...anything is possible.
Takes Dr Dyer's adult version of the 10 Secrets for Success and Inner Peace and interprets them for children.
Teaches kids the profound message: God is not far off in the distance, or even merely beside us, in other words, we are not separate from God, we are God!
Demonstrates how to make the change from negative thoughts and words to those that are positive.
3 stories to help today's children grow up with a sense of self-esteem and courage.
Introduces children to meditation in a fun and playful way.
Introduces children to the core of Tolle's teachings: Living in the Now.
Teaches reverence for all beings and the wonder and joy found of living in the present moment.
The children's version of the self-help best seller The Secret. Henry learns the secret to unlocking his imagination when finding his missing stuffed bunny.
The teenager's version of the bestseller, The Secret, explaining the law of attraction in relation the life issues they face.
An introduction for young children about the world of angels.


Getting around Prague is very easy thanks to Prague's excellent transport system. There are many trams, bus and metros that take you all around the city.
The network is very dense, and it's very quick to get from one point to another. When you're in Prague for a few days, it's always nice to catch the tram. First they've been in Prague for long and it's a great way to get around the city and enjoy sightseeing.
You can already use the public transport network when you arrive at the airport. It'll take you all the way to the centre in a bit more than 30 minutes. First you catch the 119 bus that takes you to Dejvicka metro & tram stop. And from there you pick the tram or metro that will take you to your accommodation. It is convenient and easy to get around.
This entry was posted in Public transport and tagged airport, bus, centre, DPP, info, metro, prague, public transports, tram on February 5, 2010 by Nicolas.


Unmasking the Cozy Bear hackers would provide key evidence for investigators trying to unravel the DNC breach.
The Dutch spy service broke into the computers used by a powerful Russian hacking group and may be sitting on evidence relating to the breach of the U.S. Democratic National Committee.
Reports carried in the respected daily Volkskrant and the current affairs show Nieuwsuur say hackers working for the Dutch General Intelligence and Security Service penetrated the computers used by the group, often nicknamed Cozy Bear, in mid-2014 and watched them for at least a year, even managing to catch the hackers on camera, Voice of America (VOA) reported with reference to The Associated Press (AP).
Read alsoRussian hackers try to target U.S. Senate's email system – APDutch officials declined comment; Interior Minister Kajsa Ollongren, interviewed by reporters in The Hague before the government's weekly cabinet meeting, said she was "very happy that we have good security services in the Netherlands that do their work well. I can't say anything about this case that has been published."


Located in Central Victoria, Sugarloaf Creek Estate is situated on the boundaries of the Goulburn Valley, Upper Goulburn and Macedon Ranges wine regions in the rolling hills of the Great Dividing Range. The location of the property is perfect for cool climate viticulture leading to a long and slow ripening period for the fruit.
The soil is rich, black volcanic with red clay deep below that holds on to water through the driest conditions. We therefore employ no artificial means of irrigation relying purely on rainfall and the excellent properties of our terroir. The result of 'dry farm' viticulture is that the berries, bunches and overall yields are often smaller intensifying the fruit flavours in the wine.
Established by the Blyth and Hunter families in the 1990's the vines have been planted and nurtured to maturity by hand. The entire vineyard is planted with Shiraz PT23 on vertical shoot positioned (VSP) trellis. Each vine is carefully spur-pruned, trained, trimmed, thinned and picked by hand to encourage the highest quality fruit possible from the site. The vineyard block slopes towards the east, high on a hill to minimise any potential frost damage.
Weed control in the vineyard is managed by our cute and friendly flock of Southdown Baby Doll sheep ably captained by Craig, the Ram.
The historic 1860's homestead was built by the Zwar Family and did previously include a small vineyard as well as operating for a time as a turkey farm! The property is now home to James and Julie Hunter and their young family.


a comedy about a Russian Family in Berlin, discovering that their neighbor might not be the innocent student he said he was. For this, accordion and balalaika (a Russian Guitar) were my weapons to meet the dynamic of the film.
a drama around the way we see Father Christmas and what would happen if he didn't look exactly like how we expect him to be. The main challenge for me was to compose the score while always keeping the Christmas atmosphere (with piano and glockenspiel!), whatever happens on the screen.
a drama about a woman bringing a kid from the street to her home. The score is based on two themes on the piano only, in order to emphasize the realitstic approach of the sad story. An extract is available under "Videos > Drama".
a fiction about 2 characters playing a game of identity. This is probably something a bit more experimental, the music being based on textures and sounds, sometimes theatrical, sometimes floating.
a drama based on a poem from Oscar Wilde, about a boy who's never cried. I based the score on piano, strings and violin solo, to fully carry the theatricality of the film. The Film's main actor, Wolfgang Richter, is also a professional violinist that accepted to play for me the violin parts of the music I wrote.


In virtuаllу аnу pokеr gаmе bе it frеe internet poker or cash gаme, a baсkdооr drаw iѕ а draw misѕed in the Floр but made on the Turn. Inside frее pоkеr аrtісle you will discover by mеаnѕ оf examplеs hоw to most reаdіlу useful рlау bасkdоor draws.
Todаy it reаlly is area оf the Galа Corаl group, the moms аnd dаd business whiсh operates Corаl amоngst а numbеr оf other well known brandѕ. Others the different pаrtѕ оf the team arе Gala gambling enterprises, Gala Bingо and Eurobеt. They operate acrоѕѕ European countries, with the Eurobеt brand namе specially successful in Italу, in whiсh there are several high-street betting shops.
Winnіng pоkеr is approximately obtaining the cash. It is nоt abоut рlaying as high as уou'rе able buy in, or havіng shоwу piles оf potato chips, оr wіnnіng a number of competition games. You might achieve thеѕе things for any other rеasоnѕ, they cоuld frequently Daftar disini be bу-products of winning, however these aren't thе material оf рlaying tо wіn. Winnіng pоkеr may be the art, science аnd craft оf taking above yоur equаl sharе associated with money bеіng endangered оn а poker dining tablе. In thе evеnt that уоu play to wіn, that's what matters – ingesting cash, perhaps not ѕquаndеring money, putting cash in danger іn mathеmatісallу sоund means, geаrіng yоur plау to finish uр with more cаѕh thаn yоu started wіth.
Pоker lobbyistѕ behind huge amount оf money іn overseas gаmbling organizations, that is positioned in Antіguа, Mаlta as well аs other international sanctuarіeѕ. Lobbying efforts had bеen successful, and alsо to some degree, Obаma's Administration has chose to postpone utilization оf thе illegal online Gаmbling Enforcement Act (UIGEA) tіl j??nius 2010th Thіѕ has provided somе rеlief towards thе online gаmblіng oреratоrs, who аrgue that if the game isn't fixed in thе uѕ сould cause huge amounts оf bucks іn taxation administration.
Thе grеat suсceѕs of internet poker hаs issued thousands of people frоm all оver thе world the chance to relаx and play for a reаl inсоme thе game they enjoyed. From ten dоllаrs buy-inѕ to 1000s оf dollars potѕ, there was a spot for аll within wondеrful wоrld of on-line pokеr. The vaѕt maјоritу of оnline poker plауers аrе іnеxрeriеnсed and unskilled beіng referred tо аѕ "fiѕhеs". But there arе thе skillеd people who earn аn inсоme frоm playing poker online. Thoѕе will bе thе feаrеd рoker sharks.
One оf the crucial sport betting tips would bе to look for expert gаmblerѕ on thе web. Theѕe expert gamblers provides уоu with different activities gambling tips. Theіr exрeriеnсe will helр you out on how tо handle it and how to pick top рlayers for yоu уоurѕelf to win. Browse the essential guidelines they've supplied for you and use thеm іn your suсceedіng online betting gаmеs. A few оf these professional gamblеrs, but will ѕimрly offer ѕрort wagering guidelines in return fоr аn amоunt of cash. Even better is as yоu are аblе to get freе guidelines that other websites are providing. From important іnformatіоn as possible get, certainly you shоuld havе an advisable endeavor within online bettіng gamе.
Andrеw, welcome towards the world of online recreations video gaming. Its a pleasurable globe so рrepare to invest many enjoyable аnd rеlаxіng hоurѕ. Below аrе а fеw remіnders you neеd to think about before рlaуіng аnd putting уоur money on online gaming.
Be verу careful whеn considering gаmbling on line. There аre numerоuѕ frauds online waіting to have уour hard-earned cash. Thеrе is really nо 100per сеnt option tо actually understand whіch websites аre genuine, therefore simply search for anythіng that mау seem dubious.


text:
Products & Releases
Egress Software Technologies Granted Patent For Secure Data Exchange
The new patent, "Media Device Access Control Mechanism," defines a method for ensuring shared information is only accessible by intended recipients
London, U.K. and Chicago, IL " July 13, 2009 " Egress Software Technologies, an innovator in secure data exchange, announced today that it has been granted patent GB2450197 by the UK Patent Office. The new patent, "Media Device Access Control Mechanism," defines a method for ensuring shared information is only accessible by intended recipients. The patent is also pending in the United States.
"Effective solutions to control information once it leaves the owner's possession have been slow to enter the market due to complexity of operation and deployment," said Bob Egner, U.S. President of Egress Software Technologies. "Contrasted with an increasing trend of data breaches from third-party mishandling of information, Egress Switch is designed to secure information through encryption and accurately ensure that only intended recipients can gain access. This patent reinforces the status of Egress as an innovator in the field of developing affordable, easy-to-use, trusted data security solutions."
Egress Switch allows an information owner to package their sensitive information using strong AES 256-bit encryption and send it to a recipient in a variety of ways such as attached to an email, burned on a CD/DVD, copied to a USB stick or transferred through the web or FTP. The owner can then set or change security policies independent of the package through a service in the cloud. Security policies can include authorizing recipients and limiting recipient access. These changes can be made in real time, even after the information is sent or shared. This allows a user to "pull information back" if it needs to be recalled.
Egress Switch also offers a complete view of when the information recipient has opened or used the shared information, as well as unauthorized access attempts, providing an audit trail. The owner can then easily track activity of their shared information through logs arranged by package or recipient.
Continued Egner, "Our customers have made their needs perfectly clear and this innovative technology paves the way for new generation of secure data exchange."
Delivered in a Software-as-a-Service (SaaS) model, Egress Switch was introduced in March and has a growing base of users. For more information on Egress Switch or to download the latest version, please visit www.egress.com.
About Egress Software Technologies Egress Software Technologies is an innovator in secure data exchange. The company provides easy-to-use security technologies that can protect data no matter where it is shared or how it is stored - CD/DVD, USB stick, file attachment, FTP, and other methods. Founded in 2007 as a data security reseller, the company is self-funded, based in London, UK, and is led by senior executives from leading data security software companies Reflex Magnetics, Pointsec Mobile Technologies and Check Point Software. Egress' growing customer base includes blue chip companies and government organizations around the world.
Beyond Passwords: New Thinking and Strategies for Authentication
Resilience & Reinvention: Enterprise IT in 2022 Virtual Event 12/9
New Uses for Amazon S3 are Creating Security Risks for Your Business. This is Why.


text:
Contract Solutions
Master Planning and Sustainable Urban Development
Chemical & Life Science
Government & Municipals
Highways & Intelligent Transport Systems
Ports & Industrial Infrastructure
Rail & Urban Transport
Water & Utilities
General Business Principles
Global Sustainability Policy
Planning for Connected Autonomous...
Capabilities: Transportation Planning, Business Advisory, Digital Innovation
Sectors: Transportation, Highways and Intelligent Transport Systems
Planning for Connected Autonomous Vehicles in Louisiana
Louisiana, USA - All over the world, autonomous vehicles are being created and tested, creating a need for cities to think and plan for this emerging technology.
collision reduction estimated for connected cars by government agency
To view the interactive version on this project, please click here. Connected and autonomous vehicles (CAVs) are self-driving vehicles equipped with sensors aided by laser-guided Lidar and radar to enable breaking and lane changing decisions without driver involvement. They can also be supported by new technologies in transportation infrastructure such as transponders that send navigational information. All over the world, autonomous vehicles are being created and tested, creating a need for cities to think and plan for this emerging technology.
The State of Louisiana's Department of Transportation and Development (DOTD) is recognizing the need to plan for connected autonomous vehicles, keep up to date on industry trends and prepare Louisiana for the future. Thus, they are engaging with Arcadis and partners including California-based Iteris, Inc. and Texas-based Alliance Transportation Group Inc. to provide technical support services and facilitate planning activities related to connected and autonomous vehicles and their impact on highway infrastructure.
The project will develop the implementation plan for connected and autonomous vehicles with Louisiana DOTD and performing intelligent transport systems architectures and system engineering analysis for connected and autonomous vehicles. It will incorporate the needs of commuters, freight delivery from ports, interstate drivers, bicyclists, pedestrians and travelers throughout the state. Strategies and plans such as this aid state departments of transportation in creating safer roadways for the future while synchronizing existing and new infrastructure with connected and autonomous vehicles.
As part of the project, Arcadis will analyze emerging technologies in roadway infrastructure. For instance, cars, trucks and tractor trailers are expected to be manufactured with new connected technologies that allow them to instantaneously "talk" to one another as well as communicate with roadway infrastructure to alert drivers quickly to upcoming traffic hazards. Using vehicle-to-vehicle communications and Dedicated Short Range Communications (DSRC) frequencies, connected vehicles traveling on specially equipped roadways can help save lives like previous automobile safety innovations such as air bags and seat belts. In fact, the National Highway Transportation Safety Alliance estimates that connected cars could reduce collisions by 80 percent for non-impaired operators.
Questions about this project
Akhil Chauhan
Vice President Transportation Services Ask me a question
Driverless Future: Autonomous Vehicles and Urban Policy
Sustainable Cities Mobility Index
Manchester Smart Motorways - Development Phase
Tiquatira
Hunter Expressway
The world in a complex place. Arcadis helps you navigate this complexity by understanding the bigger picture. Click here to read our latest thinking.
Arcadis is committed to providing a healthy and safe environment for all employees.
Rewarding work for people passionate about making a difference. Improve lives. Start with yours.
© 2019 Chamber of Commerce Amsterdam, the Netherlands
Trade Registry no. 09051284 VAT: NL 0062.92.227.B.01 Cookies Terms of Use Privacy
Accept Manage


A reusable water bottle is an eco-friendly way to make sure you've always got liquid refreshment within reach. Unfortunately, it's easy to forget that they're also a great breeding ground for bacteria.
Those stylish "cola-style" bottles can be especially tricky to clean properly. What if cleaning your water bottle was as easy as pressing a button?
That will soon be a reality thanks to the team at Microlyscs. They're currently running a crowdfunding campaign on Kickstarter to produce a clever little gadget called CrazyCap.
CrazyCap is a rechargeable sterilization device that is compatible with most cola-style water bottles. Juice it up, swap out the bottle's original cap, and give the button a double tap. That's all you have to do to kill the bacteria, viruses, mold, and algae in your bottle.
The dirty work is handled by a 10mW LG UVC LED. It's an industrial-grade unit that's rated for 10,000 hours of use, which Microlyscs estimates should provide you 10 years of sterilization.
It's remarkably efficient, too. According to Microlyscs you'll only need to charge CrazyCap once a month using the slick induction charger (there's no charging port in CrazyCap to make sure it's sealed ).
Once it's available for retail purchase, CrazyCap will sport an MSRP of $95. Backers of the Kickstarter project can secure one at a massive discount. There's still plenty of early bird perks available for a $38 pledge.
Not sure CrazyCap will fit your bottle? You can pick up a 17 ounce insulated from Microlyscs that's guaranteed to fit for an extra $14 ($18 if you miss out on the early bird perks).


text:
Game #34 – Hawks vs. Stars: Q&A With Taylor Baird… She Lives Here Now
By Sam Fels December 21, 2017 1415 0
For the second time in two weeks or so, we go and bother Taylor Baird from DefendingBigD.com. Follow her on Twitter @TaylorBaird.
The Stars are one of the lowest event teams in the league, which is something of a Hitchcock specialty. But given how this roster is built, is that really conducive to success? Is that why the record has been a touch wonky?
I think they're still trying to figure out the balance between structure and suppressing chances against while being creative offensively. When they won five games straight right after Thanksgiving, they scored an average of 4.4 goals per game (excluding shootouts/empty netters) and they only allowed 2.2 goals per game on average. That's a terrific recipe for success, and now they've shown they can do it. The trick is finding the consistency to put it into place each night while still adjusting to new linemates/system/coaching/etc. Sometimes that takes longer to put together than fans would like, but I think they're capable.
The Stars traded Jamie Oleksiak, which seems to be a vote of confidence for Julius Honka. Why are Stars fans so excited about him?
He's mobile and very creative with the puck in flashes in games he played last season, something the Stars have lacked at times from their blueline. Stars fans are excited that Dallas could have two of the offensive defensemen style blueliners in the lineup and believe it will help improve the transition game immensely. And while these kinds of players come with inherent risks, Honka has shown that he has the speed to be able to recover from his mistakes, something that Oleksiak struggled with in Dallas. It's not that people felt Oleksiak was a pylon, but for many fans his defensive shortcomings when he wasn't providing much in the way of possession/scoring was tough to swallow.
Martin Hanzal, five points, some of the worst metrics on the team. This has not gone well so far, has it?
The better penalty kill from the terribad one last season might say otherwise. He doesn't look good statistically, but he has had flashes in games this season when healthy of doing all the little things that help maintain possession or cycle in the offensive zone that has created the environment for goal scoring by the next line on the ice. I'd say it's more likely an "incomplete" grade at this point in the season, especially given that he's missed games due to injury.
Marc Methot is returning from injury soon. What kind of difference will that make?
I think it will really solidify a top six, and maybe the Stars can stop the bottom four merry-go-round that they've run searching for the right combinations. If they can get a group in consistently for a stretch, I'd expect the team as a whole will look much better in general.
What will the Stars need to pick up to lock down a playoff spot this year?
Most likely a top six forward, as the Stars haven't found the right answer to have a consistent second line threat without breaking up the dynamite grouping of Jamie Benn – Tyler Seguin – Alexander Radulov. It doesn't seem to be ready to be answered from inside the system today, so acquiring that will probably be a top target for Jim Nill at the trade deadline (or sooner) this season.
Game #34 Preview
Douchebag Du Jour
I Make A Lot Of Graphs
Lineups & How Teams Were Built


We accept the Holy Bible as God's authoritative Word. God moved by the awesome power of the Holy Spirit enabling man to write the inerrant, infallible truth of God for mankind.
We believe that Water Baptism, Holy Communion and holy living are the identifying marks of a believer in Jesus Christ. All believers are to be expressly identified with Jesus and His teachings and manifest the fruits of the Holy Spirit in consistent, godly living.
Although not everyone we pray for is healed, everyone who is sick does get prayed for and miracles do happen today!


text:
Clinical characteristics of patients with bipolar disorder and premorbid traumatic brain injury: a cross-sectional study
Ole Kristian Drange1, 2Email authorView ORCID ID profile,
Arne Einar Vaaler1, 2,
Gunnar Morken1, 2,
Ole Andreas Andreassen3, 4,
Ulrik Fredrik Malt3, 5 and
Per Ivar Finseth6
About one in ten diagnosed with bipolar disorder (BD) has experienced a premorbid traumatic brain injury (TBI), while not fulfilling the criteria of bipolar and related disorder due to another medical condition (BD due to TBI). We investigated whether these patients have similar clinical characteristics as previously described in BD due to TBI (i.e. more aggression and irritability and an increased hypomania/mania:depression ratio) and other distinct clinical characteristics.
Five hundred five patients diagnosed with BD type I, type II, or not otherwise specified, or cyclothymia were interviewed about family, medical, and psychiatric history, and assessed with the Young Mania Rating Scale (YMRS) and the Inventory of Depressive Symptoms Clinician Rated 30 (IDS-C30). Principal component analyses of YMRS and IDS-C30 were conducted. Bivariate analyses and logistic regression analyses were used to compare clinical characteristics between patients with (n = 37) and without (n = 468) premorbid TBI.
Premorbid TBI was associated with a higher YMRS disruptive component score (OR 1.7, 95% CI 1.1–2.4, p = 0.0077) and more comorbid migraine (OR 4.6, 95% CI 1.9–11, p = 0.00090) independently of several possible confounders. Items on disruptive/aggressive behaviour and irritability had the highest loadings on the YMRS disruptive component. Premorbid TBI was not associated with an increased hypomania/mania:depression ratio.
Disruptive symptoms and comorbid migraine characterize BD with premorbid TBI. Further studies should examine whether the partial phenomenological overlap with BD due to TBI could be explained by a continuum of pathophysiological effects of TBI across the diagnostic dichotomy.
Trial registration ClinicalTrials.gov: NCT00201526. Registered September 2005 (retrospectively registered)
Principal component analysis
Irritable mood
Migraine disorders
About one in ten diagnosed with bipolar disorder (BD) has experienced a premorbid traumatic brain injury (TBI) (Sagduyu 2002; Orlovska et al. 2014; Chi et al. 2016). An association between TBI and risk of BD is established by nation-wide cohort studies from Denmark (Orlovska et al. 2014) and Taiwan (Chi et al. 2016) and a meta-analysis of prior smaller studies (Perry et al. 2016). The nature of this association could theoretically include inverse causation, confounding, and causation (Malaspina et al. 2001). A review on the topic using Bradford Hill's criteria finds evidence for a causal relationship in some cases (van Reekum and Cohen 2000). The American Psychiatric Association also acknowledges that TBI can cause BD (American Psychiatric Association 2013).
The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM 5) distinguishes between a diagnosis of BD and a diagnosis of bipolar and related disorder due to another medical condition (in the context of this paper abbreviated to BD due to TBI) (American Psychiatric Association 2013). To fulfil the criteria of the latter, there must be evidence from the history (e.g. an acute or subacute onset of the mood disturbance after the onset of the general medical condition), physical examination, or laboratory findings that the mood disturbance is the direct physiological consequence of the general medical condition. Similar criteria exist for the corresponding diagnosis in the DSM fourth edition (DSM IV) (American Psychiatric Organization 1994). Thus, among patients with symptoms of BD, a premorbid TBI does not per se qualify for a diagnosis of BD due to TBI.
The validity of this dichotomy between BD with premorbid TBI and BD due to TBI is questionable (Kendell and Jablensky 2003). First, BD has a non-absolute monozygotic concordance (Craddock and Sklar 2013). Environmental factors must thus be of some etiological importance in both diagnoses. Second, a latency in the onset of BD after TBI does not exclude a pathophysiological impact of the latter. In a nation-wide sibling-controlled cohort study from Sweden (Sariaslan et al. 2016), TBI predicted risks of later psychiatric visits and hospitalizations. The risks were also increased among those with TBI in childhood and of mild severity. Even though these findings were not stratified by diagnoses, they highlight the possibility of a causative effect of TBI in childhood on psychiatric disorders in adulthood. Third, TBI can induce a range of pathophysiological processes which are not necessarily detected by standard radiological or electrophysiological assessment (Mayer et al. 2010; Nuwer et al. 2005; Blennow et al. 2012).
It is thus possible that TBI could have had an impact in the pathophysiological trajectory of BD in some patients who do not fulfil the criteria of BD due to TBI. If so, these patients would be expected to have some of the same clinical characteristics as previously described in BD due to TBI. Such clinical characteristics are more aggression and irritability, and a high hypomania/mania:depression ratio (Shukla et al. 1987; Jorge et al. 1993). Clinical characteristics of BD with premorbid TBI could obviously be influenced by other factors than the TBI. Family history of mental illness is particularly of relevance, since it is associated with both risk of TBI (Malaspina et al. 2001) and more severe clinical characteristics of BD (Antypa and Serretti 2014). Also, some clinical characteristics (e.g. levels of aggression and irritability) could be sensitive to potential differences between those with and without premorbid TBI in regard to BD subtypes (Baek et al. 2011; Serretti and Olgiati 2005), and mood states (Young et al. 1978) and pharmacological treatment (Müller-Oerlinghausen and Lewitzka 2010) at assessment.
The aim of the present study was to identify clinical characteristics in patients with BD and premorbid TBI, using a large sample of patients from psychiatric care. We hypothesized to find more aggression and irritability, a higher hypomania/mania:depression ratio, and other clinical characteristics distinguishing patients with premorbid TBI from those without. Further, we hypothesized that eventual findings would be independent of possible confounders.
The study has a cross-sectional design.
Psychiatric health care services in Norway are publicly funded and the hospitals have catchment area responsibilities. From 2003 to 2012 data were collected from 17 psychiatric hospitals and outpatient clinics collaborating in the Bipolar Research And Innovation Network Norway (BRAIN) study (Morken et al. 2009).
Patients diagnosed with BD type I, type II, or not otherwise specified (NOS), or cyclothymia were invited to participate. Diagnoses were confirmed by trained clinicians with the Structured Clinical Interview for DSM IV Axis I Disorders (SCID I) (First et al. 1997) or the Mini-International Neuropsychiatric Interview (M.I.N.I.) (Sheehan et al. 1998). The only exclusion criterion was inability to give informed consent. There is no information available on the number of patients who refused to participate. A total of 549 patients were included. The present study consists of the 505 patients who answered the questions about TBI and age at onset of BD.
All patients were assessed with a Norwegian adaptation of the Network Entry Questionnaire (NEQ). NEQ is a semi-structured interview developed by the Bipolar Collaboration Network (Leverich et al. 2001). The Norwegian adaptation of NEQ was used to obtain data on TBI, demographic factors, family history, course of illness, pharmacological treatment, somatic comorbidity, and psychiatric comorbidity in childhood. The Young Mania Rating Scale (YMRS) (Young et al. 1978) and the Inventory of Depressive Symptomatology Clinician Rated 30 (IDS-C30) (Rush et al. 1996) were used to obtain data on symptom composition and burden. The SCID I or the M.I.N.I. were used to obtain data on current mood state.
The grouping variable was premorbid TBI. Patients were asked if they had had a head injury with loss of consciousness (LOC) and if they had had a head injury without LOC. The questions could be answered yes (diagnosed), no, or don't know. An answer of yes (diagnosed) thus implicated a prior diagnostic evaluation of a general practitioner or hospital doctor. In Norway, head injuries are in general practice defined according to the International Classification of Primary Care (ICPC) (Brage et al. 1996; Lamberts and Wood 1987), and in hospital settings according to the International Classification of Diseases (ICD) 10th revision (World Health Organization 1993). An ICPC diagnosis of head injury (N79–N80) requires loss of consciousness, neurological sequela, or cerebral injury, while an ICD-10 diagnosis of head injury implies that the criteria for hospital admission (i.e. loss of consciousness, amnesia, reduced responsiveness, focal neurological deficits, or Glasgow Coma Scale Score < 15) in Norway have been met (Lamberts and Wood 1987; Ingebrigtsen et al. 2000). If answering yes (diagnosed), patients where further asked about their age at the time of diagnosis. We defined premorbid TBI as having received a diagnosis of head injury of any severity at an age lower than age at onset of BD. The definition of age at onset of BD was age at first depressive symptoms associated with dysfunction or first hypomanic or manic symptoms similar to those experienced in adulthood (Morken et al. 2009).
Years of education refers to the accumulated time spent at upper secondary schools, university colleges, and universities.
From variables of family history of mental illness, we computed answers of yes (diagnosed) as positive and probable or no as negative to questions of schizophrenia, BD, and depression in 1st degree relatives.
Duration of illness was calculated as the difference between age at inclusion and age at onset. Variables on affective episodes per year were calculated as fractions of number of episodes above duration of illness. Rapid cycling was dichotomized from a question of four or more episodes per year during lifetime, where answers of yes were defined as positive and no or uncertain were defined as negative. The variable on serious suicidal attempts was defined by lifetime history of suicidal attempts leading to medical assistance, emergency room visit, or hospitalization.
Variables on pharmacological treatment were defined by current use of lithium, anticonvulsants, antipsychotics, and antidepressants.
History of epileptic seizures and comorbid migraine were defined by answers of yes (diagnosed) to questions of lifetime history of the two, while answers of no or don't know were regarded as negative. Obesity was defined as body mass index ≥ 30 kg/m2 as calculated from self-reported height and weight. Psychiatric comorbidity was defined by one variable on abuse or dependence of alcohol and a similar variable on other substances, both defined by SCID-I or M.I.N.I., as well as one variable on self-reported diagnosis of childhood attention deficit (hyperactivity) disorder (AD(H)D) obtained from the NEQ.
Variables on symptom composition and burden were obtained from principal components and total scores, respectively, of YMRS and IDS-C30 at inclusion (see statistical methods).
As an indirect test of bias in self-reported variables, we compared the groups on a four-point ordinal item in the NEQ on the clinicians' judgement of the reliability of the patients' answers. The item scores ranged from 1 to 4, corresponding to very reliable and unreliable answers, respectively.
Statistical methods
R (version 3.4.0) (2018) and RStudio (version 1.0.143) (2018) were used for statistical analyses.
The R package psych was used for principal component analyses (PCA) of items in the YMRS and IDS-C30. The purpose of conducting a PCA was to limit the number of comparisons in analyses of symptomatology. Items on appetite and weight in the IDS-C30 are pair-wise optional and were excluded to avoid large amounts of missing data. Cronbach's alpha was used to test the internal reliability of the rating scales. A Kaiser-Meyer-Olkin (KMO) test was used to measure sample size adequacy. A determinant cut-off at > 0.00001 was used to avoid multicollinearity. The Velicer's map criterion was used to determine the number of components to retain. Direct oblimin oblique rotation was used since components were assumed to be correlated. Pattern matrices of component loadings > 0.4 were used to interpret the results. Standardized component scores were saved for each participant.
Bivariate analyses of differences between the groups were undertaken for all variables. Pearson's Chi squared tests, Fisher's exact tests, Mann–Whitney U-tests, and independent samples t-tests were used as appropriate. The alpha level was set to < 0.05. A Bonferroni correction of 40 comparisons, two of which were not included in the paper due to large amounts of missing data, yielded a p-value threshold of < 0.0013. The beta level for each comparison was not calculated.
A backward likelihood ratio logistic regression analysis was conducted in order to find clinical characteristics associated with premorbid TBI independent of each other and possible confounders. We included variables with p-values < 0.1 from bivariate analyses, and possible confounding variables based on the literature and clinical experience. These were age, sex, years of education, 1st degree family members with schizophrenia, BD, or depression, rapid cycling, migraine, AD(H)D in childhood, comorbid alcohol abuse or dependence, comorbid substance abuse or dependence, YMRS total score, IDS-C30 total score, YMRS disruptive component score, and IDS-C30 activated component score. Depressive episodes per year and hypomanic episodes per year were not included due to large amounts of missing data. YMRS total score had a skewed distribution with large amounts of null scores. Logarithmic transformation of total score plus one was therefore used in the regression model.
Further, we built additional logistic regression models to test whether our findings from the backward likelihood ratio logistic regression analysis were dependent on BD subtypes, mood states, and pharmacological treatments. First, we built a base model (Model 1) including sociodemographic factors (age, gender, and years of education), family history of mental illness (schizophrenia, BD, and depression), and clinical characteristics significantly associated with premorbid TBI in the backward likelihood ratio logistic regression analysis (YMRS disruptive component score and comorbid migraine) as independent variables. Then, we added and removed dummy variables of BD subtypes (Model 2a: type 1 vs. others; Model 2b: type 2 vs. others), mood states (Model 3a: depressed vs. others; Model 3b: euthymic vs. others etc.), and pharmacological treatments (Model 4a: lithium vs. others; Model 4b: anticonvulsants vs. others etc.) in successive models.
Variance inflation factors (VIF) between all independent variables were calculated to assess for multicollinearity.
Sample characteristics
Five hundred five patients were included. Mean age was 42 years (SD 14), 286 (57%) were women, and 256 (53%) had BD type I. Thirty-seven patients (7.3%) reported a premorbid TBI, of whom 23 (4.6%) had LOC. Age at TBI and years from age at TBI to age at onset of BD had mean values of 10 years (SD 9.0) and 8.9 years (SD 7.3), respectively.
Clinicians judged the reliability of the patients' answers as high in both groups (median 1 vs. 1 (interquartile range 1 vs. 1), p = 0.45).
Principal component analyses
Cronbach's alpha was 0.90 for both YMRS and IDS-C30, which implicates a very good internal reliability of the rating scales.
Two components were extracted from items in both YMRS (Table 1) and IDS-C30 (Table 2). The KMO measure of sampling adequacy was 0.89 and 0.93, respectively. Barlett's test of spherity was significant for both. The determinant was 0.0017 and 0.000029, respectively. The components accounted for 62% of the variance in the YMRS and 39% of the variance in the IDS-C30.
Items loadings on principal components of the Young Mania Rating Scale
Components (variance explained)
Elated (37%)
Elevated mood
Increased motor activity/energy
Language/thought disorder
Sexual interest
Disruptive/aggressive behavior
Item loadings on principal components of the Inventory of Depressive Symptomatology Clinican Rated 30
Energy/fatiguability
Pleasure/enjoyment
Mood (sad)
Outlook (future)
Reactivity of mood
Psychomotor slowing
Outlook (self)
Mood (anxious)
Leaden paralysis/physical energy
Concentration/decision making
Mood variation
Psychomotor agitation
Mid-nocturnal insomnia
Early morning insomnia
Sleep onset insomnia
Mood (irritable)
Bivariate analyses
By applying bivariate analyses with correction for multiple testing, we found more comorbid migraine (36 vs. 13%, p = 0.00030) among patients with premorbid TBI (Table 3).
Demographics, family history, and clinical characteristics in patients with and without premorbid traumatic brain injury
All (n = 505)
+pTBI (n = 37)
−pTBI (n = 468)
Female sex
Years of education
9/459 (2.0)
0.012d
0.0027c
Mood state
Euthymic
1/37 (2.7)
12/467 (2.6)
Hypomanic
Course of illness
Age at onset
Duration of illness
Bipolar disorder subtype
0.57d
1/468 (2)
Depressive episodes per year
0.78 (1.1)
0.014b
Hypomanic episodes per year
Manic episodes per year
Hypomania/mania:depression ratio
Admissions per decade
Rapid cycling
Serious suicidal attempt(s)
Current pharmacological treatment
Comorbidity
Epileptic seizures
59/465 (13)
0.00030c*
Alcohol, abuse or dependence
Other substances, abuse or dependence
Childhood AD(H)D
Symptom composition
YMRS elated component score
− 0.020 (0.98)
YMRS disruptive component score
0.0044b
IDS-C30 depressed component score
0.011 (1.0)
IDS-C30 activated component score
0.21 (0.86)
Symptom burden
YMRS total score
IDS-C30 total score
Results are presented by fraction (%) for categorical variables and mean (SD) for continuous variables. +pTBI premorbid traumatic brain injury. −pTBI no premorbid traumatic brain injury
* Multiple comparisons p-value threshold = 0.0013
aIndependent samples t-test
bMann–Whitney-U test
cPearson's Chi squared test
dFisher's exact test
Logistic regression analyses
Data for 395 of 505 participants (78%) were complete and thereby included in the backward likelihood ratio logistic regression analysis. Among clinical characteristics, the YMRS disruptive component score (OR 1.7, 95% CI 1.1–2.4, p = 0.0077) and comorbid migraine (OR 4.6, 95% CI 1.9–11, p = 0.00090) were independently associated with premorbid TBI (Table 4). Family history of schizophrenia (OR 11, 95% CI 2.3–51, p = 0.0025) was also independently associated with premorbid TBI.
Final step of the backward likelihood ratio logistic regression analysis on variables independently associated with premorbid traumatic brain injury among patients with bipolar disorder
95% CI
Wald Z
− 1.2
Family history schizophrenia
Comorbid migraine
YMRS disruptive component
S.E. standard error, OR odds ratio, CI confidence interval
The associations between premorbid TBI and YMRS disruptive component score and comorbid migraine remained significant after correction for BD subtypes, mood states, and pharmacological treatments (Additional file 1: Table S1).
Nagelkerke R2 of 0.31 implied a low relationship between prediction and grouping in the backward likelihood ratio logistic regression analysis. VIF was < 3.0 between all independent variables in all logistic regression models.
We found that premorbid TBI was associated with comorbid migraine in bivariate analyses with correction for multiple comparisons. In a logistic regression model, we found that premorbid TBI was associated with disruptive symptoms and comorbid migraine independently of a range of possible confounders. Family history of schizophrenia was also independently associated with premorbid TBI. We did not find associations between premorbid TBI and any other clinical characteristics and specifically not with hypomania/mania:depression ratio.
The finding of more disruptive symptoms corresponds with our hypothesis of finding similar clinical characteristics in BD with premorbid TBI as previously described in BD due to TBI (Shukla et al. 1987; Jorge et al. 1993). Aggression and irritability, which in our study had the highest loadings on the disruptive component, are common symptoms after TBI of all severities (Lique Sté Fan and Mathé 2015; Hammond et al. 2016). A cross-sectional study on 89 patients with and without aggression after TBI of all severities, found that aggression was associated with premorbid substance use disorders, affective disorders, and poor social functioning (Tateno et al. 2003). Similarly, a study on 97 children with severe TBI found that preinjury affective lability and psychosocial adversity predicted affective lability (including irritability and temper outbursts) at one year follow-up (Vasa et al. 2015). These studies suggest that TBI could result in more disruptive symptoms among patients with a disposition to affective symptoms and lower social function/support. Further, aggression after TBI was in the same studies associated with frontal lobe lesions (Tateno et al. 2003; Vasa et al. 2015), highlighting a possible structural substrate for disruptive symptoms after TBI. Frontal lobe regions are also implicated in mania secondary to focal brain lesions in general (Satzer and Bond 2016), and are on average thinner among patients with BD than among healthy controls (Hibar et al. 2018).
The mean YMRS score in the premorbid TBI group in our study was low. Further, the association between the YMRS disruptive component score and premorbid TBI remained significant after corrections for BD subtypes, mood states, and pharmacological treatments (Additional file 1: Table S1). It is thus a possibility that the disruptive symptoms in most patients represent a personality trait related to premorbid TBI rather than a mood state related to BD. However; disruptive symptoms after TBI could also be rapidly alternating (Arciniegas and Wortzel 2014) and thereby resemble, and possibly fulfil the criteria of, short lasting manic states (Coetzer 2008).
Our results are in line with previous findings that migraine is a common headache after TBI (Lucas et al. 2014; Stacey et al. 2017). Inflammation and impaired pain modulation after TBI are two of the suggested pathophysiological mechanisms (Ruff et al. 2016). Furthermore, migraine and BD are bi-directionally associated (Fornaro et al. 2015) and possibly influenced by shared environmental and genetic factors (Sucksdorff et al. 2016). It is thus difficult to conclude on the nature behind our finding of an association between migraine and premorbid TBI among patients with BD.
Although it was not a primary outcome of our study, our finding of more family history of schizophrenia among those with premorbid TBI harmonizes with findings in a study of Malaspina et al. (Malaspina et al. 2001). They assessed for TBI in members of families where at least two 1st degree-relatives had schizophrenia or BD. Members of the schizophrenia pedigrees had an increased risk of TBI which was independent of their own diagnoses. The effect of family history of schizophrenia on risk of premorbid TBI could be mediated by several factors. Examples are co-inherited motor coordination problems (Ismail et al. 1998; Burton et al. 2017), and co-inherited susceptibility to risk-taking behaviour (Strawbridge et al. 2018).
Regarding course of illness, the findings of more rapid cycling, depressive episodes per year and hypomanic episodes per year were not significant after correction for multiple testing. Due to missing data in the latter two variables, only rapid cycling was included in the regression model, and it was not independently associated with premorbid TBI. In the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study, mild TBI after age at onset of BD, but not before, was associated with rapid cycling (Sagduyu 2002). One of several possible explanations to our and the STEP-BD study's findings is that the co-occurrence of TBI and more rapid cycling are epiphenomena of increased genetic susceptibility to BD (Antypa and Serretti 2014). We found a hypomania/mania:depression ratio of 1:1 in the premorbid TBI group, which was not higher than among those without premorbid TBI. In comparison, Shukla et al. reported a ratio of 15:1 in a study on patients with BD due to TBI (Shukla et al. 1987). Several differences between the samples, e.g. regarding clinical setting, severity of TBI, and frequency of comorbid epilepsy, make it difficult to conclude on the cause(s) of this discrepancy.
There were no differences between the groups on current treatment with lithium, anticonvulsants, antipsychotics or antidepressants. Previous studies have found increased treatment response to valproate among patients with BD and a history of TBI (Pope et al. 1988; Stoll et al. 1994). However, treatment response is not directly comparable to our measures, which could be influenced by the prescribing clinicians' preferences and discontinuation due to side effects.
Epilepsy is previously suggested as the pathophysiological mechanism in BD due to TBI (van Reekum and Cohen 2000). In our study of BD with premorbid TBI, self-report did not unveil higher frequencies of epileptic seizures. Nevertheless, not all seizures are recognized by patients (Elger and Hoppe 2018).
The prevalence of premorbid TBI in our study from Norway (7.3%) was lower than in the STEP-BD study from the United States (10% with premorbid mild TBI) (Sagduyu 2002) and in register-based studies from Denmark (11%) (Orlovska et al. 2014) and Taiwan (25%) (Chi et al. 2016). However, both variation in prevalence of TBI across nations and different methodologies across studies (Corrigan et al. 2010) warrant caution when interpreting these differences.
Our study has several limitations that should be taken into account. The reliability and validity of the definition of TBI in the NEQ is unknown. While the definition implies an ICPC or ICD-10 diagnosis of head injury, the NEQ did not harvest data on specific symptoms of head injury or on diagnostic codes from the patients' health records. Self-reported data implies risk of recall bias. It is possible that patients with disruptive symptoms and comorbid migraine look for explanations in the past and thus report a higher prevalence of premorbid TBI. The inter-rater reliability of the diagnostic evaluations was not measured. There exists no data on the overall participation rate. The generalizability of our findings to all patients in psychiatric care is thus unknown. We included patients with all BD subtypes, mood states, and pharmacological treatments. It is possible that our results would have been different if the sample had been restricted to more selected groups, e.g. patients with medication naïve first manic episodes. The Bonferroni correction for multiple testing in the bivariate analyses implies a high risk of type II errors. However, interpretation of the results should be based not only on the Bonferroni corrected p-values alone, but also on the strength of effects, prior knowledge, and biological plausibility of the associations. The design of our study makes it impossible draw conclusions about whether the findings of more disruptive symptoms and comorbid migraine are causal. Inverse causation is an alternative explanation. In regard the association between premorbid TBI and disruptive symptoms, a review found that aggression and irritability are common parts of the distal prodrome of BD (Skjelstad et al. 2010). Aggression and irritability might even characterize a prodromal subgroup of BD type II with neurocognitive deficits (Skjelstad et al. 2011), which can be hypothesized to be more prone to injuries including TBI. Residual confounding could also explain the associations. In our study, disruptive symptoms, comorbid migraine, and family history of schizophrenia were independently associated with premorbid TBI. Taken together, these variables represent a pattern of symptomatology (Hanwella and de Silva 2011), comorbidity (Fornaro et al. 2015), and heritability (Cross-Disorder Group of the Psychiatric Genomics Consortium 2013) typical for BD. We emphasize the possibility that their apparently independent associations with premorbid TBI could be a consequence of residual confounding by genetic susceptibility to BD. Examples of other factors that could have contributed to residual confounding are AD(H)D, which was probably seldom evaluated when the majority of patients in our study grew up, and psychological trauma, on which we have no data despite its known association with more severe clinical characteristics (Leverich and Post 2006) and possibly also with physical trauma including TBI.
Premorbid TBI is associated with disruptive symptoms and comorbid migraine independently of the measured possible confounders including family history of mental disorders, while it is not associated with an increased hypomania/mania:depression ratio. The finding of more disruptive symptoms is in line with our hypothesis of finding similar clinical characteristics in BD with premorbid TBI as in BD due to TBI. Studies designed to draw conclusions of causal inference from observational data, e.g. by using family-based quasi-experimental designs (D'Onofrio et al. 2013), are warranted to clarify whether our findings could be explained by a continuum of pathophysiological effects of premorbid TBI across the diagnostic dichotomy of BD with premorbid TBI and BD due to TBI.
BD:
BRAIN:
Bipolar Research And Innovation Network Norway
DSM:
Diagnostic and Statistical Manual of Mental Disorders
ICD:
ICPC:
International Classification of Primary Care
IDS-C30:
Inventory of Depressive Symptoms Clinician Rated 30
KMO:
Kaiser-Meyer-Olkin
LOC:
Mini-International Neuropsychiatric Interview
NEQ:
Network Entry Questionnaire
PCA:
SCID I:
Structured Clinical Interview for DSM IV Axis I Disorders
STEP-BD:
Systematic Treatment Enhancement Program for Bipolar Disorder
TBI:
VIF:
variance inflation factor
YMRS:
Young Mania Rating Scale
UFM, OAA, GM, and AEV designed the BRAIN study. OKD, AEV, and PIF wrote the protocol for the present study. All authors included patients to the BRAIN study. OKD and PIF conducted the analyses. All authors interpreted the results. OKD drafted the manuscript under supervision of AEV and PIF. All authors contributed with the further writing of the manuscript. All authors read and approved the final manuscript.
We want to thank the patients for participating in the study, colleagues for recruitment and interviews, and Thomas D. Bjella for preparation of data.
UFM has received honoraria from Takeda and Lundbeck for lectures about mood disorders to primary care physicians and psychiatrists. He has also received honoraria from Takeda and Lundbeck Norway for giving scientific advice. OAA has received speaker's honoraria from GSK and Lundbeck. OKD, AEV, GM and PIF report no competing interests.
The informed consents do not allow sharing of data to others than collaborating researchers.
The Regional Committee for Research Ethics, Central Norway, approved the BRAIN study (ref. 233-04). The study is conducted in accordance with the Helsinki Declaration of 1975. The BRAIN study is registered in ClinicalTrials.gov (ref. NCT00201526, retrospectively registered September 2005). All participants gave written, informed consent.
The study was supported by the South-East Norway Health Authority, the KG Jebsen Foundation, and the Research Council of Norway. The funding bodies have not been involved in the design of the present study, in the collection, analysis, or interpretation of data, or in the writing of the manuscript.
40345_2018_128_MOESM1_ESM.docx Additional file 1: Table S1. Logistic regression models on the associations between premorbid traumatic brain injury and different covariates that could attenuate its associations with the YMRS disruptive component score and comorbid migraine (values given in odds ratios with 95% confidence intervals).
Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
Department of Østmarka, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
Department of Research and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
Department of Brøset, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.View ArticleGoogle Scholar
American Psychiatric Organization. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Organization; 1994.Google Scholar
Antypa N, Serretti A. Family history of a mood disorder indicates a more severe bipolar disorder. J Affect Disord. 2014;156:178–86.View ArticlePubMedGoogle Scholar
Arciniegas DB, Wortzel HS. Emotional and behavioral dyscontrol after traumatic brain injury. Psychiatr Clin North Am. 2014;37:31–53.View ArticlePubMedGoogle Scholar
Baek JH, Park DY, Choi J, Kim JS, Choi JS, Ha K, et al. Differences between bipolar I and bipolar II disorders in clinical features, comorbidity, and family history. J Affect Disord. 2011;131:59–67.View ArticlePubMedGoogle Scholar
Blennow K, Hardy J, Zetterberg H. The neuropathology and neurobiology of traumatic brain injury. Neuron. 2012;76:886–99.View ArticlePubMedGoogle Scholar
Brage S, Bentsen BG, Bjerkedal T, Nygård JF, Tellnes G. ICPC as a standard classification in Norway. Fam Pract. 1996;13:391–6.View ArticlePubMedGoogle Scholar
Burton BK, Thorup AAE, Jepsen JR, Poulsen G, Ellersgaard D, Spang KS, et al. Impairments of motor function among children with a familial risk of schizophrenia or bipolar disorder at 7 years old in Denmark: an observational cohort study. Lancet Psychiatry. 2017;4:400–8.View ArticlePubMedGoogle Scholar
Chi Y-C, Wu H-L, Chu C-P, Huang M-C, Lee P-C, Chen Y-Y. Traumatic brain injury and affective disorder: a nationwide cohort study in Taiwan, 2000–2010. J Affect Disord. 2016;191:56–61.View ArticlePubMedGoogle Scholar
Coetzer R. Diagnostic dilemmas associated with bipolar disorder after traumatic brain injury. CNS Spectr. 2008;13:1022–3.View ArticlePubMedGoogle Scholar
Corrigan JD, Selassie AW, Orman JAL. The epidemiology of traumatic brain injury. J Head Trauma Rehabil. 2010;25:72–80.View ArticlePubMedGoogle Scholar
Craddock N, Sklar P. Genetics of bipolar disorder. Lancet. 2013;381:1654–62.View ArticlePubMedGoogle Scholar
Cross-Disorder Group of the Psychiatric Genomics Consortium. Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs. Nat Genet. 2013;45:984–94.View ArticlePubMed CentralGoogle Scholar
D'Onofrio BM, Lahey BB, Turkheimer E, Lichtenstein P. Critical need for family-based, quasi-experimental designs in integrating genetic and social science research. Am J Public Health. 2013;103(Suppl 1):46–55.View ArticleGoogle Scholar
Elger CE, Hoppe C. Diagnostic challenges in epilepsy: seizure under-reporting and seizure detection. Lancet Neurol. 2018;17:279–88.View ArticlePubMedGoogle Scholar
First MB, Spitzer R, Gibbon M, Williams JB. Structured clinical interview for DSM–IV—patient version. Washington, DC: Am Psychiatr Press; 1997.Google Scholar
Fornaro M, De Berardis D, De Pasquale C, Indelicato L, Pollice R, Valchera A, et al. Prevalence and clinical features associated to bipolar disorder-migraine comorbidity: a systematic review. Compr Psychiatry. 2015;56:1–16.View ArticlePubMedGoogle Scholar
Hammond FM, Davis C, Cook JR, Philbrick P, Hirsch MA. A conceptual model of irritability following traumatic brain injury. J Head Trauma Rehabil. 2016. https://doi.org/10.1097/HTR.0000000000000136.PubMedView ArticleGoogle Scholar
Hanwella R, de Silva VA. Signs and symptoms of acute mania: a factor analysis. BMC Psychiatry. 2011;11:137.View ArticlePubMedPubMed CentralGoogle Scholar
Hibar DP, Westlye LT, Doan NT, Jahanshad N, Cheung JW, Ching CRK, et al. Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. Mol Psychiatry. 2018;23:932–42.View ArticlePubMedGoogle Scholar
Ingebrigtsen T, Rise IR, Wester K, Romner B, Kock-Jensen C. Scandinavian guidelines for management of minimal, mild and moderate head injuries. Tidsskr den Nor Laegeforen. 2000;120:1985–90.Google Scholar
Ismail B, Cantor-Graae E, McNeil TF. Neurological abnormalities in schizophrenic patients and their siblings. Am J Psychiatry. 1998;155:84–9.View ArticlePubMedGoogle Scholar
Jorge RE, Robinson RG, Starkstein SE, Arndt SV, Forrester AW, Geisler FH. Secondary mania following traumatic brain injury. Am J Psychiatry. 1993;150:916–21.View ArticlePubMedGoogle Scholar
Kendell R, Jablensky A. Distinguishing between the validity and utility of psychiatric diagnoses. Am J Psychiatry. 2003;160:4–12.View ArticlePubMedGoogle Scholar
Lamberts H, Wood M. International Classification of Primary Care (ICPC). Oxford: Oxford University Press; 1987.Google Scholar
Leverich GS, Post RM. Course of bipolar illness after history of childhood trauma. Lancet. 2006;367:1040–2.View ArticlePubMedGoogle Scholar
Leverich GS, Nolen WA, Rush AJ, McElroy SL, Keck PE, Denicoff KD, et al. The Stanley Foundation Bipolar Treatment Outcome Network: I longitudinal methodology. J Affect Disord. 2001;67:33–44.View ArticlePubMedGoogle Scholar
Lique Sté Fan A, Mathé J-F. What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices. Ann Phys Rehabil Med. 2015;59:5–17.Google Scholar
Lucas S, Hoffman JM, Bell KR, Dikmen S. A prospective study of prevalence and characterization of headache following mild traumatic brain injury. Cephalalgia. 2014;34:93–102.View ArticlePubMedGoogle Scholar
Malaspina D, Goetz RR, Friedman JH, Kaufmann CA, Faraone SV, Tsuang M, et al. Traumatic brain injury and schizophrenia in members of schizophrenia and bipolar disorder pedigrees. Am J Psychiatry. 2001;158:440–6.View ArticlePubMedGoogle Scholar
Mayer AR, Ling J, Mannell MV, Gasparovic C, Phillips JP, Doezema D, et al. A prospective diffusion tensor imaging study in mild traumatic brain injury. Neurology. 2010;74:643–50.View ArticlePubMedPubMed CentralGoogle Scholar
Morken G, Vaaler AE, Folden GE, Andreassen OA, Malt UF. Age at onset of first episode and time to treatment in in-patients with bipolar disorder. Br J Psychiatry. 2009;194:559–60.View ArticlePubMedGoogle Scholar
Müller-Oerlinghausen B, Lewitzka U. Lithium reduces pathological aggression and suicidality: a mini-review. Neuropsychobiology. 2010;62:43–9.View ArticlePubMedGoogle Scholar
Nuwer MR, Hovda DA, Schrader LM, Vespa PM. Routine and quantitative EEG in mild traumatic brain injury. Clin Neurophysiol. 2005;116:2001–25.View ArticlePubMedGoogle Scholar
Orlovska S, Pedersen MS, Benros ME, Mortensen PB, Agerbo E, Nordentoft M. Head injury as risk factor for psychiatric disorders: a nationwide register-based follow-up study of 113,906 persons with head injury. Am J Psychiatry. 2014;171:463–9.View ArticlePubMedGoogle Scholar
Perry DC, Sturm VE, Peterson MJ, Pieper CF, Bullock T, Boeve BF, et al. Association of traumatic brain injury with subsequent neurological and psychiatric disease: a meta-analysis. J Neurosurg. 2016;124:511–26.View ArticlePubMedGoogle Scholar
Pope HG, Mcelroy SL, Satlin A, Hudson JI, Keck PE, Kalish R. Head injury, bipolar disorder, and response to valproate. Compr Psychiatry. 1988;29:34–8.View ArticlePubMedGoogle Scholar
R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.r-project.org/. Accessed 8 July 2018.
RStudio Team. RStudio: Integrated Development for R. RStudio, Inc., Boston, MA. http://www.rstudio.com/. Assessed 8 July 2018.
Ruff RL, Blake K. Pathophysiological links between traumatic brain injury and post-traumatic headaches. F1000Res. 2016. https://doi.org/10.12688/f1000research.9017.1.PubMedPubMed CentralView ArticleGoogle Scholar
Rush AJ, Gullion CM, Basco MR, Jarrett RB, Trivedi MH. The inventory of depressive symptomatology (IDS): psychometric properties. Psychol Med. 1996;26:477–86.View ArticlePubMedGoogle Scholar
Sagduyu K. Association of mild traumatic brain injury with bipolar disorder. J Clin Psychiatry. 2002;63:595–8.View ArticleGoogle Scholar
Sariaslan A, Sharp DJ, D'Onofrio BM, Larsson H, Fazel S. Long-term outcomes associated with traumatic brain injury in childhood and adolescence: a Nationwide Swedish Cohort Study of a wide range of medical and social outcomes. PLOS Med. 2016. https://doi.org/10.1371/journal.pmed.1002103.PubMedPubMed CentralView ArticleGoogle Scholar
Satzer D, Bond DJ. Mania secondary to focal brain lesions: implications for understanding the functional neuroanatomy of bipolar disorder. Bipolar Disord. 2016;18:205–20.View ArticlePubMedGoogle Scholar
Serretti A, Olgiati P. Profiles of "manic" symptoms in bipolar I, bipolar II and major depressive disorders. J Affect Disord. 2005;84:159–66.View ArticlePubMedGoogle Scholar
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 2):22–33.PubMedGoogle Scholar
Shukla S, Cook BL, Mukherjee S, Godwin C, Miller MG. Mania following head trauma. Am J Psychiatry. 1987;144:93–6.View ArticlePubMedGoogle Scholar
Skjelstad DV, Malt UF, Holte A. Symptoms and signs of the initial prodrome of bipolar disorder: a systematic review. J Affect Disord. 2010;126:1–13.View ArticlePubMedGoogle Scholar
Skjelstad DV, Malt UF, Holte A. Symptoms and behaviors prior to the first major affective episode of bipolar II disorder. An exploratory study. J Affect Disord. 2011;132:333–43.View ArticlePubMedGoogle Scholar
Stacey A, Lucas S, Dikmen S, Braden CA, Brown AW, Brunner R, et al. Natural history of headache five years after traumatic brain injury. J Neurotrauma. 2017;34:1558–64.View ArticlePubMedGoogle Scholar
Stoll AL, Banov M, Kolbrener M, Mayer PV, Tohen M, Strakowski SM, et al. Neurologic factors predict a favorable valproate response in bipolar and schizoaffective disorders. J Clin Psychopharmacol. 1994;14:311–3.View ArticlePubMedGoogle Scholar
Strawbridge RJ, Ward J, Cullen B, Tunbridge EM, Hartz S, et al. Genome-wide analysis of self-reported risk-taking behaviour and cross-disorder genetic correlations in the UK Biobank cohort. Transl Psychiatry. 2018;8:39.View ArticlePubMedPubMed CentralGoogle Scholar
Sucksdorff D, Brown AS, Chudal R, Heinimaa M, Suominen A, Sourander A. Parental and comorbid migraine in individuals with bipolar disorder: a nationwide register study. J Affect Disord. 2016;206:109–14.View ArticlePubMedPubMed CentralGoogle Scholar
Tateno A, Jorge RE, Robinson RG. Clinical correlates of aggressive behavior after traumatic brain injury. J Neuropsychiatry Clin Neurosci. 2003;15:155–60.View ArticlePubMedGoogle Scholar
van Reekum R, Cohen T. Can traumatic brain injury cause psychiatric disorders? J Neuropsychiatry Clin Neurosci. 2000;12:316–27.View ArticlePubMedGoogle Scholar
Vasa RA, Suskauer SJ, Thorn JM, Kalb L, Grados MA, Slomine BS, et al. Prevalence and predictors of affective lability after paediatric traumatic brain injury. Brain Inj. 2015;29:921–8.View ArticlePubMedPubMed CentralGoogle Scholar
World Health Organization. The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organization; 1993.Google Scholar
Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429–35.View ArticlePubMedGoogle Scholar