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Mass-personalization (MP) presents an opportunity to meet diversifying customer needs in consumer products market with a near mass-production efficiency. Traditional product development methodologies fall short to guide design for MP and a dedicated systematic methodology is essential. The proposed approach bases on a dynamic product template that automatically adapts with user input and produces a reliable output. This paper presents the workflow towards mass-personalization of saxophone mouthpieces with focus on design automation.
The aim of this study is to evaluate the differences in dimensions of temperament between alcohol dependent inpatients and healthy control subjects.
The study is consisted of 77 alcohol-dependent patients according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition and 80 healthy control subjects. Cloninger's Temperament and Character Inventory (TCI), Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) scale and semi structured sociodemographic form were applied to the subjects after detoxification period.
Age and education level were similar rates in both alcohol dependent (mean age= 43.7 ± 10.1 and education level= 9.0 ± 4.2) and healthy control subjects (mean age: 42.5 ± 11.8 and education level: 10.2 ± 3.8). Alcohol-dependent patients were characterized by higher Novelty-Seeking (p=0.006) and Harm Avoidance (p=0.002) than non-psychiatric control subjects. Also, subjects suffering from Alcohol-dependence exhibited significantly more depressive (p=0.003), anxious (p=0.001), irritable (p=0.004) and cyclothymic (p=0.001) temperament. Novelty-Seeking [95% C.I = 1.08 (1.07-1.16)] and cyclothymic temperament [95% C.I = 1.13 (1.03-1.23)] were predictors of alcohol dependency.
Novelty seeking and harm avoidance were significantly higher in the patients than in the healthy subjects. Novelty-Seeking and cyclothymic temperament were predictors for alcohol dependency. It seems to be important to consider TCI dimensions and affective temperaments in planning the treatment and maybe in preventing of alcohol dependence.
The shift work has various negative influences on health, performance, activity, and social relationships as well as causing impairment in cognitive functions.
We aimed to investigate the effects of shift work on participants’ cognitive functions in terms of memory, attention and learning, and on oxidative stress indicated by total oxidant status, total antioxidant capacity, and oxidative stress index.
90 health workers participated in the study (45 subjects were night shift workers). The neuropsychological tests were applied to the participants for assessing the cognitive functions and blood samples were taken to detect their total antioxidant capacity and total oxidant at 8.00 in the morning. Depression, anxiety, chronobiological characteristics, cognitive functions were assessed by using the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Morningness- Eveningness Questionnaire (MEQ), Wechsler Memory Scale- Revised (WMS-R), Auditory-Verbal Learning Test (AVLT) and Stroop Test.
Night shift workers reported significantly lower scores on the verbal memory, the attention-concentration, and the digit span forward sub-scales of the WMS-R as well as the immediate memory and the total learning sub-scales of the AVLT. Oxidative stress parameters were significantly associated with some types of the cognitive functions in both groups.
The findings suggest that health workers in night shift generally revealed significantly poorer performance in cognitive assessment as compared to day shift workers. The oxidative stress indicators associated with the cognitive functioning.
The main description of alexithymia is a personality construct characterized by difficulties in experiencing and verbalizing emotions, and a poor capacity for symbolic thought reflected as a tendency toward externally oriented thinking.
The aim of the present study is to investigate the effects of alexithymia on tendency of somatization and sleep quality in depressive patients.
Eighty-five major depression patientswere included in the study. the Beck Depression Inventory (BDI), Toronto Alexithmia Scale, Symptom Interpretation Questionairre (SIQ) and Pittsburgh Sleep Quality Index (PSQI) were used for assesments and measurements.
Patients with major depression were divided into two groups that alexithymic and non-alexithymic according to the aim of the study. there were significant differences in the BDI scores, the number of somatizating symptoms and psychologizing and somatizing scale scores in the SIQ, and daytime functionality scores in PSQI between alexithmic and non-alexithymic depressive patients.
Alexithymia seems to be related with depressive symptomatology. Depressive patients with alexithymia may display abnormal health belief and difficulty in expressing their complaints. Therefore, alexithymia is a feature that affects the pattern of depressive symptoms. This present study confirmed that depressive patients have high prevalence of alexithymia, somatization and difficulty in expressing the feelings. Because of the loss of daytime functionality in the alexithymic depressive patients, clinicians should consider alexithymia in clinical practices.
Sleep hygiene can be described as practices to ease sleep and to avoid factors which decrease sleep quality. Inadequate sleep hygiene generally results in disturbance of daily life activities due to inability to sustain sleep quality and daytime wakefulness. The aim of the study was to assess psychometric properties of the Sleep Hygiene Index in clinical and non-clinical Turkish samples.
Data were collected from 106 patients with major depression and 200 were volunteers recruited from community sample who were enrolled at the university. The Sleep Hygiene Index (SHI), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) were administered to the subjects. All depression patients and thirty-two healthy volunteers underwent a twenty-day test-retest procedure. Factor structure of the SHI was evaluated with explanatory and multi-sample confirmatory factor analyses. Pearson product-moment correlation coefficients of the SHI with the PSQI, ISI and ESS were performed. Item analyses, internal consistency coefficients and intra-class correlations between two repeated applications in both patient and healthy subjects were calculated.
Cronbach's alphas for the SHI in community sample and patients with major depression were 0.70 and 0.71, respectively. Scale scores had comparatively good temporal stability over a three-week time for either clinical or non-clinical samples. SHI had good internal reliability.
The findings of this present study suggest that the SHI may be a useful research or clinical assessment tool for evaluating sleep hygiene to guide case formulation, treatment planning in depression as well as nonclinical population.
Individuals with posttraumatic stress disorder (PTSD) often have symptoms of re-experiencing traumatic life events, recurring nightmares, hyper arousal and insomnia. Evidence is increasing that stress-related hyperglutamatergic states may contribute to dissociative symptoms and neurodegeneration in temporo-parietal cortical areas. Cognitive performance is also be effected in some of the traumatized patients. We are going to present a PTSD case who demonstrates significant memory impairment.
38 years-old, male patient. He had experienced combat related traumatic life events June in 2009 and diagnosed with PTSD according to DSM-IV criteria. Disturbance in short time memory, perception, attention, concentration deficiency was observed in the clinical interview. As a result of cognitive assessment, calculating and remembering subtests were lower than the others so it could be associated with cognitive impairment. To evaluate the organic brain pathology CT was applied and it was within normal limits. After than PET was conducted to reveal the metabolic abnormalities. Left parietal cortical global hypo-metabolic activity, global hypometabolism in temporal cortex and regional hypometabolism in medial parietal cortical regions was demonstrated. He has been treated and fallowed up for two years and provided significant improvement in PTSD symptoms but cognitive impairment was still showed constancy.
It is well known that left parietal and temporal cortical region would be associated with impaired memory performance. The areas that we have found at PET are known to be involved in episodic memory consolidation and retrieval. Comorbid PTSD and hypometabolism in lateral cortical region has not been well documented in the literature.
Noise is defined as unwanted sounds and can cause psychological symptoms such as anxiety, restlessness, irritability, sleep disturbances and difficulty concentrating. Transportation noise represents a large majority of external noise that affects people in large cities. Professional drivers are the highest risk group.
The aim of this study is to investigate the correlation between noise pollution and, general psychological symptoms, quality of life in public transport drivers.
Material and methods:
Bus drivers of varying bus brands (F, O and P) were subjected in this study. SCL-90-R and SF-36 questionnaire were used to assess the presence and severity of psychiatric symptoms and quality of life. Sound level meter (Smart Sensor AR844) was used for noise pollution measurements (dB(A)) within the buses and city main streets.
F, O and P brand buses average 65.16 dB(A), 70.86 dB(A) and 75.33 dB(A) noise produces respectively. Especially, P brand mini-bus drivers were found to have worked under continuously high noise (75.33 dB(A), average 11.22 ± 3.86 hours daily). According to psychiatric SCL-90-R and SF-36 assessments, observed psychiatric symptoms were more pronounced between the high noise exposed group than other groups (P < 0.001).
Psychologies and quality of life of bus drivers were affected by the noise pollution and noise pollution had cause to serious psychological symptoms on drivers such as anxiety, depression, hostility, etc., and noise had negative effects over the quality of life in the east region of Turkey, particularly, when drivers were exposed for longer working periods and above certain values.
Pseudocholinesterase (PCHE) deficiency is an inherited condition, in which recovery from anesthetic agents like succinylcholine and mivacurium is slow and complicated with prolonged paralysis of respiratory muscles in susceptible patients. Succinylcholine is used very frequently as a muscle relaxant during the procedure.
In Bakirkoy research and training hospital for psychiatric and neurological diseases, 24.310 patients were hospitalized for acute conditions and 3490 of these patients were treated with electroconvulsive therapy (ECT) in 3 years. We present a very rare case that we encountered in our practice; a severe PCHE deficiency case that could have complicated the modified ECT procedure unless necessary precautions were taken.
Detection of PCHE levels of all patients eligible for ECT is part of our pre-ECT assessments procedure, and the case presented here shows the benefits of this method.
The patient is a 29-year-old woman, with a 15 year history of schizophrenia. She was hospitalized for homicidal risk and refusal of treatment. Inadequate clinical response with pharmacological interventions and continuous aggressive excitations directed us to consider ECT.
After the detection of PCHE deficiency (PCHE level: 126 U/L), we performed the modified ECT with propophol and rocuronium instead of succinylcholine as usual. Sugammadex 100 mg was used for fastening the recovery. Response to treatment, which is recorded with positive and negative syndrome scale, was good and we completed 9 ECT sessions without complication.
Screening for PCHE levels in the pre-ECT assessments is efficacious in order to decrease the complications of the ECT procedure.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Our aim was to describe demographic data of pregnant patients admitted to an inpatient psychiatric unit and analyze treatment preferences for acutely ill pregnant patients.
A prospective chart review was carried out to identify pregnant patients who admitted to the inpatient unit during the period April 2014–September 2015. Details regarding their sociodemographic, clinical, and treatment data were obtained from these records for the study.
The total number of pregnant patients, admitted to our psychiatry inpatient clinic during the survey period was 15. The mean age of the patients was 30.33 (with a range of 21–38 years). Two thirds of the patients were hospitalized in the 1st trimester. Bipolar disorder (46.6%) was the most common diagnosis, followed by psychotic disorder (33%), and unipolar severe depression (20%). Eleven patients (67%) out of 15 had a psychiatric illness before getting pregnant. It was found that premenstrual syndrome was reported by 60% of patients. Haloperidol was the most frequently used psychotropic drug for the treatment of psychotic disorders and bipolar manic episodes.
The information regarding the course of bipolar disorder in pregnancy is controversial. While some studies support the opinion that pregnancy appeared to have a protective effect against an increase in symptoms, others stress that the risk for relapse in the pregnancy period is high. It is noteworthy that the majority of our patients are bipolar patients in the 1st trimester. The abrupt cease of mood stabilizer use may lead to recurrence in bipolar disorder.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The aim of the present study was to investigate whether the use of lithium followed recommended practice in acutely manic adolescent inpatients. This study was a 12-month retrospective review of patients with manic episode admitted to Bakırköy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital. Length of stay, medication data, serum levels and adverse effects were recorded for patients who started lithium treatment within average of 7 days of admission (n = 52). Average length of stay was 23.63 (SD = 17.6). The maximum dose prescribed within 24 h of starting treatment was 721.15 mg (SD = 239.5). The maximum daily dose was reached in an average of 7 days to 1136.5 mg (SD = 336.4). The average time after starting treatment until the first recorded serum level was 5 days. The average serum level reached was 0.5 mEq/L (SD = 0.22), which was raised to 0.6 mEq/L (SD = 0.3) at discharge with an average daily dose of 1038.46 mg (SD = 460). In 8 admissions (15.4%), one adverse effect was recorded that could have been related to lithium treatment but adverse events did not lead to discontinuation of drug. The literature supports that rapidly attained high serum levels are associated with positive outcomes. In this current study, clinicians used a relatively slow dose titration and lower serum levels were obtained suggesting that lithium was not considered as a primary agent for treating mania. Taking advantage of lithium especially for the maintenance treatment of bipolar disorder and tolerability may have driven these findings.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This prospective study aimed to evaluate the relationship between serum ischaemia-modified albumin levels and Bell's palsy severity.
The study included 30 patients diagnosed with Bell's palsy and 30 healthy individuals. The patients were separated into three disease severity groups (grades 2, 3 and 4) according to House–Brackmann classification. Blood samples were collected from all participants and the results compared between groups.
Significant differences in serum ischaemia-modified albumin were found between the study and control groups (p < 0.001); values were significantly higher in the study group than in the control group.
The significantly higher levels of serum ischaemia-modified albumin in the study group suggest that Bell's palsy pathogenesis is associated with oxidative stress.
The aim of this study was to examine the direct and indirect effects (via mental toughness) of strength-based parenting on adolescents’ psychological distress and subjective happiness. Participants included 370 adolescents (M = 15.86 years, SD = 0.50, range = 14–18 years, 51.6% girls) attending public high schools in Turkey. Participants completed a battery of questionnaires that included measures of strength-based parenting, mental toughness, psychological distress, and subjective happiness. Findings provided evidence of both direct as well as indirect effects (via mental toughness) of strength-based parenting on adolescents’ psychological outcomes. Specifically, results showed that strength-based parenting was negatively and directly related to psychological distress, and positively and directly related to subjective happiness. In addition, strength-based parenting was indirectly related to psychological distress and subjective happiness through mental toughness. The findings highlight the importance of strength-based parenting and mental toughness on psychological outcomes in adolescents.
Singularity analysis of parallel manipulators is an active research field in robotics. The present article derives for the first time in the literature a condition under which a five-bar parallel robot encounters high-order parallel singularities. In this regard, by focusing on the planar 5R mechanism, a theorem is given in terms of the slope of its coupler curve at the parallel singular configurations. At high-order parallel singularities, the associated determinant vanishes simultaneously with at least its first-order time derivative. The determination of such singularities is quite important since in their presence, some special conditions should be satisfied for bounded inverse dynamic solutions.
Hydatid disease is a zoonotic parasitic infection endemic in livestock-raising countries. Isolated cardiac hydatid cyst is a very rare disease, and chest pain, palpitations, cough, and dyspnoea are the most common presenting symptoms. Here a case of isolated cardiac hydatid cyst in a female patient with chest pain and electrocardiographic changes mimicking myocardial ischaemia is presented.
Premature ventricular contractions are accepted as benign in structurally normal hearts. However, reversible cardiomyopathy can sometimes develop. Omega-3 polyunsaturated fatty acids have anti-arrhythmic properties in animals and humans.
We evaluated left ventricular function in children with premature ventricular contractions with normal cardiac anatomy and assessed the impact of omega-3 fatty acid supplementation on left ventricular function in a prospective trial.
A total of 25 patients with premature ventricular contraction, with more than 2% premature ventricular contractions on 24-hour Holter electrocardiography, and 30 healthy patients were included into study. All patients underwent electrocardiography, left ventricular M-mode echocardiography, and myocardial performance index testing. Patients with premature ventricular contraction were given omega-3 fatty acids at a dose of 1 g/day for 3 months, and control echocardiography and 24-hour Holter electrocardiography were performed. Neither placebo nor omega-3 fatty acids were given to the control group.
Compared with the values of the control group, the patients with premature ventricular contraction had significantly lower fractional shortening. The myocardial performance index decreased markedly in the patient groups. The mean heart rate and mean premature ventricular contraction percentage of Group 2 significantly decreased in comparison with their baseline values after the omega-3 supplementation.
In conclusion, premature ventricular contractions can lead to systolic cardiac dysfunction in children. Omega-3 supplementation may improve cardiac function in children with premature ventricular contractions. This is the first study conducted in children to investigate the possible role of omega-3 fatty acid supplementation on treatment of premature ventricular contractions.
Trace elements are essential micronutrients for the human body. In this study, we evaluated the alterations in copper, chromium, manganese, selenium, magnesium, zinc, iron, arsenic, boron, and silicon levels in children with cyanotic and acyanotic CHD who underwent cardiac surgery with cardiopulmonary bypass. Participants were divided into the following three groups: patients acyanotic CHDs (n=34), patients with cyanotic CHDs (n=30), and healthy controls (n=30). Blood samples were collected before the surgery and 1 hour after the sternum was closed. Serum trace elements were determined by Inductively Coupled Plasma Optical Emission Spectrometer-ICAP 6000. The baseline serum arsenic, manganese, and zinc levels of both patient groups were lower compared with controls, but there was no significant difference between baseline serum trace element levels of cyanotic and acyanotic patients. In both the patient groups, there was a significant decrease in postoperative serum arsenic, boron, copper, and zinc levels, and a significant increase in postoperative serum iron and magnesium levels. Silicon levels increased in cyanotic patients. Alterations in trace element levels were in the same direction in cyanotic and acyanotic patients. Copper, zinc, and manganase replacement may be needed after on-pump cardiac surgery.
In this chapter, we first review mathematical creativity with an emphasis on the nature of novelty in mathematics. We compare mathematical creativity to creativity in other domains, provide examples of novelty, and contrast these to novelty in other domains and explain types of creativity in mathematics based on perspectives in philosophy. All the theoretical perspectives we reviewed led us to synthesize that mathematical creativity involves knowledge production which is either discovery or invention. The chapter also covers pioneers and their contributions to the study of mathematical creativity, such as Polya and Krutetskii. The last part of the chapter includes a review and critique of the assessment of mathematical creativity, such as paper and pencil assessments, observations and interviews, and self-assessment.
Development of winter wheat (Triticum aestivum) synthetics started at CIMMYT-Mexico in 2004, when winter durum wheat (Triticum turgidum) germplasm from Ukraine and Romania was crossed with Aegilops tauschii accessions from the Caspian Sea region. Chromosomes were doubled after pollination and embryo rescue, but chromosome number and cytological validation was not performed. F2 populations were grown in Mexico and were shipped to Turkey in 2008. During 2009–2015, these populations were subjected to rigorous pedigree selection under dry, cold, disease-affected environments of the Central Anatolian Plateau. The wide segregation and partial sterility observed in 2009 gradually decreased and, by 2016, most of the F8 single spike progenies demonstrated good fertility and agronomic performance. Since 2013, lines have been selected from synthetic populations and evaluated at multiple sites. Superior lines were characterized for resistance to leaf, stripe and stem rust, plant height, and reaction to common bunt and soil-borne pathogens. Thousand kernel weight of many lines exceeded 50 g, compared with the check varieties that barely reached 40 g. Threshability of synthetic lines varied from 0 to 95%, demonstrating genetic variation for this important domestication trait. Screening against Hessian fly, sunny pest and Russian wheat aphid identified several resistant genotypes. Both durum and Aegilops parents affected synthetic wheat traits. Several studies are underway to reveal the genetic diversity of synthetic lines and the basis of resistance to diseases and insects. This synthetic germplasm represents a new winter bread wheat parental pool. It is available upon request to interested breeding/research programmes.
To evaluate the effect of agmatine sulphate on facial nerve regeneration after facial nerve injury using electron and light microscopy.
The study was performed on 30 male Wistar albino rats split into: a control group, a sham-treated group, a study control group, an anastomosis group, and an anastomosis plus agmatine sulphate treatment group. The mandibular branch of the facial nerve was dissected, and a piece was removed for histological and electron microscopic examination.
Regeneration was better in the anastomosis group than in the study control group. However, the best regeneration findings were seen in the agmatine sulphate treatment group. There was a significant difference between the agmatine group and the others in terms of median axon numbers (p < 0.004) and diameters (p < 0.004).
Agmatine sulphate treatment with anastomosis in traumatic facial paralysis may enhance nerve regeneration.
To perform a retrospective analysis of survival, local–regional control and the effect of prognostic factors in 61 non-small cell lung cancer patients who were treated with postoperative radiotherapy (PORT) by a linear accelerator (LINAC).
Material and methods
A total of 50–66 Gy PORT with a fractional dose of 1·8–2 Gy was administered to 24 patients (24·5%) for surgical margin positivity, 33 patients (54%) for mediastinal lymph node involvement and 13 patients (21·5%) for both mediastinal lymph node involvement and positive surgical margins.
Median follow-up was 17 months, and the median survival and median distant metastasis-free survival were 25 and 19 months, respectively. Local-regional progression was observed in 10 patients (16·4%). Treatment modality (2D/3D) (p=0·021), tumour size >4 cm (p=0·004), surgical margin positivity (p=0·001), and left lung localisation of the tumour (p≤0·05) were the prognostic factors in terms of survival.
A survey of the literature shows that, without PORT, local recurrence or progression rates increase while overall survival rates decrease. In this study, only patients with PORT are studied and the results show that the local progression and overall survival rates are comparable with literature of LINAC-based PORT. In the case of overall survival, 3D treatment shows better results than 2D treatment modality.