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As the complexity of the systems increases, so does the complexity of designing a suitable engineering IT architecture. Challenges reach from the definition of required and consistent functionalities and interfaces to the evaluation, which combination of IT tools fulfils the required functionality, usability and interoperability in the best way. Thus, we provide a procedure, methodology and modelling support for the definition of functional and logical engineering IT architectures and their holistic evaluation. The approach is part of an overall procedure and demonstrated in an example.
For the development of intelligent technical systems, Systems Engineering and Solution Patterns are the guarantee for success. In order to avoid cost-intensive iterations, the documentation and reuse of solution knowledge is addressed during the systems design. Using an interdisciplinary specification technique, a uniform structuring of Solution Patterns as well as the composition in a multidimensional knowledge space takes place. This is the basis of an associated systematics for a solution pattern-based system design of mechatronic systems, which is validated by two cooperating DeltaRobots.
Recent evidence has questioned modern psychiatric clinical practice, specifically the prescribing of “atypical” antipsychotics. Our Pan-European Research Group wished to ascertain clinical practice amongst European trainees, which treatments trainees would desire for themselves, and factors influencing this.
A semi-structured survey was constructed from prior literature, piloted, and a homogenous sample size of at least 50 was agreed upon from each country, with 50% minimum response rate. It was distributed via web-link, with questions on preference of antipsychotic for patients in given scenarios, and factors influencing choice. Physicians were asked for their preference should they develop psychosis.
i) Treatment choice of antipsychotic for patients
93% (n=600) of respondents chose to prescribe “atypical” antipsychotics (excluding Clozapine), 6% (n=42) choosing “typical” antipsychotics, 1% (n=6) choosing Clozapine as first-line therapy.
ii) Treatment choice if trainees developed psychosis
89% (n=530) of responders chose to prescribe “atypical” antipsychotics (excluding Clozapine), 7% (n=40) choosing “typical” antipsychotics, 4% (n=23) choosing Clozapine as first-line therapy.
iii) Factors influencing choice
These mapped onto three domains: cost, efficacy and side-effect profile (less than 5% other reasons). 79% (n=458) of those who responded felt efficacy most important, 46% (n=270) felt side-effect profile most important and 3% (n=16) considered cost of paramount importance.
38% (n=272) of those who responded to the survey stated that the CATIE trial had influenced their decision-making.
Psychiatry trainees’ choice of antipsychotic medication for both patients and themselves is based on perceived benefits, as opposed to evidence base and recent literature.
Guidelines produced for management of Bipolar Disorder illustrate change in evidence-base for treatment of acute and maintenance phases of illness. Our Pan-European Research Group assessed clinical practice and desired treatments amongst amongst Psychiatry trainees.
A semi-structured survey was piloted, and homogenous sample size (at least 50) agreed upon from each country, with 50% minimum response rate. It was distributed via web-link, questioning preference of mood stabiliser for patients, trainees themselves and factors influencing choice.
Tables 1 summarise choices.
Lithium and Sodium Valproate
2nd Generation Atypical antipsychotics
[Choice of mood stabiliser for patient/themselves]
Factors influencing decision-making mapped onto cost, efficacy and side-effect profile (less than 4% other reasons). 66% (n=538) of respondents felt efficacy most important, 25% (n=202) felt side-effect profile most important and 3% (n=24) considered cost of most importance.
No clear difference exists in choice of mood stabiliser for European trainees and their patients, and decisions based on perceived efficacy are generally in keeping with established guidelines.
Poor response of psychotic symptoms to a single antipsychotic drug appears to be the most common reason for combination of two antipsychotic drugs. Antipsychotic combinations are in clinical practice very common, although there are not sufficient evidences of their efficacy from randomized, controlled trials. We evaluated the efficacy and safety of augmenting amisulpride with quetiapine in patients with sub-optimal response to amisulpride.
In this open-label, non-randomized study, 36 patients who were partially responsive to amisulpride after 4 weeks of treatment were assigned to receive up to 600mg/day quetiapine along with an ongoing stable dose of 800mg/day amisulpride. Patients were evaluated at baseline and at week 1, 3, 6 and 8. Efficacy was assessed using Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression (CGI) scale and for tolerability we used Simpson-Angus Rating Scale (SAS).
Thirty-one patients completed the study. There was an improvement in the mean scores for PANSS (with more than 30%) and CGI after 8 weeks of treatment, with no major changes in side effect profile.
In patients with a suboptimal response to amisulpride, the addition of quetiapine improved overall positive and negative symptoms of schizophrenia. The combination seems to be safe and well tolerated. Augmentation with quetiapine may provide clinical benefits for patients who are only partially responsive to amisulpride alone. Randomized controlled trials are necessary to evaluate the possible role of this augmentation strategy.
We have pursued the association between clinical and socio-demographic characteristics and the suicide attempts at inpatients with major depressive disorder.
We ran an historical case control study to analyse the individual characteristics associated with suicide attempts in the depression inpatients admitted into the 9th Department of the Clinical Psychiatric Hospital “Al. Obregia” between 01 January 2007 - 01 January 2008. A total of 168 subjects with major depressive disorder (MDD) were included in the study. The patients were separated into two subgroups: “S” - the group with suicide attempt as reason of the present admission into hospital and the comparative group “C” - those without a suicidal attempt at the present admission (used as control group). The two groups were compared with respect to the individual characteristics, following their possible association with the suicidal attempts risk. We used the chi-square (x2) statistic for categorical variables.
Our findings suggest that the most robust predictors of suicide attempts in depression are the younger age of the depression onset, previous psychiatric hospitalizations, low socio-economic status, “single” marital status (widowed/divorced), with no children, heredocolateral history of suicidal attempts and the comorbidity with the problematic alcohol consumption.
The risk factors associated with the suicidal attempts are useful for the screening, finding, prediction and prophylaxis of suicide attempts in major depression.
The study is assessing the knowledge, attitudes and behaviours of the different categories of medical professionals towards the psychiatric patients.
The transversal descriptive study was developed in the hospitals from two cities of Romania: Bucharest and Targoviste. We have studied the opinions about patients with mental disorders of 8 groups of medical professionals: psychiatrists, medical doctors, trainees from psychiatry and from other medical specialities, nurses from psychiatry and from other medical specialities, medical students and student nurses. We have conceived an anonymous self-administered questionnaire with 18 items concerning knowledge, attitudes, affects and actions of the medical professionals toward people with a psychiatric disorder.
From the 450 medical professionals that were asked to complete the questionnaire, 379 returned the questionnaire completed. The comparison between the eight groups of medical professionals showed that the clinical experience is a differentiating factor in the opinions about the cognitions, affects and behaviours towards psychiatric patients. The psychiatric specialists and trainees demonstrated a more tolerant attitude towards the patients with mental disorders. The knowledge about the psychiatric illness had positive correlations with the tolerance in attitude and behavior, apart from the medical category of the respondents.
Based on the fact that the modification of the cognitions influences the attitude and behavior, the stigma-reducing campaigns between medical professionals should have the main objective of informing about the psychiatric illness and patients.
“Bath salts” target the endocannabinoid system in a similar manner to cannabis. In the case of designer drug misuse, subjects seem to be at higher risk of psychotic symptoms.
To investigate the nature and frequency of psychotic symptoms associated with cannabis and/or bath salts misuse in a male inpatient population.
The files of 107 patients admitted to the department of addictions, “Al. Obregia” Psychiatric Hospital Bucharest July 2015–July 2016 were reviewed. Cases had a diagnosis of psychotic disorder with recorded cannabis/bath salts abuse.
Mean age was 26.65 years old (STDV = 5.9). Mean duration of use was of 83.94 months – cannabis; 60.48 months – bath salts and 33.75 months – both substances (BS). Sixty-three patients (73.3%) presented disorganised behaviour; 55.8% (n = 48) formal thought disorder; 45% (n = 39) paranoid delusions. A strong positive association between the length of use of cannabis and disorganised behaviour (n = 33; r = 0.05; P < 0.05) was found. Grandiose ideation was frequent in cannabis users. (X2 = 4.1; n = 0.03; P < 0.05). Multidrug abuse was associated with increased formal thought disorders compared to subjects with cannabis abuse (X2 = 10.9; n = 0.001; P < 0.05). Negative symptoms were more frequent with bath salts users than with users of both substances (X2 = 13.4; X2 = 23.21; X2 = 16.8; P < 0.05).
Positive psychotic symptoms were associated with cannabis and BS abuse, while bath salts promoted negative symptoms.
Disclosure of interest
The author has not supplied his/her declaration of competing interest.
In recent years, rapid technical progress has led to additive manufacturing achieving a high degree of technological maturity that enables a broad range of applications. This is reinforced in particular by the advantages of the technology, such as the production of complex components, smaller quantities and fast reaction times. However, a lack of knowledge of the various process techniques, such as insufficient potential assessment, specific design guidelines or even of process restrictions, often lead to different errors.
This paper presents a methodological approach to support designers in the manufacturing process selection of specific parts at an early stage of product development. In a four-stage procedure, potential part candidates are first identified and part classes formed on the basis of characteristics. Building on this, AM thinking is to be stimulated, for example, with the aid of design guidelines. A comparison between conventionally and additively manufactured parts can be made using a simplified cost model. The results are incorporated into a process model that supports companies in the systematic selection of manufacturing processes.
The increasingly intelligent, highly complex, technical systems of tomorrow - for instance autonomous vehicles - result in the necessity for a systematic security- and safety-oriented development process that starts in the early phases of system design. Automotive Systems Engineering (ASE) as one approach is increasingly gaining ground in the automotive industry. However, this approach is still in a prototype stage. The consideration of security and safety within the early stages of systems design leads to so- called ill-defined problems. Such are not covered by ASE, but can be addressed by means of Design Thinking. Therefore we introduce an approach to combine both approaches. Based on this combination, we derive potentials in the context of the consideration of security and safety. Essential advantages are the possibility to think ahead of threat scenarios at an early stage in system design. Due to an incomplete database, this is not supported or only partially supported by conventional approaches. The resulting potentials are derived based upon a practical example.
The total 14C content and its speciation (inorganic/organic) were measured in spent ion exchange resins (SIERs) received from Cernavoda Nuclear Power Plant (NPP). Also, 14C release from SIERs was investigated by desorption tests carried out in alkaline solution relevant for cementitious environment disposal. The method used for total 14C measurement consists of combustion in oxygen-rich atmosphere, while for speciation measurements, both in SIERs and in desorption solutions, an analytical method based on acid stripping and wet oxidation was applied. Around 97% from the total 14C inventory measured on the Cernavoda SIERs (33.7 kBq/g) was found to be in inorganic form and only 7% as organic 14C. Under alkaline conditions, 14C could be released both as gaseous and as soluble species: from the total 14C present in the SIERs samples around 7% was released as inorganic 14C in the gas phase and 79% as dissolved species (mainly as inorganic 14C). These percentages were obtained for unconditioned SIERs in NaOH solution. The SIERs will be immobilized in a suitable matrix for disposal, and the presence of Ca ions dissolved in cement pore water favor precipitation of 14C and consequently the amount of 14C released from disposal area should be lower.
The aim of this study is to conduct an extended surface and cross-section characterization of a denture base acrylic resin subjected to 500, 650, and 750 W microwave irradiation for 2, 3, and 5 min to assess its morphological modifications. A commercial heat-cured powder was polymerized according to the manufacturer’s specifications and distributed into 20 circular samples. A stainless-steel wire was partially embedded in half of the discs, in order to investigate the metal–polymer interface. High-resolution scanning electron microscopy (SEM) imaging, white light interferometry, roughness measurements and Fourier transform infrared spectrometry were employed for morphological and structural evaluation of the irradiated polymer. Superficial adaptation was discovered after 5 min exposure at 500 W, 650 W, and 750 W, revealing significant roughness correction for 750 W. SEM characterization revealed the inner alteration of the resin for the 750 W protocol and a metal–polymer gap developed regardless of the irradiation conditions. The considerable temperature fluctuations that the samples were subject to during the experiments did not essentially change the poly(methyl-methacrylate) bond structure.
Anglo-Saxons valued education yet understood how precarious it could be, alternately bolstered and undermined by fear, desire, and memory. They praised their teachers in official writing, but composed and translated scenes of instruction that revealed the emotional and cognitive complexity of learning. Irina Dumitrescu explores how early medieval writers used fictional representations of education to explore the relationship between teacher and student. These texts hint at the challenges of teaching and learning: curiosity, pride, forgetfulness, inattention, and despair. Still, these difficulties are understood to be part of the dynamic process of pedagogy, not simply a sign of its failure. The book demonstrates the enduring concern of Anglo-Saxon authors with learning throughout Old English and Latin poems, hagiographies, histories, and schoolbooks.