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Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied.
International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used.
In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040).
The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%.
Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.
This paper presents a novel method for modeling a 3-degree of freedom open kinematic chain using quaternions algebra and neural network to solve the inverse kinematic problem. The structure of the network was composed of 3 hidden layers with 25 neurons per layer and 1 output layer. The network was trained using the Bayesian regularization backpropagation. The inverse kinematic problem was modeled as a system of six nonlinear equations and six unknowns. Finally, both models were tested using a straight path to compare the results between the Newton–Raphson method and the network training.
To assess infectious and thrombotic complications of peripherally inserted central catheters (PICCs) in adults.
A 5-year prospective cohort study.
Tertiary-care teaching hospital in Seville, Spain.
Adult patients undergoing PICC insertion.
Catheter-associated bloodstream infection (CABSI) including catheter-related bloodstream infection (CRBSI), primary bacteremia (PB), and upper extremity deep vein thrombosis (UEDVT) were recorded. Independent predictors of complications were assessed by multivariate analysis.
In total, 1,142 PICCs were inserted, with 153,191 catheter days (median, 79). Complications included 66 cases of CABSI (5.78%; 0.43‰ catheter days), 38 cases of CRBSI (3.33%; 0.25‰ catheter days), 28 cases of PB (2.45%; 0.18‰ catheter days), and 23 cases of UEDVT (2.01%; 0.15‰ catheter days). The median times to infection were 24, 41, and 60 days for CRBSI, PB, and UEDVT, respectively. Parenteral nutrition (odds ratio [OR], 3.40; 95% confidence interval [CI], 1.77–6.52) and admission to the hematology ward (OR, 4.90; 95% CI, 2.25–10.71) were independently associated with CRBSI and PB, respectively. Admission to the hematology ward (OR, 12.46; 95% CI, 2.49–62.50) or to the oncology ward (OR, 7.89; 95% CI, 1.77–35.16) was independently associated with UEDVT. The crude mortality rate was 24.8%. Only 2 patients died of complications.
PICCs showed a low rate of thrombotic and infectious complications. Compared to PB, CRBSI showed significantly different risk factors, a higher incidence density per catheter days, and a shorter median time to infection. Separate analyses of CRBSI and PB are more specific and clinically useful when analyzing infectious complications.
The complex geographical scenario of Mexico allowed the cultural diversification and development of multiple cultures such as Tolteca, Teotihuacan, Mexica, and Maya, among others. Despite this rich cultural heritage, radiometric dating of Mexican cultural samples with radiocarbon (14C) began only in the 1980s and with accelerator mass spectrometry (AMS) in 2013. Analysis of 14C with AMS is the most widely used technique to date archaeological objects and cultural heritage. Since 2013, the Accelerator Mass Spectrometry Laboratory (LEMA) facility of the Institute of Physics at UNAM (IF-UNAM) has supported archaeological research in Mexico, but also investigation in other areas such as geology, physics, chemistry, and environmental sciences through the analysis of 14C, 10Be, 26Al, 129I, and Pu. The absolute dating with 14C continues to be the core of LEMA’s work, where different geographical scenarios of the country and climatic conditions present very diverse analytical challenges. This work presents a basic description of the AMS system of the LEMA laboratory and describes some applications that are currently being developed.
Pomegranate peel is an agro-industrial residue obtained after fruit processing with high total polyphenol (TP) content, making it an attractive by-product for its reuse. Pomegranate peel extract (PPE) and its bioactive compounds have shown positive effects on obesity models. Effects on favouring mitochondrial biogenesis and function have also been described. However, once phenolic compounds are extracted, their stability can be affected by diverse factors. Microencapsulation could improve PPE stability, allowing its incorporation into functional foods. Nevertheless, studies on the potential biological effects of PPE microparticles (MPPE) in obesity models are lacking. This study aims to evaluate the effect of MPPE on brown adipose tissue (BAT) mitochondrial structure and function and metabolic alterations related to obesity in mice fed a high-fat diet (HFD). PPE was microencapsulated by spray drying using inulin (IN) as a wall material and physically–chemically characterised. Eight-week-old male C57BL/6J mice (n 40) were randomly distributed into five groups: control diet (CD), HFD, HFD + IN, HFD + PPE (50 mg/kg per d TP) and HFD + MPPE (50 mg/kg per d TP), for 14 weeks. A glucose tolerance test and indirect calorimetry were conducted. Blood and adipose tissue samples were obtained. MPPE supplementation prevented HFD-induced body weight gain (P < 0·001), fasting glycaemia (P = 0·007) and total cholesterol rise (P = 0·001). MPPE resulted in higher BAT mitochondrial complex IV activity (P = 0·03) and prevented HFD-induced mitochondrial cristae alteration (P = 0·02). In conclusion, MPPE prevented HFD-induced excessive body weight gain and associated metabolic disturbances, potentially by activating complex IV activity and preserving mitochondrial cristae structure in BAT in mice fed with a HFD.
Older subjects are susceptible to develop gambling problems, and researchers have attempted to assess the mechanisms underlying the gambling profile in later life. The objective of this study was to identify the main stressful life events (SLE) across the lifespan which have discriminative capacity for detecting the presence of gambling disorder (GD) in older adults. Data from two independent samples of individuals aged 50+ were analysed: N = 47 patients seeking treatment at a Pathological Gambling Outpatient Unit and N = 361 participants recruited from the general population. Sexual problems (p < 0.001), exposure to domestic violent behaviour (p < 0.001), severe financial problems (p = 0.002), alcohol or drug-related problems (p = 0.004) and extramarital sex (p < 0.001) were related to a higher risk of GD, while getting married (p = 0.005), moving to a new home (p = 0.003) and moving to a new city (p = 0.006) decreased the likelihood of disordered gambling. The accumulated number of SLE was not a predictor of the presence of GD (p = 0.732), but patients who met clinical criteria for GD reported higher concurrence of SLE in time than control individuals (p < 0.001). Empirical research highlights the need to include older age groups in evidence-based policies for gambling prevention, because these individuals are at high risk of onset and/or progression of behavioural addiction-related problems such as GD. The results of this study may be useful for developing reliable screening/diagnostic tools and for planning effective early intervention programmes aimed to reduce the harm related to the onset and evolution of problem gambling in older adults.
Not all patients who acquire carbapenemase-producing Enterobacteriaceae (CPE) develop infections by these organisms; many remain only colonized. Of 54 CPE-colonized patients, 16 (30%) developed CPE infections. We identified indwelling urinary catheter exposure, exposure to intravenous colistin, and overseas transfer as variables associated with CPE infection development among colonized patients.
We report on what appear to be increasing predation events on nesting Thick-billed Parrots Rhychopsitta pachyrhyncha. Thick-billed Parrots are classified as ‘Endangered’ and their seasonal breeding range is restricted to increasingly fragmented and degraded high elevation mixed conifer forest habitat within the Sierra Madre Occidental region of north-western Mexico. Predation of established breeding pairs has recently contributed to the ongoing decline of Thick-billed Parrot populations by removing mature birds with high reproductive value, which has associated consequences for future recruitment. We observed increasing predation events on nesting Thick-billed Parrots by bobcats Lynx rufus accompanied by kittens throughout the 2018–2019 breeding seasons, and we speculate that recent reductions in bobcat habitat have pushed them into new ranges where they are supplementing their diet with nontraditional prey items.
Pulses such as peas, beans or lentils are one of the most complete foods at the nutritional level; however, they are one of the most often neglected foods in the diets of university students. Entrance to university translates into a major lifestyle change for many young people, and the habits acquired or cemented at this time will remain into adulthood. The objective of this study is to analyse the association between personal/sociodemographic factors, dietary intake of other food groups and the consumption of pulses in first-year university students. This cross-sectional study is part of the UniHcos project, a multicentre study of multipurpose prospective cohorts in eleven Spanish universities. Data from 9862 university students were collected through an online self-questionnaire completed by all students who met the selection criteria and agreed to participate in the project during the 2011–2018 academic years. Of students, 75·8 % presented an inadequate (≤2 times/week) consumption of pulses. Living outside the family home in either a student residence (OR 0·76; 95 % CI 0·69, 0·84) or rental (OR 0·81; 95 % CI 0·70, 0·95) decreased the compliance with recommendations on the consumption of pulses. Low consumption of pulses is seemingly not restricted to a specific profile or dietary pattern among university students, and no specific focus group for intervention can be identified. Policies promoting the consumption of pulses among the university population as a whole are necessary to increase compliance rates with the dietary recommendations.
Parasomnias are involuntary behaviors or subjective experiences during sleep. Our objective was to review existing information on the presence of parasomnias in patients with addictions or during treatment for addictions. Information about parasomnias related to rapid-eye-movement (REM) and non-REM sleep in patients with addictions, while using substances or in abstinence, was reviewed. A systematic search of published articles reporting parasomnias as a consequence of drug use or abuse was conducted in the PubMed and SciELO databases. The search for the studies was performed in three phases: (1) by title, (2) by abstract, and (3) by complete text. The search was performed independently by two researchers, who then compared their results from each screening phase. Seventeen articles were found. The consumption of alcohol was reported in association with arousal disorders, such as sexsomnia and sleep-related eating disorder; and REM sleep behavior disorder was reported during alcohol withdrawal. Cocaine abuse was associated with REM sleep behavior disorder with drug consumption dream content. Overall, we found that several types of parasomnias were very frequent in patients with addictions. To avoid accidents in bedroom, legal problems, and improve evolution and prognosis; must be mandatory to include security measures related to sleep period; avoid pharmacological therapy described as potential trigger factor; improve sleep hygiene; and give pharmacological and behavioral treatments for patients with these comorbid sleep disorders.
There is evidence that environmental and genetic risk factors for schizophrenia spectrum disorders are transdiagnostic and mediated in part through a generic pathway of affective dysregulation.
We analysed to what degree the impact of schizophrenia polygenic risk (PRS-SZ) and childhood adversity (CA) on psychosis outcomes was contingent on co-presence of affective dysregulation, defined as significant depressive symptoms, in (i) NEMESIS-2 (n = 6646), a representative general population sample, interviewed four times over nine years and (ii) EUGEI (n = 4068) a sample of patients with schizophrenia spectrum disorder, the siblings of these patients and controls.
The impact of PRS-SZ on psychosis showed significant dependence on co-presence of affective dysregulation in NEMESIS-2 [relative excess risk due to interaction (RERI): 1.01, p = 0.037] and in EUGEI (RERI = 3.39, p = 0.048). This was particularly evident for delusional ideation (NEMESIS-2: RERI = 1.74, p = 0.003; EUGEI: RERI = 4.16, p = 0.019) and not for hallucinatory experiences (NEMESIS-2: RERI = 0.65, p = 0.284; EUGEI: −0.37, p = 0.547). A similar and stronger pattern of results was evident for CA (RERI delusions and hallucinations: NEMESIS-2: 3.02, p < 0.001; EUGEI: 6.44, p < 0.001; RERI delusional ideation: NEMESIS-2: 3.79, p < 0.001; EUGEI: 5.43, p = 0.001; RERI hallucinatory experiences: NEMESIS-2: 2.46, p < 0.001; EUGEI: 0.54, p = 0.465).
The results, and internal replication, suggest that the effects of known genetic and non-genetic risk factors for psychosis are mediated in part through an affective pathway, from which early states of delusional meaning may arise.
Following the suggestion from the Monte–Carlo experiments in Jiménez (J. Turbul., 2020, doi:10.1080/14685248.2020.1742918) that dipoles are as important to the dynamics of decaying two-dimensional turbulence as individual vortex cores, it is found that the kinetic energy of this flow is carried by elongated streams formed by the concatenation of dipoles. Vortices separate into a family of small fast-moving cores, and another family of larger slowly moving ones, which can be described as ‘frozen’ into a slowly evolving ‘crystal.’ The kinematics of both families are very different, and only the former is self-similar. The latter is responsible for most of the kinetic energy of the flow, and its vortices form the dipoles and the streams. Mechanisms are discussed for the growth of this slow component.
This study attempted to replicate whether a bias in probabilistic reasoning, or ‘jumping to conclusions’(JTC) bias is associated with being a sibling of a patient with schizophrenia spectrum disorder; and if so, whether this association is contingent on subthreshold delusional ideation.
Data were derived from the EUGEI project, a 25-centre, 15-country effort to study psychosis spectrum disorder. The current analyses included 1261 patients with schizophrenia spectrum disorder, 1282 siblings of patients and 1525 healthy comparison subjects, recruited in Spain (five centres), Turkey (three centres) and Serbia (one centre). The beads task was used to assess JTC bias. Lifetime experience of delusional ideation and hallucinatory experiences was assessed using the Community Assessment of Psychic Experiences. General cognitive abilities were taken into account in the analyses.
JTC bias was positively associated not only with patient status but also with sibling status [adjusted relative risk (aRR) ratio : 4.23 CI 95% 3.46–5.17 for siblings and aRR: 5.07 CI 95% 4.13–6.23 for patients]. The association between JTC bias and sibling status was stronger in those with higher levels of delusional ideation (aRR interaction in siblings: 3.77 CI 95% 1.67–8.51, and in patients: 2.15 CI 95% 0.94–4.92). The association between JTC bias and sibling status was not stronger in those with higher levels of hallucinatory experiences.
These findings replicate earlier findings that JTC bias is associated with familial liability for psychosis and that this is contingent on the degree of delusional ideation but not hallucinations.
A 10-year-old girl with genetically confirmed Jervell-Lange-Nielsen syndrome treated with beta-blocker and developed electrical storm after changing propranolol syrup to tablets. Jervell-Lange-Nielsen is characterised by long QT and congenital sensorineural deafness, with high risk of malignant arrhythmias at early ages. Gastric involvement and achlorhydria may be present, with subsequent alteration of medication bioavailability which can trigger severe arrhythmic complications.
Numerous research studies have demonstrated an association between higher symptom severity and cognitive impairment with poorer social functioning in first-episode psychosis (FEP). By contrast, the influence of subjective experiences, such as social relatedness and self-beliefs, has received less attention. Consequently, a cohesive understanding of how these variables interact to influence social functioning is lacking.
We used structural equation modeling to examine the direct and indirect relationships among neurocognition (processing speed) and social cognition, symptoms, and social relatedness (perceived social support and loneliness) and self-beliefs (self-efficacy and self-esteem) in 170 individuals with FEP.
The final model yielded an acceptable model fit (χ2 = 45.48, comparative fit index = 0.96; goodness of fit index = 0.94; Tucker–Lewis index = 0.94; root mean square error of approximation = 0.06) and explained 45% of social functioning. Negative symptoms, social relatedness, and self-beliefs exerted a direct effect on social functioning. Social relatedness partially mediated the impact of social cognition and negative symptoms on social functioning. Self-beliefs also mediated the relationship between social relatedness and social functioning.
The observed associations highlight the potential value of targeting social relatedness and self-beliefs to improve functional outcomes in FEP. Explanatory models of social functioning in FEP not accounting for social relatedness and self-beliefs might be overestimating the effect of the illness-related factors.
En las unidades domésticas de las comunidades chinamperas en Xochimilco del posclásico tardío, han sido localizadas un tipo de jarras que tienen como característica principal una aplicación en la parte frontal de la pieza que posiblemente representa una deidad. Con el propósito de entender su función y establecer elementos que permitan identificar estos objetos y su uso en otros contextos, proponemos estudiar estas piezas mediante métodos diferentes a los de los análisis formales tradicionales. Este trabajo expone los resultados de los estudios de residuos químicos impregnados en materiales porosos (spot test) y análisis de gránulos de almidón de 27 muestras obtenidas en 26 ejemplares de jarras efigie procedentes de tres sitios al sur de la cuenca de México. Los resultados indican que fueron enriquecidas con fosfatos, residuos proteicos, carbohidratos, y ácidos grasos, mientras que los almidones recuperados indican una presencia importante de maíz, y en menor medida, de camote, chile, y dioscórea. Basado en lo anterior, en sus contextos de procedencia y en la identificación de las deidades representadas, proponemos que estas jarras contenían bebidas de maíz y que fueron utilizadas en ceremonias domésticas dedicadas a la agricultura—como la fiesta de Huey Tozoztli, entre otras—del calendario mexica.
Alzheimer’s disease (AD) and dementia has emerged as a significant societal issue and a global priority. The prevalence of dementia is rising more rapidly in low and middle income countries (LMIC) than in high income countries. Yet, knowledge of dementia risk factors is dominated by research from high income countries (HIC), which cannot be readily translated to LMIC. Latin American countries (LAC) have unique challenges related to dementia, including rapid aging population, high admixture degree and risk factors profile, which influence the prevalence and presentation of dementia. Several epidemiological studies during the past decade have shown a rapid increase of dementia in LAC, but the impact of genetic, protective and risk factors remain poorly understood. This research session will feature a series of short and engaging talks about new trends of dementia in the region and will answer key questions regarding dementia determinants and consequences in Hispanic populations. Participants will be first introduced to the aging process in LAC, prevalence and incidence of dementia within the region. The second presentation will report on genetics of Alzheimer disease in Hispanic populations. The third presenter will discuss the complexities of dementia multimorbidity and the impact of neuropsychiatric symptoms. The fourth presenter will discuss about Nationals and Regional Strategies to address dementia and reflects on recommendations and future directions for the region. All presentations will be based on findings from multiple research projects across the region. Furthermore, presenters will extended comparison to Non-Hispanics whites and Hispanics populations living in US, which allows cross countries/society comparisons. Overall, new information about dementia will be shared with the audience. Attendees will be able to identify the unique genetic and social determinants that drive AD in LAC. Recommendations will be given for preventive strategies tailored to LMIC. The findings to be shared will be essential for building evidence-based interventions that achieve the goals of the National Plan to Address Alzheimer’s Disease.
Background: Hand hygiene (HH) is the most important measure for preventing healthcare-associated infections. The objective is to gain insight into the evolution of the degree of compliance with recommendations (DCR) on HH and its associated factors in the surgical areas of a tertiary-care hospital. Methods: This observational, cross-sectional study, was repeated over time, with direct observation of the DCR on HH during the daily activity of healthcare workers in surgical areas: general surgery, urology, vascular surgery, traumatology, neurosurgery, thoracic surgery, heart surgery, pediatric surgery, otorhinolaryngology, gynecology and obstetrics, ophthalmology. Over 14 years (from 2005 to 2018), 15,946 HH opportunities were registered, together with different additional variables (age, sex, professional position, surgical area ). The 2 test was used to study the association and the crude, and adjusted odds ratios were used to quantify its magnitude. Results: The DCR on HH in surgical areas was 49.7% (95% CI, 48.9%–50.5%), and in the group of nonsurgical areas it was 53.4% (95% CI, 53.1%–54.1%). The area with the highest degree of compliance was urology (56.7%; 95% CI, 53.9%–59.6%), and the area with the lowest degree of compliance was traumatology (43.3%; 95% CI, 40.4%–46.2%). Some associated factors were the indications after an activity has been performed (58.6%; aOR, 2.7; 95% CI, 2.5–2.9) and the availability of pocket-size alcohol-based disinfectant (63.8%; aOR, 2.4; 95% CI, 2.2–2.5). Conclusions: The DCR on HH in surgical areas is lower than in other hospital areas, and there is still some margin for improvement. We have identified some modifiable factors that have an independent association with HH compliance in surgical areas. Focusing on them will increase compliance with HH with the ultimate goal of reducing healthcare-associated infections.