To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Despite the widely recognized value of wetlands in providing vital ecosystem services, these are presently being degraded and ultimately destroyed, leading to a decrease in the biodiversity associated with these areas. Some species inextricably linked to wetlands, however, have been increasing and (re)colonizing areas across their range; a notable example being the Eurasian Spoonbill Platalea leucorodia. In this study we aimed to identify the most important habitats for juvenile spoonbills fledging from a traditional colony in Portugal, located in Ria Formosa, during the period of their life with the lowest survival rates: the first months after leaving the colony. We deployed 16 GPS/GSM tags on juveniles captured in different years (2016 to 2020) and tracked them during post-fledging dispersal and first winter (average 166.4 ± 29.2 SE days). Using Corine Land Cover data, we were able to identify which habitats were most important. Several habitats were used in variable proportions by individuals originating from the same colony, but there was a general trend towards using fewer habitats along the first months of life. Intertidal wetlands were the most used habitat, but anthropogenic habitats such as Wastewater Treatment Plants, saltpans and rice fields were identified as alternative habitats for young spoonbills, and may had contributed to the recent expansion of this species in Portugal.
Paediatric and adult psychiatric emergency department (ED) visits decreased during the initial COVID-19 pandemic outbreak. Long-term consequences of the pandemic will include increases in mental healthcare needs especially among especially vulnerable groups such as children and adolescents.
This study examined changes in the number of overall and diagnosis-specific mental health ED visits among patients aged <18 years following onset of the COVID-19 pandemic in Madrid, Spain.
We used electronic health records to extract the monthly numbers of total and diagnosis-specific mental health ED visits among patients aged <18 years, between October 2018 and April 2021, to La Paz University Hospital. We conducted interrupted time-series analyses and compared trends before and after the day of the first ED COVID-19 case (1st March 2020).
In March 2020, there was a marked initial decrease of -12.8 (95%CI -21.9, -7.9) less monthly mental health ED visits. After April 2020, there was a subsequent increasing trend of 3.4 (95%CI 2.6, 4.2) additional monthly mental health ED visits.
After onset of the COVID-19 pandemic, there was an increase in paediatric psychiatric ED visits, especially due to suicide-related reasons. These data reinforce the crucial role of the ED in the management of acute mental health problems among youth and highlight the need for renovated efforts to enhance access to care outside of and during acute crises during the pandemic and its aftermath.
Maternal depressive symptoms in pregnancy may affect offspring health through prenatal programming of the hypothalamic–pituitary–adrenal (HPA) axis. The biological mechanisms that explain the associations between maternal prenatal depressive symptoms and offspring HPA axis regulation are not yet clear. This pre-registered investigation examines whether patterns of maternal depressive symptoms in pregnancy are associated with infant cortisol reactivity and whether this association is mediated by changes in placental corticotropin-releasing hormone (pCRH).
A sample of 174 pregnant women completed assessments in early, mid, and late pregnancy that included standardized measures of depressive symptoms and blood samples for pCRH. Infant cortisol reactivity was assessed at 1 and 6 months of age.
Greater increases in maternal depressive symptoms in pregnancy were associated with higher cortisol infant cortisol reactivity at 1 and 6 months. Greater increases in maternal depressive symptoms in pregnancy were associated with greater increases in pCRH from early to late pregnancy which in turn were associated with higher infant cortisol reactivity.
Increases in maternal depressive symptoms and pCRH over pregnancy may contribute to higher infant cortisol reactivity. These findings help to elucidate the prenatal biopsychosocial processes contributing to offspring HPA axis regulation early in development.
This study sought to explain results of the Water Up!@Home randomised controlled trial where low-income parents were randomised to receive an educational intervention +a low-cost water filter pitcher or only the filter. Parents in both groups had reported statistically significant reductions in sugar-sweetened beverages (SSB) and increases in water intake post-intervention.
Qualitative explanatory in-depth interviews analysed thematically and deductively.
Washington, DC metropolitan area, USA.
Low-income Latino parents of infants/toddlers who had participated in the Water Up! @Home randomised controlled trial.
The filter-stimulated water consumption in both groups by (1) increasing parents’ perception of water safety; (2) acting as a cue to action to drink water; (3) improving the flavour of water (which was linked to perceptions of safety) and (4) increasing the perception that this option was more economical than purchasing bottled water. Safe and palatable drinking water was more accessible and freely available in their homes; participants felt they did not need to ration their water consumption as before. Only intervention participants were able to describe a reduction in SSB intake and described strategies, skills and knowledge gained to reduce SSB intake. Among the comparison group, there was no thematic consensus about changes in SSB or any strategies or skills to reduce SSB intake.
A low-cost water filter facilitated water consumption, which actively (or passively for comparison group) displaced SSB consumption. The findings have implications for understanding and addressing the role of water security on SSB consumption.
Background: There is growing body of evidence linking abnormal eye movements in people with multiple sclerosis (MS) to disease severity and cognition which could better detect disease progression. The objective of this study is to determine if a novel eye-tracking tool can accurately predict disease severity and cognitive status based on eye movement metrics and characterize how they evolve with progression. Methods: Persons with MS (n=132) will be followed over 4 years with clinical assessments every 6 months. Eye movements are also assessed while performing oculomotor tasks using Innodem Neurosciences’ patented eye-tracking technology. The eye movement metrics will be inputted into machine learning classifying algorithms to identify which metrics can serve as reliable Eye Movement Biomarkers (EMB) for MS progression and cognitive status. Results: There were 16 participants recruited as of January 2022 with mean age 47. 3 (SD 10.4; range 26-67), gender (12F/4M), EDSS 2.59 (SD 1.49; range 1.5-6.5), SDMT 51.4 (SD 14.1, range 24-78). With current enrollment, there is a negative correlation between EDSS and SDMT (r = -0.47) as observed in the literature. Conclusions: This trial will demonstrate the utility of EMBs for monitoring MS progression by improving physicians’ access to a reliable, non-invasive, sensitive and accessible marker of disease progression.
Cannabis use in university students is associated with academic achievement failure and health issues. The objective of the study was to evaluate the association between attention deficit hyperactivity disorder (ADHD) symptoms and cannabis use after 1 year among students according to previous cannabis use.
Students in France were recruited from February 2013 to July 2020 in the i-Share cohort. 4,270 participants were included (2,135 who never used cannabis at inclusion and 2,135 who did). The Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptoms at inclusion. Cannabis use frequency was evaluated 1 year after inclusion. Multinomial regressions were conducted to assess the association between inclusion ADHD symptoms and cannabis use after 1 year.
Increase in ASRS scores was linked with a greater probability to use cannabis after 1 year and to have a higher cannabis use frequency (once a year—once a month adjusted odds ratio [OR]: 1.24 (1.15–1.34), more than once a month adjusted OR: 1.43 (1.27–1.61)). Among participants who never used cannabis at inclusion, this association disappeared (once a year—once a month adjusted OR: 1.15 (0.95–1.39), more than once a month adjusted OR: 1.16 (0.67–2)) but remained in participants who ever used cannabis at inclusion (once a year—once a month adjusted OR: 1.17 (1.06–1.29), more than once a month adjusted OR: 1.35 (1.18–1.55)).
High levels of ADHD symptoms in students could lead to continued cannabis use rather than new initiations.
Childhood maltreatment (CM) exerts various long-lasting psychological and biological changes in affected individuals, with inflammation being an interconnecting element. Besides chronic low-grade inflammation, CM might also affect the energy production of cells by altering the function and density of mitochondria, i.e. the body's main energy suppliers. Here, we compared mitochondrial respiration and density in intact peripheral blood mononuclear cells (PBMC), from women with and without CM between two time points, i.e. at the highly inflammatory phase within 1 week after parturition (t0) and again after 1 year (t2).
CM exposure was assessed with the Childhood Trauma Questionnaire. Whole blood was collected from n = 52 healthy women within the study ‘My Childhood – Your Childhood’ at both time points to isolate and cryopreserve PBMC. Thawed PBMC were used to measure mitochondrial respiration and density by high-resolution respirometry followed by spectrophotometric analyses of citrate-synthase activity.
Over time, quantitative respiratory parameters increased, while qualitative flux control ratios decreased, independently of CM. Women with CM showed higher mitochondrial respiration and density at t0, but not at t2. We found significant CM group × time interaction effects for ATP-turnover-related respiration and mitochondrial density.
This is the first study to longitudinally investigate mitochondrial bioenergetics in postpartum women with and without CM. Our results indicate that CM-related mitochondrial alterations reflect allostatic load, probably due to higher inflammatory states during parturition, which normalize later. However, later inflammatory states might moderate the vulnerability for a second-hit on the level of mitochondrial bioenergetics, at least in immune cells.
The recent development of new offshore projects in pre-salt deepwater fields has placed offshore loading operations as the main production outflow alternative, increasing the operational complexity and risks. Numerous dangerous situations are associated with oil offloading, such as the messenger line transfer during the mooring stage. Nowadays, this critical task is realized by launching a thin messenger cable using the pneumatic line throwing apparatus. This is a complex and slow process since the operation usually occurs with the ship opposite to the wind. This work proposes a hybrid flight methodology based on computer vision and sensor fusion techniques for autonomous unmanned aerial vehicles (UAVs). The UAV takes off from an oil rig and precisely reaches a specific point in the shuttle tanker without using expensive positioning devices and augmenting UAV’s orientation (yaw) precision since the compass can suffer from severe interference due to naval metallic structures near the vehicle. The proposed framework was tested in a realistic simulated environment considering several practical operational constraints. The results demonstrated both the robustness and efficiency of the methodology.
This paper presents the current state of mathematical modelling of the electrochemical behaviour of lithium-ion batteries (LIBs) as they are charged and discharged. It reviews the models developed by Newman and co-workers, both in the cases of dilute and moderately concentrated electrolytes and indicates the modelling assumptions required for their development. Particular attention is paid to the interface conditions imposed between the electrolyte and the active electrode material; necessary conditions are derived for one of these, the Butler–Volmer relation, in order to ensure physically realistic solutions. Insight into the origin of the differences between various models found in the literature is revealed by considering formulations obtained by using different measures of the electric potential. Materials commonly used for electrodes in LIBs are considered and the various mathematical models used to describe lithium transport in them discussed. The problem of upscaling from models of behaviour at the single electrode particle scale to the cell scale is addressed using homogenisation techniques resulting in the pseudo-2D model commonly used to describe charge transport and discharge behaviour in lithium-ion cells. Numerical solution to this model is discussed and illustrative results for a common device are computed.
The tropical cyclone Idai hit Mozambique in the city of Beira on March 15, 2019. During the following days, the Portuguese Emergency Medical Team (PT EMT) and its infrastructure deployed to Mozambique with the mission of helping local people and collaborating with the authorities.
Data analyzed were collected in the period of the deployment, from April 1-April 30, 2019. All patients admitted to PT EMT were registered through the Clinical Record of PT EMT.
In total, 1,662 patients were admitted to PT EMT during the 30-day mission. The five most prevalent diagnoses were: 61.49% classified with “code 29” (which corresponds to “other unspecified diagnoses”), 9.15% of cases of skin disease, 8.90% of minor injuries, 6.74% of acute respiratory infection, and 3.19% of obstetric/genecology complications.
Discussion and Challenges:
An important challenge identified was the need for a robust and effective network for transporting patients, allowing transfers between EMTs, enabling a true network response in the provision of care to disaster victims.
The benefit of the deployment of PT EMT in Mozambique after Cyclone Idai was in line with the EMT initiative standards, allowing a direct delivery of care to the affected Mozambican population and support to the local health authorities.
Embryo development in eggs of the spittlebug Mahanarva spectabilis (Distant) (Hemiptera: Cercopidae) passes through four phases (known as S1 to S4) being stopped at S2 during diapause. Studies about the molecular basis of diapause in spittlebugs are nonexistent. Here, we analyzed proteins from non-diapausing (ND), diapausing (D) and post-diapausing (PD) eggs of the spittlebug M. spectabilis. In total, we identified 87 proteins where 12 were in common among the developmental and diapause phases and 19 remained as uncharacterized. Non-diapausing eggs (S2ND and S4ND) showed more proteins involved in information storage and processing than the diapausing ones (S2D). Eggs in post-diapausing (S4PD) had a higher number of proteins associated with metabolism than S2D. The network of protein interactions and metabolic processes allowed the identification of different sets of molecular interactions for each developmental and diapause phases. Two heat shock proteins (Hsp65 and Hsp70) along with two proteins associated with intracellular signaling (MAP4K and a serine/threonine-protein phosphatase) were found only in diapausing and/or post-diapausing eggs and are interesting targets to be explored in future experiments. These results shine a light on one key biological process for spittlebug survival and represent the first search for proteins linked to diapause in this important group of insects.
Psychosocial rehabilitation is a challenge in a society with demands unsuitable for those with severe mental illness (SMI). The Mental Health Department of Matosinhos Local Health Unity (MHD-MLHU) has developed a solidarity project aiming to evaluate and elaborate individualized rehabilitative responses with people with SMI, including people from the community motivated for solidarity initiatives.
To describe a psychosocial rehabilitation project focused on community integration of people with SMI, considering needs and resources of the population, and to present the individualized rehabilitation plans carried out for people with SMI.
In January 2019, we began the home evaluation of people with SMI monitored in the MHD-MLHU. To develop solidary based play-occupational groups, we interviewed people from the community and from the common mental pathology outpatient clinic willing to participate.
We present the description and evaluation of the psychosocial responses developed by the project. These responses include recreational-occupational groups, tailored to interests of each person with SMI, and using the community support group built for the purpose. These responses promote face-to-face activities, and enhance the destigmatization of SMI. The constraints resulting from the COVID-19 pandemic led to the creation of digital responses aimed at people with SMI and the community in general.
This experience has revealed the great potential of rehabilitating the community context of people with SMI, rather than just contemplating pre-existing structured responses. The pandemic created specific challenges but made the initiative even more relevant for SMI people and for promoting the mental health of the general population.
Patients with substance use disorders (SUD) have higher alexithymia levels and present frequently suicidal ideation (SI) and suicide (SA) [1,2]. Beside, alexithymia has been related to suicidal behaviors in several psychiatric disorders. Although, there are some studies on alexithymia and suicidality in SUD patients, to our knowledge there are no studies on this issue in Spanish population.
To compare the alexithymia levels in SUD patients with and without SI and SA in an outpatient addiction treatment center in Spain.
This is a cross-sectional study performed on 110 patients (74.3%males; mean age 43.6±14.5years old) for whom we had information from the Toronto Alexithymia Scale(TAS-20) and the presence or not of lifetime SI and SA.
Lifetime SI and SA were present in 55.5% and 35.5% of the sample respectively. The mean score of TAS-20, difficulties identifying feelings (DIF), difficulties describing feelings (DDT), and externally-oriented thinking(EOT) were 57.2±13.3, 20.0±7.0, 14.7±4.5, and 22.5±4.5 respectively.
SI and SA may be related to alexithymia levels. Hence, alexithymia should be further analyzed in SUD patients in longitudinal studies in order to analyze the bilateral association with suicidal spectrum behaviors. REFERENCES Rodríguez-Cintas L, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res. 2018;262:440-5. Morie KP, et al. Alexithymia and Addiction: A Review and Preliminary Data Suggesting Neurobiological Links to Reward/Loss Processing. Curr Addict Rep. 2016;3(2):239-48. Hemming L, et al. A systematic review and meta-analysis of the association between alexithymia and suicide ideation and behaviour. J Affect Disord. 2019;254:34-48.
Dissociative Amnesia remains an enigmatic and controversial entity. It is classically described as responsible for autobiographic amnesia associated with a traumatic event.
To report a clinical case and review the literature.
We collected data from the patient’s clinical file with his informed consent. We conducted a non-systematic review of the literature.
A 46-years-old patient presents to the emergency department for sudden global retrograde amnesia, with multiple domain amnestic syndrome (impairing verbal and visual memory, processing speed, mental flexibility, calculus, executive functions and language). He was initially admitted for a suspected infectious meningoencephalitis, which was not confirmed. Later an autoimmune encephalitis was pursued. Brain MRI showed a nonspecific left temporal and hipocampal hyperintensity and the EEG a mild left temporal dysfunction. The autoimmune encephalitis panel was negative and the formal diagnostic criteria were not met. The neurologic examination at discharge presented only with autobiographical and semantic amnesia. On the mental state examination, he presented with depressive symptoms reactive to the situation. There was no evident traumatic event apart from a promotion received the day before the amnesia started. He was prescribed escitalopram 10 mg/day. The amnesia was maintained at 9 months follow-up.
Our case report illustrates a case of amnesia without evident organic or psychogenic cause, assumed as a dissociative amnesia. Further studies are necessary to clarify the pathophysiology of this condition and develop specific treatments.
Genital pain is a heterogeneous chronic pain condition and the relationship between biological, psychological and social factors sets a complex clinical challenge. The importance of negative thoughts and emotions has opened up an opportunity for the role of third generation cognitive-behavioral therapies (CBT). While the majority of evidence revolves around female sexual desire and arousal problems, research on genital pain disorders is beginning to take shape.
To review the evidence of third generation CBT on genital pain disorder.
Review of literature using the Pubmed platform.
We identified 21 publications. Evidence shows that mindfulness-based CBT (MbCBT) improves reduction of fear linked to sexual activity, pain acceptance, catastrophizing and decentering. MbCBT shows significant improvements on secondary outcomes (overall sexual function, sexual satisfaction, depression and anxiety) while reduction of genital pain has yielded contradictory results. Acceptance and commitment therapy (ACT) has been studied for chronic pain disorders with improvements on pain acceptance, psychological flexibility, anxiety, depression and functioning. Compassion-focused therapy (CFT) has yielded favorable results on pain distress and intensity, self-efficacy, self-acceptance, anxiety and depression. Self-compassion may be a promising protective factor in genital pain. Both ACT and CFT have not yet been studied specifically for genital pain.
Third generation CBT are most commonly used for depressive, anxiety and chronic pain disorders which signals the logical role that these interventions may have in genital pain. While MbCBT has started to present favorable results in treating genital pain (as well other sexual problems), ACT and CFT require more research.
Insomnia has been related to a more severe substance use disorder presentation (1). There are few longitudinal studies in outpatients center for SUD treatment that evaluate how insomnia impacts on relapses.
To analyze how insomnia impacts on the time of the first substance relapse in SUD outpatients after the onset of addiction treatment.
This is a one-year follow-up study performed on 116 patients (73.3% males; mean age 43.4±14.3) for whom we had information from baseline insomnia and the time for the first relapse. A Kaplan-Meier survival analysis was performed. This is part of a greater research on Alexithymia in SUD in a longitudinal study.
The initial sample consisted of 116 patients, information on relapses was available for 113 patients. The main substances used at baseline were alcohol (62.1%), cocaine (56.0%), cannabis (42.2%), and opiates (30.2%).
It is important to evaluate insomnia at the onset of addiction treatment because insomnia may be related to earlier relapses. Furthermore, it should be analyzed further on how insomnia treatment impact on substance relapses. REFERENCES 1. Miller MB, Donahue ML, Carey KB, Scott-Sheldon LAJ. Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis. Drug Alcohol Depend. 2017;181:200-207. doi:10.1016/j.drugalcdep.2017.09.029
In Spain, we are forced to familiarize ourselves with Arab-Muslim culture to properly treat our patients. The diagnosis becomes complicatedbecause western health professionals are not usually familiar with thisform of symptom presentation.
The objective of this work is to study the influence of Arab culture and Muslim religion on the psychopathological symptoms presented duringa psychotic episode.
We present two cases of psychosis in two brothers of Maghreb originwho were treated for the first psychotic episode in the acute psychiatricunit in a Spanish regional hospital. Then, we carried out a litle researchfrom the literatura.
The common psychopathological symptoms presented by two brothersof 26 and 27 years were: symptoms of thought, control and influence of the self. Delusional ideas of self-referential harm and persecution. Auditory and cenesthetic hallucinations. In the literature we find that patients with Islamic backgrounds whosuffer hallucinations can attribute these experiences to different beliefssuch as geniuses (jinn), black magic and the evil eye. One of the siblings was diagnosed with a psychotic episode withoutspecification, while the other brother got the schizophrenia label. Webelieve that this may be related to the fact that mental healthprofessionals generally tend to label fantastic stories as mind-blowingor delusional in nature.
1. Religious beliefs and fantastic tales of Muslim culture can be considered psychotic symptoms if healthcare professionals are notfamiliar with this culture. 2. Teamwork between mental health professionals, translators and religious counselors can improve care for Muslim patients.
The differential diagnosis between Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD) is often challenging and detrimental to early and timely treatment. Co-current and overlapping symptoms contribute to erode differential diagnostic accuracy, based mainly on clinical assessment supported by standardized instruments and reports from parents and teachers. The microbiota was recently considered a valuable resource in the search for biological markers in neurodevelopmental disorders.
Our objective was to examine the published literature in order to clarify the role of the microbiome as a possible differential biomarker between ASD and ADHD.
Five hundred and sixteen articles were reviewed in order to contextualize the role of Gut- Brain Axis in neurodevelopment and neurodevelopmental disorders, the microbiome as a biomarker and ultimately to unravel microbiome abnormalities reported in patients diagnosed with ASD and/or ADHD.
Although gut microbiome appears to be involved in the pathogenesis of ASD with several reports identifying changes in gut populations and functions, a “microbial signature” is still not reached. In ADHD patients, research confirms that the composition and predicted functions of gut microbiome are also altered, but identically controversial results were found.
Future studies are needed to confirm the relationship between the composition and function of the microbiome and the occurrence or presentation of each of the disorders. A specific signature of the microbiota could then constitute itself as a differential biomarker in ASD and ADHD.
Healthcare workers (HCWs) not fulfilling the coronavirus disease 2019 (COVID-19) case definition underwent severe acute respiratory coronavirus virus 2 (SARS-CoV-2) screening. Risk of exposure, adherence to personal protective equipment (PPE), and symptoms were assessed. In total, 2,000 HCWs were screened: 5.5% were positive for SARS-CoV-2 by polymerase chain reaction (PCR). There were no differences in PPE use between SARS-CoV-2–positive and –negative HCWs (adherence, >90%). Nursing and kitchen staff were independently associated with positive SARS-CoV-2 results.
DNA methylation of the elongation of very long chain fatty acids protein 2 (ELOVL2) was suggested as a biomarker of biological aging, while childhood maltreatment (CM) has been associated with accelerated biological aging. We investigated the association of age and CM experiences with ELOVL2 methylation in peripheral blood mononuclear cells (PBMC). Furthermore, we investigated ELOVL2 methylation in the umbilical cord blood mononuclear cells (UBMC) of newborns of mothers with and without CM. PBMC and UBMC were isolated from 113 mother–newborn dyads and genomic DNA was extracted. Mothers with and without CM experiences were recruited directly postpartum. Mass array spectrometry and pyrosequencing were used for methylation analyses of ELOVL2 intron 1, and exon 1 and 5′ end, respectively. ELOVL2 5′ end and intron 1 methylation increased with higher age but were not associated with CM experiences. On the contrary, overall ELOVL2 exon 1 methylation increased with higher CM, but these changes were minimal and did not increase with age. Maternal CM experiences and neonatal methylation of ELOVL2 intron 1 or exon 1 were not significantly correlated. Our study suggests region-specific effects of chronological age and experienced CM on ELOVL2 methylation and shows that the epigenetic biomarker for age within the ELOVL2 gene does not show accelerated biological aging years after CM exposure.