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To determine the prevalence of low scores for two neuropsychological tests with five total scores that evaluate learning and memory functions.
N = 5402 healthy adults from 11 countries in Latin America and the commonwealth of Puerto Rico were administered the Rey–Osterrieth Complex Figure (ROCF) and the Hopkins Verbal Learning Test (HVLT-R). Two-thirds of the participants were women, and the average age was 53.5 ± 20.0 years. Z-scores were calculated for ROCF Copy and Memory scores and HVLT-R Total Recall, Delayed Recall, and Recognition scores, adjusting for age, age2, sex, education, and interaction variables if significant for the given country. Each Z-score was converted to a percentile for each of the five subtest scores. Each participant was categorized based on his/her number of low scoring tests in specific percentile cutoff groups (25th, 16th, 10th, 5th, and 2nd).
Between 57.3% (El Salvador) and 64.6% (Bolivia) of the sample scored below the 25th percentile on at least one of the five scores. Between 27.1% (El Salvador) and 33.9% (Puerto Rico) scored below the 10th percentile on at least one of the five subtests. Between 5.9% (Chile, El Salvador, Peru) and 10.3% (Argentina) scored below the 2nd percentile on at least one of the five scores.
Results are consistent with other studies that found that low scores are common when multiple neuropsychological outcomes are evaluated in healthy individuals. Clinicians should consider the higher probability of low scores when evaluating learning and memory using various sets of scores to reduce false-positive diagnoses of cognitive deficits.
Depression in palliative advanced cancer patients is common, but often goes unrecognized. One of the first steps toward improving detection is the development of tools that are valid in the specific language and setting in which they are to be used. The Brief Edinburgh Depression Scale (BEDS) is a sensitive case-finding tool for depression in advanced cancer patients that was developed in the United Kingdom. There are no validated instruments to identify depression in Mexican palliative patients. Our aim was to validate the Spanish-language version of the BEDS in Mexican population with advanced cancer.
We conducted a cross-sectional study with outpatients from the palliative care unit at the Instituto Nacional de Cancerología in Mexico City. The Mexican BEDS was validated against a semistructured psychiatric clinical interview according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, classification criteria for major depressive disorder. The interviewer was blind to the BEDS score at the time of the assessment.
Seventy subjects completed the scale and interview. Women represented 71.4% of the sample and median age of subjects was 56.5 years (range, 20–85 years). The prevalence of major depressive disorder according to the psychiatric interview was 20%. The most valid cutoff for defining a case of depression was a score ≥5 of 18 on the Mexican BEDS, which gave a sensitivity of 85.7% and specificity of 62.5%. The scale's Cronbach's alpha was 0.71.
Significance of results
Major depressive disorder is frequent in Mexican palliative patients. The Spanish-language Mexican version of the BEDS is the first valid case-finding tool in advanced cancer patients in this setting.
To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care units (ICUs) in Argentina from January 2014 to April 2017.
This prospective, pre–post surveillance study of 3,940 ICU patients was conducted in 11 hospitals in 5 cities in Argentina. During our baseline evaluation, we performed outcome and process surveillance of CLABSI applying Centers for Disease Control and Prevention/National Health Safety Network (CDC/NHSN) definitions. During the intervention, we implemented the IMA through ISOS: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on CLABSI rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate.
During the baseline period, 5,118 CL days and 49 CLABSIs were recorded, for a rate of 9.6 CLABSIs per 1,000 central-line (CL) days. During the intervention, 15,659 CL days and 68 CLABSIs were recorded, for a rate of 4.1 CLABSIs per 1,000 CL days. The CLABSI rate was reduced by 57% (incidence density rate: 0.43; 95% confidence interval, 0.34–0.6; P<.001).
Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in ICUs in Argentina.
Insulin is a key hormone controlling metabolic homeostasis. Loss or dysfunction of pancreatic β-cells lead to the release of insufficient insulin to cover the organism needs, promoting diabetes development. Since dietary nutrients influence the activity of β-cells, their inadequate intake, absorption and/or utilisation can be detrimental. This review will highlight the physiological and pathological effects of nutrients on insulin secretion and discuss the underlying mechanisms. Glucose uptake and metabolism in β-cells trigger insulin secretion. This effect of glucose is potentiated by amino acids and fatty acids, as well as by entero-endocrine hormones and neuropeptides released by the digestive tract in response to nutrients. Glucose controls also basal and compensatory β-cell proliferation and, along with fatty acids, regulates insulin biosynthesis. If in the short-term nutrients promote β-cell activities, chronic exposure to nutrients can be detrimental to β-cells and causes reduced insulin transcription, increased basal secretion and impaired insulin release in response to stimulatory glucose concentrations, with a consequent increase in diabetes risk. Likewise, suboptimal early-life nutrition (e.g. parental high-fat or low-protein diet) causes altered β-cell mass and function in adulthood. The mechanisms mediating nutrient-induced β-cell dysfunction include transcriptional, post-transcriptional and translational modifications of genes involved in insulin biosynthesis and secretion, carbohydrate and lipid metabolism, cell differentiation, proliferation and survival. Altered expression of these genes is partly caused by changes in non-coding RNA transcripts induced by unbalanced nutrient uptake. A better understanding of the mechanisms leading to β-cell dysfunction will be critical to improve treatment and find a cure for diabetes.
Understanding the response of biodiversity to land-use changes is an important challenge for ecologists. We assessed the effects of five landscape metrics (forest cover, number of patches, edge density, mean inter-patch isolation distance and matrix quality) and three patch metrics (patch size, shape and isolation) on the number of species and patch occupancy of medium- and large-sized terrestrial mammals in the fragmented Lacandona rain forest, Mexico. We sampled mammal assemblages in 24 forest patches and four control areas within a continuous forest. The landscape metrics were measured within a 100-ha buffer, and within a 500-ha buffer from the centre of each sampling site. A total of 21 species from 13 families was recorded. The number of species increased with shape complexity and patch size at the patch scale, and with matrix quality within 100-ha landscapes. When considering 500-ha landscapes, only the number of patches (i.e. forest fragmentation level) tended to have a negative influence at the community level. Different landscape and patch metrics predicted the occurrence of each species within the sites. Our results indicate that there is a gradient of tolerance to forest cover change, from highly sensitive species to those tolerant of, or even benefited by, forest-cover change.
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
Information about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
Infants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
Daily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
Most of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
To compare BMI with abdominal skinfold thickness (ASF), waist circumference and waist-to-height ratio in the prediction of insulin resistance (IR) in prepubertal Colombian children.
We calculated age- and sex-specific Z-scores for BMI, ASF, waist circumference, waist-to-height ratio and three other skinfold-thickness sites. Logistic regression with stepwise selection (P = 0·80 for entry and P = 0·05 for retention) was performed to identify predictors of IR and extreme IR, which were determined by age- and sex-specific Z-scores to identify the ≥ 90th and ≥ 95th percentile of homeostasis model assessment (HOMAIR), respectively. We used receiver operating characteristic curves to compare the area under the curve between models.
Children (n 1261) aged 6–10 years in Tanner stage 1 from a population-based study.
A total of 127 children (seventy girls and fifty-seven boys) were classified with IR, including sixty-three children (thirty-three girls and thirty boys) classified with extreme IR. Only ASF and BMI Z-scores were retained as predictors of IR by stepwise selection. Adding ASF Z-score to BMI Z-score improved the area under the curve from 0·794 (95 % CI 0·752, 0·837) to 0·811 (95 % CI 0·770, 0·851; P for contrast = 0·01). In predicting extreme IR, the addition of ASF Z-score to BMI Z-score improved the area under the curve from 0·837 (95 % CI 0·790, 0·884) to 0·864 (95 % CI 0·823, 0·905; P for contrast = 0·01).
ASF Z-score predicted IR independent of BMI Z-score in our population of prepubertal children. ASF and BMI Z-scores together improved IR risk stratification compared with BMI Z-score alone, opening new perspectives in the prediction of cardiometabolic risk in prepubertal children.
In this work, different methods to estimate the value of thin film residual stresses using instrumented indentation data were analyzed. This study considered procedures proposed in the literature, as well as a modification on one of these methods and a new approach based on the effect of residual stress on the value of hardness calculated via the Oliver and Pharr method. The analysis of these methods was centered on an axisymmetric two-dimensional finite element model, which was developed to simulate instrumented indentation testing of thin ceramic films deposited onto hard steel substrates. Simulations were conducted varying the level of film residual stress, film strain hardening exponent, film yield strength, and film Poisson’s ratio. Different ratios of maximum penetration depth hmax over film thickness t were also considered, including h/t = 0.04, for which the contribution of the substrate in the mechanical response of the system is not significant. Residual stresses were then calculated following the procedures mentioned above and compared with the values used as input in the numerical simulations. In general, results indicate the difference that each method provides with respect to the input values depends on the conditions studied. The method by Suresh and Giannakopoulos consistently overestimated the values when stresses were compressive. The method provided by Wang et al. has shown less dependence on h/t than the others.
Arid zones of northern Venezuela are represented by isolated areas, important from an ornithological and ecological perspective due to the occurrence of restricted-range species of birds. We analysed the prevalence and molecular diversity of haemosporidian parasites of wild birds in this region by screening 527 individuals (11 families and 20 species) for parasite mitochondrial DNA. The overall prevalence of parasites was 41%, representing 17 mitochondrial lineages: 7 of Plasmodium and 10 of Haemoproteus. Two parasite lineages occurred in both the eastern and western regions infecting a single host species, Mimus gilvus. These lineages are also present throughout northern and central Venezuela in a variety of arid and mesic habitats. Some lineages found in this study in northern Venezuela have also been observed in different localities in the Americas, including the West Indies. In spite of the widespread distributions of some of the parasite lineages found in northern Venezuela, several, including some that are relatively common (e.g. Ven05 and Ven06), have not been reported from elsewhere. Additional studies are needed to characterize the host and geographical distribution of avian malaria parasite lineages, which will provide a better understanding of the influence of landscape, vector abundance and diversity, and host identity on haemosporidian parasite diversity and prevalence.
In this work we present the bases to perform investigation on the effects on the morphology and size of nanostructures of silver, owed to the modification of synthesis factors in a polyol process such as temperature, concentration, time of reaction, injection speed and time of injection. It is claimed that control over Ag nanostructures shape could be improved and significant information about the synthesis process can be obtained. The design of experiments was done aimed to obtain useful information about how to yield as much as possible specific structures of interest.
The fracture behavior of polypropylene (PP) and its composites was studied as a function of concentration of multiwall carbon nanotubes (MWCNT) and modified montmorillonite (m-MMT). SAXS and WAXS (Small/Wide Angle X-ray Scattering) techniques were used to monitor the morphological changes (i.e. nanocomposite structure and crystalline morphology) caused by various nanoparticle concentrations and polymer uniaxial stretching deformation. The effect of nanoparticle nature was also investigated. The mechanical analysis shows a great effect of nanoclay concentration on the PP deformation, while uniaxial stretching of the PP/MWCNT nanocomposites was less affected by carbon nanotubes concentration. The SAXS and WAXS analysis of stretched samples indicated that the pure polypropylene and nanocomposites with low nanoparticles concentrations (1 wt/wt%) developed a fracture governed by shear yielding mechanism, while PP nanocomposites with higher concentrations of carbon nanotubes and nanoclay showed a crazing and microcraking fracture mechanism. On the other hand, different chemical nature of MWCNT and m-MMT did not affect the fracture mechanism of polypropylene at low nanoparticles concentrations.
The healthy action of probiotics is not only due to their nutritional properties and their influence on the gastrointestinal environment, but also to their action on the immune system. The aim of the present study was to determine if 6 weeks of probiotic intake would be able to modulate the immune system in women who had recently delivered and were breast-feeding. The design consisted of a randomised, controlled and double-blind nutritional intervention study with parallel groups with a sample size of 104 women. The main variable is the T helper type 1/T helper type 2 (Th1/Th2) profile determined by measuring interferon-γ (Th1) and IL-4 (Th2) values in peripheral blood by flow cytometry. The modifications of cytokines were evaluated in maternal milk by cytometric bead array in a flow cytometer and ELISA at three stages of breast-feeding: colostrum, early milk (10 d) and mature milk (45 d). Additionally, the anthropometry and infectious and allergic episodes in the newborn were followed up throughout the first 6 months of life. After the consumption of milk fermented with Lactobacillus casei during the puerperium, we observed a non-significant increase in T and B lymphocytes and a significant increase in natural killer cells. A decrease in the pro-inflammatory cytokine TNF-α in maternal milk and fewer gastrointestinal disturbances were also observed in the breast-fed child of the mothers who consumed L. casei. The intake of milk fermented with L. casei during the lactation period modestly contributes to the modulation of the mother's immunological response after delivery and decreases the incidence of gastrointestinal episodes in the breast-fed child.
The effect of single or mixtures of antioxidants on the lag phase prior to growth, growth rate, hydrolytic enzyme
production (N-acetyl-β-glucosaminidase, β-D-glucosidase and
α-D-galactosidase) and fumonisin production by Fusarium
verticillioides and F. proliferatum was evaluated on maize-based media at 25 °C,
and under different water activity (aW) conditions. An increase in the lag phase (h) was observed
for both F. verticillioides and F. proliferatum especially with
propyl paraben (PP)+butylated hydroxyanisole (BHA) treatments at all aW levels tested. For both species PP alone or
in combination with BHA, at concentrations of 0.5 and 1 mM reduced the growth rates by > 85% at the three aW
levels tested (0.995; 0.98 and 0.95). PP+butylated hydroxytoluene (BHT) or trihydroxybutyrophenone (THBP) were
less effective in controlling growth, regardless of aW level. Combinations of PP+BHA reduced the fumonisin
concentrations produced by F. verticillioides and F. proliferatum at 0.995 and 0.98 aW significantly. However, at low
concentrations of antioxidants (0.5 mM) some stimulation in fumonisin production was observed with some treatments.
The efficacy of the treatments was reflected in the impact on enzyme production. In the untreated control the highest
total enzyme activity of three hydrolytic enzymes was observed at 0.995 aW after 96 h. All the antioxidant treatments
alone or combined resulted in a significant reduction (P < 0.001) of the total enzyme activity at the aW levels tested.
Only 10 mM THBP produced an increase in the total amount of N-acetyl-β-D-glucosidase by both F. verticillioides and
F. proliferatum. For the three enzymes single factors: time, aW and antioxidant treatments, most two and all three way
interactions were significant (P < 0.001). The use of combined mixtures of antioxidants could be a good strategy to
diminish the entry of fumonisin into the animal feed and human food chains.
Lolium multiflorum Lam., a winter annual grass species originating from the Mediterranean region, has become widespread in native grasslands of the flooding pampa (Argentina). The dynamics of dormancy release of L. multiflorum seeds in simulated natural conditions was studied. Dormancy was overcome by exposing imbibed seeds to mild cool temperatures (15°C or below) for brief periods (pre-chilling). After-ripening progressively released dormancy, at a higher rate in seeds that remained under the canopy (30/20°C) than those that were dry-stored (20°C). Germination was promoted by red light only when the after-ripening requirement was partially fulfilled or after pre-chilling treatment. These results provide useful knowledge for designing grazing strategies aimed at obtaining well-developed ryegrass canopy of high forage quality during winter and spring.
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