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A commercial drinkable yogurt with and without 4% of added trehalose (as cell protectant) was spray-dried obtaining a powder with low water activity (aw). Total bacterial count in the powder was between 8.48–8.90 log cfu/g. The dried yogurt was stored: (i) at 38 °C and aw = 0.33; (ii) at 38 °C in hermetically sealed flasks (aw = 0.21/0.22); (iii) in a cyclic temperature chamber (10–20 °C) in hermetically sealed flasks (aw = 0.21/0.22). Whole milk was then fermented by adding an inoculum of spray-dried yogurt after storage under these different conditions. The kinetics of acidification showed the presence of a lag time which was strongly dependent on storage conditions. The data was fitted with a logistic type equation from which the lag time was calculated. To evaluate structural differences among samples, Fourier Transform Infrared spectra (FTIR) were recorded. Partial Least Squares (PLS) models enabled a good correlation between lag time of fermentation and FTIR spectra. The lag time for yogurt powder stored at aw about 0.21/0.22 and cyclic temperature 10–20 °C remained approximately constant over the 12 weeks of storage, while all the other conditions resulted in a dramatic increase. The addition of trehalose had a small influence on lag time and, therefore, as a protectant of lactobacilli.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
The majority of groceries purchased by US households are industrially processed, yet it is unclear how processing level influences diet quality. We sought to determine if processing level is associated with diet quality of grocery purchases.
We analysed grocery purchasing data from the National Household Food Acquisition and Purchase Survey 2012–2013. Household grocery purchases were categorized by the NOVA framework as minimally processed, processed culinary ingredients, processed foods or ultra-processed foods. The energy share of each processing level (percentage of energy; %E) and Healthy Eating Index-2015 (HEI-2015) component and total scores were calculated for each household’s purchases. The association between %E from processed foods and ultra-processed foods, respectively, and HEI-2015 total score was determined by multivariable linear regression. Foods purchased by households with the highest v. lowest ultra-processed food purchases and HEI-2015 total score <40 v. ≥60 were compared using linear regression.
Nationally representative sample of 3961 households.
Processed foods and ultra-processed foods provided 9·2 (se 0·3) % and 55·8 (se 0·6) % of purchased energy, respectively. Mean HEI-2015 score was 54·7 (se 0·4). Substituting 10 %E from minimally processed foods and processed culinary ingredients for ultra-processed foods decreased total HEI-2015 score by 1·8 points (β = −1·8; 95 % CI −2·0, −1·5). Processed food purchases were not associated with diet quality. Among households with high ultra-processed food purchases, those with HEI-2015 score <40 purchased less minimally processed plant-foods than households with HEI-2015 score ≥60.
Increasing purchases of minimally processed foods, decreasing purchases of ultra-processed foods and selecting healthier foods at each processing level may improve diet quality.
The Erasmus Plus programme ‘Innovative Education and Training in high power laser plasmas’, otherwise known as PowerLaPs, is described. The PowerLaPs programme employs an innovative paradigm in that it is a multi-centre programme where teaching takes place in five separate institutes with a range of different aims and styles of delivery. The ‘in class’ time is limited to four weeks a year, and the programme spans two years. PowerLaPs aims to train students from across Europe in theoretical, applied and laboratory skills relevant to the pursuit of research in laser–plasma interaction physics and inertial confinement fusion (ICF). Lectures are intermingled with laboratory sessions and continuous assessment activities. The programme, which is led by workers from the Technological Educational Institute (TEI) of Crete, and supported by co-workers from the Queen’s University Belfast, the University of Bordeaux, the Czech Technical University in Prague, Ecole Polytechnique, the University of Ioannina, the University of Salamanca and the University of York, has just completed its first year. Thus far three Learning Teaching Training (LTT) activities have been held, at the Queen’s University Belfast, the University of Bordeaux and the Centre for Plasma Physics and Lasers (CPPL) of TEI Crete. The last of these was a two-week long Intensive Programme (IP), while the activities at the other two universities were each five days in length. Thus far work has concentrated upon training in both theoretical and experimental work in plasma physics, high power laser–matter interactions and high energy density physics. The nature of the programme will be described in detail and some metrics relating to the activities carried out to date will be presented.
In this work, a new concentric circles detection method for object detection is proposed. It has been applied to the images of a commercial radar, captured with a Charge-Coupled Device (CCD) camera. The processing includes the detection of centres and concentric circles in the images and the identification of the radar scale. Several methods found in the literature have been applied and compared with our novel proposal for multiple concentric circles detection, called “Propagation Method based on Circular Regression”. This methodology has been validated with real radar images, proving its efficiency in obtaining the distance of any object to a marine vessel, with high accuracy and low computational cost, in real time. This system can not only be applied to most existing radars in the market by adjusting the parameters of each model but our proposal for concentric circle detection can be also applied to other sensing applications.
A raw clay from Uruguay was modified with aluminium to obtain an aluminium pillared clay (Al-PILC). The solids were characterized by scanning electron microscopy, X-ray diffraction and nitrogen adsorption-desorption isotherms. The Al-PILC retained the typical laminar structure of montmorillonite. The specific surface area and the microporous volume of the Al-PILC, 235 m2 g-1 and 0.096 cm3 g-1, respectively, were much higher than those of the clay. The phosphate adsorption capacity of the Al-PILC was higher than those of the clay. The phosphate adsorption kinetic followed the pseudo-first-order model for both, the clay and the Al-PILC, and the phosphate adsorption isotherm for the Al-PILC fit the Freundlich model.
The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.
This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene–Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.
A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.
Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
In Brazil, the National Committee for Health Technology Incorporation in the public health system (CONITEC) advises the Ministry of Health about incorporation, exclusion and alteration of health technologies in Brazilian public health system (SUS). Decision making considers multiple criteria, included or not in legislation. This analysis was the first step for a multiple-criteria decision analysis (MCDA) building. This study aims to identify criteria that influence Health Technology Assessment (HTA) for SUS.
Five real cases of controversial recommendations of technology incorporation made by CONITEC were reviewed by listening to the plenary recordings and reviewing committee minutes. The choice was guided by convenience, with prioritization according to CONITEC's members, using a pre-defined standardized form. Weight in decision making was also raised and identified. Selected technologies judgments were: Trastuzumab for metastatic/advanced Breast Cancer; Fingolimod for Multiple Sclerosis; Clozapine, Lamotrigine, Olanzapine, Quetiapine and Risperidone for Bipolar Affective Disorder; Hematopoietic stem cell transplantation for Sickle Cell Disease; and Positron Emission Computed Tomography (PET-CT) for Lung Cancer and for hepatic metastasis from Colorectal Cancer.
The choice of different technologies allowed verifying specific criteria used for the incorporation of each type of technology, as well as the similar criteria discussed and used by all these technology types. In addition, some identified criteria were specific to the Brazilian reality, such as: “Incorporation by other countries”, “Potential technologies without registration in Brazil” and “Off-label use”. These criteria were not previously identified in studies conducted in other countries. Some criteria have been identified in all decisions, such as: efficacy, disease severity, quality and confidence in the evidences, logistic challenges for implementation, unmet needs, budget impact and treatment costs. Relative impact of cost-effectiveness was considered low.
CONITEC's recordings are an important source to understand the Brazilian decision-making process. To identify the important criteria can help to standardize and improve the HTA process.
We performed a systematic review and meta-analysis on the prevalence and factors associated with Schistosoma mansoni infection in Brazil. We searched the PubMed, Web of Science and Latin-American and Caribbean System on Health Sciences Information (LILACS) databases, scientific publications articles, according to The PRISMA Statement, from 2000 to 2016. A total of 27 studies were included according to the established criteria. The prevalence of S. mansoni infection varied widely, from 0·1 to 73·1%, based on Kato-Katz technique. Of the identified studies, 42·9% were performed in the state of Minas Gerais, and 33·3% were performed in the northeast region of Brazil. We identified sex, age, education level, family income, contact with water and the presence of the intermediate host snail as major risk factors associated with infection. The meta-analysis summarized a high prevalence rate pooled for Schistosoma mansoni. On the other hand, the analysis of the subgroup showed a highly significant reduction of the prevalence rate after control measures. The epidemiological factors evidenced in the studies show the influence of environmental and social conditions on the occurrence of schistosomiasis.
Empirical data on the use of services due to mental health problems in older adults in Europe is lacking. The objective of this study is to identify factors associated with service utilization in the elderly.
As part of the MentDis_ICF65+ study, N = 3,142 people aged 65–84 living in the community in six European and associated countries were interviewed. Based on Andersen's behavioral model predisposing, enabling, and need factors were analyzed with logistic regression analyses.
Overall, 7% of elderly and 11% of those with a mental disorder had used a service due to mental health problems in the last 12 months. Factors significantly associated with underuse were male sex, lower education, living in the London catchment area, higher functional impairment and more comorbid mental disorders. The most frequently reported barrier to service use was personal beliefs, e.g. “I can deal with my problem on my own” (90%).
Underutilization of mental health services among older people in the European community is common and interventions are needed to achieve an adequate use of services.
Except for dementia and depression, little is known about common mental disorders in elderly people.
To estimate current, 12-month and lifetime prevalence rates of mental disorders in different European and associated countries using a standardised diagnostic interview adapted to measure the cognitive needs of elderly people.
The MentDis_ICF65+ study is based on an age-stratified, random sample of 3142 older men and women (65–84 years) living in selected catchment community areas of participating countries.
One in two individuals had experienced a mental disorder in their lifetime, one in three within the past year and nearly one in four currently had a mental disorder. The most prevalent disorders were anxiety disorders, followed by affective and substance-related disorders.
Compared with previous studies we found substantially higher prevalence rates for most mental disorders. These findings underscore the need for improving diagnostic assessments adapted to the cognitive capacity of elderly people. There is a need to raise awareness of psychosocial problems in elderly people and to deliver high-quality mental health services to these individuals.
Rouya polygama (Apiaceae) is an endangered Mediterranean species of great phytogeographical and ecological interest, growing on coastal sandy dunes. Intraspecific variability in the responses to constant temperatures (5–25°C) and an alternating temperature regime (25/10°C), salt stress (0–600 mM NaCl) and recovery of seed germination was evaluated among six populations from Sardinia and Corsica. Seeds were non-dormant and germination percentages ranged from 10 to 83%, depending on temperature and population. Differences in germination percentages were mainly due to different seed mortality among seed lots. R. polygama seeds germinated in salt concentrations up to 200 mM NaCl, whereas higher salt concentrations totally inhibited germination. Salt affected seed viability, and the recovery response decreased with increasing salinity and temperature. Inter-population variability and different sensitivity to NaCl in seed germination were detected. Our results are consistent with field germination in a period from autumn to spring, when water is available in the soil and temperatures are not prohibitive for seedling establishment, representing an advantageous ecological adaptation for seedling establishment to the unpredictable Mediterranean rainfall pattern. Further studies on R. polygama are needed to investigate germination requirements at temperatures higher than 25°C and its germination in the field, and to clarify genetic inter-population variability, considering a higher number of populations and possibly extending to North African populations.
Galacto-oligosaccharides (GOS) are prebiotics that have a beneficial effect on human health by promoting the growth of probiotic bacteria in the gut. GOS are commonly produced from lactose in an enzymatic reaction catalysed by β-galactosidase, named transglycosylation. Lactose is the main constituent of whey permeate (WP), normally wasted output from the cheese industry. Therefore, the main goal of this work was to optimise the synthesis of GOS in WP using β-galatosidase from Aspergillus oryzaea. WP and whey permeate enzymatically treated (WP-GOS) were used as culture media of Lactobacillus plantarum 299v. Lb. plantarum 299v attained the stationary phase in approximately 16 h, reaching 3·6 and 4·1×108 CFU/ml in WP and WP-GOS, respectively. The in situ synthesised GOS were not consumed during growth. No significant differences were observed in the growth kinetics of microorganisms in both media. After fermentation, microorganisms were dehydrated by freeze-drying and spray-drying and stored. The recovery of microorganisms after fermentation, dehydration and storage at 4 °C for at least 120 d was above 108 CFU/g. These studies demonstrated that WP is an appropriate substrate for the synthesis of GOS and the obtained product is also adequate as culture medium of Lb. plantarum 299v. The coexistence of GOS and dehydrated viable probiotic microorganisms, prepared using an effluent as raw material, represents the main achievement of this work, with potential impact in the development of functional foods.
In order to improve the methodology for growing and maintaining corals in captivity, a consortium of European zoos, aquaria and academia executed a four-year public/private collaborative research and innovation project (CORALZOO) on the breeding and husbandry of stony corals. CORALZOO comprised the following topics: (1) sexual and asexual breeding of corals in captivity, including techniques for propagation, feeding and induction of natural coral colony morphogenesis; and (2) coral husbandry: development of generic bioassays to evaluate biotic and abiotic husbandry parameters and to monitor coral health, elaboration of methods for identification and treatment of coral diseases and optimization of transport and acclimation procedures. The results of this project are reviewed.
OVERVIEW. Substance use disorders cover a range of problems associated with using and abusing psychoactive substances such as alcohol, cannabis, cocaine, heroin, benzodiazepines, as well as a variety of other substances taken to affect thoughts, feelings, and behavior. Interventions may include a “mix” of approaches, both modern and indigenous, including assessment and diagnosis, self-help intervention, outpatient, diversion and restorative justice approaches, residential care, and harm-reduction tactics. In this chapter, various substance use disorder concepts, the history of substance use disorder practice and research, substance use disorder recovery theories, legal and professional issues related to substance use disorders, as well as issues for further research and scholarship in Africa are examined. Cultural issues that affect and influence the use and treatment of substances use disorders within the African context are also explored.
By the end of the chapter, the reader should be able to:
Define key concepts relevant to substance use disorders.
Outline core African indigenous and modern practices used to treat or counsel clients with substance use disorders.
Discuss the rationale of major recovery theories and psychosocial theories relating to substance use disorder counseling.
Discuss legal and professional issues related to substance use disorders within the African context.
Identify prospective areas of research that would advance the knowledge of substance use disorder intervention and scholarship within the African context.
The present work details, to our knowledge, the first examination of the influence of blue-light radiation on the optical properties of organic luminescent films in attempting to develop an indicator dosimeter for phototherapy of neonatal jaundice. Jaundice is the most common problem encountered in newborns due to immature functioning in the liver. The operating principle of the device is based on the optical response of poly[2-methoxy-5-(2'-ethylhexyloxy)-p-phenylene (MEH-PPV) and tris(8-hydroxyquinolinato) aluminum (Alq3) materials dispersed in polystyrene (PS) matrix (denoted as PS/MEH-PPV/Alq3). It is observed a blue-shift on the photoluminescence of PS/MEH-PPV/Alq3 system from red to orange-yellow, and then to green as function of the blue-light radiation exposure time. The result is attributed to the spectral overlap between emission of Alq3 and absorption of MEH-PPV. The optical response of PS/MEH-PPV/Alq3 to radiation was investigated to design a low-cost (< US$ 0.05) “smart” sensor to represent easily the radiation dosage normally used in blue-light phototherapy. The basic idea behind this concept considers the sensor as a traffic light device, where red represents underdose and green the prescription dose or overdose, while orange-yellow suggests that radiation therapy is an ongoing process. This personal real-time radiation dosimeter appears here as a key requirement for successful development of innovations in effective management of the radiation dose planning before treatment of neonatal where control of dose absorption of infants is extremely important.
Andreia Santos, Central Institute of Mental Health Mannheim, Germany,
Andreas Meyer-Lindenberg, Department of Psychiatry and Psychotherapy University of Heidelberg and Central Institute of Mental Health Mannheim, Germany
This chapter reviews imaging studies delineating the unique neuropsychiatric features of Williams-Beuren syndrome (WS), as well as recent advances in investigating the neural substrates of the disorder, which have provided significant contributions to unraveling the impact of a specific genetic defect on brain structure and function. It discusses the clinical, behavioral, cognitive and genetic profiles of WS. Studies using high-resolution magnetic resonance imaging (MRI) have found significant brain differences between WS and typically developing individuals. Significant advances in the understanding of the structural basis of WS have come from the application of voxel-based morphometry (VBM), which allows the study of genetic variation without restriction to anatomical boundaries. Findings of the studies reviewed in the chapter offer a systems-level characterization of genetically mediated abnormalities of neural interactions that can be probed for the identification of single-gene effects on brain maturation.