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The history of maize in Central America and surrounding areas has implications for the slow transition from hunting and gathering to agriculture. The spread of early forms of domesticated maize from southern Mexico across Mesoamerica and into South America has been dated to about 8,700–6,500 years ago on the basis of a handful of studies relying primarily on the analysis of pollen, phytoliths, or starch grains. Recent genomic data from southern Belize have been used to identify Archaic period south-to-north population movements from lower Central America, suggesting this migration pattern as a mechanism that introduced genetically improved maize races from South America. Gradually, maize productivity increased to the point that it was suitable for use as a staple crop. Here we present a summary of paleoecological data that support the late and uneven entry of maize into the Maya area relative to other regions of Central America and identify the Pacific coastal margin as the probable route by which maize spread southward into Panama and South America. We consider some implications of the early appearance of maize for Late Archaic populations in these areas; for example, with respect to the establishment of sedentary village life.
Esketamine had been rised as a potential treatment for Resistant Depression, becoming an alternative for the use of Electroconvulsive Therapy. In Spain since 2020, it has been applied for compassionate use but is not widely used. Although Esketamine is defined safe and effective in preliminary studies, there are common side effects which could reduce it use.
Objectives
Increasing blood pressure has been found commonly in ederly population treated with Esketamine Nasal. Studies showed as very common side effect (10% or more) increasing systolic and diastolic blood pressure which is higher in elderly people. Our aim is to show that esketamine is well tolerated and safe in ederly people without increasing blood pressure, although is combinate with oral antidepressant therapy.
Methods
Presenting female 65-year-old with 4 years of treatment maintaining a moderate-severe symptoms. Althougt numerous pharmacological strategies have been attempted, with optimal time and maximum doses, which have been progressively withdrawing showing lack of efficacy or appearance of adverse effects. Among the drugs used we find; 11 antidepressants, 3 antipsychotics, benzodiazepines and even lithium, without response after 6 weeks of treatment. Futhermore, patient refusal to receive Electro-Convulsive Therapy. Treating with Esketamine nasal and applying the established guidelines.
Results
Assess the response to Esketamine Nasal with Montgomery-Asberg depression scale (MADRS) we found that decrease the initial score in 26 points. Evaluating blood pressure before and after each time with no increased value.
Conclusions
Concluding esketamine is well tolerated and safe in ederly people without increasing blood pressure. These findings and results should be confirmed with futher studies.
Recently, artificial intelligence-powered devices have been put forward as potentially powerful tools for the improvement of mental healthcare. An important question is how these devices impact the physician-patient interaction.
Aims
Aifred is an artificial intelligence-powered clinical decision support system (CDSS) for the treatment of major depression. Here, we explore the use of a simulation centre environment in evaluating the usability of Aifred, particularly its impact on the physician–patient interaction.
Method
Twenty psychiatry and family medicine attending staff and residents were recruited to complete a 2.5-h study at a clinical interaction simulation centre with standardised patients. Each physician had the option of using the CDSS to inform their treatment choice in three 10-min clinical scenarios with standardised patients portraying mild, moderate and severe episodes of major depression. Feasibility and acceptability data were collected through self-report questionnaires, scenario observations, interviews and standardised patient feedback.
Results
All 20 participants completed the study. Initial results indicate that the tool was acceptable to clinicians and feasible for use during clinical encounters. Clinicians indicated a willingness to use the tool in real clinical practice, a significant degree of trust in the system's predictions to assist with treatment selection, and reported that the tool helped increase patient understanding of and trust in treatment. The simulation environment allowed for the evaluation of the tool's impact on the physician–patient interaction.
Conclusions
The simulation centre allowed for direct observations of clinician use and impact of the tool on the clinician–patient interaction before clinical studies. It may therefore offer a useful and important environment in the early testing of new technological tools. The present results will inform further tool development and clinician training materials.
The excavation of a building in the village of Felanitx in the eastern part of the island of Mallorca (Balearic Islands) has revealed the existence of a small necropolis. The inhumations did not provide grave goods except for a bronze belt buckle for which the typological study suggests a Late Antique chronology. The stratigraphical sequence however seems to suggest a possible evolution of the space across time since some graves are cut by others. In order to obtain an absolute date for the necropolis and to verify if there are chronological differences between the graves, a total of 6 human bones samples have been 14C dated by AMS. The results of the radiocarbon dating confirm a Late Antique chronology (4th to 7th century AD) for the graves but do not suggest a chronological evolution. Despite the fact that the knowledge of the necropolis is still fragmentary, the results are extremely important because they provide an absolute date for a Late Antique necropolis in the Mallorcan rural area.
We implemented universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of patients undergoing surgical procedures as a means to conserve personal protective equipment (PPE). The rate of asymptomatic coronavirus disease 2019 (COVID-19) was <0.5%, which suggests that early local public health interventions were successful. Although our protocol was resource intensive, it prevented exposures to healthcare team members.
Previous research has linked OCPD with increased distress levels that may lead to differences in treatment response.
Objectives:
The present study aimed to investigate the influence of pre-treatment distress on patient's response to groupbased cognitive-behavioral therapy (CBT) for OCPD.
Methods:
116 out-patients who met DSM-IV-TR diagnostic criteria for OCPD completed a pre-treatment assessment including BDI, STAI, STAXI-2, GRAI and Rosemberg Self-Esteem Scale. Pre-treatment distress was operationalized as depression and anxiety levels.
Intervention was comprised of ten group sessions including psychoeducation, specific CBT techniques and relapse prevention. in order to assess treatment response after intervention, the sample was divided in two groups:
1) discharged patients -responders and
2) patients who needed to continue treatment -non responders.
Assessment scores were compared using t test in order to analyze differences between groups. The extent to which potential predictor variables were related to treatment response was assessed using logistic regression.
Results:
Results showed statistically significant differences (p < 0.05) in depressed mood and state anxiety scores between responder and non-responder groups. Initial variable selection for logistic regression model included age, sex, depression, anxiety, anger, assertiveness and selfesteem scores. The final model included state anxiety as a significant predictor of treatment response.
Conclusions:
Our findings indicate that responder patients had lower pre-treatment distress levels than non-responder patients and that state anxiety score is a significant predictor of group-based CBT response in OCPD. According to this, pretreatment distress levels might be considered for treatment planning, despite more research in this direction would be necessary.
Substance use disorder is a growing phenomenon among old adults. It is usually significantly undervalued, misidentified, under diagnosed and poorly treated. It has been related to cognitive impairment but there are few studies focused on the elderly.
Aim
To evaluate the relationship between drug use and cognitive impairment in old adults.
Methods
We conducted a prospective study (basal and 6 month follow up) in 67 patients over 65 years old seeking for treatment for drug misuse (alcohol and prescription drugs, mainly benzodiacepines) in addiction and dual diagnosis unit in Barcelona. A specific protocol was performed to evaluate attention, executive function, working memory, learning capacity, fonetic and visual fluency, decision-making, visual construction and cognitive flexibility (FCT, CPT-II, N-BACK, COWAT FAS, TAP, SDMT, IGT, CVLT, TOL, RFFT, STROOP). Patients were compared with a control group (healthy non drug users) with same characteristics (gender, age range and education status). The protocol consisted in two separated sessions of 90 minutes each one performed by a neuropsychologist.
Results
Results obtained suggested that patients under drug misuse had worse scores in fluency, visual construction, memory and attention compared with controls. After 6 month treatment and achieving abstinence patients improve in cognitive skills as verbal learning, short-term memory and free recall of verbal information. Cognitive impairment profile changes depending on the substance abused (alcohol or benzodiacepines).
Conclusions
Drug use can produce deleterious effects in old adults. However, those who achieve abstinence may improve some cognitive functioning as verbal learning, short-term memory and free recall of verbal information.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Substance use disorder is a growing phenomenon among the elderly. It is undervalued, misidentified, underdiagnosed and poorly treated.
Aim
Study prevalence, characteristics and risk factors associated with drug use among the elderly.
Method
A 6-month prospective study of substance use in elderly patients (65+) who attended the addiction and dual diagnosis unit, Vall d’Hebron University Hospital.
Results
Fifty-nine patients evaluated, mean age 70.04 years, 60% men. A total of 49.1% are married, 35.8% divorced and 53.8% live with a partner and/or children. A total of 67.3% have basic studies and 78.8% are pensioners. A total of 82.7% have no criminal record.
Medical comorbidity presents in 90.4% of the sample, psychiatric and addictive family background in 42.3% and 37.3%. A total of 67.3% have comorbid Axis I (mainly affective disorders) and 25% Axis II (cluster B most). A total of 7.7% attempted suicide at least once.
The main substance is alcohol (76.9%), followed by prescription drugs (19.3%). A total of 28.8% are multi-drug users. A total of 67.3% have used tobacco in their life and 63.5% are currently dependent. The average age of onset for a disorder for any substance consumption is 28.19, being lower for alcohol and illegal substances and higher for prescription drugs.
A total of 61.5% have gone through treatment before but only 32.7% has been admitted because of addiction. The adherence rate is 90.4% and the relapse rate 8.3% at first month and 13% at 6 months.
Conclusions
Old adults present differences compared to overall drug user population: prevalence by gender is almost equal, lower Axis II, less multi-drug consumption and both dropout and relapse rate are drastically lower.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Better control of highly pathogenic avian influenza (HPAI) outbreaks requires deeper understanding of within-flock virus transmission dynamics. For such fatal diseases, daily mortality provides a proxy for disease incidence. We used the daily mortality data collected during the 2015 H5N2 HPAI outbreak in Minnesota turkey flocks to estimate the within-flock transmission rate parameter (β). The number of birds in Susceptible, Exposed, Infectious and Recovered compartments was inferred from the data and used in a generalised linear mixed model (GLMM) to estimate the parameters. Novel here was the correction of these data for normal mortality before use in the fitting process. We also used mortality threshold to determine HPAI-like mortality to improve the accuracy of estimates from the back-calculation approach. The estimated β was 3.2 (95% confidence interval (CI) 2.3–4.3) per day with a basic reproduction number of 12.8 (95% CI 9.2–17.2). Although flock-level estimates varied, the overall estimate was comparable to those from other studies. Sensitivity analyses demonstrated that the estimated β was highly sensitive to the bird-level latent period, emphasizing the need for its precise estimation. In all, for fatal poultry diseases, the back-calculation approach provides a computationally efficient means to obtain reasonable transmission parameter estimates from mortality data.
Bismuth iron oxide BFO films were produced by the pulsed laser deposition technique. These films are a mixture of BiFeO3 ferroelectrical and Bi25FeO40 piezoelectrical phases. The ferroelectrical domain structure of these films was studied via contact resonance piezoresponse force microscopy (CR-PFM) and resonance tracking PFM (RT-PFM). The proportions of area of these BFO phases were derived from the PFM images. The ferroelectrical domain size corresponds to the size of the BiFeO3 crystals. The CR-PFM and RT-PFM techniques allowed us to be able to distinguish between the ferroelectric domains and the piezoelectric regions existing in the polycrystalline films.
Hyperuricaemia is one of the components of metabolic syndrome. Both oxidative stress and hyperinsulinism are important variables in the genesis of this syndrome and have a close association with uric acid (UA). We evaluated the effect of an oral glucose challenge on UA concentrations. The study included 656 persons aged 18 to 65 years. Glycaemia, insulin, UA and plasma proteins were measured at baseline and 120 min after an oral glucose tolerance test (OGTT). The baseline sample also included measurements of total cholesterol, triacylglycerol (TAG) and HDL-cholesterol. Insulin resistance was calculated with the homeostasis model assessment. UA levels were significantly lower after the OGTT (281·93 (sd 92·19) v. 267·48 (sd 90·40) μmol/l; P < 0·0001). Subjects with a drop in UA concentrations >40·86 μmol/l (>75th percentile) had higher plasma TAG levels (P = 0·0001), baseline insulin (P = 0·02) and greater insulin resistance (P = 0·034). Women with a difference in plasma concentrations of UA above the 75th percentile had higher baseline insulin levels (P = 0·019), concentration of plasma TAG (P = 0·0001) and a greater insulin resistance index (P = 0·029), whereas the only significant difference in men was the level of TAG. Multiple regression analysis showed that the basal TAG levels, insulin at 120 min, glycaemia at 120 min and waist:hip ratio significantly predicted the variance in the UA difference (r2 0·077). Levels of UA were significantly lower after the OGTT and the individuals with the greatest decrease in UA levels are those who have greater insulin resistance and higher TAG levels.
Choice of the targeted host developmental stage, regulation of parasitoid numbers released and introduction of food supplements are operational factors with a potential to influence the level of biological control. In a closed laboratory storage system maintained over two generations of the host, the impact of these three parameters on the control potential of the parasitoid Dinarmus basalis Rondani was investigated for high populations of larvae of Acanthoscelides obtectus (Say) feeding inside dry common bean seeds Phaseolus vulgaris. The beans were already infested with immature bruchids at the beginning of the storage period to simulate harvest conditions, characterized in a previous study. Treatments resulted in a reduction of 48–75% of the bruchid population within 16 weeks of storage. The best timing of parasitoid release was at the simulated harvest, as later releases reduced the bruchid population only by about half this percentage. Host feeding is postulated to be the key factor involved in the observed difference. The effect of increasing the number of parasitoids strongly depended on host age and food supplement. Addition of vials with honey had no direct effect on the bruchid population or on the parasitoid progeny. The ecological significance of these findings and implications for biological control are discussed.
Gallium–lanthanum sulfide glasses are potential hosts for 1.3-μm optical fiber amplifiers and for fiber lasers in the near and middle infrared. In these glasses the addition of CsCl increases the thermal stability region making possible to draw optical fibers, without altering the optical properties of the glass. Ga2S3–La2S3 glasses modified by 10 to 40% CsCl have been studied by x-ray absorption spectroscopy, to investigate the structural role of CsCl. The chlorine environment is found similar to that in CsCl. The gallium-based network is composed from almost regular tetrahedra weakly connected by corners and is not altered by the addition of CsCl.
A mineralogical study and multivariant geochemical analysis have been carried out to determine the sedimentation processes and the influence of surrounding rocks on sediments. Analyses were made on the clay fraction of sediments and on bulk samples of rocks from nearby reliefs in the Sorbas Basin (SE Spain). Source rocks were identified by statistical analysis of trace elements and by comparison of the crystallographic parameters of phyllosilicates in sediments and supposed sources. Palaeoenvironmental conditions are recorded by specific elements in the clay minerals. The study of the B and Mg content and of the different types of smectites and palygorskite found in distinct areas has permitted a description of these conditions for this Basin. In this way, different types of deposition environment, showing varying degrees of confinement and influence from marine or continental water, have been distinguished.
The surface layer of single crystal GaAs that has been bombarded with high energy (2-15 MeV) ions is strained and contains many defects, but it remains crystalline. We have studied the isochronal annealing behavior of this layer using phonon shifts and widths, which were detected by Raman measurements. We do not find any sharp annealing stages to 500 C, at which temperature the phonons have returned to their positions in the unbombarded crystals. These results are consistent with the idea that the phonon shifts are primarily due to antisites and their complexes with other primary defects. However, other extended defects may still be present, and the Raman data show some evidence for this.
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