To send 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 sending content to .
To send 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 sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent 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.
Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear.
We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed.
This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model.
A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R = −0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure.
Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.
Evidence suggests the incidence of non-affective psychotic disorders (NAPDs) varies across persons and places, but data from the Global South is scarce. We aimed to estimate the treated incidence of NAPD in Chile, and variance by person, place and time.
We used national register data from Chile including all people, 10–65 years, with the first episode of NAPD (International Classification of Diseases, Tenth Revision: F20–F29) between 1 January 2005 and 29 August 2018. Denominators were estimated from Chilean National Census data. Our main outcome was treated incidence of NAPD and age group, sex, calendar year and regional-level population density, multidimensional poverty and latitude were exposures of interest.
We identified 32 358 NAPD cases [12 136 (39.5%) women; median age-at-first-contact: 24 years (interquartile range 18–39 years)] during 171.1 million person-years [crude incidence: 18.9 per 100 000 person-years; 95% confidence interval (CI) 18.7–19.1]. Multilevel Poisson regression identified a strong age–sex interaction in incidence, with rates peaking in men (57.6 per 100 000 person-years; 95% CI 56.0–59.2) and women (29.5 per 100 000 person-years; 95% CI 28.4–30.7) between 15 and 19 years old. Rates also decreased (non-linearly) over time for women, but not men. We observed a non-linear association with multidimensional poverty and latitude, with the highest rates in the poorest regions and those immediately south of Santiago; no association with regional population density was observed.
Our findings inform the aetiology of NAPDs, replicating typical associations with age, sex and multidimensional poverty in a Global South context. The absence of association with population density suggests this risk may be context-dependent.
A study to understand the experience of autonomy with durable products was undertaken based on qualitative research. The study involved thirteen participants, who selected a durable product that enhanced autonomy. Using in-depth interviews, the map of experience and interaction properties the experience was studied. Our findings indicate that there are three structures involved in the experience of autonomy: orchestration, control and product integration. The three structures are described in detail. It was also identified that the experience of autonomy enhances positive experiences and stimulates wellbeing. Designers can apply the three structures of autonomy to underscore design decisions.
The most effective rehabilitation model for job (re-)entry of people with mental illness is supported employment. A barrier to introducing supported employment into standard care is its temporally unlimited provision, which conflicts with health and social legislation in many European countries.
To test the impact of different ‘placement budgets’, i.e. a predefined maximum time budget for job seeking until take-up of competitive employment.
Participants (116) were randomly assigned to 25 h, 40 h or 55 h placement budgets in an intent-to-treat analysis. We applied the individual placement and support model over 24 months, following participants for 36 months. Primary outcome was employment in the labour market for at least 3 months.
The proportion of participants obtaining competitive employment was 55.1% in the 25 h group, 37.8% in the 40 h group and 35.8% in the 55 h group. In a Cox regression analysis, time to employment was slightly lower in the 25 h group relative to the 40 h (hazard ratio 1.78, 95% CI 0.88–3.57, P = 0.107) and 55 h groups (hazard ratio 1.74, 95% CI 0.86–3.49, P = 0.122), but this was not statistically significant. The vast majority of all participants who found a job did so within the first 12 months (80.4%).
A restricted time budget for job finding and placement does not affect the rate of successful employment. In accordance with legislation, a restriction of care provision seems justified and enhances the chances of supported employment being introduced in statutory services.
Young star clusters are a promising environment for forming binary black holes. Such binaries may form dynamically or via binary star evolution or through the interplay of these two channels. To study these formation pathways, we have performed high precision direct N-body simulations of low-mass (M < 1000 M⊙) young star clusters. The simulations were carried out with the code Nbody6++GPU coupled with the population synthesis code MOBSE. Our results highlight the importance of dynamics to form massive black hole binaries even in low-mass young star clusters.
In this article we evaluate ∼48km2 of airborne lidar data collected at a target density of 15 laser shots/m in central Yucatán, Mexico. This area covers parts of the sites of Chichén Itzá and Yaxuná, a kilometer-wide transect between these two sites, and a transect along the first few kilometers of Sacbé 1 from Yaxuná to Cobá. The results of our ground validation and mapping demonstrate that not all sizable archaeological features can be detected in the lidar images due to: (1) the slightly rolling topography interspersed with 1-6 m-high bedrock hummocks, which morphologically mimic house mounds, further complicated by the presence of low foundations; (2) the complex forest structure in central Yucatán, which has particularly dense near-ground understory resulting in a high number of mixed-signal ground and low vegetation returns which reduces the fidelity and accuracy of the bare-earth digital elevation models; and (3) the predominance of low archaeological features difficult to discern from the textural noise of the near-ground vegetation. In this article we explore different visualization techniques to increase the identification of cultural features, but we conclude that, in this portion of the Maya region, lidar should be used as a complement to traditional on-the-ground survey techniques.
Crush syndrome, of which little is known, occurs as a result of compression injury to the muscles. This syndrome is characterized by systemic manifestations such as acute kidney injury (AKI), hypovolemic shock, and hydroelectrolytic variations. This pathology presents high morbidity and mortality if not managed aggressively by prehospital care.
A 40-year-old worker was rescued after being buried underground in a ditch for 19 hours. The patient was administered early resuscitation with isotonic solutions and monitored during the entire rescue operation. Despite having increased plasma levels of total creatine kinase (CK), the patient did not develop AKI or hydroelectrolytic variations.
Aggressive early management with isotonic solutions before hospital arrival is an effective option for nephron-protection and prevention of crush syndrome.
MardonesA, ArellanoP, RojasC, GutierrezR, OliverN, BorgnaV. Prevention of Crush Syndrome through Aggressive Early Resuscitation: Clinical Case in a Buried Worker. Prehosp Disaster Med. 2016;31(3):340–342.
Illegal killing/taking of birds is a growing concern across the Mediterranean. However, there are few quantitative data on the species and countries involved. We assessed numbers of individual birds of each species killed/taken illegally in each Mediterranean country per year, using a diverse range of data sources and incorporating expert knowledge. We estimated that 11–36 million individuals per year may be killed/taken illegally in the region, many of them on migration. In each of Cyprus, Egypt, Italy, Lebanon and Syria, more than two million birds may be killed/taken on average each year. For species such as Blackcap Sylvia atricapilla, Common Quail Coturnix coturnix, Eurasian Chaffinch Fringilla coelebs, House Sparrow Passer domesticus and Song Thrush Turdus philomelos, more than one million individuals of each species are estimated to be killed/taken illegally on average every year. Several species of global conservation concern are also reported to be killed/taken illegally in substantial numbers: Eurasian Curlew Numenius arquata, Ferruginous Duck Aythya nyroca and Rock Partridge Alectoris graeca. Birds in the Mediterranean are illegally killed/taken primarily for food, sport and for use as cage-birds or decoys. At the 20 worst locations with the highest reported numbers, 7.9 million individuals may be illegally killed/taken per year, representing 34% of the mean estimated annual regional total number of birds illegally killed/taken for all species combined. Our study highlighted the paucity of data on illegal killing/taking of birds. Monitoring schemes which use systematic sampling protocols are needed to generate increasingly robust data on trends in illegal killing/taking over time and help stakeholders prioritise conservation actions to address this international conservation problem. Large numbers of birds are also hunted legally in the region, but specific totals are generally unavailable. Such data, in combination with improved estimates for illegal killing/taking, are needed for robustly assessing the sustainability of exploitation of birds.
We estimated the abundance of Antillean manatees (Trichechus manatus manatus) through a large-scale project conducted in 2010 in north-eastern Brazil and evaluated the efficacy of an aerial survey for conservation purposes. Two observers conducted the survey via flights that maintained an altitude of 150 m and an air speed of 140 km h−1, covering over 2590.2 km2 of the coastline. Strip transects were flown in a zigzag pattern. A total of 67 manatees (on- and off-effort) were recorded in 55 sightings. Historical published records of occurrence were formally incorporated using a Bayesian approach. We estimated the manatee population for north-eastern Brazil in the form of a posterior distribution with a mean of 1104 individuals and a 95% posterior probability interval ranging from 485 to 2221 individuals, which indicates high uncertainty. More large-scale studies in the region are warranted to understand temporal trends, in addition to further studies in hotspot areas, with smaller spatial scales, to reduce the coefficient of variation and to allow the use of improved techniques for monitoring the manatees. A greater emphasis on species-specific characteristics and methods to enhance detection probability (e.g. dual observers) are also recommended. The conditions prevailing along the study area were not conducive to aerial surveillance; thus, the results are not a precise estimate of the manatee population. However, these highlight the importance of conservation efforts for the Antillean manatee, considered the most endangered aquatic mammal in Brazil.
To evaluate whether involuntary out-patient commitment (OPC) in patients with severe mental disorder reduces their use of hospital services. This is a retrospective case-control study comparing a group of patients on OPC (n = 75) and a control group (n = 75) which was composed of patients whose sociodemographic variables and clinical characteristics were similar to those of the OPC group. Each control case is paired with an OPC case, so the control case must have an involuntary admission in the month that the index OPC case admission occurred. Emergency room visits, admissions and average length of hospital stay over a 2-year follow-up after the initiation of OPC were compared.
No statistically significant evidence was found in the use of mental healthcare services between the two groups. Different reasons for admission found between the groups limit similarity when comparing the two.
The findings cast doubt over the effectiveness of this legal measure to reduce emergency visits, the number of admissions and the length of stay in the hospital.
One of the main areas of improvement in capacitive deionization technologies is the materials used for electrodes which have very specific requirements. In the present work, a wide range of material characterization techniques are employed to determine the suitability of a multiwall carbon nanostructure thin film as electrode material. The electrical, mechanical, surface and wetting characteristics are studied proving the membrane highly conductive (σ=7.25 103 S/m), having competitive electro-sorption capacity (11.7 F/g at 10 mV/s) and surface area (149 m2/g), strain rate dependent mechanical properties and hydrophobic wetting behavior.
Electron tomography is becoming one of the most used methods for structural analysis at nanometric scale in biological and materials sciences. Combined with chemical mapping, it provides qualitative and semiquantitative information on the distribution of chemical elements on a given sample. Due to the current difficulties in obtaining three-dimensional (3D) maps by energy-filtered transmission electron microscopy (EFTEM), the use of 3D chemical mapping has not been widely adopted by the electron microscopy community. The lack of specialized software further complicates the issue, especially in the case of data with a low signal-to-noise ratio (SNR). Moreover, data interpretation is rendered difficult by the absence of efficient segmentation tools. Thus, specialized software for the computation of 3D maps by EFTEM needs to include optimized methods for image series alignment, algorithms to improve SNR, different background subtraction models, and methods to facilitate map segmentation. Here we present a software package (EFTEM-TomoJ, which can be downloaded from http://u759.curie.fr/fr/download/softwares/EFTEM-TomoJ), specifically dedicated to computation of EFTEM 3D chemical maps including noise filtering by image reconstitution based on multivariate statistical analysis. We also present an algorithm named BgART (for background removing algebraic reconstruction technique) allowing the discrimination between background and signal and improving the reconstructed volume in an iterative way.