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To investigate the nature of the relationship between cognitive function, mood state, and functionality in predicting awareness in a non-clinically depressed sample of participants with mild to moderate Alzheimer’s disease (AD) in Brazil.
People with AD (PwAD) aged 60 years or older were recruited from an outpatient unit at the Center of AD of the Federal University of Rio de Janeiro, Brazil. Measures of awareness of condition (Assessment Scale of the Psychosocial Impact of the Diagnosis of Dementia), cognitive function (Mini-Mental State Examination), mood state (Cornell Scale for Depression in Dementia), and functionality (Pfeffer Functional Activities Questionnaire) were applied to 264 people with mild to moderate AD and their caregivers. Hypotheses were tested statistically using SEM approach. Three competing models were compared.
The first model, in which the influence of mood state and cognitive function on awareness was mediated by functionality, showed a very good fit to the data and a medium effect size. The competing models, in which the mediating variables were mood state and cognitive function, respectively, only showed poor model fit.
Our model supports the notion that the relationship between different factors and awareness in AD is mediated by functionality and not by depressive mood state or cognitive level. The proposed direct and indirect effects on awareness are discussed, as well as the missing direct influence of mood state on awareness. The understanding of awareness in dementia is crucial and our model gives one possible explanation of its underlying structure in AD.
The present study investigated the effects of nutritional programming through parental feeding on offspring performance and expression of selected genes related to stress resistance in a marine teleost. Gilthead seabream broodstock were fed diets containing various fish oil (FO)/vegetable oil ratios to determine their effects on offspring performance along embryogenesis, larval development and juvenile on-growing periods. Increased substitution of dietary FO by linseed oil (LO) up to 80 % LO significantly reduced the total number of eggs produced by kg per female per spawn. Moreover, at 30 d after hatching, parental feeding with increasing LO up to 80 % led to up-regulation of the fatty acyl desaturase 2 gene (fads2) that was correlated with the increase in conversion rates of related PUFA. Besides, cyclo-oxygenase 2 (cox2) and TNF-α (tnf-α) gene expression was also up-regulated by the increase in LO in broodstock diets up to 60 or 80 %, respectively. When 4-month-old offspring were challenged with diets having different levels of FO, the lowest growth was found in juveniles from broodstock fed 100 % FO. An increase in LO levels in the broodstock diet up to 60LO raised LC-PUFA levels in the juveniles, regardless of the juvenile’s diet. The results showed that it is possible to nutritionally programme gilthead seabream offspring through the modification of the fatty acid profiles of parental diets to improve the growth performance of juveniles fed low FO diets, inducing long-term changes in PUFA metabolism with up-regulation of fads2 expression. The present study provided the first pieces of evidence of the up-regulation of immune system-related genes in the offspring of parents fed increased FO replacement by LO.
The Florida Department of Health in Miami-Dade County (DOH-Miami-Dade) investigated 106 reported carbon monoxide (CO) exposures over a 9-day timeframe after Hurricane Irma. This report evaluates risk factors for CO poisoning and the importance of heightened surveillance following natural disasters.
Data on CO poisoning cases from September 9 to 18, 2017 were extracted from Merlin, the Florida Department of Health Surveillance System. Medical records were obtained and follow-up interviews were conducted to collect data on the confirmed CO poisoning cases. Data were analyzed using SAS v9.4.
Ninety-one of the 106 people exposed to CO met the case definition for CO poisoning: 64 confirmed, 7 probable, and 20 suspect cases. Eighty-eight percent of the affected individuals were evaluated in emergency departments and 11.7% received hyperbaric oxygen treatment. The most frequently reported symptoms included headache (53.3%), dizziness (50.7%), and nausea (46.7%). Three patients expired due to their exposure to CO.
Post Hurricane Irma, the DOH-Miami-Dade investigated numerous cases for CO exposure. By understanding who is most likely to be impacted by CO and the impact of generators’ location on people’s health, education efforts can be tailored to the population most at risk and further CO exposures and related mortalities following natural disasters can be reduced. (Disaster Med Public Health Preparedness. 2019;13:94–96)
Sleep problems are pervasive in people with schizophrenia, but there are no clinical guidelines for their treatment. The Better Sleep Trial (BEST) concluded that suitably adapted cognitive–behavioural therapy (CBT) is likely to be highly effective, although its cost-effectiveness is unknown.
To assess the potential cost-effectiveness of CBT for sleep disorders in patients with schizophrenia.
An economic evaluation of the BEST study with a 6-month time horizon was used to establish the cost-effectiveness of CBT plus usual care in terms of costs per quality-adjusted life year (QALY) gained. Uncertainty was displayed on cost-effectiveness planes and acceptability curves. Value of information analysis was performed to estimate the benefits of obtaining further evidence.
On average, the treatment led to a 0.035 QALY gain (95% CI −0.016 to 0.084), and £1524 (95% CI −10 529 to 4736) and £1227 (95% CI −10 395 to 5361) lower costs from National Health Service and societal perspectives, respectively. The estimated value of collecting more information about the effects of the CBT on costs and QALYs was approximately £87 million.
CBT for insomnia in people with schizophrenia is effective and potentially cost-effective. A larger trial is needed to provide clear evidence about its cost-effectiveness.
Patients with schizophrenia have multiple complex health needs, as well as very high rates of depression, suicidal ideation and poor physical health. The results of this study showed that treating pervasive sleep problems in this patient group with cognitive–behavioural therapy (CBT) is very likely to improve patient quality of life in the short term. Clinicians most commonly use hypnotic medication to treat sleeping disorders. This study indicates that CBT may be an effective and cost-effective intervention in this patient group. This alternative would also be aligned with patient preferences for psychological and behavioural-type therapy.
Despite conservation discourses in Madagascar increasingly emphasizing the role of customary institutions for wildlife management, we know relatively little about their effectiveness. Here, we used semi-structured interviews with 54 adults in eight villages to investigate whether sacred caves and taboos offer conservation benefits for cave-dwelling bats in and around Tsimanampetsotsa National Park, south-west Madagascar. Although some caves were described as sites of spiritual significance for the local communities, most interviewees (c. 76%) did not recognize their present-day sacred status. Similarly, only 22% of the interviewees recognized taboos inhibiting bat hunting and consumption. Legal protection of bats and caves through protected areas was often more widely acknowledged than customary regulations, although up to 30% of the interviewees reported consumption of bats within their communities. Guano extraction was often tolerated in sacred caves in exchange for economic compensation. This may benefit bat conservation by creating incentives for bat protection, although extraction is often performed through destructive and exploitative practices with little benefit for local communities. In view of these results our study questions the extent to which sacred sites, taboos and protected areas offer protection for bats in Madagascar. These results support previous studies documenting the erosion of customary institutions in Madagascar, including the loss of the spiritual values underpinning sacred sites. Given that many Malagasy bats are cave-dwelling species and that most depend on the customary protection of these sites, it is important to obtain a better understanding of the complex interactions between spiritual practices, taboos and protected areas in sustaining bat diversity.
The synthesis of inorganic/organic nanocomposite systems, well known as hybrid materials, represents a new class of polymeric materials, which combine properties of inorganic particles, such as barrier, optical, catalytic and conductive properties, among others, with flexibility and transparency of the organic polymer matrix, being easily processable. They could be applied in a diversity of areas such as textiles, inks, adhesion, biomaterials, paints, adhesives, and electronics [1-2]. Within the inorganic materials, silica nanoparticles which present excellent properties, such as high mechanical strength, thermal and chemical stability, and high surface area, have been widely incorporated into a polymer matrix to prepare polymer/silica hybrid materials [3-4]. It is reported that the quantity and the dispersion of nano-SiO2 in the polymer matrix have a real effect on the properties of the final materials [5-6].
In this work, hybrid silica/poly(butyl acrylate-methyl methacrylate-acrylic acid) (SiO2/P(BA-MMA-AA)) were synthesized via in situ semi-batch emulsion polymerization. The results showed that this process was produced with high monomer conversion and low formation of agglomerates. The thermomechanical behavior of the films obtained from latexes was characterized by using thermogravimetric analysis, differential scanning calorimetry, and tensile test. The nanocomposite films displays significantly improved mechanical and thermal properties over its pure polymer film, and also presents almost the same high transparency.
Nutrition during periconception and early development can modulate metabolic routes to prepare the offspring for adverse conditions through a process known as nutritional programming. In gilthead sea bream, replacement of fish oil (FO) with linseed oil (LO) in broodstock diets improves growth in the 4-month-old offspring challenged with low-FO and low-fishmeal (FM) diets for 1 month. The present study further investigated the effects of broodstock feeding on the same offspring when they were 16 months old and were challenged for a second time with the low-FM and low-FO diet for 2 months. The results showed that replacement of parental moderate-FO feeding with LO, combined with juvenile feeding at 4 months old with low-FM and low-FO diets, significantly (P<0·05) improved offspring growth and feed utilisation of low-FM/FO diets even when they were 16 months old: that is, when they were on the verge of their first reproductive season. Liver fatty acid composition was significantly affected by broodstock or reminder diets as well as by their interaction. Moreover, the reduction of long-chain PUFA and increase in α-linolenic acid and linoleic acid in broodstock diets lead to a significant down-regulation of hepatic lipoprotein lipase (P<0·001) and elongation of very long-chain fatty acids protein 6 (P<0·01). Besides, fatty acid desaturase 2 values were positively correlated to hepatic levels of 18 : 4n-3, 18 : 3n-6, 20 : 5n-3, 22 : 6n-3 and 22 : 5n-6. Thus, this study demonstrated the long-term nutritional programming of gilthead sea bream through broodstock feeding, the effect of feeding a ‘reminder’ diet during juvenile stages to improve utilisation of low-FM/FO diets and fish growth as well as the regulation of gene expression along the fish’s life-cycle.
Conservation policies have often been designed and implemented assuming that targeted communities are socially and politically homogeneous. Payment for environmental services (PES) programmes have often overlooked intra-community differences, which affect the understanding of implementation requirements and access to benefits, thus underestimating their effects on the programme's legitimacy and impacts. We explore how the views of local communities about the socio-environmental performance and dynamics of Mexico's PES differ within forest communities, considering two groups: local community authorities and the remaining beneficiaries in two different PES programmes. Informed by a nationwide survey, we constructed 35 indicators and found significant differences between these groups for 10 indicators. Local community authorities concentrated knowledge and information, relations with outside actors and control over benefit distribution. We found that community authorities and beneficiaries diverged in their views about the extent to which PES knowledge is shared across community members, how related implementation decisions are pursued and the fairness of benefit distribution, which we argue suggests this is a form of ‘elite capture’ favoured by PES design and implementation. Efforts should be invested in ensuring that PES programme benefits are equitably distributed in order to avoid widening pre-existing social and political asymmetries.
The cattle tick Rhipicephalus (Boophilus) microplus is a hematophagous ectoparasite of major importance for the livestock industry. It shows a remarkable ability to survive over long periods without feeding. However, the mechanisms used to endure long-term starvation are poorly understood. It is believed that autophagy, a process of intracellular protein degradation, may play a significant role to confront adverse environmental conditions. To advance our understanding of autophagy in R. microplus, in the present study we report the molecular characterization of three autophagy-related (ATG) genes, namely, RmATG3, RmATG4 and RmATG6, as well as their expression profiles in different developmental stages and organs of the parasite. The deduced amino acid sequences derived from the characterized gene sequences were subjected to Basic Local Alignment Search Tool analysis. The testing produced significant alignments with respective ATG proteins from Haemaphysalis longicornis and Ixodes scapularis ticks. Real-time polymerase chain reaction assays revealed that RmATG4 and RmATG6 transcripts were elevated in egg and ovary tissue, when compared with larva and midgut samples, while RmATG3 expression in midgut was 2-fold higher than in egg, larva and ovary samples.
Integration between phylogenetic systematics and paleontological data has proved to be an effective method for identifying periods that lack fossil evidence in the evolutionary history of clades. In this study we aim to analyze whether there is any correlation between various ecomorphological variables and the duration of these underrepresented portions of lineages, which we call ghost lineages for simplicity, in ruminants. Analyses within phylogenetic (Generalized Estimating Equations) and non-phylogenetic (ANOVAs and Pearson correlations) frameworks were performed on the whole phylogeny of this suborder of Cetartiodactyla (Mammalia). This is the first time ghost lineages are focused in this way. To test the robustness of our data, we compared the magnitude of ghost lineages among different continents and among phylogenies pruned at different ages (4, 8, 12, 16, and 20 Ma). Differences in mean ghost lineage were not significantly related to either geographic or temporal factors. Our results indicate that the proportion of the known fossil record in ruminants appears to be influenced by the preservation potential of the bone remains in different environments. Furthermore, large geographical ranges of species increase the likelihood of preservation.
This study used high-precision radiocarbon bomb-pulse dating of selected wood rings to provide an independent validation of the tree growth periodicity of Pseudolmedia rigida (Klotzsch & H. Karst) Cuatrec. from the Moraceae family, collected in the Madidi National Park in Bolivia. 14C content was measured by accelerator mass spectrometry (AMS) in 10 samples from a single tree covering over 70 yr from 1939 to 2011. These preliminary calendar dates were determined by dendrochronological techniques and were also used to select the samples for 14C AMS. In order to validate these preliminary dates using the established Southern Hemisphere (SH) 14C atmospheric concentration data set, the targeted rings were selected to be formed during periods before and after the 14C bomb spike nuclear tests (i.e. 1950s–1960s). The excellent agreement of the dendrochronological dates and the 14C signatures in tree rings associated with the same dates provided by the bomb-pulse 14C atmospheric values for the SH (SHCal zone 1–2) confirms the annual periodicity of the observed growth layers, and thus the high potential of this species for tree-ring analysis. The lack of discrepancies between both data sets also suggests that there are no significant latitudinal differences between the 14C SHCal zone 1–2 curve and the 14C values obtained from the selected tree rings at this geographic location (14°33′S, 68°49′W) in South America. The annual resolution of P. rigida tree rings opens the possibility of broader applications of dendrochronological analysis for ecological and paleoclimatic studies in the Bolivian tropics, as well as the possibility of using wood samples from some tree species from this region to improve the quality of the bomb-pulse 14C SHCal curve at this latitude.
In the present work was used Dynamical Mechanical Analysis (DMA) to study the magnesium alloy Mg AZ31-B, in plate form with a thickness of 2.5 mm. The plates were processed using Equal Channel Angular Sheet Drawing (ECASD), which is a severe plastic deformation technique, which allows imposing strain without dimensional changes to a metal plate, at room temperature with an angle of 135°. The obtained results show dependence between the storage modulus (M’), temperature and frequency used on the tests. The greater M’ values were obtained at the lower temperatures and at the higher frequency used. However, at lower frequencies M’ response is not affected by the used frequencies. At the higher temperatures there is an M’ reduction, which promotes the material deformation.
To develop and evaluate a novel teaching session on clinical assessment using role play simulation. Teaching and research sessions occurred sequentially in computer laboratories. Ten medical students were divided into two online small-group teaching sessions. Students role-played as clinician avatars and the teacher played a suicidal adolescent avatar. Questionnaire and focus-group methodology evaluated participants' attitudes to the learning experience. Quantitative data were analysed using SPSS, qualitative data through nominal-group and thematic analyses.
Participants reported improvements in psychiatric skills/knowledge, expressing less anxiety and more enjoyment than role-playing face to face. Data demonstrated a positive relationship between simulator fidelity and perceived utility. Some participants expressed concern about added value over other learning methods and non-verbal communication.
The study shows that virtual worlds can successfully host role play simulation, valued by students as a useful learning method. The potential for distance learning would allow delivery irrespective of geographical distance and boundaries.
The Iberian Peninsula is part of the South European Atlantic Shelf within the Lusitanian ecoregion. Given the characteristics of this region, a great invertebrate biodiversity is expected. Nevertheless, no literature records of Polycladida are known for the Cantabrian Sea. Here, we report the presence of six polyclad species, including one new species. Notoplana vitrea, considered endemic to the Mediterranean Sea, was found in the Cantabrian Sea, demonstrating its presence in Atlantic waters. This species was previously reported for these waters on two natural history photographic websites: the importance of searching, indexing and disseminating this type of record for the scientific community is discussed. Discocelis tigrina is reported for the first time for the Cantabrian Sea, and is the northernmost record to date. In this paper, Pleioplana atomata is reported for the second time for the Iberian Peninsula, yet is the first record for the Cantabrian Sea. Although a literature record of Leptoplana tremellaris for the Iberian Peninsula exists, it is considered a misidentification of L. mediterranea; therefore, this work provides the first record of L. tremellaris for the Iberian Peninsula. The cosmopolitan species Cycloporus papillosus is also reported for the Cantabrian Sea. A new species, Imogine fafai sp. nov., is described and taxonomically compared with other species of the genus.
During the research programme conducted on the OV Puerto Deseado in the summers of 2011 and 2013, 36 stations were sampled using a demersal net at depths between 53–590 m in the Antarctic Peninsula and South Shetland Islands. A total 3378 fish specimens belonging to 36 species were recorded. Notothenidae was the best-represented family in species number, with Lepidonotothen nudifrons, L. larseni and Trematomus scotti being the most numerous species. Of the fish assemblages, 20% of the species were considered as dominant, 10% as common, 13% as occasional and 57% as rare. Six groups (and two sub-groups) were obtained by the ordination diagram based on geographical location: group 1=Gerlache Strait, group 2=Deception Islands, group 3=Biscoe Island, group 4=between Elephant and King George islands, group 5=northern Antarctic Peninsula, and group 6=South Shetland Islands, with sub-groups 6a shallower South Shetland Islands and 6b deeper South Shetland Islands. Sampling depth and water temperature significantly explained the spatial pattern. A latitudinal pattern of decreasing abundance from north-east to south-west was found in L. larseni and the opposite in T. scotti. The predictability of fish composition in the assemblages’ areas could be a useful tool for ecosystem-based management.