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Pain medication misuse is commonly found in patients under headache treatment and may produce co-morbid anxiety and depressive symptomatology. Management of this issue requires a comprehensive and integrative treatment including psychotherapy. Group interventions have been scarcely studied in addictive disorders, those interventions aims to decrease drug misuse and improve related psychiatric symptoms.
To study the efficacy of group interventions base on cognitive-behavior approach in patients with pain medication misuse.
Patients with pain medication misuse were included and were evaluated with BDI, STAI, SF36 and HIT scales (basal and at the end of treatment sessions). Patients were recruited from headache outpatient unit. Twelve sessions of one hour were performed with a cognitive-behavior approach (weekly).
We present preliminary results about the efficacy of group interventions in patients with pain medication misuse. Descriptive results pre- and post- treatment were analyzed in depressive symptoms (M = 20.14, SD = 12.25; M = 14.67, SD = 19.50) and in areas of quality of life: physical functioning (M = 48.75, SD = 31.13; M = 60.50, SD = 41.68), bodily pain (M = 12, SD = 9.25; M = 42.75, SD = 34.09), general health perceptions (M = 25.75, SD = 16.96; M = 44.25, SD = 22.33), vitality (M = 33.75, SD = 13.82; M = 48, SD = 34.82).
Pain medication misuse is commonly found in chronic headache patients, consequently worst outcomes for both pathologies. Group interventions may be useful in management of pain, anxiety and other comorbidities. Furthermore, it may favor drug use decrease and even abstinence.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Legal and illegal drugs can cause psychotic symptoms, in cocaine-dependent patients the prevalence of these symptoms may reach 86% (Vorspan, 2012). It is estimated that 13–32% of cocaine-dependent patients have kinaesthetic hallucinations (Siegel, 1978; Mahoney, 2008; Roncero, 2012).
To compare the prevalence of substance-induced psychotic symptoms and compare the use of welfare/social resources and social adjustment among cocaine-dependent patients (CD) and other substances dependences (OtherD).
Two hundred and six patients seeking treatment at the Addictions and Dual Diagnosis Unit of the Vall d’Hebron. Patients were assessed by ad hoc questionnaire designed to collect demographic data and psychotic symptoms associated with consumption, a record of the care/social resources used by the patient and the scale of social adaptation (SASS). A descriptive and bivariate analysis of the data was performed.
CD were 47.1% vs. 52.9% OtherD (66.1% alcohol, 17.4% cannabis, 8.3% opioid, 8.3% benzodiazepines/other drugs). Of cocaine dependent-patients, 65.6% present psychotic symptoms vs. 32.1% for the OtherD. Different exhibiting psychotic symptoms are: self-referential (69.7% vs. 30.7%), delusions of persecution (43.4% vs. 12.2%), hallucinations (49.4% vs. 14.3%), auditory hallucinations (43.5% vs. 11.4%), visual hallucinations (30.4% vs. 5.7%) and kinaesthetic hallucinations (7.2% vs. 2.9%).
Cocaine-dependent patients significantly use more health care resources in reference addiction unit (76.3% vs. 62.4%, P:.035) and infectious diseases (22.7% vs. 5.5%, P:.000) and justice-related (50.5% vs. 26 resources 0.6%; P:1.001) and less resources and mental health (25.8% vs. 43.1%; P:.013).
Regarding social adaptation, no differences were found in the SASS. Kinaesthetic hallucinations do not appear to be related to a greater use of resources and in social adaptation.
References not available.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.
The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.
At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).
Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.
With the aim to elucidate gonococcal antimicrobial resistance (AMR)–risk factors, we undertook a retrospective analysis of the molecular epidemiology and AMR of 104 Neisseria gonorrhoeae isolates from clinical samples (urethra, rectum, pharynx and cervix) of 94 individuals attending a sexually transmitted infection clinic in Madrid (Spain) from July to October 2016, and explored potential links with socio-demographic, behavioural and clinical factors of patients. Antimicrobial susceptibility was determined by E-tests, and isolates were characterised by N. gonorrhoeae multi-antigen sequence typing. Penicillin resistance was recorded for 15.4% of isolates, and most were susceptible to tetracycline, cefixime and azithromycin; a high incidence of ciprofloxacin resistance (~40%) was found. Isolates were grouped into 51 different sequence types (STs) and 10 genogroups (G), with G2400, ST5441, ST2318, ST12547 and G2992 being the most prevalent. A significant association (P = 0.015) was evident between HIV-positive MSM individuals and having a ciprofloxacin-resistant strain. Likewise, a strong association (P = 0.047) was found between patient age of MSM and carriage of isolates expressing decreased susceptibility to azithromycin. A decrease in the incidence of AMR gonococcal strains and a change in the strain populations previously reported from other parts of Spain were observed. Of note, the prevalent multi-drug resistant genogroup G1407 was represented by only three strains in our study, while the pan-susceptible clones such as ST5441, and ST2318, associated with extragenital body sites were the most prevalent.
Diarrhoeagenic Escherichia coli (DEC) is a leading cause of infectious diarrhoea worldwide. In recent years, Escherichia albertii has also been implicated as a cause of human enteric diseases. This study describes the occurrence of E. coli pathotypes and serotypes associated with enteric illness and haemolytic uremic syndrome (HUS) isolated in Brazil from 2011 to 2016. Pathotypes isolated included enteropathogenic E. coli (EPEC), enteroaggregative E. coli (EAEC), enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC) and Shiga toxin-producing E. coli (STEC). PCR of stool enrichments for DEC pathotypes was employed, and E. albertii was also sought. O:H serotyping was performed on all DEC isolates. A total of 683 DEC and 10 E. albertii strains were isolated from 5047 clinical samples. The frequencies of DEC pathotypes were 52.6% (359/683) for EPEC, 32.5% for EAEC, 6.3% for ETEC, 4.4% for EIEC and 4.2% for STEC. DEC strains occurred in patients from 3 months to 96 years old, but EPEC, EAEC and STEC were most prevalent among children. Both typical and atypical isolates of EPEC and EAEC were recovered and presented great serotype heterogeneity. HUS cases were only associated with STEC serotype O157:H7. Two E. albertii isolates belonged to serogroup O113 and one had the stx2f gene. The higher prevalence of atypical EPEC in relation to EAEC in community-acquired diarrhoea in Brazil suggests a shift in the trend of DEC pathotypes circulation as previously EAEC predominated. This is the first report of E. albertii isolation from active surveillance. These results highlight the need of continuing DEC and E. albertii surveillance, as a mean to detect changes in the pattern of pathotypes and serotypes circulation and provide useful information for intervention and control strategies.
The objective was to compare the performance of the updated Charlson comorbidity index (uCCI) and classical CCI (cCCI) in predicting 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB). All cases of SAB in patients aged ⩾14 years identified at the Microbiology Unit were included prospectively and followed. Comorbidity was evaluated using the cCCI and uCCI. Relevant variables associated with SAB-related mortality, along with cCCI or uCCI scores, were entered into multivariate logistic regression models. Global model fit, model calibration and predictive validity of each model were evaluated and compared. In total, 257 episodes of SAB in 239 patients were included (mean age 74 years; 65% were male). The mean cCCI and uCCI scores were 3.6 (standard deviation, 2.4) and 2.9 (2.3), respectively; 161 (63%) cases had cCCI score ⩾3 and 89 (35%) cases had uCCI score ⩾4. Sixty-five (25%) patients died within 30 days. The cCCI score was not related to mortality in any model, but uCCI score ⩾4 was an independent factor of 30-day mortality (odds ratio, 1.98; 95% confidence interval, 1.05–3.74). The uCCI is a more up-to-date, refined and parsimonious prognostic mortality score than the cCCI; it may thus serve better than the latter in the identification of patients with SAB with worse prognoses.
The discovery of the first electromagnetic counterpart to a gravitational wave signal has generated follow-up observations by over 50 facilities world-wide, ushering in the new era of multi-messenger astronomy. In this paper, we present follow-up observations of the gravitational wave event GW170817 and its electromagnetic counterpart SSS17a/DLT17ck (IAU label AT2017gfo) by 14 Australian telescopes and partner observatories as part of Australian-based and Australian-led research programs. We report early- to late-time multi-wavelength observations, including optical imaging and spectroscopy, mid-infrared imaging, radio imaging, and searches for fast radio bursts. Our optical spectra reveal that the transient source emission cooled from approximately 6 400 K to 2 100 K over a 7-d period and produced no significant optical emission lines. The spectral profiles, cooling rate, and photometric light curves are consistent with the expected outburst and subsequent processes of a binary neutron star merger. Star formation in the host galaxy probably ceased at least a Gyr ago, although there is evidence for a galaxy merger. Binary pulsars with short (100 Myr) decay times are therefore unlikely progenitors, but pulsars like PSR B1534+12 with its 2.7 Gyr coalescence time could produce such a merger. The displacement (~2.2 kpc) of the binary star system from the centre of the main galaxy is not unusual for stars in the host galaxy or stars originating in the merging galaxy, and therefore any constraints on the kick velocity imparted to the progenitor are poor.
To describe the utilization of electronic medical data resources, including health records and nursing scheduling resources, to conduct a tuberculosis (TB) exposure investigation in a high-risk oncology unit.
A 42-bed inpatient unit with a mix of surgical and medical patients at a large tertiary-care cancer center in New York City.
High-risk subjects and coworkers exposed to a healthcare worker (HCW) with cavitary smear positive lung TB.
During the 3-month exposure period, 270 patients were admitted to the unit; 137 of these (50.7%) received direct care from the index case HCW. Host immune status and intensity of exposure were used to establish criteria for postexposure testing, and 63 patients (45%) met these criteria for first-tier postexposure testing. No cases of active TB occurred. Among coworkers, 146 had significant exposure (ie, >8 hours cumulative). In the 22-month follow-up period after the exposure, no purified protein derivative or interferon gamma release assay conversions or active cases of TB occurred among exposed HCWs or patients.
Electronic medical records and employee scheduling systems are useful resources to conduct otherwise labor-intensive contact investigations. Despite the high-risk features of our index case, a highly vulnerable immunocompromised patient population, and extended proximity to coworkers, we did not find any evidence of transmission of active or latent tuberculosis infection among exposed individuals.
Body image disturbance (BID) is a core symptom of anorexia nervosa (AN), but as yet distinctive features of BID are unknown. The present study aimed at disentangling perceptual and attitudinal components of BID in AN.
We investigated n = 24 women with AN and n = 24 controls. Based on a three-dimensional (3D) body scan, we created realistic virtual 3D bodies (avatars) for each participant that were varied through a range of ±20% of the participants’ weights. Avatars were presented in a virtual reality mirror scenario. Using different psychophysical tasks, participants identified and adjusted their actual and their desired body weight. To test for general perceptual biases in estimating body weight, a second experiment investigated perception of weight and shape matched avatars with another identity.
Women with AN and controls underestimated their weight, with a trend that women with AN underestimated more. The average desired body of controls had normal weight while the average desired weight of women with AN corresponded to extreme AN (DSM-5). Correlation analyses revealed that desired body weight, but not accuracy of weight estimation, was associated with eating disorder symptoms. In the second experiment, both groups estimated accurately while the most attractive body was similar to Experiment 1.
Our results contradict the widespread assumption that patients with AN overestimate their body weight due to visual distortions. Rather, they illustrate that BID might be driven by distorted attitudes with regard to the desired body. Clinical interventions should aim at helping patients with AN to change their desired weight.
To assess quality of life of children and teenagers with recurrent respiratory papillomatosis, according to the evidence of infection by human papillomavirus types 6 and 11, compared with healthy volunteers and patients with chronic otitis media.
Participants and their parents completed the Pediatric Quality of Life Inventory 4.0.
Patients with recurrent respiratory papillomatosis and their parents reported lower quality of life than healthy subjects (p < 0.01), but similar quality of life to patients with chronic otitis media. Those with human papillomavirus type 11 showed the lowest scores among all participants (p < 0.05).
Young Mexican patients with recurrent respiratory papillomatosis and their parents perceive a poor quality of life, and they may experience limitations in interactions with their peers. Infection by human papillomavirus type 11 may increase the impact of the disease on quality of life.
Vegetable oils are used to increase energy density of dairy cow diets, although they can provoke changes in rumen bacteria populations and have repercussions on the biohydrogenation process. The aim of this study was to evaluate the effect of two sources of dietary lipids: soybean oil (SO, an unsaturated source) and hydrogenated palm oil (HPO, a saturated source) on bacterial populations and the fatty acid profile of ruminal digesta. Three non-lactating Holstein cows fitted with ruminal cannulae were used in a 3×3 Latin square design with three periods consisting of 21 days. Dietary treatments consisted of a basal diet (Control, no fat supplement) and the basal diet supplemented with SO (2.7% of dry matter (DM)) or HPO (2.7% of DM). Ruminal digesta pH, NH3–N and volatile fatty acids were not affected by dietary treatments. Compared with control and HPO, total bacteria measured as copies of 16S ribosomal DNA/ml by quantitative PCR was decreased (P<0.05) by SO. Fibrobacter succinogenes, Butyrivibrio proteoclasticus and Anaerovibrio lipolytica loads were not affected by dietary treatments. In contrast, compared with control, load of Prevotella bryantii was increased (P<0.05) with HPO diet. Compared with control and SO, HPO decreased (P<0.05) C18:2 cis n-6 in ruminal digesta. Contents of C15:0 iso, C18:11 trans-11 and C18:2 cis-9, trans-11 were increased (P<0.05) in ruminal digesta by SO compared with control and HPO. In conclusion, supplementation of SO or HPO do not affect ruminal fermentation parameters, whereas HPO can increase load of ruminal P. bryantii. Also, results observed in our targeted bacteria may have depended on the saturation degree of dietary oils.
West Nile virus (WNV) is a mosquito-borne neurotropic viral pathogen maintained in an enzootic cycle between mosquitoes (vectors) and birds (natural hosts) with equids, humans, and other vertebrates acting as dead-end hosts. WNV activity in Mexico has been reported in several domestic and wild fauna and in humans, and the virus has been isolated from birds, mosquitoes, and humans. However, no serological studies have been conducted in monkeys, and only two in a limited number of crocodiles (Crocodylus moreletii). Here we present data on the prevalence of neutralizing antibodies against WNV in 53 healthy wild monkeys (49 Ateles geoffroyi and four Alouatta pigra), and 80 semi-captive healthy crocodiles (60 C. acutus and 20 C. acutus–C. moreletti hybrids) sampled during 2012. None of the monkey sera neutralized WNV, whereas 55% of the crocodile sera presented neutralizing antibodies against WNV. These results can contribute to the design of surveillance programmes in Mexico.
It is well known that the interaction between two disk galaxies generates tidal spiral arms and a connection in the form of a bridge. Here we address the question of the formation of tidal arms and bridges from a dynamical point of view. We model the bridges and tails observed in interacting galaxies using the invariant manifolds associated to the Lyapunov orbits of the Lagrangian points of the galactic system, when the two galaxies are considered as two point masses in a circular orbit.
Functional imaging studies in relatives of schizophrenic patients have had inconsistent findings, particularly with respect to altered dorsolateral prefrontal cortex activation. Some recent studies have also suggested that failure of deactivation may be seen.
A total of 28 patients with schizophrenia, 28 of their siblings and 56 healthy controls underwent functional magnetic resonance imaging during performance of the n-back working memory task. An analysis of variance was fitted to individual whole-brain maps from each set of patient–relative–matched pair of controls. Clusters of significant difference among the groups were then used as regions of interest to compare mean activations and deactivations among the groups.
In all, five clusters of significant differences were found. The schizophrenic patients, but not the relatives, showed reduced activation compared with the controls in the lateral frontal cortex bilaterally, the left basal ganglia and the cerebellum. In contrast, both the patients and the relatives showed significant failure of deactivation compared with the healthy controls in the medial frontal cortex, with the relatives also showing less failure than the patients. Failure of deactivation was not associated with schizotypy scores or presence of psychotic-like experiences in the relatives.
Both schizophrenic patients and their relatives show altered task-related deactivation in the medial frontal cortex. This in turn suggests that default mode network dysfunction may function as a trait marker for schizophrenia.
The discovery of relativistic jets and superluminal sources associated with accreting X-ray binaries in the Galaxy opened new ways of investigating the physics of outflows from compact objects. The short timescales and relatively large angular sizes of Galactic jets allow to probe the physics of relativistic outflows to unprecedented details. In this article I discuss results of recent modelling of Galactic jets, covering both radiative and dynamical aspects, which can shed light on different features of their extragalactic cousins.
The objective of the National Renewable Energy Laboratory’s (NREL) current three-year CdTe plan under the U.S. Department of Energy’s SunShot Initiative is to identify primary mechanisms that limit the open-circuit voltage and fill factor of polycrystalline CdTe photovoltaic (PV) devices, and develop CdTe synthesis processes and/or device designs that avoid these limitations. Part of this project relies on analysis of crystalline materials and pseudocrystalline CdTe layers where point and extended defects can be introduced sequentially without the complications of extensive impurities and grain boundaries that are typical of present polycrystalline films. The ultimate goals of the project include producing CdTe PV devices that demonstrate ≥20% conversion efficiency, while significantly improving our understanding of processes and materials capable of attaining cost goals of <$0.50 per watt. While NREL is investigating several options for the routine fabrication of high-quality CdTe layers, one pathway involves CdTe molecular beam heteroepitaxy (MBE) on Si in collaboration with the University of Illinois at Chicago. Although CdTe/Si heteroepitaxy is relatively unfamiliar to researchers in the PV community, it has been used successfully for more than 20 years to produce high-quality CdTe surfaces required for commercial production of large-area single-crystal HgCdTe infrared detectors and focal-plane arrays. The process involves chemical and thermal preparation of Si (211) wafers, followed by deposition of As-passivation and ZnTeaccommodation layers. MBE-grown CdTe layers deposited on top of this “template” have been shown to demonstrate low etch-pit density (EPD, preferably ≤ ∼5x105 cm-2) and high structural quality (full width at half maximum ∼ 60 arcs). These initial studies indicate that 10-μm-thick CdTe layers on Si are indeed epitaxial with cathodoluminescence-determined dislocation density consistent with historic EPD measurements, and that recombination rates are distinct from either as-deposited polycrystalline or crystalline materials.